The key drivers and challenges of Business-NGO partnerships in creating sustainable innovation

DEFF Research Database (Denmark)

Lodsgård, Lise; Aagaard, Annabeth

2014-01-01

A growing body of research emphasizes the potentials of business-NGO partnerships (BNP’s) in developing sustainable innovation. However the business-NGO literature is still at an early stage of development and shrouded in rhetoric with dominant articulations and anecdotes with a lack of empirical...... evidence. One of the main challenges of studying sustainable innovation relates to the fact that there is no established definition and mapping of drivers and internal and external challenges of these collaborations. The observations above and the gab in literature point to the theoretical and empirical...... relevance of exploring business-NGO partnerships in the creation of sustainable innovation. The findings and contributions of this theoretical study are an identification and modeling of six archetypes of Business-NGO partnerships in creating sustainable innovation. Through an exploration of characteristics...

Economic Programmes and Poverty Reduction: NGO Experiences from Tamil Nadu

OpenAIRE

D Rajasekhar; P Shobana

2000-01-01

The impact of economic programmes of SHARE, an NGO from Tamil Nadu, on poverty reduction is analysed with the help of data from 84 hosueholds. The economic programmes contributed to savings and income increase, and enhanced the leadership qualities, awareness and knowledge. The member group is not significantly different from the comparison group in terms of control over income and decision-making. This suggests that the NGO economic programmes have limitation is bringing about non-economic b...

American Institute for Cancer Research

Science.gov (United States)

... Phytochemicals in your food Red and processed meat Sugar and cancer risk Alcohol and cancer risk Physical Activity Are ... Updates: Diabetes Rates are High and Rising, That Links with Cancer Apples and Oranges, What Americans are Eating and ...

American Indian Women Cancer Survivor's Needs and Preferences: Community Support for Cancer Experiences.

Science.gov (United States)

Burnette, Catherine E; Roh, Soonhee; Liddell, Jessica; Lee, Yeon-Shim

2018-03-15

Cancer (the focus of this inquiry) is the leading cause of death among American Indian and Alaska Native women. The purpose of this study was to identify American Indian women cancer survivors' needs and preferences related to community supports for their cancer experience. This qualitative study examined female American Indian cancer survivors' needs and preferences about community support. The sample included 43 American Indian women cancer survivors (the types of cancer survivors included cervical cancer: n = 14; breast cancer: n = 14; and colon and other types: n = 15) residing in the Northern Plains region, in the state of South Dakota. Data were analyzed using qualitative content analysis and were collected between June of 2014 and February of 2015. When asked about their needs and preferences, 82% of participants (n = 35) of female American Indian cancer survivors reported at least one of the following most commonly reported themes: cancer support groups (n = 31, 72%), infrastructure for community support (n = 17, 40%), and cancer education (n = 11, 26%). In addition to the aforementioned themes, 33% of participants (n = 14) indicated the need for an improved healthcare system, with 11% (n = 5) of participants expressly desiring the integration of spirituality and holistic healing options. The majority of American Indian women cancer survivor participants of this study identified a need for more community-based support systems and infrastructures to aid with the cancer survivor experience. Results warrant a community approach to raise awareness, education, and support for American Indian cancer survivors.

Breast Cancer Risk in American Women

Science.gov (United States)

... of Breast & Gynecologic Cancers Breast Cancer Screening Research Breast Cancer Risk in American Women On This Page What ... risk of developing the disease. Personal history of breast cancer : Women who have had breast cancer are more ...

American Indian Men's Perceptions of Breast Cancer Screening for American Indian Women.

Science.gov (United States)

Filippi, Melissa K; Pacheco, Joseph; James, Aimee S; Brown, Travis; Ndikum-Moffor, Florence; Choi, Won S; Greiner, K Allen; Daley, Christine M

2014-01-01

Screening, especially screening mammography, is vital for decreasing breast cancer incidence and mortality. Screening rates in American Indian women are low compared to other racial/ethnic groups. In addition, American Indian women are diagnosed at more advanced stages and have lower 5-year survival rate than others. To better address the screening rates of American Indian women, focus groups (N=8) were conducted with American Indian men (N=42) to explore their perceptions of breast cancer screening for American Indian women. Our intent was to understand men's support level toward screening. Using a community-based participatory approach, focus groups were audio-taped, transcribed verbatim, and analyzed using a text analysis approach developed by our team. Topics discussed included breast cancer and screening knowledge, barriers to screening, and suggestions to improve screening rates. These findings can guide strategies to improve knowledge and awareness, communication among families and health care providers, and screening rates in American Indian communities.

Active smoking and survival following breast cancer among African American and non-African American women in the Carolina Breast Cancer Study.

Science.gov (United States)

Parada, Humberto; Sun, Xuezheng; Tse, Chiu-Kit; Olshan, Andrew F; Troester, Melissa A; Conway, Kathleen

2017-09-01

To examine racial differences in smoking rates at the time of breast cancer diagnosis and subsequent survival among African American and non-African American women in the Carolina Breast Cancer Study (Phases I/II), a large population-based North Carolina study. We interviewed 788 African American and 1,020 Caucasian/non-African American women diagnosed with invasive breast cancer from 1993 to 2000, to assess smoking history. After a median follow-up of 13.56 years, we identified 717 deaths using the National Death Index; 427 were breast cancer-related. We used Cox regression to examine associations between self-reported measures of smoking and breast cancer-specific survival within 5 years and up to 18 years after diagnosis conditional on 5-year survival. We examined race and estrogen receptor status as potential modifiers. Current (vs never) smoking was not associated with 5-year survival; however, risk of 13 year conditional breast cancer-specific mortality was elevated among women who were current smokers at diagnosis (HR 1.54, 95% CI 1.06-2.25), compared to never smokers. Although smoking rates were similar among African American (22.0%) and non-African American (22.1%) women, risk of breast cancer-specific mortality was elevated among African American (HR 1.69, 95% CI 1.00-2.85), but only weakly elevated among non-African American (HR 1.22, 95% CI 0.70-2.14) current (vs. never) smokers (P Interaction  = 0.30). Risk of breast cancer-specific mortality was also elevated among current (vs never) smokers diagnosed with ER - (HR 2.58, 95% CI 1.35-4.93), but not ER + (HR 1.11, 95% CI 0.69-1.78) tumors (P Interaction  = 0.17). Smoking may negatively impact long-term survival following breast cancer. Racial differences in long-term survival, as related to smoking, may be driven by ER status, rather than by differences in smoking patterns.

Building a Latin American cancer patient advocacy movement: Latin American cancer NGO regional overview Desarrollando un movimiento de apoyo para pacientes de cáncer en America Latina: resumen regional - ONGs de cáncer

Directory of Open Access Journals (Sweden)

Alessandra Durstine

2009-01-01

Full Text Available The objective of the this paper is to assess and identify the key strengths and weaknesses for cancer control NGOs in Latin America, with the goal to make recommendations about how to improve thev impact of the patient advocacy movement as it pertains to cancer. The methods included literature review, expert interviews and site visits to Latin American cancer hospitals and NGOs. The overall findings conclude that NGOs currently do not take a leadership role in cancer control in Latin America. The lack of a survivorship movement, faulty patient information services and failure of the governments to include NGOs in policy creation are identified as areas for further project work and collaboration. The stigma of cancer still remains and a burgeoning patient movement can be created to help destigmatize and debunk the myths that surround cancer.El objetivo de este artículo es el de identificar y evaluar las fortalezas y debilidades clave de las ONG dedicadas al control del cáncer en Latinoamérica, con el fin de generar recomendaciones sobre el modo de mejorar el impacto del movimiento de apoyo para pacientes de cáncer. Los métodos incluyeron una revisión de la literatura, entrevistas a expertos y visitas a hospiptales y ONG dedicados al cáncer en Latinoamérica. Los hallazgos principales permiten concluir que en este momento las ONG no tienen un rol de liderazgo para el control del cáncer en Latinoamérica. La ausencia de un movimiento de sobrevivientes, servicios de información deficientes a los pacientes y el fracaso del gobierno para incluir a las ONG en la creación de políticas se identifican como áreas de trabajo y colaboración en proyectos a futuro. El estigma del cáncer aún subsiste y es factible crear un movimiento que florezca y ayude a desvanecerlo al exponer los mitos que rodean este padecimiento.

Differences in knowledge of breast cancer screening among African American, Arab American, and Latina women.

Science.gov (United States)

Williams, Karen Patricia; Mabiso, Athur; Todem, David; Hammad, Adnan; Hill-Ashford, Yolanda; Hamade, Hiam; Palamisono, Gloria; Robinson-Lockett, Murlisa; Zambrana, Ruth E

2011-01-01

We examined differences in knowledge and socioeconomic factors associated with 3 types of breast cancer screening (breast self-examination, clinical breast examination, and mammogram) among African American, Arab, and Latina women. Community health workers used a community-based intervention to recruit 341 women (112 Arab, 113 Latina, and 116 African American) in southeastern Michigan to participate in a breast cancer prevention intervention from August through October 2006. Before and after the intervention, women responded to a previously validated 5-item multiple-choice test on breast cancer screening (possible score range: 0 to 5) in their language of preference (English, Spanish, or Arabic). We used generalized estimating equations to analyze data and to account for family-level and individual correlations. Although African American women knew more about breast cancer screening at the baseline (pretest median scores were 4 for African American, 3 for Arab and 3 for Latina women), all groups significantly increased their knowledge after participating in the breast cancer prevention intervention (posttest median scores were 5 for African American and 4 for Arab and Latina women). Generalized estimating equations models show that Arab and Latina women made the most significant gains in posttest scores (P American, Arab, and Latina women to promote adherence to breast cancer screening guidelines.

Business-NGO interactions in a multi-stakeholder context

NARCIS (Netherlands)

Huijstee, M.M. van; Glasbergen, P.

2010-01-01

The main purpose of this paper is to contribute to our understanding of the conditions under which Business– nongovernmental organization (NGO) interactions lead to improvements in corporate social responsibility (CSR), by assessing the role that the stakeholder context of the firm plays in the

A Genome-Wide Breast Cancer Scan in African Americans

Science.gov (United States)

2010-06-01

SNPs from the African American breast cancer scan to COGs , a European collaborative study which is has designed a SNP array with that will be genotyped...Award Number: W81XWH-08-1-0383 TITLE: A Genome-wide Breast Cancer Scan in African Americans PRINCIPAL INVESTIGATOR: Christopher A...SUBTITLE A Genome-wide Breast Cancer Scan in African Americans 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-08-1-0383 5c. PROGRAM

Increasing Breast Cancer Surveillance among African American Breast Cancer Survivors

National Research Council Canada - National Science Library

Thompson, Hayley

2005-01-01

...; they also are at considerable risk for breast cancer recurrence. According to the American Society of Clinical Oncology, survivors should undergo careful breast cancer surveillance, including annual mammography and breast self-exam...

Health beliefs and cancer prevention practices of Filipino American women

OpenAIRE

Ko, Celine M.

2006-01-01

Cancer is the number one cause of death among Asian Americans, and Filipino Americans are the second largest Asian American group in number. Filipino American women have relatively low rates of breast and colorectal cancer screening compared to their White counterparts; however, they experience higher numbers of late-stage diagnoses and mortality rates. Thus, early detection of cancer and maintenance of healthy prevention behaviors are very important. Little is known about this community's pr...

Health-related quality of life of African-American female breast cancer survivors, survivors of other cancers, and those without cancer.

Science.gov (United States)

Claridy, Mechelle D; Ansa, Benjamin; Damus, Francesca; Alema-Mensah, Ernest; Smith, Selina A

2018-04-27

The purpose of this study was to compare differences in health-related quality of life (HRQOL) between African-American female breast cancer survivors, African-American female survivors of other cancers, and African-American women with no history of cancer. Using data from the 2010 National Health Interview Survey (NHIS), the HRQOL of African-American women aged 35 years or older was compared by cancer status. Physical and mental health items from the Patient-Reported Outcomes Measurement Information System (PROMIS) global health scale were used to assess differences in HRQOL. For summary physical and mental health measures, no significant differences were found between breast cancer survivors and women with no history of cancer; survivors of other cancers reported poorer physical and mental health than did women with no history of cancer. Similar differences were found at the item level. When we examined the two African-American female cancer survivor groups, we found that cancer survivors whose cancer was being treated reported substantially poorer physical health and mental health than did those whose cancer was not being treated. Survivors who had private insurance and were cancer free reported better physical and mental health than did those who did not have private insurance and those who were not cancer free. Breast cancer survivors reported slightly better physical and mental health than did survivors of other cancers. Our findings highlight the need for public health agencies to adopt practices to improve the mental and physical health of African-American female survivors of cancer.

Breast cancer among American Japanese in the San Francisco Bay area.

Science.gov (United States)

Dunn, J E

1977-12-01

The Japanese-American population was particularly well suited for the study of cancer occurrence because: 1) An American-born population as well as the immigrant Japanese-American population could be studied; 2) good cancer incidence and mortality data from Japan could be compared with data from the United States; and 3) some differences in the rate of occurrence of several specific cancer sites in Japan as compared with the United States were striking. The most significant of these involved the gastrointestinal tract and sex organs. Data were presented concerning cancer incidence rates for the Japanese-American population of the San Francisco Bay area. The high gastric rates for the Japanese in Japan were reduced in a stepwise fashion in the immigrant Japanese-American population to the American-born Japanese who were approaching the low rate of the United States. Colon cancer rates, which were low in Japan, approached the rates in the United States in both the immigrants from Japan and in Japanese Americans. The low rates of cancers of the breast, uterine corpus, and ovary of Japanese women in Japan and for prostate cancer among men rapidly approached the higher rates for these cancer sites that existed in the United States. A study of nutritional factors related to the increase of cancer of the breast in Japanese Americans is being conducted.

Chinese Anti-Cancer Association as a non-governmental organization undertakes systematic cancer prevention work in China

Science.gov (United States)

2015-01-01

Cancer has become the first leading cause of death in the world, particularly in low- and middle-income countries. Facing the increasing trend of cancer incidence and mortality, China issued and implemented “three-early (early prevention, early diagnosis and early treatment)” national cancer prevention plan. As the main body and dependence of social governance, non-governmental organizations (NGOs) take over the role of government in the field of cancer prevention and treatment. American Cancer Society (ACS) made a research on cancer NGOs and civil society in cancer control and found that cancer NGOs in developing countries mobilize civil society to work together and advocate governments in their countries to develop policies to address the growing cancer burden. Union for International Cancer Control (UICC), Cancer Council Australia (CCA), and Malaysian cancer NGOs are the representatives of cancer NGOs in promoting cancer control. Selecting Chinese Anti-Cancer Association (CACA) as an example in China, this article is to investigate how NGOs undertake systematic cancer prevention work in China. By conducting real case study, we found that, as a NGO, CACA plays a significant role in intensifying the leading role of government in cancer control, optimizing cancer outcomes, decreasing cancer incidence and mortality rates and improving public health. PMID:26361412

Differences in cultural beliefs and values among African American and European American men with prostate cancer.

Science.gov (United States)

Hughes Halbert, Chanita; Barg, Frances K; Weathers, Benita; Delmoor, Ernestine; Coyne, James; Wileyto, E Paul; Arocho, Justin; Mahler, Brandon; Malkowicz, S Bruce

2007-07-01

Although cultural values are increasingly being recognized as important determinants of psychological and behavioral outcomes following cancer diagnosis and treatment, empirical data are not available on cultural values among men. This study evaluated differences in cultural values related to religiosity, temporal orientation, and collectivism among African American and European American men. Participants were 119 African American and European American men who were newly diagnosed with early-stage and locally advanced prostate cancer. Cultural values were evaluated by self-report using standardized instruments during a structured telephone interview. After controlling for sociodemographic characteristics, African American men reported significantly greater levels of religiosity (Beta = 24.44, P cultural values, clinical experiences with prostate cancer may also be important. This underscores the importance of evaluating the effects of both ethnicity and clinical factors in research on the influence of cultural values on cancer prevention and control.

The NGO/Military Relationship and Complex Contingencies: A Tool Review

National Research Council Canada - National Science Library

Wright, Stephanie

2000-01-01

.... This is a review of factors driving that involvement and, as a result, the tools that are developing for interagency coordination in cases of complex contingencies with a focus primarily on the NGO...

グローバリゼーションのもとでのマイクロファイナンスの妥当性―南インドの NGO 評価事例から―

OpenAIRE

雨森, 孝悦; Takayoshi, Amenomori

2004-01-01

This article is an attempt to examine the relevance of microfinance against the background of globalization, i.e. the global spread of commercialism and Americanization, the integration of markets, among others, and the decline of the rural community. As a case, a Japanese NGO with local NGO partners in South India was chosen, whose activities the author was entrusted to evaluate. The main strategy of these NGOs was to form and strengthen self-help groups （SHGs） in poor rural areas, with the ...

Stomach cancer incidence rates among Americans, Asian Americans and Native Asians from 1988 to 2011

Directory of Open Access Journals (Sweden)

Yeerae Kim

2015-02-01

Full Text Available Stomach cancer is the second most common cancer in Eastern Asia, accounting for approximately 50% of all new cases of stomach cancer worldwide. Our objective was to compare the stomach cancer incidence rates of Asian Americans in Los Angeles with those of native Asians to assess the etiology of stomach cancer from 1988 to 2011. To examine these differences, Asian Americans (Korean, Japanese, Chinese, and Filipino Americans living in Los Angeles, California, USA and native Asians (from Korea, Japan, China, and the Philippines were selected for this study. Using the Cancer Incidence in Five Continents database, stomach cancer incidence rates were examined. Data from the National Cancer Registry of Korea were used for native Koreans. Between native countries, the incidence rates in Japan, China, the Philippines, and the US declined over time, but the incidence in Korea has remained constant. The incidences among Asian immigrants were lower than those among native Asians. The incidence rates of males were approximately 2 times higher than those among females in Asian countries were. The effect of immigration on stomach cancer incidence suggests that lifestyle factors are a significant determinant of stomach cancer risk. However, the incidence in Korea remains the highest of these countries

The promise and challenge of collaboration for CSR: Corporate- NGO engagement

NARCIS (Netherlands)

V. Chaudri (Vidhi)

2015-01-01

markdownabstractAgainst the backdrop of a new Indian legislation that makes CSR mandatory, this short piece unpacks the pragmatic and ideological tensions and challenges in achieving the promise of corporate-NGO engagement.

Vietnamese American women’s beliefs and perceptions on cervical cancer, cervical cancer screening, and cancer prevention vaccines: A community-based participatory study

Directory of Open Access Journals (Sweden)

Connie Kim Yen Nguyen-Truong

2017-12-01

Full Text Available Cervical cancer remains commonly diagnosed in Vietnamese American women. Despite efforts to increase cervical cancer screening among Vietnamese American women, participation rates are persistently lower than the national goal. The objective of this study is to explore beliefs of Vietnamese American women about cervical cancer, cervical cancer screening, and cancer prevention vaccines. A qualitative descriptive investigation captured group perceptions about meaning and beliefs of cervical cancer, screening, and cancer prevention vaccines, and participants’ stories using a community-based participatory research approach. Forty Vietnamese American women were recruited from the Portland, Oregon metropolitan area into four focus groups. Using a process of directed content analysis, focus group transcripts were coded for themes. We found that cervical cancer continues to be a difficult topic to discuss, and Vietnamese American women may not bring the topic up themselves to their health care providers. Some women experienced intense emotions of fear or shame of having their cervix examined. Women delayed seeking cervical cancer screening and needed to have early warning signs, which guided them as to when to seek health care. Women focused on cleanliness through vaginal and/or perineal washing as primary prevention for cervical cancer. There were limited awareness and knowledge about cancer prevention vaccines, specifically the human papillomavirus. Some women relied heavily on their informal social networks of family, friends, or community for health knowledge. Fear and misunderstanding dominated the beliefs of Vietnamese American women about cervical cancer screening and prevention. These findings underscored the importance of having culturally-specific findings, which will inform a multicomponent intervention to promote cervical cancer screening and cancer prevention vaccine uptake within this population.

Ngo accountability and sustainability issues in the changing global environment

NARCIS (Netherlands)

Unerman, J.; O'Dwyer, B.

2010-01-01

This article, based on a plenary lecture given at the First International Conference on Sustainable Management of Public and Not for Profit Organizations held at the University of Bologna, Forli Campus, Italy in July 2009, provides an overview of issues in non-governmental organization (NGO)

Differential Serum Cytokine Levels and Risk of Lung Cancer between African and European Americans

Science.gov (United States)

Pine, Sharon R.; Mechanic, Leah E.; Enewold, Lindsey; Bowman, Elise D.; Ryan, Bríd M.; Cote, Michele L.; Wenzlaff, Angela S.; Loffredo, Christopher A.; Olivo-Marston, Susan; Chaturvedi, Anil; Caporaso, Neil E.; Schwartz, Ann G.; Harris, Curtis C.

2015-01-01

Background African Americans have a higher risk of developing lung cancer than European Americans. Previous studies suggested that certain circulating cytokines were associated with lung cancer. We hypothesized that variations in serum cytokine levels exist between African Americans and European Americans, and increased circulating cytokine levels contribute to lung cancer differently in the two races. Methods Differences in ten serum cytokine levels, interleukin (IL)-1β, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12, granulocyte macrophage colony-stimulating factor (GMCSF), interferon (IFN)-γ and tumor necrosis factor (TNF)-α between 170 African-American and 296 European-American controls from the National Cancer Institute-Maryland (NCI-MD) case-control study were assessed. Associations of the serum cytokine levels with lung cancer were analyzed. Statistically significant results were replicated in the prospective Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial and the Wayne State University (WSU) Karmanos Cancer Institute case-control study. Results Six cytokines: IL-4, IL-5, IL-8, IL-10, IFNγ, and TNFα, were significantly higher among European-American as compared to African-American controls. Elevated IL-6 and IL-8 levels were associated with lung cancer among both races in all three studies. Elevated IL-1β, IL-10 and TNFα levels were associated with lung cancer only among African Americans. The association between elevated TNFα levels and lung cancer among European Americans was significant after adjustment for additional factors. Conclusions Serum cytokine levels vary by race and might contribute to lung cancer differently between African Americans and European Americans. Impact Future work examining risk prediction models of lung cancer can measure circulating cytokines to accurately characterize risk within racial groups. PMID:26711330

Exploring Coping Strategies Among Young Asian American Women Breast Cancer Survivors.

Science.gov (United States)

Yoo, Grace J; Sudhakar, Anantha; Le, Mai Nhung; Levine, Ellen G

2017-03-01

In recent years, breast cancer rates among young Asian American women have been increasing. Despite increases in breast cancer among young Asian American women, little is known about how this population copes throughout diagnosis, treatment, and survivorship. This study was a qualitative exploration of how young Asian American women cope with breast cancer diagnosis, treatment, and survivorship. In-depth interviews with 22 young (under the age of 50) Asian American women diagnosed with early stage breast cancer were conducted. Through qualitative data analysis, three major themes emerged including moving from managing the emotions of others to expressing emotional vulnerability, moving from work and productivity to work-life balance, and moving beyond the family and reaching out to breast cancer survivors. At diagnosis, participants worked to maintain normalcy including caring for others and working during treatment. Once treatment was over, women worked to find ways to use their experience as a transformative one and also to develop more positive coping skills including expressing emotional vulnerability and reaching out to others. Further studies are needed to create and test culturally tailored supportive interventions that enhance positive coping tools among young Asian American women diagnosed by breast cancer.

The situation-specific theory of pain experience for Asian American cancer patients.

Science.gov (United States)

Im, Eun-Ok

2008-01-01

Studies have indicated the need for theories that explain and target ethnic-specific cancer pain experiences, including those of Asian Americans. In this article, I present a situation-specific theory that explains the unique cancer pain experience of Asian Americans. Unlike other existing theories, this situation-specific theory was developed on the basis of evidence, including a systematic literature review and research findings, making it comprehensive and highly applicable to research and practice with Asian American patients with cancer. Thus, this theory would strengthen the interconnections among theory, evidence, and practice in pain management for Asian American cancer patients.

Type III methyltransferase M.NgoAX from Neisseria gonorrhoeae FA1090 regulates biofilm formation and human cell invasion

Directory of Open Access Journals (Sweden)

Agnieszka eKwiatek

2015-12-01

Full Text Available Neisseria gonorrhoeae is the etiological factor of the sexually transmitted gonorrhea disease that may lead, under specific conditions, to systemic infections. The gonococcal genome encodes many Restriction Modification (RM systems, which main biological role is to defend the pathogen from potentially harmful foreign DNA. However, RM systems seem also to be involved in several other functions. In this study, we examined the effect of inactivation the N. gonorrhoeae FA1090 ngo0545 gene encoding M.NgoAX methyltransferase on the global gene expression, biofilm formation, interactions with human epithelial host cells and overall bacterial growth. Expression microarrays showed at least a two-fold deregulation of a total of 121 genes in the NgoAX knock-out mutant compared to the wt strain under standard grow conditions. As determined by the assay with crystal violet, the NgoAX knock-out strain formed a slightly larger biofilm biomass per cell than the wt strain (OD570/600 = 13.8  2.24 and 9.35  2.06, respectively. SCLM observations showed that the biofilm formed by the gonococcal ngo0545 gene mutant is more relaxed and dispersed than the one formed by the wt strain. Thickness of the biofilm formed by both strains was 48.3 (14.9 µm for the mutant and 28.6 (4.0 µm for the wt. This more relaxed feature of the biofilm in respect to adhesion and bacterial interactions seems advantageous for pathogenesis of the NgoAX-deficient gonococci at the stage of human epithelial cell invasion. Indeed, the overall adhesion of mutant bacterial cells to human cells was lower than adhesion of the wt gonococci (adhesion index = 0.672 ( 0.2 and 2.15 ( 1.53, respectively; yet, a higher number of mutant than wt bacteria were found inside the Hec-1-B epithelial cells (invasion index = 3.38 ( 0.93  105 for mutant and 4.67 ( 3.09  104 for the wt strain. These results indicate that NgoAX-deficient cells have lower ability to attach to human cells

Longitudinal analysis of domain-level breast cancer literacy among African-American women.

Science.gov (United States)

Mabiso, Athur; Williams, Karen Patricia; Todem, David; Templin, Thomas N

2010-02-01

Functional breast cancer literacy was assessed among African-American women and measured at the domain level over time. We used the Kin Keeper(SM) Cancer Prevention Intervention to educate 161 African-American women on three domains of breast cancer literacy: (i) cancer awareness, (ii) knowledge of breast cancer screening modalities and (iii) cancer prevention and control. A breast cancer literacy assessment was administered pre- and post-educational intervention at two time points followed by another assessment 12 months after the second intervention. Generalized estimating equations were specified to predict the probability of correctly answering questions in each domain over time. Domain-level literacy differentials exist; at baseline, women had higher test scores in the breast cancer prevention and control domain than the cancer awareness domain (odds ratio = 1.67, 95% confidence interval 1.19-2.34). After Kin Keeper(SM) Cancer Prevention Intervention, African-American women consistently improved their breast cancer literacy in all domains over the five time stages (P < 0.001) though at different rates for each domain. Differences in domain-level breast cancer literacy highlight the importance of assessing literacy at the domain level. Interventions to improve African-American women's breast cancer literacy should focus on knowledge of breast cancer screening modalities and cancer awareness domains.

Understanding participation by African Americans in cancer genetics research.

Science.gov (United States)

McDonald, Jasmine A; Barg, Frances K; Weathers, Benita; Guerra, Carmen E; Troxel, Andrea B; Domchek, Susan; Bowen, Deborah; Shea, Judy A; Halbert, Chanita Hughes

2012-01-01

Understanding genetic factors that contribute to racial differences in cancer outcomes may reduce racial disparities in cancer morbidity and mortality. Achieving this goal will be limited by low rates of African American participation in cancer genetics research. We conducted a qualitative study with African American adults (n = 91) to understand attitudes about participating in cancer genetics research and to identify factors that are considered when making a decision about participating in this type of research. Participants would consider the potential benefits to themselves, family members, and their community when making a decision to participate in cancer genetics research. However, concerns about exploitation, distrust of researchers, and investigators' motives were also important to participation decisions. Individuals would also consider who has access to their personal information and what would happen to these data. Side effects, logistical issues, and the potential to gain knowledge about health issues were also described as important factors in decision making. African Americans may consider a number of ethical, legal, and social issues when making a decision to participate in cancer genetics research. These issues should be addressed as part of recruitment efforts.

Differences in Knowledge of Breast Cancer Screening Among African American, Arab American, and Latina Women

OpenAIRE

Williams, Karen Patricia; Mabiso, Athur; Todem, David; Hammad, Adnan; Hamade, Hiam; Hill-Ashford, Yolanda; Robinson-Lockett, Murlisa; Palamisono, Gloria; Zambrana, Ruth E.

2010-01-01

Introduction We examined differences in knowledge and socioeconomic factors associated with 3 types of breast cancer screening (breast self-examination, clinical breast examination, and mammogram) among African American, Arab, and Latina women. Methods Community health workers used a community-based intervention to recruit 341 women (112 Arab, 113 Latina, and 116 African American) in southeastern Michigan to participate in a breast cancer prevention intervention from August through October 20...

Small NGO Schools in India: Implications for Access and Innovation

Science.gov (United States)

Blum, Nicole

2009-01-01

In addition to the proliferation of private, fee-paying schools in India, non-governmental organisations (NGOs) play an important role in providing educational services, especially in un-served and under-served communities. This paper uses qualitative research to critically examine the nature and potential of NGO provision of primary schooling in…

Teaching strategies to facilitate breast cancer screening by African-American women.

Science.gov (United States)

Gibson, Lynette M

2008-12-01

The objective of this paper is to report on the recent literature concerning coverage of breast cancer epidemiology, the barriers to breast cancer screening, and the strategies to facilitate screening by African-American women. Based on these findings, the author suggests culturally appropriate techniques to be used to promote breast cancer screening in African-American women. Barriers to breast cancer screening in African-American women include emotional reasons, spiritual/religious reasons, fatalism, logistic concerns, lack of knowledge, and lack of follow-up by health-care professionals. Numerous strategies that have been targeted toward African-American women are reported. These include storytelling, witnessing, and testimonies; providing social support and having social support networks; and conducting multifaceted programs that include culturally specific breast health information. Based on the literature reviewed, the author suggests some examples of creative and culturally appropriate techniques that have been implemented with African-American women and that have resulted in positive feedback. These examples include the use of testimonies, photographs, prose, narratives, poetry, and quotations.

Knowledge, attitudes, and beliefs of Arab-American women regarding inherited cancer risk.

Science.gov (United States)

Mellon, Suzanne; Gauthier, Jacqueline; Cichon, Michelle; Hammad, Adnan; Simon, Michael S

2013-04-01

The increasing incidence of breast cancer in the Arab world, coupled with a relatively early age of onset, raises concern for the presence of hereditary risk factors in this population. However, due to potential structural and cultural barriers, Arab Americans make up the smallest percentage of individuals tested for Hereditary Breast and Ovarian Cancer Syndrome in the United States. The objectives of this qualitative pilot focus group of 13 Arab-American women were to explore attitudes, knowledge and beliefs regarding hereditary breast cancer in the Arab-American community in metropolitan Detroit, identify barriers that would prevent women from seeking hereditary cancer screening/testing and determine who women would talk to about inherited cancer. Results indicated that cultural beliefs and personal experiences with cancer influenced the women's perspectives on hereditary cancer risk. A high level of secrecy about cancer within Arab-American families was present, which may prevent accurate risk assessment and referral for genetic services. Other identified barriers that may influence hereditary risk assessment included stigma, fears and misconceptions of cancer. While these barriers were present, participants also expressed a strong need for education and tailored cancer risk information for their community.

The incentive effects of missions - Evidence from experiments with NGO employees and students

DEFF Research Database (Denmark)

Gerhards, Leonie

2015-01-01

This paper studies the incentive effects of an organization׳s ‘mission’ on the effort provision of agents. Across treatments, I exogenously vary how much the agents׳ and their projects׳ missions match. In the first study, NGO employees are assigned the role of agents in an online, one-shot, princ......This paper studies the incentive effects of an organization׳s ‘mission’ on the effort provision of agents. Across treatments, I exogenously vary how much the agents׳ and their projects׳ missions match. In the first study, NGO employees are assigned the role of agents in an online, one......-agent game with random matching, I do not find a motivational effect of missions, unlike in my first two studies....

NGO Management Case Study: Civitas Foundation for Civil Society

Directory of Open Access Journals (Sweden)

Ramona BERE

2000-06-01

Full Text Available As idealistic as it may sound, the truth is that NGOs act to make the world a better place. They often do that by taking action in areas where the government fails to succeed or does not do a very good job. In this context I would like to present a very special NGO: CIVITAS Foundation for Civil Society, evaluating its governance and services.

Barriers to cancer screening in Hmong Americans: the influence of health care accessibility, culture, and cancer literacy.

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Lee, Hee Yun; Vang, Suzanne

2010-06-01

Hmong Americans face high cancer mortality rates even in comparison to their Asian American counterparts, and report low utilization of cancer screenings. To date, no study has been conducted on the cultural barriers this population faces in undergoing cancer screenings. A systematic review of the literature was conducted to examine the existing knowledge regarding the barriers to cancer screening for Hmong Americans. Potential barriers were identified from this examination to include: health access factors (type of health insurance, ethnicity of provider, low English proficiency, and years spent in the U.S.); cultural factors (belief in the spiritual etiology of diseases, patriarchal values, modesty, and mistrust of the western medical system); and cancer literacy factors (cancer and prevention illiteracy). Based on this review, potential cultural and ethnic group-specific prevention strategies and cancer health policies are discussed to address these barriers and enhance screening behavior among the Hmong.

PEGylated lipid bilayer-wrapped nano-graphene oxides for synergistic co-delivery of doxorubicin and rapamycin to prevent drug resistance in cancers

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Thapa, Raj Kumar; Byeon, Jeong Hoon; Choi, Han-Gon; Yong, Chul Soon; Kim, Jong Oh

2017-07-01

Nano-graphene oxide (nGO) is a carbon allotrope studied for its potential as carrier for chemotherapeutic delivery and its photoablation effects. However, interaction of nGO with blood components and the subsequent toxicities warrant a hybrid system for effective cancer drug delivery. Combination chemotherapy aids in effective cancer treatment and prevention of drug resistance. Therefore, in this study, we attempted to prepare polyethylene glycosylated (PEGylated) lipid bilayer-wrapped nGO co-loaded with doxorubicin (DOX) and rapamycin (RAPA), GOLDR, for the prevention and treatment of resistant cancers. Our results revealed a stable GOLDR formulation with appropriate particle size (∼170 nm), polydispersity (∼0.19) and drug loading. Free drug combination (DOX and RAPA) presented synergistic anticancer effects in MDA-MB-231, MCF-7, and BT474 cells. Treatment with GOLDR formulation maintained this synergism in treated cancer cells, which was further enhanced by the near infrared (NIR) laser irradiation-induced photothermal effects of nGO. Higher chromatin condensation and apoptotic body formation, and enhanced protein expression of apoptosis-related markers (Bax, p53, p21, and c-caspase 3) following GOLDR treatment in the presence of NIR laser treatment clearly suggests its superiority in effective chemo-photothermal therapy of resistant cancers. The hybrid nanosystem that we developed provides a basis for the effective use of GOLDR treatment in the prevention and treatment of resistant cancer types.

