Racial and Ethnic Variation in COVID-19 Vaccination Uptake Among Medicare Beneficiaries with Cancer History.

Background: The purpose of this study was to estimate COVID-19 vaccination rate among Medicare beneficiaries with cancer history and determine whether COVID-19 vaccine uptake is higher among non-Hispanic White beneficiaries compared with racially and ethnically minoritized beneficiaries.

Methods: We used US representative, cross-sectional data from the Medicare Current Beneficiary Survey COVID-19 Winter 2021 Rapid Response Community Supplement Survey. A total of 1,863 respondents with self-reported cancer history (other than skin cancer) were included.

Insurance Coverage Mandates and the Adoption of Digital Breast Tomosynthesis.

Importance: Digital breast tomosynthesis (DBT) is a breast cancer screening modality that has gained popularity in recent years. Although insurance coverage for DBT is not mandated under the Patient Protection and Affordable Care Act, several states have required coverage without cost sharing for private insurers.

Objective: To evaluate the association between state-level insurance coverage mandates for DBT and changes in DBT use, price, and out-of-pocket payments.

Cost-Effectiveness of Nivolumab Plus Ipilimumab With and Without Chemotherapy for Advanced Non-Small Cell Lung Cancer.

Background: First-line treatment with nivolumab plus ipilimumab (N+I) or nivolumab plus ipilimumab with two cycles of chemotherapy (N+I+chemotherapy) improve overall survival and progression-free survival for patients with metastatic non-small cell lung cancer (NSCLC), yet researchers have not concomitantly compared the cost-effectiveness of N+I and N+I+chemotherapy with chemotherapy alone.

Materials And Methods: Using outcomes data from the CheckMate 227 and CheckMate 9LA phase 3 randomized trials, we developed a Markov model with lifetime horizon to compare the costs and effectiveness of N+I and N+I+chemotherapy versus chemotherapy from the U.S.

Comparative Effectiveness of Digital Breast Tomosynthesis and Mammography in Older Women.

Background: Digital breast tomosynthesis (DBT) has become a prevalent mode of breast cancer screening in recent years. Although older women are commonly screened for breast cancer, little is known about screening outcomes using DBT among older women.

Objective: To assess proximal screening outcomes with DBT compared to traditional two-dimensional(2-D) mammography among women 67-74 and women 75 and older.

Trends in Breast Cancer Screening Costs Among Privately Insured Women Aged 40 to 64 Years.

This cohort study characterizes changes in breast cancer screening costs as digital breast tomosynthesis has been adopted at both the patient and population levels.

Primary care physician continuity, survival, and end-of-life care intensity.

Objective: To examine the associations of primary care physician (PCP) care continuity with cancer-specific survival and end-of-life care intensity.

Data Sources: Surveillance, epidemiology, and end results linked to Medicare claims data from 2001 to 2015.

Study Design: Cox proportional hazards models with mixed effects and hierarchical generalized logistic models were used to examine the associations of PCP care continuity with cancer-specific survival and end-of-life care intensity, respectively.

Relative risks of COVID-19 fatality between the first and second waves of the pandemic in Ontario, Canada.

Objectives: To examine whether the case fatality rate (CFR) of COVID-19 decreased over time and whether the COVID-19 testing rate is a driving factor for the changes if the CFR decreased.

Methods: Analyzing COVID-19 cases, deaths and tests in Ontario, Canada, we compared the CFR between the first wave and the second wave across 26 public health units in Ontario. We also explored whether a high testing rate was associated with a large CFR decrease.

Treatment patterns and survival in hepatocellular carcinoma in the United States and Taiwan.

Background: Survival in hepatocellular carcinoma (HCC) is lower in the USA than in Taiwan. Little is known about the extent to which differences in stage at diagnosis and treatment contribute to this difference. We examined treatment patterns and survival in HCC and analyzed factors driving the difference.

Associations Among Health Literacy, End-of-Life Care Expenditures, and Rurality.

Purpose: To examine differential associations between health literacy (HL) and end-of-life (EOL) care expenditures by rurality.

