Association of health insurance coverage disruptions and breast and colorectal cancer screening.

Background: Health insurance coverage is critical for ensuring access to recommended health care in the United States. This study investigated the associations of health insurance coverage disruptions, also known as coverage churn, and receipt of breast and colorectal cancer screening.

Methods: Adults who were age-eligible and younger than 65 years (range, 50-64 years) for breast (n = 17,128 women) and colorectal (n = 32,562 individuals) cancer screening were identified from 5 years of the National Health Interview Survey.

County-level jail and state-level prison incarceration and cancer mortality in the United States.

This study examined the association of county-level jail and state-level prison incarceration rates and cancer mortality rates in the United States. Incarceration rates (1995-2018) were sourced from national data and categorized into quartiles. County- and state-level mortality rates (2000-2019) with invasive cancer as the underlying cause of death were obtained from the National Vital Statistics System.

Blood Profiles of Community-Dwelling People with Sarcopenia: Analysis Based on the China Health and Retirement Longitudinal Study.

Introduction: Routine blood factors can be economical and easily accessible candidates for sarcopenia screening and monitoring. The associations between sarcopenia and routine blood factors remain unclear. This study aimed to examine sarcopenia and blood factor associations based on a nation-wide cohort in China.

US Medicare Hospice and Palliative Medicine Physician Workforce and Service Delivery in 2008-2020.

Context: Despite clinical benefits of early palliative care, little is known about Medicare physician workforce specialized in Hospice and Palliative Medicine (HPM) and their service delivery settings.

Objectives: To examine changes in Medicare HPM physician workforce and their service delivery settings in 2008-2020.

Methods: Using the Medicare Data on Provider Practice and Specialty from 2008 to 2020, we identified 2375 unique Medicare Fee-For-Service (FFS) physicians (15,565 physician-year observations) with self-reported specialty in "Palliative Care and Hospice".

Associations of Medical Debt With Health Status, Premature Death, and Mortality in the US.

Importance: Medical debt is increasingly common in the US. Little is known regarding its association with population health.

Objective: To examine the associations of medical debt with health status, premature death, and mortality at the county level in the US.

Health-related quality of life among prostate cancer survivors with metastatic disease and non-metastatic disease and men without a cancer history in the USA.

Background: Few studies have comprehensively compared health-related quality of life (HRQoL) between metastatic prostate cancer survivors, survivors with non-metastatic disease, and men without a cancer history.

Methods: We used the Surveillance, Epidemiology, and End Results-Medicare Health Outcomes Survey (SEER-MHOS) data linkage to identify men aged ≥ 65 years enrolled in Medicare Advantage (MA) plans. Prostate cancer survivors were diagnosed between 1988 and 2017 and completed MHOS surveys between 1998 and 2019.

Medicaid expansion is associated with treatment receipt, timeliness, and outcomes among young adults with breast cancer.

Female breast cancer is a common cancer in young adults, an age group with the highest uninsured rate. Among 51 675 young adult women (ages 18-39 years) diagnosed with breast cancer between 2011 and 2018 in the National Cancer Database, we estimated changes in guideline-concordant treatment receipt, treatment timeliness, and survival associated with the Affordable Care Act Medicaid expansion. Of young adults with stage I-III estrogen receptor-positive or progesterone receptor-positive breast cancer, Medicaid expansion was associated with a net increase of 2.

The Association Between Allostatic Load and Frailty Trajectories Among Adults Aged 50+ Years: Mediating Role of Physical Activity.

Objectives: To identify frailty trajectories and examine its association with allostatic load (AL) and mediating effect of physical activity (PA).

Methods: This study included 8,082 adults from the English Longitudinal Study of Aging over Waves 4-9. AL was calculated by 14 biological indicators, and a 53-item frailty index was used to evaluate frailty.

Changes in cancer diagnoses and stage distribution during the first year of the COVID-19 pandemic in the USA: a cross-sectional nationwide assessment.

Background: The emergence of COVID-19 disrupted health care, with consequences for cancer diagnoses and outcomes, especially for early stage diagnoses, which generally have favourable prognoses. We aimed to examine nationwide changes in adult cancer diagnoses and stage distribution during the first year of the COVID-19 pandemic by cancer type and key sociodemographic factors in the USA.

