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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 72 Research Studies DisplayedHenrikson NB, Ivlev I, Blasi PR
Skin cancer screening: updated evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this study was to investigate the advantages and potential risks of skin cancer screening to assist the decision-making of the US Preventive Services Task Force. The researchers utilized the data sources MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials, dated between June 1, 2015, and January 7, 2022. Two independent reviewers evaluated the articles and extracted pertinent data from studies of fair or good quality; the findings were summarized narratively. The primary outcomes and indicators were morbidity; mortality; stage, precursor lesions, or lesion thickness of skin cancer at detection; potential harms of screening. Twenty studies from 29 articles were included (N = 6,053,411). Direct evidence on the effectiveness of screening was obtained from 3 nonrandomized analyses of 2 population-based skin cancer screening initiatives in Germany (n = 1,791,615), indicating no significant reduction in melanoma mortality benefit at the population level over a period of 4 to 10 years of follow up activities. Six studies (n = 2,935,513) offered inconclusive evidence on the relationship between physician-conducted skin examination and lesion thickness or stage at diagnosis. Usual care vs. routine physician-conducted skin examination was not associated with increased detection of skin cancer or precursor lesions (5 studies) or stage at melanoma detection (3 studies). The correlation between physician-conducted skin examination and lesion thickness at detection was inconsistent (3 studies). Nine studies (n = 1 326 051) found a consistent positive association between more advanced stage at melanoma detection and increasing risk of melanoma-associated and all-cause mortality. Two studies (n = 232) found negligible enduring cosmetic or psychosocial harms related to screening.
AHRQ-funded; 75Q80120D00004.
Citation: Henrikson NB, Ivlev I, Blasi PR .
Skin cancer screening: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2023 Apr 18; 329(15):1296-307. doi: 10.1001/jama.2023.3262..
Keywords: U.S. Preventive Services Task Force (USPSTF), Cancer: Skin Cancer, Cancer, Screening, Prevention, Evidence-Based Practice, Guidelines
JE Wallis, CJD Huang, LC
Association between adherence to radiation therapy quality metrics and patient reported outcomes in prostate cancer.
Researchers evaluated the impact of compliance with nationally recognized radiation therapy quality measures on patient-reported health-related quality of life outcomes in the Comparative Effectiveness Analysis of Surgery and Radiation (CEASAR) population-based, prospective cohort study of men with localized prostate cancer. Eight quality measures were identified based on national guidelines. In multivariable analyses, no clinically significant associations were discovered between compliance with evaluated radiation therapy quality measures and patient-reported outcomes such as urinary irritation, urinary incontinence, bowel, sexual or hormonal function. The researchers concluded that further work would be needed to identify patient-centered quality measures of prostate cancer care.
AHRQ-funded; HS019356.
Citation: JE Wallis, CJD Huang, LC .
Association between adherence to radiation therapy quality metrics and patient reported outcomes in prostate cancer.
Prostate Cancer Prostatic Dis 2023 Mar;26(1):80-87. doi: 10.1038/s41391-022-00518-5.
Keywords: Cancer: Prostate Cancer, Cancer, Patient-Centered Outcomes Research, Evidence-Based Practice, Quality Measures
Miyashita M, Balogun OB, Olopade OI
The optimization of postoperative radiotherapy in de novo stage IV breast cancer: evidence from real-world data to personalize treatment decisions.
The purpose of this study was to investigate the survival benefit of radiotherapy in de novo stage IV breast cancer. Data were taken from the National Cancer DataBase on Stage IV breast cancer patients who received breast surgery and had survived 12 months after diagnosis. Radiotherapy was found to be associated with improved survival in patients with bone or lung metastasis but not patients with liver or brain metastasis. It was also associated with improved survival in patients with one or two metastatic sites but not three or more. Survival impact did not differ among subtypes. The authors concluded that these “real-world data” show that postoperative radiotherapy might improve overall survival for de novo Stage IV breast cancer with bone or lung metastasis, regardless of subtypes.
