Last data update: Sep 23, 2024. (Total: 47723 publications since 2009)
Records 1-30 (of 32 Records) |
Query Trace: Lunsford A [original query] |
---|
Outbreak of invasive Serratia marcescens among persons incarcerated in a state prison, California, USA, March 2020-December 2022
Kamali A , Ferguson D , Dowless H , Ortiz N , Mukhopadhyay R , Schember C , Lunsford R , Hutchinson J , Scherer M , Crandall J , Bauer H , Yu A , Kimura A . Emerg Infect Dis 2024 30 (13) S41-s48 Serratia marcescens is an environmental gram-negative bacterium that causes invasive disease in rare cases. During 2020-2022, an outbreak of 21 invasive Serratia infections occurred in a prison in California, USA. Most (95%) patients had a history of recent injection drug use (IDU). We performed whole-genome sequencing and found isolates from 8 patients and 2 pieces of IDU equipment were closely related. We also identified social interactions among patients. We recovered S. marcescens from multiple environmental samples throughout the prison, including personal containers storing Cell Block 64 (CB64), a quaternary ammonium disinfectant solution. CB64 preparation and storage conditions were suboptimal for S. marcescens disinfection. The outbreak was likely caused by contaminated CB64 and propagated by shared IDU equipment and social connections. Ensuring appropriate preparation, storage, and availability of disinfectants and enacting interventions to counteract disease spread through IDU can reduce risks for invasive Serratia infections in California prisons. |
Counts, incidence rates, and trends of pediatric cancer in the United States, 2003-2019
Siegel DA , King JB , Lupo PJ , Durbin EB , Tai E , Mills K , Van Dyne E , Buchanan Lunsford N , Henley SJ , Wilson RJ . J Natl Cancer Inst 2023 115 (11) 1337-1354 BACKGROUND: Cancer is a leading cause of death by disease among children and adolescents in the United States. This study updates cancer incidence rates and trends using the most recent and comprehensive US cancer registry data available. METHODS: We used data from US Cancer Statistics to evaluate counts, age-adjusted incidence rates, and trends among children and adolescents aged <20 years diagnosed with malignant tumors during 2003-2019. We calculated average annual percent change and annual percent change (APC) using joinpoint regression. Rates and trends were stratified by demographic and geographic characteristics and by cancer type. RESULTS: With 248,749 cases reported during 2003-2019, the overall cancer incidence rate was 178.3 per 1 million; incidence rates were highest for leukemia (46.6), central nervous system (CNS) neoplasms (30.8), and lymphoma (27.3). Rates were highest for males, children aged 0-4 years, Non-Hispanic White children and adolescents, those in the Northeast census region, top 25% of counties by economic status, and metropolitan counties with population ≥1 million. While the overall incidence rate of pediatric cancer increased 0.5% per year on average during 2003-2019, the rate increased during 2003-2016 (APC = 1.1%) and then decreased during 2016-2019 (APC = -2.1%). During 2003-2019, rates of leukemia, lymphoma, hepatic tumors, bone tumors, and thyroid carcinomas increased, while melanoma rates decreased. CNS neoplasms rates increased until 2017 and then decreased. Other cancer types remained stable. CONCLUSIONS: Incidence of pediatric cancer increased overall, although increases were limited to certain cancer types. These findings may guide future public health and research priorities. |
US cigarette smoking disparities by race and ethnicity - keep going and going!
Arrazola RA , Griffin T , Lunsford NB , Kittner D , Bammeke P , Courtney-Long EA , Armour BS . Prev Chronic Dis 2023 20 E45 INTRODUCTION: Although current cigarette smoking among US adults decreased from 42.4% in 1965 to 12.5% in 2020, prevalence is higher among certain racial and ethnic groups, including non-Hispanic American Indian and Alaska Native (AIAN) adults. METHODS: We examined trends in current cigarette smoking prevalence, population estimates, and relative disparity among US adults (aged ≥18 y) between 2011 and 2020 by using data from the National Health Interview Survey. SAS-callable SUDAAN was used to obtain prevalence and population estimates, and relative disparity was calculated on the basis of findings in the literature. Trends were significant at P < .05. RESULTS: From 2011 to 2020, linear decreases in prevalence and population estimates were observed for non-Hispanic White (20.6% to 13.3%; 32.1 million to 20.7 million), non-Hispanic Black (19.4% to 14.4%; 5.1 million to 4.0 million), and Hispanic (12.9% to 8.0%; 4.2 million to 3.3 million) adults. For non-Hispanic AIAN adults, prevalence remained around 27%, and a linear increase in the population estimate was observed from 400,000 to 510,000. Relative disparity did not change across racial and ethnic categories. CONCLUSION: Linear decreases have occurred between 2011 and 2020 for non-Hispanic White, non-Hispanic Black, and Hispanic adults who smoke, but the number of non-Hispanic AIAN adults who currently smoke has increased by 110,000, and relative disparities persist. To reduce racial and ethnic disparities in smoking, understanding how factors at multiple socioecologic levels impact smoking and helping to inform paths to equitable reach and implementation of tobacco control interventions for all population groups are needed. |
Support for policies to prohibit the sale of menthol cigarettes and all tobacco products among adults, 2021
Al-Shawaf M , Grooms KN , Mahoney M , Buchanan Lunsford N , Lawrence Kittner D . Prev Chronic Dis 2023 20 E05 This study assessed support for commercial tobacco retail policies among adults. Data came from SpringStyles 2021, a web panel survey of adults in the US aged 18 years or older (N = 6,455). Overall, 62.3% of adults supported a policy prohibiting the sale of menthol cigarettes, and 57.3% supported a policy prohibiting the sale of all tobacco products. A majority of adults supported tobacco retail policies aimed at preventing initiation, promoting quitting, and reducing tobacco-related disparities. These findings can help inform federal, state, and local efforts to prohibit the sale of tobacco products, including menthol cigarettes. |
Executive summary: Clinical practice guideline for the evaluation and treatment of children and adolescents with obesity