Cancer incidence among Arab Americans in California, Detroit, and New Jersey SEER registries.

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Bergmans, Rachel; Soliman, Amr S; Ruterbusch, Julie; Meza, Rafael; Hirko, Kelly; Graff, John; Schwartz, Kendra

2014-06-01

We calculated cancer incidence for Arab Americans in California; Detroit, Michigan; and New Jersey, and compared rates with non-Hispanic, non-Arab Whites (NHNAWs); Blacks; and Hispanics. We conducted a study using population-based data. We linked new cancers diagnosed in 2000 from the Surveillance, Epidemiology, and End Results Program (SEER) to an Arab surname database. We used standard SEER definitions and methodology for calculating rates. Population estimates were extracted from the 2000 US Census. We calculated incidence and rate ratios. Arab American men and women had similar incidence rates across the 3 geographic regions, and the rates were comparable to NHNAWs. However, the thyroid cancer rate was elevated among Arab American women compared with NHNAWs, Hispanics, and Blacks. For all sites combined, for prostate and lung cancer, Arab American men had a lower incidence than Blacks and higher incidence than Hispanics in all 3 geographic regions. Arab American male bladder cancer incidence was higher than that in Hispanics and Blacks in these regions. Our results suggested that further research would benefit from the federal recognition of Arab Americans as a specified ethnicity to estimate and address the cancer burden in this growing segment of the population.

Factors Affecting Quality of Life for Korean American Cancer Survivors: An Integrative Review.

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Yoon, Hyojin; Chatters, Linda; Kao, Tsui-Sui; Saint-Arnault, Denise; Northouse, Laurel

2016-05-01

Understanding of Korean American cancer survivors' quality of life (QOL) within a cultural context is limited. This article examines factors associated with the QOL of Korean American cancer survivors.
. A systematic literature search was conducted of PubMed, CINAHL®, Google Scholar, and EBSCO databases from January 2000 to January 2014.
. The studies were assessed for the relevance to the purpose of the review. Each study was rated on a two-point scale using an 11-item quality criteria checklist.
. The 13 studies that met the criteria for inclusion included 7 descriptive, 5 qualitative, and 1 mixed-method. 
. Social support, communication, and acculturation were key factors associated with Korean Americans' QOL. Cultural differences were evident for Korean Americans versus other Asian American ethnic groups.
. More innovative and culturally driven research is needed to understand each minority group's cultural barriers, as well as to improve cancer survivors' QOL. Improving the doctor-patient relationship is critical to promoting better cancer experiences for Korean American cancer survivors.

Participation of Asian-American women in cancer treatment research: a pilot study.

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Nguyen, Tung T; Somkin, Carol P; Ma, Yifei; Fung, Lei-Chun; Nguyen, Thoa

2005-01-01

Few Asian-American women participate in cancer treatment trials. In a pilot study to assess barriers to participation, we mailed surveys to 132 oncologists and interviewed 19 Asian-American women with cancer from Northern California. Forty-four oncologists responded. They reported as barriers language problems, lack of culturally relevant cancer information, and complex protocols. Most stated that they informed Asian-American women about treatment trials. Only four women interviewed knew about trials. Other patient-identified barriers were fear of side effects, language problems, competing needs, and fear of experimentation. Family decision making was a barrier for both oncologists and patients. Compared to non-Asian oncologists, more Asian oncologists have referred Asian-American women to industry trials and identified barriers similar to patients' reports. Our findings indicate that Asian-American women need to be informed about cancer treatment trials, linguistic barriers should be addressed, and future research should evaluate cultural barriers such as family decision making.

Cancer-specific mortality of Asian Americans diagnosed with cancer: a nationwide population-based assessment.

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Trinh, Quoc-Dien; Nguyen, Paul L; Leow, Jeffrey J; Dalela, Deepansh; Chao, Grace F; Mahal, Brandon A; Nayak, Manan; Schmid, Marianne; Choueiri, Toni K; Aizer, Ayal A

2015-06-01

Racial disparities in cancer survival outcomes have been primarily attributed to underlying biologic mechanisms and the quality of cancer care received. Because prior literature shows little difference exists in the socioeconomic status of non-Hispanic whites and Asian Americans, any difference in cancer survival is less likely to be attributable to inequalities of care. We sought to examine differences in cancer-specific survival between whites and Asian Americans. The Surveillance, Epidemiology, and End Results Program was used to identify patients with lung (n = 130 852 [16.9%]), breast (n = 313 977 [40.4%]), prostate (n = 166 529 [21.4%]), or colorectal (n = 165 140 [21.3%]) cancer (the three leading causes of cancer-related mortality within each sex) diagnosed between 1991 and 2007. Fine and Gray's competing risks regression compared the cancer-specific mortality (CSM) of eight Asian American groups (Chinese, Filipino, Hawaiian/Pacific Islander, Japanese, Korean, other Asian, South Asian [Indian/Pakistani], and Vietnamese) to non-Hispanic white patients. All P values were two-sided. In competing risks regression, the receipt of definitive treatment was an independent predictor of CSM (hazard ratio [HR] = 0.37, 95% confidence interval [CI] = 0.35 to 0.40; HR = 0.55, 95% CI = 0.53 to 0.58; HR = 0.61, 95% CI = 0.60 to 0.62; and HR = 0.27, 95% CI = 0.25 to 0.29) for prostate, breast, lung, and colorectal cancers respectively, all P < .001). In adjusted analyses, most Asian subgroups (except Hawaiians and Koreans) had lower CSM relative to white patients, with hazard ratios ranging from 0.54 (95% CI = 0.38 to 0.78) to 0.88 (95% CI = 0.84 to 0.93) for Japanese patients with prostate and Chinese patients with lung cancer, respectively. Despite adjustment for potential confounders, including the receipt of definitive treatment and tumor characteristics, most Asian subgroups had better CSM than non-Hispanic white patients. These findings suggest that underlying genetic

I'm a Jesus girl: coping stories of Black American women diagnosed with breast cancer.

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Gregg, Godfrey

2011-12-01

Breast cancer continues to be the most diagnosed cancer for all women, excluding non-melanoma skin cancer, in the United States. Incidence rates are 1 in 8 for an American woman being diagnosed. Moreover, statistics indicate that every 13 min an American woman dies from complications related to breast cancer. Despite all the gains made in the area of cancer research, Black American women continue to have a 67% higher mortality rate than their White counterparts. There is no preparation for a diagnosis of breast cancer. Upon hearing the words: you have breast cancer, a woman's life is forever altered. The woman's initial reactions of denial and/or anger yield to strategic responses. These responses may strengthen the woman's resiliency both during and following treatments. Research indicates that Black Americans, specifically Black American women, exhibit greater religiosity/spirituality than do other racial/ethnic groups. In addition, the use of religiosity/spirituality by Black Americans increases during a crisis. This qualitative study examines how religiosity/spirituality was utilized as a coping mechanism by a group of Black American women following their diagnoses of breast cancer.

Case of ex-Yugoslavia and struggle for its interpretation: Case of NGO's in Serbia

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Radojičić Mirjana

2008-01-01

Full Text Available In this article author considers the case of disintegration/decomposition of Yugoslavia from the angle of struggle for interpretation that several NGO's have fought on Serbian public scene. Clue of whole matter is in a kind of politic of interpretation engaged by these NGO's as for the near Yugoslav past. After the brief summary of this kind of interpretation author asks for key tenets of alleged "new politicity" that have been formed as a model of civil activity in Serbia during the last decade. In concluding part of the article geopolitical dimension of that phenomena is pointed out as well as importance of its precise legislation needed to restrict this kind of practice considerably.

Breast cancer characteristics at diagnosis and survival among Arab-American women compared to European- and African-American women.

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Hensley Alford, Sharon; Schwartz, Kendra; Soliman, Amr; Johnson, Christine Cole; Gruber, Stephen B; Merajver, Sofia D

2009-03-01

Data from Arab world studies suggest that Arab women may experience a more aggressive breast cancer phenotype. To investigate this finding, we focused on one of the largest settlements of Arabs and Iraqi Christians (Chaldeans) in the US, metropolitan Detroit- a SEER reporting site since 1973. We identified a cohort of primary breast cancer cases diagnosed 1973-2003. Using a validated name algorithm, women were identified as being of Arab/Chaldean descent if they had an Arab last or maiden name. We compared characteristics at diagnosis (age, grade, histology, SEER stage, and marker status) and overall survival between Arab-, European-, and African-Americans. The cohort included 1,652 (2%) women of Arab descent, 13,855 (18%) African-American women, and 63,615 (80%) European-American women. There were statistically significant differences between the racial groups for all characteristics at diagnosis. Survival analyses overall and for each SEER stage showed that Arab-American women had the best survival, followed by European-American women. African-American women had the poorest overall survival and were 1.37 (95% confidence interval: 1.23-1.52) times more likely to be diagnosed with an aggressive tumor (adjusting for age, grade, marker status, and year of diagnosis). Overall, Arab-American women have a distribution of breast cancer histology similar to European-American women. In contrast, the stage, age, and hormone receptor status at diagnosis among Arab-Americans was more similar to African-American women. However, Arab-American women have a better overall survival than even European-American women.

Transnational NGO, Development and Global Governance

DEFF Research Database (Denmark)

Li, Xing; Farah, Abdulkadir Osman

2014-01-01

Empirically recent global developments have shown that transnational NGOs operate in between civic mobilization dimension to organizational and institutional dimensions depending on the particular contextual event. NGOs have demonstrated capabilities to move between civic mobilization grass root...... orientations and top down organizational platforms (Stachursky, 2013). In this regard the state remains significant in the process of NGO activities. Although globalizations in the form of mobility and technological advancement diminished state monopoly, NGOs continue to struggle overcoming national priorities...... not just for acquiring funds but also for engaging in an increasingly complex but still state centric world. We can nonetheless agree on the point that Transnational NGOs as non-state actors and have the capacity to simultaneously operate local, global and transnational. On one way these are competent...

Multi-generational perspectives on health, cancer, and biomedicine: Northeastern Native American perspectives shaped by mistrust.

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Canales, Mary K; Weiner, Diane; Samos, Markos; Wampler, Nina S

2011-08-01

Cancer is the second leading cause of death among Native Americans, who have-some of the poorest cancer survival rates of any race/ethnicity nationwide. Considering the cancer burden experienced by Native Americans and the lack of research exploring Northeastern tribal communities' cancer experiences, a qualitative investigation of Native Americans' cancer coping strategies and health education needs was undertaken. Data were collected through group (74) and individual (17) interviews with 91 Native Americans from the Northeast. Relationships between intergenerational mistrust, individual mistrust, and utilization of biomedical health care systems for Northeastern Native Americans are presented. Trust is central to the provider-patient relationship and the foundation for developing and maintaining connections to Native American communities. Intergenerational mistrust, shaped by historical and contemporary issues of prejudice and miscommunication, affect cancer health experiences and views. Approaches for reducing mistrust and building relationships between health care providers and Native communities are highlighted.

Relationship of early-onset baldness to prostate cancer in African-American men.

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Zeigler-Johnson, Charnita; Morales, Knashawn H; Spangler, Elaine; Chang, Bao-Li; Rebbeck, Timothy R

2013-04-01

Early-onset baldness has been linked to prostate cancer; however, little is known about this relationship in African-Americans who are at elevated prostate cancer risk. We recruited 219 African-American controls and 318 African-American prostate cancer cases. We determined age-stratified associations of baldness with prostate cancer occurrence and severity defined by high stage (T3/T4) or high grade (Gleason 7+.) Associations of androgen metabolism genotypes (CYP3A4, CYP3A5, CYP3A43, AR-CAG, SRD5A2 A49T, and SRD5A2 V89L), family history, alcohol intake, and smoking were examined by baldness status and age group by using multivariable logistic regression models. Baldness was associated with odds of prostate cancer [OR = 1.69; 95% confidence interval (CI), 1.05-2.74]. Frontal baldness was associated with high-stage (OR = 2.61; 95% CI, 1.10-6.18) and high-grade (OR = 2.20; 95% CI, 1.05-4.61) tumors. For men diagnosed less than the age of 60 years, frontal baldness was associated with high stage (OR = 6.51; 95% CI, 2.11-20.06) and high grade (OR = 4.23; 95% CI, 1.47-12.14). We also observed a suggestion of an interaction among smoking, median age, and any baldness (P = 0.02). We observed significant associations between early-onset baldness and prostate cancer in African-American men. Interactions with age and smoking were suggested in these associations. Studies are needed to investigate the mechanisms influencing the relationship between baldness and prostate cancer in African-American men. African-American men present with unique risk factors including baldness patterns that may contribute to prostate cancer disparities.

Dietary patterns, food groups, and rectal cancer risk in Whites and African-Americans.

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Williams, Christina Dawn; Satia, Jessie A; Adair, Linda S; Stevens, June; Galanko, Joseph; Keku, Temitope O; Sandler, Robert S

2009-05-01

Associations between individual foods and nutrients and colorectal cancer have been inconsistent, and few studies have examined associations between food, nutrients, dietary patterns, and rectal cancer. We examined the relationship between food groups and dietary patterns and risk for rectal cancer in non-Hispanic Whites and African-Americans. Data were from the North Carolina Colon Cancer Study-Phase II and included 1,520 Whites (720 cases, 800 controls) and 384 African-Americans (225 cases, 159 controls). Diet was assessed using the Diet History Questionnaire. Multivariate logistic regression models were used to estimate odds ratios and 95% confidence intervals. Among Whites, non-whole grains and white potatoes were associated with elevated risk for rectal cancer whereas fruit, vegetables, dairy, fish, and poultry were associated with reduced risk. In African-Americans, high consumption of other fruit and added sugar suggested elevated risk. We identified three major dietary patterns in Whites and African-Americans. The high fat/meat/potatoes pattern was observed in both race groups but was only positively associated with risk in Whites (odds ratio, 1.84; 95% confidence interval, 1.03-3.15). The vegetable/fish/poultry and fruit/whole grain/dairy patterns in Whites had significant inverse associations with risk. In African-Americans, there was a positive dose-response for the fruit/vegetables pattern (P(trend) pattern (P(trend) dietary patterns with rectal cancer risk differ between Whites and African-Americans, highlighting the importance of examining diet and cancer relationships in racially diverse populations.

Sustainability of NGO capacity building in southern Africa: successes and opportunities.

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Humphries, Debbie; Gomez, Ligia; Hartwig, Kari

2011-01-01

Despite an increase in organizational capacity building efforts by external organizations in low and middle income countries, the documentation of these efforts and their effects on health programs and systems remains limited. This paper reviews key frameworks for considering sustainability of capacity building and applies these frameworks to an evaluation of the sustainability of an AIDS non-governmental organization (NGO) capacity building initiative. From 2004-2007 Bristol-Myers Squibb Foundation's Secure the Future(TM) initiative in southern Africa funded a five country program, the NGO Training Institute (NGOTI), to build capacity of NGOs working to address HIV/AIDS. Lessons learned from this project include issues of ownership, the importance of integrating planning for sustainability within capacity-building projects, and the value of identifying primary capacity-building objectives in order to select sustainability strategies that are focused on maintaining program benefits. Sustainability for capacity building projects can be developed by discussing key issues early in the planning process with all primary stakeholders. Copyright © 2010 John Wiley & Sons, Ltd.

Cancer statistics for African Americans, 2016: Progress and opportunities in reducing racial disparities.

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DeSantis, Carol E; Siegel, Rebecca L; Sauer, Ann Goding; Miller, Kimberly D; Fedewa, Stacey A; Alcaraz, Kassandra I; Jemal, Ahmedin

2016-07-01

In this article, the American Cancer Society provides the estimated number of new cancer cases and deaths for blacks in the United States and the most recent data on cancer incidence, mortality, survival, screening, and risk factors for cancer. Incidence data are from the National Cancer Institute, the Centers for Disease Control and Prevention, and the North American Association of Central Cancer Registries, and mortality data are from the National Center for Health Statistics. Approximately 189,910 new cases of cancer and 69,410 cancer deaths will occur among blacks in 2016. Although blacks continue to have higher cancer death rates than whites, the disparity has narrowed for all cancers combined in men and women and for lung and prostate cancers in men. In contrast, the racial gap in death rates has widened for breast cancer in women and remained level for colorectal cancer in men. The reduction in overall cancer death rates since the early 1990s translates to the avoidance of more than 300,000 deaths among blacks. In men, incidence rates from 2003 to 2012 decreased for all cancers combined (by 2.0% per year) as well as for the top 3 cancer sites (prostate, lung, and colorectal). In women, overall rates during the corresponding time period remained unchanged, reflecting increasing trends in breast cancer combined with decreasing trends in lung and colorectal cancer rates. Five-year relative survival is lower for blacks than whites for most cancers at each stage of diagnosis. The extent to which these disparities reflect unequal access to health care versus other factors remains an active area of research. Progress in reducing cancer death rates could be accelerated by ensuring equitable access to prevention, early detection, and high-quality treatment. CA Cancer J Clin 2016;66:290-308. © 2016 American Cancer Society. © 2016 American Cancer Society, Inc.

Characterizing genetic risk at known prostate cancer susceptibility loci in African Americans.

Directory of Open Access Journals (Sweden)

Christopher A Haiman

2011-05-01

Full Text Available GWAS of prostate cancer have been remarkably successful in revealing common genetic variants and novel biological pathways that are linked with its etiology. A more complete understanding of inherited susceptibility to prostate cancer in the general population will come from continuing such discovery efforts and from testing known risk alleles in diverse racial and ethnic groups. In this large study of prostate cancer in African American men (3,425 prostate cancer cases and 3,290 controls, we tested 49 risk variants located in 28 genomic regions identified through GWAS in men of European and Asian descent, and we replicated associations (at p≤0.05 with roughly half of these markers. Through fine-mapping, we identified nearby markers in many regions that better define associations in African Americans. At 8q24, we found 9 variants (p≤6×10(-4 that best capture risk of prostate cancer in African Americans, many of which are more common in men of African than European descent. The markers found to be associated with risk at each locus improved risk modeling in African Americans (per allele OR = 1.17 over the alleles reported in the original GWAS (OR = 1.08. In summary, in this detailed analysis of the prostate cancer risk loci reported from GWAS, we have validated and improved upon markers of risk in some regions that better define the association with prostate cancer in African Americans. Our findings with variants at 8q24 also reinforce the importance of this region as a major risk locus for prostate cancer in men of African ancestry.

Ethics, Risk, and Media Intervention: Women's Breast Cancer in Venezuela.

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Eid, Mahmoud; Nahon-Serfaty, Isaac

2015-07-01

Breast cancer incidence and mortality rates are of concern among Latin American women, mainly due to the growing prevalence of this disease and the lack of compliance to proper breast cancer screening and treatment. Focusing on Venezuelan women and the challenges and barriers that interact with their health communication, this paper looks into issues surrounding women's breast cancer, such as the challenges and barriers to breast cancer care, the relevant ethics and responsibilities, the right to health, breast cancer risk perception and risk communication, and the media interventions that affect Venezuelan women's perceptions and actions pertaining to this disease. In particular, it describes an action-oriented research project in Venezuela that was conducted over a four-year period of collaborative work among researchers, practitioners, NGOs, patients, journalists, and policymakers. The outcomes include positive indications on more effective interactions between physicians and patients, increasing satisfactions about issues of ethical treatment in providing healthcare services, more sufficient and responsible media coverage of breast cancer healthcare services and information, a widely supported declaration for a national response against breast cancer in Venezuela, and the creation of a code of ethics for the Venezuelan NGO that led the expansion of networking in support of women's breast cancer healthcare.

Understanding sleep disturbances in African-American breast cancer survivors: a pilot study.

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Taylor, Teletia R; Huntley, Edward D; Makambi, Kepher; Sween, Jennifer; Adams-Campbell, Lucile L; Frederick, Wayne; Mellman, Thomas A

2012-08-01

The goals of this study were (i) to report the prevalence and nature of sleep disturbances, as determined by clinically significant insomnia symptoms, in a sample of African-American breast cancer survivors; (ii) to assess the extent to which intrusive thoughts about breast cancer and fear of recurrence contributes to insomnia symptoms; and (iii) to assess the extent to which insomnia symptoms contribute to fatigue. African-American breast cancer survivors completed surveys pertaining to demographics, medical history, insomnia symptoms, and intrusive thoughts about breast cancer, fear of cancer recurrence, and fatigue. Hierarchical regression models were performed to investigate the degree to which intrusive thoughts and concerns of cancer recurrence accounted for the severity of insomnia symptoms and insomnia symptom severity's association with fatigue. Forty-three percent of the sample was classified as having clinically significant sleep disturbances. The most commonly identified sleep complaints among participants were sleep maintenance, dissatisfaction with sleep, difficulty falling asleep, and early morning awakenings. Intrusive thoughts about breast cancer were a significant predictor of insomnia symptoms accounting for 12% of the variance in insomnia symptom severity. After adjusting for covariates, it was found that insomnia symptom severity was independently associated with fatigue accounting for 8% of variance. A moderate proportion of African-American breast cancer survivors reported significant problems with sleep. Sleep disturbance was influenced by intrusive thoughts about breast cancer, and fatigue was associated with the severity of participants' insomnia symptoms. This study provides new information about sleep-related issues in African-American breast cancer survivors. Copyright © 2011 John Wiley & Sons, Ltd.

Clinical trials: understanding and perceptions of female Chinese-American cancer patients.

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Tu, Shin-Ping; Chen, Hueifang; Chen, Anthony; Lim, Jeanette; May, Suepattra; Drescher, Charles

2005-12-15

Under-representation of minority and female participants prompted the U.S. legislature to mandate the inclusion of women and minorities in federally funded research. Recruitment of minorities to participate in clinical trials continues to be challenging. Although Asian Americans constitute one of the major minority groups in the U.S., published literature contains sparse data concerning the participation of Asian Americans in cancer clinical trials. The authors completed qualitative, semistructured interviews with 34 participants: Chinese-American female cancer patients ages 20-85 years or their family members. Interviews were conducted in Cantonese, Mandarin, or English and were audiotaped. Chinese interviews were translated into English, and all interviews were transcribed subsequently into English. A team of five coders individually reviewed then met to discuss the English transcripts. The authors used the constant comparative technique throughout the entire coding process as part of the analysis. Among participants, 62% lacked any knowledge of clinical trials, and many expressed negative attitudes toward clinical trials. Barriers to participation included inadequate resources, language issues, and a lack of financial and social support. Facilitating factors included recommendations by a trusted oncologist or another trusted individual and information in the appropriate language. It is noteworthy that family members played an important role in the cancer experience of these participants. To promote participation, there is a need to increase knowledge of clinical trials among Chinese cancer patients. It also is necessary to examine the applicability of current patient-physician communication and interaction models. In addition, decision-making based on Asian philosophies within the context of Euro-American bioethics requires further study. Cancer 2005. (c) 2005 American Cancer Society.

Look local: the value of cancer surveillance and reporting by American Indian clinics.

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Creswell, Paul D; Strickland, Rick; Stephenson, Laura; Pierce-Hudson, Kimmine; Matloub, Jacqueline; Waukau, Jerry; Adams, Alexandra; Kaur, Judith; Remington, Patrick L

2013-11-27

Cancer incidence and mortality rates for American Indians in the Northern Plains region of the United States are among the highest in the nation. Reliable cancer surveillance data are essential to help reduce this burden; however, racial data in state cancer registries are often misclassified, and cases are often underreported. We used a community-based participatory research approach to conduct a retrospective ascertainment of cancer cases in clinic medical records over a 9-year period (1995-2003) and compared the results with the state cancer registry to evaluate missing or racially misclassified cases. Six tribal and/or urban Indian clinics participated in the study. The project team consisted of participating clinics, a state cancer registry, a comprehensive cancer center, an American Indian/Alaska Native Leadership Initiative on Cancer, and a set of diverse organizational partners. Clinic personnel were trained by project staff to accurately identify cancer cases in clinic records. These records were then matched with the state cancer registry to assess misclassification and underreporting. Forty American Indian cases were identified that were either missing or misclassified in the state registry. Adding these cases to the registry increased the number of American Indian cases by 21.3% during the study period (P = .05). Our results indicate that direct reporting of cancer cases by tribal and urban Indian health clinics to a state cancer registry improved the quality of the data available for cancer surveillance. Higher-quality data can advance the efforts of cancer prevention and control stakeholders to address disparities in Native communities.

Barriers of Female Breast, Colorectal, and Cervical Cancer Screening Among American Indians—Where to Intervene?

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Lin, Yan; Gong, Xi; Mousseau, Richard

2016-01-01

Female breast, colorectal, and cervical cancer are three common cancers among people in the United States. Both their incidence and mortality rates can be dramatically reduced if effective prevention and intervention programs are developed and implemented, because these cancers are preventable through regular screenings. American Indians in the United States especially in the Northern Plains have a disproportionally high burden of these cancers. As a hard-to-reach population group, less attention has been paid to American Indians regarding cancer screening compared with other population groups. This study examined barriers experienced by American Indians residing in South Dakota regarding three cancer sites: female breast, colorectal, and cervical cancer through a community-based survey. A total of 199 participants were recruited and factors significantly associated with cancer screening included knowledge about cancer screening, geographic access to PCPs, encouragement by doctors, as well as socioeconomic barriers. Meanwhile, integrating geographic access, socioeconomic deprivation, and geographic distribution of American Indians, the study identified geographic areas of low access to cancer screening where hard-to-reach populations resided. Results from the study will provide crucial information for the development of targeted intervention programs to increase the acceptability and uptake of cancer screening among American Indians. PMID:29546202

Barriers of Female Breast, Colorectal, and Cervical Cancer Screening Among American Indians—Where to Intervene?

Directory of Open Access Journals (Sweden)

Yan Lin

2016-10-01

Full Text Available Female breast, colorectal, and cervical cancer are three common cancers among people in the United States. Both their incidence and mortality rates can be dramatically reduced if effective prevention and intervention programs are developed and implemented, because these cancers are preventable through regular screenings. American Indians in the United States especially in the Northern Plains have a disproportionally high burden of these cancers. As a hard-to-reach population group, less attention has been paid to American Indians regarding cancer screening compared with other population groups. This study examined barriers experienced by American Indians residing in South Dakota regarding three cancer sites: female breast, colorectal, and cervical cancer through a community-based survey. A total of 199 participants were recruited and factors significantly associated with cancer screening included knowledge about cancer screening, geographic access to PCPs, encouragement by doctors, as well as socioeconomic barriers. Meanwhile, integrating geographic access, socioeconomic deprivation, and geographic distribution of American Indians, the study identified geographic areas of low access to cancer screening where hard-to-reach populations resided. Results from the study will provide crucial information for the development of targeted intervention programs to increase the acceptability and uptake of cancer screening among American Indians.

ATTAINING UNIVERSAL ACCESS: PUBLIC-PRIVATE PARTNERSHIP AND BUSINESS-NGO PARTNERSHIP

OpenAIRE

Chowdhury, Shyamal K.

2002-01-01

This paper evaluates two alternative mechanisms, Public-Private Partnership in Peru and Business-NGO Partnership in Bangladesh, that provide rural people with access to telecommunications. The two mechanisms that are examined here are considered as two best practices in the provision of rural telecommunications in the context of developing countries. Under two geographically distinct market segments, rural market characterized by low per-subscriber revenue and urban market characterized by hi...

A community intervention: AMBER: Arab American breast cancer education and referral program.

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Ayash, Claudia; Axelrod, Deborah; Nejmeh-Khoury, Sana; Aziz, Arwa; Yusr, Afrah; Gany, Francesca M

2011-12-01

Although the number of Arab Americans is growing in the United States, there is very little data available on this population's cancer incidence and screening practices. Moreover, there are few interventions addressing their unique needs. This study aims to determine effective strategies for increasing breast cancer screening in at-risk underserved Arab American women. AMBER utilizes a community based participatory approach to conduct formative research and program interventions, including culturally appropriate Arabic language breast cancer education, screening coordination, and cultural competency training for healthcare professionals in New York City. In 2 years, 597 women were educated, 189 underserved women were identified as being in need of assistance, 68 were screened, one new case of breast cancer was detected, and four active cases in need of follow-up reconnected with care. The AMBER model is an important intervention for breast cancer screening and care in the underserved Arab American community.

Screening for cancer: advice for high-value care from the American College of Physicians.

Science.gov (United States)

Wilt, Timothy J; Harris, Russell P; Qaseem, Amir

2015-05-19

Cancer screening is one approach to reducing cancer-related morbidity and mortality rates. Screening strategies vary in intensity. Higher-intensity strategies are not necessarily higher value. High-value strategies provide a degree of benefits that clearly justifies the harms and costs incurred; low-value screening provides limited or no benefits to justify the harms and costs. When cancer screening leads to benefits, an optimal intensity of screening maximizes value. Some aspects of screening practices, especially overuse and underuse, are low value. Screening strategies for asymptomatic, average-risk adults for 5 common types of cancer were evaluated by reviewing clinical guidelines and evidence syntheses from the American College of Physicians (ACP), U.S. Preventive Services Task Force, American Academy of Family Physicians, American Cancer Society, American Congress of Obstetricians and Gynecologists, American Gastroenterological Association, and American Urological Association. "High value" was defined as the lowest screening intensity threshold at which organizations agree about screening recommendations for each type of cancer and "low value" as agreement about not recommending overly intensive screening strategies. This information is supplemented with additional findings from randomized, controlled trials; modeling studies; and studies of costs or resource use, including information found in the National Cancer Institute's Physician Data Query and UpToDate. The ACP provides high-value care screening advice for 5 common types of cancer; the specifics are outlined in this article. The ACP strongly encourages clinicians to adopt a cancer screening strategy that focuses on reaching all eligible persons with these high-value screening options while reducing overly intensive, low-value screening.

Genomics of Colorectal Cancer in African Americans

OpenAIRE

Brim, Hassan; Ashktorab, Hassan

2016-01-01

Genome-wide studies are increasingly becoming a must, especially for complex diseases such as cancer where multiple genes and diverse molecular mechanisms are known to be involved in genes’ function alteration. In this review, we report our latest genomic and epigenomic findings in African-American colorectal cancer patients. This population suffers a higher burden of the disease and most investigators in this field are looking for the underlying genetic and epigenetic targets that might be r...

Fat, Fiber and Cancer Risk in African Americans and Rural Africans

Science.gov (United States)

O'Keefe, Stephen J.D.; Li, Jia V.; Lahti, Leo; Ou, Junhai; Carbonero, Franck; Mohammed, Khaled; Posma, Joram M; Kinross, James; Wahl, Elaine; Ruder, Elizabeth; Vipperla, Kishore; Naidoo, Vasudevan; Mtshali, Lungile; Tims, Sebastian; Puylaert, Philippe G.B.; DeLany, James; Krasinskas, Alyssa; Benefiel, Ann C.; Kaseb, Hatem O.; Newton, Keith; Nicholson, Jeremy K.; de Vos, Willem M.; Gaskins, H. Rex; Zoetendal, Erwin G.

2015-01-01

Rates of colon cancer are much higher in African Americans (65:100,000) than in rural South Africans (<5:100,000). The higher rates are associated with higher animal protein and fat and lower fiber consumption, higher colonic secondary bile acids, lower colonic short chain fatty acid quantities and higher mucosal proliferative biomarkers of cancer risk in otherwise healthy middle aged volunteers. Here we investigate further the role of fat and fiber in this association. We performed two-week food exchanges in subjects from the same populations, where African Americans were fed a high-fiber, lowfat African-style diet, and rural Africans a high-fat low-fiber western-style diet under close supervision. In comparison to their usual diets, the food changes resulted in remarkable reciprocal changes in mucosal biomarkers of cancer risk and in aspects of the microbiota and metabolome known to affect cancer risk, best illustrated by increased saccharolytic fermentation and butyrogenesis and suppressed secondary bile acid synthesis in the African Americans. PMID:25919227

Cancer of the esophagus and esophagogastric junction-Major changes in the American Joint Committee on Cancer eighth edition cancer staging manual.

Science.gov (United States)

Rice, Thomas W; Gress, Donna M; Patil, Deepa T; Hofstetter, Wayne L; Kelsen, David P; Blackstone, Eugene H

2017-07-08

Answer questions and earn CME/CNE New to the eighth edition of the American Joint Committee on Cancer (AJCC) Cancer Staging Manual for epithelial cancers of the esophagus and esophagogastric junction are separate, temporally related cancer classifications: 1) before treatment decision (clinical); 2) after esophagectomy alone (pathologic); and 3) after preresection therapy followed by esophagectomy (postneoadjuvant pathologic). The addition of clinical and postneoadjuvant pathologic stage groupings was driven by a lack of correspondence of survival, and thus prognosis, between both clinical and postneoadjuvant pathologic cancer categories (facts about the cancer) and pathologic categories. This was revealed by a machine-learning analysis of 6-continent data from the Worldwide Esophageal Cancer Collaboration, with consensus of the AJCC Upper GI Expert Panel. Survival is markedly affected by histopathologic cell type (squamous cell carcinoma and adenocarcinoma) in clinically and pathologically staged patients, requiring separate stage grouping for each cell type. However, postneoadjuvant pathologic stage groups are identical. For the future, more refined and granular data are needed. This requires: 1) more accurate clinical staging; 2) innovative solutions to pathologic staging challenges in endoscopically resected cancers; 3) integration of genomics into staging; and 4) precision cancer care with targeted therapy. It is the responsibility of the oncology team to accurately determine and record registry data, which requires eliminating both common errors and those related to incompleteness and inconsistency. Despite the new complexity of eighth edition staging of cancers of the esophagus and esophagogastric junction, these key concepts and new directions will facilitate precision cancer care. CA Cancer J Clin 2017;67:304-317. © 2017 American Cancer Society. © 2017 American Cancer Society.