AHRQ-funded; HS025806.
Citation: Miyashita M, Balogun OB, Olopade OI .
The optimization of postoperative radiotherapy in de novo stage IV breast cancer: evidence from real-world data to personalize treatment decisions.
Sci Rep 2023 Feb 18; 13(1):2880. doi: 10.1038/s41598-023-29888-z..
Keywords: Cancer: Breast Cancer, Cancer, Evidence-Based Practice, Women
Strayer TE, Spalluto LB, Burns A
Using the framework for reporting adaptations and modifications-expanded (frame) to study adaptations in lung cancer screening delivery in the Veterans Health Administration: a cohort study.
The purpose of this study was to apply the Framework for Reporting Adaptations and Modifications-Expanded (FRAME) to study adaptations in lung cancer screening delivery processes in a Veterans Health Administration (VHA) Initiative. Between 2019 and 2021 the researchers prospectively administered semi-structured interviews with lung cancer screening program navigators at 10 Veterans Affairs Medical Centers (VAMCs). Baseline process maps were developed for each program, and each program navigator reviewed process maps in subsequent years 1 and 2. Researchers then identified, documented, and mapped adaptations in screening processes to the FRAME categories. 16 interviews were conducted across 10 VHA lung cancer screening programs, with 6 of these being operational, and of those 3 reported adaptations to their screening processes that were planned or in response to COVID-19. In year 2 all 10 programs were operational and eligible. Programs reported 14 adaptations in year 2. The adaptations identified were both planned and unplanned and often prompted by increased workload; 57% of year 2 adaptations were associated with the identification and eligibility of Veterans and 43% were associated with follow-up with Veterans for screening results. During the 2 years, adaptations associated with data management and patient tracking took place in 60% of programs to improve the data collection and tracking of Veterans in the screening process. The study concluded that adaptations took place predominantly in the categories of patient identification and communication of results due to increased workload.
AHRQ-funded; HS026122; HS026395.
Citation: Strayer TE, Spalluto LB, Burns A .
Using the framework for reporting adaptations and modifications-expanded (frame) to study adaptations in lung cancer screening delivery in the Veterans Health Administration: a cohort study.
Implement Sci Commun 2023 Jan 12; 4(1):5. doi: 10.1186/s43058-022-00388-x..
Keywords: Cancer: Lung Cancer, Cancer, Screening, Evidence-Based Practice, Learning Health Systems
Kim HS, Hernaez R, Sansgiry S
Comparative effectiveness of surveillance colonoscopy intervals on colorectal cancer outcomes in a national cohort of patients with inflammatory bowel disease.
The purpose of this study was to determine the comparative effectiveness of varying colonoscopy intervals on colorectal cancer (CRC) outcomes among patients with inflammatory bowel disease (IBD). Data was from the National Veterans Health Administration. Findings showed that, in a national cohort of patients with CRC-IBD, colonoscopy within 3 years prior to CRC diagnosis was associated with early tumor stage at diagnosis, and colonoscopy within 1 year was associated with a reduced all-cause mortality compared with no colonoscopy, supporting colonoscopy intervals of 1 to 3 years in patients with IBD in order to reduce late-stage CRC and all-cause mortality.
AHRQ-funded; HS024122.
Citation: Kim HS, Hernaez R, Sansgiry S .
Comparative effectiveness of surveillance colonoscopy intervals on colorectal cancer outcomes in a national cohort of patients with inflammatory bowel disease.
Clin Gastroenterol Hepatol 2022 Dec;20(12):2848-57.e2. doi: 10.1016/j.cgh.2022.02.048..
Keywords: Cancer: Colorectal Cancer, Cancer, Digestive Disease and Health, Imaging, Screening, Comparative Effectiveness, Evidence-Based Practice, Patient-Centered Outcomes Research
De B, Pasalic D, Barocas DA
Patient-reported outcomes after external beam radiotherapy with low dose rate brachytherapy boost vs radical prostatectomy for localized prostate cancer: five-year results from a prospective comparative effectiveness study.