Hampl SE , Hassink SG , Skinner AC , Armstrong SC , Barlow SE , Bolling CF , Avila Edwards KC , Eneli I , Hamre R , Joseph MM , Lunsford D , Mendonca E , Michalsky MP , Mirza N , Ochoa ER , Sharifi M , Staiano AE , Weedn AE , Flinn SK , Lindros J , Okechukwu K . Pediatrics 2023 151 (2) Obesity is a common, complex, and often persistent chronic disease associated with serious health and social consequences if not treated.1 Yet, despite the disease’s complexity, treatment of obesity can be successful.2–4 The current and long-term health of 14.4 million children and adolescents is affected by obesity,5,6 making it one of the most common pediatric chronic diseases in the United States.5,7,8 | | Obesity has long been stigmatized as a reversible consequence of personal choices but has, in reality, complex genetic, physiologic, socioeconomic, and environmental contributors. An increased understanding of the impact of social determinants of health (SDoHs) on the chronic disease of obesity—along with heightened appreciation of the impact of the chronicity and severity of obesity-related comorbidities—has enabled broader and deeper understanding of the complexity of both obesity risk and treatment.9,10 |
Clinical practice guideline for the evaluation and treatment of children and adolescents with obesity
Hampl SE , Hassink SG , Skinner AC , Armstrong SC , Barlow SE , Bolling CF , Avila Edwards KC , Eneli I , Hamre R , Joseph MM , Lunsford D , Mendonca E , Michalsky MP , Mirza N , Ochoa ER , Sharifi M , Staiano AE , Weedn AE , Flinn SK , Lindros J , Okechukwu K . Pediatrics 2023 151 (2) You have in your hands, or at your fingertips, the first edition of the American Academy of Pediatrics clinical practice guideline for evaluation and management of children and adolescents with overweight and obesity. Putting together this guideline was no small task, and the Academy is grateful to the efforts of all the professionals who contributed to the production of this document. This work is a true testament to their passion and dedication to combatting childhood and adolescent overweight and obesity. |
Pediatric cancer mortality and survival in the United States, 2001-2016
Siegel DA , Richardson LC , Henley SJ , Wilson RJ , Dowling NF , Weir HK , Tai EW , Buchanan Lunsford N . Cancer 2020 126 (19) 4379-4389 BACKGROUND: Although pediatric cancer mortality and survival have improved in the United States over the past 40 years, differences exist by age, race/ethnicity, cancer site, and economic status. To assess progress, this study examined recent mortality and survival data for individuals younger than 20 years. METHODS: Age-adjusted death rates were calculated with the National Vital Statistics System for 2002-2016. Annual percent changes (APCs) and average annual percent changes (AAPCs) were calculated with joinpoint regression. Five-year relative survival was calculated on the basis of National Program of Cancer Registries data for 2001-2015. Death rates and survival were estimated overall and by sex, 5-year age group, race/ethnicity, cancer type, and county-based economic markers. RESULTS: Death rates decreased during 2002-2016 (AAPC, -1.5), with steeper declines during 2002-2009 (APC, -2.6), and then plateaued (APC, -0.4). Leukemia and brain cancer were the most common causes of death from pediatric cancer, and brain cancer surpassed leukemia in 2011. Death rates decreased for leukemia and lymphoma but were unchanged for brain, bone, and soft-tissue cancers. From 2001-2007 to 2008-2015, survival improved from 82.0% to 85.1%. Survival was highest in both periods among females, those aged 15 to 19 years, non-Hispanic Whites, and those in counties in the top 25% by economic status. Survival improved for leukemias, lymphomas, and brain cancers but plateaued for bone and soft-tissue cancers. CONCLUSIONS: Although overall death rates have decreased and survival has increased, differences persist by sex, age, race/ethnicity, cancer type, and economic status. Improvements in pediatric cancer outcomes may depend on improving therapies, access to care, and supportive and long-term care. |
Survivorship objectives in comprehensive cancer control plans: a systematic review
Mollica MA , Falisi AL , Geiger AM , Jacobsen PB , Lunsford NB , Pratt-Chapman ML , Townsend JS , Nekhlyudov L . J Cancer Surviv 2020 14 (2) 235-243 PURPOSE: Over a decade ago, the National Academy of Medicine (NAM) recommended that states develop, implement, and evaluate plans that include consideration of survivorship care. The purpose of this study was to review comprehensive cancer control plans in the USA, specifically to identify the inclusion of cancer survivorship-focused goals and objectives and examine alignment of survivorship-focused objectives with the NAM recommendations. METHODS: Plans from 50 states, 7 territories, 5 tribal organizations, and the District of Columbia were reviewed to assess inclusion of survivorship goals and objectives. One territory plan was excluded because it did not include a survivorship-focused goal or objective (final n = 62). Objectives were assigned to domains based on NAM survivorship recommendations. RESULTS: Plans included between 1 and 19 survivorship-related objectives. Of the 345 survivorship objectives extracted and analyzed, the most prevalent domains addressed were raising awareness, survivorship care plans, healthcare professional capacity, and models of coordinated care. Employment-related concerns, developing and implementing quality measures, and investments in research were not frequently included in objectives. CONCLUSIONS: Comprehensive cancer control plans represent an important strategy that may reduce the impact of cancer and its treatment. State, territorial, and tribal coalitions can use these results to systematically focus future survivorship efforts on areas relevant to their region and population. IMPLICATIONS FOR CANCER SURVIVORS: The growing number of survivors requires broad-ranging policy strategies. Future efforts are needed to assess the implementation and impact of plan strategies to improve the overall wellness of cancer survivors. |
Impact of informal cancer caregiving across the cancer experience: A systematic literature review of quality of life
