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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.
Results
1 to 25 of 31 Research Studies DisplayedShah 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
Longacre CF, Neprash HT, Shippee ND
Evaluating travel distance to radiation facilities among rural and urban breast cancer patients in the Medicare population.
This study characterizes the actual distance older breast cancer patients traveled to radiation treatment and the minimum distance necessary to reach radiation care, and examines whether any patient demographic or clinical factors are associated with greater travel distance. Findings showed that patients living in rural areas traveled on average nearly 3 times as far as those from urban areas, and their nearest facility was more than 4 times farther away. Older age, being single or widowed, and lower household income were significantly associated with shorter actual travel distance, while increasing rurality was significantly associated with greater actual and minimum travel distance to radiation treatment.
AHRQ-funded; HS026660.
Citation: Longacre CF, Neprash HT, Shippee ND .
Evaluating travel distance to radiation facilities among rural and urban breast cancer patients in the Medicare population.
J Rural Health 2020 Jun;36(3):334-46. doi: 10.1111/jrh.12413..
Keywords: Rural Health, Cancer: Breast Cancer, Cancer, Elderly, Women, Access to Care, Disparities
Garcia-Albeniz X, Hernan MA, Logan RW
Continuation of annual screening mammography and breast cancer mortality in women older than 70 years.
This study examined whether discontinuing annual mammography screening in women older than 70 years results in an increased 8-year breast cancer mortality. The researchers used data from the Medicare program and looked at over 1 million beneficiaries aged 70 to 84 who had no previous breast cancer diagnosis, and who underwent screening mammography from 2000 to 20008. The 8-year risk difference for women aged 70 to 74 years was -1.0 death per 1000 women and for women aged 75 to 84 years it was 0.07. Neither of these show substantial reductions in 8-year breast cancer mortality compared with stopping screening.
AHRQ-funded; HS023128.
Citation: Garcia-Albeniz X, Hernan MA, Logan RW .
Continuation of annual screening mammography and breast cancer mortality in women older than 70 years.
Ann Intern Med 2020 Mar 17;172(6):381-89. doi: 10.7326/m18-1199..
Keywords: Cancer: Breast Cancer, Cancer, Screening, Prevention, Women, Elderly, Mortality
Davis SN, Wischhusen JW, Sutton SK
Demographic and psychosocial factors associated with limited health literacy in a community-based sample of older Black Americans.
This study examined the frequency of limited health literacy and demographic and psychosocial factors associated with limited health literacy in a sample of older black Americans. The participants enrolled in a community-based intervention to promote colorectal cancer screening and completed baseline surveys that assessed their health literacy using the Rapid Estimate of Adult Literacy in Medicine, Revised (REALM-R) test, CRC awareness, cancer fatalism, Preventive Health Model (PHM) constructs, and demographics. Findings showed that limited health literacy was associated with multiple complex factors. Recommendations include interventions to incorporate patient health literacy and low-literacy materials that can be delivered through multiple channels.
AHRQ-funded; HS026120.
Citation: Davis SN, Wischhusen JW, Sutton SK .
Demographic and psychosocial factors associated with limited health literacy in a community-based sample of older Black Americans.
Patient Educ Couns 2020 Feb;103(2):385-91. doi: 10.1016/j.pec.2019.08.026..
Keywords: Health Literacy, Racial and Ethnic Minorities, Elderly, Screening, Cancer: Colorectal Cancer, Cancer, Prevention
Killelea BK, Evans SB, Mougalian SS
Association between perceived benefits and receipt of radiotherapy among older breast cancer patients.
This study examined perceptions of older women with stage I estrogen-receptor-positive breast cancer who underwent lumpectomy and were considering or receiving radiotherapy. Perceptions among 63 older women was that radiotherapy would reduce their 10-year-risk of local recurrent by an average of 18.7% although the literature showed only an 8% risk reduction. Participants who had the perception of a larger benefit were more likely to receive radiotherapy treatment.
AHRQ-funded; HS023900.
Citation: Killelea BK, Evans SB, Mougalian SS .
Association between perceived benefits and receipt of radiotherapy among older breast cancer patients.
Breast J 2020 Feb;26(2):231-34. doi: 10.1111/tbj.13518..
Keywords: Elderly, Cancer: Breast Cancer, Cancer, Women, Patient-Centered Outcomes Research, Shared Decision Making
Fiala MA, Gettinger T, Wallace CL
Cost differential associated with hospice use among older patients with multiple myeloma.
