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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 25 of 57 Research Studies DisplayedStevens ER, Caverly T, Butler JM
Considerations for using predictive models that include race as an input variable: the case study of lung cancer screening.
Indiscriminate use of predictive models incorporating race can reinforce biases present in source data and lead to an exacerbation of health disparities. In some countries, such as the United States, there is therefore a push to remove race from prediction models; however, there are still many prediction models that use race as an input. Biomedical informaticists who are given the responsibility of using these predictive models in healthcare environments are likely to be faced with questions like how to deal with race covariates in these models. The authors report that there is a need for a practical framework to facilitate model user thinking on how to incorporate race in their chosen model to avoid inadvertently amplifying disparities. The purpose of this paper is to utilize a case study of lung cancer screening to propose a simple framework to guide model users in approaching race inputs in the predictive models they are attempting to leverage in electronic health records and clinical workflows.
AHRQ-funded; HS028791.
Citation: Stevens ER, Caverly T, Butler JM .
Considerations for using predictive models that include race as an input variable: the case study of lung cancer screening.
J Biomed Inform 2023 Nov; 147:104525. doi: 10.1016/j.jbi.2023.104525..
Keywords: Cancer: Lung Cancer, Cancer, Racial and Ethnic Minorities
Kerlikowske K, Bissell MCS, Sprague BL
Impact of BMI on prevalence of dense breasts by race and ethnicity.
Researchers evaluated differences in body mass index (BMI) in relation to differences in dense breasts prevalence by race/ethnicity. Their results indicated that dense breasts were most prevalent among Asian women followed by non-Hispanic White, Hispanic, and Black women. Clinically important differences in breast density prevalence are present across racial/ethnic groups after accounting for age, menopausal status, and BMI. IMPACT: If breast density is the sole criterion used to notify women of dense breasts and discuss supplemental screening it may result in implementing inequitable screening strategies across racial/ethnic groups.
AHRQ-funded; HS018366.
Citation: Kerlikowske K, Bissell MCS, Sprague BL .
Impact of BMI on prevalence of dense breasts by race and ethnicity.
Cancer Epidemiol Biomarkers Prev 2023 Nov; 32(11):1524-30. doi: 10.1158/1055-9965.Epi-23-0049..
Keywords: Obesity, Women, Racial and Ethnic Minorities, Cancer: Breast Cancer, Cancer, Imaging
Reed KG, Sun Z, Yabes JG
Assessing characteristics of populations seen at Commission on Cancer facilities using Pennsylvania linked data.
The purpose of this study was to evaluate variations among patients who do and do not visit Commission on Cancer (CoC) accredited facilities. The researchers utilized Pennsylvania Cancer Registry data linked to facility records for 87,472 patients diagnosed with cancer between 2018 and 2019. The study found that patients in the most advantaged Area Deprivation Index quartiles were more likely to visit CoC facilities compared with other quartiles. Urban patients were more likely than rural to be seen at a CoC facility as were Hispanic patients and non-Hispanic Black patients compared with White patients.
AHRQ-funded; HS027396.
Citation: Reed KG, Sun Z, Yabes JG .
Assessing characteristics of populations seen at Commission on Cancer facilities using Pennsylvania linked data.
JNCI Cancer Spectr 2023 Oct 31; 7(6). doi: 10.1093/jncics/pkad080..
Keywords: Cancer, Health Information Technology (HIT), Racial and Ethnic Minorities, Rural Health, Rural/Inner-City Residents
Bonner SN, Lagisetty K, Reddy RM
Clinical implications of removing race-corrected pulmonary function tests for African American patients requiring surgery for lung cancer.