Ochoa CY , Buchanan Lunsford N , Lee Smith J . Palliat Support Care 2019 18 (2) 1-21 OBJECTIVE: Informal caregiving may likely increase as the number of cancer survivors grows. Caregiving responsibilities can impact caregivers' quality of life (QOL). Understanding the current state of the science regarding caregiving QOL could help inform future research and intervention development. METHODS: A systematic literature review in PubMed/Medline examined research on QOL among informal cancer caregivers and related psychosocial health outcomes. Original research articles in English, published between 2007 and 2017 about caregivers (aged >18 years) of adult cancer patients in the United States were included. Abstracted articles were categorized according to caregiving recipient's phase of survivorship (acute, middle to long-term, end of life/bereavement). RESULTS: Of 920 articles abstracted, 60 met inclusion criteria. Mean caregiver age ranged from 37 to 68 with the majority being female, non-Hispanic white, with at least a high school degree, and middle income. Almost half of the studies focused on caregivers who provided care for survivors from diagnosis through the end of active treatment. Studies examined physical health, spirituality, psychological distress, and social support. Differences in QOL were noted by caregiver age, sex, and employment status. SIGNIFICANCE OF RESULTS: Additional research includes the examination of the needs of diverse cancer caregivers and determines how additional caregiver characteristics (e.g., physical functioning, financial burden, etc.) affect QOL. This includes studies examining caregiver QOL in the phases following the cessation of active treatment and assessments of health systems, support services, and insurance to determine barriers and facilitators needed to meet the immediate and long-term needs of cancer caregivers. |
Melanoma among non-Hispanic black Americans
Culp MB , Lunsford NB . Prev Chronic Dis 2019 16 E79 INTRODUCTION: Few studies have examined melanoma incidence and survival rates among non-Hispanic black populations because melanoma risk is lower among this group than among non-Hispanic white populations. However, non-Hispanic black people are often diagnosed with melanoma at later stages, and the predominant histologic types of melanomas that occur in non-Hispanic black people have poorer survival rates than the most common types among non-Hispanic white people. METHODS: We used the US Cancer Statistics 2001-2015 Public Use Research Database to examine melanoma incidence and 5-year survival among non-Hispanic black US populations. RESULTS: From 2011 through 2015, the overall incidence of melanoma among non-Hispanic black people was 1.0 per 100,000, and incidence increased with age. Although 63.8% of melanomas in non-Hispanic black people were of unspecified histology, the most commonly diagnosed defined histologic type was acral lentiginous melanoma (16.7%). From 2001 through 2014, the relative 5-year melanoma survival rate among non-Hispanic black people was 66.2%. CONCLUSION: Although incidence of melanoma is relatively rare among non-Hispanic black populations, survival rates lag behind rates for non-Hispanic white populations. Improved public education is needed about incidence of acral lentiginous melanoma among non-Hispanic black people along with increased awareness among health care providers. |
Public health efforts to address mental health conditions among cancer survivors
Ekwueme DU , Lunsford NB , Khushalani JS , Rim SH . Am J Public Health 2019 109 S179-s180 The Centers for Disease Control and Prevention (CDC) examines mental health indicators and trends, conducts surveillance of mental health concerns, and supports programs to address the mental health needs of men, women, and children (www.cdc.gov/mentalhealth/learn/index.htm). The Healthy People 2020 objectives (www.healthypeople.gov/2020/topics-objectives/topic/mental-health-and-mental-disorders) and National Prevention Strategy (www.hhs.gov/sites/default/files/disease-prevention-wellness-report.pdf) offer examples of public health objectives that can improve mental health through prevention by ensuring access to appropriate, quality mental health services. |
Merkel cell carcinoma incidence, trends, and survival rates among adults aged 50 years from United States Cancer Statistics
Freeman MB , Holman DM , Qin J , Lunsford NB . J Am Acad Dermatol 2019 80 (4) 1154-1156 Merkel cell carcinoma (MCC) is a rare form of skin cancer that frequently metastasizes and is associated with low survival rates.1 A recent examination of data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) program—specifically SEER-18 data, which captures 28% of the US population—revealed an increase in MCC incidence rates during 2000–2013.2 For the current study, we used data from the United States Cancer Statistics, which combines state cancer registry data from the Centers for Disease Control and Prevention’s National Program of Cancer Registries and the SEER program (https://www.cdc.gov/cancer/uscs/about/index.htm), to examine patterns in MCC incidence and survival by sex, age, race/ethnicity, tumor stage, and anatomic site. |
Iterative development of a tailored mHealth intervention for adolescent and young adult survivors of childhood cancer
Schwartz LA , Psihogios AM , Henry-Moss D , Daniel LC , Ver Hoeve ES , Velazquez-Martin B , Butler E , Hobbie WL , Buchanan Lunsford N , Sabatino SA , Barakat LP , Ginsberg JP , Fleisher L , Deatrick JA , Jacobs LA , O'Hagan B , Anderson L , Fredericks E , Amaral S , Dowshen N , Houston K , Vachani C , Hampshire MK , Metz JM , Hill-Kayser CE , Szalda D . Clin Pract Pediatr Psychol 2019 7 (1) 31-43 Objective: Methods for developing mobile health (mHealth) interventions are not well described. To guide the development of future mHealth interventions, we describe the application of the agile science framework to iteratively develop an mHealth intervention for adolescent and young adult (AYA) survivors of childhood cancer. Method: We created the AYA STEPS mobile app (AYA Self-management via Texting, Education, and Plans for Survivorship) by modifying and integrating 2 existing programs: an online survivorship care plan (SCP) generator and a text messaging self-management intervention for AYA off treatment. The iterative development process involved 3 stages of agile science: (1) formative work, (2) obtaining feedback about the first AYA STEPS prototype, and (3) pilot testing and finalization of a prototype. We determined preferences of AYA stakeholders as well as discovered and addressed technology problems prior to beginning a subsequent randomized controlled trial. Results: AYA survivors reported that the app and the embedded tailored messages related to their health and SCP were easy to use and generally satisfying and beneficial. Usage data supported that AYA were engaged in the app. Technology glitches were discovered in the pilot and addressed. Conclusion: The iterative development of AYA STEPS was essential for creating a consistent and acceptable end user experience. This study serves as one example of how behavioral scientists may apply agile science to their own mHealth research. |
