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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
76 to 100 of 144 Research Studies DisplayedEzer N, Mhango G, Bagiella E
Racial disparities in resection of early stage non-small cell lung cancer: variability among surgeons.
This study examined racial disparities in resection surgery of non-small cell lung cancer (NSCLC). These disparities are well documented. The authors identified 19,624 patients with stage I-II NSCLC 65 years and older from the SEER-Medicare database. They studied patients evaluated by a surgeon within 6 months of diagnosis. Black patients were less likely to undergo resection with resection rates varying among surgeons. Thoracic surgeon specialists were less likely to have any disparities with resection rates.
AHRQ-funded; HS019670.
Citation: Ezer N, Mhango G, Bagiella E .
Racial disparities in resection of early stage non-small cell lung cancer: variability among surgeons.
Med Care 2020 Apr;58(4):392-98. doi: 10.1097/mlr.0000000000001280..
Keywords: Disparities, Racial and Ethnic Minorities, Cancer: Lung Cancer, Cancer, Surgery, Practice Patterns
Herb JN, Dunham LN, Ollila DW
Use of completion lymph node dissection for sentinel lymph node-positive melanoma.
This study examined the use and time trends of completion lymph node dissection (CLND) for sentinel lymph node-positive melanoma (SNPM). There has been found to be no benefit for CLND in SNPM patients. The National Cancer Database was used to find patients 18 years and older from 2012 to 2016 with SNPM. During that time period, 7,146 patients were identified with SNPM. From 2012 to 2014 the proportion of patients undergoing CLND was steady (61-63%) but decreased to 57% in 2015 and 50% in 2016. Use was less likely for women and increasing age. Higher use was more likely at high-volume centers, and associated with increased Breslow depth and ulceration.
Citation: Herb JN, Dunham LN, Ollila DW .
Use of completion lymph node dissection for sentinel lymph node-positive melanoma.
J Am Coll Surg 2020 Apr;230(4):515-24. doi: 10.1016/j.jamcollsurg.2019.12.010..
Keywords: Cancer: Skin Cancer, Cancer, Skin Conditions, Treatments
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
Fan T, Fakolade A
AHRQ Author: Fan T
Medication use to reduce risk of breast cancer.
In this case study, a 40-year-old woman comes to her doctor’s office for a routine gynecologic visit. She is not taking any medications and is generally healthy. She is sexually active, and her last menstrual period started 10 days ago. She states that her mother was diagnosed with bilateral breast cancer at 49 years of age and that she would like to discuss her options for reducing the risk of breast cancer. Three questions are posed about risk-reducing medications.
AHRQ-authored
Citation: Fan T, Fakolade A .
Medication use to reduce risk of breast cancer.
Am Fam Physician 2020 Mar 15;101(6):373-74..
Keywords: U.S. Preventive Services Task Force (USPSTF), Cancer: Breast Cancer, Cancer, Medication, Risk, Prevention, Case Study, Women
Sprague BL, Coley RY, Kerlikowske K
Assessment of radiologist performance in breast cancer screening using digital breast tomosynthesis vs digital mammography.
Many US radiologists have screening mammography recall rates above the expert-recommended threshold of 12%. The influence of digital breast tomosynthesis (DBT) on the distribution of radiologist recall rates is uncertain. The objective of this study was to evaluate radiologists' recall and cancer detection rates before and after beginning interpretation of DBT examinations.
AHRQ-funded; HS018366.
Citation: Sprague BL, Coley RY, Kerlikowske K .
Assessment of radiologist performance in breast cancer screening using digital breast tomosynthesis vs digital mammography.
JAMA Netw Open 2020 Mar 2;3(3):e201759. doi: 10.1001/jamanetworkopen.2020.1759..
Keywords: Cancer: Breast Cancer, Cancer, Diagnostic Safety and Quality, Imaging, Screening, Women, Prevention, Provider Performance
Senft N, Abrams J, Katz
eHealth activity among African American and white cancer survivors: a new application of theory.
eHealth is a promising resource for cancer survivors and may contribute to reducing racial disparities in cancer survivorship. This research applied the Unified Theory of Acceptance and Use of Technology (UTAUT) to examine eHealth activity among African American (AfAm) and White cancer survivors.
AHRQ-funded; HS022955.
Citation: Senft N, Abrams J, Katz .
eHealth activity among African American and white cancer survivors: a new application of theory.
Health Commun 2020 Mar;35(3):350-55. doi: 10.1080/10410236.2018.1563031..