The purpose of this study was to compare patient reported outcomes through 5 years following radical prostatectomy or external beam radiation therapy with low dose rate brachytherapy boost for localized prostate cancer. The researchers enrolled men 80 years of age or under who had localized prostate adenocarcinoma and followed them longitudinally from 2011 to 2012. The study found that when compared with radical prostatectomy, external beam radiation therapy with low dose rate brachytherapy boost was related with clinically meaningful worse urinary irritative/obstructive and better urinary incontinence function through 5 years. Urinary function bother was similar between groups. Treatment with external beam radiation therapy with low dose rate brachytherapy boost was associated with worse bowel function through 5 years compared to radical prostatectomy. Treatment with external beam radiation therapy with low dose rate brachytherapy boost was associated with better sexual function at 1 year compared to radical prostatectomy, but there was insufficient evidence to reject the supposition that no difference was seen at 3 or 5 years. The researcher concluded that external beam radiation therapy with low dose rate brachytherapy boost was related with clinically meaningful worse urinary irritative/obstructive and bowel functions but better urinary incontinence function through 5 years after treatment compared to radical prostatectomy.
AHRQ-funded; HS019356; HS022640.
Citation: De B, Pasalic D, Barocas DA .
Patient-reported outcomes after external beam radiotherapy with low dose rate brachytherapy boost vs radical prostatectomy for localized prostate cancer: five-year results from a prospective comparative effectiveness study.
J Urol 2022 Dec;208(6):1226-39. doi: 10.1097/ju.0000000000002902..
Keywords: Cancer: Prostate Cancer, Cancer, Comparative Effectiveness, Evidence-Based Practice, Patient-Centered Outcomes Research, Treatments
Tracer H, Justus M
Vitamin, mineral, and multivitamin supplementation to prevent cardiovascular disease and cancer.
This Putting Prevention into Practice case study is used to increase understanding of the USPSTF final recommendation on vitamin, mineral, and multivitamin supplementation to prevent cardiovascular disease and cancer. A case study was presented using a 53-year-old-patient with no significant history presenting for a wellness visit. The patient’s 10-year cardiovascular risk and BMI are described. Three multiple-choice questions are presented regarding harms and benefits, and recommendations not to use supplementation to prevent cardiovascular disease and cancer.
AHRQ-authored.
Citation: Tracer H, Justus M .
Vitamin, mineral, and multivitamin supplementation to prevent cardiovascular disease and cancer.
Am Fam Physician 2022 Nov;106(5):565-66..
Keywords: U.S. Preventive Services Task Force (USPSTF), Cardiovascular Conditions, Cancer, Vitamins and Supplements, Prevention, Evidence-Based Practice, Guidelines
Adhia AH, Feinglass JM, Schlick CJR
Hospital volume predicts guideline-concordant care in stage III esophageal cancer.
This study developed quality measures for management of stage III esophageal cancer including: utilization of neoadjuvant therapy, surgical sampling of at least 15 lymph nodes, resection within 60 days of chemotherapy or radiation, and completeness of resection to determine whether hospital volume varies measure adherence of published guidelines. A total of 1345 hospitals participating in the National Cancer Database from 2004 to 2016 were included. The authors examined association of volume, program accreditation, safety net status, geographic region, and patient travel distance on adequate adherence (≥85% of patients are adherent) using logistic regression modeling. The rate of adequate adherence was worst in nodal staging at 12.6% and highest for utilization of neoadjuvant therapy at 84.8%. Academic programs had the highest rate of adequate adherence for induction therapy (77.2%), timing of surgery (56.6%), and completeness of resection (78.5%) but lowest for nodal staging at only 4.4%. Every additional esophagectomy performed per year increased the odds of adequate adherence for induction therapy and completeness of resection but decreased for nodal staging.