Skin cancer prevention behaviors among agricultural and construction workers in the United States, 2015
Ragan KR , Buchanan Lunsford N , Thomas CC , Tai EW , Sussell A , Holman DM . Prev Chronic Dis 2019 16 E15 INTRODUCTION: Nearly 5 million people are treated for skin cancer each year in the United States. Agricultural and construction workers (ACWs) may be at increased risk for skin cancer because of high levels of ultraviolet radiation exposure from the sun. This is the first study that uses nationally representative data to assess sun-protection behaviors among ACWs. METHODS: We analyzed data from the 2015 National Health Interview Survey Cancer Control Supplement to examine the prevalence of sun-protection behaviors among ACWs. We calculated national, weighted, self-reported prevalence estimates. We used chi(2) tests to assess differences between ACWs by industry and occupation. RESULTS: Most of the 2,298 agricultural and construction workers studied were male (by industry, 72.4% in agriculture and 89.3% in construction; by occupation, 66.1% in agriculture and 95.6% in construction) and non-Hispanic white. About one-third had at least 1 sunburn in the past year. The prevalence of sunscreen use and shade seeking was low and did not significantly differ among groups, ranging from 15.1% to 21.4% for sunscreen use and 24.5% to 29.1% for shade seeking. The prevalence of wearing protective clothing was significantly higher among agricultural workers than among construction workers by industry (70.9% vs 50.7%) and occupation (70.5% vs 53.0%). CONCLUSION: Our findings could be used to improve occupational health approaches to reducing skin cancer risk among ACWs and to inform education and prevention initiatives addressing skin cancer. Sun-safety initiatives may include modifying work sites to increase shade and adding sun safety to workplace policies and training. Employers can help reduce occupational health inequities and protect workers by creating workplaces that facilitate sun protection. |
Smoking cessation attitudes and practices among cancer survivors - United States, 2015
Gallaway MS , Glover-Kudon R , Momin B , Puckett M , Lunsford NB , Ragan KR , Rohan EA , Babb S . J Cancer Surviv 2019 13 (1) 66-74 PURPOSE: The prevalence of smoking among cancer survivors is similar to the general population. However, there is little evidence on the prevalence of specific smoking cessation behaviors among adult cancer survivors. METHODS: The 2015 National Health Interview Survey (NHIS) data were analyzed to examine the prevalence of smoking cessation behaviors and use of treatments among cancer survivors. Weighted self-reported prevalence estimates and 95% confidence intervals were calculated using a sample of 2527 cancer survivors. RESULTS: Among this sample of US cancer survivors, 12% were current smokers, 37% were former smokers, and 51% were never smokers. Compared with former and never smokers, current smokers were younger (< 65 years), less educated, and less likely to report being insured or Medicaid health insurance (p < 0.01). More males were former smokers than current or never smokers. Current smokers reported wanting to quit (57%), a past year quit attempt (49%), or a health professional advised them to quit (66%). Current smokers reported the use of smoking cessation counseling (8%) or medication (38%). CONCLUSIONS: Even after a cancer diagnosis, about one in eight cancer survivors continued to smoke. All could have received advice to quit smoking by a health professional, but a third did not. IMPLICATIONS FOR CANCER SURVIVORS: Health professionals could consistently advise cancer survivors about the increased risks associated with continued smoking, provide them with cessation counseling and medications, refer them to other free cessation resources, and inform them of cessation treatments covered by their health insurance. |
Long-term survivorship care after cancer treatment - summary of a 2017 National Cancer Policy Forum Workshop
Kline RM , Arora NK , Bradley CJ , Brauer ER , Graves DL , Lunsford NB , McCabe MS , Nasso SF , Nekhlyudov L , Rowland JH , Schear RM , Ganz PA . J Natl Cancer Inst 2018 110 (12) 1300-1310 The National Cancer Policy Forum of the National Academies of Sciences, Engineering and Medicine sponsored a workshop on July 24 and 25, 2017 on Long-Term Survivorship after Cancer Treatment. The workshop brought together diverse stakeholders (patients, advocates, academicians, clinicians, research funders, and policymakers) to review progress and ongoing challenges since the Institute of Medicine (IOM)'s seminal report on the subject of adult cancer survivors published in 2006. This commentary profiles the content of the meeting sessions and concludes with recommendations that stem from the workshop discussions. Although there has been progress over the past decade, many of the recommendations from the 2006 report have not been fully implemented. Obstacles related to the routine delivery of standardized physical and psychosocial care services to cancer survivors are substantial, with important gaps in care for patients and caregivers. Innovative care models for cancer survivors have emerged, and changes in accreditation requirements such as the Commission on Cancer's (CoC) requirement for survivorship care planning have put cancer survivorship on the radar. The Center for Medicare & Medicaid Innovation's Oncology Care Model (OCM), which requires psychosocial services and the creation of survivorship care plans for its beneficiary participants, has placed increased emphasis on this service. The OCM, in conjunction with the CoC requirement, is encouraging electronic health record vendors to incorporate survivorship care planning functionality into updated versions of their products. As new models of care emerge, coordination and communication among survivors and their clinicians will be required to implement patient- and community-centered strategies. |
Adverse childhood experiences and the presence of cancer risk factors in adulthood: A scoping review of the literature from 2005 to 2015