Keywords: Racial and Ethnic Minorities, Cancer, Disparities, Health Status, Telehealth, Health Information Technology (HIT)
Kierkegaard P, Vale MD, Garrison S
Mechanisms of decision-making in preoperative assessment for older adult prostate cancer patients-a qualitative study.
The purpose of this study was to identify and examine the underlying mechanisms that uniquely shape preoperative surgical decision-making strategies concerning older adult prostate cancer patients. Results showed that surgeons’ personal experiences had a significant impact on the decision-making processes during preoperative assessments. However, non-patient factors such as institutional microcultures passively and actively influenced the decision-making process during preoperative assessment.
AHRQ-funded; HS025707.
Citation: Kierkegaard P, Vale MD, Garrison S .
Mechanisms of decision-making in preoperative assessment for older adult prostate cancer patients-a qualitative study.
J Surg Oncol 2020 Mar;121(3):561-69. doi: 10.1002/jso.25819..
Keywords: Decision Making, Cancer: Prostate Cancer, Cancer, Surgery, Men's Health
Ellis RJ, Ho JW, Schlick CJR
National use of chemotherapy in initial management of stage I pancreatic cancer and failure to perform subsequent resection.
This paper investigated rates of resection surgery after upfront chemotherapy for patients treated for clinical stage I pancreatic adenocarcinoma. The authors used the National Cancer Database to identify eligible patients and a total of 17,495 patients were included. A total of 26.6% received upfront chemotherapy. Chemotherapy was most common in patients 80 years old or greater, had a T2 tumor, or were treated at a low-volume center. Only 33.5% of patients receiving upfront chemotherapy underwent subsequent resection. Resection was more likely in patients with T1 tumors or receiving treatment at a high-volume center. Rates of surgical resection after upfront chemotherapy are relatively low, but should be considered as part of an internal quality-of-cancer-care measure.
AHRQ-funded; HS023011; HS000078.
Citation: Ellis RJ, Ho JW, Schlick CJR .
National use of chemotherapy in initial management of stage I pancreatic cancer and failure to perform subsequent resection.
Ann Surg Oncol 2020 Mar;27(3):909-18. doi: 10.1245/s10434-019-08023-1..
Keywords: Cancer, Treatments, Surgery
Lee SJC, Hamann HA, Browning T
Stakeholder engagement to initiate lung cancer screening in an urban safety-net health system.
The authors sought to develop a population-based lung cancer screening program using low-dose computed tomography imaging at Parkland Health & Hospital System, Dallas County, Texas, providing coverage of uninsured patients through a combination of Medicare, Medicaid, and the Dallas medical assistance program for under- and uninsured, low-income county residents. They found that establishing a uniform clinical pathway connecting different clinical specialists requires a system-level view of care coordination to ensure that referrals trigger appointments, result reporting, and follow-up. Additionally, primary care providers need to educate and refer patients, address smoking cessation needs, and document shared decision-making counseling between the referring provider and the patient.
AHRQ-funded; HS022418.
Citation: Lee SJC, Hamann HA, Browning T .
Stakeholder engagement to initiate lung cancer screening in an urban safety-net health system.
Healthc 2020 Mar;8(1):100370. doi: 10.1016/j.hjdsi.2019.100370.
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Keywords: Cancer: Lung Cancer, Cancer, Screening, Prevention, Urban Health, Rural/Inner-City Residents
Kamal AH, Bausewein C, Casarett DJ
Standards, guidelines, and quality measures for successful specialty palliative care integration into oncology: current approaches and future directions.
This review paper discusses the need to integrate specialty palliative care into oncology and that there is robust evidence that it improves patient and health system outcomes. Three of the most cited standards/guidelines are discussed as well as quality measures related to integrated palliative and oncology care. They also recommend changes to the quality measurement framework for palliative care and a new way to match palliative care services to patients with advanced cancer.
AHRQ-funded; HS023681.
Citation: Kamal AH, Bausewein C, Casarett DJ .
Standards, guidelines, and quality measures for successful specialty palliative care integration into oncology: current approaches and future directions.
J Clin Oncol 2020 Mar 20;38(9):987-94. doi: 10.1200/jco.18.02440..
Keywords: Palliative Care, Cancer, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Evidence-Based Practice
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
Fakhri B, Fiala MA, Shah N
Measuring cardiopulmonary complications of carfilzomib treatment and associated risk factors using the SEER-Medicare database.
This study’s goal was to measure rates of cardiopulmonary complications from carfilzomib treatment in patients with recurrent myeloma. Myeloma case data was extracted from the SEER-Medicare linked database from 2000 to 2013, and corresponding claims through 2014. There were 635 patients identified as being treated with carfilzomib. Of these, median age was 72 years, 55% were male, and 79% were white. Median duration of treatment was 58 days. Overall, 66% of patients had codes identifying cardiac or pulmonary adverse events. Cardiac adverse events included hypertension, peripheral edema and heart failure. Pulmonary adverse events included dyspnea, cough, and pneumonia.