Hospice is an effective end-of-life care approach for patients with incurable illnesses such as multiple myeloma; however, it has been historically underutilized. In addition to improving quality of life, hospice enrollment reduces healthcare spending in many incurable illnesses but this has been unstudied in the myeloma population to date. This study examined the cost differential associated with hospice use among older patients with multiple myeloma.
AHRQ-funded; R24 HS019455.
Citation: Fiala MA, Gettinger T, Wallace CL .
Cost differential associated with hospice use among older patients with multiple myeloma.
J Geriatr Oncol 2020 Jan;11(1):88-92. doi: 10.1016/j.jgo.2019.06.010..
Keywords: Elderly, Palliative Care, Cancer, Healthcare Costs
De Roo AC, Li Y, Abrahamse PH
Long-term functional decline after high-risk elective colorectal surgery in older adults.
This study examined the long-term risks of functional decline after elective colorectal surgery in older adults. This retrospective matched cohort study used data from the Health and Retirement Study, a nationally representative, longitudinal survey of adults >50 years of age. This survey collected data on functional status, cognition, and demographics, among other topics. The survey was linked with Medicare claims and National Death Index data from 1992 to 2012 and used patients 65 years and older. Surgery patients did experience a greater likelihood of functional decline with or without complications compared to control subjects. The older the patient, the more likelihood of a functional decline occurring after surgery.
AHRQ-funded; HS000053.
Citation: De Roo AC, Li Y, Abrahamse PH .
Long-term functional decline after high-risk elective colorectal surgery in older adults.
Dis Colon Rectum 2020 Jan;63(1):75-83. doi: 10.1097/dcr.0000000000001541..
Keywords: Elderly, Cancer: Colorectal Cancer, Cancer, Surgery, Adverse Events, Risk
Raval AD, Madhavan S, Mattes MD
Association between types of chronic conditions and cancer stage at diagnosis among elderly Medicare beneficiaries with prostate cancer.
The current retrospective observational study was conducted to examine the association between types of chronic conditions and cancer stage at diagnosis among elderly Medicare beneficiaries with prostate cancer. It found that those with none of the 3 types of chronic conditions (cardiometabolic, mental health, and respiratory) were 44 percent more likely to be diagnosed with advanced prostate cancer compared to men with all 3 types of chronic conditions.
AHRQ-funded; HS018622.
Citation: Raval AD, Madhavan S, Mattes MD .
Association between types of chronic conditions and cancer stage at diagnosis among elderly Medicare beneficiaries with prostate cancer.
Popul Health Manag 2016 Dec;19(6):445-53. doi: 10.1089/pop.2015.0141.
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Keywords: Cancer, Cancer: Prostate Cancer, Elderly, Medicare
Kenzik KM, Kent EE, Martin MY
Chronic condition clusters and functional impairment in older cancer survivors: a population-based study.
The purpose of this study was to identify chronic condition clusters at pre- and post-cancer diagnosis, evaluate predictors of developing clusters post-cancer, and examine the impact on functional impairment among older cancer survivors. It found that distinct condition clusters of two or more chronic conditions are prevalent among older cancer survivors. Cluster prevalence increases from pre- to post-cancer diagnosis.
AHRQ-funded; HS023009; HS013852.
Citation: Kenzik KM, Kent EE, Martin MY .
Chronic condition clusters and functional impairment in older cancer survivors: a population-based study.
J Cancer Surviv 2016 Dec;10(6):1096-103. doi: 10.1007/s11764-016-0553-4.
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Keywords: Chronic Conditions, Cancer, Elderly, Research Methodologies, Health Status
Vemana G, Kim EH, Bhayani SB
Survival comparison between endoscopic and surgical management for patients with upper tract urothelial cancer: a matched propensity score analysis using surveillance, epidemiology and end results-Medicare data.
The researchers sought to determine survival differences among patients receiving endoscopic vs surgical management for upper tract urothelial carcinoma (UTUC). They found that although initial survival outcomes are similar for endoscopic and surgical management of nonmuscle-invasive, low-grade UTUC, both cancer-specific survival and overall survival are significantly inferior for the endoscopic management group in the longer term. They also found that transition from initial endoscopic management to surgical intervention appears to have limited impact on survival.
AHRQ-funded; HS019455.
Citation: Vemana G, Kim EH, Bhayani SB .
Survival comparison between endoscopic and surgical management for patients with upper tract urothelial cancer: a matched propensity score analysis using surveillance, epidemiology and end results-Medicare data.
