Showing papers by "American Cancer Society published in 2022"

Public Education Interventions and Uptake of Human Papillomavirus Vaccine: A Systematic Review.

Abstract: Context Human papillomavirus (HPV) vaccine uptake remains suboptimal in the United States. Public education is considered an important aspect of increasing vaccination rates. Objectives We systematically reviewed the literature on the impact of public education on HPV vaccine uptake. Design PubMed was searched to identify studies published between January 1, 2007, and April 30, 2018, meeting the following inclusion criteria: the study was conducted in the US, education was directed toward the public, and the research included HPV vaccine uptake and/or completion as outcomes. Results A total of 3764 studies were screened, and 30 published studies were included in the review. Among those, 13 focused on parent/guardian education, 8 on young adults, 6 on parent/daughter dyads, 1 focused only on adolescents, and 2 studies recruited a mixed-age population. Studies that included parents and young adults and were delivered by experts led to increased uptake of HPV vaccination (n = 14). A majority of the studies included female and Non-Hispanic White population (n = 20). Less than a third of studies included minority groups: Hispanic (n = 4), African American (n = 1), Cambodian American (n = 1), Indian American (n = 1), Korean American (n = 1), and combined Haitian and African American (n = 1) population. Minority group interventions that provided individually tailored messages, addressed misconceptions, removed barriers to vaccination, and engaged parents and community members improved HPV vaccine acceptance (n = 5). Conclusion Interventions that delivered HPV-related education by authoritative sources and included parents improved HPV vaccination rates among adolescents and young adults. Community engagement played an important role in vaccine uptake among minority populations. Future studies should focus on male participants and minority populations to reduce disparities in HPV-related cancer incidence and HPV vaccine coverage.

Health insurance status and cancer stage at diagnosis and survival in the United States

Abstract: Previous studies using data from the early 2000s demonstrated that patients who were uninsured were more likely to present with late-stage disease and had worse short-term survival after cancer diagnosis in the United States. In this report, the authors provide comprehensive data on the associations of health insurance coverage type with stage at diagnosis and long-term survival in individuals aged 18-64 years who were diagnosed between 2010 and 2013 with 19 common cancers from the National Cancer Database, with survival follow-up through December 31, 2019. Compared with privately insured patients, Medicaid-insured and uninsured patients were significantly more likely to be diagnosed with late-stage (III/IV) cancer for all stageable cancers combined and separately. For all stageable cancers combined and for six cancer sites-prostate, colorectal, non-Hodgkin lymphoma, oral cavity, liver, and esophagus-uninsured patients with Stage I disease had worse survival than privately insured patients with Stage II disease. Patients without private insurance coverage had worse short-term and long-term survival at each stage for all cancers combined; patients who were uninsured had worse stage-specific survival for 12 of 17 stageable cancers and had worse survival for leukemia and brain tumors. Expanding access to comprehensive health insurance coverage is crucial for improving access to cancer care and outcomes, including stage at diagnosis and survival.

<scp>COVID</scp> ‐19 and access to cancer care in Kenya: patient perspective

Abstract: COVID-19 disruptions severely impacted access to health services for noncommunicable diseases, including cancer, but few studies have examined patient perspectives of COVID-19-induced barriers to care in low/middle-income countries. Data come from a survey completed online, over the phone or in person of 284 adult people with cancer in Kenya. One-third (36%) of participants had primary or no education and 34% had some or complete secondary education. Half of the participants (49%) were aged 40 to 59, 21% were 18 to 39 and 23% were 60 or older. Two-thirds were female (65%) and most visited a national referral hospital in Nairobi to receive care (84%). Mean travel time to Nairobi from the respondent county of residence was 2.47 hours (±2.73). Most participants reported decreased household income (88%) and were worried about their ability to afford cancer treatment due to COVID-19 (79%). After covariate adjustment, participants who lost access to hospitals due to COVID-19 travel restrictions were 15 times more likely to experience a cancer care delay (OR = 14.90, 95% CI: 7.44-29.85) compared to those with continued access to hospitals. Every additional hour of travel time to Nairobi from their county of residence resulted in a 20% increase in the odds of a cancer care delay (OR = 1.20, 95% CI: 1.06-1.36). Transportation needs and uninterrupted access to cancer care and medicines should be accounted for in COVID-19 mitigation strategies. These strategies include permits for cancer patients and caregivers to travel past curfew time or through block posts to receive care during lockdowns, cash assistance and involving patient navigators to improve patient communication.