Ethics, Risk, and Media Intervention: Women’s Breast Cancer in Venezuela

Science.gov (United States)

Eid, Mahmoud; Nahon-Serfaty, Isaac

2016-01-01

Breast cancer incidence and mortality rates are of concern among Latin American women, mainly due to the growing prevalence of this disease and the lack of compliance to proper breast cancer screening and treatment. Focusing on Venezuelan women and the challenges and barriers that interact with their health communication, this paper looks into issues surrounding women’s breast cancer, such as the challenges and barriers to breast cancer care, the relevant ethics and responsibilities, the right to health, breast cancer risk perception and risk communication, and the media interventions that affect Venezuelan women’s perceptions and actions pertaining to this disease. In particular, it describes an action-oriented research project in Venezuela that was conducted over a four-year period of collaborative work among researchers, practitioners, NGOs, patients, journalists, and policymakers. The outcomes include positive indications on more effective interactions between physicians and patients, increasing satisfactions about issues of ethical treatment in providing healthcare services, more sufficient and responsible media coverage of breast cancer healthcare services and information, a widely supported declaration for a national response against breast cancer in Venezuela, and the creation of a code of ethics for the Venezuelan NGO that led the expansion of networking in support of women’s breast cancer healthcare. PMID:27867750

Understanding the Association of Type 2 Diabetes Mellitus in Breast Cancer Among African American and European American Populations in South Carolina.

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Samson, Marsha E; Adams, Swann Arp; Orekoya, Olubunmi; Hebert, James R

2016-09-01

In South Carolina, the co-occurrence of diabetes mellitus (DM) and breast cancer (BrCA) is much more prevalent among African American populations than among European American populations. The underlying relationship between diabetes and breast cancer may influence breast cancer survival. The purpose of this investigation is to examine the effect of diabetes on developing breast cancer and to reduce racial disparities in breast cancer outcomes. Study participants included women of European American (EA) and African American (AA) ethnicity from both the Medicaid ICD-9 designations and the South Carolina Central Cancer Registry (SCCCR). A historical prospective cohort design was used to determine the risk of developing breast cancer among women of different ethnicities with and without DM. The chi-square test was used to determine the significance of the association; the logistic model was used to assess the relationship between breast cancer and other factors among EA and AA women. Menopause may have protective properties for AA compared to EA women. AA women have twice the odds of not surviving from each breast cancer stage compared to EA women with respect to their breast cancer stage. Adherence to diabetes medication may contribute to lower breast cancer death in EA. This study illustrates the discrepancy between EA and AA women in terms of breast cancer survival. AA women bear a higher disease burden than EA women. To create ethnic-appropriate public health policies, it is imperative that we understand the effect of comorbidities on breast cancer and how we can prevent them from occurring.

Young Asian Americans' knowledge and perceptions of cervical cancer and the human papillomavirus.

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Gor, Beverly J; Chilton, Janice A; Camingue, Pamela T; Hajek, Richard A

2011-02-01

Cervical cancer is a major health disparity among Asian Americans, with cervical cancer rates of Vietnamese women being significantly higher than for the general US female population and low screening rates reported for Asian American females. Focus groups and interviews were conducted with young Vietnamese, Filipino, and Korean adults (ages 18-29) to collect information on knowledge, perceptions and sources of information regarding cervical cancer, Pap tests and the human papillomavirus. 16 Korean, 18 Vietnamese, and 18 Filipino (50% female) adults participated in the study. Many participants had never heard of HPV, cervical cancer and Pap testing. Cervical cancer screening rates were low for Korean and Vietnamese females and were influenced by moral beliefs and lack of awareness. Culturally relevant education materials that consider specific Asian ethnicity and language are needed to increase awareness of cervical cancer, Pap testing, and HPV among Asian American young adults.

Time, trust, and transparency: Lessons learned from collecting blood biospecimens for cancer research from the Asian American community.

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Dang, Julie H T; Chen, Moon S

2018-04-01

Biospecimens from racially diverse groups are needed to advance cancer research. The Asian American Cancer Education Study was developed to increase the number and proportion of blood biospecimen donations from Asian Americans for cancer research. The authors' targeted approach included 2 types of community engagement, in-reach (within institution to Asian American patients with cancer) and outreach (external to institution to the general Asian American community). Participants received in-language biospecimen education followed by the opportunity to donate blood biospecimens. Outreach participants donated through our community biospecimen blood drives, and in-reach participants consented to donating an extra tube of blood during their routine blood draws as a patient. Donated blood biospecimens were spun down to serum and plasma to be stored in a biorepository or were sent to the laboratory to test for cancer-related risk factors. Three hundred eighty-eight Asian Americans donated 1127 blood biospecimens for cancer research. Four hundred twenty tubes of plasma and serum are currently being stored at the cancer center's biorepository, 39 tubes have been used for cancer genomic research, and 668 tubes were used to characterize cancer-related risk factors. Building upon the past decade of the National Cancer Institute-funded Asian American Network for Cancer Awareness, Research, and Training's foundation of trust and service among Asian Americans, researchers were able to leverage relationships not only to introduce the idea of biospecimen contribution to the community but to also exceed expectations with regard to the quantity of blood biospecimens collected from Asian Americans. Cancer 2018;124:1614-21. © 2018 American Cancer Society. © 2018 American Cancer Society.

Disparities in cervical cancer survival among Asian American women

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Nghiem, Van T.; Davies, Kalatu R.; Chan, Wenyaw; Mulla, Zuber D.; Cantor, Scott B.

2015-01-01

Purpose We compared overall survival and influencing factors between Asian American women as a whole and by subgroup with white women with cervical cancer. Methods Cervical cancer data were from the Surveillance, Epidemiology, and End Results registry; socioeconomic information was from the Area Health Resource File. We used standard tests to compare characteristics between groups; the Kaplan-Meier method with log-rank test to assess overall survival and compare it between groups; and Cox proportional hazards models to determine the effect of race and other covariates on overall survival (with/without age-stratification). Results Being 3.3 years older than white women at diagnosis (pAsian American women were more likely to be in a spousal relationship, had more progressive disease, and were better off socioeconomically. Women of Filipino, Japanese, and Korean origin had similar clinical characteristics compared with white women. Asian American women had higher 36- and 60-month survival rates (p=0.004 and p=0.013, respectively), higher overall survival rates (p=0.049), and longer overall survival durations after adjusting for age and other covariates (hazard ratio=0.77, 95% confidence interval: 0.68–0.86). Overall survival differed across age strata between the two racial groups. With the exception of women of Japanese or Korean origin, Asian American women grouped by geographic origin had better overall survival than white women. Conclusions Although Asian American women, except those of Japanese or Korean origin, had better overall survival than white women, their older age at cervical cancer diagnosis suggests that they have less access to screening programs. PMID:26552330

Disparities in cervical cancer survival among Asian-American women.

Science.gov (United States)

Nghiem, Van T; Davies, Kalatu R; Chan, Wenyaw; Mulla, Zuber D; Cantor, Scott B

2016-01-01

We compared overall survival and influencing factors between Asian-American women as a whole and by subgroup with white women with cervical cancer. Cervical cancer data were from the Surveillance, Epidemiology, and End Results registry; socioeconomic information was from the Area Health Resource File. We used standard tests to compare characteristics between groups; the Kaplan-Meier method with log-rank test to assess overall survival and compare it between groups; and Cox proportional hazards models to determine the effect of race and other covariates on overall survival (with and/or without age stratification). Being 3.3 years older than white women at diagnosis (P Asian-American women were more likely to be in a spousal relationship, had more progressive disease, and were better off socioeconomically. Women of Filipino, Japanese, and Korean origin had similar clinical characteristics compared to white women. Asian-American women had higher 36- and 60-month survival rates (P = .004 and P = .013, respectively), higher overall survival rates (P = .049), and longer overall survival durations after adjusting for age and other covariates (hazard ratio = 0.77, 95% confidence interval: 0.68-0.86). Overall survival differed across age strata between the two racial groups. With the exception of women of Japanese or Korean origin, Asian-American women grouped by geographic origin had better overall survival than white women. Although Asian-American women, except those of Japanese or Korean origin, had better overall survival than white women, their older age at cervical cancer diagnosis suggests that they have less access to screening programs. Copyright © 2016 Elsevier Inc. All rights reserved.

In the Name of ‘Poor and Marginalised’? Politics of NGO Activism with Dalit Women in Rural North India

OpenAIRE

Govinda, Radhika

2009-01-01

Assertion by the Dalits or ex-untouchables is one of the most signifi cant developments in contemporary India. Dalit women have actively participated in Dalit movements and in women’s and development NGOs activism. However, their voices and perspectives are said to have been marginalised by movements and NGOs alike. This article unpacks the complexities, contradictions and challenges that are produced, reproduced and subverted in NGO activism with Dalit women by examining a women’s NGO and its...

African American women's limited knowledge and experiences with genetic counseling for hereditary breast cancer.

Science.gov (United States)

Sheppard, Vanessa B; Graves, Kristi D; Christopher, Juleen; Hurtado-de-Mendoza, Alejandra; Talley, Costellia; Williams, Karen Patricia

2014-06-01

Genetic counseling and testing for hereditary breast cancer have the potential benefit of early detection and early interventions in African American women. However, African American women have low use of these services compared to White women. We conducted two focus groups with African American women diagnosed with breast cancer (affected group, n = 13) and women with at least one first-degree relative with breast/ovarian cancer (unaffected group, n = 8). A content analysis approach was employed to analyze interview data. Breast cancer survivors had more knowledge about genetic counseling and testing than participants who were unaffected with cancer. However, knowledge about genetic counseling was limited in both groups. Barriers to pursuing genetic counseling and testing included poor understanding of the genetic counseling and testing process, fear of carrying the mutation, concerns about discrimination, and cost. Motivators to participate in genetic counseling and testing included desire to help family members, insurance coverage, and potential of benefiting the larger African American community. Education efforts are needed to increase genetic counseling and testing awareness in the African American community.

Efficacy of a Weight Loss Intervention for African American Breast Cancer Survivors.

Science.gov (United States)

Stolley, Melinda; Sheean, Patricia; Gerber, Ben; Arroyo, Claudia; Schiffer, Linda; Banerjee, Anjishnu; Visotcky, Alexis; Fantuzzi, Giamila; Strahan, Desmona; Matthews, Lauren; Dakers, Roxanne; Carridine-Andrews, Cynthia; Seligman, Katya; Springfield, Sparkle; Odoms-Young, Angela; Hong, Susan; Hoskins, Kent; Kaklamani, Virginia; Sharp, Lisa

2017-08-20

Purpose African American women with breast cancer have higher cancer-specific and overall mortality rates. Obesity is common among African American women and contributes to breast cancer progression and numerous chronic conditions. Weight loss interventions among breast cancer survivors positively affect weight, behavior, biomarkers, and psychosocial outcomes, yet few target African Americans. This article examines the effects of Moving Forward, a weight loss intervention for African American breast cancer survivors (AABCS) on weight, body composition, and behavior. Patients and Methods Early-stage (I-III) AABCS were randomly assigned to a 6-month interventionist-guided (n = 125) or self-guided (n = 121) weight loss program supporting behavioral changes to promote a 5% weight loss. Anthropometric, body composition, and behavioral data were collected at baseline, postintervention (6 months), and follow-up (12 months). Descriptive statistics and mixed models analyses assessed differences between groups over time. Results Mean (± standard deviation) age, and body mass index were 57.5 (± 10.1) years and 36.1 (± 6.2) kg/m 2 , respectively, and 82% had stage I or II breast cancer. Both groups lost weight. Mean and percentage of weight loss were greater in the guided versus self-guided group (at 6 months: 3.5 kg v 1.3kg; P 3% at 6 months is associated with improved health outcomes. Affordable, accessible health promotion programs represent a critical resource for AABCS.

Characteristics and predictors of oral cancer knowledge in a predominantly African American community

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Adjei Boakye, Eric; Hussaini, Adnan S.; Sujijantarat, Nanthiya; Ganesh, Rajan N.; Snider, Matthew; Thompson, Devin; Varvares, Mark A.

2017-01-01

Purpose To characterize smoking and alcohol use, and to describe predictors of oral cancer knowledge among a predominantly African-American population. Methods A cross-sectional study was conducted between September, 2013 among drag racers and fans in East St. Louis. Oral cancer knowledge was derived from combining questionnaire items to form knowledge score. Covariates examined included age, sex, race, marital status, education status, income level, insurance status, tobacco and alcohol use. Adjusted linear regression analysis measured predictors of oral cancer knowledge. Results Three hundred and four participants completed questionnaire; 72.7% were African Americans. Smoking rate was 26.7%, alcohol use was 58.3%, and mean knowledge score was 4.60 ± 2.52 out of 17. In final adjusted regression model, oral cancer knowledge was associated with race and education status. Compared with Caucasians, African Americans were 29% less likely to have high oral cancer knowledge (β = -0.71; 95% CI: -1.35, -0.07); and participants with a high school diploma or less were 124% less likely to have high oral cancer knowledge compared with college graduates (β = -1.24; 95% CI: -2.44, -0.41). Conclusions There was lower oral cancer knowledge among African Americans and those with low education. The prevalence of smoking was also very high. Understanding predictors of oral cancer knowledge is important in future design of educational interventions specifically targeted towards high-risk group for oral cancer. PMID:28545057

Explaining and improving breast cancer information acquisition among African American women in the Deep South.

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Anderson-Lewis, Charkarra; Ross, Levi; Johnson, Jarrett; Hastrup, Janice L; Green, B Lee; Kohler, Connie L

2012-06-01

A major challenge facing contemporary cancer educators is how to optimize the dissemination of breast cancer prevention and control information to African American women in the Deep South who are believed to be cancer free. The purpose of this research was to provide insight into the breast cancer information-acquisition experiences of African American women in Alabama and Mississippi and to make recommendations on ways to better reach members of this high-risk, underserved population. Focus group methodology was used in a repeated, cross-sectional research design with 64 African American women, 35 years old or older who lived in one of four urban or rural counties in Alabama and Mississippi. Axial-coded themes emerged around sources of cancer information, patterns of information acquisition, characteristics of preferred sources, and characteristics of least-preferred sources. It is important to invest in lay health educators to optimize the dissemination of breast cancer information to African American women who are believed to be cancer free in the Deep South.

American Cancer Society: the world's wealthiest "nonprofit" institution.

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Epstein, S S

1999-01-01

The American Cancer Society is fixated on damage control--diagnosis and treatment--and basic molecular biology, with indifference or even hostility to cancer prevention. This myopic mindset is compounded by interlocking conflicts of interest with the cancer drug, mammography, and other industries. The "nonprofit" status of the Society is in sharp conflict with its high overhead and expenses, excessive reserves of assets and contributions to political parties. All attempts to reform the Society over the past two decades have failed; a national economic boycott of the Society is long overdue.

Breast and cervical cancer screening disparity among Asian American women: does race/ethnicity matter [corrected]?

Science.gov (United States)

Lee, Hee Yun; Ju, Eunsu; Vang, Pa Der; Lundquist, Melissa

2010-10-01

Ethnic minorities are frequently considered as one homogeneous group in research, and this trend is particularly true for Asian Americans. This article seeks to uncover the intragroup differences in cancer screening behavior among subgroups of Asian American women by disaggregating them into six subgroups. The subgroups were compared with non-Latina white women to examine differences in breast and cancer screening rates and relevant factors associated with receiving these screenings. Three-year merged data from the 2001, 2003, and 2005 California Health Interview Survey (CHIS) were used to investigate the subgroup differences. Samples for the current study were restricted to non-Latina white and Asian American women whose age was ≥ 18 years (n = 58,000) for cervical cancer screening and ≥ 40 years (n = 43,518) for breast cancer screening at the time of the interview. Results showed marked differences in cancer screening rates among Asian American subgroups and between cancer types. Cervical cancer screening rates were noticeably higher than breast cancer screening rates in all groups. The Korean group consistently showed the lowest rates of both cancer screenings. Japanese ranked the highest (79.5%) in breast cancer screening but the second lowest (79.7%) in cervical cancer screening. Enabling factors, such as having private health insurance and a usual source of care, were found to be the strongest predictors of receiving both breast and cervical cancer screening. Screenings for both types of cancer increased if a woman was married or was born in the United States. The findings of this study illustrate the heterogeneity that exists among Asian American subgroups in their cancer screening behaviors. Further development of culturally relevant and ethnic-specific cancer prevention strategies and policies that address the subgroup differences within the larger racial/ethnic population are needed. Public health outreach and cancer education should be prioritized to

NGO participation in international lawmaking and democratic legitimacy : The debate and its future

NARCIS (Netherlands)

Beijerman, M.

2016-01-01

Over the last few decades, scholars - mainly in the field of law and international relations - have argued that NGOs are indispensable in making international law more democratically legitimate. This study refers to this as the ‘NGO democratic legitimacy thesis’. The thesis is presented as a

Social Entrepreneurship Practice in Malaysia - The Case of Social NGO

OpenAIRE

Fakhrul Anwar Zainol; Wan Norhayate Wan Daud; Zulhamri Abdullah; Mohd Rafi Yaacob

2014-01-01

This study scrutinises innovation, proactiveness and risk taking as indicators of effectiveness of a social NGO within the context of urban poverty, using Global Outreach as a case. This study begins with the introduction of brief background of organisation. Later,innovation, proactiveness and risk taking which are the gists of the content of the paper are discussed at length. As far as this case study is concerned, Global Outreach is effective enough. Capitasing on amended model of Grameen’s...

Effectiveness of an NGO primary health care programme in rural Bangladesh: evidence from the management information system.

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Mercer, Alec; Khan, Mobarak Hossain; Daulatuzzaman, Muhammad; Reid, Joanna

2004-07-01

This paper considers evidence of the effectiveness of a non-governmental organization (NGO) primary health care programme in rural Bangladesh. It is based on data from the programme's management information system reported by 27 partner NGOs from 1996-2002. The data indicate relatively high coverage has been achieved for reproductive and child health services, as well as lower infant and child mortality. On the basis of a crude indicator of socio-economic status, the programme is poverty-focused. There is good service coverage among the poorest one-third and others, and the infant and child mortality differential has been eliminated over recent years. A rapid decline in infant mortality among the poorest from 1999-2002 reflects a reduction in neonatal mortality of about 50%. Allowing for some under-reporting and possible misclassification of deaths to the stillbirths category, neonatal mortality is relatively low in the NGO areas. The lower child and maternal mortality for the NGO areas combined, compared with estimates for Bangladesh in recent years, may at least in part be due to high coverage of reproductive and child health services. Other development programmes implemented by many of the NGOs could also have contributed. Despite the limited resources available, and the lower infant and child mortality already achieved, there appears to be scope for further prevention of deaths, particularly those due to birth asphyxia, acute respiratory infection, diarrhoeal disease and accidents. Maternal mortality in the NGO areas was lower in 2000-02 than the most recent estimate for Bangladesh. Further reduction is likely to depend on improved access to qualified community midwives and essential obstetric care at government referral facilities.

The utility of cancer-related cultural constructs to understand colorectal cancer screening among African Americans

Directory of Open Access Journals (Sweden)

Vetta L. Sanders Thompson

2013-09-01

Full Text Available Background. Data suggest that colorectal cancer could be cut by approximately 60% if all people aged 50 years or older received regular screening. Studies have identified socio-cultural attitudes that might inform cancer education and screening promotion campaigns. This article applies item response theory (IRT to a set of survey items selected to assess sociocultural attitudes in order to determine how current measures may affect what we know about how these attitudes affect colorectal cancer screening (CRCS.Design and Methods. A survey of colorectal cancer screening, screening attitudes and cultural beliefs was administered to 1021 African Americans – 683 women and 338 men, ages 50 to 75. Eligibility crite ria for participation included being born in the United States, self-identified African American male or female, age 50 to 75 years. The IRT analysis was performed on 655 individuals with complete data for the 43 observed variables. Results. Twenty-nine items comprise the Multi-construct African American Cultural Survey (MAACS that addresses seven cultural con- structs: mistrust/distrust, privacy, ethnic identity, collectivism, empowerment, and male gender roles. The items provide adequate information about the attitudes of the population across most levels of the constructs assessed. Among the sociocultural variables considered, empowerment (OR=1.078; 95% CI: 1.008, 1.151 had the strongest association with CRCS adherence and privacy showed promise. Conclusions. The MAACS provides a fixed length questionnaire to assess African American CRCS attitudes, two new constructs that might assist in CRCS promotion, and a suggested focus for identification of additional constructs of interest.

The comparative advantage of NGO (non-governmental organizations) in the health sector--a look at the evidence.

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Matthias, A R; Green, A T

1994-01-01

Attention being given to the development of an appropriate public/private mix in health-care delivery should not exclude the role of non-governmental organizations (NGOs). There is a widely accepted thesis of NGO comparative advantage over government, but evidence to support this thesis is generally more anecdotal than analytical. This paper considers evidence available in the literature and from field research in southern Africa, especially with regard to efficiency, innovation and reaching grass-roots communities. The paper concludes that the comparative advantage of the NGO sector needs to be analysed in relation to both the private for-profit sector and the public sector.

Dietary patterns and colon cancer risk in Whites and African Americans in the North Carolina Colon Cancer Study.

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Satia, Jessie A; Tseng, Marilyn; Galanko, Joseph A; Martin, Christopher; Sandler, Robert S

2009-01-01

We examined associations of dietary patterns with colon cancer risk in African Americans and Whites from a case-control study in North Carolina. Incident colon cancer cases, 40 to 80 yr (n = 636), and matched controls (n = 1,042) were interviewed in person to elicit information on potential colon cancer risk factors. A validated food frequency questionnaire adapted to include regional foods captured diet over the year prior to diagnosis (cases) or interview date (controls). Three meaningful intake patterns were identified in both Whites and African Americans: "Western-Southern," "fruit-vegetable," and "metropolitan." Compared to the Western-Southern pattern, the fruit-vegetable and metropolitan patterns were associated with more healthful dietary behaviors (e.g., higher vegetable intake and lower red meat consumption), and demographic/lifestyle characteristics typically correlated with low colon cancer risk, for example, lower BMI, higher education, and higher NSAID use. The fruit-vegetable pattern was significantly inversely associated with colon cancer risk in Whites (OR = 0.4, 95% CI = 0.3-0.6) and the metropolitan pattern with a nonsignificant 30% risk reduction in both Whites and African Americans after adjustment for education. The Western-Southern pattern was not associated with colon cancer risk. These findings may explain some of the racial differences in colon cancer incidence and underscore the importance of examining diet-cancer associations in different population subgroups.

The discursive construction of identity through interaction on social media in a Chinese NGO

NARCIS (Netherlands)

Peverelli, P.J.; Ruelle, O.

2017-01-01

This article investigates the discursive construction of social identity in a Chinese NGO involved in ongoing online discussions on WeChat, China’s fastest growing social networking site. While there is extensive literature on various aspects of online interaction, the analysis of identity

Novel Somatic Copy Number Alteration Identified for Cervical Cancer in the Mexican American Population

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Alireza Torabi

2016-08-01

Full Text Available Cervical cancer affects millions of Americans, but the rate for cervical cancer in the Mexican American is approximately twice that for non-Mexican Americans. The etiologies of cervical cancer are still not fully understood. A number of somatic mutations, including several copy number alterations (CNAs, have been identified in the pathogenesis of cervical carcinomas in non-Mexican Americans. Thus, the purpose of this study was to investigate CNAs in association with cervical cancer in the Mexican American population. We conducted a pilot study of genome-wide CNA analysis using 2.5 million markers in four diagnostic groups: reference (n = 125, low grade dysplasia (cervical intraepithelial neoplasia (CIN-I, n = 4, high grade dysplasia (CIN-II and -III, n = 5 and invasive carcinoma (squamous cell carcinoma (SCC, n = 5 followed by data analyses using Partek. We observed a statistically-significant difference of CNA burden between case and reference groups of different sizes (>100 kb, 10–100 kb and 1–10 kb of CNAs that included deletions and amplifications, e.g., a statistically-significant difference of >100 kb deletions was observed between the reference (6.6% and pre-cancer and cancer (91.3% groups. Recurrent aberrations of 98 CNA regions were also identified in cases only. However, none of the CNAs have an impact on cancer progression. A total of 32 CNA regions identified contained tumor suppressor genes and oncogenes. Moreover, the pathway analysis revealed endometrial cancer and estrogen signaling pathways associated with this cancer (p < 0.05 using Kyoto Encyclopedia of Genes and Genomes (KEGG. This is the first report of CNAs identified for cervical cancer in the U.S. Latino population using high density markers. We are aware of the small sample size in the study. Thus, additional studies with a larger sample are needed to confirm the current findings.

Study shows aspirin reduces the risk and recurrence of prostate cancer in African-American men | Center for Cancer Research

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African-American men who take a daily dose of aspirin experience a significantly lower risk of developing advanced prostate cancer – the aggressive and deadly form of the disease – than African-American men who do not regularly use aspirin, according to a study from the Center for Cancer Research (CCR) Laboratory of Human Carcinogenesis. Learn more...

African American Women’s Limited Knowledge and Experiences with Genetic Counseling for Hereditary Breast Cancer

Science.gov (United States)

Sheppard, Vanessa B.; Graves, Kristi D.; Christopher, Juleen; Hurtado-de-Mendoza, Alejandra; Talley, Costellia; Williams, Karen Patricia

2014-01-01

Genetic counseling and testing for hereditary breast cancer have the potential benefit of early detection and early interventions in African American women. However, African American women have low use of these services compared to White women. We conducted two focus groups with African American women diagnosed with breast cancer (affected group, n=13) and women with at least one first-degree relative with breast/ovarian cancer (unaffected group, n= 8). A content analysis approach was employed to analyze interview data. Breast cancer survivors had more knowledge about genetic counseling and testing than participants who were unaffected with cancer. However, knowledge about genetic counseling was limited in both groups. Barriers to pursuing genetic counseling and testing included poor understanding of the genetic counseling and testing process, fear of carrying the mutation, concerns about discrimination, and cost. Motivators to participate in genetic counseling and testing included desire to help family members, insurance coverage, and potential of benefiting the larger African American community. Education efforts are needed to increase genetic counseling and testing awareness in the African American community. PMID:24186304

Acculturation in the adaptation of Chinese-American women to breast cancer: a mixed-method approach.

Science.gov (United States)

Tsai, Tzu-I; Morisky, Donald E; Kagawa-Singer, Marjorie; Ashing-Giwa, Kimlin T

2011-12-01

To explore how and to what extent acculturation and immigration affect Chinese-American immigrant women's breast cancer experience. Acculturation is an important indicator for immigrant health. Less empirical research has been conducted on the association between acculturation and breast cancer experience among Chinese immigrant women in the USA. A mixed methods study. A total of 107 Chinese-American women with breast cancer completed the structured questionnaire survey, and 16 women completed face-to-face in-depth interviews. In the quantitative findings, acculturation was related to health beliefs, social support and life stress. Cultural interpretations of the qualitative information are offered to show that breast cancer experience was intertwined with cultural adaptation in a given immigrant environment. Chinese cultural beliefs persistently, even after years of immigration, guide Chinese-American immigrant women to respond to breast cancer across the meaning of health and illness, family ties and involvement and social interaction. Our findings show that acculturation is related to health beliefs, social support and life stress in the trajectory of breast cancer adaptation among Chinese-American immigrant women. Life stresses derived from immigration bring additional difficulties for immigrant women living with cancer. This study pinpoints that traditional cultural beliefs and immigration stress may influence Chinese-American women to cope with breast cancer. To promote culturally sensitive cancer care for immigrants, healthcare professionals should be aware of and learn intercultural competence. Ethnic social support or outreach healthcare programme may benefit new immigrant families or the immigrant families, who lack social connection, to cope with cancer. © 2011 Blackwell Publishing Ltd.

A comprehensive examination of breast cancer risk loci in African American women.

Science.gov (United States)

Feng, Ye; Stram, Daniel O; Rhie, Suhn Kyong; Millikan, Robert C; Ambrosone, Christine B; John, Esther M; Bernstein, Leslie; Zheng, Wei; Olshan, Andrew F; Hu, Jennifer J; Ziegler, Regina G; Nyante, Sarah; Bandera, Elisa V; Ingles, Sue A; Press, Michael F; Deming, Sandra L; Rodriguez-Gil, Jorge L; Palmer, Julie R; Olopade, Olufunmilayo I; Huo, Dezheng; Adebamowo, Clement A; Ogundiran, Temidayo; Chen, Gary K; Stram, Alex; Park, Karen; Rand, Kristin A; Chanock, Stephen J; Le Marchand, Loic; Kolonel, Laurence N; Conti, David V; Easton, Douglas; Henderson, Brian E; Haiman, Christopher A

2014-10-15

Genome-wide association studies have identified 73 breast cancer risk variants mainly in European populations. Given considerable differences in linkage disequilibrium structure between populations of European and African ancestry, the known risk variants may not be informative for risk in African ancestry populations. In a previous fine-mapping investigation of 19 breast cancer loci, we were able to identify SNPs in four regions that better captured risk associations in African American women. In this study of breast cancer in African American women (3016 cases, 2745 controls), we tested an additional 54 novel breast cancer risk variants. Thirty-eight variants (70%) were found to have an association with breast cancer in the same direction as previously reported, with eight (15%) replicating at P University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Challenges of NGO-to-state Referral in the Delivery of HIV Prevention Programs in Ukraine Supported by the Global Fund

Directory of Open Access Journals (Sweden)

Svetlana McGill

2016-03-01

Conclusions: Gaps in linking HIV patients to the HIV care continuum have been identified as a potentially problematic issue in delivery of HIV prevention services by GF funded NGOs. With an anticipated GF exit from Ukraine, the lack of clearly defined NGO-to-state referrals of HIV patients complicates the transition of NGO run services into state funding. Further steps to improve referral systems are necessary to ensure a smooth transition and enable Ukraine to fight its HIV epidemic effectively.

African American Women's Recollected Experiences of Adherence to Breast Cancer Treatment.

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Heiney, Sue P; Hilfinger Messias, DeAnne K; Felder, Tisha M; Phelps, Kenneth W; Quinn, Jada C

2017-03-01

To explore African American women's recollected experiences of breast cancer treatment.
. Qualitative description and narrative analysis.
. South Carolina Oncology Associates, an outpatient oncology clinic serving rural and urban populations.
. 16 African American women with breast cancer previously enrolled in the control arm (n = 93) of a completed randomized, controlled trial. 
. Feminist narrative analysis of in-depth individual interviews.
. The authors identified three themes within the African American breast cancer survivors' recollected experiences of treatment adherence. Although little evidence was presented of shared decision making with providers, patients were committed to completing the prescribed therapies. The narratives highlighted the value of in-depth examination of patients' perspectives, particularly among minority and underserved groups. With the exception of voicing personal choice of surgical treatment, the women trusted providers' recommendations with a resolve to "just do it." Although trust may enhance treatment adherence, it may also reflect power differentials based on gender, race, education, and culture.
. Nurses should listen to patients describe their experience with cancer treatment and compare the themes from this study with their patients' story. This comparison will help nurses support patients through various aspect of diagnosis and treatment.

Effective colorectal cancer education for Asian Americans: a Michigan program.

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Wu, Tsu-Yin; Kao, John Y; Hsieh, Hsing-Fang; Tang, Yu-Ying; Chen, Judy; Lee, Janilla; Oakley, Deborah

2010-06-01

Asian Americans are among the fastest growing population groups in the USA. Despite the fact that colorectal cancer (CRC) is the second most common cancer for this group, Asian Americans have low CRC screening rates. An established health promotion program, Healthy Asian Americans Project (HAAP), expanded to include community-based CRC education during 2005-2006. Using Asian-language media, HAAP promoted awareness throughout local Asian Indian, Chinese, Filipino, Hmong, Japanese, Korean, and Vietnamese American communities and recruited men and women over 50 years to attend health fairs at local community/cultural centers. Evaluation data from 304 participants in an evidence-based educational intervention showed significantly increased knowledge and attitudes about the importance of screening. Follow-up conducted between 6 and 12 months showed that 78% of those receiving the educational intervention had been screened in the last 12 months, compared with the 37% who had ever been screened with any of the tests prior to the study. This community-based health promotion program reached underserved populations and the educational intervention improved CRC screening rates. This and similar programs may help lower CRC mortality among Asian Americans.

Knowledge and screening of head and neck cancer among American Indians in South Dakota.

Science.gov (United States)

Dwojak, Sunshine; Deschler, Daniel; Sargent, Michele; Emerick, Kevin; Guadagnolo, B Ashleigh; Petereit, Daniel

2015-06-01

We established the level of awareness of risk factors and early symptoms of head and neck cancer among American Indians in South Dakota and determined whether head and neck cancer screening detected clinical findings in this population. We used the European About Face survey. We added questions about human papillomavirus, a risk factor for head and neck cancer, and demographics. Surveys were administered at 2 public events in 2011. Participants could partake in a head and neck cancer screening at the time of survey administration. Of the 205 American Indians who completed the survey, 114 participated in the screening. Mean head and neck cancer knowledge scores were 26 out of 44. Level of education was the only factor that predicted higher head and neck cancer knowledge (b = 0.90; P = .01). Nine (8%) people had positive head and neck cancer screening examination results. All abnormal clinical findings were in current or past smokers (P = .06). There are gaps in American Indian knowledge of head and neck cancer risk factors and symptoms. Community-based head and neck cancer screening in this population is feasible and may be a way to identify early abnormal clinical findings in smokers.

Unexpected inverse correlation between Native American ancestry and Asian American variants of HPV16 in admixed Colombian cervical cancer cases.

Science.gov (United States)

Lopera, Esteban A; Baena, Armando; Florez, Victor; Montiel, Jehidys; Duque, Constanza; Ramirez, Tatiana; Borrero, Mauricio; Cordoba, Carlos M; Rojas, Fredy; Pareja, Rene; Bedoya, Astrid M; Bedoya, Gabriel; Sanchez, Gloria I

2014-12-01

European (E) variants of HPV 16 are evenly distributed among world regions, meanwhile Non-European variants such as European-Asian (EAs), Asian American (AA) and African (Af) are mostly confined to Eastern Asia, The Americas and African regions respectively. Several studies have shown that genetic variation of HPV 16 is associated with the risk of cervical cancer, which also seems to be dependent on the population. This relationship between ethnicity and variants have led to the suggestion that there is co-evolution of variants with humankind. Our aim was to evaluate the relationship between the individual ancestry proportion and infection with HPV 16 variants in cervical cancer. We examined the association between ancestry and HPV 16 variants in samples of 82 cervical cancer cases from different regions of Colombia. Individual ancestry proportions (European, African and Native American) were estimated by genotyping 106 ancestry informative markers. Variants were identified by PCR amplification of the E6 gene, followed by reverse line blot hybridization (RLB) with variants specific probes. Overall European (E) and Asian American (AA) variants frequency was 66.5% and 33.5% respectively. Similar distribution was observed in cases with higher proportions of European or African ancestry. A higher Native American ancestry was significantly associated with higher frequency of E variants (median ancestry>23.6%, Age and place of birth adjusted OR: 3.55, 95% CI: 1.26-10.03, p=0.01). Even further, an inverse geographic correlation between Native American ancestry and frequency of infections with AA variants was observed (ρ=-0.825, p=0.008). Regions with higher proportion of Native American ancestry had a lower frequency of AA variants of HPV 16. This study suggests replacement of AA variants by E variants of human papillomavirus 16 in cervical cancer cases with high Native American ancestry. Copyright © 2014 Elsevier B.V. All rights reserved.

