Background and objectives: This study examines the long-term quality of life (QOL) and priorities of survivors who underwent management for esophageal cancer (EC).
Methods: We cross-sectionally surveyed EC patients through online support groups to assess the relative importance of their overall survival, experience, costs of care, and QOL. Kendall's co-efficient of Concordance (W) was utilized to assess agreement among respondents.
Results: Among 100 respondents (age 57.2 ± 10.4 years, 54% male, 90% Caucasian), median overall survival was 18.0 (7.8-49.8) months, with a maximum survivorship of 48.3 years. Respondents ranked overall survival most important, followed by functional independence, emotional well-being, treatment experience, and costs of care (W = 0.342, p < 0.001). Some survivors ranked treatment experience (4%) or costs (6%) as their most important priority. The cohort's physical QOL (P-QOL; 39.79 ± 10.16) and mental QOL (M-QOL; 42.29 ± 15.43) were below that of the general population (50.00 ± 10.00); both p < 0.050. There was no difference in P-QOL and M-QOL based on the presence of metastatic disease (both p > 0.050). Patients who underwent curative surgery had superior M-QOL (45.00 ± 15.22 vs. 36.70 ± 14.53, p = 0.010). Although P-QOL was similar based on duration of survival (40.30 ± 9.75 [< 1 year], 39.33 ± 10.52 [1-5 years], 39.81 ± 10.68 [> 5 years], p = 0.873), M-QOL was higher in patients with extended survivorship (36.87 ± 14.24 [< 1 year], 45.05 ± 14.94 [1-5 years], 47.30 ± 16.36 [> 5 years], p = 0.008).
Conclusions: Despite enduring physical health impairments, a majority of EC survivors prioritized their survival. However, a few survivors prioritized costs and treatment experience, underscoring the importance of tailoring treatments to ensure alignment with individual patient-driven priorities.
{"title":"Long-Term Quality of Life and Survivorship Priorities in Esophageal Cancer Patients: A Survey-Based Assessment.","authors":"Edward A Joseph, Casey J Allen","doi":"10.1002/jso.28045","DOIUrl":"https://doi.org/10.1002/jso.28045","url":null,"abstract":"<p><strong>Background and objectives: </strong>This study examines the long-term quality of life (QOL) and priorities of survivors who underwent management for esophageal cancer (EC).</p><p><strong>Methods: </strong>We cross-sectionally surveyed EC patients through online support groups to assess the relative importance of their overall survival, experience, costs of care, and QOL. Kendall's co-efficient of Concordance (W) was utilized to assess agreement among respondents.</p><p><strong>Results: </strong>Among 100 respondents (age 57.2 ± 10.4 years, 54% male, 90% Caucasian), median overall survival was 18.0 (7.8-49.8) months, with a maximum survivorship of 48.3 years. Respondents ranked overall survival most important, followed by functional independence, emotional well-being, treatment experience, and costs of care (W = 0.342, p < 0.001). Some survivors ranked treatment experience (4%) or costs (6%) as their most important priority. The cohort's physical QOL (P-QOL; 39.79 ± 10.16) and mental QOL (M-QOL; 42.29 ± 15.43) were below that of the general population (50.00 ± 10.00); both p < 0.050. There was no difference in P-QOL and M-QOL based on the presence of metastatic disease (both p > 0.050). Patients who underwent curative surgery had superior M-QOL (45.00 ± 15.22 vs. 36.70 ± 14.53, p = 0.010). Although P-QOL was similar based on duration of survival (40.30 ± 9.75 [< 1 year], 39.33 ± 10.52 [1-5 years], 39.81 ± 10.68 [> 5 years], p = 0.873), M-QOL was higher in patients with extended survivorship (36.87 ± 14.24 [< 1 year], 45.05 ± 14.94 [1-5 years], 47.30 ± 16.36 [> 5 years], p = 0.008).</p><p><strong>Conclusions: </strong>Despite enduring physical health impairments, a majority of EC survivors prioritized their survival. However, a few survivors prioritized costs and treatment experience, underscoring the importance of tailoring treatments to ensure alignment with individual patient-driven priorities.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Eliel N Arrey, Darren GoPaul, David Anderson, Joel Okoli, Tamra McKenzie-Johnson
This article addresses the persistent disparities in breast cancer outcomes across different racial, ethnic, and socioeconomic groups despite advancements in diagnosis and treatment. The disparities are rooted in various factors, including access to care, socioeconomic status, and cultural barriers. The article emphasizes the need for targeted interventions, such as expanding insurance coverage, mobile mammography units, and culturally tailored outreach programs to promote health equity. Achieving this requires comprehensive strategies addressing systemic and social determinants of health.