This study’s objective was to identify how many hospitals providing lung cancer surgery use race correction in pulmonary function tests (PFTs), examine the association of race correction with predicted lung function, and test the effect of decorrection on surgeons' treatment recommendations. Percent predicted preoperative and postoperative forced expiratory volume in 1 second (FEV1) was calculated for African American patients who underwent lung cancer resection between January 1, 2015, and September 31, 2022, using race-corrected and race-neutral equations for hospitals performing race correction. Randomization of US cardiothoracic surgeons was conducted to receive 1 clinical vignette that differed by the use of Global Lung Function Initiative equations for (1) African American patients (percent predicted postoperative FEV1, 49%), (2) other race or multiracial patients (percent predicted postoperative FEV1, 45%), and (3) race-neutral patients (percent predicted postoperative FEV1, 42%). A total of 515 African American patients (308 [59.8%] female; mean age, 66.2 years) were included in the study. Among these patients, the percent predicted preoperative FEV1 and postoperative FEV1 would have decreased by 9.2% and 7.6%, respectively, if race-neutral equations had been used. A total of 225 surgeons (194 male [87.8%]; mean time in practice, 19.4 years) were successfully randomized and completed the vignette items regarding risk perception and treatment outcomes (76% completion rate). Surgeons randomized to the vignette with African American race-corrected PFTs were more likely to recommend lobectomy (79.2%) compared with surgeons randomized to the other race or multiracial-corrected (61.7%) or race-neutral PFTs (52.8%).
AHRQ-funded; HS028038.
Citation: Bonner SN, Lagisetty K, Reddy RM .
Clinical implications of removing race-corrected pulmonary function tests for African American patients requiring surgery for lung cancer.
JAMA Surg 2023 Oct; 158(10):1061-68. doi: 10.1001/jamasurg.2023.3239..
Keywords: Racial and Ethnic Minorities, Cancer: Lung Cancer, Cancer, Surgery, Diagnostic Safety and Quality
Landy R, Gomez I, Caverly TJ
Methods for using race and ethnicity in prediction models for lung cancer screening eligibility.
The purpose of this study was to compare eligibility for lung cancer screening in a representative United States population by refitting the life-years gained from screening-computed tomography (LYFS-CT) model to exclude race and ethnicity versus a counterfactual eligibility method that recalculates life expectancy for racial and ethnic minority individuals utilizing the same covariates but substitutes White race and utilizes the higher predicted life expectancy, preventing historically underserved groups from being penalized. The National Health Interview Survey (NHIS) 2015-2018 included 25,601 individuals aged 50 to 80 years who ever smoked. The study found that removing race and ethnicity from the submodels underestimated lung cancer death risk and all-cause mortality in African American individuals. It also overestimated mortality in Hispanic American and Asian American individuals. As a result, the LYFS-CT NoRace model increased Hispanic American and Asian American eligibility by 108% and 73%, respectively, while decreasing African American eligibility by 39%. Utilizing LYFS-CT with the counterfactual all-cause mortality model better maintained calibration across groups and increased African American eligibility by 13% without decreasing eligibility for Hispanic American and Asian American individuals.
AHRQ-funded; HS026198.
Citation: Landy R, Gomez I, Caverly TJ .
Methods for using race and ethnicity in prediction models for lung cancer screening eligibility.
JAMA Netw Open 2023 Sep; 6(9):e2331155. doi: 10.1001/jamanetworkopen.2023.31155..
Keywords: Racial and Ethnic Minorities, Cancer: Lung Cancer, Cancer, Screening, Prevention
Khor S, Heagerty PJ, Basu A
Racial disparities in the ascertainment of cancer recurrence in electronic health records.
This study examined whether the accuracy of a proxy for colorectal cancer (CRC) recurrence differed by race/ethnicity and the possible mechanisms that drove the differences. Using data from a large integrated health care system, the authors identified a stratified random sample of 282 Black/African American (AA), Hispanic, and non-Hispanic White (NHW) patients with CRC who received primary treatment. The recurrence proxy was found to have excellent overall accuracy (positive predictive value [PPV] 89.4%; negative predictive value 96.5%; mean difference in timing 1.96 months); however, accuracy varied by race/ethnicity. Compared with NHW patients, PPV was 14.9% lower among Hispanic patients and 4.3% lower among Black/AA patients. The proxy disproportionately inflated the 5-year recurrence incidence for Hispanic patients by 10.6%. Compared with NHW patients, proxy recurrences for Hispanic patients were almost three times as likely to have been misclassified as positive (adjusted risk ratio 2.91). The authors theorize that higher false positives among racial/ethnic minorities may be related to higher prevalence of noncancerous lung-related problems and substantial delays in primary treatment because of insufficient patient-provider communication and abnormal treatment patterns.
AHRQ-funded; HS013853.
Citation: Khor S, Heagerty PJ, Basu A .