AHRQ-funded; HS019455.
Citation: Fakhri B, Fiala MA, Shah N .
Measuring cardiopulmonary complications of carfilzomib treatment and associated risk factors using the SEER-Medicare database.
Cancer 2020 Feb 15;128(4):808-13. doi: 10.1002/cncr.32601..
Keywords: Adverse Events, Medication, Cardiovascular Conditions, Risk, Cancer, Patient Safety
Mills J, Fakolade A
AHRQ Author: Mills J
Risk assessment, genetic counseling, and genetic testing for BRCA-related cancer.
In this case study, a 31-year-old woman presents for a well-woman examination. She indicates that her mother was diagnosed with tubal cancer at age 40, that her 42-year-old sister was recently diagnosed with breast cancer, and that her maternal aunt was diagnosed with breast cancer at age 45.
AHRQ-authored.
Citation: Mills J, Fakolade A .
Risk assessment, genetic counseling, and genetic testing for BRCA-related cancer.
Am Fam Physician 2020 Feb 15;101(4):239-40..
Keywords: U.S. Preventive Services Task Force (USPSTF), Cancer: Breast Cancer, Cancer, Genetics, Screening, Women, Prevention, Case Study
Takvorian SU, Oganisian A, Mamtani R
Association of Medicaid expansion under the Affordable Care Act with insurance status, cancer stage, and timely treatment among patients with breast, colon, and lung cancer.
The effect of the Patient Protection and Affordable Care Act's Medicaid expansion on cancer care delivery and outcomes is unknown. Patients with cancer are a high-risk group for whom treatment delays are particularly detrimental. The objective of this study was to examine the association between Medicaid expansion and changes in insurance status, stage at diagnosis, and timely treatment among patients with incident breast, colon, and non-small cell lung cancer.
AHRQ-funded; HS026116.
Citation: Takvorian SU, Oganisian A, Mamtani R .
Association of Medicaid expansion under the Affordable Care Act with insurance status, cancer stage, and timely treatment among patients with breast, colon, and lung cancer.
JAMA Netw Open 2020 Feb 5;3(2):e1921653. doi: 10.1001/jamanetworkopen.2019.21653.
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Keywords: Cancer: Breast Cancer, Cancer: Colorectal Cancer, Cancer: Lung Cancer, Cancer, Health Insurance, Medicaid, Policy, Health Services Research (HSR)
Murphy CC, Sen A, Watson B
A systematic review of repeat fecal occult blood tests for colorectal cancer screening.
This systematic review examined the prevalence of repeat fecal occult blood tests (FOBT) for colorectal cancer screening. MEDLINE, Embase, and the Cochrane Library were searched for studies published from 1997 to 2017 and reported repeat FOBT over 2 and more screening rounds. Thirty-five articles (n=27) were identified which measured repeat FOBT as 1) proportion of Round 1 participants completing repeat FOBT in Round 2; 2) proportion completing two, consecutive FOBTs; or 3) proportion completing 3 or more rounds. The number of participants completing Round 1 ranged from 24.6% to 89.6%. Those who completed Round 2 ranged from 16.4% to 80%; and completion of 3 or more rounds ranged from 0.8% to 64.1%. Repeat FOBT was higher in mailed outreach than opportunistic screening.
AHRQ-funded; HS022418.
Citation: Murphy CC, Sen A, Watson B .
A systematic review of repeat fecal occult blood tests for colorectal cancer screening.
Cancer Epidemiol Biomarkers Prev 2020 Feb;29(2):278-87. doi: 10.1158/1055-9965.Epi-19-0775..
Keywords: Cancer: Colorectal Cancer, Cancer, Screening, Diagnostic Safety and Quality, Prevention, Patient Adherence/Compliance, Patient-Centered Outcomes Research, Evidence-Based Practice
Gawron AJ, Shah SC, Altayar O
AGA technical review on gastric intestinal metaplasia-natural history and clinical outcomes.