本文论述了尽管诊断和治疗方面取得了进步,但不同种族、民族和社会经济群体在乳腺癌治疗效果方面仍然存在差距。这些差异源于各种因素,包括获得治疗的机会、社会经济地位和文化障碍。文章强调,有必要采取有针对性的干预措施,如扩大保险覆盖面、设立流动乳腺 X 光检查站、开展针对不同文化背景的外展项目等,以促进健康公平。要做到这一点,需要采取综合战略,解决系统性和社会性的健康决定因素。
{"title":"Addressing Breast Cancer Disparities: A Comprehensive Approach to Health Equity.","authors":"Eliel N Arrey, Darren GoPaul, David Anderson, Joel Okoli, Tamra McKenzie-Johnson","doi":"10.1002/jso.28011","DOIUrl":"https://doi.org/10.1002/jso.28011","url":null,"abstract":"<p><p>This article addresses the persistent disparities in breast cancer outcomes across different racial, ethnic, and socioeconomic groups despite advancements in diagnosis and treatment. The disparities are rooted in various factors, including access to care, socioeconomic status, and cultural barriers. The article emphasizes the need for targeted interventions, such as expanding insurance coverage, mobile mammography units, and culturally tailored outreach programs to promote health equity. Achieving this requires comprehensive strategies addressing systemic and social determinants of health.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alice Zhu, Ekaterina Kosyachkova, Teresa Tiano, Natalie G Coburn
{"title":"Letter to the Editor: Reporting of Core Outcomes in Gastric Cancer Surgical Trials Over the Past 25 Years (Systematic Review).","authors":"Alice Zhu, Ekaterina Kosyachkova, Teresa Tiano, Natalie G Coburn","doi":"10.1002/jso.28057","DOIUrl":"https://doi.org/10.1002/jso.28057","url":null,"abstract":"","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fengling Li, Yani Wei, Li Li, Fei Chen, Chunjuan Bao, Hong Bu, Zhang Zhang
Background and objectives: The tumor-associated stroma is an essential compartment in breast cancer, and collagen fiber organization in the stroma has been reported to be correlated with prognosis. In this study, we sought to evaluate collagen fiber characteristics in relation to pathological complete response (pCR) after neoadjuvant chemotherapy (NAC) in breast cancer patients.
Methods: A total of 388 breast cancer patients receiving NAC were enrolled. The stroma type was manually assessed on pretreatment hematoxylin and eosin (HE)-stained slides, and the collagen fiber features were quantified by a computer tool. The relationship between syndecan-1 expression and collagen fibers and its correlation with treatment efficacy were detected by immunohistochemistry.
Results: The pCR rate of patients with collagen-dominant stroma was lower than that of patients with lymphocyte-dominant stroma (19.6% vs. 40.0%, p = 0.001). Patients who achieved pCR had straighter and less dense fibers in pretreatment biopsied tissue than non-pCR patients (p = 0.031, p = 0.044). Additionally, the pCR group had greater syndecans-1 expression on the tumor epithelium than the non-pCR group (p < 0.001), while there was no statistically significant difference in the stroma (p = 0.333). Collagen fiber density was the only factor associated with pCR after correction for other clinicopathological variables in triple-negative breast cancer (TNBC) patients (OR 0.466, 95% CI 0.227-0.956, p = 0.037); patients with lower fiber density had a greater pCR rate (37.5% vs. 12.5%, p = 0.021).
Conclusions: Collagen fiber density was associated with pCR in patients with breast cancer, and it could be a potential candidate for discriminating between responders and nonresponders for TNBC patients receiving NAC.