Racial disparities in the ascertainment of cancer recurrence in electronic health records.
JCO Clin Cancer Inform 2023 Jun; 7:e2300004. doi: 10.1200/cci.23.00004..
Keywords: Cancer, Electronic Health Records (EHRs), Health Information Technology (HIT), Racial and Ethnic Minorities, Disparities
Enzinger AC, Ghosh K, Keating NL
Racial and ethnic disparities in opioid access and urine drug screening among older patients with poor-prognosis cancer near the end of life.
This research characterized racial and ethnic disparities and trends in opioid access and urine drug screening (UDS) among older patients dying of cancer, and to explore potential mechanisms. Among 18,549 non-Hispanic White (White), Black, and Hispanic Medicare decedents older than 65 years with poor-prognosis cancers, the authors examined 2007-2019 trends in opioid prescription fills and potency (morphine milligram equivalents [MMEs] per day [MMEDs]) near the end of life (EOL), defined as 30 days before death or hospice enrollment. They found that between 2007 and 2019, White, Black, and Hispanic decedents experienced steady declines in EOL opioid access and rapid expansion of UDS. Compared with White patients, Black and Hispanic patients were less likely to receive any opioid (Black, -4.3 percentage points; Hispanic, -3.6 percentage points) and long-acting opioids (Black, -3.1 percentage points; Hispanic, -2.2 percentage points). They also received lower daily doses (Black, -10.5 MMED; Hispanic, -9.1 MMED) and lower total doses (Black, -210 MMEs; Hispanic, -179 MMEs). Black patients were also more likely to undergo UDS (0.5 percentage points).
AHRQ-funded; HS024072.
Citation: Enzinger AC, Ghosh K, Keating NL .
Racial and ethnic disparities in opioid access and urine drug screening among older patients with poor-prognosis cancer near the end of life.
J Clin Oncol 2023 May 10; 41(14):2511-22. doi: 10.1200/jco.22.01413..
Keywords: Elderly, Opioids, Medication, Cancer, Racial and Ethnic Minorities, Disparities, Access to Care
Griesemer I, Lightfoot AF, Eng E
Examining ACCURE's nurse navigation through an antiracist lens: transparency and accountability in cancer care.
This paper discussed an intervention that was conducted to eliminate racial disparity in cancer treatment through a program called Accountability for Cancer Care through Undoing Racism and Equity (ACCURE). The program successfully eliminated the Black-White disparity in cancer treatment completion among patients with early-stage breast and lung cancer. It used specially trained nurse navigators who leveraged real-time data to follow-up with patients during their treatment journeys. Thematic analysis on all clinical notes that were written by ACCURE navigators after each contact with patients in the specialized navigation arm (n = 162) was conducted by community and academic research partners. The authors identified six themes in the navigator notes that demonstrated enhanced accountability of the care system to patient needs. Those themes include: (1) patient-centered advocacy, (2) addressing system barriers to care, (3) connection to resources, (4) re-engaging patients after lapsed treatment, (5) addressing symptoms and side effects, and (6) emotional support.
AHRQ-funded; HS000032.
Citation: Griesemer I, Lightfoot AF, Eng E .
Examining ACCURE's nurse navigation through an antiracist lens: transparency and accountability in cancer care.
Health Promot Pract 2023 May; 24(3):415-25. doi: 10.1177/15248399221136534..
Keywords: Cancer, Racial and Ethnic Minorities, Disparities, Health Promotion
Richmond J, Murray MH, Milder CM
Racial disparities in lung cancer stage of diagnosis among adults living in the southeastern United States.
The purpose of this study was to identify factors contributing to racial disparities in stage of lung cancer stage diagnosis in low-income adults. The researchers identified cases of incident lung cancer from the prospective observational Southern Community Cohort Study by linking them with state cancer registries in 12 southeastern states. A subset of participants who answered psychosocial questions such as those related to racial discrimination experiences were assessed to determine if model predictive power improved. The study identified 1,572 patients with incident lung cancer with available lung cancer stage. Compared with White participants Black participants with lung cancer reflected higher unadjusted odds of distant stage diagnosis. Higher neighborhood area deprivation was related with distant stage diagnosis. No significant differences were found in distant stage disease for Black vs White participants after controlling for individual- and area-level factors, but participants with COPD showed decreased odds of distant stage diagnosis in the primary model.
