Julie S. Townsend

Health status of adolescent and young adult cancer survivors

Adolescents and young adults (AYA) ages 15 to 29 years who are diagnosed with cancer are at risk for long‐term morbidity and mortality associated with treatment of their cancer and the cancer itself. In this article, the authors describe the self‐reported health status of AYA cancer survivors.

Racial and regional disparities in lung cancer incidence

Lung cancer is the second most commonly diagnosed cancer and the leading cause of cancer‐related death in the United States (US). We examined data from 2004 to 2006 for lung cancer incidence rates by demographics, including race and geographic region, to identify potential health disparities.

Incidence of Testicular Cancer in the United States, 1999-2004

Testicular cancer is rare but primarily affects young men. To characterize the current incidence of testicular cancer in the United States, U.S. Cancer Statistics data from 1999 through 2004 were examined. Age-adjusted (2000 U.S. standard) incidence rates were calculated for seminoma and nonseminoma testicular germ cell tumors (TGCTs). Hispanic men had the largest increase in incidence rates for nonseminomas, followed by non-Hispanic White men (annual percentage change of 3.2% and 1.9%, respectively, p < .05). Nonseminomas peaked at a younger age for Hispanic, American Indian/Alaska Native (AIAN), and Asian/Pacific Islander (API) men. Whereas 9.6% of TGCTs were diagnosed at a distant stage in non-Hispanic White men, more Hispanic (16.1%), Black (13.8%), AIAN (16.8%), and API (14.9%) men with TGCTs were diagnosed with distant stage. Monitoring incidence rates for rare cancers by race/ethnicity has improved with national population-based cancer registry coverage. Disparities in diagnosis stage have implications for effective treatment of TGCTs.

Health behaviors and cancer screening among Californians with a family history of cancer

Purpose:The purpose of this study was to compare health behaviors and cancer screening among Californians with and without a family history of cancer.Methods:We analyzed data from the 2005 California Health Interview Survey to ascertain cancer screening test use and to estimate the prevalence of health behaviors that may reduce the risk of cancer. We used logistic regression to control for demographic factors and health-care access.Results:Women with a family history of breast or ovarian cancer were more likely to be up to date with mammography as compared with women with no family history of cancer (odds ratio = 1.69, 95% confidence interval (1.39, 2.04)); their health behaviors were similar to other women. Men and women with a family history of colorectal cancer were more likely to be up to date with colorectal cancer screening as compared with individuals with no family history of cancer (odds ratio = 2.77, 95% confidence interval (2.20, 3.49)) but were less likely to have a body mass index <25 kg/m2 (odds ratio = 0.80, 95% confidence interval (0.67, 0.94)).Conclusion:Innovative methods are needed to encourage those with a moderate-to-strong familial risk for breast cancer and colorectal cancer to increase their physical activity levels, strive to maintain a healthy weight, quit smoking, and reduce alcohol use.Genet Med 2013:15(3):212–221

Differences in Non-Hodgkin Lymphoma Survival Between Young Adults and Children

OBJECTIVE To examine differences in non-Hodgkin lymphoma (NHL) survival between young adults and children/adolescents. DESIGN Survival analysis using 13 Surveillance, Epidemiology, and End Results registries. SETTING Cancer survival information from population-based cancer registries from 1992 through 2001. PARTICIPANTS A total of 2442 cases of NHL among children/adolescents (aged 0-19 years) and young adults (aged 20-29 years). MAIN EXPOSURE Differences in NHL survival between young adults and children. MAIN OUTCOME MEASURES Comparison of 5-year survival by constructing Kaplan-Meier survival curves and modeling 5-year survival with multivariate Cox proportional hazards. RESULTS Young adults were more likely to die compared with children/adolescents (hazard ratio = 2.06; 95% confidence interval, 1.65-2.56) even after accounting for NHL subtype and stage at diagnosis. Persons diagnosed with stage III disease (hazard ratio = 1.71; 95% confidence interval, 1.20-2.46) and stage IV disease (hazard ratio = 3.19; 95% confidence interval, 2.47-4.13) were more likely to die compared with persons diagnosed with stage I disease. CONCLUSIONS Being a young adult at diagnosis and having a higher stage of disease at diagnosis were associated with higher risk of death from NHL. Increasing survival with NHL is dependent on receiving appropriate cancer therapy. Therefore, efforts to address survival should include improving enrollment in clinical trials as well as increasing access to care.

Comprehensive cancer control programs and coalitions: partnering to launch successful colorectal cancer screening initiatives

Colorectal cancer control has long been a focus area for Comprehensive Cancer Control programs and their coalitions, given the high burden of disease and the availability of effective screening interventions. Colorectal cancer control has been a growing priority at the national, state, territorial, tribal, and local level. This paper summarizes several national initiatives and features several Comprehensive Cancer Control Program colorectal cancer control successes.