Ports KA , Holman DM , Guinn AS , Pampati S , Dyer KE , Merrick MT , Lunsford NB , Metzler M . J Pediatr Nurs 2019 44 81-96 Exposure to Adverse Childhood Experiences (ACEs) is associated with a host of harmful outcomes, including increased risk for cancer. A scoping review was conducted to gain a better understanding of how ACEs have been studied in association with risk factors for cancer. This review includes 155 quantitative, peer-reviewed articles published between 2005 and 2015 that examined associations between ACEs and modifiable cancer risk factors, including alcohol, environmental carcinogens, chronic inflammation, sex hormones, immunosuppression, infectious agents, obesity, radiation, ultraviolet (UV) radiation, and tobacco, among U.S. adults. This review highlights the growing body of research connecting ACEs to cancer risk factors, particularly alcohol, obesity, and tobacco. Fewer studies investigated the links between ACEs and chronic inflammation or infectious agents. No included publications investigated associations between ACEs and environmental carcinogens, hormones, immunosuppression, radiation, or ultraviolet radiation. Mitigating the impact of ACEs may provide innovative ways to effect comprehensive, upstream cancer prevention. © 2018 |
Skin cancer knowledge, awareness, beliefs and preventive behaviors among black and Hispanic men and women
Buchanan Lunsford N , Berktold J , Holman DM , Stein K , Prempeh A , Yerkes A . Prev Med Rep 2018 12 203-209 Black and Hispanic populations perceive their skin cancer risk to be low and are less likely to use sun protection strategies. We conducted formative research to understand knowledge, awareness, beliefs, and behaviors among these groups. In 2017, eighteen focus groups were conducted with black and Hispanic respondents(18-44 years) in four US cities. Groups were segmented by participant characteristics associated with elevated or lower risk for skin cancer, by race/ethnicity, gender, and age. A professional moderator followed a semi-structured discussion guide, and focus group transcripts were analyzed using conventional content analysis and NVIVO 11 Software. Most participants perceived themselves to be at low skin cancer risk due to their "darker skin tone" and/or "lack of family history." Skin cancer signs and symptoms were more inconsistently reported by blacks than Hispanics. Few participants reported regular sun protection behaviors. Those who did used sunscreen, wore protective clothing, and had elevated risk based on sun sensitivity or UV exposure. While most participants recalled family discussions (as youth) about sunscreen and sun protection, the understood intent was to warn against "further skin darkening" or to "prevent aging," not to reduce sun burns or skin cancer risk. Tanning bed use was low across all segments, especially among black respondents. Tailored skin cancer prevention campaigns need to address misperceptions about risks and benefits of skin cancer prevention behaviors among black and Hispanic populations. Families, peer groups, and healthcare providers need to be engaged in the creation of educational interventions and messaging efforts that target these populations. |
Lung cancer among women in the United States
Henley SJ , Gallaway S , Singh SD , O'Neil ME , Buchanan Lunsford N , Momin B , Richards TB . J Womens Health (Larchmt) 2018 27 (11) 1307-1316 November marks Lung Cancer Awareness Month, and reminds us that lung cancer is the leading cause of cancer death among women in the United States. In this brief report, we highlight CDC resources that can be used to examine the most recent data on lung cancer incidence, survival, prevalence, and mortality among women. Using the U.S. Cancer Statistics Data Visualizations tool, we report that in 2015, 104,992 new cases of lung cancer and 70,073 lung cancer deaths were reported among women in the United States. The 5-year relative survival among females diagnosed with lung cancer was 22%, and as of 2015, approximately 185,759 women were living with a lung cancer diagnosis. We also describe ways CDC works to collect and disseminate quality cancer surveillance data, prevent initiation of tobacco use, promote cessation, eliminate exposure to secondhand smoke, identify and eliminate disparities, promote lung cancer screening, and help cancer survivors live longer by improving health outcomes. |
Geographic variation in pediatric cancer incidence - United States, 2003-2014
Siegel DA , Li J , Henley SJ , Wilson RJ , Lunsford NB , Tai E , Van Dyne EA . MMWR Morb Mortal Wkly Rep 2018 67 (25) 707-713 Approximately 15,000 persons aged <20 years receive a cancer diagnosis each year in the United States (1). National surveillance data could provide understanding of geographic variation in occurrence of new cases to guide public health planning and investigation (2,3). Past research on pediatric cancer incidence described differences by U.S. Census region but did not provide state-level estimates (4). To adequately describe geographic variation in cancer incidence among persons aged <20 years in the United States, CDC analyzed data from United States Cancer Statistics (USCS) during 2003-2014 and identified 171,432 cases of pediatric cancer during this period (incidence = 173.7 cases per 1 million persons). The cancer types with the highest incidence rates were leukemias (45.7), brain tumors (30.9), and lymphomas (26.2). By U.S. Census region, pediatric cancer incidence was highest in the Northeast (188.0) and lowest in the South (168.0), whereas by state (including the District of Columbia [DC]), rates were highest in New Hampshire, DC, and New Jersey. Among non-Hispanic whites (whites) and non-Hispanic blacks (blacks), pediatric cancer incidence was highest in the Northeast, and the highest rates among Hispanics were in the South. The highest rates of leukemia were in the West, and the highest rates of lymphoma and brain tumors were in the Northeast. State-based differences in pediatric cancer incidence could guide interventions related to accessing care (e.g., in states with large distances to pediatric oncology centers), clinical trial enrollment, and state or regional studies designed to further explore variations in cancer incidence. |
Systematic review of health care costs related to mental health conditions among cancer survivors
Khushalani JS , Qin J , Cyrus J , Buchanan Lunsford N , Rim SH , Han X , Yabroff KR , Ekwueme DU . Expert Rev Pharmacoecon Outcomes Res 2018 18 (5) 505-517 INTRODUCTION: This systematic review examines healthcare costs associated with mental health conditions among cancer survivors in the United States. Areas covered: Ten published studies were identified. Studies varied substantially in terms of population, mental health conditions examined, data collection methods, and type of cost reported. Cancer survivors with mental health conditions incurred significantly higher total medical costs and costs of most service types compared to cancer survivors without a mental health condition. Additionally, the total healthcare expenditure related to mental health was higher among cancer survivors compared with people without history of cancer. Expert commentary: Mental health conditions are associated with increased healthcare costs among cancer survivors. Future examination of other components of economic burden, including patient out-of-pocket costs, non-medical costs, such as transportation, childcare, and productivity losses for patients and their caregivers, will be important. Additionally, evaluation of economic burden by cancer site, stage at diagnosis, duration of survivorship, and treatment(s) will increase understanding of the overall impact of mental health conditions on cancer survivors and on the healthcare system. |