AHRQ-funded; HS026122.
Citation: Richmond J, Murray MH, Milder CM .
Racial disparities in lung cancer stage of diagnosis among adults living in the southeastern United States.
Chest 2023 May; 163(5):1314-27. doi: 10.1016/j.chest.2022.11.025..
Keywords: Disparities, Racial and Ethnic Minorities, Cancer: Lung Cancer, Cancer
Agochukwu-Mmonu N, Qin Y, Kaufman S
Understanding the role of urology practice organization and racial composition in prostate cancer treatment disparities.
This study examined the associations between urology practice organization and racial composition and treatment patterns for Medicare beneficiaries with incident prostate cancer. The authors used a 20% sample of national Medicare data to identify beneficiaries diagnosed with prostate cancer between January 2010 and December 2015 and followed them through 2016. They then linked urologists to their practices with tax identification numbers and patients to their practices based on their primary urologist. They identified 54,443 patients with incident prostate cancer, with most (87%) White and 9% Black. They found wide variation in racial practice composition and practice segregation. Patients in practices with the highest proportion of Black patients had the lowest socioeconomic status (43.1%), highest comorbidity (9.9% with comorbidity score ≥ 3), and earlier age at prostate cancer diagnosis (33.5% age 66-69 years). Black patients had lower odds of definitive therapy and underwent less treatment than White patients in every practice context. Black patients had lower predicted probability of treatment (66%) than White patients (69%).
AHRQ-funded; HS025707.
Citation: Agochukwu-Mmonu N, Qin Y, Kaufman S .
Understanding the role of urology practice organization and racial composition in prostate cancer treatment disparities.
JCO Oncol Pract 2023 May; 19(5):e763-e72. doi: 10.1200/op.22.00147..
Keywords: Cancer: Prostate Cancer, Cancer, Men's Health, Disparities, Racial and Ethnic Minorities
Jackson Levin N, Zhang A, Reyes-Gastelum D
Change in worry over time among Hispanic women with thyroid cancer.
This survey assessed change in worry over time in Hispanic women with thyroid cancer. A total of 273 Hispanic women with thyroid cancer diagnosed in 2014-2015 were recruited from SEER Los Angeles. Participants were surveyed at two points in time: time 1 from 2017 to 2018 and time 2 in 2019 on recurrence, quality of life, family at risk, death, and harm from treatments. Women were surveyed on their amount of worry: high worry (somewhat, quite a bit, very much) or low worry (not at all, a little). The survey showed 20.1-39.6% had high worry at both time 1 and time 2. An additional 7.6-13.4% had low worry at time 1 that evolved into high worry at time 2. Women with younger age (20-39) compared to older (40-79) had higher worry about thyroid cancer recurrence. A history of recurrent or persistent disease was associated with high worry about harms from treatment. Greater number of complications or side effect symptoms was associated with worry across all five items.
AHRQ-funded; HS024512.
Citation: Jackson Levin N, Zhang A, Reyes-Gastelum D .
Change in worry over time among Hispanic women with thyroid cancer.
J Cancer Surviv 2022 Aug;16(4):844-52. doi: 10.1007/s11764-021-01078-8..
Keywords: Cancer, Women, Racial and Ethnic Minorities, Quality of Life, Anxiety
Roberson ML, Nichols HB, Olshan AF
Trends in surgical treatment of early-stage breast cancer reveal decreasing mastectomy use between 2003 and 2016 by age, race, and rurality.
The authors sought to examine trends in the surgical treatment of breast cancer by age, rurality, and among Black women in a populous, racially diverse, state in the Southeastern United States of America. Using data from the North Carolina Central Cancer Registry, they found declining mastectomy rates in the early 2000s in a Southern US state with a racially and geographically diverse population. These decreasing trends were consistent among key subgroups affected by cancer inequities, including Black and White rural women.
AHRQ-funded; HS027299.
Citation: Roberson ML, Nichols HB, Olshan AF .
Trends in surgical treatment of early-stage breast cancer reveal decreasing mastectomy use between 2003 and 2016 by age, race, and rurality.
Breast Cancer Res Treat 2022 Jun;193(2):445-54. doi: 10.1007/s10549-022-06564-w..
