Trends in Cancer Survival by Health Insurance Status in California From 1997 to 2014

Ellis, Libby; Canchola, Alison J.; Spiegel, David; Ladabaum, Uri; Haile, Robert W.; Gomez, Scarlett Lin

doi:10.1001/jamaoncol.2017.3846

Cited by 144 publications

(137 citation statements)

References 31 publications

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“…Historically, racial/ethnic minorities, the poor, and the uninsured are less likely to receive evidence‐based cancer prevention and screening, and they are more likely to be diagnosed with advanced disease . Racial/ethnic minorities, the poor, and the uninsured are less likely to receive effective cancer treatment and have poorer survival after diagnosis . A substantial proportion of insured Americans are underinsured, and their access to high‐quality care is also limited.…”

Section: Introductionmentioning

confidence: 99%

Minimizing the burden of cancer in the United States: Goals for a high‐performing health care system

Yabroff

Gansler

Wender

et al. 2019

CA A Cancer J Clinicians

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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.

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Section: Introductionmentioning

confidence: 99%

Minimizing the burden of cancer in the United States: Goals for a high‐performing health care system

Yabroff

Gansler

Wender

et al. 2019

CA A Cancer J Clinicians

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“…As the rising positive screening rate drives increases in the rate of prostate cancer (PCa) diagnosis, the overtreatment of PCa urgently needs to be addressed . The method used presently for the screening and preliminary diagnosis of PCa mainly depends on serum prostate‐specific antigen (PSA) levels.…”

Section: Introductionmentioning

confidence: 99%

HnRNPM is a potential mediator of YY1 which promotes EMT in prostate cancer cells

Yang

Zhang

et al. 2019

The Prostate

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Background With the popularity of serum prostate‐specific antigen (PSA) screening, the number of newly diagnosed prostate cancer (PCa) patients is increasing. However, indolent and invasive PCa cannot be distinguished by the PSA level. Here, we mainly explored the role of heterogeneous nuclear ribonucleoprotein M (hnRNPM) in the invasiveness of PCa. Methods Reverse‐transcription quantitative polymerase chain reaction and Western blotting were used to detect the expression of hnRNPM in PCa and benign prostate hyperplasia (BPH) tissue samples as well as PCa cell lines. Immunohistochemistry was applied to detect hnRNPM or Yin Yang 1 (YY1) expression in BPH, prostate adenocarcinoma (ADENO) and neuroendocrine prostate cancer (NEPC) tissue samples. After aberrant hnRNPM expression was detected in C4‐2 and PC3 cells, changes in cell migration and invasion were observed through wound healing and transwell assays, respectively. We also predicted the transcription factor (TF) of hnRNPM through databases and then verified the association between hnRNPM and YY1 using chromatin immunoprecipitation and luciferase assays. Results The hnRNPM expression pattern exhibited a gradual reduction from BPH tissue to ADENO tissue to NEPC tissue, and hnRNPM had lower expression in more aggressive PCa cell lines. The overexpression of hnRNPM could significantly reduce the expression of Twist1, which inhibits the migration and invasion of PCa cells in vitro. In PCa cells, the overexpression of YY1 could promote epithelial‐mesenchymal transition (EMT) by reducing hnRNPM expression. Furthermore, this effect caused by the overexpression of YY1 could be partially attenuated by the simultaneous overexpression of hnRNPM. Conclusions Our study demonstrates that hnRNPM negatively regulates PCa cell migration and invasion, and that hnRNPM expression can be transcriptionally inhibited by YY1. We speculate that hnRNPM may be a biomarker that can assist in assessing PCa aggressiveness.

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“…Several groups have suggested that patientlevel interventions, such as improved treatment education, improved insurance enrollment and coverage, 11 and patient navigators, 24 can improve patient outcomes. Several groups have suggested that patientlevel interventions, such as improved treatment education, improved insurance enrollment and coverage, 11 and patient navigators, 24 can improve patient outcomes.…”

Section: Editorialmentioning

confidence: 99%

“…4,6 However, there are some distinct limitations to consider with the SES classification in the SEER database. 11 In conjunction with SES, a more in-depth analysis of insurance coverage may further highlight factors affecting survival, such as access to care and adherence to treatment. Because individuals are uniformly labeled, variations in education, income, and occupation within the area-based grouping will not be detectable.…”

mentioning

confidence: 99%

Socioeconomics, race, and ethnicity in childhood cancer survival: Accessing and addressing root causes of disparities

Colton

Hawkins

Goulding

et al. 2018

Cancer

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In this issue of Cancer, Kehm et al 1 report on racial and ethnic differences in childhood cancer survival and quantify how socioeconomic status (SES) mediates these disparities. They show that SES accounts for 28% to 73% of racial and ethnic disparities for several childhood cancers, including acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), neuroblastoma, and non-Hodgkin lymphoma. In addition, the authors note that there are still statistically significant racial and ethnic disparities in survival independent of SES, the sources of which remain unclear. Both of these statements represent important steps in the understanding of childhood cancer disparities; they are at once calls for further work to improve our understanding of inequalities as well as opportunities to address them. In this editorial, we explore the epidemiologic challenges of understanding social determinants of childhood cancer survival, specifically those concerning racial and ethnic disparities, and we discuss future directions for increasing health equity for childhood cancer patients.There is resounding evidence that social factors, including race, ethnicity, and SES, are associated with disparities in cancer survival. 2,3 The current study makes important progress in deconvoluting these different factors while also highlighting the challenges of these efforts. Large databases such as the Surveillance, Epidemiology, and End Results (SEER) database provide powerful evidence that is widely generalizable and not prone to selection and survival biases. 4,5 Compared with clinical trials, this population-based study provides a better opportunity for understanding possible differences in racial and ethnic populations, which are often underrepresented in clinical trials. 4,6 However, there are some distinct limitations to consider with the SES classification in the SEER database. Because it is an ecological variable rather than an individual-level determination, there may be significant measurement error or misclassification of individuals, which may bias the socioeconomic effect toward the null 7,8 ; therefore, its contribution to disparities may be underestimated. Because individuals are uniformly labeled, variations in education, income, and occupation within the area-based grouping will not be detectable. The individuals who are worst off and in turn may have the worst survival outcomes will not be identified. Previous research has shown large variability between area-based and household incomes. 9 Consortium trials may provide a balance between collecting individual data and being widely generalizable, but requiring access to advanced centers may limit the generalizability to geographically or economically isolated populations. Furthermore, with the adjustment of the SES status, there is the risk of residual confounding stemming from the broadness of the SES grouping parameters and errors in the classification of SES grouping. 10 A more comprehensive analysis of health insurance status, rather than the crude measure used in th...

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Trends in Cancer Survival by Health Insurance Status in California From 1997 to 2014

Cited by 144 publications

References 31 publications

Minimizing the burden of cancer in the United States: Goals for a high‐performing health care system

Minimizing the burden of cancer in the United States: Goals for a high‐performing health care system

HnRNPM is a potential mediator of YY1 which promotes EMT in prostate cancer cells

Socioeconomics, race, and ethnicity in childhood cancer survival: Accessing and addressing root causes of disparities

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