{"title":"Collagen Density Is Associated With Pathological Complete Response to Neoadjuvant Chemotherapy in Triple-Negative Breast Cancer Patients.","authors":"Fengling Li, Yani Wei, Li Li, Fei Chen, Chunjuan Bao, Hong Bu, Zhang Zhang","doi":"10.1002/jso.28046","DOIUrl":"https://doi.org/10.1002/jso.28046","url":null,"abstract":"<p><strong>Background and objectives: </strong>The tumor-associated stroma is an essential compartment in breast cancer, and collagen fiber organization in the stroma has been reported to be correlated with prognosis. In this study, we sought to evaluate collagen fiber characteristics in relation to pathological complete response (pCR) after neoadjuvant chemotherapy (NAC) in breast cancer patients.</p><p><strong>Methods: </strong>A total of 388 breast cancer patients receiving NAC were enrolled. The stroma type was manually assessed on pretreatment hematoxylin and eosin (HE)-stained slides, and the collagen fiber features were quantified by a computer tool. The relationship between syndecan-1 expression and collagen fibers and its correlation with treatment efficacy were detected by immunohistochemistry.</p><p><strong>Results: </strong>The pCR rate of patients with collagen-dominant stroma was lower than that of patients with lymphocyte-dominant stroma (19.6% vs. 40.0%, p = 0.001). Patients who achieved pCR had straighter and less dense fibers in pretreatment biopsied tissue than non-pCR patients (p = 0.031, p = 0.044). Additionally, the pCR group had greater syndecans-1 expression on the tumor epithelium than the non-pCR group (p < 0.001), while there was no statistically significant difference in the stroma (p = 0.333). Collagen fiber density was the only factor associated with pCR after correction for other clinicopathological variables in triple-negative breast cancer (TNBC) patients (OR 0.466, 95% CI 0.227-0.956, p = 0.037); patients with lower fiber density had a greater pCR rate (37.5% vs. 12.5%, p = 0.021).</p><p><strong>Conclusions: </strong>Collagen fiber density was associated with pCR in patients with breast cancer, and it could be a potential candidate for discriminating between responders and nonresponders for TNBC patients receiving NAC.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shu-Jie Ren, Fan Yang, Qing-Quan Tan, Chang Liu, Xu-Bao Liu, Chun-Lu Tan, Xing Wang
Background and objectives: To find the association between preoperative computed tomography (CT) features combined with tumor marker and known high-risk factors of small nonfunctioning pancreatic neuroendocrine tumors (NF-PNETS), thereby selecting appropriate treatment strategy for these patients.
Method: One hundred fourteen patients with NF-PNETs< 20 mm who underwent surgical operation were retrospectively analyzed from 2009 to 2023. Univariate and multivariable logistic regression analyses were performed to find the relationship between preoperative clinical psychological and CT features and high-risk factors. The overall survival (OS) rates with and without high-risk factors were compared.
Results: Of 114 patients, 29(25%) had at least one of these high-risk factors. Main pancreatic duct dilation (OR, 3.315; 95% CI, 1.079-10.184; p = 0.036), irregular tumor margin (OR, 2.955; 95% CI, 1.021-8.551; p = 0.046), positive tumor marker (OR, 6.047; 95% CI, 1.408-25.963; p = 0.015) were associated with increased odds of having any of these high-risk factors. The time to death differed significantly between patients with and without high-risk factors. Patients combining with high-risk factors were associated with lower 3- and 5-year OS (100% vs. 81.8%, 93.1% vs. 81.8%, respectively; p = 0.035 for both).
Conclusion: Main pancreatic duct dilation, irregular tumor margin and positive tumor marker could screen a subset of patients recommended for surgery.