This technical review from the American Gastroenterological Association (AGA) describes the natural history and clinical outcomes of gastric intestinal metaplasia (GIM) which can be a precursor to gastric cancer. A comprehensive systematic literature review was first conducted to provide guidance for formulating evidence-based recommendations on the management of GIM in the absence of concurrence neoplasia (dysplasia or cancer). The purpose of the literature review was to gather the evidence to determine what the best recommendations would be. A technical review team consisting of 1 GRADE methodologist, 3 gastroenterologists, 1 pathologist, and 2 gastroenterology fellows came to together to identify 4 questions using the PICO (population, intervention, comparator, and outcomes) format. H. pylori is sometimes concurrent with GIM and the first question is whether testing for it can affect patient-important outcomes. The other questions involve whether an upper endoscopy should be conducted depending on a patient’s risk. The systematic review process is described and out of a total of 3716 articles, 580 were reviewed, with 121 included in the meta-analyses. The panel was able to find evidence to inform the first 3 questions, but there was no direct evidence to inform PICO 4 so they used indirect evidence to reach a consensus. In general, they concluded H. pylori testing and treatment in patients with confirmed infection provided some protection against incident gastric cancer. However there was only indirect evidence to support use of an endoscopy in patients with GIM.
AHRQ-funded; HS026395.
Citation: Gawron AJ, Shah SC, Altayar O .
AGA technical review on gastric intestinal metaplasia-natural history and clinical outcomes.
Gastroenterology 2020 Feb;158(3):705-31.e5. doi: 10.1053/j.gastro.2019.12.001..
Keywords: Evidence-Based Practice, Cancer, Outcomes
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, Decision Making
Hu QL, Liu JB, Ellis RJ
Association of preoperative biliary drainage technique with postoperative outcomes among patients with resectable hepatobiliary malignancy.
Endoscopic biliary stenting (EBS) and percutaneous transhepatic biliary drainage (PTBD) are two techniques used for preoperative biliary drainage prior to hepatobiliary resection. The objectives of this study were to determine predictors of the drainage technique selection and to evaluate the association between drainage technique and postoperative outcomes. The investigators concluded that patients undergoing hepatobiliary resection selected for PTBD had significantly more preoperative co-morbidities and nutritional deficits. Compared to EBS, PTBD was associated with significantly higher odds of postoperative morbidity and mortality.
AHRQ-funded; HS026385; 233201500020I.
Citation: Hu QL, Liu JB, Ellis RJ .
Association of preoperative biliary drainage technique with postoperative outcomes among patients with resectable hepatobiliary malignancy.
HPB 2020 Feb;22(2):249-57. doi: 10.1016/j.hpb.2019.06.011..
Keywords: Cancer, Surgery, Adverse Events, Outcomes
Rohner E, Butikofer L, Schmidlin K
Cervical cancer risk in women living with HIV across four continents: a multicohort study.
In this study, the investigators compared invasive cervical cancer (ICC) incidence rates in Europe, South Africa, Latin and North America among women living with HIV who initiated antiretroviral therapy (ART) between 1996 and 2014. The investigators concluded that improving access to early ART initiation and effective cervical cancer screening in women living with HIV should be key parts of global efforts to reduce cancer-related health inequities.
AHRQ-funded; 90047713.
Citation: Rohner E, Butikofer L, Schmidlin K .
Cervical cancer risk in women living with HIV across four continents: a multicohort study.
Int J Cancer 2020 Feb;146(3):601-09. doi: 10.1002/ijc.32260..
Keywords: Cancer: Cervical Cancer, Cancer, Human Immunodeficiency Virus (HIV), Women, Medication, Chronic Conditions
Ellis RJ, Schlick CJR, Feinglass J
Failure to administer recommended chemotherapy: acceptable variation or cancer care quality blind spot?
This study examined hospital variation in cancer patients who did not receive recommended chemotherapy. Patients with breast, colon, and lung cancers who did not receive chemotherapy from 2000 to 2015 were identified from the National Cancer Database. A total of 183,148 patients at 1281 hospitals were included. For breast cancer, 3.5% of patients failed to receive recommended chemotherapy, and 6.6% with colon, and 10.7% with lung cancer. Sociodemographic factors showed that patients were less likely to receive chemotherapy if they were uninsured or on Medicaid, as were non-Hispanic black patients with both breast and colon cancer. There was also significant hospital variation with failure to administer as high as 21.8% for breast, 40.2% for colon, and 40.0% for lung cancer.
AHRQ-funded; HS000078; HS026385.
Citation: Ellis RJ, Schlick CJR, Feinglass J .
Failure to administer recommended chemotherapy: acceptable variation or cancer care quality blind spot?
BMJ Qual Saf 2020 Feb;29(2):103-12. doi: 10.1136/bmjqs-2019-009742..
Keywords: Treatments, Cancer, Healthcare Delivery, Access to Care, Healthcare Utilization, Social Determinants of Health, Vulnerable Populations, Uninsured, Hospitals, Quality of Care
Pabla BS, Shah SC, Corral JE
Increased incidence and mortality of gastric cancer in immigrant populations from high to low regions of incidence: a systematic review and meta-analysis.