Urology 2016 Sep;95:115-20. doi: 10.1016/j.urology.2016.05.033.
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Keywords: Cancer, Comparative Effectiveness, Elderly, Mortality, Surgery
Nadpara PA, Madhavan SS, Tworek C
Tobacco-use cessation counseling service usage.
The authors evaluated patterns of receipt of Tobacco-use Cessation Counseling (TCC) services among elderly lung cancer patients. They found a critical need to address disparities in receipt of TCC services among elderly. They concluded that, although lung cancer preventive services are covered under the Medicare program, these services are underutilized.
AHRQ-funded; HS018622.
Citation: Nadpara PA, Madhavan SS, Tworek C .
Tobacco-use cessation counseling service usage.
W V Med J 2016 Sep-Oct;112(5):66-71.
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Keywords: Cancer, Cancer: Lung Cancer, Elderly, Healthcare Utilization, Lifestyle Changes, Tobacco Use
Wang SY, Hall J, Pollack CE
Associations between end-of-life cancer care patterns and Medicare expenditures.
The authors examined the extent to which patterns of intensive end-of-life care explain geographic variation in end-of-life care expenditures among cancer decedents. The mean expenditure per cancer decedent in the last month of life was $10,800, with considerable variation in the percentage of decedents receiving intensive end-of-life care intervention. Regional patterns of late chemotherapy or late hospice use explained only approximately 1% of the expenditure difference, while the proportion of decedents who had ICU admissions within 30 days of death was a major driver of variation, explaining 37.6% of the expenditure difference. They concluded that promoting appropriate end-of-life care has the potential to reduce geographic variation in end-of-life care expenditures.
AHRQ-funded; HS023900.
Citation: Wang SY, Hall J, Pollack CE .
Associations between end-of-life cancer care patterns and Medicare expenditures.
J Natl Compr Canc Netw 2016 Aug;14(8):1001-8.
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Keywords: Cancer, Elderly, Healthcare Costs, Medicare, Palliative Care
Kenzik KM, Kvale EA, Rocque GB
Treatment summaries and follow-up care instructions for cancer survivors: improving survivor self-efficacy and health care utilization.
The researchers examined the association of receiving summaries and care plans with cancer survivor self-efficacy for chronic illness management. They found that explanation of the follow-up care plan, beyond the written component, enhances survivor self-efficacy for managing cancer as a chronic condition-an important mediator for improving health care utilization outcomes.
AHRQ-funded; HS023009; HS013852.
Citation: Kenzik KM, Kvale EA, Rocque GB .
Treatment summaries and follow-up care instructions for cancer survivors: improving survivor self-efficacy and health care utilization.
Oncologist 2016 Jul;21(7):817-24. doi: 10.1634/theoncologist.2015-0517.
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Keywords: Cancer, Chronic Conditions, Education: Patient and Caregiver, Elderly, Patient Self-Management
Raval AD, Madhavan S, Mattes MD
Types of chronic conditions combinations and initial cancer treatment among elderly Medicare beneficiaries with localised prostate cancer.
The authors sought to examine the association between types of chronic conditions combinations and initial cancer treatment among elderly Medicare beneficiaries with localised prostate cancer. They found that a significant proportion of elderly men with chronic conditions have received aggressive initial cancer treatment, and they suggested a conservative approach for the initial prostate cancer treatment among elderly men with significant chronic conditions and localised prostate cancer.
AHRQ-funded; HS018622.
Citation: Raval AD, Madhavan S, Mattes MD .
Types of chronic conditions combinations and initial cancer treatment among elderly Medicare beneficiaries with localised prostate cancer.
Int J Clin Pract 2016 Jul;70(7):606-18. doi: 10.1111/ijcp.12838.
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Keywords: Cancer, Cancer: Prostate Cancer, Care Management, Chronic Conditions, Elderly, Men's Health
Pollack CE, Blackford AL, Schoenborn NL
Comparing prognostic tools for cancer screening: considerations for clinical practice and performance assessment.
The researchers compared the agreement and rates of cancer screening using four prognostic tools that require different types of clinical information. They found high agreement among the four prognostic tools. They concluded that the high rates of cancer screening of individuals with limited life expectancy suggest the importance of incorporating tools into clinical decision-making.
AHRQ-funded; HS000029.
Citation: Pollack CE, Blackford AL, Schoenborn NL .
Comparing prognostic tools for cancer screening: considerations for clinical practice and performance assessment.
J Am Geriatr Soc 2016 May;64(5):1032-8. doi: 10.1111/jgs.14089.