背景和目的研究小型无功能胰腺神经内分泌肿瘤(NF-PNETS)术前计算机断层扫描(CT)特征结合肿瘤标志物与已知高危因素之间的关联,从而为这些患者选择合适的治疗策略:方法:114 名 NF-PNETs 患者:在114名患者中,29人(25%)至少有一个高危因素。主胰管扩张(OR,3.315;95% CI,1.079-10.184;P = 0.036)、肿瘤边缘不规则(OR,2.955;95% CI,1.021-8.551;P = 0.046)、肿瘤标志物阳性(OR,6.047;95% CI,1.408-25.963;P = 0.015)与高危因素几率增加有关。有高危因素和没有高危因素的患者的死亡时间差异很大。合并高危因素的患者3年和5年的OS较低(分别为100% vs. 81.8%、93.1% vs. 81.8%;两者的P = 0.035):结论:主胰管扩张、肿瘤边缘不规则和肿瘤标志物阳性可筛选出一部分建议手术的患者。
{"title":"Predictors Based on the Radiologic Characteristics for Aggressiveness of Small (< 20 mm) Nonfunctioning Pancreatic Neuroendocrine Tumors.","authors":"Shu-Jie Ren, Fan Yang, Qing-Quan Tan, Chang Liu, Xu-Bao Liu, Chun-Lu Tan, Xing Wang","doi":"10.1002/jso.28049","DOIUrl":"https://doi.org/10.1002/jso.28049","url":null,"abstract":"<p><strong>Background and objectives: </strong>To find the association between preoperative computed tomography (CT) features combined with tumor marker and known high-risk factors of small nonfunctioning pancreatic neuroendocrine tumors (NF-PNETS), thereby selecting appropriate treatment strategy for these patients.</p><p><strong>Method: </strong>One hundred fourteen patients with NF-PNETs< 20 mm who underwent surgical operation were retrospectively analyzed from 2009 to 2023. Univariate and multivariable logistic regression analyses were performed to find the relationship between preoperative clinical psychological and CT features and high-risk factors. The overall survival (OS) rates with and without high-risk factors were compared.</p><p><strong>Results: </strong>Of 114 patients, 29(25%) had at least one of these high-risk factors. Main pancreatic duct dilation (OR, 3.315; 95% CI, 1.079-10.184; p = 0.036), irregular tumor margin (OR, 2.955; 95% CI, 1.021-8.551; p = 0.046), positive tumor marker (OR, 6.047; 95% CI, 1.408-25.963; p = 0.015) were associated with increased odds of having any of these high-risk factors. The time to death differed significantly between patients with and without high-risk factors. Patients combining with high-risk factors were associated with lower 3- and 5-year OS (100% vs. 81.8%, 93.1% vs. 81.8%, respectively; p = 0.035 for both).</p><p><strong>Conclusion: </strong>Main pancreatic duct dilation, irregular tumor margin and positive tumor marker could screen a subset of patients recommended for surgery.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"About the Cover.","authors":"Paul H Sugarbaker","doi":"10.1002/jso.28054","DOIUrl":"https://doi.org/10.1002/jso.28054","url":null,"abstract":"","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Letter to \"Body Mass Index and Breast Cancer-Related Lymphedema: A Retrospective Cohort Study\".","authors":"Xiaoyang Wang, Jiamei Jin, Yekang Zhu, Xiaogu Liu","doi":"10.1002/jso.28055","DOIUrl":"https://doi.org/10.1002/jso.28055","url":null,"abstract":"","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Reply to \"Comment on 'Prognostic Impact of the Cholangiolar Component in Combined Hepatocellular-Cholangiocarcinoma: Insights From a Western Single-Center Study'\".","authors":"Gilton Marques Fonseca, Paulo Herman","doi":"10.1002/jso.28056","DOIUrl":"https://doi.org/10.1002/jso.28056","url":null,"abstract":"","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Carly C Tymm, Reena M Vattakalam, David R Flum, Jason D Wright, Katherine N Fischkoff
Background and objectives: Opportunity salpingectomy (OS), or prophylactic removal of the fallopian tubes during an operation for another indication, is broadly accepted as a risk-reduction strategy for ovarian cancer during gynecological operations. However, OS during nongynecological abdominal surgery is rare in the United States. A better understanding of surgeon and patient attitudes and perceived barriers to OS during nongynecological surgeries may facilitate implementation in the United States.
Study design: Qualitative interviews were conducted with general surgeons (n = 10), gynecologic surgeons (n = 10), and patients (n = 20) to assess perspectives and barriers towards OS during nongynecological surgeries. Interviews were transcribed and inductive analysis was carried out to identify themes and categorize responses using NVivo data analysis software.
Results: OS during nongynecological surgery was viewed favorably by most patients and surgeons interviewed. While patients emphasized the importance of raising awareness of OS, both subsets of surgeons highlighted coordination, counseling, and billing barriers that would need to be overcome for efficient implementation.
Conclusion: OS was positively accepted by both patients and surgeons in our cohort. Improved attention to the shared barriers to implementation from our study may facilitate OS implementation during nongynecological surgery in the United States.