Circumstances of suicide among individuals with a history of cancer
Massetti GM , Holland KM , Jack SPD , Ragan KR , Lunsford NB . Psychooncology 2018 27 (7) 1750-1756 OBJECTIVE: Cancer can trigger psychological distress, which may be associated with risk of suicide. We explored precipitating circumstances of suicides among decedents with and without a history of cancer. METHODS: Coroner or medical examiner and law enforcement narratives of adult suicides were coded from 17 participating states in Centers for Disease Control and Prevention's National Violent Death Reporting System during 2004 to 2013. Bivariate and multivariate analyses examined associations between cancer history and factors that precipitated suicide. RESULTS: Of 90 581 suicides, 4182 decedents (4.6%) had a history of cancer. Significantly more decedents with a history of cancer (versus without) were male, non-Hispanic white, married, veterans, and aged 55 or older (P < .001). Decedents with a history of cancer were more likely to die of suicide by firearm and less likely to die of suicide by suffocation compared to poisoning. In matched case analyses controlling for demographic and recent circumstances, fewer decedents with a history of cancer had mental health problems, history of suicide attempts, alcohol use problems, intimate partner problems, financial problems, job problems, and recent crisis. CONCLUSIONS: Findings highlight the potential to identify high-risk populations for suicide prevention in clinical practice. |
Young women's perceptions regarding communication with healthcare providers about breast cancer, risk, and prevention
Lunsford NB , Sapsis KF , Smither B , Reynolds J , Wilburn B , Fairley T . J Womens Health (Larchmt) 2018 27 (2) 162-170 BACKGROUND: Women younger than 45 years old have lower rates of breast cancer, but higher risk of recurrence and mortality after a cancer diagnosis. African American women are at risk for early onset and increased mortality; Ashkenazi Jewish women are at risk for genetic mutations leading to breast and ovarian cancer. Although younger women are encouraged to talk to doctors about their family history, little is known about these discussions. MATERIALS AND METHODS: In 2015, 167 women aged 18-44 years participated in 20 focus groups segmented by geographic location, age, race/ethnicity, and family history of breast and ovarian cancer. Transcript data were analyzed using NVivo 10 software. RESULTS: Although the majority of women talked to their doctor about breast and ovarian cancer, these conversations were brief and unsatisfying due to a lack of detail. Topics included family history, breast cancer screening, and breast self-examination. Some women with and without family history reported that healthcare providers offered screening and early detection advice based on their inquiries. However, few women took action or changed lifestyle behaviors with the intent to reduce risk as a result of the conversations. CONCLUSIONS: Conversations with young women revealed missed opportunities to: enhance patient-provider communication and increase knowledge about breast cancer screening and surveillance for higher risk patients. Physicians, allied health professionals, and the public health community can better assist women in getting accurate and timely information about breast and ovarian cancer, understanding their family history to determine risk, and increasing healthy behaviors. |
Geographic access to cancer care and mortality among adolescents
Tai E , Hallisey E , Peipins LA , Flanagan B , Buchanan Lunsford N , Wilt G , Graham S . J Adolesc Young Adult Oncol 2017 7 (1) 22-29 PURPOSE: Adolescents with cancer have had less improvement in survival than other populations in the United States. This may be due, in part, to adolescents not receiving treatment at Children's Oncology Group (COG) institutions, which have been shown to increase survival for some cancers. The objective of this ecologic study was to examine geographic distance to COG institutions and adolescent cancer mortality. METHODS: We calculated cancer mortality among adolescents and sociodemographic and healthcare access factors in four geographic zones at selected distances surrounding COG facilities: Zone A (area within 10 miles of any COG institution), Zones B and C (concentric rings with distances from a COG institution of >10-25 miles and >25-50 miles, respectively), and Zone D (area outside of 50 miles). RESULTS: The adolescent cancer death rate was highest in Zone A at 3.21 deaths/100,000, followed by Zone B at 3.05 deaths/100,000, Zone C at 2.94 deaths/100,000, and Zone D at 2.88 deaths/100,000. The United States-wide death rate for whites without Hispanic ethnicity, blacks without Hispanic ethnicity, and persons with Hispanic ethnicity was 2.96 deaths/100,000, 3.10 deaths/100,000, and 3.26 deaths/100,000, respectively. Zone A had high levels of poverty (15%), no health insurance coverage (16%), and no vehicle access (16%). CONCLUSIONS: Geographic access to COG institutions, as measured by distance alone, played no evident role in death rate differences across zones. Among adolescents, socioeconomic factors, such as poverty and health insurance coverage, may have a greater impact on cancer mortality than geographic distance to COG institution. |
Mental health problems and cancer risk factors among young adults
