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Minimizing the burden of cancer in the United States: Goals for a high-performing health care system
K. Robin Yabroff PhD Ted Gansler MD MPH MBA Richard C. Wender MD Kevin J. Cullen MD Otis W. Brawley MD 《CA: a cancer journal for clinicians》2019,69(3):166-183
Between 1991 and 2015, the cancer mortality rate declined dramatically in the United States, reflecting improvements in cancer prevention, screening, treatment, and survivorship care. However, cancer outcomes in the United States vary substantially between populations defined by race/ethnicity, socioeconomic status, health insurance coverage, and geographic area of residence. Many potentially preventable cancer deaths occur in individuals who did not receive effective cancer prevention, screening, treatment, or survivorship care. At the same time, cancer care spending is large and growing, straining national, state, health insurance plans, and family budgets. Indeed, one of the most pressing issues in American medicine is how to ensure that all populations, in every community, derive the benefit from scientific research that has already been completed. Addressing these questions from the perspective of health care delivery is necessary to accelerate the decline in cancer mortality that began in the early 1990s. This article, part of the Cancer Control Blueprint series, describes challenges with the provision of care across the cancer control continuum in the United States. It also identifies goals for a high-performing health system that could reduce disparities and the burden of cancer by promoting the adoption of healthy lifestyles; access to a regular source of primary care; timely access to evidence-based care; patient-centeredness, including effective patient-provider communication; enhanced coordination and communication between providers, including primary care and specialty care providers; and affordability for patients, payers, and society. 相似文献
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Kelly A. Stahl Elizabeth J. Olecki Matthew E. Dixon June S. Peng Madeline B. Torres Niraj J. Gusani Chan Shen 《Current oncology (Toronto, Ont.)》2021,28(1):138
Gastric cancer is the third most common cause of cancer deaths worldwide. Despite evidence-based recommendation for treatment, the current treatment patterns for all stages of gastric cancer remain largely unexplored. This study investigates trends in the treatments and survival of gastric cancer. The National Cancer Database was used to identify gastric adenocarcinoma patients from 2004–2016. Chi-square tests were used to examine subgroup differences between disease stages: Stage I, II/III and IV. Multivariate analyses identified factors associated with the receipt of guideline concordant care. The Kaplan–Meier method was used to assess three-year overall survival. The final cohort included 108,150 patients: 23,584 Stage I, 40,216 Stage II/III, and 44,350 Stage IV. Stage specific guideline concordant care was received in only 73% of patients with Stage I disease and 51% of patients with Stage II/III disease. Patients who received guideline consistent care had significantly improved survival compared to those who did not. Overall, we found only moderate improvement in guideline adherence and three-year overall survival during the 13-year study time period. This study showed underutilization of stage specific guideline concordant care for stage I and II/III disease. 相似文献
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Changes in treatment patterns for patients with locally advanced rectal cancer in the United States over the past decade: An analysis from the National Cancer Data Base 下载免费PDF全文
Helmneh M. Sineshaw MD MPH Ahmedin Jemal DVM PhD Charles R. Thomas MD Jr Timur Mitin MD PhD 《Cancer》2016,122(13):1996-2003
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Judith Swan MHS Nancy Breen PhD Barry I. Graubard PhD Timothy S. McNeel BA Donald Blackman PhD Florence K. Tangka PhD Rachel Ballard‐Barbash PhD 《Cancer》2010,116(20):4872-4881
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This paper examines the prevalence of cancer screening use as reported in 2005 among US adults, focusing on differences among historically underserved subgroups. We also examine trends from 1992 through 2005 to determine whether differences in screening use are increasing, staying the same, or decreasing.METHODS:
Data from the National Health Interview Surveys between 1992 and 2005 were analyzed to describe patterns and trends in cancer screening practices, including Papanicolaou test, mammography, prostate‐specific antigen, and colorectal screening. Logistic regression was used to report 2005 data for population subgroups defined by several demographic and socioeconomic characteristics.RESULTS:
Rates of use for cancer tests are rising only for colorectal cancer, due largely to the increase in colorectal endoscopy screening. Use of all the modalities was strongly influenced by contact with a physician and by having health insurance coverage.CONCLUSIONS:
There remain large gaps in use for all screening modalities by education, income, usual source of care, health insurance, and recent physician contact. These specific populations would benefit from interventions to overcome these barriers to screening. Cancer 2010. Published 2010 by the American Cancer Society. 相似文献10.