AHRQ-funded; HS026385.
Citation: Adhia AH, Feinglass JM, Schlick CJR .
Hospital volume predicts guideline-concordant care in stage III esophageal cancer.
Ann Thorac Surg 2022 Oct;114(4):1176-82. doi: 10.1016/j.athoracsur.2021.07.092..
Keywords: Hospitals, Cancer, Guidelines, Evidence-Based Practice
Gupta N, Patel HD, Taylor J
Systematic review of the impact of a plant-based diet on prostate cancer incidence and outcomes.
The objective of this study was to perform a systematic review of plant-based diets and prostate cancer. Findings showed that interventional studies displayed generally favorable results of lifestyle modifications incorporating a plant-based diet with prostate cancer outcomes as well as improvements in nutrition and general health. Further, observational studies demonstrated either a lower risk of prostate cancer or no significant difference.
AHRQ-funded; HS026120.
Citation: Gupta N, Patel HD, Taylor J .
Systematic review of the impact of a plant-based diet on prostate cancer incidence and outcomes.
Prostate Cancer Prostatic Dis 2022 Sep;25(3):444-52. doi: 10.1038/s41391-022-00553-2..
Keywords: Cancer: Prostate Cancer, Cancer, Evidence-Based Practice, Nutrition, Outcomes
O'Connor EA, Evans CV, Ivlev I
Vitamin and mineral supplements for the primary prevention of cardiovascular disease and cancer: updated evidence report and systematic review for the US Preventive Services Task Force.
This evidence report and systematic review updated the 2013 USPSTF final recommendation to assess benefits and harms of using vitamin and mineral supplements for the primary prevention of cardiovascular disease and cancer. After an extensive literature review, 84 studies were included. While multivitamin use was significantly associated with a lower incidence of any cancer and lung cancer, the evidence had serious limitations. Beta carotene was significantly associated with an increased risk of lung cancer and cardiovascular mortality. Vitamins D and E were not significantly associated with all-cause mortality, cardiovascular disease events, or cancer incidence. Evidence for the benefit of other supplements was equivocal, minimal, or absent. There was limited evidence that suggested some supplements may be associated with higher risk of serious harms (hip fracture [vitamin A], hemorrhagic stroke [vitamin E], and kidney stones [vitamin C, calcium]).
AHRQ-funded; 290201500007I.
Citation: O'Connor EA, Evans CV, Ivlev I .
Vitamin and mineral supplements for the primary prevention of cardiovascular disease and cancer: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2022 Jun 21;327(23):2334-47. doi: 10.1001/jama.2021.15650..
Keywords: U.S. Preventive Services Task Force (USPSTF), Vitamins and Supplements, Cardiovascular Conditions, Cancer, Prevention, Evidence-Based Practice
Loo S, Mullikin K, Robbins C
Patient navigator team perceptions on the implementation of a citywide breast cancer patient navigation protocol: a qualitative study.
This study’s goal was to assess the implementation of the 2018 Translating Research Into Practice (TRIP), an evidence-based patient navigation intervention aimed at addressing breast cancer care disparities, across six Boston hospitals. Patient navigator team member perspectives regarding implementation barriers and facilitators one-year post-study implementation were assessed. Seventeen interviews were conducted with patient navigators, patient navigator supervisors, and designated clinical champions. The following benefits were identified by participants: 1) increased networking and connections for navigators across clinical sites (Cosmopolitanism), 2) formalization of the patient navigation process (Goals and Purpose, Access to Knowledge and Information, and Relative Advantage), and 3) flexibility within the TRIP intervention that allowed for diversity in implementation and use of TRIP components across sites (Adaptability). Barriers included documentation requirements and the structured patient follow up guidelines that did not always align with the timeline of existing site navigation processes.
AHRQ-funded; HS022242.
Citation: Loo S, Mullikin K, Robbins C .
