American Cancer Society

About: American Cancer Society is a nonprofit organization based out in Atlanta, Georgia, United States. It is known for research contribution in the topics: Cancer & Population. The organization has 1339 authors who have published 3700 publications receiving 688166 citations. The organization is also known as: American Cancer Society, ACS & American Society for the Control of Cancer.

Utilization and Outcomes of BRCA Genetic Testing and Counseling in a National Commercially Insured Population: The ABOUT Study

Abstract: Importance BRCA genetic testing has substantial public health impact, yet little is known of the real-world experiences of the more than 100 000 Americans undergoing testing annually. Objective To identify factors associated with use of BRCA testing, assess whether delivery of genetic counseling and testing services adheres to professional guidelines, and measure the impact on patient-reported outcomes. Design, Setting, and Participants The American BRCA Outcomes and Utilization of Testing (ABOUT) Study analyzed data from a consecutive national series of 11 159 women whose clinicians ordered BRCA testing between December 2011 and December 2012. Aetna mailed recruitment information across the United States to commercial health plan members whose clinicians had ordered BRCA testing. A total of 3874 women (34.7%) completed questionnaires. Deidentified clinician-reported data from all respondents and a random sample of 2613 nonrespondents were also analyzed. Main Outcomes and Measures The proportion of eligible participants who met testing criteria and respondents’ report of receiving genetic counseling by a genetics clinician and its association with BRCA knowledge, understanding, and satisfaction were assessed. Results Among 3628 women respondents whose clinicians ordered comprehensive BRCA testing, most were white non-Hispanic (2502 [69.0%]), college educated (2953 [81.4%]), married (2751 [75.8%]), and had higher incomes (2011 [55.4%]). Approximately 16.4% (596) did not meet testing criteria. Mutations were identified in 161 (5.3%) of these women who received comprehensive testing. Only 1334 (36.8%) reported receiving genetic counseling from a genetics clinician prior to testing; the lowest rates (130 [12.3%]) were among patients of obstetrician/gynecologists. The most commonly reported reason for not receiving this clinical service was lack of clinician recommendation. Those who received it demonstrated greater knowledge about BRCA (mean score difference adjusted for demographics and clinician specialty, β = 0.99 [95% CI, 0.83-1.14]; P .001) and expressed greater understanding (β = 0.47 [95% CI, 0.41-0.54]; P .001) and satisfaction (β = 2.21 [95% CI, 1.60-2.81]; P .001). Conclusions and Relevance Despite improved patient knowledge, understanding, and satisfaction among patients who receive genetic counseling provided by a genetics clinician, as well as multiple guidelines emphasizing the importance of genetic counseling, most US women undergoing BRCA genetic testing do not receive this clinical service. Lack of physician recommendation is the most commonly reported reason. These findings demonstrate important gaps in clinical genetics services. Recently mandated coverage of genetic counseling services as a preventive service without patient cost sharing should contribute to improving clinical genetics services and associated outcomes in the future.

Alcohol as a primary risk factor in oral squamous carcinoma.

Abstract: This case-control study investigates the role of alcohol as a primary risk factor in the development of oral cancer. A total of 181 patients diagnosed as having squamous carcinoma of the oral cavity were interviewed, and 497 controls. The relative risk for drinkers adjusted for smoking was 3.3, 15.2, and 10.6 for those who drank less than six, six to nine, and 10 or more whiskey equivalents (WEs) a day, respectively. The relative risk for smokers adjusted for drinking rose only from 3.2 to 4.5 to 5.0 for smokers of 10 to 19, 20 to 39, and 40 or more cigarettes a day, respectively. Beer/wine drinkers had much higher relative risks than the whiskey drinkers. The adjusted relative risk for whiskey drinkers consuming 10 or more WEs a day was 7.3; the adjusted relative risk for beer/wine drinkers consuming 10 or more WEs a day was 20.4. These results indicate that drinkers of six or more WEs a day may be at greater risk than smokers of 40 or more cigarettes a day, and that beer and wine may be greater risk factors than whiskey in the development of oral cancer.

A new method of estimating United States and state-level cancer incidence counts for the current calendar year.

Abstract: The American Cancer Society (ACS) has published the estimated number of new cancer cases and deaths in the current year for the United States that are commonly used by cancer control planners and the media. The methods used to produce these estimates have changed over the years as data (incidence) and statistical models improved. In this paper we present a new method that uses statistical models of cancer incidence that incorporate potential predictors of spatial and temporal variation of cancer occurrence and that account for delay in case reporting and then projects these estimated numbers of cases ahead 4 years using a piecewise linear (joinpoint) regression method. Based on evidence presented here that the new method produces more accurate estimates of the number of new cancer cases for years and areas for which data are available for comparison, the ACS has elected to use it to estimate the number of new cancer cases in Cancer Facts & Figures 2007 and in Cancer Statistics, 2007.

Physician preferences and attitudes regarding different models of cancer survivorship care: a comparison of primary care providers and oncologists

Abstract: New strategies for delivering cancer follow-up care are needed. We surveyed primary care providers (PCPs) and oncologists to assess how physician attitudes toward and self-efficacy with cancer follow-up affect preferences for different cancer survivorship models. The survey of physician attitudes regarding the care of cancer survivors was mailed to a randomly selected national sample of PCPs and oncologists to evaluate their perspectives regarding physician roles, knowledge about survivorship care processes, and views on cancer surveillance. Multinomial logistic regression models were constructed to examine how physician attitudes towards, and self-efficacy with, their own skills affected preferences for different cancer survivorship care models. Of 3,434 physicians identified, a total of 2,026 participants provided eligible responses: 938 PCPs and 1,088 oncologists. Most PCPs (51 %) supported a PCP/shared care model; whereas, the majority of specialists (59 %) strongly endorsed an oncologist-based model (p < 0.001). Less than a quarter of PCPs and oncologists preferred specialized survivor clinics. A significant proportion of oncologists (87 %) did not feel that PCPs should take on the primary role of cancer follow-up. Most PCPs believed that they were better able to perform breast and colorectal cancer follow-up (57 %), detect recurrent cancers (74 %), and offer psychosocial support (50 %), but only a minority (32 %) was willing to assume primary responsibility. PCPs already involved with cancer surveillance (43 %) were more likely to prefer a PCP/shared care than oncologist-based survivorship model (OR, 2.08; 95 % CI, 1.34–3.23). PCPs and oncologists have different preferences for models of cancer survivorship care. Prior involvement with cancer surveillance was one of the strongest predictors of PCPs’ willingness to assume this responsibility.