Overview of the National Cancer Screening Programme and the Cancer Screening Status in Korea 下载免费PDF全文
《Asian Pacific journal of cancer prevention》2011,12(3):725-730
Organised cancer screening in Korea began in 1999. Operating system has been stabilised, target populationhave expanded and participation rate has been increased throughout its ten years. Here we present an overviewof the organised cancer screening system in Korea and introduce the National Cancer Screening Programmeincluding results from 2002 to 2008. Furthermore, we present the results of the Korea National Cancer ScreeningSurvey, a survey that is representative of the population, from 2004 to 2009. Finally, we discuss our achievementsand the future challenges. 相似文献
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Okensama La-Anyane BS Brandon E. Alba MD Kelly A. Harmon BS Jocelyn To MS Charalampos Siotos MD Jubril Adepoju BS Andrea Madrigrano MD Rosalinda Alvarado MD Cristina O'Donoghue MD Claudia B. Perez DO David E. Kurlander MD Deana S. Shenaq MD George Kokosis MD 《Journal of surgical oncology》2024,129(3):584-591
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Racial disparities in preoperative chemotherapy use in gastric cancer patients in the United States: Analysis of the National Cancer Data Base, 2006‐2014 下载免费PDF全文
Naruhiko Ikoma MD MS Janice N. Cormier MD MPH Barry Feig MD Xianglin L. Du MB MS PhD Jose‐Miguel Yamal PhD Wayne Hofstetter MD Prajnan Das MD Jaffer A. Ajani MD Christina L. Roland MD MS Keith Fournier MD Richard Royal MD Paul Mansfield MD Brian D. Badgwell MD MS 《Cancer》2018,124(5):998-1007
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Robert A. Smith PhD Durado Brooks MD MPH Vilma Cokkinides PhD Debbie Saslow PhD Otis W. Brawley MD 《CA: a cancer journal for clinicians》2013,63(2):87-105
Answer questions and earn CME/CNE Each year the American Cancer Society (ACS) publishes a summary of its recommendations for early cancer detection, a report on data and trends in cancer screening rates, and select issues related to cancer screening. In this issue of the journal, current ACS cancer screening guidelines are summarized, as are updated guidelines on cervical cancer screening and lung cancer screening with low‐dose helical computed tomography. The latest data on the use of cancer screening from the National Health Interview Survey also are described, as are several issues related to screening coverage under the Patient Protection and Affordable Care Act of 2010. CA Cancer J Clin 2013;. © 2013 American Cancer Society. 相似文献
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What does Medicaid expansion mean for cancer screening and prevention? Results from a randomized trial on the impacts of acquiring Medicaid coverage 下载免费PDF全文
Bill J. Wright PhD Alison K. Conlin MD Heidi L. Allen PhD Jennifer Tsui PhD MPH Matthew J. Carlson PhD Hsin Fang Li PhD 《Cancer》2016,122(5):791-797
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Anne C. Kirchhoff PhD MPH Courtney R. Lyles PhD Mark Fluchel MD Jennifer Wright MD Wendy Leisenring ScD 《Cancer》2012,118(23):5964-5972
BACKGROUND:
Health care outcomes for long‐term survivors of adolescent and young adult (AYA) cancer were compared with young adults without a cancer history, using the 2009 Behavioral Risk Factor Surveillance System data.METHODS:
Eligible participants were 20 to 39 years of age. There were N = 979 who self‐reported a cancer diagnosis between the ages of 15 to 34 years and were at least 5 years from diagnosis (excluding nonmelanoma skin cancer). The remaining 67,216 participants with no cancer history were used as controls. Using multivariable regressions, relative risks and 95% confidence intervals were generated to examine the relationship of survivor status on indicators of poor health care (uninsured, no personal health care provider, no routine care, and avoiding seeing a doctor due to cost). Adjusted proportions were calculated by demographic groups. Results are weighted by Behavioral Risk Factor Surveillance System survey design.RESULTS:
Although the proportion uninsured did not differ (21% of survivors vs 23% of controls), AYA survivors reported forgoing care due to cost at higher levels than controls (relative risk = 1.67, 95% CI = 1.44‐1.94). Cost barriers were particularly high for survivors aged 20 to 29 years (44% vs 16% of controls; P < .001) and female survivors (35% vs 18% of controls; P < .001). Survivors reporting poorer health had more cost barriers. Moreover, uninsured survivors tended to report lower use of health care than did controls.CONCLUSIONS:
AYA cancer survivors may forgo health care due to cost barriers, potentially inhibiting the early detection of late effects. Expanding health insurance coverage for young cancer survivors may be insufficient without adequate strategies to reduce their medical cost burdens. Cancer 2012. © 2012 American Cancer Society. 相似文献18.
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