Physical Activity and Cervical Cancer Testing among American Indian Women

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Muus, Kyle J.; Baker-Demaray, Twyla B.; Bogart, T. Andy; Duncan, Glen E.; Jacobsen, Clemma; Buchwald, Dedra S.; Henderson, Jeffrey A.

2012-01-01

Purpose: Studies have shown that women who engage in high levels of physical activity have higher rates of cancer screening, including Papanicalaou (Pap) tests. Because American Indian (AI) women are at high risk for cervical cancer morbidity and mortality, we examined Pap screening prevalence and assessed whether physical activity was associated…

Reduced disparities and improved surgical outcomes for Asian Americans with colorectal cancer.

Science.gov (United States)

Mulhern, Kayln C; Wahl, Tyler S; Goss, Lauren E; Feng, Katey; Richman, Joshua S; Morris, Melanie S; Chen, Herbert; Chu, Daniel I

2017-10-01

Studies suggest Asian Americans may have improved oncologic outcomes compared with other ethnicities. We hypothesized that Asian Americans with colorectal cancer would have improved surgical outcomes in mortality, postoperative complications (POCs), length of stay (LOS), and readmissions compared with other racial/ethnic groups. We queried the 2011-2014 American College of Surgeons National Surgical Quality Improvement Program for patients who underwent surgery for colorectal cancer and stratified patients by race. Primary outcome was 30-d mortality with secondary outcomes including POCs, LOS, and 30-d readmission. Stepwise backward logistic regression analyses and incident rate ratio calculations were performed to identify risk factors for disparate outcomes. Of the 28,283 patients undergoing colorectal surgery for malignancy, racial/ethnic groups were divided into Caucasian American (84%), African American (12%), or Asian American (4%). On unadjusted analyses, compared with other racial/ethnic groups, Asian Americans were more likely to have normal weight, not smoke, and had lower American Society of Anesthesiologists score of 1 or 2 (P Asian Americans had the shortest LOS and the lowest rates of complications due to ileus, respiratory, and renal complications (P Asian American race was independently associated with less postoperative ileus (odds ratio 0.8, 95% confidence interval 0.66-0.98, P American and Caucasian American patients, respectively (P Asian Americans undergoing surgery for colorectal cancer have shorter LOS and fewer POCs when compared with other racial/ethnic groups without differences in 30-d mortality or readmissions. The mechanism(s) underlying these disparities will require further study, but may be a result of patient, provider, and healthcare system differences. Copyright © 2017 Elsevier Inc. All rights reserved.

Breast cancer literacy and health beliefs related to breast cancer screening among American Indian women.

Science.gov (United States)

Roh, Soonhee; Burnette, Catherine E; Lee, Yeon-Shim; Jun, Jung Sim; Lee, Hee Yun; Lee, Kyoung Hag

2018-08-01

The purpose of this article is to examine the health beliefs and literacy about breast cancer and their relationship with breast cancer screening among American Indian (AI) women. Using the Health Belief Model (HBM) and hierarchical logistic regression with data from a sample of 286 AI female adults residing in the Northern Plains, we found that greater awareness of breast cancer screening was linked to breast cancer screening practices. However, perceived barriers, one of the HBM constructs, prevented such screening practices. This study suggested that culturally relevant HBM factors should be targeted when developing culturally sensitive breast cancer prevention efforts.

Effect of Tribal Language Use on Colorectal Cancer Screening among American Indians

OpenAIRE

Gonzales, Angela A.; Garroutte, Eva; Ton, Thanh G.N.; Goldberg, Jack; Buchwald, Dedra

2012-01-01

American Indians have one of the lowest colorectal cancer (CRC) screening rates for any racial/ethnic group in the U.S., yet reasons for their low screening participation are poorly understood. Limited English language use may create barriers to cancer screening in Hispanic and other ethnic minority immigrant populations; the extent to which this hypothesis is generalizable to American Indians is unknown. We examine whether tribal (indigenous) language use is associated with knowledge and use...

Business-NGO collaboration in a conflict setting: partnership activities in the Democratic Republic of Congo

NARCIS (Netherlands)

Kolk, A.; Lenfant, F.

2012-01-01

Although business-NGO (nongovernmental organizations) partnerships have received much attention in recent years, insights have been obtained only from research in "stable" contexts, not from conflict-ridden countries where such collaboration may be even more crucial in building trust and capacity

Communication, coping, and quality of life of breast cancer survivors and family/friend dyads: a pilot study of Chinese-Americans and Korean-Americans.

Science.gov (United States)

Lim, Jung-Won

2014-11-01

This study aimed to understand the dyadic relationships between family communication and quality of life (QOL) and between coping and QOL in Chinese-American and Korean-American breast cancer survivor (BCS)-family member dyads. A cross-sectional survey design was used. A total of 32 Chinese-American and Korean-American BCS-family member dyads were recruited from the California Cancer Surveillance Program and area hospitals in Los Angeles County, California, USA. The dyadic data were analyzed using a pooled regression actor-partner interdependence model. The study findings demonstrated that the survivors' general communication and use of reframing coping positively predicted their own QOL. The survivors' and family members' general communication was also a strong predictor of the family members' physical-related QOL score specifically. Meanwhile, each person's use of mobilizing coping negatively predicted his or her partner's QOL. The study findings add important information to the scarce literature on the QOL of Asian-American survivors of breast cancer. The findings suggest that Chinese-American and Korean-American BCS and their family members may benefit from interventions that enhance communication and coping within the family unit. Copyright © 2014 John Wiley & Sons, Ltd.

Knowledge, Attitudes, and Beliefs of Arab-American Women Regarding Inherited Cancer Risk

OpenAIRE

Mellon, Suzanne; Gauthier, Jacqueline; Cichon, Michelle; Hammad, Adnan; Simon, Michael S.

2012-01-01

The increasing incidence of breast cancer in the Arab world, coupled with a relatively early age of onset, raises concern for the presence of hereditary risk factors in this population. However, due to potential structural and cultural barriers, Arab Americans make up the smallest percentage of individuals tested for Hereditary Breast and Ovarian Cancer Syndrome in the United States. The objectives of this qualitative pilot focus group of 13 Arab-American women were to explore attitudes, know...

High cancer-related mortality in an urban, predominantly African-American, HIV-infected population.

Science.gov (United States)

Riedel, David J; Mwangi, Evelyn Ivy W; Fantry, Lori E; Alexander, Carla; Hossain, Mian B; Pauza, C David; Redfield, Robert R; Gilliam, Bruce L

2013-04-24

To determine mortality associated with a new cancer diagnosis in an urban, predominantly African-American, HIV-infected population. Retrospective cohort study. All HIV-infected patients diagnosed with cancer between 1 January 2000 and 30 June 2010 were reviewed. Mortality was examined using Kaplan-Meier estimates and Cox proportional hazards models. There were 470 cases of cancer among 447 patients. Patients were predominantly African-American (85%) and male (79%). Non-AIDS-defining cancers (NADCs, 69%) were more common than AIDS-defining cancers (ADCs, 31%). Cumulative cancer incidence increased significantly over the study period. The majority (55.9%) was taking antiretroviral therapy (ART) at cancer diagnosis or started afterward (26.9%); 17.2% never received ART. Stage 3 or 4 cancer was diagnosed in 67%. There were 226 deaths during 1096 person years of follow-up, yielding an overall mortality rate of 206 per 1000 person years. The cumulative mortality rate at 30 days, 1 year, and 2 years was 6.5, 32.2, and 41.4%, respectively. Mortality was similar between patients on ART whether they started before or after the cancer diagnosis but was higher in patients who never received ART. In patients with a known cause of death, 68% were related to progression of the underlying cancer. In a large cohort of urban, predominantly African-American patients with HIV and cancer, many patients presented with late-stage cancer. There was substantial 30-day and 2-year mortality, although ART had a significant mortality benefit. Deaths were most often caused by progression of cancer and not from another HIV-related or AIDS-related event.

Business-NGO Collaboration in a Conflict Setting: Partnership Activities in the Democratic Republic of Congo

NARCIS (Netherlands)

A. Kolk (Ans); F. Lenfant (François)

2012-01-01

textabstractWhile business-NGO partnerships have received much attention in recent years, insights have been obtained from research in ‘stable’ contexts, not from conflict-ridden countries where such collaboration may be even more crucial in building trust and capacity and in addressing

An exploratory analysis of fear of recurrence among African-American breast cancer survivors.

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Taylor, Teletia R; Huntley, Edward D; Sween, Jennifer; Makambi, Kepher; Mellman, Thomas A; Williams, Carla D; Carter-Nolan, Pamela; Frederick, Wayne

2012-09-01

Fear of recurrence (FOR) is a psychological concern that has been studied extensively in cancer survivors but has not been adequately examined in African-American breast cancer survivors. This exploratory study describes the extent and nature of FOR in African-American breast cancer survivors. FOR is examined in relation to socio-demographic characteristics, treatment-related characteristics, psychological distress, and quality of life (QOL). Participants completed questionnaires assessing FOR, psychological distress, QOL, and demographic and treatment characteristics. Pearson r correlations, t tests, and ANOVAs were used to determine the association between FOR and demographic and treatment-related characteristics. Hierarchical multiple regression models were performed to investigate the degree to which FOR dimensions account for the variance in QOL and psychological distress. Fifty-one African-American breast cancer survivors participated in this study. The mean age of participants was 64.24 (SD = 12.3). Overall fears as well as concerns about death and health were rated as low to moderate. Role worries and womanhood worries were very low. Inverse relationships were observed between age and FOR dimensions. FOR was positively correlated with measures of psychological distress and negatively correlated with QOL. FOR significantly accounted for a portion of the variance in QOL and distress after controlling for other variables. This study suggests that African-American women in this sample demonstrated some degree of FOR. Results indicate that FOR among African-American breast cancer survivors decreases with age and time since diagnosis and co-occurs with psychological distress as well as diminished quality of life.

The Asian American Network for Cancer Awareness, Research, and Training’s Role in Cancer Awareness, Research, and Training

Science.gov (United States)

Chen, Moon S.

2006-01-01

Purpose The purpose of this paper is to describe the content for the Asian American Network for Cancer Awareness Research and Training (AANCART) with respect to Asian American demographic characteristics and their cancer burden, highlights of accomplishments in various AANCART regions, aspirations for AANCART, and an interim assessment of AANCART’s activities to date. Methods The author compiled literature and other data references to describe the context for Asian American demographic characteristics and their cancer burden. As the AANCART Principal Investigator, he collected data from internal AANCART reports to depict highlights of accomplishments in various AANCART regions and offer evidence that AANCART’s first two specific aims have been attained. Principal Findings With respect to our first specific aim, we have built an infrastructure for cancer awareness, research and training operationally at a Network-wide basis through program directors for biostatistics, community, clinical, and research and in our four original AANCART regions: New York, Seattle, San Francisco, and Los Angeles. With respect to our second specific aim, we have established partnerships as exemplified by working collaboratively with New York’s Charles B. Wang Community Health Center in securing external funding with them for a tobacco control initiative and nationally with the American Cancer Society. With respect to our third specific aim, we have been fortunate to assist at least eight junior investigators in receiving NCI-funded pilot studies. The most notable change was the transfer of AANCART’s national headquarters from Columbus, Ohio to Sacramento, California along with potentially an increased diversification of Asian American ethnic groups as well as an expansion to Hawaii and Houston. Conclusion As of the end of year 2 of AANCART, AANCART’s two specific aims have been achieved. We are focusing on our third specific aim. PMID:15352772

Risks, Health and Environment. NGO Background document for the Third Ministerial Conference on Environment and Health and parallel Healthy Planet Forum, London 16- 18 juni 1999.

NARCIS (Netherlands)

Butter, Maureen E.

1999-01-01

NGO Background document for the Third Ministerial Conference on Environment and Health and parallel Healthy Planet Forum, London 16-18 June 1999. This reader was composed as a background document to the 3rd WHO/ UNECE Ministerial Conference on Environment and Health and parallel NGO Conference in

Perceived Stress as a Mediator Between Social Support and Posttraumatic Growth Among Chinese American Breast Cancer Survivors.

Science.gov (United States)

Yeung, Nelson C Y; Lu, Qian

Studies have shown that social support is positively associated with posttraumatic growth (PTG) among white cancer survivors. Whether the same relationship holds among Asian American cancer survivors and through what mechanism social support may influence PTG is unclear. This study examined the association between social support and PTG among Chinese American breast cancer survivors and proposed perceived stress as a mediator. Chinese American breast cancer survivors (n = 118) were recruited from Southern California. Participants' social support, perceived stress, and PTG were measured in a questionnaire package. Social support was associated with lower perceived stress (r= -0.34, Pstress was negatively associated with PTG (r=-0.36, Psocial support to PTG via perceived stress (β = .07, Psocial support and PTG (β= .40, Pstress between social support and PTG. The positive association between social support and Chinese American breast cancer survivors' PTG was supported. Our findings also suggested that social support may facilitate PTG through reduction of perceived stress. Interventions that help to enhance Chinese American breast cancer survivors' social support may also facilitate their PTG.

Post-treatment problems of African American breast cancer survivors.

Science.gov (United States)

Barsevick, Andrea M; Leader, Amy; Bradley, Patricia K; Avery, Tiffany; Dean, Lorraine T; DiCarlo, Melissa; Hegarty, Sarah E

2016-12-01

African American breast cancer survivors (AABCS) have a lower survival rate across all disease stages (79 %) compared with White survivors (92 %) and often have more aggressive forms of breast cancer requiring multimodality treatment, so they could experience a larger burden of post-treatment quality of life (QOL) problems. This paper reports a comprehensive assessment of the number, severity, and domains of problems faced by AABCS within 5 years after treatment completion and identifies subgroups at risk for these problems. A population-based random sample was obtained from the Pennsylvania Cancer Registry of African American females over 18 years of age who completed primary treatment for breast cancer in the past 5 years. A mailed survey was used to document survivorship problems. Two hundred ninety-seven AABCS completed the survey. The median number of survivor problems reported was 15. Exploratory factor analysis of the problem scale revealed four domains: emotional problems, physical problems, lack of resources, and sexuality problems. Across problem domains, younger age, more comorbid conditions, and greater medical mistrust were risk factors for more severe problems. The results demonstrated that AABCS experienced significant problem burden in the early years after diagnosis and treatment. In addition to emotional and physical problem domains that were documented in previous research, two problem domains unique to AABCS included lack of resources and sexuality concerns. At risk groups should be targeted for intervention. The study results reported in this manuscript will inform future research to address problems of AABCS as they make the transition from cancer patient to cancer survivor.

African American Women: Surviving Breast Cancer Mortality against the Highest Odds

Directory of Open Access Journals (Sweden)

Shelley White-Means

2015-12-01

Full Text Available Among the country’s 25 largest cities, the breast cancer mortality disparity is highest in Memphis, Tennessee, where African American women are twice as likely to die from breast cancer as White women. This qualitative study of African-American breast cancer survivors explores experiences during and post treatment that contributed to their beating the high odds of mortality. Using a semi-structured interview guide, a focus group session was held in 2012 with 10 breast cancer survivors. Thematic analysis and a deductive a priori template of codes were used to analyze the data. Five main themes were identified: family history, breast/body awareness and preparedness to manage a breast cancer event, diagnosis experience and reaction to the diagnosis, family reactions, and impact on life. Prayer and family support were central to coping, and survivors voiced a cultural acceptance of racial disparities in health outcomes. They reported lack of provider sensitivity regarding pain, financial difficulties, negative responses from family/friends, and resiliency strategies for coping with physical and mental limitations. Our research suggested that a patient-centered approach of demystifying breast cancer (both in patient-provider communication and in community settings would impact how women cope with breast cancer and respond to information about its diagnosis.

African American Women: Surviving Breast Cancer Mortality against the Highest Odds

Science.gov (United States)

White-Means, Shelley; Rice, Muriel; Dapremont, Jill; Davis, Barbara; Martin, Judy

2015-01-01

Among the country’s 25 largest cities, the breast cancer mortality disparity is highest in Memphis, Tennessee, where African American women are twice as likely to die from breast cancer as White women. This qualitative study of African-American breast cancer survivors explores experiences during and post treatment that contributed to their beating the high odds of mortality. Using a semi-structured interview guide, a focus group session was held in 2012 with 10 breast cancer survivors. Thematic analysis and a deductive a priori template of codes were used to analyze the data. Five main themes were identified: family history, breast/body awareness and preparedness to manage a breast cancer event, diagnosis experience and reaction to the diagnosis, family reactions, and impact on life. Prayer and family support were central to coping, and survivors voiced a cultural acceptance of racial disparities in health outcomes. They reported lack of provider sensitivity regarding pain, financial difficulties, negative responses from family/friends, and resiliency strategies for coping with physical and mental limitations. Our research suggested that a patient-centered approach of demystifying breast cancer (both in patient-provider communication and in community settings) would impact how women cope with breast cancer and respond to information about its diagnosis. PMID:26703655

ANALISIS SOUND GOVERNANCE: SIKAP PEMERINTAH DAERAH TERHADAP KETERLIBATAN NGO DALAM PEMBERDAYAAN MASYARAKAT PESISIR

OpenAIRE

Safitri, Dian Prima; Edison, Edison; Kurniasih, Fitri

2018-01-01

Penelitian ini mengkaji persoalan respond pemerintah daerah khususnya terkait sikap pemerintah dalam dimensi Sound Governance terhadap Non Government Organization (NGO) yang sangat aktif melakukan pemberdayaan masyarakat pesisir. Kegiatan pemberdayan tersebut dilakukan di Kabupaten Bintan Kepulauan Riau (Kepri). Setting penelitian ini di lokasi Kampung Wisata Panglong di Desa Berakit Kabupaten Bintan. Penelitian ini menerapkan jenis penelitian deskriptif dengan pendekatan kualitatif. Data dip...

Human Trafficking and Education: A Qualitative Case Study of Two NGO Programs in Thailand

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Spires, Robert Weber

2012-01-01

In this qualitative, ethnographic case study, I examine two Thai NGO shelters/schools working with human trafficking survivors and at-risk populations of children ages 5-18. The two NGOs had a residential component, meaning that children live at the shelter, and an educational component, meaning that children are taught academic and vocational…

Disparities in Barriers to Follow-up Care between African American and White Breast Cancer Survivors

Science.gov (United States)

Palmer, Nynikka R. A.; Weaver, Kathryn E.; Hauser, Sally P.; Lawrence, Julia A.; Talton, Jennifer; Case, L. Douglas; Geiger, Ann M.

2015-01-01

Purpose Despite recommendations for breast cancer survivorship care, African American women are less likely to receive appropriate follow-up care, which is concerning due to their higher mortality rates. This study describes differences in barriers to follow-up care between African American and White breast cancer survivors. Methods We conducted a mailed survey of women treated for non-metastatic breast cancer in 2009–2011, 6–24 months post-treatment (N=203). Survivors were asked about 14 potential barriers to follow-up care. We used logistic regression to explore associations between barriers and race, adjusting for covariates. Results Our participants included 31 African American and 160 White survivors. At least one barrier to follow-up care was reported by 62%. Compared to White survivors, African Americans were more likely to identify barriers related to out-of-pocket costs (28% vs. 51.6%, p=0.01), other healthcare costs (21.3% vs. 45.2%, p=0.01), anxiety/worry (29.4% vs. 51.6%, p=0.02), and transportation (4.4% vs. 16.1%, p=0.03). After adjustment for covariates, African Americans were three times as likely to report at least one barrier to care (OR=3.3, 95%CI=1.1–10.1). Conclusions Barriers to care are common among breast cancer survivors, especially African American women. Financial barriers to care may prevent minority and underserved survivors from accessing follow-up care. Enhancing insurance coverage or addressing out-of-pocket costs may help address financial barriers to follow-up care among breast cancer survivors. Psychosocial care aimed at reducing fear of recurrence may also be important to improve access among African American breast cancer survivors. PMID:25821145

NGO Partnerships in Using Ecotourism for Conservation: Systematic Review and Meta-Analysis.

Directory of Open Access Journals (Sweden)

Tania P Romero-Brito

Full Text Available We analyse 214 cases worldwide where non-governmental organisations (NGOs use ecotourism for conservation. Other stakeholders in these initiatives include local communities, the private sector, and government agencies. Stakeholder relationships determine NGO roles and project management structures and governance. We classified cases into 10 structural categories based on the initiating stakeholder and the NGO role, and used these categories to analyze geographic patterns and success factors. Most of the 214 cases are community-based (~170; 79%; most are in developing countries (190; 89%; and most are in protected areas (196; 91%. Frequencies of structural categories differ between continents. More cases in Latin America and Asia are initiated by NGOs and local communities, and more in Africa by the private sector. Case-study authors used a range of economic, socio-cultural and environmental criteria to judge whether projects were successful. At global scale, we found no significant association between project success and the involvement of private tourism entrepreneurs. Projects involving either local or international NGOs had higher success rates than those that involved both simultaneously. Future research could adopt political ecology approaches to examine: the factors that lead NGOs to adopt ecotourism enterprises; their internal decision-making processes and strategies; their interactions with the stakeholders involved; and their conservation goals and outcomes.

NGO Partnerships in Using Ecotourism for Conservation: Systematic Review and Meta-Analysis.

Science.gov (United States)

Romero-Brito, Tania P; Buckley, Ralf C; Byrne, Jason

2016-01-01

We analyse 214 cases worldwide where non-governmental organisations (NGOs) use ecotourism for conservation. Other stakeholders in these initiatives include local communities, the private sector, and government agencies. Stakeholder relationships determine NGO roles and project management structures and governance. We classified cases into 10 structural categories based on the initiating stakeholder and the NGO role, and used these categories to analyze geographic patterns and success factors. Most of the 214 cases are community-based (~170; 79%); most are in developing countries (190; 89%); and most are in protected areas (196; 91%). Frequencies of structural categories differ between continents. More cases in Latin America and Asia are initiated by NGOs and local communities, and more in Africa by the private sector. Case-study authors used a range of economic, socio-cultural and environmental criteria to judge whether projects were successful. At global scale, we found no significant association between project success and the involvement of private tourism entrepreneurs. Projects involving either local or international NGOs had higher success rates than those that involved both simultaneously. Future research could adopt political ecology approaches to examine: the factors that lead NGOs to adopt ecotourism enterprises; their internal decision-making processes and strategies; their interactions with the stakeholders involved; and their conservation goals and outcomes.

Cultural values and secondary prevention of breast cancer in african american women.

Science.gov (United States)

Beckjord, Ellen Burke; Klassen, Ann C

2008-01-01

Improving mammography initiation and maintenance among African American women has been suggested as a strategy for reducing breast cancer mortality in this population. We examined cultural values in relation to self-reported breast cancer screening among 572 low-income, urban, African American women. Cultural values examined included time orientation, family authority, employment aspirations, value of past vs modern life, and reliance on medical professionals. Also, implications for continued development of culturally tailored health interventions and opportunities for the consideration of cultural values in health communication are discussed. Bivariate analyses showed that more traditional values were associated with worse screening histories and lower intentions for future screening. In multivariate analyses, two interactions were observed between cultural values and age: for younger women, more traditional values were associated with lower odds of having ever received a mammogram, and for older women, more traditional values were associated with lower odds of intentions to receive a mammogram in the next 2 years. This study adds to the evidence that cultural constructs, such as values, are associated with secondary prevention of breast cancer and supports the consideration of cultural constructs as important in increasing mammography and reducing breast cancer disparities for African American women.

Structural and sociocultural factors associated with cervical cancer screening among HIV-infected African American women in Alabama.

Science.gov (United States)

Williams, Michelle; Moneyham, Linda; Kempf, Mirjam-Colette; Chamot, Eric; Scarinci, Isabel

2015-01-01

African American women have disproportionately high prevalence rates of HIV and cervical cancer. HIV-infected women are significantly less likely to obtain recommended cervical cancer screenings than HIV-uninfected women. The purpose of this study was to examine sociocultural and structural factors associated with cervical cancer screening among HIV-infected African American in Alabama. The PEN-3 Model and the Health Belief Model were used as theoretical frameworks. In-depth interviews were conducted with twenty HIV-infected African American women to identify perceptions, enablers, and nurturers, perceived susceptibility, perceived severity, and perceived benefits related to cervical cancer and screening. The most common positive perceptions, enablers, and nurturers that contributed to cervical cancer screening included internal motivation and awareness of the importance of HIV-infected women getting Pap tests due to their weakened immune system. Negative perceptions, enablers, and nurturers included lack of knowledge about cervical cancer and screening, and lack of perceived susceptibility to cervical cancer. The results of this study can be used to guide the development of culturally relevant cervical cancer and screening education interventions aimed at increasing cervical cancer screening adherence among HIV-infected African American women.

Introducing operations research into management and policy practices of a non-governmental organization (NGO): a partnership between an Indian leprosy NGO and an international academic institution.

Science.gov (United States)

Porter, J D H; Ogden, J A; Rao, P V Ranganadha; Rao, V Prabhakar; Rajesh, D; Buskade, R A; Soutar, D

2004-03-01

This paper reports on a partnership between LEPRA, a non-governmental organization (NGO), and the London School of Hygiene and Tropical Medicine (LSHTM) to explore the feasibility and appropriateness of incorporating operations research into the management and decision-making of a leprosy NGO. A pilot study in Orissa was used to determine the advantages and disadvantages of introducing operations research to assist in decision-making and programme implementation within the organization. The results highlight the difficulty and complexity of the process, but point to several important themes: partnership, changing perspectives, use of time and priority-setting, identification of gaps in systems, and building institutional and personal capabilities. The results of the study provide support to encourage NGOs to become actively involved in research. Because of their work and service to local communities, NGOs have the opportunity to collect information about the perceptions, resources and constraints of individuals, families and the communities themselves in accessing appropriate care. Their proximity to communities gives them a feeling of responsibility for ensuring that this information is translated to the district, national and ultimately international level. This will help to ensure the creation of appropriate infectious disease control policies that support the needs of patients. 'Outside' academic institutions can help NGOs to facilitate this up-stream flow of information from the local to the national and international level, to help to ensure that international disease control policies are appropriately serving local communities.

Major challenges to scale up of visual inspection-based cervical cancer prevention programs: the experience of Guatemalan NGOs.

Science.gov (United States)

Chary, Anita Nandkumar; Rohloff, Peter J

2014-08-01

Like many other low- and middle-income countries, Guatemala has adopted visual inspection with acetic acid (VIA) as a low-resource alternative to the Pap smear for cervical cancer screening. Nongovernmental organizations (NGOs) introduced VIA to Guatemala in 2004, and a growing number of NGOs, working both independently and in collaboration with the Guatemalan Ministry of Health, employ VIA in cervical cancer prevention programs today. While much research describes VIA efficacy and feasibility in Latin America, little is known about NGO involvement with VIA programming or experiences with VIA outside the context of clinical trials and pilot projects in the region. To explore challenges faced by NGOs implementing VIA programs in Guatemala, we conducted semi-structured interviews with 36 NGO staff members involved with 20 VIA programs as direct service providers, program administrators, and training course instructors. Additionally, we collected data through observation at 30 NGO-sponsored cervical cancer screening campaigns, 8 cervical cancer prevention conferences, and 1 week-long NGO-sponsored VIA training course. Frequently highlighted challenges included staff turnover, concerns over training quality, a need for opportunities for continued supervision, and problems with cryotherapy referrals when immediate treatment for VIA-positive women was unavailable. Reducing staff turnover, budgeting to train replacement providers, standardizing training curricula, and offering continued supervision are key strategies to improve VIA service quality and program sustainability. Alternative training methods, such as on-the-job mentoring and course prerequisites of online learning, could help increase training time available for clinical supervision. Efforts should be made to ensure that VIA testing is coupled with immediate cryotherapy, that providers trained in VIA are also trained in cryotherapy, and that cryotherapy supplies and equipment are maintained. Where this is not

Understanding and effectively addressing breast cancer in African American women: Unpacking the social context.

Science.gov (United States)

Williams, David R; Mohammed, Selina A; Shields, Alexandra E

2016-07-15

Black women have a higher incidence of breast cancer before the age of 40 years, more severe disease at all ages, and an elevated mortality risk in comparison with white women. There is limited understanding of the contribution of social factors to these patterns. Elucidating the role of the social determinants of health in breast cancer disparities requires greater attention to how risk factors for breast cancer unfold over the lifecourse and to the complex ways in which socioeconomic status and racism shape exposure to psychosocial, physical, chemical, and other individual and community-level assaults that increase the risk of breast cancer. Research that takes seriously the social context in which black women live is also needed to maximize the opportunities to prevent breast cancer in this underserved group. Cancer 2016;122:2138-49. © 2016 American Cancer Society. © 2016 American Cancer Society.

Prostate Cancer in African-American Men: Serum Biomarkers for Early Detection Using Nanoparticles

National Research Council Canada - National Science Library

Phelan, Catherine M

2008-01-01

We have blood samples from 40 African-American men with prostate cancer and 30 ethnically-matched control healthy men with questionnaire data on demographics, general health and cancer family history...

Gene by Environment Investigation of Incident Lung Cancer Risk in African-Americans

Directory of Open Access Journals (Sweden)

Sean P. David

2016-02-01

Interpretation: These results suggest that chromosome 15q25.1 variants are robustly associated with CPD and lung cancer in African-Americans and that the allelic dose effect of these polymorphisms on lung cancer risk is most pronounced in lighter smokers.

American Society of Clinical Oncology position statement on obesity and cancer.

Science.gov (United States)

Ligibel, Jennifer A; Alfano, Catherine M; Courneya, Kerry S; Demark-Wahnefried, Wendy; Burger, Robert A; Chlebowski, Rowan T; Fabian, Carol J; Gucalp, Ayca; Hershman, Dawn L; Hudson, Melissa M; Jones, Lee W; Kakarala, Madhuri; Ness, Kirsten K; Merrill, Janette K; Wollins, Dana S; Hudis, Clifford A

2014-11-01

Rates of obesity have increased significantly over the last three decades in the United States and globally. In addition to contributing to heart disease and diabetes, obesity is a major unrecognized risk factor for cancer. Obesity is associated with worsened prognosis after cancer diagnosis and also negatively affects the delivery of systemic therapy, contributes to morbidity of cancer treatment, and may raise the risk of second malignancies and comorbidities. Research shows that the time after a cancer diagnosis can serve as a teachable moment to motivate individuals to adopt risk-reducing behaviors. For this reason, the oncology care team--the providers with whom a patient has the closest relationships in the critical period after a cancer diagnosis--is in a unique position to help patients lose weight and make other healthy lifestyle changes. The American Society of Clinical Oncology is committed to reducing the impact of obesity on cancer and has established a multipronged initiative to accomplish this goal by 1) increasing education and awareness of the evidence linking obesity and cancer; 2) providing tools and resources to help oncology providers address obesity with their patients; 3) building and fostering a robust research agenda to better understand the pathophysiology of energy balance alterations, evaluate the impact of behavior change on cancer outcomes, and determine the best methods to help cancer survivors make effective and useful changes in lifestyle behaviors; and 4) advocating for policy and systems change to address societal factors contributing to obesity and improve access to weight management services for patients with cancer. © 2014 by American Society of Clinical Oncology.

British American Tobacco's partnership with Earthwatch Europe and its implications for public health.

Science.gov (United States)

McDaniel, Patricia A; Malone, Ruth E

2012-01-01

This paper explores a partnership between British American Tobacco (BAT) and the environmental organisation Earthwatch Europe (EE) and considers its implications for countries implementing Article 5.3 of the World Health Organization Framework Convention on Tobacco Control. We reviewed approximately 100 internal BAT documents, interviewed EE's former executive director and examined media accounts and BAT and EE websites. We analysed materials by reviewing them iteratively, identifying themes, constructing a timeline of events and assembling a case study. BAT sought a partnership with EE to gain a global ally that could provide entrée into the larger non-governmental organisation (NGO) community. EE debated the ethics of working with BAT, resolving them in BAT's favour and taking a narrow view of its own overall organisational mission. To protect its reputation, EE delayed public disclosure of the partnership. Instead, EE promoted it to policy-makers and other NGOs, extending BAT's reputation and reach into influential circles. The potential for normalising the tobacco industry presence within government through NGO partnerships and the benefits that accrued to BAT even when the partnership was not being publicised show why governments seeking to protect effective tobacco control policies from industry influence need to consider ways to identify and discourage 'hidden' NGO partnerships.

Obesity is associated with breast cancer in African-American women but not Hispanic women in South Los Angeles.

Science.gov (United States)

Sarkissyan, Marianna; Wu, Yanyuan; Vadgama, Jaydutt V

2011-08-15

Obesity is considered a risk factor for breast cancer. Modifying life styles that reduce obesity offers the potential for prevention and improved outcomes from cancer. The effects of obesity and breast cancer among African-American women and Hispanic women have been explored in a limited number of studies. The objective of the current study was to investigate the association of obesity with breast cancer in a minority cohort. This was a cross-sectional study of 471 African-American and Hispanic women with and without breast cancer in South Los Angeles. Data regarding body mass index (BMI) and clinical factors were obtained by medical record abstraction. Data were assessed using logistic regression with multivariate analysis. Kaplan-Meier survival analysis was used to assess disease-free survival. Women with breast cancer were more likely to be obese (BMI >30 kg/m(2)) than women without breast cancer (odds ratio [OR], 2.0; P = .01). There was a significant association of being overweight or obese and breast cancer among postmenopausal women (OR, 2.3 [P = .03] and 2.9 [P obesity and breast cancer was significant only among African-American women (OR, 2.70; P American women (OR, 4.8; P obesity and later disease stage at diagnosis (P = .06). An association also was observed between higher BMI (for cutoff points of both 30 kg/m(2) and 28 kg/m(2)) and poorer disease-free survival (P = .045 and P = .019, respectively). The current data suggested an association between obesity and breast cancer, especially among postmenopausal women and most significantly in the African-American cohort. Copyright © 2011 American Cancer Society.

Knowledge, beliefs and barriers associated with prostate cancer prevention and screening behaviors among African-American men.

Science.gov (United States)

Blocker, Deborah E; Romocki, LaHoma Smith; Thomas, Kamilah B; Jones, Belinda L; Jackson, Ethel Jean; Reid, LaVerne; Campbell, Marci K

2006-08-01

African-American men have the highest prostate cancer rates worldwide, and innovative efforts are needed to increase cancer prevention and screening behaviors among this population. Formative research was conducted to assess attitudes and behaviors linked to prostate cancer prevention activities that could be used to develop a culturally relevant intervention for an African-American church-based population. Four gender-specific focus groups were conducted with 29 men and women at two African-American churches in central North Carolina. Three primary themes emerged from the focus group discussions: culturally and gender-influenced beliefs and barriers about cancer prevention and screening; barriers related to the healthcare system: and religious influences, including the importance of spiritual beliefs and church support. These discussions revealed the importance of the black family, the positive influence of spouses/partners on promoting cancer screening and healthy behaviors, the roles of faith and church leadership, and beliefs about God's will for good health. These findings also revealed that there are still major barriers and challenges to cancer prevention among African Americans, including continued mistrust of the medical community and negative attitudes toward specific screening tests. Findings provide important insights to consider in implementing successful prostate cancer prevention interventions designed for church-based audiences.