Keywords: Cancer: Breast Cancer, Cancer, Women, Surgery, Racial and Ethnic Minorities, Rural Health
Fernandez JR, Richmond J, Nápoles AM
Everyday discrimination and cancer metaphor preferences: the mediating effects of needs for personal significance and cognitive closure.
This study examined the relationship between discrimination and preferences for cancer battle metaphors versus journey metaphors. Four-hundred twenty-seven cancer patients completed an online survey. Question items included on every day discrimination, need for personal significance, need for cognitive closure, and preference for cancer scenarios using battle or journey metaphors. Discrimination was associated with battle metaphor preferences through serial mediation when discrimination was not associated to race. When discrimination was associated with race, it was directly associated with journey metaphor preferences and the serial medication was nonsignificant. The single mediation model was strongest for non-Hispanic White participants and varied across racial/ethnic groups.
AHRQ-funded; HS026122.
Citation: Fernandez JR, Richmond J, Nápoles AM .
Everyday discrimination and cancer metaphor preferences: the mediating effects of needs for personal significance and cognitive closure.
SSM Popul Health 2022 Mar;17:100991. doi: 10.1016/j.ssmph.2021.100991..
Keywords: Cancer, Racial and Ethnic Minorities
Cunningham-Erves J, Campbell L, Barlow C
Reducing HPV associated cancers and disparities: engaging African American men to develop a culturally-appropriate program that addresses their needs.
Reducing HPV associated cancers and disparities: engaging African American men to develop a culturally-appropriate program that addresses their needs.
Am J Health Educ 2021;52(4):194-206. doi: 10.1080/19325037.2021.1930614.
This paper discusses the results of the Healthy Men, Healthy Communities program that aims to improve preventive behaviors among African American men to reduce HPV-related cancer disparities. An educational intervention was developed using cultural-targeting strategies such as linguistics, peripherals, evidence, socio-culture, and constituent-involving. Research team members were recruited from community-based (CBO) leaders. Three focus groups, 30 surveys, and a community review and program evaluation with African American men were conducted. The five focus group themes were: 1) The Known and Unknown of Cancer, HPV, and the vaccine; (2) Personal experiences with cancer were commonplace; (3) Barriers to Engaging HPV Cancer Preventive Behaviors; (4) Multi-Modal Strategies are needed to improve preventive behaviors; and (5) Actual versus Preferred Sources of Information. Survey data showed men desired information on penile (52%) and oral cancer (48%). A speaker summit on various topics was the preferred education format (96%). A post-summit evaluation indicated most males intended to get screened (73%), eat healthier (77%), and exercise more (65%). After these interventions the HPV vaccine was administered to about 40% of the men, and their children and grandchildren.
Am J Health Educ 2021;52(4):194-206. doi: 10.1080/19325037.2021.1930614.
This paper discusses the results of the Healthy Men, Healthy Communities program that aims to improve preventive behaviors among African American men to reduce HPV-related cancer disparities. An educational intervention was developed using cultural-targeting strategies such as linguistics, peripherals, evidence, socio-culture, and constituent-involving. Research team members were recruited from community-based (CBO) leaders. Three focus groups, 30 surveys, and a community review and program evaluation with African American men were conducted. The five focus group themes were: 1) The Known and Unknown of Cancer, HPV, and the vaccine; (2) Personal experiences with cancer were commonplace; (3) Barriers to Engaging HPV Cancer Preventive Behaviors; (4) Multi-Modal Strategies are needed to improve preventive behaviors; and (5) Actual versus Preferred Sources of Information. Survey data showed men desired information on penile (52%) and oral cancer (48%). A speaker summit on various topics was the preferred education format (96%). A post-summit evaluation indicated most males intended to get screened (73%), eat healthier (77%), and exercise more (65%). After these interventions the HPV vaccine was administered to about 40% of the men, and their children and grandchildren.
AHRQ-funded; HS022990.
Citation: Cunningham-Erves J, Campbell L, Barlow C .
Reducing HPV associated cancers and disparities: engaging African American men to develop a culturally-appropriate program that addresses their needs.
Am J Health Educ 2021;52(4):194-206. doi: 10.1080/19325037.2021.1930614..