Methods: This cross-sectional study included all urban and rural counties in the United States. County-level HL data were estimated using 2010 US Census and 2011 American Community Surveys data; EOL expenditures in 2010 were derived from the Dartmouth Atlas of Health Care database.

Associations Between End-of-Life Expenditures and Hospice Stay Length Vary by Clinical Condition and Expenditure Duration.

Objectives: Hospice use reduces costly aggressive end-of-life (EOL) care (eg, repeated hospitalizations, intensive care unit care, and emergency department visits). Nevertheless, associations between hospice stays and EOL expenditures in prior research have been inconsistent. We examined the differential associations between hospice stay duration and EOL expenditures among newly diagnosed patients with cancer, congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), and dementia.

Trends in Provision of Palliative Radiotherapy and Chemotherapy Among Hospices in the United States, 2011-2018.

This case series study uses Medicare 2011-2019 Hospice Cost Report Data to analyze trends in the proportion of freestanding hospices in the United States providing radiotherapy and chemotherapy, as well as the expenses incurred for providing these therapies.

A Value of Information Analysis of Research on the 21-Gene Assay for Breast Cancer Management.

Objectives: The 21-gene assay Oncotype DX (21-GA) shows promise as a guide in deciding when to initiate adjuvant chemotherapy in women with hormone receptor-positive early-stage breast cancer. Nevertheless, its routine use remains controversial, owing to insufficient evidence of its clinical utility and cost-effectiveness. Accordingly, we aim to quantify the value of conducting further research to reduce decision uncertainty in the use of the 21-GA.

Factors Associated With Hospices' Nonparticipation in Medicare's Hospice Compare Public Reporting Program.

Background: To enhance the quality of hospice care and to facilitate consumers' choices, the Centers for Medicare and Medicaid Services (CMS) began the Hospice Quality Reporting Program, in which CMS posted the quality measures of participating hospices on its reporting website, Hospice Compare. Little is known about the participation rate and the types of nonparticipating hospices.

Objective: To examine the factors associated with hospices' nonparticipation in Hospice Compare.

Associations of preoperative breast magnetic resonance imaging with subsequent mastectomy and breast cancer mortality.

Purpose: To examine associations between pre-operative magnetic resonance imaging (MRI) use and clinical outcomes among women undergoing breast-conserving surgery (BCS) with or without radiotherapy for early-stage breast cancer.

Methods: We identified women from the Surveillance, Epidemiology, and End Results-Medicare dataset aged 67-94 diagnosed during 2004-2010 with stage I/II breast cancer who received BCS. We compared subsequent mastectomy and breast cancer mortality with versus without pre-operative MRI, using Cox regression and competing risks models.

Regional Practice Patterns and Racial/Ethnic Differences in Intensity of End-of-Life Care.

Objective: To examine whether regional practice patterns impact racial/ethnic differences in intensity of end-of-life care for cancer decedents.

Data Sources: The linked Surveillance, Epidemiology, and End Results (SEER)-Medicare database.

Study Design: We classified hospital referral regions (HRRs) based on mean 6-month end-of-life care expenditures, which represented regional practice patterns.

Cyclin-dependent kinase 1 (CDK1) and CDK2 have opposing roles in regulating interactions of splicing factor 3B1 with chromatin.

Splicing factor 3B1 (SF3B1) is a core splicing protein that stabilizes the interaction between the U2 snRNA and the branch point in the mRNA target during splicing. SF3B1 is heavily phosphorylated at its N terminus and a substrate of cyclin-dependent kinases (CDKs). Although SF3B1 phosphorylation coincides with splicing catalysis, the functional significance of SF3B1 phosphorylation is largely undefined.

Associations Between Sentinel Lymph Node Biopsy and Complications for Patients with Ductal Carcinoma In Situ.

Purpose: To examine the associations between sentinel lymph node biopsy (SLNB) and complications among older patients who underwent breast-conserving surgery (BCS) for ductal carcinoma in situ (DCIS).