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Keywords: Elderly, Cancer, Screening, Shared Decision Making
Rocque GB, Taylor RA, Acemgil A
Guiding lay navigation in geriatric patients with cancer using a distress assessment tool.
This study assessed the feasibility and impact of using distress assessments to frame lay navigator interactions with geriatric patients with cancer who were enrolled in navigation between January 1, 2014, and December 31, 2014. It concluded that lay navigators were able to routinely screen for patient distress at a high degree of penetration using a structured distress assessment.
AHRQ-funded; HS013852.
Citation: Rocque GB, Taylor RA, Acemgil A .
Guiding lay navigation in geriatric patients with cancer using a distress assessment tool.
J Natl Compr Canc Netw 2016 Apr;14(4):407-14.
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Keywords: Elderly, Cancer, Tools & Toolkits, Stress, Behavioral Health
Wang SY, Hall J, Pollack CE
Trends in end-of-life cancer care in the Medicare program.
The researchers sought to examine contemporary trends in end-of-life cancer care and geographic variation of end-of-life care aggressiveness among Medicare beneficiaries. They found that the proportion of beneficiaries receiving at least one potentially aggressive end-of-life intervention increased in repeated hospitalization, repeated ED visits, ICU admissions, and late hospice enrollment but declined in in-hospital death. End-of-life chemotherapy use did not change significantly over time. They concluded that despite growing focus on providing appropriate end-of-life care, there has not been an improvement in aggressive end-of-life cancer care in the Medicare program.
AHRQ-funded; HS023900.
Citation: Wang SY, Hall J, Pollack CE .
Trends in end-of-life cancer care in the Medicare program.
J Geriatr Oncol 2016 Mar;7(2):116-25. doi: 10.1016/j.jgo.2015.11.007.
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Keywords: Cancer, Care Management, Elderly, Medicare, Palliative Care, Outcomes, Patient-Centered Outcomes Research, Practice Patterns
Banerjee M, Lao CD, Wancata LM
Implications of age and conditional survival estimates for patients with melanoma.
This study identified newly diagnosed cutaneous melanoma patients and estimated conditional 5-year survival. Over time, conditional survival estimates improved for older patients with localized and regional disease. Understanding the conditional 5-year disease-specific survival of melanoma based on age and stage can help patients and physicians, informing decision-making about treatment and surveillance.
AHRQ-funded; HS020937.
Citation: Banerjee M, Lao CD, Wancata LM .
Implications of age and conditional survival estimates for patients with melanoma.
Melanoma Res 2016 Feb;26(1):77-82. doi: 10.1097/cmr.0000000000000213.
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Keywords: Elderly, Cancer: Skin Cancer, Cancer, Mortality, Skin Conditions
Poonawalla IB, Piller LB, Lairson DR
Impact of hematopoietic growth factors on blood transfusion needs, incidence of neutropenia, and overall survival among elderly advanced ovarian cancer patients treated with chemotherapy.
The researchers sought to determine the effectiveness of erythropoietin-stimulating agent (ESA) and granulocyte colony-stimulating factor (CSF) in reducing blood transfusion needs and neutropenia incidence in community-dwelling elderly ovarian cancer patients. They found that erythropoietin-stimulating agents were effective in reducing blood transfusion need. Granulocyte colony-stimulating factors were effective in lowering neutropenia incidence and also were associated with improved survival in elderly ovarian cancer patients.
AHRQ-funded; HS018956.
Citation: Poonawalla IB, Piller LB, Lairson DR .
Impact of hematopoietic growth factors on blood transfusion needs, incidence of neutropenia, and overall survival among elderly advanced ovarian cancer patients treated with chemotherapy.
Int J Gynecol Cancer 2016 Jan;26(1):95-103. doi: 10.1097/igc.0000000000000564.
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Keywords: Cancer, Treatments, Comparative Effectiveness, Elderly, Patient-Centered Outcomes Research
Garcia-Albeniz X, Hsu J, Lipsitch M
Infective endocarditis and cancer in the elderly.
The researchers investigated the magnitude of the association between infective endocarditis and cancer, and the natural history of cancer patients with concomitant diagnosis of infective endocarditis. They found that in this elderly population, the incidence of infective endocarditis around a colorectal cancer diagnosis was substantially higher than around the diagnosis of lung, breast and prostate cancers.
AHRQ-funded; HS023128.
Citation: Garcia-Albeniz X, Hsu J, Lipsitch M .
Infective endocarditis and cancer in the elderly.