Keywords: Sexual Health, Infectious Diseases, Cancer, Disparities, Racial and Ethnic Minorities, Men's Health, Prevention, Health Promotion, Education: Patient and Caregiver
Chen DW, Reyes-Gastelum D, Hawley ST
Unmet information needs among Hispanic women with thyroid cancer.
The authors sought to determine the relationship between acculturation level and unmet information needs among Hispanic women with thyroid cancer. They assessed acculturation with the Short Acculturation Scale for Hispanics. They found that low-acculturated (vs high-acculturated) Hispanic women with thyroid cancer have greater unmet information needs, emphasizing the importance of patient-focused approaches to providing medical information.
AHRQ-funded; HS024512.
Citation: Chen DW, Reyes-Gastelum D, Hawley ST .
Unmet information needs among Hispanic women with thyroid cancer.
J Clin Endocrinol Metab 2021 Jun 16;106(7):e2680-e87. doi: 10.1210/clinem/dgab128..
Keywords: Cancer, Women, Racial and Ethnic Minorities, Education: Patient and Caregiver, Cultural Competence
Lee K, Gani F, Canner JK
Racial disparities in utilization of palliative care among patients admitted with advanced solid organ malignancies.
The primary objective of this study was to describe racial differences in the use of inpatient palliative care consultations (IPCC) for patients with advanced cancer who are admitted to a hospital in the United States. Hospital admissions of patients with advanced cancers were identified through the National Inpatient Dataset. Findings showed that death during hospitalization was a significant modifier of the relationship between race and receipt of palliative care consultation. There were significant racial disparities in the utilization of IPCC for patients with advanced cancer.
AHRQ-funded; HS024736.
Citation: Lee K, Gani F, Canner JK .
Racial disparities in utilization of palliative care among patients admitted with advanced solid organ malignancies.
Am J Hosp Palliat Care 2021 Jun;38(6):539-46. doi: 10.1177/1049909120922779..
Keywords: Healthcare Cost and Utilization Project (HCUP), Palliative Care, Cancer, Disparities, Racial and Ethnic Minorities, Healthcare Utilization, Inpatient Care, Chronic Conditions
Danan ER, White KM, Wilt TJ
Reactions to recommendations and evidence about prostate cancer screening among White and Black male veterans.
This study looked at differences in attitudes about recommendations and evidence on prostate cancer screening among White and Black male veterans. The authors provided a draft educational pamphlet about the benefits and harms of Prostate Specific Antigen (PSA) screening to 44 men, ages 55-81 at a midwestern VA medical center in 2013 and 2015. The groups were divided into four White and two Black focus groups. Three universal themes were low baseline familiarity with prostate cancer, surprise and resistance to the guidelines not to test routinely, and negative emotions in response to ambiguity. Discussions in the White groups highlighted the potential benefits of screening, minimized the harms, and emphasized personal choice in screening decisions. Discussions in Black groups devoted almost no time to benefits, considered harms significant, and emphasized personal and collective responsibility for cancer prevention through diet, exercise, and alternative medicine. Discussion in Black groups also emphasized the history of racism and discrimination in healthcare and medical research.
AHRQ-funded; HS026379.
Citation: Danan ER, White KM, Wilt TJ .
Reactions to recommendations and evidence about prostate cancer screening among White and Black male veterans.
Am J Mens Health 2021 May-Jun;15(3):15579883211022110. doi: 10.1177/15579883211022110..
Keywords: Cancer: Prostate Cancer, Cancer, Screening, Prevention, Racial and Ethnic Minorities, Evidence-Based Practice, Health Promotion, Education: Patient and Caregiver
Lee CI, Zhu W, Onega T
Comparative access to and use of digital breast tomosynthesis screening by women's race/ethnicity and socioeconomic status.
This study looked at access to digital breast tomography (DBT) versus regular mammography and whether women of minority race/ethnicity and lower socioeconomic status experienced lower DBT access during the early adoption period and persistently lower DBT use over time. This cross-sectional study included 92 geographically diverse imaging facilities across 5 US states, with over 2.3 million screening examinations performed among women aged 40 to 89 years from January 1, 2011, to December 31, 2017. Data were analyzed from June 2019, to August 2020. Women who used DBT increased for all women from 3.3% in 2011 to 82.6% in 2017. In 2012, Black, Hispanic, Asian American, and women with less than a high school education had lower DBT access compared to White women attending the same facility and also college graduates. Lower DBT access continued over time regardless of the number of years after facility-level DBT adoption.