Patient navigator team perceptions on the implementation of a citywide breast cancer patient navigation protocol: a qualitative study.
BMC Health Serv Res 2022 May 21;22(1):683. doi: 10.1186/s12913-022-08090-3..
Keywords: Patient-Centered Healthcare, Cancer: Breast Cancer, Cancer, Patient-Centered Outcomes Research, Evidence-Based Practice
Guirguis-Blake JM, Evans CV, Perdue LA
Aspirin use to prevent cardiovascular disease and colorectal cancer: updated evidence report and systematic review for the US Preventive Services Task Force.
This evidence summary reviewed the benefits and harms of aspirin in primary cardiovascular disease (CVD) and colorectal cancer (CRC) prevention to accompany the final recommendation and evidence review of the US Preventive Services Task Force. A literature review was conducted of English-language randomized clinical trials (RCTs) of low-dose aspirin compared with placebo or no intervention in primary prevention populations. Aspirin was found not to be significantly associated with reductions in CVD mortality or all-cause mortality. There was limited trial evidence on benefits for CRC, with the findings highly variable by length of follow-up and statistically significant only when considering long-term observational follow-up beyond randomized trial periods. Low-dose aspirin was associated with significant increases in total major bleeding and in site-specific bleeding.
AHRQ-funded; 290201500007I.
Citation: Guirguis-Blake JM, Evans CV, Perdue LA .
Aspirin use to prevent cardiovascular disease and colorectal cancer: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2022 Apr 26;327(16):1585-97. doi: 10.1001/jama.2022.3337..
Keywords: U.S. Preventive Services Task Force (USPSTF), Cardiovascular Conditions, Cancer: Colorectal Cancer, Cancer, Prevention, Evidence-Based Practice
Dehmer SP, O'Keefe LR, Evans CV
Aspirin use to prevent cardiovascular disease and colorectal cancer: updated modeling study for the US Preventive Services Task Force.
The purpose of the study was to develop, model, and report estimates of the harms from and benefits of the use of low-dose aspirin for the prevention of cardiovascular disease (CVD) and colorectal cancer (CRC.) The researchers developed and used a simulation model to provide estimates for hypothetical United States cohorts of men and women between the ages of forty and seventy-nine years without a previous history of elevated bleeding risks or CVD, and up to a 20% 10-year risk for a CVD event. The model focused on the routine, lifetime use of low-dose aspirin with 5-year intervals of no use between 65 and 85 years of age. The study’s primary outcome was lifetime net benefit which was measured in life-years and quality-adjusted life-years (QALYs.) Harms included an increase in nonfatal intracranial hemorrhage and gastrointestinal bleeding, and benefits included a reduction in nonfatal ischemic stroke and myocardial infarction. The study found that the estimated lifetime net quality-adjusted life-years was positive for men and women with 5% or more 10-year CVD risk when they started use between the ages of 40-59 years, and for men and women with 10% or greater 10-year CVD risk when starting between the ages of 60 and 69 years. The estimated lifetime net life-years were mostly negative for those starting low-dose aspirin use between 60 and 79 years of age. Five-year intervals of stopping use between 65 and 85 years of age did not provide a significant advantage to lifetime use. The researchers concluded that the routine, lifetime use of low-dose aspirin may benefit several population groups, with the largest estimated benefit in those with greater 10-year CVD risk who begin routine, low-dose aspirin dosage at younger ages.
AHRQ-funded; 290201500007I.
Citation: Dehmer SP, O'Keefe LR, Evans CV .
Aspirin use to prevent cardiovascular disease and colorectal cancer: updated modeling study for the US Preventive Services Task Force.
JAMA 2022 Apr 26;327(16):1598-607. doi: 10.1001/jama.2022.3385..
Keywords: U.S. Preventive Services Task Force (USPSTF), Prevention, Cardiovascular Conditions, Cancer: Colorectal Cancer, Cancer, Prevention, Evidence-Based Practice
Brajcich BC, Benson AB, Gantt G
Management of colorectal cancer during the COVID-19 pandemic: recommendations from a statewide multidisciplinary cancer collaborative.