Association of diabetes and cancer mortality in American Indians: the Strong Heart Study.

Science.gov (United States)

Best, Lyle G; García-Esquinas, Esther; Yeh, Jeun-Liang; Yeh, Fawn; Zhang, Ying; Lee, Elisa T; Howard, Barbara V; Farley, John H; Welty, Thomas K; Rhoades, Dorothy A; Rhoades, Everett R; Umans, Jason G; Navas-Acien, Ana

2015-11-01

The metabolic abnormalities that accompany diabetes mellitus are associated with an increased risk of many cancers. These associations, however, have not been well studied in American Indian populations, which experience a high prevalence of diabetes. The Strong Heart Study is a population-based, prospective cohort study with extensive characterization of diabetes status. Among a total cohort of 4,419 participants who were followed for up to 20 years, 430 cancer deaths were identified. After adjusting for sex, age, education, smoking status, drinking status, and body mass index, participants with diabetes at baseline showed an increased risk of gastric (HR 4.09; 95% CI 1.42-11.79), hepatocellular (HR 2.94; 95% CI 1.17-7.40), and prostate cancer mortality (HR 3.10; 95% CI 1.22-7.94). Further adjustment for arsenic exposure showed a significantly increased risk of all-cause cancer mortality with diabetes (HR 1.27; 95% CI 1.03-1.58). Insulin resistance among participants without diabetes at baseline was associated with hepatocellular cancer mortality (HR 4.70; 95% CI 1.55-14.26). Diabetes mellitus, and/or insulin resistance among those without diabetes, is a risk factor for gastric, hepatocellular, and prostate cancer in these American Indian communities, although relatively small sample size suggests cautious interpretation. Additional research is needed to evaluate the role of diabetes and obesity on cancer incidence in American Indian communities as well as the importance of diabetes prevention and control in reducing the burden of cancer incidence and mortality in the study population.

Arab American women's lived experience with early-stage breast cancer diagnosis and surgical treatment.

Science.gov (United States)

Obeidat, Rana Fakhri; Lally, Robin M; Dickerson, Suzanne S

2012-01-01

Currently, limited literature addresses Arab American women's responses to the impact of breast cancer and its treatments. The objective of the study was to understand the experience of being diagnosed with and undergoing surgical treatment for early-stage breast cancer among Arab American women. A qualitative interpretive phenomenological research design was used for this study. A purposive sample of 10 Arab American women who were surgically treated for early-stage breast cancer in the United States was recruited. Data were collected using individual interviews and analyzed using the Heideggerian hermeneutical methodology. Arab American women accepted breast cancer diagnosis as something in God's hands that they had no control over. Although they were content with God's will, the women believed that the diagnosis was a challenge that they should confront. The women confronted this challenge by accessing the healthcare system for treatment, putting trust in their physicians, participating when able in treatment decisions, using religious practices for coping, maintaining a positive attitude toward the diagnosis and the treatment, and seeking information. Arab American women's fatalistic beliefs did not prevent them from seeking care and desiring treatment information and options when diagnosed with breast cancer. It is important that healthcare providers encourage patients to express meanings they attribute to their illness to provide them with appropriate supportive interventions. They should also individually assess patients' decision-making preferences, invite them to participate in decision making, and provide them with tailored means necessary for such participation without making any assumptions based on patients' ethnic/cultural background.

The Characteristics of Effective Cancer Education Media Interventions among African Americans: A Systematic Review.

Science.gov (United States)

Adedoyin, A Christson; Sherr, Michael E; Adedoyin, Oreoluwa O; Royse, David D; Jackson, Mary S; Adu-Boahene, Akosua B

2016-01-01

Cancer incidence and mortality is a significant area of health disparity between African Americans and Caucasians. In the current article the authors used a systematic review design to examine the characteristics of different cancer media education intervention (CMEI) to increase access to cancer screenings for African Americans within a 30 year period (1980-2010). Ten computerized databases were searched using inclusion-exclusion criteria. Consequently, 179 potential studies were identified, and later reduced to 41 eligible studies through the inclusion-exclusion criteria. The eligible studies had a combined sample size of N = 12,764 respondents. The findings revealed that multi-media intervention strategies were the most common media intervention that led to increased cancer screenings among African Americans. The authors conclude with a call for social workers to be more involved in developing and following up with culturally appropriate media strategies that can increase the likelihood of early detection and successful treatment, thus reducing this important area of health disparity.

Cancer Fatalism, Literacy, and Cancer Information Seeking in the American Public.

Science.gov (United States)

Kobayashi, Lindsay C; Smith, Samuel G

2016-08-01

Information seeking is an important behavior for cancer prevention and control, but inequalities in the communication of information about the disease persist. Conceptual models have suggested that low health literacy is a barrier to information seeking, and that fatalistic beliefs about cancer may be a mediator of this relationship. Cancer fatalism can be described as deterministic thoughts about the external causes of the disease, the inability to prevent it, and the inevitability of death at diagnosis. This study aimed to examine the associations between these constructs and sociodemographic factors, and test a mediation model using the American population-representative Health Information and National Trends Survey (HINTS 4), Cycle 3 (n = 2,657). Approximately one third (34%) of the population failed to answer 2/4 health literacy items correctly (limited health literacy). Many participants agreed with the fatalistic beliefs that it seems like everything causes cancer (66%), that one cannot do much to lower his or her chances of getting cancer (29%), and that thinking about cancer makes one automatically think about death (58%). More than half of the population had "ever" sought information about cancer (53%). In analyses adjusted for sociodemographic characteristics and family cancer history, people with limited health literacy were less likely to have ever sought cancer information (odds ratio [OR] = 0.63; 0.42-0.95) and more frequently endorsed the belief that "there's not much you can do . . ." (OR = 1.61; 1.05-2.47). This fatalistic belief partially explained the relationship between health literacy and information seeking in the mediation model (14% mediation). Interventions are needed to address low health literacy and cancer fatalism to increase public interest in cancer-related information. © 2015 Society for Public Health Education.

Use of electric bedding devices and risk of breast cancer in African-American women.

Science.gov (United States)

Zhu, Kangmin; Hunter, Sandra; Payne-Wilks, Kathleen; Roland, Chanel L; Forbes, Digna S

2003-10-15

In this case-control study, the authors aimed to examine whether use of an electric bedding device increased breast cancer risk in African-American women. Cases were 304 African-American patients diagnosed with breast cancer during 1995-1998 who were aged 20-64 years and lived in one of three Tennessee counties. Controls were 305 African-American women without breast cancer who were selected through random digit dialing and frequency-matched to cases by age and county. Information on the use of an electric blanket or heated water bed and other risk factors was collected through telephone interviews. Breast cancer risk associated with use of an electric bedding device increased with the number of years of use, the number of seasons of use, and the length of time of use during sleep. When women who used an electric bedding device for more than 6 months per year (and therefore were more likely to have used a heated water bed, which generates lower magnetic fields) were excluded, the corresponding dose-response relations were more striking. Similar trends in dose response were shown in both premenopausal and postmenopausal women and for both estrogen receptor-positive and estrogen receptor-negative tumors. The use of electric bedding devices may increase breast cancer risk in African-American women aged 20-64 years. Such an association might not vary substantially by menopausal status or estrogen receptor status.

Difference in Association of Obesity With Prostate Cancer Risk Between US African American and Non-Hispanic White Men in the Selenium and Vitamin E Cancer Prevention Trial (SELECT).

Science.gov (United States)

Barrington, Wendy E; Schenk, Jeannette M; Etzioni, Ruth; Arnold, Kathryn B; Neuhouser, Marian L; Thompson, Ian M; Lucia, M Scott; Kristal, Alan R

2015-06-01

African American men have the highest rates of prostate cancer incidence and mortality in the United States. Understanding underlying reasons for this disparity could identify preventive interventions important to African American men. To determine whether the association of obesity with prostate cancer risk differs between African American and non-Hispanic white men and whether obesity modifies the excess risk associated with African American race. Prospective study of 3398 African American and 22,673 non-Hispanic white men who participated in the Selenium and Vitamin E Cancer Prevention Trial (2001-2011) with present analyses completed in 2014. Total, low-grade (Gleason score American men and a corresponding 1453, 898, and 441 cases in non-Hispanic white men, respectively. Although not associated with risk among non-Hispanic white men, BMI was positively associated with an increase in risk among African American men (BMI, American race increased from 28% (HR, 1.28 [95% CI, 0.91-1.80]) among men with BMI less than 25 to 103% (HR, 2.03 [95% CI, 1.38-2.98]) among African American men with BMI at least 35 (P for trend = .03). Body mass index was inversely associated with low-grade prostate cancer risk within non-Hispanic white men (BMI, American men (BMI, American men, although the increase may be larger within African American men, albeit the racial interaction was not statistically significant (BMI, Obesity is more strongly associated with increased prostate cancer risk among African American than non-Hispanic white men and reducing obesity among African American men could reduce the racial disparity in cancer incidence. Additional research is needed to elucidate the mechanisms underlying the differential effects of obesity in African American and non-Hispanic white men.

Internet-driven changes in environmental NGO action

Directory of Open Access Journals (Sweden)

Pedro Pereira Neto

2008-12-01

Full Text Available Information and Communication Technologies, considered both as a technological resource and as a social technology, play an important role in the shaping of existing social relations and in the creation of new modes of interaction and social organization (AA. VV., 2000. However, traditional approaches of political action frequently misstate just how politically active citizens are by underrating changes occurred in the realm of political mediation (Norris, 2002, p. 2; Epstein, 1991, p. 230. The changes in the organizational and action repertoires go hand in hand with the specificities of each NGO's cultural interpretative devices, which are influenced by technological change (Zald, 1996, p. 266-270. On the other hand, frames are also subject to internal debate, a process in which ICTs also take part (Webster, 2001, p. 7. Hence, this paper focuses on clarifying the ways in which NGOs have their structure and action repertoires changed by the use of ICTs.

How to calculate the annual costs of NGO-implemented programmes to support orphans and vulnerable children: a six-step approach.

Science.gov (United States)

Larson, Bruce A; Wambua, Nancy

2011-12-19

Information on the costs of implementing programmes designed to provide support of orphans and vulnerable children (OVC) in sub-Saharan Africa and elsewhere is increasingly being requested by donors for programme evaluation purposes. To date, little information exists to document the costs and structure of costs of OVC programmes as actually implemented "on the ground" by local non-governmental organizations (NGOs). This analysis provides a practical, six-step approach that NGOs can incorporate into routine operations to evaluate their costs of implementing their OVC programmes annually. This approach is applied to the Community-Based Care for Orphans and Vulnerable Children (CBCO) Program implemented by BIDII (a Kenyan NGO) in Eastern Province of Kenya. The costing methodology involves the following six steps: accessing and organizing the NGO's annual financial report into logical sub-categories; reorganizing the sub-categories into input cost categories to create a financial cost profile; estimating the annual equivalent payment for programme equipment; documenting donations to the NGO for programme implementation; including a portion of NGO organizational costs not attributed to specific programmes; and including the results of Steps 3-5 into an expanded cost profile. Detailed results are provided for the CBCO programme. This paper shows through a concrete example how NGOs implementing OVC programmes (and other public health programmes) can organize themselves for data collection and documentation prospectively during the implementation of their OVC programmes so that costing analyses become routine practice to inform programme implementation rather than a painful and flawed retrospective activity. Such information is required if the costs and outcomes achieved by OVC programmes will ever be clearly documented and compared across OVC programmes and other types of programmes (prevention, treatment, etc.).

African Security Challenges: Now and Over the Horizon - Voices from the NGO Community

Science.gov (United States)

2010-11-01

economies will have a tendency to shift back to dependence on unskilled sectors such as mining, black -market or informal trading and international aid...PEPFAR Watch. Pepfarwatch.org. Rice , A. 2007. “An African Solution.” Nation, June 11. Voices from the NGO Community - 5.19 - African Security...oversight role in this area by parliaments, regardless of formal mandates, roles and responsibilities. In order to avoid the risk of cosmetic changes

Brief communication: economic comparison of opportunistic infection management with antiretroviral treatment in people living with HIV/AIDS presenting at an NGO clinic in Bangalore, India.

Science.gov (United States)

John, K R; Rajagopalan, Nirmala; Madhuri, K V

2006-11-01

Highly active antiretroviral treatment (HAART) usage in India is escalating. With the government of India launching the free HAART rollout as part of the "3 by 5" initiative, many people living with HIV/AIDS (PLHA) have been able to gain access to HAART medications. Currently, the national HAART centers are located in a few district hospitals (in the high- and medium-prevalence states) and have very stringent criteria for enrolling PLHA. Patients who do not fit these criteria or patients who are too ill to undergo the prolonged wait at the government hospitals avail themselves of nongovernment organization (NGO) services in order to take HAART medications. In addition, the government program has not yet started providing second-line HAART (protease inhibitors). Hence, even with the free HAART rollout, NGOs with the expertise to provide HAART continue to look for funding opportunities and other innovative ways of making HAART available to PLHA. Currently, no study from Indian NGOs has compared the direct and indirect costs of solely managing opportunistic infections (OIs) vs HAART. Compare direct medical costs (DMC) and nonmedical costs (NMC) with 2005 values accrued by the NGO and PLHA, respectively, for either HAART or exclusive OI management. Retrospective case study comparison. Low-cost community care and support center--Freedom Foundation (NGO, Bangalore, south India). Retrospective analysis data on PLHA accessing treatment at Freedom Foundation between January 1, 2003 and January 1, 2005. The HAART arm included case records of PLHA who initiated HAART at the center, had frequent follow-up, and were between 18 and 55 years of age. The OI arm included records of PLHA who were also frequently followed up, who were in the same age range, who had CD4+ cell counts NGO and Rs 1155/- paid by PLHA. Median DMC and NMC pppy in the HAART arm were Rs 1425/- paid by NGO and Rs 17,606/- paid by PLHA. Good health at no increased expenditure justifies providing PLHA with HAART

Family involvement for breast cancer decision making among Chinese-American women.

Science.gov (United States)

Lee, Shiuyu Katie C; Knobf, M Tish

2016-12-01

To describe family involvement in decision making for primary treatment in Chinese-American women with early-stage breast cancer. Qualitative data were collected in 2003 from semi-structured questions in interviews with a sample of Chinese-American (ChA) women with breast cancer, who were recruited from the metropolitan New York area. Responses to the questions were written in Chinese immediately during the interview and read back to the subject for accuracy and validation. Content analysis was used to inductively code and analyze the data to generate themes. The participants consisted of 123 ChA women with early stage breast cancer with a mean age of 48.7 years (±9.3) and who had lived in the United States a median of 13.6 years. Support and Caring was the major theme that described family involvement in the breast cancer decision-making process. Gathering Information, Being There, Navigating the Health Care System, Maintaining Family Life and Making the Decision described the aspects of family support in the process. The majority of women described the treatment decision making as a collaborative supportive process with the family, but limited English fluency, strong opinions, lack of a shared perspective, distant living proximity and competing work responsibilities of family members were stressful for the women and perceived as non-supportive. Family involvement in health care decision making is culturally embedded in Asian populations. Culturally sensitive patient and family consultation strategies are needed to assist informed treatment decision making in Chinese-American women diagnosed with breast cancer. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Cancer screening promotion among medically underserved Asian American women: integration of research and practice.

Science.gov (United States)

Yu, Mei-yu; Seetoo, Amy D; Hong, Oi Saeng; Song, Lixin; Raizade, Rekha; Weller, Adelwisa L Agas

2002-01-01

Mammography and Pap smear tests are known to be effective early detection measures for breast and cervical cancers, respectively, but Asian Americans are reluctant to make visits for routine preventive care. Quantitative and qualitative research conducted by the Healthy Asian Americans Project (HAAP) between 1996 and 1999 indicated that Asian residents in southeastern Michigan, like the general Asian population in the US, underutilized early cancer screening programs due to cultural, psychosocial, linguistic, and economic barriers. This article reports how the HAAP's research findings guided the Michigan Breast and Cervical Cancer Control Program (BCCCP) promotion (conducted from 2000 to 2001 among medically underserved Asian women residing in southeastern Michigan), and how evaluation of the HAAP's BCCCP promotion will direct future research and health promotion programs. The article presents strategies used to improve access to cancer screening programs for diverse Asian sub-groups as well as outcomes of the 2-year HAAP's BCCCP promotion among the target population. Discussion regarding lessons and experiences gained from integration of research and practice has implications on design and implementation of the cancer screening promotion for the rapidly increasing Asian American population as well as other medically underserved minority populations in the US.

Socioecological perspectives on cervical cancer and cervical cancer screening among Asian American women.

Science.gov (United States)

Lee, Jongwon; Carvallo, Mauricio

2014-10-01

Although cervical cancer is one of the most commonly diagnosed cancers among Vietnamese American women (VAW) and Korean American women (KAW), both groups consistently report much lower rates of cervical cancer screening compared with other Asian ethnic subgroups and non-Hispanic Whites. This study aimed to explore multilevel factors that may underlie low screening rates among VAW and KAW living in a city where their ethnic communities are relatively small. The socioecological model was used as a conceptual framework. Thirty participants were conveniently recruited from ethnic beauty salons run by VA and KA cosmetologists in Albuquerque, New Mexico. The participants' average age was 44.6 years (SD = .50; range = 21-60). Most participants were married (80 %) and employed (73.3 %), and had health insurance (83.3 %). A qualitative interview was conducted in Vietnamese or Korean and transcribed verbatim. A thematic content analysis was used to identify major codes, categories, and patterns across the transcripts. The study identified several factors at the individual (e.g., pregnancy, poverty, personality), interpersonal (e.g., family responsibility, mother as influential referent), and community (e.g., lack of availability, community size) levels. The study sheds light on four major areas that must be taken into consideration in the development of culturally appropriate, community-based interventions aimed to reduce disparities in cervical cancer screening among ethnic minority women in the United States: (1) ethnic community size and geographic location; (2) cross-cultural similarities and dissimilarities; (3) targeting of not only unmarried young women, but also close referents; and (4) utilization of trusted resources within social networks.

NGO 'S ROLE IN SOCIAL ECONOMY

Directory of Open Access Journals (Sweden)

MARIANA CLAUDIA MUNGIU-PUPĂZAN

2016-06-01

Full Text Available This paper aims to be a company - NGO relationship analysis and points out that a company can find its strategic stakeholders among non - profit organizations. In world practice social responsibility is spoken frequently about the collaboration between the business sector and non - profit. At the international level, NGOs are one of the most important dialogue partners of the business sector. In Romania, NGOs are often seen as something always require organizations that sponsor or if you want to do exercises image. On the one hand NGOs are wondering what to do to see their sponsored projects, although according to modern definitions, sponsorship does not really have much in common with corporate social. On the other hand companies are trying to answer the question "who are strategic stakeholders". Their proactive involvement of the stakeholders helps to cultivate relationships that can provide a competitive advantage especially in times of crisis. Like any business, stakeholder engagement has a number of constraints: requires time, financial and human resources dedicated to rely on a continuous process of monitoring and may require. Moreover, if not properly planned and implemented, could damage relations between the company and stakeholders

Healing pathways: art therapy for American Indian cancer survivors.

Science.gov (United States)

Warson, Elizabeth

2012-04-01

There is a paucity of research addressing quality of life factors for American Indian and Alaska Native cancer survivors. Complementary forms of therapy, such as art therapy, are beginning to address quality of life factors through the "healing" arts for cancer survivors. The purpose of this mixed methods pilot was to explore the effects of culturally relevant art interventions on stress reduction for American Indian cancer survivors and their family members. Forty-six adult participants attended one of three workshops held within two settlements of the Coharie tribe and one southeastern urban tribal center. The data collected consisted of a pretest and posttest State-Trait Personality Inventory (STPI) and artwork resulting from three directed interventions. The artwork was analyzed using qualitative coding methods; however, the scores from the STPI were inconclusive because the inventory was determined to be culturally biased. While statistical significance was not achieved, the findings from qualitative coding reinforced a native concept of wellness focusing on the complex interaction between mind, body, spirit, and context. This pilot study also demonstrated how a community-driven approach was instrumental in the development of the overall workshop format. An expansion of the pilot study is also presented with preliminary results available in 2012.

African American women's experiences with the initial discovery, diagnosis, and treatment of breast cancer.

Science.gov (United States)

Lackey, N R; Gates, M F; Brown, G

2001-04-01

To describe the experiences of African American women living with breast cancer following the primary diagnosis and while undergoing initial treatment. Phenomenologic. 13 African American women (ages 30-66) purposefully selected from two oncology clinics in the mid-South. Phenomenologic interviews (transcribed verbatim) and field notes were analyzed using Colaizzi's method of phenomenologic description and analysis. Experience Trajectory, Femininity, and Spirituality were the three major themes. The Experience Trajectory subthemes were finding the lump, getting the diagnosis, undergoing surgery and adjuvant treatment. The Femininity subthemes were loss of all or part of the breast, loss of hair, and sexual attractiveness to a man. Spirituality was reflected as a reliance on God. Telling the story of their experience trajectory during their breast cancer experience is valuable in assessing African American women's feelings, emotions, and fears of body changes that occur during surgery and treatment. Their spirituality helps them through this experience. Research involving both African American women and their partners would provide greater insight into specific relationship patterns and communication related to sexuality during this experience. Nurses need to listen to the stories of African American women about the initial experience of discovery, diagnosis, and treatment of breast cancer so they can be more informed advocates for these women. African American women need more information from healthcare providers regarding the whole experience trajectory.

Genetic Counseling for Breast Cancer Susceptibility in African American Women

National Research Council Canada - National Science Library

Hughes, Chanita

2004-01-01

.... The objectives of this study are to develop a Culturally Tailored Genetic (CTGC) protocol for African American women and evaluate its impact on decision-making and satisfaction about BRCAl/2 testing, quality of life, and cancer control practices...

Perceived social support in African American breast cancer patients: Predictors and effects.

Science.gov (United States)

Thompson, Tess; Pérez, Maria; Kreuter, Matthew; Margenthaler, Julie; Colditz, Graham; Jeffe, Donna B

2017-11-01

Social support plays an important role in quality of life and health outcomes after breast cancer diagnosis and treatment. To examine changes in perceived social support in African American women during the two years following a new breast cancer diagnosis. This secondary analysis uses data collected from 2009 to 2015 from 227 newly diagnosed, African American women with breast cancer (mean age 56 [SD = 10], 59% household income social support (measured by the Medical Outcomes Study Social Support Survey) as well as correlates of baseline levels of social support and predictors of change in individuals' social support. Additional analyses examined whether change in social support over the first year affected depressive symptoms (Center for Epidemiologic Studies Depression Scale) and general health perceptions (RAND SF-36 subscale) at two years. Being married, reporting greater spirituality, and reporting fewer depressive symptoms at baseline were significantly associated with higher initial levels of perceived social support. Women whose social support declined during the first year after diagnosis reported more severe depressive symptoms and worse general health perceptions at two years. Clinicians should periodically assess perceived social support among African American women with breast cancer to help find support resources for those who have low initial social support and for those whose support declines in the first year after diagnosis. Copyright © 2017 Elsevier Ltd. All rights reserved.

Body Mass Index and Cancer Screening in Older American Indian and Alaska Native Men

Science.gov (United States)

Muus, Kyle J.; Baker-Demaray, Twyla; McDonald, Leander R.; Ludtke, Richard L.; Allery, Alan J.; Bogart, T. Andy; Goldberg, Jack; Ramsey, Scott D.; Buchwald, Dedra S.

2009-01-01

Context: Regular screenings are important for reducing cancer morbidity and mortality. There are several barriers to receiving timely cancer screening, including overweight/obesity. No study has examined the relationship between overweight/obesity and cancer screening among American Indian/Alaska Natives (AI/ANs). Purpose: To describe the…

Effectiveness of an Ongoing, Community-Based Breast Cancer Prevention Program for Korean American Women.

Science.gov (United States)

Koh, Eun; Choi, Ga-Young; Cho, Ji Young

2016-02-01

The study evaluates the effectiveness of an ongoing, community-based breast cancer prevention program offered by a local social services agency in the Washington, DC, metropolitan area. Korean American women who participated in this breast cancer prevention program were compared with those who did not participate in their knowledge, attitude, and screening behaviors. The study found that the intervention group was more knowledgeable on breast cancer and related services and reported more positive attitudes toward breast cancer screening services than the comparison group. The participants in the intervention group were also more likely to plan to receive a mammogram than those in the comparison group. However, significant differences were not observed in the two groups in their intention to receive a clinical breast examination. The study findings suggest that an ongoing, community-based breast cancer prevention program can be an effective method of addressing breast cancer prevention disparities observed among Korean American women.

Genetic Counseling for Breast Cancer Susceptibility in African American Women

National Research Council Canada - National Science Library

Hughes, Chanita

2005-01-01

.... The objectives of this study are to develop a Culturally Tailored Genetic (CTGC) protocol for African American women and evaluate its impact on decision-making and satisfaction about BRCA1/2 testing, quality of life, and cancer control practices...

Knowledge of colorectal cancer screening guidelines and intention to obtain screening among nonadherent Filipino, Hmong, and Korean Americans.

Science.gov (United States)

Tsoh, Janice Y; Tong, Elisa K; Sy, Angela U; Stewart, Susan L; Gildengorin, Ginny L; Nguyen, Tung T

2018-04-01

Nonadherence to colorectal cancer (CRC) screening among Asian Americans is high but not well understood. This study examined correlates of screening intention among Filipino, Hmong, and Korean Americans who were nonadherent to CRC screening. Using cross-sectional, preintervention survey data from 504 Asian Americans (115 Filipinos, 185 Hmong, and 204 Koreans) aged 50-75 years who were enrolled in a multisite cluster randomized controlled trial of lay health educator intervention, we analyzed correlates of self-reported CRC screening nonadherence, which was defined as not being up-to-date for fecal occult blood test, sigmoidoscopy, or colonoscopy. Only 26.8% of participants indicated intention to obtain screening within 6 months (Hmong: 12.4%; Korean: 30.8%; and Filipino: 42.6%; P Filipinos, which was unexplained by socio-demographics, health care factors, perceived needs for CRC screening, or knowledge of screening guidelines. CRC screening intention among nonadherent Filipino, Hmong, and Korean Americans was low. Targeting knowledge of CRC screening guidelines may be effective strategies for increasing CRC screening intention among nonadherent Asian Americans. Cancer 2018;124:1560-7. © 2018 American Cancer Society. © 2018 American Cancer Society.

Impact of Culture on Breast Cancer Screening in Chinese American Women

National Research Council Canada - National Science Library

Wang, Judy H

2006-01-01

The purpose of this study is to develop and use culturally appropriate and stage-tailored Chinese language breast cancer brochures to promote older Chinese American women's intentions to obtain mammography...

Impact of Culture on Breast Cancer Screening in Chinese American Women

National Research Council Canada - National Science Library

Wang, Judy H

2005-01-01

The purpose of this study is to develop and use culturally appropriate and stage-tailored Chinese language breast cancer brochures to promote older Chinese-American women's intentions to obtain mammography...

Impact of Culture on Breast Cancer Screening in Chinese American Women

National Research Council Canada - National Science Library

Wang, Judy

2003-01-01

The purpose of this study is to develop and use culturally appropriate and stage-tailored Chinese language breast cancer brochures to promote older Chinese-American women's intentions to obtain mammography...

Impact of Culture on Breast Cancer Screening in Chinese American Women

National Research Council Canada - National Science Library

Huei-Yu Wang, Judy

2004-01-01

The purpose of this study is to develop and use culturally appropriate and stage-tailored Chinese language breast cancer brochures to promote older Chinese-American women's intentions to obtain mammography...

Health seeking behavioral analysis associated with breast cancer screening among Asian American women

Directory of Open Access Journals (Sweden)

Ma GX

2012-05-01

Full Text Available Grace X Ma,1 Wanzhen Gao,1 Sunmin Lee,2 MinQi Wang,3 Yin Tan,1 Steven E Shive,1,41Department of Public Health, Center for Asian Health, College of Health Professions, Temple University, Philadelphia, PA, USA; 2Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD, USA; 3Department of Public and Community Health, University of Maryland, College Park, Maryland, MD, USA; 4East Stroudsburg University, East Stroudsburg, PA, USAObjective: The purpose of this community-based study was to apply a Sociocultural Health Behavior Model to determine the association of factors proposed in the model with breast cancer screening behaviors among Asian American women.Methods: A cross-sectional design included a sample of 682 Chinese, Korean, and Vietnamese women aged 40 years and older. The frequency distribution analysis and Chi-square analysis were used for the initial screening of the following variables: sociodemographic, cultural, enabling, environmental, and social support. Univariate and multivariate analyses were conducted on factors for breast cancer screening using multinomial logistic regression analysis.Results: Correlates to positive breast cancer screening included demographics (ethnicity, cultural factors (living in the United States for 15 years or more, speaking English well, enabling factors (having a regular physician to visit, health insurance covering the screening, and family/social support factors (those who had a family/friend receiving a mammogram.Conclusions: The results of this study suggest that breast cancer screening programs will be more effective if they include the cultural and health beliefs, enabling, and social support factors associated with breast cancer screening. The use of community organizations may play a role in helping to increase breast cancer screening rates among Asian American women.Keywords: breast cancer screening, Vietnamese, Korean, Chinese, breast

Adherence to Analgesics for Cancer Pain: A Comparative Study of African Americans and Whites Using an Electronic Monitoring Device.

Science.gov (United States)

Meghani, Salimah H; Thompson, Aleda M L; Chittams, Jesse; Bruner, Deborah W; Riegel, Barbara

2015-09-01

Despite well-documented disparities in cancer pain outcomes among African Americans, surprisingly little research exists on adherence to analgesia for cancer pain in this group. We compared analgesic adherence for cancer-related pain over a 3-month period between African Americans and whites using the Medication Event Monitoring System (MEMS). Patients (N = 207) were recruited from outpatient medical oncology clinics of an academic medical center in Philadelphia (≥18 years of age, diagnosed with solid tumors or multiple myeloma, with cancer-related pain, and at least 1 prescription of oral around-the-clock analgesic). African Americans reported significantly greater cancer pain (P < .001), were less likely than whites to have a prescription of long-acting opioids (P < .001), and were more likely to have a negative Pain Management Index (P < .001). There were considerable differences between African Americans and whites in the overall MEMS dose adherence, ie, percentage of the total number of prescribed doses that were taken (53% vs 74%, P < .001). On subanalysis, analgesic adherence rates for African Americans ranged from 34% (for weak opioids) to 63% (for long-acting opioids). Unique predictors of analgesic adherence varied by race; income levels, analgesic side effects, and fear of distracting providers predicted analgesic adherence for African Americans but not for whites. Perspective: Despite evidence of disparities in cancer pain outcomes among African Americans, surprisingly little research exists on African Americans' adherence to analgesia for cancer pain. This prospective study uses objective measures to compare adherence to prescribed pain medications between African American and white patients with cancer pain. Copyright © 2015 American Pain Society. Published by Elsevier Inc. All rights reserved.

Differential splicing of oncogenes and tumor suppressor genes in African and Caucasian American populations: contributing factor in prostate cancer disparities

Science.gov (United States)

2017-12-01

populations: contributing factor in prostate cancer disparities? PRINCIPAL INVESTIGATOR: Norman H Lee, PhD CONTRACTING ORGANIZATION: George Washington...splicing of oncogenes and tumor suppressor genes in African and Caucasian American populations: contributing factor in prostate cancer disparities? 5b...American (AA) versus Caucasian American (CA) prostate cancer (PCa). We focused our efforts on two oncogenes, phosphatidylinositol-4,5-bisphosphate 3

Psychosocial predictors of depression among older African American patients with cancer.

Science.gov (United States)

Hamilton, Jill B; Deal, Allison M; Moore, Angelo D; Best, Nakia C; Galbraith, Kayoll V; Muss, Hyman

2013-07-01

To determine whether psychosocial factors predict depression among older African American patients with cancer. A descriptive correlational study. Outpatient oncology clinic of a National Cancer Institute-designated cancer center in the southeastern United States. African American patients with cancer aged 50-88 years. Fisher's exact and Wilcoxon rank-sum tests were used to evaluate differences between patients who were possibly depressed (Geriatric Depression Scale) or not. Multivariate linear regression statistics were used to identify the psychosocial factors that predicted higher depression scores. Education and gender were included as covariates. Religiosity, emotional support, collectivism, perceived stigma, and depression. Participants (N = 77) had a mean age of 61 years (SD = 8.4), and a majority were well-educated, insured, religiously affiliated, and currently in treatment. Participants who were in the lowest income category, not married, or male had higher depression scores. The multivariable model consisting of organized religion, emotional support, collectivism, education, and gender explained 52% (adjusted R2) of the variation in depression scores. Stigma became insignificant in the multivariable model. Psychosocial factors are important predictors of depression. Emotional support and organized religious activities may represent protective factors against depression, whereas collectivism may increase their risk. Nurses need to be particularly aware of the potential psychological strain for patients with collectivist values, experienced stigma, disruptions in church attendance, and lack of emotional support. In addition, the treatment plans for these patients should ensure that family members are knowledgeable about cancer, its treatment, and side effects so they are empowered to meet support needs. Among older African American patients with cancer, emotional support and reassurance from family and friends that they will not abandon them decreases the

Cost recovery of NGO primary health care facilities: a case study in Bangladesh

OpenAIRE

Alam, Khurshid; Ahmed, Shakil

2010-01-01

Abstract Background Little is known about the cost recovery of primary health care facilities in Bangladesh. This study estimated the cost recovery of a primary health care facility run by Building Resources Across Community (BRAC), a large NGO in Bangladesh, for the period of July 2004 - June 2005. This health facility is one of the seven upgraded BRAC facilities providing emergency obstetric care and is typical of the government and private primary health care facilities in Bangladesh. Give...

Expectations and reality: perceptions of support among African American breast cancer survivors.