AHRQ-funded; HS018366.
Citation: Lee CI, Zhu W, Onega T .
Comparative access to and use of digital breast tomosynthesis screening by women's race/ethnicity and socioeconomic status.
JAMA Netw Open 2021 Feb;4(2):e2037546. doi: 10.1001/jamanetworkopen.2020.37546..
Keywords: Cancer: Breast Cancer, Cancer, Imaging, Access to Care, Women, Social Determinants of Health, Racial and Ethnic Minorities, Screening
Reese TJ, Schlechter CR, Potter LN
Evaluation of revised US Preventive Services Task Force lung cancer screening guideline among women and racial/ethnic minority populations.
The purpose of this study was to determine the changes associated with the revised USPSTF guideline for lung cancer screening eligibility among female, Black, and Hispanic populations using a large nationwide survey. The investigators concluded that the revised USPSTF guideline may likely increase lung cancer screening rates for female, Black, and Hispanic populations. However, despite these potential improvements, lung cancer screening inequities may persist without tailored eligibility criteria.
AHRQ-funded; HS026198.
Citation: Reese TJ, Schlechter CR, Potter LN .
Evaluation of revised US Preventive Services Task Force lung cancer screening guideline among women and racial/ethnic minority populations.
JAMA Netw Open 2021 Jan;4(1):e2033769. doi: 10.1001/jamanetworkopen.2020.33769..
Keywords: U.S. Preventive Services Task Force (USPSTF), Cancer: Lung Cancer, Cancer, Screening, Racial and Ethnic Minorities, Women, Guidelines, Evidence-Based Practice
Shah SC, Canakis A, Peek RM
Endoscopy for gastric cancer screening is cost effective for Asian Americans in the United States.
Endoscopic screening for gastric cancer is routine in some countries with high incidence and is associated with reduced gastric cancer-related mortality. Immigrants from countries of high incidence to low incidence of gastric cancer retain their elevated risk, but no screening recommendations have been made for these groups in the United States. In this study the investigators aimed to determine the cost effectiveness of different endoscopic screening strategies for noncardia gastric cancer, compared with no screening, among Chinese, Filipino, Southeast Asian, Vietnamese, Korean, and Japanese Americans.
AHRQ-funded; HS026395.
Citation: Shah SC, Canakis A, Peek RM .
Endoscopy for gastric cancer screening is cost effective for Asian Americans in the United States.
Clin Gastroenterol Hepatol 2020 Dec;18(13):3026-39. doi: 10.1016/j.cgh.2020.07.031..
Keywords: Cancer, Digestive Disease and Health, Screening, Racial and Ethnic Minorities, Healthcare Costs
Shah SC, McKinley M, Gupta S
Population-based analysis of differences in gastric cancer incidence among races and ethnicities in individuals age 50 years and older.
There are racial and ethnic differences in the incidence of gastric adenocarcinoma worldwide and in the US. Based on a decision analysis, screening for noncardia gastric adenocarcinoma might be cost-effective for non-White individuals 50 years or older. In this study, the investigators aimed to estimate the differences in gastric adenocarcinoma incidence in specific anatomic sites among races and ethnicities in individuals 50 years or older.
AHRQ-funded; HS026395.
Citation: Shah SC, McKinley M, Gupta S .
Population-based analysis of differences in gastric cancer incidence among races and ethnicities in individuals age 50 years and older.
Gastroenterology 2020 Nov;159(5):1705-14.e2. doi: 10.1053/j.gastro.2020.07.049..
Keywords: Elderly, Cancer, Digestive Disease and Health, Racial and Ethnic Minorities, Disparities
Fiala MA, Wildes TM, Vij R
Racial disparities in the utilization of novel agents for frontline treatment of multiple myeloma.