J Surg Oncol 2022 Mar;125(4):560-63. doi: 10.1002/jso.26758.
AHRQ-funded; HS026385.
Citation: Brajcich BC, Benson AB, Gantt G .
Management of colorectal cancer during the COVID-19 pandemic: recommendations from a statewide multidisciplinary cancer collaborative.
J Surg Oncol 2022 Mar;125(4):560-63. doi: 10.1002/jso.26758..
Keywords: COVID-19, Cancer: Colorectal Cancer, Cancer, Guidelines, Evidence-Based Practice, Healthcare Delivery
Wallis CJD, Huang LC, Zhao Z
Association between pelvic nodal radiotherapy and patient-reported functional outcomes through 5 years among men undergoing external-beam radiotherapy for prostate cancer: an assessment of the Comparative Effectiveness Analysis of Surgery and Radiation (C
In this study, the investigators sought to compare functional outcomes for men receiving prostate and pelvic versus prostate-only radiotherapy, longitudinally over 5 years. The investigators concluded that there were no clinically important differences in disease-specific or general health-related quality of life with the addition of pelvic irradiation to prostate radiotherapy, supporting the use of pelvic radiotherapy when it may be of clinical benefit, such as men with increased risk of nodal involvement.
AHRQ-funded; HS022640; HS019356.
Citation: Wallis CJD, Huang LC, Zhao Z .
Association between pelvic nodal radiotherapy and patient-reported functional outcomes through 5 years among men undergoing external-beam radiotherapy for prostate cancer: an assessment of the Comparative Effectiveness Analysis of Surgery and Radiation (C
Urol Oncol 2022 Feb;40(2):56.e1-56.e8. doi: 10.1016/j.urolonc.2021.04.035..
Keywords: Cancer: Prostate Cancer, Cancer, Men's Health, Comparative Effectiveness, Outcomes, Evidence-Based Practice, Patient-Centered Outcomes Research, Quality of Life
Popp J, Weinberg DS, Ems E
Reevaluating the evidence for intensive postoperative extracolonic surveillance for nonmetastatic colorectal cancer.
This study reevaluated the evidence for intensive postoperative extracolonic surveillance for nonmetastatic colorectal cancer. The authors looked at the FACS, GILDA, and COLOFOL trials and used a model to predict the large-sample mortality reduction expected for each trial and the implied statistical power. An investigation was done of a potential recurrence imbalance in the FACS trial. The model predicted a mortality reduction of ≤5% and power of <10% for all 3 trials. The FACS recurrence imbalance most likely led to a large relative bias (>2.5) in the hazard ratio for overall survival favoring control. After adjustment, both COLOFOL and FACS results were consistent with model predictions. A 2.6 and 3.6 month increase in life expectancy is predicted comparing intensive extracolonic surveillance-routine computed tomography scans and carcinoembryonic antigen assays with 1 computed tomography scan at 12 months or no surveillance, respectively. A larger trial that would randomize at least 200 to 300 patients is needed, but is not feasible at this time. The authors concluded recent trial results do not warrant de novo skepticism or metastasectomy nor targeted extracolonic surveillance.
AHRQ-funded; HS022998.
Citation: Popp J, Weinberg DS, Ems E .
Reevaluating the evidence for intensive postoperative extracolonic surveillance for nonmetastatic colorectal cancer.
Value Health 2022 Jan; 25(1):36-46. doi: 10.1016/j.jval.2021.07.017..
Keywords: Cancer: Colorectal Cancer, Cancer, Surgery, Evidence-Based Practice
Kwee Wong, LL Sato, MM
Transarterial radioembolization for hepatocellular carcinoma with major vascular invasion: a nationwide propensity score-matched analysis with target trial emulation.