Science.gov (United States)

Felder, Tisha M; Estrada, Robin Dawson; Quinn, Jada C; Phelps, Kenneth W; Parker, Pearman D; Heiney, Sue P

2017-09-04

The experience of an illness such as breast cancer is not a static event. Just as physiological needs change as a patient transitions through diagnosis, treatment, to long-term survivorship, so too will their needs for social support. We applied a transitions theory framework to explore how African American women with breast cancer conceptualized and experienced support along their breast cancer journey. We recruited 16 African American women with breast cancer from a regional cancer center in South Carolina to complete qualitative, semi-structured interviews. We iteratively examined verbatim transcripts using thematic analysis. Three core themes emerged: 'I guess she was supposed to': When support meets patient expectations; 'I wasn't expecting that and that just made me feel so good': When reality exceeds expectations; and 'Don't try to make an invalid out of me': When support given wasn't what was desired. Survivors shared how their family, friends and clergy met their needs for emotional (e.g. prayer, sharing affirmations about God) and instrumental support (e.g. cooking meals, house cleaning). They emphasized how receiving emotional support from their healthcare providers was a pleasant surprise. However, survivors also described unexpected disappointments when family members offered support that was un-needed or un-desired. Applying transitions theory, we found that social support is a process of bidirectional negotiation where African American women with breast cancer perceive support as helpful and acceptable depending on who offers support, what type of support is offered, and when it is offered. Members of their social support network (e.g. family, friends, providers) should periodically assess the survivor's evolving needs to ensure the social support harmonizes with the needs and expectations of the survivor.

Graphic Narratives and Cancer Prevention: A Case Study of an American Cancer Society Comic Book.

Science.gov (United States)

Krakow, Melinda

2017-05-01

As the interest in graphic medicine grows, health communicators have started engaging readers with compelling visual and textual accounts of health and illness, including via comic books. One context where comics have shown promise is cancer communication. This brief report presents an early example of graphic medicine developed by the American Cancer Society. "Ladies … Wouldn't It Be Better to Know?" is a comic book produced in the 1960s to provide the public with lay information about the Pap test for cervical cancer prevention and detection. An analysis of a key narrative attribute, plot development, illustrates the central role that perceived barriers played in this midcentury public health message, a component that remains a consideration of cancer communication design today. This case study of an early graphic narrative identifies promising cancer message features that can be used to address and refute barriers to cervical cancer screening and connects contemporary research with historical efforts in public health communication.

Development of Prostate Cancer Survey Measures for African American Urban Men

National Research Council Canada - National Science Library

Klassen, Ann

1999-01-01

The purpose of the Minority Population Focussed Training Program was to prepare the trainee to conduct research in the area of excess burden of prostate cancer among African American men, with excess...

Colorectal cancer beliefs, knowledge, and screening among Filipino, Hmong, and Korean Americans.

Science.gov (United States)

Tran, Mi T; Jeong, Matthew B; Nguyen, Vickie V; Sharp, Michael T; Yu, Edgar P; Yu, Filmer; Tong, Elisa K; Kagawa-Singer, Marjorie; Cuaresma, Charlene F; Sy, Angela U; Tsoh, Janice Y; Gildengorin, Ginny L; Stewart, Susan L; Nguyen, Tung T

2018-04-01

To the authors' knowledge, there are few studies to date regarding colorectal cancer (CRC) beliefs, knowledge, and screening among multiple Asian American populations, who are reported to have lower CRC screening rates compared with white individuals. The current study was performed to assess knowledge and beliefs regarding the causes of CRC, its prevention, and factors associated with CRC screening among 3 Asian American groups. The authors conducted an in-language survey with Filipino (Honolulu, Hawaii), Hmong (Sacramento, California), and Korean (Los Angeles, California) Americans aged 50 to 75 years who were sampled through social networks. Bivariate and multivariable analyses were conducted to assess factors associated with CRC screening. The sample of 981 participants was 78.3% female and 73.8% reported limited proficiency in English. Few of the participants were aware that age (17.7%) or family history (36.3%) were risk factors for CRC; 6.2% believed fate caused CRC. Only 46.4% of participants knew that screening prevented CRC (74.3% of Filipino, 10.6% of Hmong, and 55.8% of Korean participants; PFilipino, 72.0% of Hmong, and 51.4% of Korean participants; PFilipino, 43.8% of Hmong, and 41.4% of Korean participants; PFilipino), having a family history of CRC, having health insurance or a regular source of health care, and knowing that a fatty diet caused CRC. Believing that fate caused CRC and that praying prevented it were found to be negatively associated with ever screening. Factors associated with being up to date for CRC screening included being born in the United States, having a family history of CRC, and having access to health care. Knowledge regarding the causes of CRC and its prevention among Filipino, Hmong, and Korean individuals is low. However, health care access, not knowledge or beliefs, was found to be a key determinant of CRC screening. Cancer 2018;124:1552-9. © 2018 American Cancer Society. © 2018 American Cancer Society.

Dietary Patterns and Colon Cancer Risk in Whites and African Americans in the North Carolina Colon Cancer Study

OpenAIRE

Satia, Jessie A.; Tseng, Marilyn; Galanko, Joseph A.; Martin, Christopher; Sandler, Robert S.

2009-01-01

We examined associations of dietary patterns with colon cancer risk in African Americans and Whites from a case-control study in North Carolina. Incident colon cancer cases, 40 to 80 yr (n = 636), and matched controls (n = 1,042) were interviewed in person to elicit information on potential colon cancer risk factors. A validated food frequency questionnaire adapted to include regional foods captured diet over the year prior to diagnosis (cases) or interview date (controls). Three meaningful i...

American Society of Clinical Oncology/College of American Pathologists guideline recommendations for human epidermal growth factor receptor 2 testing in breast cancer

NARCIS (Netherlands)

Wolff, Antonio C.; Hammond, M. Elizabeth H.; Schwartz, Jared N.; Hagerty, Karen L.; Allred, D. Craig; Cote, Richard J.; Dowsett, Mitchell; Fitzgibbons, Patrick L.; Hanna, Wedad M.; Langer, Amy; McShane, Lisa M.; Paik, Soonmyung; Pegram, Mark D.; Perez, Edith A.; Press, Michael F.; Rhodes, Anthony; Sturgeon, Catharine; Taube, Sheila E.; Tubbs, Raymond; Vance, Gail H.; van de Vijver, Marc; Wheeler, Thomas M.; Hayes, Daniel F.

2007-01-01

PURPOSE: To develop a guideline to improve the accuracy of human epidermal growth factor receptor 2 (HER2) testing in invasive breast cancer and its utility as a predictive marker. METHODS: The American Society of Clinical Oncology and the College of American Pathologists convened an expert panel,

Prostate Cancer Screening Efficacy in African-Americans Using Case-Control Methodology

National Research Council Canada - National Science Library

Godley, Paul

1999-01-01

...-control study of PSA screening for prostate cancer in African Americans. The lack of symptoms documented in the patient's medical record was to be used as evidence that PSA was intended as a screening examination...

Associations among physical symptoms, fear of cancer recurrence, and emotional well-being among Chinese American breast cancer survivors: a path model.

Science.gov (United States)

Cho, Dalnim; Chu, Qiao; Lu, Qian

2018-06-01

Most existing studies on fear of cancer recurrence (FCR) are exploratory without theoretical underpinnings and have been conducted among non-Hispanic Whites. Based on theoretical models, we hypothesized that more physical symptoms (pain and fatigue) would be associated with higher FCR, which, in turn would be related to lower emotional well-being among Chinese American breast cancer survivors. Participants were 77 Chinese American women who were diagnosed with breast cancer of stages 0-III. A cross-sectional path analysis was conducted with a bootstrapping method. The final model showed that indirect paths from pain interference to emotional well-being and from fatigue to emotional well-being via FCR were significant. That is, higher levels of pain interference and fatigue were associated with higher FCR, which was further related to lower emotional well-being. To our best knowledge, this is the first theory-driven study that investigates FCR experiences among Chinese American breast cancer survivors. Our study might provide a more comprehensive understanding of FCR as it simultaneously shows predictors and a psychological consequence of FCR. Results need to be replicated in large, racially/ethnically diverse samples and longitudinal studies.

Adverse Clinical Outcome Associated With Mutations That Typify African American Colorectal Cancers.

Science.gov (United States)

Wang, Zhenghe; Li, Li; Guda, Kishore; Chen, Zhengyi; Barnholtz-Sloan, Jill; Park, Young Soo; Markowitz, Sanford D; Willis, Joseph

2016-12-01

African Americans have the highest incidence and mortality from colorectal cancer (CRC) of any US racial group. We recently described a panel of 15 genes that are statistically significantly more likely to be mutated in CRCs from African Americans than in Caucasians (AA-CRC genes). The current study investigated the outcomes associated with these mutations in African American CRCs (AA-CRCs). In a cohort of 66 patients with stage I-III CRCs, eight of 27 CRCs with AA-CRC gene mutations (Mut+) developed metastatic disease vs only four of 39 mutation-negative (Mut-) cases (P = .03, Cox regression model with two-sided Wald test). Moreover, among stage III cases (n = 33), Mut+ cancers were nearly three times more likely to relapse as Mut- cases (7 of 15 Mut+ vs 3 of 18 Mut-; P = .03, Cox regression model with two-sided Wald test). AA-CRC mutations may thus define a high-risk subset of CRCs that contributes to the overall disparity in CRC outcomes observed in African Americans. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Unintended Effects of Emphasizing Disparities in Cancer Communication to African-Americans

OpenAIRE

Nicholson, Robert A.; Kreuter, Matthew W.; Lapka, Christina; Wellborn, Rachel; Clark, Eddie M.; Sanders-Thompson, Vetta; Jacobsen, Heather M.; Casey, Chris

2008-01-01

Little is known about how minority groups react to public information that highlights racial disparities in cancer. This double-blind randomized study compared emotional and behavioral reactions to four versions of the same colon cancer (CRC) information presented in mock news articles to a community sample of African-American adults (n = 300). Participants read one of four articles that varied in their framing and interpretation of race-specific CRC mortality data, emphasizing impact (CRC is...

Romania- New Tobacco control law from an NGO perspective

Directory of Open Access Journals (Sweden)

Mihaltan Florin Dumitru

2016-03-01

Full Text Available In our presentation we are evaluating the progress of the tobacco control in Romania looking form the point of view on NGO in the last 26 years. We are signalling the progressive steps towards policy and an advocacy from our perspective and the consequences of our success. The final result is reflected in the new law starting in force on March 17th, 2016, a real advance in our fight. We are identifying in the same time the new challenging problems after launching the new law. Probably the biggest gain of our fight is the extensive partnership with all the factors, our efforts to bring together in a big family as the coalition “Romania Respira” politicians, advocates, judges, economists, young’s and also the new way found to encourage all: mass media, politicians, journalists, public to support us.

Knowledge and Attitudes about Colon Cancer Screening among African Americans

Science.gov (United States)

James, Aimee S.; Daley, Christine M.; Greiner, K. Allen

2011-01-01

Objectives: To explore knowledge and attitudes about colorectal cancer (CRC) screening among African American patients age 45 and older at a community health center serving low-income and uninsured patients. Methods: We conducted 7 focus groups and 17 additional semistructured interviews. Sessions were audio-recorded, transcribed, and analyzed…

Impact of Age and Comorbidity on Cervical and Breast Cancer Literacy of African Americans, Latina, and Arab Women.

Science.gov (United States)

Talley, Costellia H; Williams, Karen Patricia

2015-09-01

This study examines the relationship between age, comorbidity, and breast and cervical cancer literacy in a sample of African American, Latina, and Arab women (N = 371) from Detroit, Michigan. The Age-adjusted Charlson Comorbidity Index (ACC) was used characterize the impact of age and comorbidity on breast and cervical cancer literacy. The relationship between ACC and breast and cervical cancer screening, and group differences, were assessed. There was a statistically significant difference between breast cancer literacy scores. ACC had a greater impact on breast cancer literacy for African Americans. Copyright © 2015 Elsevier Inc. All rights reserved.

Communication strategies to reduce cancer disparities: Insights from African-American mother-daughter dyads.

Science.gov (United States)

Mosavel, Maghboeba; Wilson Genderson, Maureen; Ports, Katie A; Carlyle, Kellie E

2015-12-01

Mothers and daughters share a powerful and unique bond, which has potential for the dissemination of information on a variety of women's health issues, including the primary and secondary prevention of breast and cervical cancer. This study presents formative research from a long-term project examining the potential of mother-daughter communication in promoting cancer screening among African American women. Thirty-two mother-daughter pairs (N = 64) completed orally administered surveys regarding their cancer knowledge, beliefs and attitudes, and barriers to care. This study compares the attitudes and beliefs of low-income, urban, African American mothers and their adolescent daughters regarding cervical and breast cancer screening. Both mothers and daughters had fairly high levels of knowledge about breast and cervical cancer. In addition, there was a high concordance rate between mothers' and daughters' responses, suggesting a potential sharing of health knowledge between mother and daughter. These results have implications for selecting communication strategies to reduce health disparities, and support that the mother-daughter dyad could be a viable unit to disseminate targeted screening information. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

American Society of Clinical Oncology guidance statement: the cost of cancer care.

Science.gov (United States)

Meropol, Neal J; Schrag, Deborah; Smith, Thomas J; Mulvey, Therese M; Langdon, Robert M; Blum, Diane; Ubel, Peter A; Schnipper, Lowell E

2009-08-10

Advances in early detection, prevention, and treatment have resulted in consistently falling cancer death rates in the United States. In parallel with these advances have come significant increases in the cost of cancer care. It is well established that the cost of health care (including cancer care) in the United States is growing more rapidly than the overall economy. In part, this is a result of the prices and rapid uptake of new agents and other technologies, including advances in imaging and therapeutic radiology. Conventional understanding suggests that high prices may reflect the costs and risks associated with the development, production, and marketing of new drugs and technologies, many of which are valued highly by physicians, patients, and payers. The increasing cost of cancer care impacts many stakeholders who play a role in a complex health care system. Our patients are the most vulnerable because they often experience uneven insurance coverage, leading to financial strain or even ruin. Other key groups include pharmaceutical manufacturers that pass along research, development, and marketing costs to the consumer; providers of cancer care who dispense increasingly expensive drugs and technologies; and the insurance industry, which ultimately passes costs to consumers. Increasingly, the economic burden of health care in general, and high-quality cancer care in particular, will be less and less affordable for an increasing number of Americans unless steps are taken to curb current trends. The American Society of Clinical Oncology (ASCO) is committed to improving cancer prevention, diagnosis, and treatment and eliminating disparities in cancer care through support of evidence-based and cost-effective practices. To address this goal, ASCO established a Cost of Care Task Force, which has developed this Guidance Statement on the Cost of Cancer Care. This Guidance Statement provides a concise overview of the economic issues facing stakeholders in the cancer

Admixture mapping of African-American women in the AMBER Consortium identifies new loci for breast cancer and estrogen-receptor subtypes

Directory of Open Access Journals (Sweden)

Edward Antonio Ruiz-Narvaez

2016-09-01

Full Text Available Recent genetic admixture coupled with striking differences in incidence of estrogen receptor (ER breast cancer subtypes, as well as severity, between women of African and European ancestry, provides an excellent rationale for performing admixture mapping in African American women with breast cancer risk. We performed the largest breast cancer admixture mapping study with in African American women to identify novel genomic regions associated with the disease. We conducted a genome-wide admixture scan using 2,624 autosomal ancestry informative markers (AIMs in 3,629 breast cancer cases (including 1,968 ER-positive, 1093 ER-negative and 601 triple-negative and 4,658 controls from the African American Breast Cancer Epidemiology and Risk (AMBER Consortium, a collaborative study of four large geographically different epidemiological studies of breast cancer in African American women. We used an independent case-control study to test for SNP association in regions with genome-wide significant admixture signals. We found two novel genome-wide significant regions of excess African ancestry, 4p16.1 and 17q25.1, associated with ER-positive breast cancer. Two regions known to harbor breast cancer variants, 10q26 and 11q13, were also identified with excess of African ancestry. Fine-mapping of the identified genome-wide significant regions suggests the presence of significant genetic associations with ER-positive breast cancer in 4p16.1 and 11q13. In summary, we identified three novel genomic regions associated with breast cancer risk by ER status, suggesting that additional previously unidentified variants may contribute to the racial differences in breast cancer risk in the African American population.

Participant evaluation of teleconference support for African American women with breast cancer.

Science.gov (United States)

Heiney, Sue P; Adams, Swann Arp; Wells, Linda M; Johnson, Hiluv; King, Jennifer M

2012-01-01

African American women with breast cancer face obstacles such as transportation and family obligations when attending standard support groups. Teleconference support circumvents barriers such as transportation to participation, but few evaluations have been reported about teleconference support. The purpose of this article was to describe the format of a teleconference group and to provide a descriptive account of the participants' feedback about a teleconference group intervention. A descriptive design was used. Participants completed the Overall Support Group Evaluation tool at the end of the 10th group session. Teleconference group participants' feedback indicated that they perceived they had gained knowledge about breast cancer and coping. The participants expressed that the group helped them to reach out and ask for support and improved family and work relationships. Also, participants rated the group highly for the presence of therapeutic factors. On a scale of 1 to 4, with 4 being the highest, mean scores ranged from 3.97 to 3.56. The participants gave high ratings of satisfaction in terms of knowledge gained, leadership style, and benefits. The participants perceived that the group increased their knowledge about cancer, improved family connections, and increased their ability to deal with their cancer. Using teleconferencing technology to deliver a support group to African American breast cancer patients is a beneficial method to reach a disadvantaged population that may be unable to attend face-to-face groups.

The contribution of culture to Korean American women's cervical cancer screening behavior: the critical role of prevention orientation.

Science.gov (United States)

Lee, Hee Yun; Roh, Soonhee; Vang, Suzanne; Jin, Seok Won

2011-01-01

Despite the proven benefits of Pap testing, Korean American women have one of the lowest cervical cancer screening rates in the United States. This study examined how cultural factors are associated with Pap test utilization among Korean American women participants. Quota sampling was used to recruit 202 Korean American women participants residing in New York City. Hierarchical logistic regression was used to assess the association of cultural variables with Pap test receipt. Overall, participants in our study reported significantly lower Pap test utilization; only 58% reported lifetime receipt of this screening test. Logistic regression analysis revealed one of the cultural variables--prevention orientation--was the strongest correlate of recent Pap test use. Older age and married status were also found to be significant predictors of Pap test use. Findings suggest cultural factors should be considered in interventions promoting cervical cancer screening among Korean American women. Furthermore, younger Korean American women and those not living with a spouse/partner should be targeted in cervical cancer screening efforts.

African Americans' and Hispanics' information needs about cancer care.

Science.gov (United States)

Muñoz-Antonia, Teresita; Ung, Danielle; Montiel-Ishino, F Alejandro; Nelson, Alison; Canales, Jorge; Quinn, Gwendolyn P

2015-06-01

Few studies have reported on African American and Hispanic (AA and H) populations' informational needs when seeking cancer care at an institution that offers clinical trials. Moffitt Cancer Center (MCC) sought to identify and examine the decision making process, the perceptions, and the preferred channels of communication about cancer care services for AA and H communities in order to develop a list of marketing recommendations. Five focus groups (N = 45) consisting of two AA and three H were conducted in four counties of the MCC catchment area in Tampa, FL. Participants were asked about their perceptions, knowledge, attitudes, and beliefs about cancer care and MCC. Focus groups were audio-recorded and verbatim transcripts were analyzed using content analysis. Similarities in responses were found between AA and H participants. Participants received general health and cancer information from media sources and word of mouth and preferred to hear patient testimonials. There were concerns about costs, insurance coverage, and the actual geographic location of the cancer center. In general, H participants were not opposed to participating in cancer clinical trials/research, whereas, AA participants were more hesitant. A majority of participants highly favored an institution that offered standard care and clinical trials. AA and H participants shared similar concerns and preferences in communication channels, but each group had specific informational needs. The perceptions and preferences of AA and H must be explored in order to successfully and efficiently increase cancer clinical trial participation.

Residential Segregation, Housing Status, and Prostate Cancer in African American and White Men

Science.gov (United States)

2008-04-01

estimated that pan frying and chicken are the cooking method and meat that comprise the primary source of dietary PhIP exposure in American men (15,28), but...of cooking temperature on the formation of heterocyclic amines in fried meat products and pan residues. Carcinogenesis 1995;16:861–7. [PubMed: 7728968...6) and stomach cancer (7), intake of fried meat increased lung cancer risk (8), and higher estimated HCA intake increased breast cancer risk (9). A

Bridging the Gap: Racial concordance as a strategy to increase African American participation in breast cancer research.

Science.gov (United States)

Frierson, Georita M; Pinto, Bernardine M; Denman, Deanna C; Leon, Pierre A; Jaffe, Alex D

2017-11-01

Lack of African American females in breast cancer research has been receiving substantial attention. This study seeks to identify research perceptions and motivating factors needed to increase racial/ethnic minority participation in breast cancer research. A total of 57 African American women (Σ = 47.8 years), from Rhode Island and Texas, completed a questionnaire and focus group. While many participants were not breast cancer survivors, they reported knowledge of their racial group's risk for breast cancer. One major finding that could be seen as both a facilitator and barrier is racial concordance between participant and researcher. Cultural sensitivity and trust building is recommended to increase minority participation.

Broadening the examination of sociocultural constructs relevant to African-American colorectal cancer screening.

Science.gov (United States)

Thompson, V L Sanders; Harris, J; Clark, E M; Purnell, J; Deshpande, A D

2015-01-01

The importance of sociocultural constructs as influences on cancer attitudes and screening has been established in the literature. This paper reports on the efforts to explore alternatives to sociocultural constructs previously associated with African-American cancer screening, but with low acceptance among community members or incomplete measurement (empowerment and collectivism) and develop a measure for a recently identified construct of interest (privacy). We report preliminary psychometric data on these sociocultural scales and their associations with cancer attitudes. African-Americans (N = 1021), 50-75 years of age participated in this study. Participants were identified via a listed sample and completed a telephone survey administered via call center. Sociocultural attitudes were assessed using items identified through computerized database searches, reviewed by advisory panels, edited and tested using cognitive response strategies. Cancer screening pros and cons, cancer worry, perceived cancer risk, colorectal cancer (CRC) screening subjective norms, and perceived self-efficacy for colorectal cancer screening (CRCS) were also assessed. Confirmatory factor analyses and multivariate analyses were conducted to provide support for the validity of the constructs and to understand the associations among the selected sociocultural constructs (empowerment, collectivism, and privacy) and cancer beliefs and attitudes (CRC perceived benefits and barriers, perceived risks, subjective norms, and perceived behavioral control/self-efficacy). Consistent with the literature, the factor analytic model (RMSEA for the model was .062; 90% CI: .060-.065) provided support for the empowerment, collectivism, and privacy constructs. The modified collectivism and privacy scales had acceptable reliability. The privacy scale demonstrated the strongest associations with measures of cancer beliefs and attitudes. The implication of the findings and need for further scale

Acculturation and Cancer Screening among Asian Americans: Role of Health Insurance and Having a Regular Physician

OpenAIRE

Lee, Sunmin; Chen, Lu; Jung, Mary Y.; Baezconde-Garbanati, Lourdes; Juon, Hee-Soon

2014-01-01

Cancer is the leading cause of death among Asian Americans, but screening rates are significantly lower in Asians than in non-Hispanic Whites. This study examined associations between acculturation and three types of cancer screening (colorectal, cervical, and breast), focusing on the role of health insurance and having a regular physician. A cross-sectional study of 851 Chinese, Korean, and Vietnamese Americans was conducted in Maryland. Acculturation was measured using an abridged version o...

Effort of NGO in Promoting Comprehensive Sexuality Education to Improve Quality of Life among Local and Refugee Communities

Science.gov (United States)

Yeo, Kee Jiar; Lee, Shih Hui; Handayani, Lina

2018-01-01

Federation of Reproductive Health Association, Malaysia (FRHAM) is a pioneer Non-governmental Organization (NGO) in disseminating the knowledge and services of sexual reproductive health in Malaysia. A qualitative case study research design was employed to explore the roles of FRHAM in promoting Comprehensive Sexuality Education (CSE) for the…

Socioeconomic and nutritional factors account for the association of gastric cancer with Amerindian ancestry in a Latin American admixed population.

Directory of Open Access Journals (Sweden)

Latife Pereira

Full Text Available Gastric cancer is one of the most lethal types of cancer and its incidence varies worldwide, with the Andean region of South America showing high incidence rates. We evaluated the genetic structure of the population from Lima (Peru and performed a case-control genetic association study to test the contribution of African, European, or Native American ancestry to risk for gastric cancer, controlling for the effect of non-genetic factors. A wide set of socioeconomic, dietary, and clinic information was collected for each participant in the study and ancestry was estimated based on 103 ancestry informative markers. Although the urban population from Lima is usually considered as mestizo (i.e., admixed from Africans, Europeans, and Native Americans, we observed a high fraction of Native American ancestry (78.4% for the cases and 74.6% for the controls and a very low African ancestry (<5%. We determined that higher Native American individual ancestry is associated with gastric cancer, but socioeconomic factors associated both with gastric cancer and Native American ethnicity account for this association. Therefore, the high incidence of gastric cancer in Peru does not seem to be related to susceptibility alleles common in this population. Instead, our result suggests a predominant role for ethnic-associated socioeconomic factors and disparities in access to health services. Since Native Americans are a neglected group in genomic studies, we suggest that the population from Lima and other large cities from Western South America with high Native American ancestry background may be convenient targets for epidemiological studies focused on this ethnic group.

Gender Roles and Acculturation: Relationships With Cancer Screening Among Vietnamese American Women

OpenAIRE

Nguyen, Anh B.; Clark, Trenette T.; Belgrave, Faye Z.

2014-01-01

The aim of this study was to examine the influence of demographic variables and the interplay between gender roles and acculturation on breast and cervical cancer screening outcomes among Vietnamese American women. Convenience sampling was used to recruit 100 Vietnamese women from the Richmond, VA, metropolitan area. Women were recruited to participate in a larger cancer screening intervention. All participants completed measures on demographic variables, gender roles, acculturation, and canc...

Genomic Profiling of Prostate Cancers from African American Men

Directory of Open Access Journals (Sweden)

Patricia Castro

2009-03-01

Full Text Available African American (AA men have a higher incidence and significantly higher mortality rates from prostate cancer than white men, but the biological basis for these differences are poorly understood. Few studies have been carried out to determine whether there are areas of allelic loss or gain in prostate cancers from AA men that are over-represented in or specific to this group. To better understand the molecular mechanisms of prostate cancer in AA men, we have analyzed 20 prostate cancers from AA men with high-density single-nucleotide polymorphism arrays to detect genomic copy number alterations. We identified 17 regions showing significant loss and 4 regions with significant gains. Most of these regions had been linked to prostate cancer by previous studies of copy number alterations of predominantly white patients. We identified a novel region of loss at 4p16.3, which has been shown to be lost in breast, colon, and bladder cancers. Comparison of our primary tumors with tumors from white patients from a previously published cohort with similar pathological characteristics showed higher frequency of loss of at numerous loci including 6q13-22, 8p21, 13q13-14, and 16q11-24 and gains of 7p21 and 8q24, all of which had higher frequencies in metastatic lesions in this previously published cohort. Thus, the clinically localized cancers from AA men more closely resembled metastatic cancers from white men. This difference may in part explain the more aggressive clinical behavior of prostate cancer in AA men.

Low-Frequency Gravitational-Wave Science with eLISA/ NGO

Science.gov (United States)

Amaro-Seoane, Pau; Aoudia, Sofiane; Babak, Stanislav; Binetruy, Pierre; Berti, Emanuele; Bohe, Alejandro; Caprini, Chiara; Colpi, Monica; Cornish, Neil J.; Danzmann, Karsten;

Effect of elastic and plastic tensile mechanical loading on the magnetic properties of NGO electrical steel

Energy Technology Data Exchange (ETDEWEB)

Leuning, N., E-mail: nora.leuning@iem.rwth-aachen.de [Institute of Electrical Machines, RWTH Aachen University, D-52062 Aachen (Germany); Steentjes, S. [Institute of Electrical Machines, RWTH Aachen University, D-52062 Aachen (Germany); Schulte, M.; Bleck, W. [Steel Institute, RWTH Aachen University, D-52072 Aachen (Germany); Hameyer, K. [Institute of Electrical Machines, RWTH Aachen University, D-52062 Aachen (Germany)

2016-11-01

The magnetic properties of non-grain-oriented (NGO) electrical steels are highly susceptible to mechanical stresses, i.e., residual, external or thermal ones. For rotating electrical machines, mechanical stresses are inevitable and originate from different sources, e.g., material processing, machine manufacturing and operating conditions. The efficiency and specific losses are largely altered by different mechanical stress states. In this paper the effect of tensile stresses and plastic deformations on the magnetic properties of a 2.9 wt% Si electrical steel are studied. Particular attention is paid to the effect of magnetic anisotropy, i.e., the influence of the direction of applied mechanical stress with respect to the rolling direction. Due to mechanical stress, the induced anisotropy has to be evaluated as it is related to the stress-dependent magnetostriction constant and the grain alignment. - Highlights: • A detailed look at magnetic anisotropy of FeSi NGO electrical steel. • Study of magnetic behavior under elastic as well as plastic tensile stresses. • Correlation of magnetic behavior with microscopic deformation mechanisms. • Discussion of detrimental and beneficial effects of external stresses. • Loss separation at different polarizations and frequencies under increasing stress.

Effect of elastic and plastic tensile mechanical loading on the magnetic properties of NGO electrical steel

International Nuclear Information System (INIS)

Leuning, N.; Steentjes, S.; Schulte, M.; Bleck, W.; Hameyer, K.

2016-01-01

The magnetic properties of non-grain-oriented (NGO) electrical steels are highly susceptible to mechanical stresses, i.e., residual, external or thermal ones. For rotating electrical machines, mechanical stresses are inevitable and originate from different sources, e.g., material processing, machine manufacturing and operating conditions. The efficiency and specific losses are largely altered by different mechanical stress states. In this paper the effect of tensile stresses and plastic deformations on the magnetic properties of a 2.9 wt% Si electrical steel are studied. Particular attention is paid to the effect of magnetic anisotropy, i.e., the influence of the direction of applied mechanical stress with respect to the rolling direction. Due to mechanical stress, the induced anisotropy has to be evaluated as it is related to the stress-dependent magnetostriction constant and the grain alignment. - Highlights: • A detailed look at magnetic anisotropy of FeSi NGO electrical steel. • Study of magnetic behavior under elastic as well as plastic tensile stresses. • Correlation of magnetic behavior with microscopic deformation mechanisms. • Discussion of detrimental and beneficial effects of external stresses. • Loss separation at different polarizations and frequencies under increasing stress.

Mammography Screening Among African-American Women with a Family History of Breast Cancer

National Research Council Canada - National Science Library

Lipkus, Issac

1997-01-01

Comparisons were made between African-American women with and without a family history of breast cancer with respect to mammography screening, attitudes towards mammography screening and perceptions...

Promoting Employee Health Through an American Cancer Society Program, The CEOs Challenge, Washington State, 2013-2015.

Science.gov (United States)

Harris, Jeffrey R; Parrish, Amanda T; Kohn, Marlana; Hammerback, Kristen; McMillan, Becca; Hannon, Peggy A

2015-12-17

Evidence-based practices in the workplace can increase levels of healthy eating, cancer screening, physical activity, and tobacco cessation but are underused, even in large workplaces. This report summarizes an evaluation of the first year of The CEOs Challenge, a program developed by the American Cancer Society to promote implementation and maintenance of health-promoting, evidence-based workplace practices by large companies. Use of 17 evidence-based practices by 17 companies in the Washington State Chapter of the American Cancer Society's CEOs Against Cancer network was assessed via survey and scored from 0 to 100. Companies received a written report of their baseline performance, followed by at least quarterly consultations with American Cancer Society staff members trained to assist in implementation of these practices. Follow-up performance was measured at 1 year. At baseline, implementation scores were 54.8 for cancer screening, 46.5 for healthy eating, 59.8 for physical activity, and 68.2 for tobacco cessation. At follow-up, scores increased by 19.6 for cancer screening, 19.4 for healthy eating, 16.0 for physical activity, and 9.4 points for tobacco cessation. The CEOs Challenge is a promising approach to chronic disease prevention via the workplace. It brings together one of the nation's largest health-promoting voluntary agencies with the nation's largest employers to promote evidence-based practices targeted at the most common causes of disease and death. The program increased the adoption of these practices and was well-accepted.

Adherence to the cancer prevention recommendations of the World Cancer Research Fund/American Institute for Cancer Research and mortality: a census-linked cohort.

Science.gov (United States)

Lohse, Tina; Faeh, David; Bopp, Matthias; Rohrmann, Sabine

2016-09-01

Modifiable lifestyle factors linked to cancer offer great potential for prevention. Previous studies suggest an association between adherence to recommendations on healthy lifestyle and cancer mortality. The aim of this study was to examine whether adherence to the cancer prevention recommendations of the World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR) is associated with reduced all-cause, total cancer, and specific cancer type mortality. We built a lifestyle score that included 3 categories, based on the recommendations of the WCRF/AICR. Applying Cox regression models, we investigated the association with all-cause, total cancer, and specific cancer type mortality; in addition, we included cardiovascular disease (CVD) mortality. We used census- and death registry-linked survey data allowing a mortality follow-up for ≤32 y. Our analysis included 16,722 participants. Information on lifestyle score components and confounders was collected at baseline. Over a mean follow-up of 21.7 y, 3730 deaths were observed (1332 cancer deaths). Comparing best with poorest category of the lifestyle score showed an inverse association with all-cause (HR: 0.82; 95% CI: 0.75, 0.89) and total cancer (men only, HR: 0.69; 95% CI: 0.57, 0.84) mortality. We estimated that ∼13% of premature cancer deaths in men would have been preventable if lifestyle score levels had been high. Inverse associations were observed for lung, upper aerodigestive tract, stomach, and prostate cancer mortality [men and women combined, HR: 0.72; 95% CI: 0.51, 0.99; HR: 0.49; 95% CI: 0.26, 0.92; HR: 0.34; 95% CI: 0.14, 0.83; HR: 0.48; 95% CI: 0.28, 0.82 (men only), respectively]. CVD mortality was not associated with the lifestyle score (men and women combined, HR: 0.96; 95% CI: 0.82, 1.13). Our results support the importance of adhering to recommendations for a healthy lifestyle with regard to all-cause and cancer mortality. To reduce the burden of cancer in the

Subtypes of Native American ancestry and leading causes of death: Mapuche ancestry-specific associations with gallbladder cancer risk in Chile.