This study examined the reasons why racial disparities exist in the utilization of novel agents for frontline treatment of multiple myeloma. Higher cost of drugs has been the hypothesis, but there has been no data to support this. The authors compared relative bortezomib and lenalidomide utilization in patients with newly diagnosed multiple myeloma using the SEER-Medicare linked database. Bortezomib utilization in African Americans was 31% less likely compared to whites. There was no statistically significant difference in utilization for lenalidomide. The findings didn’t support the hypothesis that the disparities are due to higher costs, and the authors theorize that travel or logistical issues, structural barriers in the medical system, and preferences and biases among patients and providers may also be significant factors.
AHRQ-funded; HS019455.
Citation: Fiala MA, Wildes TM, Vij R .
Racial disparities in the utilization of novel agents for frontline treatment of multiple myeloma.
Clin Lymphoma Myeloma Leuk 2020 Oct;20(10):647-51. doi: 10.1016/j.clml.2020.04.018..
Keywords: Racial and Ethnic Minorities, Disparities, Cancer
Payán DD, Maggard-Gibbons M, Flórez KR
Taking Care of Yourself and Your Risk for Breast Cancer (CUIDARSE): a randomized controlled trial of a health communication intervention for Latinas.
Latinas in the United States are more likely to be diagnosed with late-stage breast cancer (BC) compared to non-Latinas. Literacy-appropriate and culturally sensitive cancer communication interventions can help address existing racial/ethnic BC disparities. In this study, the investigators formatively developed a new BC prevention brochure for Spanish-speaking Latinas (≥35 years) and conducted a randomized controlled trial of a health communication intervention for Latinas.
AHRQ-funded; HS019264.
Citation: Payán DD, Maggard-Gibbons M, Flórez KR .
Taking Care of Yourself and Your Risk for Breast Cancer (CUIDARSE): a randomized controlled trial of a health communication intervention for Latinas.
Health Educ Behav 2020 Aug;47(4):569-80. doi: 10.1177/1090198120920529..
Keywords: Cancer: Breast Cancer, Cancer, Racial and Ethnic Minorities, Health Literacy, Education: Patient and Caregiver, Cultural Competence, Health Promotion, Communication, Women, Community-Based Practice
Cunningham-Erves J, Barajas C, Mayo-Gamble TL
Formative research to design a culturally-appropriate cancer clinical trial education program to increase participation of African American and Latino communities.
This study’s goal was to address knowledge deficiencies about cancer clinical trials and biospecimen donation that can potentially improve participation among racial and ethnic minorities. The researchers included community-based organization (CBO) leaders as research team members, conducted focus groups and cognitive interviews with community members as reviewers/consultants, and interacted with two community advisory groups. Five focus group themes were identified. A final program consisted of two versions (English and Spanish) of a culturally-appropriate slide presentation with speaker notes and videos that represent community member and researcher testimonials. It is hoped these findings will help promote cancer clinical trial participation among African Americans and Latinos.
AHRQ-funded; HS026122.
Citation: Cunningham-Erves J, Barajas C, Mayo-Gamble TL .
Formative research to design a culturally-appropriate cancer clinical trial education program to increase participation of African American and Latino communities.
BMC Public Health 2020 Jun 3;20(1):840. doi: 10.1186/s12889-020-08939-4..
Keywords: Cancer, Racial and Ethnic Minorities, Cultural Competence, Research Methodologies, Disparities
Jannat-Khah DP, Khodneva Y, Bryant K
Depressive symptoms do not discriminate: racial and economic influences between time-varying depressive symptoms and mortality among REGARDS participants.
This study examined whether time-varying depressive symptoms (TVDS) predict mortality and if racial and income differences moderate the association in a large cohort. The cohort from the REGARDS study was used to look at that determination. The REGARDS study used community-dwelling U.S. adults aged 45 years or older. They found that there was similar and statistically significant differences with white, black, and low-income ($35,000 or less) participants for the association between TVDS and mortality. High-income participants were found to have a lower hazard.
AHRQ-funded; HS025198.
Citation: Jannat-Khah DP, Khodneva Y, Bryant K .
Depressive symptoms do not discriminate: racial and economic influences between time-varying depressive symptoms and mortality among REGARDS participants.
Ann Epidemiol 2020 Jun;46:31-40.e2. doi: 10.1016/j.annepidem.2020.04.004..
Keywords: Depression, Behavioral Health, Racial and Ethnic Minorities, Cardiovascular Conditions, Cancer, Low-Income, Social Determinants of Health, Mortality