Methods: In this cross-sectional study, adults (aged ≥18 years) newly diagnosed with a first primary malignant cancer between Jan 1, 2018, and Dec 31, 2020, were identified from the US National Cancer Database.

Medicaid Expansion Associated With Increase In Palliative Care For People With Advanced-Stage Cancers.

Clinical guidelines have endorsed early palliative care for patients with advanced malignancies, but receipt remains low in the US. This study examined the association between Medicaid expansion under the Affordable Care Act and receipt of palliative care among patients newly diagnosed with advanced-stage cancers. Using the National Cancer Database, we found that the percentage of eligible patients who received palliative care as part of first-course treatment increased from 17.

Interpretable Machine Learning for Fall Prediction Among Older Adults in China.

Introduction: Falls in older adults are potentially devastating, whereas an accurate fall risk prediction model for community-dwelling older Chinese is still lacking. The objective of this study was to build prediction models for falls and fall-related injuries among community-dwelling older adults in China.

Methods: This study used data (Waves 2015 and 2018) from 5,818 participants from the China Health and Retirement Longitudinal Study.

Age-stratified modifiable fall risk factors in Chinese community-dwelling older adults.

Background: Fall incident is one of the major causes of mortality and injury in older adults. Modifiable fall risk factors are the targets for fall prevention. Since the status of some fall risk factors can change with age, insights into age-stratified fall risk factors can be beneficial for developing tailored fall prevention strategies for older adults at different ages.

Rural-urban disparities in the unmet need for home visiting services among oldest-old in China: Changes over time and decomposition analysis.

Purpose: This study aims to assess trends in rural-urban disparities in the prevalence of unmet community-based home visiting services need and their contributing factors from 2005 to 2018 among oldest-old in China.

Methods: The Chinese Longitudinal Healthy Longevity Survey data of oldest-old collected with a targeted random-sampling approach from half of counties/cities from 23 provinces across China was used. Unmet need was measured as the differences between healthcare services expected and available.

Association of rurality, type of primary caregiver and place of death with end-of-life medical expenditures among the oldest-old population in China.

Background: Understanding whether the type of primary caregiver and end-of-life (EOL) care location are associated with EOL medical expenditures is crucial to inform global debates on policies for efficient and effective EOL care. This study aims to assess trends in the type of primary caregiver and place of death stratified by rural‒urban status among the oldest-old population from 1998-2018 in China. A secondary objective is to determine the associations between rurality, the type of primary caregiver, place of death and EOL medical expenditures.

Survival in Young Adults With Cancer Is Associated With Medicaid Expansion Through the Affordable Care Act.

Purpose: Medicaid expansion through the Affordable Care Act (ACA) has been shown to improve insurance coverage and early diagnosis of cancer in young adults (YAs); whether these improvements translate to survival benefits remains unknown. We examined the association between Medicaid expansion under the ACA and 2-year overall survival among YAs with cancer.

Methods: Using the National Cancer Database, we identified 345,413 YAs (age 18-39 years) diagnosed with cancer in 2010-2017.

Incarceration History and Health Insurance and Coverage Changes in the U.S.

Introduction: This study examines the association of incarceration history and health insurance coverage and coverage changes in the U.S.

Methods: Individuals with and without incarceration history were identified from the National Longitudinal Survey of Youth 1997 with follow-up through 2017-2018 (n=7,417).

Access to Care Among Adults with Limited English Proficiency.

Background: There are approximately 25.6 million individuals with limited English proficiency (LEP) in the USA, and this number is increasing.

Objective: Investigate associations between LEP and access to care in adults.

Targeting the Mitochondria with Pseudo-Stealthy Nanotaxanes to Impair Mitochondrial Biogenesis for Effective Cancer Treatment.

The clinical success of anticancer therapy is usually limited by drug resistance and the metastatic dissemination of cancer cells. Mitochondria are essential generators of cellular energy and play a crucial role in sustaining cell survival and metastatic escape. Selective drug strategies targeting mitochondria are able to rewire mitochondrial metabolism and may provide an alternative paradigm to treat many aggressive cancers with high efficiency and low toxicity.