Massetti GM , Thomas CC , King J , Ragan K , Buchanan Lunsford N . Am J Prev Med 2017 53 S30-s39 INTRODUCTION: Chronic mental health problems often emerge in young adulthood, when adults begin to develop lifelong health behaviors and access preventive health services. The associations between mental health problems and modifiable cancer risk factors in young adulthood are not well understood. METHODS: In 2016, the authors analyzed 2014 Behavioral Risk Factor Surveillance System data on demographic characteristics, health service access and use, health status, and cancer risk factors (tobacco use, alcohol use, overweight or obesity, physical activity, and sleep) for 90,821 young adults aged 18-39 years with mental health problems (depressive disorder or frequent mental distress) compared to other young adults. RESULTS: Mental health problems were associated with white race; less than a high school education; lower income; being out of work or unable to work; being uninsured (for men only); poor health; previous diagnosis of asthma, skin cancer, or diabetes; and not having a recent checkup. After controlling for demographic characteristics, health service use, and health status, mental health problems among young adults were associated with smoking, binge drinking, inadequate sleep, having no leisure time physical activity, and being overweight or obese (among women only). Cervical cancer screening was not associated with mental health problems after controlling for demographic characteristics, health service use, and health status. CONCLUSIONS: Mental health problems in young adulthood were associated with potentially modifiable factors and behaviors that increase risk for cancer. Efforts to prevent cancer and promote health must attend to mental health disparities to meet the needs of young adults. |
Perspectives of screening-eligible women and male partners on benefits of and barriers to treatment for precancerous lesions and cervical cancer in Kenya
Ragan KR , Buchanan Lunsford N , Lee Smith J , Saraiya M , Aketch M . Oncologist 2017 23 (1) 35-43 BACKGROUND: Cervical cancer is the leading cause of female cancer mortality in Kenya. Kenya's National Cervical Cancer Prevention Program Strategic Plan outlines efforts to reduce the burden; however, treatment services remain limited. This study identified male and female perspectives regarding benefits, facilitators, and barriers to treatment for precancerous lesions and cervical cancer. MATERIALS AND METHODS: Ten focus groups were conducted in Nairobi and Nyanza in 2014 with females aged 25-49 years (n = 60) and male partners (n = 40). Participants were divided into groups dependent on screening status, sex, language, and geographic location. Qualitative analytic software was used to analyze transcribed and translated data. RESULTS: Treatment was endorsed as beneficial for the prevention of death and the improvement of wellness, quality of life, symptoms, and family life. Barriers reported by males and females included the following: (a) concerns about side effects; (b) treatment-related fear and stigma; (c) marital discord; (d) financial and access issues; (e) religious and cultural beliefs; and (f) limited knowledge. Male endorsement of wanting to improve knowledge and communication with their partners, in spite of stigmatizing beliefs and misperceptions regarding females with abnormal screening results or those who have been diagnosed with cancer, was novel. CONCLUSION: Incorporating qualitative data on benefits of and barriers to treatment for precancerous lesions and cervical cancer into Kenya's national priorities and activities is important. Our findings can be used to inform the development and successful implementation of targeted, region-specific community outreach and health messaging campaigns focused on alleviating the country's cervical cancer burden. IMPLICATIONS FOR PRACTICE: This article provides important insight into female and male partner perspectives regarding benefits, facilitators, and barriers to treatment for precancerous lesions and cervical cancer. Our novel research findings can inform the development of targeted community health interventions, educational messages, and resources and aid stakeholders in strengthening strategic plans regarding treatment coverage and cervical cancer prevention. Because several treatment barriers identified in this study are similar to barriers associated with cervical cancer screening in low- and middle-resourced countries, effective messaging interventions could address barriers to receipt of both screening and treatment. |
Transforming geographic scale: A comparison of combined population and areal weighting to other interpolation methods
Hallisey E , Tai E , Berens A , Wilt G , Peipins L , Lewis B , Graham S , Flanagan B , Lunsford NB . Int J Health Geogr 2017 16 (1) 29 BACKGROUND: Transforming spatial data from one scale to another is a challenge in geographic analysis. As part of a larger, primary study to determine a possible association between travel barriers to pediatric cancer facilities and adolescent cancer mortality across the United States, we examined methods to estimate mortality within zones at varying distances from these facilities: (1) geographic centroid assignment, (2) population-weighted centroid assignment, (3) simple areal weighting, (4) combined population and areal weighting, and (5) geostatistical areal interpolation. For the primary study, we used county mortality counts from the National Center for Health Statistics (NCHS) and population data by census tract for the United States to estimate zone mortality. In this paper, to evaluate the five mortality estimation methods, we employed address-level mortality data from the state of Georgia in conjunction with census data. Our objective here is to identify the simplest method that returns accurate mortality estimates. RESULTS: The distribution of Georgia county adolescent cancer mortality counts mirrors the Poisson distribution of the NCHS counts for the U.S. Likewise, zone value patterns, along with the error measures of hierarchy and fit, are similar for the state and the nation. Therefore, Georgia data are suitable for methods testing. The mean absolute value arithmetic differences between the observed counts for Georgia and the five methods were 5.50, 5.00, 4.17, 2.74, and 3.43, respectively. Comparing the methods through paired t-tests of absolute value arithmetic differences showed no statistical difference among the methods. However, we found a strong positive correlation (r = 0.63) between estimated Georgia mortality rates and combined weighting rates at zone level. Most importantly, Bland-Altman plots indicated acceptable agreement between paired arithmetic differences of Georgia rates and combined population and areal weighting rates. CONCLUSIONS: This research contributes to the literature on areal interpolation, demonstrating that combined population and areal weighting, compared to other tested methods, returns the most accurate estimates of mortality in transforming small counts by county to aggregated counts for large, non-standard study zones. This conceptually simple cartographic method should be of interest to public health practitioners and researchers limited to analysis of data for relatively large enumeration units. |