Targeting children through school-based education and policy strategies: Comprehensive cancer control activities in melanoma prevention

BACKGROUND Primary school-based educational strategies are proven interventions to raise childrens awareness and knowledge about sun safety. OBJECTIVE We highlight barriers and facilitators to implementing interventions across multiple populations in 3 state comprehensive cancer control programs/partnerships that implemented primary school-based sun-safety educational programs. METHODS Using a case study approach, we collected semistructured program information and evaluation results from New Mexicos Raising Awareness in Youth about Sun Safety Project, the Sun Protection in Florida Project, and the Arizona SunWise Program. RESULTS Each program used different strategies for implementing school-based educational programs in their respective state based on local needs, funding constraints, and unique characteristics of their populations. Barriers to implementation included difficulties reaching schools and school administrators and changes in staff workload. Facilitators to implementation included using innovative recruitment approaches (mini grants, school assemblies), having community partners, reaching out to educators in various settings, and having program advocates within schools. Each program placed emphasis on supplementing educational programs with sun-safety policies. LIMITATIONS We only present a case study from 3 comprehensive cancer control programs/partnerships. Rigorous evaluation methods are needed to test the effectiveness of the various strategies that were used to implement these programs on a population-based level. CONCLUSION Partnerships and program advocates are important for successfully implementing and sustaining sun-safety programs. Innovative strategies for reaching school administrators are likely needed to effectively implement sun-safety programs and policies. School policy and environmental change are important and valued components of sun-safety programs.

Comprehensive cancer control: progress and accomplishments

The potential for Comprehensive Cancer Control (CCC) across the nation has been realized in the last decade with 69 Coalitions developing and implementing CCC plans. Many partners at all levels—national, state, jurisdictional, tribal and communities—have contributed to this success. This article details the contribution of these partners across these various levels, with a selection of the many activities contributing to this success. Consequently the cancer burden, although still of major importance, continues to be addressed in significant ways. Although there are future challenges, CCC coalitions continue to play an important role in addressing the cancer burden.

Use of Evidence-Based Practices and Resources Among Comprehensive Cancer Control Programs.

CONTEXT While efforts to promote use of evidence-based practices (EBPs) for cancer control have increased, questions remain whether this will result in widespread adoption of EBPs (eg, Guide to Community Preventive Services interventions) by comprehensive cancer control (CCC) programs. OBJECTIVE To examine use of EBPs among CCC programs to develop cancer control plans and select interventions. DESIGN Conducted Web-based surveys of and telephone interviews with CCC program staff between March and July 2012. SETTING CCC programs funded by the Centers for Disease Control and Preventions National Comprehensive Cancer Control Program (NCCCP). PARTICIPANTS Sixty-one CCC program directors. MAIN OUTCOME MEASURES 1) Use of and knowledge/attitudes about EBPs and related resources and 2) EBP-related technical assistance needs. RESULTS Seventy-five percent of eligible program directors reported use of EBPs to a moderate or great extent to address program objectives. Benefits of using EBPS included their effectiveness has been proven, they are an efficient use of resources, and they lend credibility to an intervention. Challenges to using EBPs included resource limitations, lack of culturally appropriate interventions, and limited skills adapting EBPs for local use. Most respondents had heard of and used Web sites for The Guide to Community Preventive Services (95% and 91%, respectively) and Cancer Control P.L.A.N.E.T. (98% and 75%, respectively). Training needs included how to adapt an EBP and its materials for cultural appropriateness (state 78%, tribe 86%, territory 80%) and how to maintain the fidelity of an EBP (state 75%, tribe 86%, territory 60%). CONCLUSIONS While awareness, knowledge, and use of EBPs and related resources are high, respondents identified numerous challenges and training needs. The findings from this study may be used to enhance technical assistance provided to NCCCP grantees related to selecting and implementing EBPs.

Cancer Screening and History of Sexual Violence Victimization Among U.S. Adults

BACKGROUND Little is known about the effect a history of sexual violence (SV) victimization has on the likelihood of reporting screening tests for cancer. This study investigates the association between SV victimization and cancer screening behaviors. METHODS We analyzed data from the 2006 Behavioral Risk Factor Surveillance System (BRFSS) from 11 states and 1 territory (U.S. Virgin Islands) that administered the SV module to describe demographic characteristics, quality of life, health status, cancer screening behaviors, healthcare coverage, and use of healthcare services for 58,665 women and men who reported SV victimization compared to women and men who did not. The SV victimization measure includes unwanted touching, exposure to sexual material, or ever experiencing completed or attempted unwanted sex. Statistical significance was determined using chi-square tests and multivariate logistic regression models. RESULTS Multivariate logistic regression results presented as adjusted proportions showed SV victimization was significantly associated with mammography screening for women (74.0 % victims vs. 77.1% nonvictims, p=0.02). SV victimization was not associated with cancer screening among men. Fewer women reporting SV victimization had healthcare insurance, a personal doctor or healthcare provider, and received regular checkups within the past 1-12 months. Fewer men reporting SV victimization had healthcare coverage. CONCLUSIONS These data suggest that SV victimization may have a negative association on overall healthcare use, including breast cancer screening for women. Healthcare providers should consider SV victimization as a potential barrier for women who report not being up-to-date with mammography.