This study’s objective was to compare overall survival (OS) rates for hepatocellular carcinoma (HCC) with major vascular invasion (HCC-MVI) for patients undergoing either transarterial radioembolization (TARE) or systemic therapy. The National Cancer Database was used to identify 1,514 patients with HCC-MVI. TARE use had doubled between 2010 and 2015. OS was compared for the two treatments and TARE was found to be associated with significant survival benefits compared with systemic therapy.
AHRQ-funded; HS023185.
Citation: Kwee Wong, LL Sato, MM .
Transarterial radioembolization for hepatocellular carcinoma with major vascular invasion: a nationwide propensity score-matched analysis with target trial emulation.
J Vasc Interv Radiol 2021 Sep;32(9):1258-66.e6. doi: 10.1016/j.jvir.2021.07.001..
Keywords: Cancer, Outcomes, Patient-Centered Outcomes Research, Evidence-Based Practice
Garsa A, Jang JK, Baxi S
Radiation therapy for brain metastases: a systematic review.
This systematic review synthesizes the available evidence on radiation therapy for brain metastases. A literature search was conducted using the major medical databases and included randomized controlled trials and large observational studies which evaluated whole brain radiation therapy (WBRT) and stereotactic radiosurgery (SRS) alone or in combination as initial or postoperative treatment, with or without systemic therapy for adults with brain metastases due to lung cancer, breast cancer, or melanoma. No statistically significant difference in overall survival was found with a combination of SRS plus WBRT compared with SRS alone or WBRT alone. Radiation therapy after surgery did not improve overall survival compared with surgery alone. WBRT plus systemic therapy was associated with increased risks for vomiting compared with WBRT alone. There was not enough data on patient-relevant outcomes such as quality of life, functional status, and cognitive effects.
AHRQ-funded; 290201500010I.
Citation: Garsa A, Jang JK, Baxi S .
Radiation therapy for brain metastases: a systematic review.
Pract Radiat Oncol 2021 Sep-Oct;11(5):354-65. doi: 10.1016/j.prro.2021.04.002..
Keywords: Cancer, Surgery, Treatments, Patient-Centered Outcomes Research, Evidence-Based Practice
Fan T, Stefanos R
Screening for colorectal cancer.
This AHRQ-authored Putting Preventions in Practice quiz has three questions and answers on the US Preventive Services Task Force final recommendation on screening for colorectal cancer. A case study is presented with questions on the best behavioral interventions, the effect of a patient’s age on the counseling approach, and what is an appropriate test and interval for colorectal screening. References are also provided at the end of the answers.
AHRQ-authored.
Citation: Fan T, Stefanos R .
Screening for colorectal cancer.
Am Fam Physician 2021 Sep 1;104(3):295-96..
Keywords: U.S. Preventive Services Task Force (USPSTF), Cancer: Colorectal Cancer, Cancer, Screening, Prevention, Guidelines, Evidence-Based Practice, Case Study
Tracer H, Pierre J
Screening for lung cancer.
This paper is part of the “Putting Prevention into Practice” series. It provides an evidence-based case study related to lung cancer screening. Questions and answers related to the case are included.
AHRQ-authored.
Citation: Tracer H, Pierre J .
Screening for lung cancer.
Am Fam Physician 2021 Jul 1;104(1):79-80..
Keywords: U.S. Preventive Services Task Force (USPSTF), Cancer: Lung Cancer, Cancer, Screening, Prevention, Case Study, Evidence-Based Practice
Pasalic D, Barocas DA, Huang LC
Five-year outcomes from a prospective comparative effectiveness study evaluating external-beam radiotherapy with or without low-dose-rate brachytherapy boost for localized prostate cancer.