Directory of Open Access Journals (Sweden)

Justo Lorenzo Bermejo

2017-05-01

Full Text Available Latin Americans are highly heterogeneous regarding the type of Native American ancestry. Consideration of specific associations with common diseases may lead to substantial advances in unraveling of disease etiology and disease prevention. Here we investigate possible associations between the type of Native American ancestry and leading causes of death. After an aggregate-data study based on genome-wide genotype data from 1805 admixed Chileans and 639,789 deaths, we validate an identified association with gallbladder cancer relying on individual data from 64 gallbladder cancer patients, with and without a family history, and 170 healthy controls. Native American proportions were markedly underestimated when the two main types of Native American ancestry in Chile, originated from the Mapuche and Aymara indigenous peoples, were combined together. Consideration of the type of Native American ancestry was crucial to identify disease associations. Native American ancestry showed no association with gallbladder cancer mortality (P = 0.26. By contrast, each 1% increase in the Mapuche proportion represented a 3.7% increased mortality risk by gallbladder cancer (95%CI 3.1-4.3%, P = 6×10-27. Individual-data results and extensive sensitivity analyses confirmed the association between Mapuche ancestry and gallbladder cancer. Increasing Mapuche proportions were also associated with an increased mortality due to asthma and, interestingly, with a decreased mortality by diabetes. The mortality due to skin, bladder, larynx, bronchus and lung cancers increased with increasing Aymara proportions. Described methods should be considered in future studies on human population genetics and human health. Complementary individual-based studies are needed to apportion the genetic and non-genetic components of associations identified relying on aggregate-data.

Subtypes of Native American ancestry and leading causes of death: Mapuche ancestry-specific associations with gallbladder cancer risk in Chile.

Science.gov (United States)

Lorenzo Bermejo, Justo; Boekstegers, Felix; González Silos, Rosa; Marcelain, Katherine; Baez Benavides, Pablo; Barahona Ponce, Carol; Müller, Bettina; Ferreccio, Catterina; Koshiol, Jill; Fischer, Christine; Peil, Barbara; Sinsheimer, Janet; Fuentes Guajardo, Macarena; Barajas, Olga; Gonzalez-Jose, Rolando; Bedoya, Gabriel; Cátira Bortolini, Maria; Canizales-Quinteros, Samuel; Gallo, Carla; Ruiz Linares, Andres; Rothhammer, Francisco

2017-05-01

Latin Americans are highly heterogeneous regarding the type of Native American ancestry. Consideration of specific associations with common diseases may lead to substantial advances in unraveling of disease etiology and disease prevention. Here we investigate possible associations between the type of Native American ancestry and leading causes of death. After an aggregate-data study based on genome-wide genotype data from 1805 admixed Chileans and 639,789 deaths, we validate an identified association with gallbladder cancer relying on individual data from 64 gallbladder cancer patients, with and without a family history, and 170 healthy controls. Native American proportions were markedly underestimated when the two main types of Native American ancestry in Chile, originated from the Mapuche and Aymara indigenous peoples, were combined together. Consideration of the type of Native American ancestry was crucial to identify disease associations. Native American ancestry showed no association with gallbladder cancer mortality (P = 0.26). By contrast, each 1% increase in the Mapuche proportion represented a 3.7% increased mortality risk by gallbladder cancer (95%CI 3.1-4.3%, P = 6×10-27). Individual-data results and extensive sensitivity analyses confirmed the association between Mapuche ancestry and gallbladder cancer. Increasing Mapuche proportions were also associated with an increased mortality due to asthma and, interestingly, with a decreased mortality by diabetes. The mortality due to skin, bladder, larynx, bronchus and lung cancers increased with increasing Aymara proportions. Described methods should be considered in future studies on human population genetics and human health. Complementary individual-based studies are needed to apportion the genetic and non-genetic components of associations identified relying on aggregate-data.

Using text messages to promote health in African-Americans: #HeartHealthyandCancerFree.

Science.gov (United States)

Jones, Allison R; Moser, Debra K; Hatcher, Jennifer

2018-04-01

African-Americans are vulnerable to both cancer and cardiovascular disease (CVD) due to intricately connected risk factors. Use of text messages is an innovative method to provide health information to reduce these risks. The aim of this study was to test the feasibility and acceptability of a text messaging intervention to reduce CVD and cancer risk factors in African-Americans. We developed an intervention using text messages culturally tailored for African-Americans over age 50 who were at risk (one or more modifiable risk factors) for CVD and/or cancer. Sociodemographic data, biologic measures, cancer screening practices, and general health status were assessed. Group interviews were conducted to assess feasibility and acceptability. Participants were primarily female (69%), aged 58 ± 5 years, who were married (59%) and worked full time (56%). In terms of feasibility and acceptability, themes of encouragement through text messages received and a desire for a longer study period emerged from group interviews with participants. Participants experienced significant decreases in waist circumference (41 ± 5 vs 40 ± 5, p = .002), systolic blood pressure (147 ± 25 mmHg vs 138 ± 20 mmHg, p = .009), diastolic blood pressure (87 ± 16 mmHg vs 82 ± 10 mmHg, p = .02), total cholesterol (194 ± 35 mg/dL vs 173 ± 32 mg/dL, p text messages was widely accepted among participants. Significant CVD risk reductions and increased cancer screenings were noted. Future studies should incorporate innovative strategies such as text messaging in promoting health in vulnerable populations.

Is adherence to diet, physical activity, and body weight cancer prevention recommendations associated with colorectal cancer incidence in African American women?

Science.gov (United States)

Nomura, Sarah J O; Dash, Chiranjeev; Rosenberg, Lynn; Yu, Jeffrey; Palmer, Julie R; Adams-Campbell, Lucile L

2016-07-01

The purpose of this study was to evaluate whether adherence to the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) cancer prevention recommendations was associated with colorectal cancer incidence in the Black Women's Health Study (BWHS). In this ongoing prospective cohort of African American women (analytic cohort n = 49,103), 354 incident colorectal cancers were diagnosed between baseline (1995) and 2011. Adherence scores for seven WCRF/AICR recommendations (adherent = 1 point, non-adherent level 1 = 0.5 points, non-adherent level 2 = 0 points) were created using questionnaire data and summed to an overall adherence score (maximum = 7). Recommendation adherence and colorectal cancer incidence were evaluated using baseline and time-varying data in Cox regression models. At baseline, 8.5 % of women adhered >4 recommendations. In time-varying analyses, the HR was 0.98 (95 % CI 0.84-1.15) per 0.5 point higher score and 0.51 (95 % CI 0.23-1.10) for adherence to >4 compared to <3 recommendations. Adherence to individual recommendations was not associated with colorectal cancer risk. Results were similar in models that considered baseline exposures only. Adherence to cancer prevention recommendations was low and not associated with colorectal cancer risk among women in the BWHS. Research in diverse populations is essential to evaluate the validity of existing recommendations, and assess whether there are alternative recommendations that are more beneficial for cancer prevention in specific populations.

"You are the vanguard of Cairo". NGO / Youth Fora.

Science.gov (United States)

Clinton, H R

1999-01-01

Everyone has a role to play in realizing the goals of the International Conference on Population and Development (ICPD) program of action. The concerns of young people presented at the Youth Forum will hopefully be kept at the forefront of Cairo+5 deliberations. Innumerable women around the world in every country struggle daily to care for and education their children, to gain greater control over their lives, and to contribute to the progress being made in their communities and countries. The nongovernmental organization (NGO) and youth fora of the Cairo+5 proceedings demonstrate that the discussions about global challenges and their solutions are no longer being held and decided upon solely by government officials and policy-makers behind closed doors. Rather, NGOs have finally taken their proper place in the debate, to help ordinary citizens be heard on the critical issues which affect their lives. Efforts must also continue to be made to reach out to young people, as well as fathers, sons, and husbands.

Prostate cancer risk profiles of Asian-American men: disentangling the effects of immigration status and race/ethnicity.

Science.gov (United States)

Lichtensztajn, Daphne Y; Gomez, Scarlett Lin; Sieh, Weiva; Chung, Benjamin I; Cheng, Iona; Brooks, James D

2014-04-01

Asian-American men with prostate cancer have been reported to present with higher grade and later stage disease than white American men. However, Asian-American men comprise a heterogeneous population with distinct health outcomes. We compared prostate cancer risk profiles among the diverse racial and ethnic groups in California. We used data from the California Cancer Registry on 90,845 nonHispanic white, nonHispanic black and Asian-American men diagnosed with prostate cancer between 2004 and 2010. Patients were categorized into low, intermediate and high risk groups based on clinical stage, Gleason score and prostate specific antigen at diagnosis. Using polytomous logistic regression we estimated adjusted ORs for the association of race/ethnicity and nativity with risk group. In addition to the nonHispanic black population, 6 Asian-American groups (United States born Chinese, foreign born Chinese, United States born Japanese, foreign born Japanese, foreign born Filipino and foreign born Vietnamese) were more likely to have an unfavorable risk profile compared to nonHispanic white men. The OR for high vs intermediate risk disease ranged from 1.23 (95% CI 1.02-1.49) for United States born Japanese men to 1.45 (95% CI 1.31-1.60) for foreign born Filipino men. These associations appeared to be driven by higher grade and prostate specific antigen rather than by advanced clinical stage at diagnosis. In this large, ethnically diverse, population based cohort Asian-American men were more likely to have an unfavorable risk profile at diagnosis. This association varied by racial/ethnic group and nativity, and was not attributable to later stage at diagnosis. This suggests that Asian men may have biological differences that predispose to more severe disease. Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Ovarian cancer survival population differences: a "high resolution study" comparing Philippine residents, and Filipino-Americans and Caucasians living in the US.

Science.gov (United States)

Redaniel, Maria Theresa M; Laudico, Adriano; Mirasol-Lumague, Maria Rica; Gondos, Adam; Uy, Gemma Leonora; Toral, Jean Ann; Benavides, Doris; Brenner, Hermann

2009-09-24

In contrast to most other forms of cancer, data from some developing and developed countries show surprisingly similar survival rates for ovarian cancer. We aimed to compare ovarian cancer survival in Philippine residents, Filipino-Americans and Caucasians living in the US, using a high resolution approach, taking potential differences in prognostic factors into account. Using databases from the SEER 13 and from the Manila and Rizal Cancer Registries, age-adjusted five-year absolute and relative survival estimates were computed using the period analysis method and compared between Filipino-American ovarian cancer patients with cancer patients from the Philippines and Caucasians in the US. Cox proportional hazards modelling was used to determine factors affecting survival differences. Despite more favorable distribution of age and cancer morphology and similar stage distribution, 5-year absolute and relative survival were lower in Philippine residents (Absolute survival, AS, 44%, Standard Error, SE, 2.9 and Relative survival, RS, 49.7%, SE, 3.7) than in Filipino-Americans (AS, 51.3%, SE, 3.1 and RS, 54.1%, SE, 3.4). After adjustment for these and additional covariates, strong excess risk of death for Philippine residents was found (Relative Risk, RR, 2.45, 95% confidence interval, 95% CI, 1.99-3.01). In contrast, no significant differences were found between Filipino-Americans and Caucasians living in the US. Multivariate analyses disclosed strong survival disadvantages of Philippine residents compared to Filipino-American patients, for which differences in access to health care might have played an important role. Survival is no worse among Filipino-Americans than among Caucasians living in the US.

Associations Between Religion-Related Factors and Breast Cancer Screening Among American Muslims

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Padela, Aasim I.; Murrar, Sohad; Adviento, Brigid; Liao, Chuanhong; Hosseinian, Zahra; Peek, Monica; Curlin, Farr

2015-01-01

American Muslims have low rates of mammography utilization, and research suggests that religious values influence their health-seeking behaviors. We assessed associations between religion-related factors and breast cancer screening in this population. A diverse group of Muslim women were recruited from mosques and Muslim organization sites in Greater Chicago to self-administer a survey incorporating measures of fatalism, religiosity, discrimination, and Islamic modesty. 254 surveys were collected of which 240 met age inclusion criteria (40 years of age or older). Of the 240, 72 respondents were Arab, 71 South Asian, 59 African American, and 38 identified with another ethnicity. 77 % of respondents had at least one mammogram in their lifetime, yet 37 % had not obtained mammography within the past 2 years. In multivariate models, positive religious coping, and perceived religious discrimination in healthcare were negatively associated with having a mammogram in the past 2 years, while having a PCP was positively associated. Ever having a mammogram was positively associated with increasing age and years of US residency, and knowing someone with breast cancer. Promoting biennial mammography among American Muslims may require addressing ideas about religious coping and combating perceived religious discrimination through tailored interventions. PMID:24700026

Associations between religion-related factors and breast cancer screening among American Muslims.

Science.gov (United States)

Padela, Aasim I; Murrar, Sohad; Adviento, Brigid; Liao, Chuanhong; Hosseinian, Zahra; Peek, Monica; Curlin, Farr

2015-06-01

American Muslims have low rates of mammography utilization, and research suggests that religious values influence their health-seeking behaviors. We assessed associations between religion-related factors and breast cancer screening in this population. A diverse group of Muslim women were recruited from mosques and Muslim organization sites in Greater Chicago to self-administer a survey incorporating measures of fatalism, religiosity, discrimination, and Islamic modesty. 254 surveys were collected of which 240 met age inclusion criteria (40 years of age or older). Of the 240, 72 respondents were Arab, 71 South Asian, 59 African American, and 38 identified with another ethnicity. 77% of respondents had at least one mammogram in their lifetime, yet 37% had not obtained mammography within the past 2 years. In multivariate models, positive religious coping, and perceived religious discrimination in healthcare were negatively associated with having a mammogram in the past 2 years, while having a PCP was positively associated. Ever having a mammogram was positively associated with increasing age and years of US residency, and knowing someone with breast cancer. Promoting biennial mammography among American Muslims may require addressing ideas about religious coping and combating perceived religious discrimination through tailored interventions.

The Internet as an emerging patient education tool among African American men with prostate cancer: an exploratory study.

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Wallington, Sherrie Flynt

2008-06-01

The lives of African American men with prostate cancer are greatly influenced by the information available to them, some of which is accessed on the Internet. Research indicates that the Internet can enhance consumer health knowledge but has not reached socioeconomic groups at highest risk for health disparities, such as African American men with prostate cancer. In this study, focus groups were used to explore the perceptions and uses of the Internet as a patient education tool among 39 African American men aged 39 years and older with diverse socioeconomic backgrounds. Nineteen (49%) participants reported using the Internet, 15 (38%) reported no use but indicated it was used on their behalf, and 5 (13%) reported no use and no use on their behalf. The findings revealed varying degrees of Internet use for information and social support. Prostate cancer diagnosis, poor patient-doctor communications, and accessibility influenced Internet use. Accessibility related more to lack of ease and familiarity with Internet use than lack of computer access. With training and awareness, the Internet has potential as a patient education tool among African American men with prostate cancer.

Research on stored biological samples: views of African American and White American cancer patients.

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Pentz, Rebecca D; Billot, Laurent; Wendler, David

2006-04-01

Proposals on consent for research with biological samples should be informed by empirical studies of individuals' views. Studies to date queried mostly white research subjects. The aim of this study was to compare the views of two groups of patients: cancer patients at a university clinic (Winship Cancer Institute at Emory Healthcare) and cancer patients at an inner city county hospital (Grady) who were given the option of tissue banking. Overall, 315/452 (70%) patients completed the survey. The Grady cohort was 86% African American; the Winship cohort was 82% White. The vast majority (95%) of individuals in both cohorts agreed to provide a biological sample for future research. Both cohorts were willing for their samples to be used to study cancer and other diseases, including Alzheimer disease. Few participants preferred to control the disease to be studied (10%) or wished to be contacted again for consent for each future research project (11%). In our sample, almost all clinical patients, regardless of site of care, ethnicity or socioeconomic status, were willing to provide a biological sample for research purposes and allow investigators to determine the research to be done without contacting the patients again. These findings support the recommendation to offer individuals a simplified consent with a one-time binary choice whether to provide biological samples for future research. Copyright 2006 Wiley-Liss, Inc.

Effects of Patient-Provider Race Concordance and Smoking Status on Lung Cancer Risk Perception Accuracy among African Americans

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Persky, Susan; Kaphingst, Kimberly A.; Allen, Vincent C.; Senay, Ibrahim

2013-01-01

Background Communication of lung cancer risk information between providers and African-American patients occurs in a context marked by race-based health disparities. Purpose A controlled experiment assessed whether perceived physician race influenced African-American patients’ (n=127) risk perception accuracy following the provision of objective lung cancer risk information. Methods Participants interacted with a virtual reality-based, simulated physician who provided personalized cancer risk information. Results Participants who interacted with a racially discordant virtual doctor were less accurate in their risk perceptions at post-test than those who interacted with a concordant virtual doctor, F(1,94)=4.02, p=.048. This effect was amplified among current smokers. Effects were not mediated by trust in the provider, engagement with the health care system, or attention during the encounter. Conclusions The current study demonstrates that African-American patients’ perceptions of a doctor’s race are sufficient to independently impact their processing of lung cancer risk information. PMID:23389688

Effects of patient-provider race concordance and smoking status on lung cancer risk perception accuracy among African-Americans.

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Persky, Susan; Kaphingst, Kimberly A; Allen, Vincent C; Senay, Ibrahim

2013-06-01

Communication of lung cancer risk information between providers and African-American patients occurs in a context marked by race-based health disparities. A controlled experiment assessed whether perceived physician race influenced African-American patients' (n = 127) risk perception accuracy following the provision of objective lung cancer risk information. Participants interacted with a virtual reality-based, simulated physician who provided personalized cancer risk information. Participants who interacted with a racially discordant virtual doctor were less accurate in their risk perceptions at post-test than those who interacted with a concordant virtual doctor, F(1,94) = 4.02, p = .048. This effect was amplified among current smokers. Effects were not mediated by trust in the provider, engagement with the health care system, or attention during the encounter. The current study demonstrates that African-American patients' perceptions of a doctor's race are sufficient to independently impact their processing of lung cancer risk information.

Broadening the examination of socio-cultural constructs relevant to African American colorectal cancer screening

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Sanders Thompson, V. L.; Harris, J.; Clark, E.M.; Purnell, J.; Deshpande, A.D.

2014-01-01

The importance of socio-cultural constructs as influences on cancer attitudes and screening has been established in the literature. This paper reports on efforts to explore alternatives to constructs previously associated with African American cancer screening, but with low acceptance among community members or incomplete measurement (empowerment and collectivism) and develop a measure for a recently identified construct of interest (privacy). We report preliminary psychometric data on these socio-cultural scales and their associations with cancer attitudes. African Americans (N=1021), 50 to 75 years of age participated in this study. Participants were identified via a listed sample and completed a telephone survey administered via call center. Socio-cultural attitudes were assessed using items identified through computerized database searches, reviewed by advisory panels, edited and tested using cognitive response strategies. Cancer screening pros and cons, cancer worry, perceived cancer risk, colorectal cancer screening subjective norms, and perceived self-efficacy for colorectal cancer screening were also assessed. Confirmatory factor analyses and multivariate analyses were conducted to provide support for the validity of the constructs and to understand the associations among the selected socio-cultural constructs (empowerment, collectivism and empowerment) and cancer beliefs and attitudes (CRC perceived benefits and barriers, perceived risks, subjective norms, and perceived behavioral control/self-efficacy). Consistent with the literature, the factor analytic model (RMSEA for the model was 0.062; 90% CI: 0.060-0.065) provided support for the empowerment, collectivism and privacy constructs. The modified collectivism and privacy scales had acceptable reliability. The privacy scale demonstrated the strongest associations with measures of cancer beliefs and attitudes. The implication of the findings and need for further scale development activities is discussed

Factors Associated with Colorectal Cancer Screening among Younger African American Men: A Systematic Review

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Goodson, Patricia; Foster, Margaret J.

2015-01-01

Of cancers affecting both men and women, colorectal cancer (CRC) is the second leading cancer killer among African Americans in the U.S. Compared to White men, African American men have incidence and mortality rates 25% and 50% higher from CRC. Despite the benefits of early detection and the availability of effective screening, most adults over age 50 have not undergone testing, and disparities in colorectal cancer screening (CRCS) persist. Owing to CRC’s high incidence and younger age at presentation among African American men, CRCS is warranted at age 45 rather than 50. However, the factors influencing young adult (i.e., age methodological quality. Utilizing Garrard’s Matrix Method, a total of 28 manuscripts met our inclusion/exclusion criteria: 20 studies followed a non-experimental research design, 4 comprised a quasi-experimental design, and 4, an experimental design. Studies were published between 2002 and 2012; the majority, between 2007 and 2011. The factors most frequently assessed were behaviors (79%), beliefs (68%), and knowledge (61%) of CRC and CRCS. Six factors associated with CRC and CRCS emerged: previous CRCS, CRC test preference, perceived benefits, perceived barriers, CRC/CRCS knowledge, and physician support/recommendation. Studies were assigned a methodological quality score (MQS – ranging from 0 to 21). The mean MQS of 10.9 indicated these studies were, overall, of medium quality and suffered from specific flaws. Alongside a call for more rigorous research, this review provides important suggestions for practice and culturally relevant interventions. PMID:26435888

Dissemination of colorectal cancer screening by Filipino American community health advisors: a feasibility study.

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Maxwell, Annette E; Danao, Leda L; Bastani, Roshan

2013-07-01

Filipino Americans underutilize life-saving screening tests for colorectal cancer, resulting in late stage of diagnosis and poor survival relative to other racial/ethnic groups. Education regarding colorectal cancer screening and distribution of free fecal occult blood test (FOBT) kits are evidence-based interventions that can significantly increase screening. However, this community will only benefit if the intervention is broadly disseminated. We assessed the feasibility of promoting colorectal cancer screening in Filipino American community settings working with community health advisors, and the practicality of conducting one-on-one or small group education, in addition to passing out free FOBT kits. Twenty community health advisors from 4 organizations engaged in recruitment and education activities with 132 participants. Community health advisors consistently completed screening questionnaires to establish eligibility and kept logs of FOBT distribution. However, they did not consistently record eligible participants who did not consent to participate. Process checklists that indicated what information was covered in each educational session and postsession follow-up logs were partially completed. Almost all participants reported receipt of intervention components and receipt of screening at 4-month follow-up and reported high acceptability of the program. The pilot study established the feasibility of working with community health advisors to promote colorectal cancer screening in Filipino American community settings. Findings informed the design of a dissemination trial that is currently ongoing with regards to monitoring recruitment, intervention implementation and follow-up and allowing flexibility regarding one-on-one or small group education.

Healthcare barriers and supports for American Indian women with cancer.

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Liddell, Jessica L; Burnette, Catherine E; Roh, Soonhee; Lee, Yeon-Shim

2018-05-18

Although American Indian (AI) women continue to experience cancer at higher rates and have not seen the same decline in cancer prevalence as the general U.S. population, little research examines how interactions with health care providers may influence and exacerbate these health disparities. The purpose of the study was to understand the experiences of AI women who receive cancer treatment, which is integral for eradication of AI cancer disparities among women. A qualitative descriptive methodology was used with a sample of 43 AI women with breast, cervical, colon, and other types of cancer from the Northern Plains region of South Dakota. Interviews were conducted from June 2014 to February 2015. Qualitative content analysis revealed that women experienced: (a) health concerns being ignored or overlooked; (b) lack of consistent and qualified providers; (c) inadequate healthcare infrastructure; (d) sub-optimal patient-healthcare provider relationships; (e) positive experiences with healthcare providers; and (f) pressure and misinformation about treatment. Results indicate the types of support AI women may need when accessing healthcare. Culturally informed trainings for healthcare professionals may be needed to provide high-quality and sensitive care for AI women who have cancer, and to support those providers already providing proper care.

African-American smokers and cancers of the lung and of the upper respiratory and digestive tracts. Is menthol part of the puzzle?

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Richardson, T L

1997-03-01

The prevalence of cigarette smoking is higher among African Americans than among whites. African Americans have higher rates of lung cancer than whites, although they smoke fewer cigarettes. To explore this black-white difference in lung cancer rates, I examine various aspects of tobacco use in African-American smokers, including the age of initiation of smoking, quantity of cigarettes smoked, quit rates, level of nicotine dependence, biochemical differences, and brand preferences, specifically menthol brand cigarettes. I also review briefly the sequelae of patterns of tobacco use, including rates of lung and other tobacco-related cancers. A preference for mentholated cigarettes by African Americans is well documented and is one of the most striking differences between African-American and white smokers. Menthol brand preference has been investigated in an attempt to explain the black-white differences in rates of cancers of the lungs and the upper respiratory and digestive tracts. Also, studies have evaluated smoking behavior both with and without menthol and have explicitly examined the question of whether menthol use helps explain the black-white difference in lung cancer rates. The results of these studies are so far inconclusive with regard to the use of menthol and the risk of lung cancer developing. I provide practical suggestions for clinicians in counseling African-American smokers to quit smoking and to maintain a nonsmoking status.

Genetic variation in IL-16 miRNA target site and time to prostate cancer diagnosis in African American men

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Hughes, Lucinda; Ruth, Karen; Rebbeck, Timothy R.; Giri, Veda N.

2013-01-01

Background Men with a family history of prostate cancer and African American men are at high risk for prostate cancer and in need of personalized risk estimates to inform screening decisions. This study evaluated genetic variants in genes encoding microRNA (miRNA) binding sites for informing of time to prostate cancer diagnosis among ethnically-diverse, high-risk men undergoing prostate cancer screening. Methods The Prostate Cancer Risk Assessment Program (PRAP) is a longitudinal screening program for high-risk men. Eligibility includes men ages 35-69 with a family history of prostate cancer or African descent. Participants with ≥ 1 follow-up visit were included in the analyses (n=477). Genetic variants in regions encoding miRNA binding sites in four target genes (ALOX15, IL-16, IL-18, and RAF1) previously implicated in prostate cancer development were evaluated. Genotyping methods included Taqman® SNP Genotyping Assay (Applied Biosystems) or pyrosequencing. Cox models were used to assess time to prostate cancer diagnosis by risk genotype. Results Among 256 African Americans with ≥ one follow-up visit, the TT genotype at rs1131445 in IL-16 was significantly associated with earlier time to prostate cancer diagnosis vs. the CC/CT genotypes (p=0.013), with a suggestive association after correction for false-discovery (p=0.065). Hazard ratio after controlling for age and PSA for TT vs. CC/CT among African Americans was 3.0 (95% CI 1.26-7.12). No association to time to diagnosis was detected among Caucasians by IL-16 genotype. No association to time to prostate cancer diagnosis was found for the other miRNA target genotypes. Conclusions Genetic variation in IL-16 encoding miRNA target site may be informative of time to prostate cancer diagnosis among African American men enrolled in prostate cancer risk assessment, which may inform individualized prostate cancer screening strategies in the future. PMID:24061634

Feasibility Study of Engaging Barbershops for Prostate Cancer Education in Rural African-American Communities.

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Luque, John S; Roy, Siddhartha; Tarasenko, Yelena N; Ross, Levi; Johnson, Jarrett; Gwede, Clement K

2015-12-01

The barbershop is a promising setting where African-American men might receive information and education about prostate cancer. In this study, we assessed the feasibility of engaging rural barbershops as venues for barbers to deliver a prostate cancer education intervention to increase informed decision-making for prostate cancer screening among customers. Twelve barbershops were recruited from two separate micropolitan areas in Georgia as intervention and control sites. Structured interviews were conducted with 11 barbers in both sites about customer characteristics as well as their willingness to participate in the study. The interviews were audio recorded and transcribed for analysis. In the intervention site, six barbers completed a survey and a pre-/posttest prostate cancer knowledge instrument following training classes. Barbers reported a wide average range of customers served per week (50 to 300). African-American men made up an average of 87% of customers. Barbers thought prostate cancer was an important discussion topic, felt they would be comfortable discussing it, and supported the participation of their barbershop in the study. For intervention group barbers, there was a statistically significant difference between the average pretest knowledge score of 72% (mean 12.2, SD=3.2) and the posttest knowledge score of 89% (mean 15.2, SD=1.1) (P=0.03) on the 17-item prostate cancer knowledge instrument. Based on the multiple interactions with the barbers, there was high receptivity to the topic and consensus about the importance of addressing prostate cancer with their customers. Rural barbershops represent feasible venues for delivering a prostate cancer education intervention.

Arab American immigrants in New York: health care and cancer knowledge, attitudes, and beliefs.

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Shah, Susan M; Ayash, Claudia; Pharaon, Nora Alarifi; Gany, Francesca M

2008-10-01

Arab immigrants living in the United States total between 1.5 million and 3.5 million, and have been growing in number each decade. New York's Arab population, at 405,000, ranks third in the U.S. after California and Michigan. Despite the large numbers, little health research has focused on this population. Data about the cancer incidence, mortality, and screening practices of Arab Americans is overwhelmingly lacking. To better understand the health care and cancer knowledge, attitudes, and beliefs of Arab American immigrants, five single-gender focus groups were convened with Arab men and women in New York City. Attention was given to factors that act as barriers to utilization of general health care services, and of cancer prevention, treatment, and support services. The data revealed the importance of providing culturally and linguistically appropriate health interventions in partnership with trusted community leaders, and the need for follow-up research of this understudied immigrant population.

A key role of microRNA-29b for the suppression of colon cancer cell migration by American ginseng.

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Deepak Poudyal

Full Text Available Metastasis of colon cancer cells increases the risk of colon cancer mortality. We have recently shown that American ginseng prevents colon cancer, and a Hexane extract of American Ginseng (HAG has particularly potent anti-inflammatory and anti-cancer properties. Dysregulated microRNA (miR expression has been observed in several disease conditions including colon cancer. Using global miR expression profiling, we observed increased miR-29b in colon cancer cells following exposure to HAG. Since miR-29b plays a role in regulating the migration of cancer cells, we hypothesized that HAG induces miR-29b expression to target matrix metalloproteinase-2 (MMP-2 thereby suppressing the migration of colon cancer cells. Results are consistent with this hypothesis. Our study supports the understanding that targeting MMP-2 by miR-29b is a mechanism by which HAG suppresses the migration of colon cancer cells.

Is public communication about end-of-life care helping to inform all? Cancer news coverage in African American versus mainstream media.

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Fishman, Jessica M; Ten Have, Thomas; Casarett, David

2012-04-15

Because cancers are a leading cause of death, these diseases receive a great deal of news attention. However, because news media frequently target specific racial or ethnic audiences, some populations may receive different information, and it is unknown whether reporting equally informs all audiences about the options for care at the end of life. This study of news reporting compared "mainstream" (general market) media with African American media, which serves the largest minority group. The specific goal of this study was to determine whether these news media communicate differently about cure-directed cancer treatment and end-of-life alternatives. This content analysis included 660 cancer news stories from online and print media that targeted either African American or mainstream audiences. The main outcome measures included whether reporting discussed adverse events of cancer treatment, cancer treatment failure, cancer death/dying, and end-of-life palliative or hospice care. Unadjusted and adjusted analyses indicated that the news stories in the African American media are less likely than those in mainstream media to discuss each of the topics studied. Comparing the proportions of news stories in mainstream versus African American media, 31.6% versus 13.6% discussed adverse events (odds ratio [OR], 2.92; 95% confidence interval [CI], 1.51-5.66; P = .001); 14.1% versus 4.2% mentioned treatment failure (OR, 3.79; 95% CI, 1.45-9.88; P = .006); and 11.9% versus 3.8% focused on death/dying (OR, 3.42; 95% CI, 1.39-8.38; P = .007). Finally, although very few news stories discussed end-of-life hospice or palliative care, all were found in mainstream media (7/396 vs 0/264). The African American news media sampled are less likely than mainstream news media to portray negative cancer outcomes and end-of-life care. Given media's segmented audiences, these findings raise concerns that not all audiences are being informed equally well. Because media content is modifiable

Generational, Cultural, and Linguistic Integration for Literacy Learning and Teaching in Uganda: Pedagogical Possibilities, Challenges, and Lessons from One NGO

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Ngaka, Willy; Graham, Ross; Masaazi, Fred Masagazi; Anyandru, Elly Moses

2016-01-01

This qualitative case study focuses on a volunteer-led local NGO in Uganda to examine how integrating generations, cultures, and languages is enhancing literacy learning to help ethnically and linguistically diverse rural communities survive in the prevailing globally competitive neoliberal environment. Immersing the study in the social practices…

Lumbee Native American ancestry and the incidence of aggressive histologic subtypes of endometrial cancer

Directory of Open Access Journals (Sweden)

Chelsea Zhang

2015-08-01

Conclusion: In this retrospective cohort analysis, Lumbee Native American ancestry was not a significant independent predictor of rates of high-risk histological subtypes of endometrial cancer or poor survival outcomes.

American Society of Clinical Oncology Policy Statement Update: Genetic and Genomic Testing for Cancer Susceptibility.

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Robson, Mark E; Bradbury, Angela R; Arun, Banu; Domchek, Susan M; Ford, James M; Hampel, Heather L; Lipkin, Stephen M; Syngal, Sapna; Wollins, Dana S; Lindor, Noralane M

2015-11-01

The American Society of Clinical Oncology (ASCO) has long affirmed that the recognition and management of individuals with an inherited susceptibility to cancer are core elements of oncology care. ASCO released its first statement on genetic testing in 1996 and updated that statement in 2003 and 2010 in response to developments in the field. In 2014, the Cancer Prevention and Ethics Committees of ASCO commissioned another update to reflect the impact of advances in this area on oncology practice. In particular, there was an interest in addressing the opportunities and challenges arising from the application of massively parallel sequencing-also known as next-generation sequencing-to cancer susceptibility testing. This technology introduces a new level of complexity into the practice of cancer risk assessment and management, requiring renewed effort on the part of ASCO to ensure that those providing care to patients with cancer receive the necessary education to use this new technology in the most effective, beneficial manner. The purpose of this statement is to explore the challenges of new and emerging technologies in cancer genetics and provide recommendations to ensure their optimal deployment in oncology practice. Specifically, the statement makes recommendations in the following areas: germline implications of somatic mutation profiling, multigene panel testing for cancer susceptibility, quality assurance in genetic testing, education of oncology professionals, and access to cancer genetic services. © 2015 by American Society of Clinical Oncology.

Metabolic profiles of triple-negative and luminal A breast cancer subtypes in African-American identify key metabolic differences.

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Tayyari, Fariba; Gowda, G A Nagana; Olopade, Olufunmilayo F; Berg, Richard; Yang, Howard H; Lee, Maxwell P; Ngwa, Wilfred F; Mittal, Suresh K; Raftery, Daniel; Mohammed, Sulma I

2018-02-20

Breast cancer, a heterogeneous disease with variable pathophysiology and biology, is classified into four major subtypes. While hormonal- and antibody-targeted therapies are effective in the patients with luminal and HER-2 subtypes, the patients with triple-negative breast cancer (TNBC) subtype do not benefit from these therapies. The incidence rates of TNBC subtype are higher in African-American women, and the evidence indicates that these women have worse prognosis compared to women of European descent. The reasons for this disparity remain unclear but are often attributed to TNBC biology. In this study, we performed metabolic analysis of breast tissues to identify how TNBC differs from luminal A breast cancer (LABC) subtypes within the African-American and Caucasian breast cancer patients, respectively. We used High-Resolution Magic Angle Spinning (HR-MAS) 1H Nuclear magnetic resonance (NMR) to perform the metabolomic analysis of breast cancer and adjacent normal tissues (total n=82 samples). TNBC and LABC subtypes in African American women exhibited different metabolic profiles. Metabolic profiles of these subtypes were also distinct from those revealed in Caucasian women. TNBC in African-American women expressed higher levels of glutathione, choline, and glutamine as well as profound metabolic alterations characterized by decreased mitochondrial respiration and increased glycolysis concomitant with decreased levels of ATP. TNBC in Caucasian women was associated with increased pyrimidine synthesis. These metabolic alterations could potentially be exploited as novel treatment targets for TNBC.

