Sun Hee Rim

Health and Economic Impact of Breast Cancer Mortality in Young Women, 1970–2008

BACKGROUND Breast cancer is the second-leading cause of cancer-related deaths among women aged <50 years. Studies on the effects of breast cancer mortality among young women are limited. PURPOSE To assess trends in breast cancer mortality rates among women aged 20-49 years, estimate years of potential life lost (YPLL), and the value of productivity losses due to premature mortality. METHODS Age-adjusted rates and rate ratios (RRs) were calculated using 1970-2008 U.S. mortality data. Breast cancer mortality rates over time were assessed using Joinpoint regression modeling. YPLL was calculated using number of cancer deaths and the remaining life expectancy at the age of death. Value of productivity losses was estimated using the number of deaths and the present value of future lifetime earnings. RESULTS From 1970 to 2008, the age-adjusted breast cancer mortality rate among young women was 12.02/100,000. Rates were higher in the Northeast (RR=1.03, 95% CI, 1.02-1.04). The annual decline in breast cancer mortality rates among blacks was smaller (-0.68%) compared with whites (-2.02%). The total number of deaths associated with breast cancer was 225,866, which accounted for an estimated 7.98 million YPLL. The estimated total productivity loss in 2008 was

The African American Women and Mass Media Campaign: A CDC Breast Cancer Screening Project

5.49 billion and individual lifetime lost earnings were

Years of Potential Life Lost and Productivity Losses From Male Urogenital Cancer Deaths—United States, 2004

1.10 million. CONCLUSIONS Considering the effect of breast cancer on women of working age and the disproportionate impact on black women, more age-appropriate interventions with multiple strategies are needed to help reduce these substantial health and economic burdens, improve survival, and in turn reduce productivity costs associated with premature death.

Discussions about prostate cancer screening between U.S. primary care physicians and their patients.

For decades, black radio has reached African American communities with relevant, culturally appropriate information, and it continues to be an ideal communication channel to use for contemporary health promotion. In an effort to combat excess breast cancer mortality rates and help eliminate cancer disparities among low-income African American women, the Centers for Disease Control and Preventions (CDC) Division of Cancer Prevention and Control designed, implemented, and evaluated the African American Women and Mass Media (AAMM) pilot campaign. The AAMM campaign uses black radio, radio stations with broad African American listenership, as a platform for targeted, culturally competent health promotion and outreach to low-income, African American women. The AAMM campaign uses radio advertisements and print materials disseminated in predominantly African American neighborhoods to promote awareness of breast cancer, early detection, and the CDCs National Breast and Cervical Cancer Early Detection Program (NBCCEDP). Evaluation of the AAMM campaign found that the campaign successfully reached its target audience of low-income, African American women and increased womens awareness of breast cancer screening services through the Breast and Cervical Cancer Program in Savannah and Macon, Georgia.

A national initiative for women and healthcare providers: CDC's Inside Knowledge: Get the Facts About Gynecologic Cancer campaign.

OBJECTIVES To estimate years of potential life lost (YPLL) and productivity losses due to deaths from male urogenital cancers in the United States in 2004. METHODS To estimate YPLL, we applied a life expectancy method using 2004 national mortality data and life tables. To estimate lifetime productivity losses, we used human capital approach accounting for both the market value and the imputed value of housekeeping services. We calculated results for age and racial/ethnic groups and for 8 categories of male urogenital cancers. RESULTS In 2004, deaths from urological cancers accounted for 244,080 YPLL, with an average of 14.4 YPLL per death, and deaths from genital cancers accounted for 309,921 YPLL, with an average of 10.5 YPLL per death. Kidney cancer accounted for 42.7% YPLL from male urological cancers, and prostate cancer accounted for 94.2% of the YPLL from male genital cancers. Testicular cancer had the highest average number of YPLL per death (37.9). Non-Hispanic whites accounted for 77.9% of the YPLL from male urogenital cancer deaths. Overall, urogenital cancers had the largest relative contribution to YPLL among men aged ≥50 years. In 2004, the estimated lifetime productivity loss because of deaths from male urogenital cancer was

Considering racial and ethnic preferences in communication and interactions among the patient, family member, and physician following diagnosis of localized prostate cancer: study of a US population

10.4 billion USD, 10.6% of the estimated

Gynecologic oncologists and ovarian cancer treatment: avenues for improved survival.

97.9 billion USD loss because of deaths from all cancers among US men. CONCLUSIONS Urogenital cancers impose a considerable health and economic burden in terms of premature deaths and productivity losses in men in the United States, particularly among the elderly and non-Hispanic whites and blacks.

The impact of chronic conditions on the economic burden of cancer survivorship: a systematic review

ObjectiveThis study examined the likelihood that U.S. primary care physicians (PCPs) discuss and recommend prostate cancer screening with their patients and physician-related and practice-related factors associated with this behavior.MethodsWe analyzed data from the 2007–2008 National Survey of Primary Care Physician Practices Regarding Prostate Cancer Screening (N = 1,256), the most recent and comprehensive survey specifically designed to address issues concerning prostate cancer screening and representing nearly 95,000 PCPs. We evaluated the relationship between PCP behavior regarding prostate cancer screening discussions and covariates, including PCP demographic and practice-related factors. Weighted percentages and Chi-square tests were used to compare use of screening discussions by PCP characteristics. Adjusted odds of discussing screening and recommending the PSA test were determined from logistic regression.ResultsEighty percent of PCPs reported that they routinely discuss prostate cancer screening with all of their male patients, and 64.1% of PCPs who discussed screening with any patients reported that they attempted to talk their patients into getting the PSA test. In multivariate analyses, encouraging PSA testing was more likely among non-Hispanic black PCPs (OR = 2.80, 95% CI [1.88, 4.16]), PCPs serving 100 or more patients per week (OR = 2.16, 95% CI [1.38, 3.37]), and PCPs spending longer hours per week in direct patient care (31–40 hours: OR = 1.90, 95% CI [1.13, 3.20]; 41 or more hours: OR = 2.09, 95% CI [1.12, 3.88]), compared to their referents. PCPs in multi-specialty group practice were more likely to remain neutral or discourage PSA testing compared to PCPs in solo practice.ConclusionsBoth individual and practice-related factors of PCPs were associated with the use of prostate cancer screening discussions by U.S. PCPs. Results from this study may prove valuable to researchers and clinicians and help guide the development and implementation of future prostate cancer screening interventions in the U.S.

Analysis of the Benefits and Costs of a National Campaign to Promote Colorectal Cancer Screening CDC’s Screen for Life—National Colorectal Cancer Action Campaign

The Inside Knowledge: Get the Facts About Gynecologic Cancer campaign raises awareness of the five main types of gynecologic cancer: cervical, ovarian, uterine, vaginal, and vulvar. It encourages women to pay attention to their bodies and know what is normal for them so they can recognize the warning signs of gynecologic cancers and seek medical care. This report provides an overview of the development of this national campaign.

Economic Burden of Chronic Conditions Among Survivors of Cancer in the United States

Prostate cancer is the most commonly diagnosed cancer among American men. The multiple treatment options for localized prostate cancer and potential side effects can complicate the decision-making process. We describe the level of engagement and communication among the patient, family member, and physician (the decision-making “triad”) in the decision process prior to treatment. Using the Family and Cancer Therapy Selection (FACTS) study baseline survey data, we note racial/ethnic variations in communication among the triad. Sensitivity to and awareness of decision-making styles of both the patient and their family member (or caregiver) may enable clinicians to positively influence communication exchanges about important clinical decisions.