Eur J Epidemiol 2016 Jan;31(1):41-9. doi: 10.1007/s10654-015-0111-9.
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Keywords: Cancer, Cancer: Colorectal Cancer, Cardiovascular Conditions, Elderly, Cancer: Prostate Cancer
Gupta A, Long JB, Chen J
Risk of vascular toxicity with platinum based chemotherapy in elderly patients with bladder cancer.
The researchers evaluated the short-term (less than 1 year) and intermediate-term (2 to 5 years) vascular toxicity of platinum agents in older patients with bladder cancer. They found that patients receiving platinum based chemotherapy were at higher risk for thromboembolism but not other vascular events, particularly in the first year after diagnosis. This risk of thromboembolism is similar for cisplatin and carboplatin.
AHRQ-funded; HS018781.
Citation: Gupta A, Long JB, Chen J .
Risk of vascular toxicity with platinum based chemotherapy in elderly patients with bladder cancer.
J Urol 2016 Jan;195(1):33-40. doi: 10.1016/j.juro.2015.08.088..
Keywords: Adverse Drug Events (ADE), Adverse Events, Cancer, Treatments, Elderly
Hannum SM, Rubinstein RL
The meaningfulness of time; narratives of cancer among chronically ill older adults.
The authors sought to describe how chronically ill older adults experience a new cancer diagnosis and the effects of this on their interpretations of personal health, aging, and the future. Among the fifteen participants, they found that perceived time was fragmented into three distinct segments: the Recalled Past, the Existent Present, and the Imagined Future. They discussed implications for how older adults understood their cancer.
AHRQ-funded; HS020177.
Citation: Hannum SM, Rubinstein RL .
The meaningfulness of time; narratives of cancer among chronically ill older adults.
J Aging Stud 2016 Jan;36:17-25. doi: 10.1016/j.jaging.2015.12.006.
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Keywords: Elderly, Cancer, Chronic Conditions, Health Status
Dimou F, Sineshaw H, Parmar AD
Trends in receipt and timing of multimodality therapy in early-stage pancreatic cancer.
The researchers described treatment patterns and time trends with regard to age and treatment center in the receipt of multimodality therapy for early-stage pancreatic cancer. They concluded that despite increased use of multimodality therapy, it remains underutilized in all patients and especially in older patients. Receipt of multimodality therapy and neoadjuvant therapy is highly dependent on treatment at NCI-designated cancer centers.
AHRQ-funded; HS022134.
Citation: Dimou F, Sineshaw H, Parmar AD .
Trends in receipt and timing of multimodality therapy in early-stage pancreatic cancer.
J Gastrointest Surg 2016 Jan;20(1):93-103; discussion 03. doi: 10.1007/s11605-015-2952-7.
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Keywords: Cancer, Disparities, Practice Patterns, Elderly, Patient-Centered Outcomes Research
Kenzik KM, Morey MC, Cohen HJ
Symptoms, weight loss, and physical function in a lifestyle intervention study of older cancer survivors.
This study examined how overweight long-term survivors’ symptom severity associated with comorbidity prior to a diet and exercise intervention was associated with post-intervention function. It found that symptom severity of older, overweight cancer survivors negatively affects physical function. However, greater weight loss and more physical activity were associated with higher functioning scores, regardless of symptom severity.
AHRQ-funded; HS013852.
Citation: Kenzik KM, Morey MC, Cohen HJ .
Symptoms, weight loss, and physical function in a lifestyle intervention study of older cancer survivors.
J Geriatr Oncol 2015 Nov;6(6):424-32. doi: 10.1016/j.jgo.2015.08.004..
Keywords: Cancer, Elderly, Obesity, Nutrition
Ning J, Peng S, Ueno N
Has racial difference in cause-specific death improved in older patients with late-stage breast cancer?
The researchers evaluated factors associated with overall, breast cancer-specific and other-cause mortalities using contemporary population data. They concluded that breast cancer-specific mortality among older women modestly improved from 2002 to 2009 across all races, but not other-cause mortality. Racial disparity in mortality persisted, but did not widen in this period.
AHRQ-funded; HS002026.
Citation: Ning J, Peng S, Ueno N .
Has racial difference in cause-specific death improved in older patients with late-stage breast cancer?
Ann Oncol 2015 Oct;26(10):2161-8. doi: 10.1093/annonc/mdv330.
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Keywords: Cancer, Cancer: Breast Cancer, Elderly, Mortality, Racial and Ethnic Minorities