This retrospective cohort study’s objective was to determine if there were differences in treatment-related regret or survival between prostate cancer patients who received external-beam radiation therapy (EBRT) with or without a brachytherapy boost (EBRT-LDR), over a 5-year period. The cohort included 695 men who met inclusion criteria and received either EBRT (n=583) or EBRT-LDR (n=112). Men who received either treatment reported clinically worse urinary irritation and bowel function through 3 years but resolved after 5 years. Men who received EBRT-LDR continued to report moderate- to-big problems with urinary function bother and frequent urination at 5 years. There was no difference in treatment-related regret or survival between patients who received either treatment.
AHRQ-funded; HS019356; HS022640.
Citation: Pasalic D, Barocas DA, Huang LC .
Five-year outcomes from a prospective comparative effectiveness study evaluating external-beam radiotherapy with or without low-dose-rate brachytherapy boost for localized prostate cancer.
Cancer 2021 Jun 1;127(11):1912-25. doi: 10.1002/cncr.33388..
Keywords: Cancer: Prostate Cancer, Cancer, Comparative Effectiveness, Evidence-Based Practice, Outcomes, Patient-Centered Outcomes Research, Treatments
Brajcic BC, Ko CY, Liu JB
A NSQIP-based randomized clinical trial evaluating choice of prophylactic antibiotics for pancreaticoduodenectomy.
This paper describes the protocol for an upcoming multicenter randomized surgical trial to evaluate choice of prophylactic antibiotics for pancreaticoduodenectomy. The rationale and methodology of the trial evaluating piperacillin-tazobactam compared to cefoxitin for surgical site infection prevention is described. The study will utilize a clinical registry for data collection.
AHRQ-funded; HS000078.
Citation: Brajcic BC, Ko CY, Liu JB .
A NSQIP-based randomized clinical trial evaluating choice of prophylactic antibiotics for pancreaticoduodenectomy.
J Surg Oncol 2021 May;123(6):1387-94. doi: 10.1002/jso.26402..
Keywords: Cancer, Antibiotics, Medication, Prevention, Surgery, Healthcare-Associated Infections (HAIs), Comparative Effectiveness, Evidence-Based Practice
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
Chan H, Zhang L, Choti MA
Recurrence patterns after surgical resection of gastroenteropancreatic neuroendocrine tumors: analysis from the national comprehensive cancer network oncology outcomes database.
Current National Comprehensive Cancer Network guidelines for gastroenteropancreatic neuroendocrine tumors (GEPNETs) recommend complete (R0) surgical resection of the primary tumor and metastases, if feasible. This study conducted large multicenter studies of recurrence patterns of GEPNETs after resection. Findings showed that R0 resection was associated with variable risk of recurrence across subtypes. Recommendations included further research to inform refinement of guidelines for the appropriate duration of surveillance after R0 resection.
AHRQ-funded; HS021700.
Citation: Chan H, Zhang L, Choti MA .
Recurrence patterns after surgical resection of gastroenteropancreatic neuroendocrine tumors: analysis from the national comprehensive cancer network oncology outcomes database.
Pancreas 2021 Apr;50(4):506-12. doi: 10.1097/mpa.0000000000001791..
Keywords: Cancer, Surgery, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes
Wilt TJ, Ullman KE, Linskens EJ
Therapies for clinically localized prostate cancer: a comparative effectiveness review.
In this study, the investigators sought to identify new information evaluating clinically localized prostate cancer therapies. The investigators concluded that radical prostatectomy reduced mortality vs watchful waiting in clinically detected localized prostate cancer but caused more harms. Effectiveness may be limited to younger men and those with intermediate risk disease. Active monitoring resulted in little to no mortality difference vs radical prostatectomy or external beam radiation plus androgen deprivation.
AHRQ-funded; 290201500008I.
Citation: Wilt TJ, Ullman KE, Linskens EJ .
Therapies for clinically localized prostate cancer: a comparative effectiveness review.
J Urol 2021 Apr;205(4):967-76. doi: 10.1097/ju.0000000000001578..
Keywords: Cancer: Prostate Cancer, Cancer, Comparative Effectiveness, Evidence-Based Practice, Patient-Centered Outcomes Research, Men's Health
