Race versus place of service in mortality among medicare beneficiaries with cancer.

Background: Evidence suggests that excess mortality among African-American cancer patients is explained in part by the healthcare setting. The objective of this study was to compare mortality among African-American and Caucasian cancer patients and to evaluate the influence of attendance at a National Cancer Institute (NCI)-designated comprehensive or clinical cancer center.

Methods: The authors conducted a retrospective cohort analysis of Medicare beneficiaries with an incident diagnosis of lung, breast, colorectal, or prostate cancer between 1998 and 2002 who were identified from Surveillance, Epidemiology, and End Results data.

Influence of place of residence in access to specialized cancer care for African Americans.

Context: Disparities in cancer care for rural residents and for African Americans have been documented, but the interaction of these factors is not well understood.

Purpose: The authors examined the simultaneous influence of race and place of residence on access to and utilization of specialized cancer care in the United States.

Methods: Access to specialized cancer care was measured using: (1) travel time to National Cancer Institute (NCI) Cancer Centers, academic medical centers, and any oncologist for the entire continental US population, and (2) per capita availability of oncologists for the entire United States.

Improving the quality of colorectal cancer screening: assessment of familial risk.

Background: Accuracy of familial risk assessment by endoscopists in determining colonoscopic screening and surveillance intervals is unknown.

Aims: To investigate follow-up recommended by endoscopists for individuals at average or increased familial risk, following colonoscopies that were normal or yielded hyperplastic polyps only.

Methods: Colonoscopy registry data was analyzed on 5,982 patients who had colonoscopy between 2004 and 2006.

Lung cancer in a U.S. population with low to moderate arsenic exposure.

Background: Little is known about the carcinogenic potential of arsenic in areas with low to moderate concentrations of arsenic (< 100 microg/L) in drinking water.

Objectives: We examined associations between arsenic and lung cancer.

Methods: A population-based case-control study of primary incident lung cancer was conducted in 10 counties in two U.

Screening mammography intervals among postmenopausal hormone therapy users and nonusers.

Background: The recent decline in US breast cancer incidence rates has been attributed to the marked reduction in use of postmenopausal hormone therapy (HT). An alternative explanation is that women who are not routinely seeking medical care to renew HT prescriptions may be less adherent to recommendations for mammographic screening. To investigate the latter possibility, we compared mammographic intervals according to HT use.

When radiologists perform best: the learning curve in screening mammogram interpretation.

Purpose: To examine changes in screening mammogram interpretation as radiologists with and radiologists without fellowship training in breast imaging gain clinical experience.

Materials And Methods: In an institutional review board-approved HIPAA-compliant study, the performance of 231 radiologists who interpreted screen-film screening mammograms from 1996 to 2005 at 280 facilities that contribute data to the Breast Cancer Surveillance Consortium was examined. Radiologists' demographic data and clinical experience levels were collected by means of a mailed survey.

Disclosing harmful mammography errors to patients.

Purpose: To assess radiologists' attitudes about disclosing errors to patients by using a survey with a vignette involving an error interpreting a patient's mammogram, leading to a delayed cancer diagnosis.

Materials And Methods: We conducted an institutional review board-approved survey of 364 radiologists at seven geographically distinct Breast Cancer Surveillance Consortium sites that interpreted mammograms from 2005 to 2006. Radiologists received a vignette in which comparison screening mammograms were placed in the wrong order, leading a radiologist to conclude calcifications were decreasing in number when they were actually increasing, delaying a cancer diagnosis.

False-positive mammography and depressed mood in a screening population: findings from the New Hampshire Mammography Network.

Background: False positives occur in approximately 11% of screening mammographies in the USA and may be associated with psychologic sequelae.

Methods: We sought to examine the association of false-positive mammography with depressed mood among women in a screening population. Using data from a state-based mammography registry, women who completed a standardized questionnaire between 7 May 2001 and 2 June 2003, a follow-up questionnaire between 19 June 2003 and 8 October 2004 and who received at least one screening mammogram during this interval were identified.

Bias associated with self-report of prior screening mammography.

Background: Self-reported screening behaviors from national surveys often overestimate screening use, and the amount of overestimation may vary by demographic characteristics. We examine self-report bias in mammography screening rates overall, by age, and by race/ethnicity.

Methods: We use mammography registry data (1999-2000) from the Breast Cancer Surveillance Consortium to estimate the validity of self-reported mammography screening collected by two national surveys.

Influence of NCI cancer center attendance on mortality in lung, breast, colorectal, and prostate cancer patients.

Some evidence links cancer outcomes to place of service, but the influence of NCI (National Cancer Institute) cancer centers on outcomes has not been established. We compared mortality for NCI cancer center attendees versus nonattendees. This retrospective cohort study included individuals with incident cancers of the lung, breast, colon/rectum, or prostate from 1998 to 2002 (N = 211,084) from SEER (Surveillance, Epidemiology, and End Results)-Medicare linked data, with claims through 2003.

Determinants of NCI Cancer Center attendance in Medicare patients with lung, breast, colorectal, or prostate cancer.

Background: Geographic access to NCI-Cancer Centers varies by region, race/ethnicity, and place of residence, but utilization of these specialized centers has not been examined at the national level in the U.S. This study identified determinants of NCI-Cancer Center attendance in Medicare cancer patients.

Geographic access to cancer care in the U.S.

Background: Although access to cancer care is known to influence patient outcomes, to the authors' knowledge, little is known regarding geographic access to cancer care, and how it may vary by population characteristics. This study estimated travel time to specialized cancer care settings for the continental U.S.

A polygon-based locally-weighted-average method for smoothing disease rates of small units.

Background: Disease rates for geographic areas with small populations may be unstable. Therefore, accurate nonparametric methods for smoothing or stabilizing rates are needed.

Methods: We propose an innovative locally-weighted-average method as an easy tool for disease surveillance.

Cancer after total joint arthroplasty: a meta-analysis.

Background: Some epidemiologic and laboratory studies have suggested that total joint arthroplasty could increase the risk of cancer. In this meta-analysis, we attempt to clarify the association of joint arthroplasty with subsequent cancer incidence.

Methods: We identified population-based studies reporting standardized incidence ratios (SIR) for cancer following large joint arthroplasty.

Constitutive and induced expression of hematopoietic growth factor genes by fibroblasts from children with Fanconi anemia.

The pathophysiological abnormalities leading to marrow failure and leukemogenesis in children with Fanconi anemia (FA) are not understood. We tested the hypothesis that the Fanconi anemia mutation results in insufficient production of hematopoietic growth factors by stromal cells by quantifying constitutive and induced production of interleukin-6 (IL-6), granulocyte-macrophage colony-stimulating factor (GM-CSF), granulocyte colony-stimulating factor (G-CSF), macrophage colony-stimulating factor (M-CSF), and steel factor (SF) by untransformed fibroblasts from eight patients with FA from five different families. While no abnormalities were noted in SF or M-CSF production, we noted substantial variability in IL-6, GM-CSF, and G-CSF responses of cells obtained from different FA patients.