Cost Implications of an Evidence-Based Approach to Radiation Treatment After Lumpectomy for Early-Stage Breast Cancer.

Introduction: Breast cancer treatment costs are rising, and identification of high-value oncology treatment strategies is increasingly needed. We sought to determine the potential cost savings associated with an evidence-based radiation treatment (RT) approach among women with early-stage breast cancer treated in the United States.

Patients And Methods: Using the National Cancer Database, we identified women with T1-T2 N0 invasive breast cancers treated with lumpectomy during 2011.

Age- and treatment-related associations with health behavior change among breast cancer survivors.

Objective: The aim of this study was to identify demographic and treatment-related factors associated with health-promoting behavior changes after a breast cancer diagnosis. Changes in health behaviors were also evaluated according to weight, exercise, diet and alcohol consumption patterns before breast cancer diagnosis.

Materials And Methods: We examined self-reported behavior changes among 1415 women diagnosed with breast cancer in the NIEHS Sister Study cohort.

Impact of the elimination of cost sharing for mammographic breast cancer screening among rural US women: A natural experiment.

Background: Rural US women experience disparities in breast cancer screening and outcomes. In 2006, a national rural health insurance provider, the National Rural Electric Cooperative Association (NRECA), eliminated out-of-pocket costs for screening mammography.

Methods: This study evaluated the elimination of cost sharing as a natural experiment: it compared trends in screening before and after the policy change.

Physician Experience and Attitudes Toward Addressing the Cost of Cancer Care.

Purpose: We surveyed US cancer doctors to examine current attitudes toward cost discussions and how they influence decision making and practice management.

Methods: We conducted a self-administered, anonymous, electronic survey of randomly selected physician ASCO members to evaluate the frequency and nature of cost discussions reported by physicians, attitudes toward discussions of cost in clinics, and potential barriers.

Results: A total of 333 of 2,290 physicians responded (response rate [RR], 15%; adjusted RR after omitting nonpracticing physician ASCO members, 25%), Respondent practice settings were 45% academic and 55% community/private practice.

Breast cancer screening utilization and understanding of current guidelines among rural U.S. women with private insurance.

Women living in rural areas of the U.S. face disparities in screening mammography and breast cancer outcomes.

Patient experience and attitudes toward addressing the cost of breast cancer care.

Background: The American Society of Clinical Oncology views patient-physician discussion of costs as a component of high-quality care. Few data exist on patients' views regarding how cost should be addressed in the clinic.

Methods: We distributed a self-administered, anonymous, paper survey to consecutive patients with breast cancer presenting for a routine visit within 5 years of diagnosis at an academic cancer center.

Overweight among children younger than 3 years in a low-income patient population: prevalence in 2010.

Objectives: To examine the prevalence and correlates of overweight and obesity among patients aged 0 to 2 years, and to compare 3 measures of early childhood weight status, weight-for-age, weight-for-length, and body mass index-for-age.

Setting: Well-child visits in the Philadelphia Health Centers, public community health centers providing primary health care to predominantly low-income residents.

Study Design: Cross-sectional.

Does comparative effectiveness research promote rationing of cancer care?

Comparative effectiveness research aims to inform health-care decisions by patients, clinicians, and policy makers. However, questions related to what information is relevant, and how to view the relative attributes of alternative interventions have political, social, and medical considerations. In particular, questions about whether cost is a relevant factor, and whether cost-effectiveness is a desirable or necessary component of such research, have become increasingly controversial as the area has gained prominence.

Severe obesity and high blood pressure among children, Philadelphia health centers, 2010.

Background: Child obesity is a major health problem particularly affecting disadvantaged population groups. Severe obesity carries additional health risks for children. In the context of the childhood obesity epidemic, high blood pressure among children is of increasing concern.