Methods: We identified women from the Surveillance, Epidemiology, and End Results-Medicare dataset aged 67-94 years diagnosed during 1998-2011 with DCIS who underwent BCS as initial treatment. We assessed incidence of complications, including lymphedema, wound infection, seroma, or pain, within 9 months of diagnosis.

Associations of Hospice Disenrollment and Hospitalization With Continuous Home Care Provision.

Objectives: To examine rates of hospice disenrollment and posthospice hospitalization among patients who are enrolled in hospices that provide continuous home care (CHC) (CHC hospices) compared with patients who are enrolled in hospices that do not offer CHC (non-CHC hospices).

Methods: We performed a retrospective cohort study among Medicare fee-for-service decedents between July and December 2011, who were 66 years and older and had used hospice in their last 6 months of life. We used propensity score matching to account for potential confounding characteristics of hospices.

Information Needs of Older Women With Early-Stage Breast Cancer When Making Radiation Therapy Decisions.

Purpose: To identify the information older women with early-stage breast cancer need when making radiation therapy decisions, and who patients identify as the main decision maker.

Methods And Materials: We surveyed (through face-to-face interview, telephone, or mail) women aged ≥65 years who received lumpectomy and were considering or receiving adjuvant radiation therapy for early-stage breast cancer. The survey instrument was constructed with input from patient and professional advisory committees, including breast cancer survivors, advocates of breast cancer care and aging, clinicians, and researchers.

The Relationship Between Geographic Access to Plastic Surgeons and Breast Reconstruction Rates Among Women Undergoing Mastectomy for Cancer.

Introduction: Despite a national health care policy requiring payers to cover breast reconstruction, rates of postmastectomy reconstruction are low, particularly among minority populations. We conducted this study to determine if geographic access to a plastic surgeon impacts breast reconstruction rates.

Methods: Using 2010 inpatient and ambulatory surgery data from 10 states, we identified adult women who underwent mastectomy for breast cancer.

Fibroblast Subtypes Regulate Responsiveness of Luminal Breast Cancer to Estrogen.

Antiendocrine therapy remains the most effective treatment for estrogen receptor-positive (ER) breast cancer, but development of resistance is a major clinical complication. Effective targeting of mechanisms that control the loss of ER dependency in breast cancer remains elusive. We analyzed breast cancer-associated fibroblasts (CAF), the largest component of the tumor microenvironment, as a factor contributing to ER expression levels and antiendocrine resistance.

Continuous Home Care Reduces Hospice Disenrollment and Hospitalization After Hospice Enrollment.

Context: Among the four levels of hospice care, continuous home care (CHC) is the most expensive care, and infrequently provided in practice.

Objectives: To identify hospice and patient characteristics associated with the use of CHC and to examine the associations between CHC utilization and hospice disenrollment or hospitalization after hospice enrollment.

Methods: Using 100% fee-for-service Medicare claims data for beneficiaries aged 66 years or older who died between July and December 2011, we identified the percentage of hospice agencies in which patients used CHC in 2011 and determined hospice and patient characteristics associated with the use of CHC.

Association between Time since Cancer Diagnosis and Health-Related Quality of Life: A Population-Level Analysis.

Objectives: To examine the association between time since cancer diagnosis and health-related quality of life (HRQOL) among cancer survivors in remission.

Methods: Analyzing data from 3,610 cancer survivors and 59,539 individuals without cancer in the Medical Expenditure Panel Survey, we examined the relationship between time since cancer diagnosis and HRQOL, taking remission status into account and controlling for patients' demographic characteristics and comorbidities. HRQOL measurements included the six-dimensional health state short form (derived from 36-item short form health survey) (SF-6D) utility scores, the physical component summary score, and the mental component summary score.

Cancer-associated SF3B1 mutants recognize otherwise inaccessible cryptic 3' splice sites within RNA secondary structures.

Recurrent mutations in core splicing factors have been reported in several clonal disorders, including cancers. Mutations in SF3B1, a component of the U2 splicing complex, are the most common. SF3B1 mutations are associated with aberrant pre-mRNA splicing using cryptic 3' splice sites (3'SSs), but the mechanism of their selection is not clear.