Gastric cancer is the leading cause of infection-related cancer death and the third-leading cause of cancer death worldwide. The effect of immigration on gastric cancer risk is not well-defined but might be helpful for screening or surveillance endeavors. In this study, the authors performed a systematic review and meta-analysis to define the risk of gastric cancer in immigrants from high-incidence regions to low-incidence regions (including Western Europe, Australia, Brazil, Canada, Israel, and the United States).
AHRQ-funded; HS026395.
Citation: Pabla BS, Shah SC, Corral JE .
Increased incidence and mortality of gastric cancer in immigrant populations from high to low regions of incidence: a systematic review and meta-analysis.
Clin Gastroenterol Hepatol 2020 Feb;18(2):347-59.e5. doi: 10.1016/j.cgh.2019.05.032..
Keywords: Cancer, Digestive Disease and Health, Mortality
Cornell M, Kaderka R, Hild SJ
Noninferiority study of automated knowledge-based planning versus human-driven optimization across multiple disease sites.
This study compared fully automated knowledge-based planning (KBP) versus human-driven plan optimization for dosimetry treatment across multiple disease types. Treatment site clinical KBP automated planning routines were developed for prostate, prostatic fossa, hypofractionated lung, and head and neck locations. Overall, fully automated KBP was noninferior to human-driven plan optimization and for many sites showed superiority.
AHRQ-funded; HS025440.
Citation: Cornell M, Kaderka R, Hild SJ .
Noninferiority study of automated knowledge-based planning versus human-driven optimization across multiple disease sites.
Int J Radiat Oncol Biol Phys 2020 Feb;106(2):430-39. doi: 10.1016/j.ijrobp.2019.10.036..
Keywords: Cancer, Treatments
Oswald LB, Kasimer R, Rappazzo K
Patient expectations of benefit from systemic treatments for metastatic prostate cancer.
Metastatic prostate cancer is incurable, but systemic therapies can improve quality of life and prolong survival. Accurate perceptions of treatment risks and benefits are vital as patients with metastatic disease make treatment decisions. In this study, the investigators assessed treatment-related expectations for benefit among patients with metastatic prostate cancer and explored associated sociodemographic characteristics.
AHRQ-funded; HS022990.
Citation: Oswald LB, Kasimer R, Rappazzo K .
Patient expectations of benefit from systemic treatments for metastatic prostate cancer.
Cancer Med 2020 Feb;9(3):980-87. doi: 10.1002/cam4.2783..
Keywords: Cancer: Prostate Cancer, Cancer, Patient-Centered Outcomes Research
Lange JM, Laviana AA, Penson DF
Prostate cancer mortality and metastasis under different biopsy frequencies in North American active surveillance cohorts.
This study projected the comparative benefits of different active surveillance (AS) schedules in men diagnosed with prostate cancer who had Gleason score (GS) </=6 disease and risk profiles similar to those in North American AS cohorts. Results showed that, among men diagnosed with GS </=6 prostate cancer, obtaining a biopsy every 3 or 4 years appeared to be an acceptable alternative to more frequent biopsies. Reducing surveillance intensity for those who have a low risk of progression reduces the number of biopsies while preserving the benefit of more frequent schedules.
AHRQ-funded; HS022990.
Citation: Lange JM, Laviana AA, Penson DF .
Prostate cancer mortality and metastasis under different biopsy frequencies in North American active surveillance cohorts.
Cancer 2020 Feb 1;126(3):583-92. doi: 10.1002/cncr.32557..
Keywords: Cancer: Prostate Cancer, Cancer, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice, Men's Health
Acree ME, McNulty M, Blocker O
Shared decision-making around anal cancer screening among black bisexual and gay men in the USA.
This study focused on shared decision-making on anal cancer screening among black gay and bisexual men in the US. The researchers conducted 30 semi-structured one-on-one interviews and two focus groups in 2016-2017. Out of forty-five participants, all were black and male, with 13 identified as bisexual and 32 as gay. Barriers to screening include internalized racism, biphobia/homophobia, provider bias lead to reduced healthcare engagement and discomfort discussing sexual practices which hindered shared decision-making.
AHRQ-funded; HS023050.
Citation: Acree ME, McNulty M, Blocker O .
Shared decision-making around anal cancer screening among black bisexual and gay men in the USA.
Cult Health Sex 2020 Feb;22(2):201-16. doi: 10.1080/13691058.2019.1581897..
Keywords: Decision Making, Cancer, Screening, Prevention, Racial and Ethnic Minorities, Vulnerable Populations