{"title":"Patient and Surgeon Attitudes Toward Opportunistic Salpingectomy During Nongynecological Surgeries for the Prevention of Ovarian Cancer: A Qualitative Study.","authors":"Carly C Tymm, Reena M Vattakalam, David R Flum, Jason D Wright, Katherine N Fischkoff","doi":"10.1002/jso.28050","DOIUrl":"https://doi.org/10.1002/jso.28050","url":null,"abstract":"<p><strong>Background and objectives: </strong>Opportunity salpingectomy (OS), or prophylactic removal of the fallopian tubes during an operation for another indication, is broadly accepted as a risk-reduction strategy for ovarian cancer during gynecological operations. However, OS during nongynecological abdominal surgery is rare in the United States. A better understanding of surgeon and patient attitudes and perceived barriers to OS during nongynecological surgeries may facilitate implementation in the United States.</p><p><strong>Study design: </strong>Qualitative interviews were conducted with general surgeons (n = 10), gynecologic surgeons (n = 10), and patients (n = 20) to assess perspectives and barriers towards OS during nongynecological surgeries. Interviews were transcribed and inductive analysis was carried out to identify themes and categorize responses using NVivo data analysis software.</p><p><strong>Results: </strong>OS during nongynecological surgery was viewed favorably by most patients and surgeons interviewed. While patients emphasized the importance of raising awareness of OS, both subsets of surgeons highlighted coordination, counseling, and billing barriers that would need to be overcome for efficient implementation.</p><p><strong>Conclusion: </strong>OS was positively accepted by both patients and surgeons in our cohort. Improved attention to the shared barriers to implementation from our study may facilitate OS implementation during nongynecological surgery in the United States.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shahzaib Zindani, Mujtaba Khalil, Zayed Rashid, Abdullah Altaf, Selamawit Woldesenbet, Timothy M Pawlik
Background and objectives: Social and environmental injustice may influence accessibility and utilization of health resources, affecting outcomes of patients with cancer. We sought to assess the impact of socio-environmental inequalities on cancer screening and mortality rates for breast, colon, and cervical cancer.
Methods: Data on cancer screening and environmental justice index social and environmental ranking (SER) was extracted from the CDC PLACES and ATSDR, respectively. Mortality rates were extracted using CDC WONDER. Screening targets were defined by Healthy People 2030.
Results: Among census tracts, 14 659 were classified as "low," 29 534 as "moderate," and 15 474 as "high" SER (high SER denoting greater socioenvironmental injustice). Screening targets were achieved by 31.1%, 16.2%, and 88.6% of tracts for colon, breast, and cervical cancers, respectively. High SER tracts were much less likely to reach screening targets compared with low SER tracts for colon (OR: 0.06), breast (OR: 0.24), and cervical cancer (OR: 0.05) (all p < 0.001). Median mortality rates for low and high SER were 16.7, and 21.0, respectively, for colon, 13.4, 14.75, respectively, for breast, and 1.0, 1.6, respectively, for cervical cancer (all p < 0.05).
Conclusion: Socioenvironmental disparities negatively influence cancer screening and mortality, underscoring the need to reduce environmental injustices through measures like equitable cancer screening services.
{"title":"Association of Socio-Environmental Burden and Inequality With Cancer Screening and Mortality.","authors":"Shahzaib Zindani, Mujtaba Khalil, Zayed Rashid, Abdullah Altaf, Selamawit Woldesenbet, Timothy M Pawlik","doi":"10.1002/jso.28039","DOIUrl":"https://doi.org/10.1002/jso.28039","url":null,"abstract":"<p><strong>Background and objectives: </strong>Social and environmental injustice may influence accessibility and utilization of health resources, affecting outcomes of patients with cancer. We sought to assess the impact of socio-environmental inequalities on cancer screening and mortality rates for breast, colon, and cervical cancer.</p><p><strong>Methods: </strong>Data on cancer screening and environmental justice index social and environmental ranking (SER) was extracted from the CDC PLACES and ATSDR, respectively. Mortality rates were extracted using CDC WONDER. Screening targets were defined by Healthy People 2030.</p><p><strong>Results: </strong>Among census tracts, 14 659 were classified as \"low,\" 29 534 as \"moderate,\" and 15 474 as \"high\" SER (high SER denoting greater socioenvironmental injustice). Screening targets were achieved by 31.1%, 16.2%, and 88.6% of tracts for colon, breast, and cervical cancers, respectively. High SER tracts were much less likely to reach screening targets compared with low SER tracts for colon (OR: 0.06), breast (OR: 0.24), and cervical cancer (OR: 0.05) (all p < 0.001). Median mortality rates for low and high SER were 16.7, and 21.0, respectively, for colon, 13.4, 14.75, respectively, for breast, and 1.0, 1.6, respectively, for cervical cancer (all p < 0.05).</p><p><strong>Conclusion: </strong>Socioenvironmental disparities negatively influence cancer screening and mortality, underscoring the need to reduce environmental injustices through measures like equitable cancer screening services.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}