Sugar- and Artificially-Sweetened Beverages and Cancer Mortality in a Large U.S. Prospective Cohort

Abstract: Sugar-sweetened beverage (SSB) consumption may be associated with cancer mortality independent of, or indirectly through, established influences on increased body adiposity.We examined the associations of SSBs and artificially-sweetened beverages (ASB) with mortality from all-cancers combined, obesity-related cancers combined, and 20 cancer types, among men and women in the Cancer Prevention Study-II (CPS-II) prospective cohort. In 1982, 934,777 cancer-free participants provided information on usual SSB and ASB consumption. Deaths were identified through 2016. Multivariable Cox proportional hazards regression models examined associations of beverage types with cancer mortality, without and with BMI adjustment.During follow-up, 135,093 CPS-II participants died from cancer. Consumption of ≥2 SSB drinks/day vs. never was not associated with all-cancer mortality, but was associated with increased risk of obesity-related cancers [HR, 1.05; 95% confidence intervals (CI), 1.01-1.08; Ptrend = 0.057], which became null after adjustment for BMI. SSBs were associated with increased mortality from colorectal (HR, 1.09; 95% CI, 1.02-1.17; Ptrend = 0.011), and kidney (HR, 1.17; 95% CI, 1.03-1.34; Ptrend = 0.056) cancers, which remained after BMI adjustment. A positive association of ASB consumption with obesity-related cancers (HR, 1.05; 95% CI, 1.01-1.08; Ptrend = 0.001) was null after controlling for BMI; however, an increased risk of pancreatic cancer was robust to BMI adjustment (HR, 1.11; 95% CI, 1.02-1.20; Ptrend < 0.008).SSB consumption was associated with higher mortality from certain cancers, partially mediated through obesity. Associations of ASB consumption and increased pancreatic cancer risk merit further study.Future research should consider the role of BMI in studies of sweetened beverages and cancer risk. These results should inform policy regarding sweetened beverage consumption.

Associations of Parental Cancer With School Absenteeism, Medical Care Unaffordability, Health Care Use, and Mental Health Among Children

Abstract: A cancer diagnosis can adversely affect other members of the family, including children. However, little is known about the extent to which history of parental cancer affects children's health.To examine associations of parental cancer with children's school absenteeism, medical care unaffordability, health care use, and mental health.This cross-sectional, nationally representative study used data from the 2010-2018 National Health Interview Survey. Statistical analyses were conducted from January to September 2021. Children aged 5 to 17 years living in families with and without a history of parental cancer were identified. Characteristics were grouped into child, parent, and family variables. Sequential multivariable regressions were conducted for unadjusted analyses and with the adjustment of child, parent, and family characteristics to assess associations between parental cancer and child outcomes.History of parental cancer.School absenteeism, medical care unaffordability, health care use, and mental health.A total of 1232 children (mean [SD] age, 11.7 [0.13] years; 579 [48.6%] female; weighted N = 846 730; 3.4% of total sample) were living in families with a history of parental cancer. Compared with 33 870 children without a history of parental cancer (mean [SD] age, 10.8 [0.03]; 16 287 [48.8%] female; weighted N = 24 315 452; 96.6% of total sample), children of cancer survivors were more likely to be older, non-Hispanic White, and living in single parent families. Parents with a history of cancer were more likely to be older, to be female, to have more comorbid conditions, and to have public health insurance compared with parents without a history of cancer. History of parental cancer was adversely associated with school absenteeism, medical care unaffordability, health care use, and mental health among children. Sequential adjustment with child, parent, and family characteristics reduced the magnitude of the associations. For example, the odds ratios for school absenteeism of 1 day or more changed from 1.33 (95% CI, 1.11-1.59; P = .002) to 1.12 (95% CI, 0.93-1.34; P = .23) and for any child hospital emergency department visit from 1.56 (95% CI, 1.31-1.86; P < .001) to 1.36 (95 % CI, 1.13-1.64; P < .001). Similar results were found for medical care unaffordability, prescription medication use, and mental health.In this study, parental cancer was associated with school absenteeism, medical care unaffordability, increased health care use, and poor mental health among children. Health care professionals and policies should consider the unique needs of affected children and develop school-, parent-, and family-directed strategies to ameliorate the negative associations between parental cancer and children's health.

On the Potential for Optimizing Colorectal Screening Outcomes

Abstract: The development of colorectal cancer screening is a cancer control success. It is preventing thousands of deaths, but it has the potential of preventing thousands more. This can be achieved through offering all eligible patients high quality screening, diagnostics, and treatment. Let us educate and encourage colorectal screening among all average risk Americans beginning at 45. Let us not allow a recommendation to start at 45 to deemphasize screening those older persons who are most likely to benefit from colorectal cancer screening. See related article by Liu et al., p. 1701.