Stephanie Shao

Trends in use of contralateral prophylactic mastectomy by racial/ethnic group and ER/PR status among patients with breast cancer: A SEER population-based study.

BACKGROUND While differences in CPM use between White and Black patients are well known, it is not clear whether CPM use differs by estrogen/progesterone receptor (ER/PR) status of tumors and whether racial/ethnic differences in the use are affected by ER/PR status, which varies between racial groups. The purpose of this study was to investigate whether CPM usage differs by racial/ethnic group and ER/PR status among patients in the Surveillance, Epidemiology, and End Results (SEER) data. METHODS The study subjects were women with histologically confirmed unilateral breast cancer who underwent breast surgery between 1998 and 2011. Age-adjusted CPM use as a proportion of all surgically treated patients or all patients who had mastectomy was analyzed by racial/ethnic group, tumor behavior, and ER/PR status. Temporal trends in age-adjusted CPM use were presented by ER/PR status and racial/ethnic group. RESULTS The analyses stratified by ER/PR status showed significant racial/ethnic differences in age-adjusted CPM use with non-Hispanic White and non-Hispanic Asian/Pacific Islander (API) patients having the most and least CPM use. Age-adjusted CPM use was significantly higher for ER+/PR+ tumors than ER-/PR- ones for each race/ethnicity group among patients with mastectomy. However, among patients with any breast surgeries, the only difference was a higher proportion of CPM use for ER-/PR- tumors (8.6%) than ER+/PR+ tumors (8.0%) in non-Hispanic Whites. CPM use has increased over time in all racial/ethnic groups despite ER/PR status. CONCLUSION CPM usage was lower not only in non-Hispanic Blacks, but also in non-Hispanic API and Hispanic patients compared to non-Hispanic White patients. CPM usage tended to be higher for ER+/PR+ tumors, but the results varied when different denominators (all mastectomies vs. all breast surgeries) were used.

Overall and recurrence-free survival among black and white bladder cancer patients in an equal-access health system

BACKGROUND While the incidence of bladder cancer is twice as high among whites than among blacks, mortality is higher among blacks than whites. Unequal access to medical care may be an important factor. Insufficient access to care could delay cancer detection and treatment, which can result in worse survival. The purpose of this study was to evaluate whether survival differed between black and white bladder cancer patients in the Department of Defense (DoD), which provides universal healthcare to all beneficiaries regardless of racial background. METHODS This study was based on data from the U.S. DoD Automated Central Tumor Registry (ACTUR). White and black patients histologically diagnosed with bladder cancer between 1990 and 2004 were included in the study and followed to the end of 2007. The outcomes were all-cause mortality and recurrence. We assessed the relationship between race and outcomes of interest using Cox proportional hazard ratios (HRs) for all, non-muscle invasive (NMIBC), and muscle invasive (MIBC) bladder cancers, separately. RESULTS The survival of black and white individuals did not differ statistically. No significant racial differences in survival (HR: 0.96, 95% CI: 0.76-1.22) or recurrence-free survival (HR: 0.94, 95% CI: 0.69-1.30) were observed after adjustment for demographic variables, tumor characteristics, and treatment. Similar findings were observed for NMIBC and MIBC patients, respectively. CONCLUSION Black patients were more likely to present with MIBC than white patients. However, white and black patients with bladder cancer were not significantly different in overall and recurrence-free survival regardless of muscle invasion. Our study suggests the importance of equal access to healthcare in reducing racial disparities in bladder cancer survival.

Costs for Breast Cancer Care in the Military Health System: An Analysis by Benefit Type and Care Source

Introduction Breast cancer care imposes a significant financial burden to U.S. healthcare systems. Health services factors, such as insurance benefit type and care source, may impact costs to the health system. Beneficiaries in the U.S. Military Health System (MHS) have universal healthcare coverage and access to a network of military facilities (direct care) and private practices (purchased care). This study aims to quantify and compare breast cancer care costs to the MHS by insurance benefit type and care source. Materials and Methods We conducted a retrospective analysis of data linked between the MHS data repository administrative claims and central cancer registry databases. The institutional review boards of the Walter Reed National Military Medical Center, the Defense Health Agency, and the National Institutes of Health Office of Human Subjects Research reviewed and approved the data linkage. We used the linked data to identify records for women aged 40-64 yr who were diagnosed with breast cancer between 2003 and 2007 and to extract information on insurance benefit type, care source, and cost to the MHS for breast cancer treatment. We estimated per capita costs for breast cancer care by benefit type and care source in 2008 USD using generalized linear models, adjusted for demographic, pathologic, and treatment characteristics. Results The average per capita (n = 2,666) total cost for breast cancer care was

Breast Cancer Treatment and Survival Among Department of Defense Beneficiaries: An Analysis by Benefit Type and Care Source

66,300 [standard error (SE)

The continuum of breast cancer care and outcomes in the U.S. Military Health System: an analysis by benefit type and care source

9,200] over 3.31 (1.48) years of follow-up. Total costs were similar between benefit types, but varied by care source. The average per capita cost was

Abstract PD6-01: Analysis of breast cancer in young women in the department of defense (DOD) database

34,500 (

Proteomic profiling of serial pre-diagnostic serum samples for early detection of colon cancer in the U.S. military.

3,000) for direct care (n = 924),

The association of percentage energy from fat and colon cancer risk among members of the US military.

96,800 (

Analysis of breast cancer in young women in the Department of Defense (DOD) database

4,800) for purchased care (n = 622), and

Benefit Type and Care Source in Relation to Mammography Screening and Breast Cancer Stage at Diagnosis Among DoD Beneficiaries

60,700 (