The Kenya Cancer Research And Control Stakeholder Program: Evaluating a bilateral partnership to strengthen national cancer efforts
Morgan C , Cira M , Karagu A , Asirwa FC , Brand NR , Buchanan Lunsford N , Dawsey SM , Galassi A , Korir A , Kupfer L , Loehrer PJ , Makumi D , Muchiri L , Sayed S , Topazian H , Welch J , Williams MJ , Duncan K . J Cancer Policy 2017 17 38-44 Background: In response to a growing cancer burden and need for improved coordination among stakeholders in Kenya, the US National Cancer Institute and the Kenya Ministry of Health collaboratively hosted a stakeholder meeting in 2014 which identified four priority areas of need (research capacity building, pathology and cancer registries, cancer awareness and education, and health system strengthening) and developed corresponding action plans. Methods: Surveys were conducted with participants to collect input on the progress and impact of the 2014 stakeholder meeting. Findings: Of 69 eligible participants, 45 responded from academia, healthcare institutions, civil society, government, and international agencies. Of the four technical focus areas, three have continued to conduct working group meetings and two have conducted in-person meetings to review and update their respective action plans. Accomplishments linked to or enhanced by the meeting include: Kenyan and international support for expansion of population-based cancer registries, increased availability of prioritized diagnostic tests in selected regional referral hospitals, a greater focus on development of a national cancer research agenda, strategic planning for a community education strategy for cancer awareness, and improved coordination of partners through in-country technical assistance. Interpretation: The Stakeholder Program has successfully united individuals and organizations to improve cancer control planning in Kenya, and has enhanced existing efforts and programs across the country. This model of partners working in parallel on prioritized track activities has supported development of long term coordination of cancer research and control activities sustainable by the Kenyan government and Kenyan institutions. |
The association between beliefs about vitamin D and skin cancer risk-related behaviors
Holman DM , Berkowitz Z , Guy GP Jr , Lunsford NB , Coups EJ . Prev Med 2017 99 326-331 Major health organizations recommend obtaining most of one's vitamin D through dietary sources rather than from sun exposure, given the link between sun exposure and increased skin cancer risk. The purpose of this study is to examine the association between beliefs about vitamin D and skin cancer risk-related behaviors, a topic on which research is limited. We analyzed cross-sectional online survey data collected in the summer of 2015 from 4127U.S. adults aged 18years and older. Overall, 19.7% of adults believed that sun protection would put them at risk of not getting enough vitamin D. However, less than half (43.1%) thought they could get enough vitamin D from dietary sources. Individuals with this belief were more likely to protect their skin when spending time outdoors (71.3%) compared with those who were neutral or disagreed (56.5%; P<0.001). Only 5.1% of adults believed that indoor tanning is an effective way to get vitamin D. Compared to those who disagreed or were neutral, those who thought it was effective were more likely to be outdoor tanners (45.1% vs. 28.5%; P<0.001) and indoor tanners (13.8% vs 1.9%; P<0.001). Beliefs about vitamin D were associated with skin cancer risk-related behaviors. Including information about vitamin D in skin cancer prevention messages may be beneficial. |
Environmental and psychosocial barriers to and benefits of cervical cancer screening in Kenya
Buchanan Lunsford N , Ragan K , Lee Smith J , Saraiya M , Aketch M . Oncologist 2017 22 (2) 173-181 BACKGROUND: Cervical cancer is the second most commonly diagnosed cancer in females and is a leading cause of cancer-related mortality in Kenya; limited cervical cancer screening services may be a factor. Few studies have examined men's and women's perceptions on environmental and psychosocial barriers and benefits related to screening. MATERIALS AND METHODS: In 2014, 60 women aged 25-49 years and 40 male partners participated in 10 focus groups (6 female and 4 male), in both rural and urban settings (Nairobi and Nyanza, Kenya), to explore perceptions about barriers to and benefits of cervical cancer screening. Focus groups were segmented by sex, language, geographic location, and screening status. Data were transcribed, translated into English, and analyzed by using qualitative software. RESULTS: Participants identified screening as beneficial for initiating provider discussions about cancer but did not report it as a beneficial method for detecting precancers. Perceived screening barriers included access (transportation, cost), spousal approval, stigma, embarrassment during screening, concerns about speculum use causing infertility, fear of residual effects of test results, lack of knowledge, and religious or cultural beliefs. All participants reported concerns with having a male doctor perform screening tests; however, men uniquely reported the young age of a doctor as a barrier. CONCLUSION: Identifying perceived barriers and benefits among people in low- and middle-income countries is important to successfully implementing emerging screening programs. The novel findings on barriers and benefits from this study can inform the development of targeted community outreach activities, communication strategies, and educational messages for patients, families, and providers. Implications for Practice: This article provides important information for stakeholders in clinical practice and research when assessing knowledge, beliefs, and acceptability of cervical cancer screening and treatment services in low- and middle-resourced countries. Formative research findings provide information that could be used in the development of health interventions, community education messages, and materials. Additionally, this study illuminates the importance of understanding psychosocial barriers and facilitators to cervical cancer screening, community education, and reduction of stigma as important methods of improving prevention programs and increasing rates of screening among women. |
- Page last reviewed:Feb 1, 2024
- Page last updated:Sep 23, 2024
- Content source:
- Powered by CDC PHGKB Infrastructure