Latest discoveries and trends in translational cancer research: highlights of the 2008 Annual Meeting of the American Association for Cancer Research.

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Cho, William C S

2008-08-01

The Annual Meeting of the American Association for Cancer Research (AACR) is the world's largest and most comprehensive gathering of cancer researchers. At the 2008 AACR Annual Meeting, innovative research approaches, novel technologies, potentially life-saving therapies in the pipeline, late-breaking clinical trial findings, and new approaches to cancer prevention were presented by top scientists. Reflecting the global state of cancer research with an eye toward future trends, several areas of great science and discovery in the cancer field were shared in this report, which include cancer biomarkers, the role of microRNAs in cancer research, cancer stem cells, tumor microenvironment, targeted therapy, and cancer prevention. This article presents an overview of hot topics discussed at the 2008 AACR Annual Meeting and recapitulates some scientific sessions geared toward new technologies, recent progress, and current challenges reported by cancer researchers. For those who did not attend the meeting, this report may serve as a highlight of this important international cancer research meeting.

Mitochondrial DNA G10398A variant is not associated with breast cancer in African-American women

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Setiawan, Veronica Wendy; Chu, Li-Hao; John, Esther M.; Ding, Yuan Chun; Ingles, Sue A.; Bernstein, Leslie; Press, Michael F.; Ursin, Giske; Haiman, Christopher A.; Neuhausen, Susan L

2009-01-01

Mitochondria play important roles in cellular energy production, free radical generation and apoptosis. In a previous report in Cancer Research, the mitochondrial DNA (mtDNA) G10398A (Thr → Ala) polymorphism was associated with breast cancer risk in African-American women. Here, we seek to replicate the association by genotyping the G10398A polymorphism in three established population-based case-control studies of breast cancer in African-American women. The 10398A allele was not significantly associated with risk in any of the studies [San Francisco study (542 cases, 282 controls, odds ratio (OR) = 1.73; 95% confidence interval (CI): 0.87, 3.47, P = 0.12); Multiethnic Cohort (391 cases, 460 controls, OR = 1.08; 95% CI: 0.62, 1.86, P = 0.79); CARE/LIFE study (524 cases, 236 controls, OR = 0.81; 95% CI: 0.43, 1.52, P = 0.50)]. When pooling the data across the three studies (1456 cases and 978 controls), no significant association was observed with the 10398A allele (OR = 1.14; 95% CI: 0.80, 1.62, P = 0.47, P heterogeneity=0.30). In analysis of advanced breast cancer cases (n=674), there also was no significant association (OR = 1.18; 95% CI: 0.76, 1.82, P = 0.46). Our results do not support the hypothesis that the mtDNA G10398A polymorphism is a marker of breast cancer risk in African Americans as previously reported. PMID:18262047

Cervical cancer prevention: Asian-American women's knowledge and participation in screening practices.

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Robison, Katina; Clark, Lindsay; Eng, Whitney; Wu, Lily; Raker, Christina; Clark, Melissa; Tejada-Berges, Trevor; Dizon, Don S

2014-01-01

The purpose of this study was to compare cervical cancer knowledge and prevention strategy participation among Chinese-American women compared with Southeast-Asian-American women. We performed a cross-sectional survey of Chinese and Southeast Asian women in Rhode Island. Anonymous surveys were administered following informed consent. The survey included demographics and questions related to health care practices, cervical cancer, and the human papilloma virus (HPV). Categorical variables were compared by Fisher's exact test. Mean scores of correct answers on the knowledge questions were compared by Student's t-test and analysis of variance. Ninety-six Chinese women and 132 Southeast Asian women were included in the analysis. Sixty-seven percent of Chinese women had at least a college education compared with 37% of Southeast Asian women (p women reported annual household incomes of greater than $100,000 compared with 3% of Southeast Asian women (p = .0003). Twenty percent of Southeast Asian women did not have health insurance compared with 10% of Chinese women (p = .06). Among both groups, 25% of participants either never had a pap test or did not know if they ever had a pap test. There was a greater lack of knowledge about the relationship between HPV and cervical cancer among Chinese (mean 2.9 out of 8 questions) compared with Southeast Asian (mean 3.6 out of 8 questions; p = .02). Regardless of ethnic subgroup, education, or income, all participants had a poor knowledge of cervical cancer and HPV. This study supports the need for improvement in cervical cancer prevention education among all Asian women. Copyright © 2014 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Inaugural Meeting of North American Pancreatic Cancer Organizations: Advancing Collaboration and Communication.

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Kenner, Barbara J; Fleshman, Julie M; Goldberg, Ann E; Rothschild, Laura J

2015-11-01

A meeting of North American Pancreatic Cancer Organizations planned by Kenner Family Research Fund and Pancreatic Cancer Action Network was held on July 15-16, 2015, in New York City. The meeting was attended by 32 individuals from 20 nonprofit groups from the United States and Canada. The objectives of this inaugural convening were to share mission goals and initiatives, engage as leaders, cultivate potential partnerships, and increase participation in World Pancreatic Cancer Day. The program was designed to provide opportunities for informal conversations, as well as facilitated discussions to meet the stated objectives. At the conclusion of the meeting, the group agreed that enhancing collaboration and communication will result in a more unified approach within the field and will benefit individuals diagnosed with pancreatic cancer. As a first step, the group will actively collaborate to participate in World Pancreatic Cancer Day, which is planned for November 13, 2015, and seeks to raise the level of visibility about the disease globally.

Association between African American race and outcomes in patients with nonmetastatic triple-negative breast cancer: a retrospective analysis by using results from the Georgia Cancer Specialist Database.

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Christiansen, Neal; Chen, Lei; Gilmore, James; Pechar, David; Szabo, Stephen

2012-08-01

The objective of this study was to evaluate, in a real-world context, the impact of race on disease recurrence and survival in patients with nonmetastatic triple-negative breast cancer (TNBC) treated with adjuvant chemotherapy. The study selected patients from the 2003-2008 Georgia Cancer Specialist Database with stage I-III confirmed TNBC who had received adjuvant chemotherapy. These patients were followed-up from initial diagnosis to death, cancer recurrence, or loss to follow-up. The primary outcome was disease-free survival (DFS). Kaplan-Meier curves compared DFS and recurrence between African American and non-African American groups. The impact of African American status was examined further through multivariate Cox models by adjusting for age, comorbidity, body mass index (BMI), smoking status, initial TNBC stage, surgery, and radiation therapy. Among 209 patients with TNBC, 89 (42.6%) were African American. The 2 groups (African American vs. non-African American) were similar in mean age at diagnosis (53.2 vs. 54.4 years; P =.487) and with surgery and radiation rates (98.9% vs. 100%; P = .244; 68.5% vs. 62.5%; P = .365, respectively). Compared with non-African Americans, African American patients had a higher BMI (30.4 vs. 28.6 kg/m(2); P = .0477) and were less likely to be diagnosed at stage I (31.5% vs. 51.7%; P = .0107). The African American patients had a lower 5-year DFS rate (45.2% vs. 79.7%; P = .0005) and a higher 5-year recurrence rate (42.5% vs. 7.0%; P = .0005) compared with the non-African American patients. Among patients with TNBC treated with adjuvant chemotherapy, African American race was associated with a worse outcome irrespective of later stage at presentation or higher BMI. Copyright © 2012 Elsevier Inc. All rights reserved.

Breast Cancer Mortality in African-American and Non-Hispanic White Women by Molecular Subtype and Stage at Diagnosis: A Population-Based Study.

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Tao, Li; Gomez, Scarlett Lin; Keegan, Theresa H M; Kurian, Allison W; Clarke, Christina A

2015-07-01

Higher breast cancer mortality rates for African-American than non-Hispanic White women are well documented; however, it remains uncertain if this disparity occurs in disease subgroups defined by tumor molecular markers and stage at diagnosis. We examined racial differences in outcome according to subtype and stage in a diverse, population-based series of 103,498 patients. We obtained data for all invasive breast cancers diagnosed between January 1, 2005, and December 31, 2012, and followed through December 31, 2012, among 93,760 non-Hispanic White and 9,738 African-American women in California. Molecular subtypes were categorized according to tumor expression of hormone receptor (HR, based on estrogen and progesterone receptors) and human epidermal growth factor receptor 2 (HER2). Cox proportional hazards models were used to calculate relative hazard (RH) and 95% confidence intervals (CI) for breast cancer-specific mortality. After adjustment for patient, tumor, and treatment characteristics, outcomes were comparable by race for stage I or IV cancer regardless of subtype, and HR(+)/HER2(+) or HR(-)/HER2(+) cancer regardless of stage. We found substantially higher hazards of breast cancer death among African-American women with stage II/III HR(+)/HER2(-) (RH, 1.31; 95% CI, 1.03-1.65; and RH, 1.39; 95% CI, 1.10-1.75, respectively) and stage III triple-negative cancers relative to Whites. There are substantial racial/ethnic disparities among patients with stages II/III HR(+)/HER2(-) and stage III triple-negative breast cancers but not for other subtype and stage. These data provide insights to assess barriers to targeted treatment (e.g., trastuzumab or endocrine therapy) of particular subtypes of breast cancer among African-American patients. ©2015 American Association for Cancer Research.

Tailored Lay Health Worker Intervention Improves Breast Cancer Screening Outcomes in Non-Adherent Korean-American Women

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Han, Hae-Ra; Lee, H.; Kim, M. T.; Kim, K. B.

2009-01-01

Despite rapidly increasing incidence rates of breast cancer, recent immigrants such as Korean-American (KA) women report disproportionately lower utilization of screening tests compared with other ethnic groups. Early screening of breast cancer for this population may be greatly facilitated by indigenous lay health workers (LHWs). We conducted an…

Ethnicity and health care in cervical cancer survival: comparisons between a Filipino resident population, Filipino-Americans, and Caucasians.

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Redaniel, Maria Theresa; Laudico, Adriano; Mirasol-Lumague, Maria Rica; Gondos, Adam; Uy, Gemma Leonora; Toral, Jean Ann; Benavides, Doris; Brenner, Hermann

2009-08-01

Few studies have assessed and compared cervical cancer survival between developed and developing countries, or between ethnic groups within a country. Fewer still have addressed how much of the international or interracial survival differences can be attributed to ethnicity or health care. To determine the role of ethnicity and health care, 5-year survival of patients with cervical cancer was compared between patients in the Philippines and Filipino-Americans, who have the same ethnicity, and between Filipino-Americans and Caucasians, who have the same health care system. Cervical cancer databases from the Manila and Rizal Cancer Registries and Surveillance, Epidemiology, and End Results 13 were used. Age-adjusted 5-year survival estimates were computed and compared between the three patient groups. Using Cox proportional hazards modeling, potential determinants of survival differences were examined. Overall 5-year relative survival was similar in Filipino-Americans (68.8%) and Caucasians (66.6%), but was lower for Philippine residents (42.9%). Although late stage at diagnosis explained a large proportion of the survival differences between Philippine residents and Filipino-Americans, excess mortality prevailed after adjustment for stage, age, and morphology in multivariate analysis [relative risk (RR), 2.07; 95% confidence interval (CI), 1.68-2.55]. Excess mortality decreased, but persisted, when treatments were included in the multivariate models (RR, 1.78; 95% CI, 1.41-2.23). A moderate, marginally significant excess mortality was found among Caucasians compared with Filipino-Americans (adjusted RR, 1.22; 95% CI, 1.01-1.47). The differences in cervical cancer survival between patients in the Philippines and in the United States highlight the importance of enhanced health care and access to diagnostic and treatment facilities in the Philippines.

Ever and Annual Use of Prostate Cancer Screening in African American Men

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Halbert, Chanita Hughes; Gattoni-Celli, Sebastiano; Savage, Stephen; Prasad, Sandip M.; Kittles, Rick; Briggs, Vanessa; Delmoor, Ernestine; Rice, LaShanta J.; Jefferson, Melanie; Johnson, Jerry C.

2016-01-01

Since prostate cancer continues to disproportionately affect African American men in terms of incidence, morbidity, and mortality, prostate-specific antigen (PSA) screening plays an important role in early detection, especially when men engage in informed decision making to accept or decline this test. The authors evaluated utilization of PSA testing among African American men based on factors that are important components of making informed decisions. Utilization of PSA testing was evaluated based on whether men had ever had PSA testing and PSA testing during the past year in a community-based sample of African American men ages 50 to 75 (n = 132). Overall, 64% of men (n = 85) reported that they had ever had a PSA test; the mean (SD) age for first use of PSA testing was 47.7 (SD = 7.4). The likelihood of ever having a PSA test increased significantly with physician communication (odds ratio [OR] = 14.2; 95% confidence interval [CI] = 4.20, 48.10; p = .0001) and with having an annual household income that was greater than $20,000 (OR = 9.80; 95% CI = 3.15, 30.51; p = .0001). The odds of ever having a PSA test were also decreased with each unit increase in future temporal orientation (OR = 0.66; 95% CI = 0.47, 0.93; p = .02). Of the men who had ever had PSA testing, 57% were screened during the past year. Only health insurance status had a significant independent association with having annual PSA testing (OR = 5.10; 95% CI = 1.67, 15.60; p = .004). Different factors were associated significantly with ever having PSA testing and annual testing among African American men. African American men may not be making an informed decision about prostate cancer screening. PMID:26240090

The promise of acceptance as an NGO security management approach.

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Fast, Larissa; Freeman, Faith; O'Neill, Michael; Rowley, Elizabeth

2015-04-01

This paper explores three questions related to acceptance as a security management approach. Acceptance draws upon relationships with community members, authorities, belligerents and other stakeholders to provide consent for the presence and activities of a non-governmental organisation (NGO), thereby reducing threats from these actors. Little is documented about how NGOs gain and maintain acceptance, how they assess and monitor the presence and degree of acceptance, or how they determine whether acceptance is effective in a particular context. Based on field research conducted in April 2011 in Kenya, South Sudan and Uganda, we address each of these three issues and argue that acceptance must be actively sought as both a programme and a security management strategy. In the paper we delineate elements common to all three contexts as well as missed opportunities, which identify areas that NGOs can and should address as part of an acceptance approach. © 2015 The Author(s). Disasters © Overseas Development Institute, 2015.

Does bigger mean better? British perspectives on American cancer treatment and research, 1948.

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Toon, Elizabeth

2007-12-20

In the summer of 1948, a delegation representing the British Empire Cancer Campaign (BECC) toured North American cancer treatment and research facilities, and reported their observations back to their organization's executive board. This historical article contextualizes the British delegation's observations of US treatment and research, and discusses what the delegation made of the United States' new, "bigger" approaches to cancer surgery and chemotherapeutic research. I argue that the BECC delegation used their observations of US practice to reinforce a positive sense of British distinctiveness, thus reassuring themselves and their colleagues that Britain could still be a leader in the increasingly international field we now call oncology.

Inter-country and ethnic variation in colorectal cancer survival: Comparisons between a Philippine population, Filipino-Americans and Caucasians

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Gondos Adam

2010-03-01

Full Text Available Abstract Background Previous population-based studies showed differences in international and within country colorectal cancer survival estimates, but few investigated the role of prognostic factors. Using a "high resolution approach", we aimed to determine the effect of ethnicity and health care by comparing Filipino-Americans with Philippine residents, who have the same ethnicity, and with Caucasians living in the US, who have the same health care system. Methods Using databases from the Manila and Rizal Cancer Registries and the United States Surveillance, Epidemiology and End Results, age-adjusted five-year absolute and relative survival estimates were computed and compared between Filipino-American colorectal cancer patients, cancer patients from the Philippines and Caucasian patients. Cox proportional hazards modelling was used to determine factors affecting survival differences. Results Much lower 5-year relative survival estimates were obtained for Philippine residents (37% as compared to those in Filipino-Americans (60.3% and Caucasians (62.4%. Differences in age, stage and receipt of surgery explained a large proportion of the survival differences between Philippine residents and Filipino-Americans. However, strong excess risk of death for Philippine residents remained after controlling for these and other variables (relative risk, RR, 2.03, 95% confidence interval, 95% CI, 1.83-2.25. Conclusions Strong survival disadvantages of Philippine residents compared to Filipino-American patients were disclosed, which most likely reflect differences in access to and utilization of health care. Health education and advocacy, for both patients and health practitioners, should likewise be given priority.

The Women's Studies Center--A Women's-Led NGO Deepening Democracy in Chile: Educating Women through Personal Empowerment and Political Agency.

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King, Caroline

This paper explores how the Women's Studies Center (Centro de Estudios de la Mujer, CEM), a feminist, women-led nongovernmental organization (NGO), is contributing to socio-cultural change in Chile 11 years after the country's democratic transition. CEM merges the theoretical and the practical, and the personal and the political through education…

Genetic variations, reproductive aging, and breast cancer risk in African American and European American women: The Women's Circle of Health Study.

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Coignet, Marie V; Zirpoli, Gary Robert; Roberts, Michelle R; Khoury, Thaer; Bandera, Elisa V; Zhu, Qianqian; Yao, Song

2017-01-01

Reproductive aging phenotypes, including age at menarche (AM) and age at natural menopause (ANM), are well-established risk factors for breast cancer. In recent years, many genetic variants have been identified in association with AM and ANM in genome-wide association studies among European populations. Using data from the Women's Circle of Health Study (WCHS) of 1,307 European-American (EA) and 1,365 African-American (AA) breast cancer cases and controls, we aimed to replicate 53 earlier GWAS variants for AM and ANM in AA and EA groups and to perform analyses on total and net reproductive lifespan (TRLS; NRLS). Breast cancer risk was also examined in relation to a polygenic risk score (PRS) for each of the reproductive aging phenotypes. We replicated a number of variants in EA women, including rs7759938 in LIN28B for AM and rs16991615 in MCM8 for ANM; whereas in the AA group, only one SNP (rs2947411 in TMEM18) for AM was directionally consistent and nominally significant. In analysis of TRLS and NRLS, several SNPs were significant, including rs466639 in RXRG that was associated with both phenotypes in both AA and EA groups. None of the PRS was associated with breast cancer risk. Given the paucity of data available among AA populations, our study contributes to the literature of genetics of reproductive aging in AA women and highlights the importance of cross population replication of GWAS variants.

An exercise trial targeting African-American women with metabolic syndrome and at high risk for breast cancer: Rationale, design, and methods.

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Dash, Chiranjeev; Makambi, Kepher; Wallington, Sherrie F; Sheppard, Vanessa; Taylor, Teletia R; Hicks, Jennifer S; Adams-Campbell, Lucile L

2015-07-01

Metabolic syndrome and obesity are known risk factors for breast cancers. Exercise interventions can potentially modify circulating biomarkers of breast cancer risk but evidence in African-Americans and women with metabolic syndrome is lacking. The Focused Intervention on Exercise to Reduce CancEr (FIERCE) trial is a prospective, 6-month, 3-arm, randomized controlled trial to examine the effect of exercise on obesity, metabolic syndrome components, and breast cancer biomarkers among African-American women at high risk of breast cancer. Two hundred-forty inactive women with metabolic syndrome and absolute risk of breast cancer ≥ 1.40 will be randomized to one of the three trial arms: 1) a supervised, facility-based exercise arm; 2) a home-based exercise arm; and 3) a control group that maintains physical activity levels through the course of the trial. Assessments will be conducted at baseline, 3 months, and 6 months. The primary outcome variables are anthropometric indicators of obesity, metabolic syndrome components, and inflammatory, insulin-pathway, and hormonal biomarkers of breast cancer risk. The FIERCE trial will provide evidence on whether a short-term exercise intervention might be effective in reducing breast cancer risk among African-American women with comorbidities and high breast cancer risk--a group traditionally under-represented in non-therapeutic breast cancer trials. NCT02103140. Copyright © 2015. Published by Elsevier Inc.

Beliefs and Behaviors about Breast Cancer Recurrence Risk Reduction among African American Breast Cancer Survivors

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Benjamin Ansa

2015-12-01

Full Text Available A growing body of evidence suggests that breast cancer recurrence risk is linked to lifestyle behaviors. This study examined correlations between breast cancer recurrence, risk reduction beliefs, and related behaviors among African American breast cancer survivors (AA BCSs. Study participants included 191 AA BCSs, mean age = 56.3 years, who completed a lifestyle assessment tool. Most respondents believed that being overweight (52.7%, lack of physical activity (48.7%, and a high fat diet (63.2% are associated with breast cancer recurrence. Over 65% considered themselves overweight; one third (33.5% agreed that losing weight could prevent recurrence, 33.0% disagreed, while the remaining 33.5% did not know; and nearly half (47.9% believed that recurrence could be prevented by increasing physical activity. Almost 90% survivors with BMI < 25 Kg/M2 reported no recurrence compared to 75.7% with BMI ≥ 25 Kg/M2 (p = 0.06; nearly all of the women (99.2% answered “yes” to seeking professional help to lose weight, 79.7% of which were recurrence-free (p = 0.05. These results provide information about AA BCSs’ beliefs and behaviors protective against breast cancer recurrence. Additional research is warranted to determine the effectiveness of educational interventions for AA BCSs that promote consumption of a healthy diet and engaging in regular physical activity.

Frantic Waiting: NGO Anti-Politics and "Timepass" for Young Syrian Refugees in Jordan

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Ann-Christin Wagner

2017-12-01

Full Text Available Drawing on Sukarieh and Tannock's political economy of youth approach, this paper explores how Syrian refugee youth is constituted in protracted displacement in Jordan. It investigates a juvenile population often overlooked in Forced Migration Studies, disenfranchised rural Syrians, who fail to develop practices of youthfulness, yet in exile are subjected to alternative productions of youth by the aid sector. Depoliticized NGO youth programming overlooks Syrians' limited access to the labour market and higher education. While educational trainings aim to produce entrepreneurial and citizen refugees, they ultimately contribute to the creation of timepass and precarious lives. This research is grounded in fourteen months of ethnographic fieldwork with Syrian refugees in a border town in northern Jordan.

Internet Recruitment of Asian American Breast Cancer Survivors.

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Im, Eun-Ok; Lee, Yaelim; Ji, Xiaopeng; Zhang, Jingwen; Kim, Sangmi; Chee, Eunice; Chee, Wonshik; Tsai, Hsiu-Min; Nishigaki, Masakazu; Yeo, Seon Ae; Shapira, Marilyn M; Mao, Jun James

2016-01-01

The purpose of this article is to identify practical issues in Internet recruitment of racial/ethnic minorities by analyzing an Internet intervention study conducted with Asian American breast cancer survivors, and to propose directions for recruitment of racial/ethnic minorities for future Internet research. Six practical issues were identified: (a) a relatively fewer number of Internet communities/groups; (b) hindrances in establishing authenticity; (c) difficulties in gaining entrée from the webmasters or Web site owners of Internet communities/groups; (d) the necessity of racially/ethnically matched research team members; (e) flexibility required in recruitment strategies; and (f) strategies to overcome the low response rate.

Patient and provider characteristics associated with colorectal, breast, and cervical cancer screening among Asian Americans.

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Thompson, Caroline A; Gomez, Scarlett Lin; Chan, Albert; Chan, John K; McClellan, Sean R; Chung, Sukyung; Olson, Cliff; Nimbal, Vani; Palaniappan, Latha P

2014-11-01

Routinely recommended screening for breast, cervical, and colorectal cancers can significantly reduce mortality from these types of cancer, yet screening is underutilized among Asians. Surveys rely on self-report and often are underpowered for analysis by Asian ethnicities. Electronic health records (EHR) include validated (as opposed to recall-based) rates of cancer screening. In this article, we seek to better understand cancer screening patterns in a population of insured Asian Americans. We calculated rates of compliance with cervical, breast, and colorectal cancer screening among Asians from an EHR population and compared them with non-Hispanic whites. We performed multivariable modeling to evaluate potential predictors (at the provider- and patient-level) of screening completion among Asian patients. Aggregation of Asian subgroups masked heterogeneity in screening rates. Asian Indians and native Hawaiians and Pacific Islanders had the lowest rates of screening in our sample, well below that of non-Hispanic whites. In multivariable analyses, screening completion was negatively associated with patient-physician language discordance for mammography [OR, 0.81; 95% confidence interval (CI), 0.71-0.92] and colorectal cancer screening (OR, 0.79; CI, 0.72-0.87) and positively associated with patient-provider gender concordance for mammography (OR, 1.16; CI, 1.00-1.34) and cervical cancer screening (OR, 1.66; CI, 1.51-1.82). In addition, patient enrollment in online health services increased mammography (OR, 1.32; CI, 1.20-1.46) and cervical cancer screening (OR, 1.31; CI, 1.24-1.37). Language- and gender-concordant primary care providers and culturally tailored online health resources may help improve preventive cancer screening in Asian patient populations. This study demonstrates how the use of EHR data can inform investigations of primary prevention practices within the healthcare delivery setting. ©2014 American Association for Cancer Research.

Evaluating Disparities in Inpatient Surgical Cancer Care Among American Indian/Alaska Native Patients

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Simianu, Vlad V.; Morris, Arden M.; Varghese, Thomas K.; Porter, Michael P.; Henderson, Jeffrey A.; Buchwald, Dedra S.; Flum, David R.; Javid, Sara H.

2016-01-01

Background American Indian/Alaska Native (AI/AN) patients with cancer have the lowest survival rates of all racial and ethnic groups, possibly because they are less likely to receive “best practice” surgical care than patients of other races. Methods Prospective cohort study comparing adherence to generic and cancer-specific guidelines on processes of surgical care between AI/AN and non-Hispanic white (NHW) patients in Washington State (2010–2014). Results 156 AI/AN and 6,030 NHW patients underwent operations for 10 different cancers, and had similar mean adherence to generic surgical guidelines (91.5% vs 91.9%, p=0.57). AI/AN patients with breast cancer less frequently received preoperative diagnostic core-needle biopsy (81% versus 94%, p=0.004). AI/AN patients also less frequently received care adherent to prostate cancer-specific guidelines (74% versus 92%,p=0.001). Conclusions While AI/ANs undergoing cancer operations in Washington receive similar overall best practice surgical cancer care to NHW patients, there remain important, modifiable disparities that may contribute to their lower survival. PMID:26846176

Obesity, weight gain, and ovarian cancer risk in African American women.

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Bandera, Elisa V; Qin, Bo; Moorman, Patricia G; Alberg, Anthony J; Barnholtz-Sloan, Jill S; Bondy, Melissa; Cote, Michele L; Funkhouser, Ellen; Peters, Edward S; Schwartz, Ann G; Terry, Paul; Schildkraut, Joellen M

2016-08-01

Although there is growing evidence that higher adiposity increases ovarian cancer risk, little is known about its impact in African American (AA) women, the racial/ethnic group with the highest prevalence of obesity. We evaluated the impact of body mass index (BMI) 1 year before diagnosis and weight gain since age 18 years on ovarian cancer risk in a population-based case-control study in AA women in 11 geographical areas in the US. Cases (n = 492) and age and site matched controls (n = 696) were identified through rapid case ascertainment and random-digit-dialing, respectively. Information was collected on demographic and lifestyle factors, including self-reported height, weight at age 18 and weight 1 year before diagnosis/interview. Multivariable logistic regression was used to compute odds ratios (OR) and 95% confidence intervals (CI), adjusting for potential covariates. Obese women had elevated ovarian cancer risk, particularly for BMI ≥ 40 kg/m(2) compared to BMI Obesity and excessive adult weight gain may increase ovarian cancer risk in post-menopausal AA women. © 2016 UICC.

Reduced mitochondrial DNA content associates with poor prognosis of prostate cancer in African American men.

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Shahriar Koochekpour

Full Text Available Reduction or depletion of mitochondrial DNA (mtDNA has been associated with cancer progression. Although imbalanced mtDNA content is known to occur in prostate cancer, differences in mtDNA content between African American (AA and Caucasian American (CA men are not defined. We provide the first evidence that tumors in AA men possess reduced level of mtDNA compared to CA men. The median tumor mtDNA content was reduced in AA men. mtDNA content was also reduced in normal prostate tissues of AA men compared to CA men, suggesting a possible predisposition to cancer in AA men. mtDNA content was also reduced in benign prostatic hyperplasia (BPH tissue from AA men. Tumor and BPH tissues from patients ≥ 60 years of age possess reduced mtDNA content compared to patients 7 compared to ≤ 7, whereas reduced mtDNA content was observed in tumors of Gleason grade >7 compared to ≤ 7. Together, our data suggest that AA men possess lower mtDNA levels in normal and tumor tissues compared to CA men, which could contribute to higher risk and more aggressive prostate cancer in AA men.

Reduced mitochondrial DNA content associates with poor prognosis of prostate cancer in African American men.

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Koochekpour, Shahriar; Marlowe, Timothy; Singh, Keshav K; Attwood, Kristopher; Chandra, Dhyan

2013-01-01

Reduction or depletion of mitochondrial DNA (mtDNA) has been associated with cancer progression. Although imbalanced mtDNA content is known to occur in prostate cancer, differences in mtDNA content between African American (AA) and Caucasian American (CA) men are not defined. We provide the first evidence that tumors in AA men possess reduced level of mtDNA compared to CA men. The median tumor mtDNA content was reduced in AA men. mtDNA content was also reduced in normal prostate tissues of AA men compared to CA men, suggesting a possible predisposition to cancer in AA men. mtDNA content was also reduced in benign prostatic hyperplasia (BPH) tissue from AA men. Tumor and BPH tissues from patients ≥ 60 years of age possess reduced mtDNA content compared to patients 7 compared to ≤ 7, whereas reduced mtDNA content was observed in tumors of Gleason grade >7 compared to ≤ 7. Together, our data suggest that AA men possess lower mtDNA levels in normal and tumor tissues compared to CA men, which could contribute to higher risk and more aggressive prostate cancer in AA men.

African-American smokers and cancers of the lung and of the upper respiratory and digestive tracts. Is menthol part of the puzzle?

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Richardson, T L

1997-01-01

The prevalence of cigarette smoking is higher among African Americans than among whites. African Americans have higher rates of lung cancer than whites, although they smoke fewer cigarettes. To explore this black-white difference in lung cancer rates, I examine various aspects of tobacco use in African-American smokers, including the age of initiation of smoking, quantity of cigarettes smoked, quit rates, level of nicotine dependence, biochemical differences, and brand preferences, specifical...

Knowledge, Perceptions, and Communication about Colorectal Cancer Screening among Chinese American Primary Care Physicians

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Wenchi Liang D.D.S., Ph.D.

2008-01-01

Full Text Available Objective To assess Chinese American primary care physicians’ knowledge, attitude, and barriers to recommending colorectal cancer (CRC screening to their Chinese American patients. Methods Chinese American primary care physicians serving Chinese American patients in two metropolitan areas were invited to complete a mailed survey on CRC screening knowledge, attitudes toward shared decision making and CRC screening, and CRC screening recommendation patterns. Results About half of the 56 respondents did not know CRC incidence and mortality figures for Chinese Americans. Those aged 50 and younger, graduating from U.S. medical schools, or working in non-private settings had higher knowledge scores ( p < 0.01. Physicians graduating from U.S. medical schools had more favorable attitudes toward shared decision making ( p < 0.01. Lack of health insurance, inconsistent guidelines, and insufficient time were the most frequently cited barriers to recommending CRC screening. Conclusions Most Chinese American physicians had knowledge, attitude, and communication barriers to making optimal CRC screening recommendations.

Sociodemographic inequalities in barriers to cancer pain management: a report from the American Cancer Society's Study of Cancer Survivors-II (SCS-II).

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Stein, Kevin D; Alcaraz, Kassandra I; Kamson, Chelsey; Fallon, Elizabeth A; Smith, Tenbroeck G

2016-10-01

Research has increasingly documented sociodemographic inequalities in the assessment and management of cancer-related pain. Most studies have focused on racial/ethnic disparities, while less is known about the impact of other sociodemographic factors, including age and education. We analyzed data from a large, national, population-based study of cancer survivors to examine the influence of sociodemographic factors, and physical and mental health comorbidities on barriers to cancer pain management. The study included data from 4707 cancer survivors in the American Cancer Society's Study of Cancer Survivors-II, who reported experiencing pain from their cancer. A multilevel, socioecological, conceptual framework was used to generate a list of 15 barriers to pain management, representing patient, provider, and system levels. Separate multivariable logistic regressions for each barrier identified sociodemographic and health-related inequalities in cancer pain management, controlling for years since diagnosis, disease stage, and cancer treatment. Two-thirds of survivors reported at least 1 barrier to pain management. While patient-related barriers were most common, the greatest disparities were noted in provider- and system-level barriers. Specifically, inequalities by race/ethnicity, education, age, and physical and mental health comorbidities were observed. Findings indicate survivors who were nonwhite, less educated, older, and/or burdened by comorbidities were most adversely affected. Future efforts in research, clinical practice, and policy should identify and/or implement new strategies to address sociodemographic inequalities in cancer pain management. Copyright © 2016 John Wiley & Sons, Ltd.

Health impact and economic analysis of NGO-supported neurosurgery in Bolivia.

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Ament, Jared D; Greene, Kevin R; Flores, Ivan; Capobianco, Fernando; Salas, Gueider; Uriona, Maria Ines; Weaver, John P; Moser, Richard

2014-04-01

Bolivia, one of the poorest countries in the world, ranks 108th on the 2013 Human Development Index. With approximately 1 neurosurgeon per 200,000 people, access to neurosurgery in Bolivia is a growing health concern. Furthermore, neurosurgery in nonindustrialized countries has been considered both cost-prohibitive and lacking in outcomes evaluation. A non-governmental organization (NGO) supports spinal procedures in Bolivia (Solidarity Bridge), and the authors sought to determine its impact and cost-effectiveness. In a retrospective review of prospectively collected data, 19 patients were identified prior to spinal instrumentation and followed over 12 months. For inclusion, patients required interviewing prior to surgery and during at least 2 follow-up visits. All causes of spinal pathology were included. Sixteen patients met inclusion criteria and were therefore part of the analysis. Outcomes measured included assessment of activities of daily living, pain, ambulation, return to work/school, and satisfaction. Cost-effectiveness was determined by cost-utility analysis. Utilities were derived using the Health Utilities Index. Complications were incorporated into an expected value decision tree. Median (± SD) preoperative satisfaction was 2.0 ± 0.3 (on a scale of 0-10), while 6-month postoperative satisfaction was 7 ± 1.4 (p Bolivia appears to be cost-effective, especially when compared with the conventional $50,000/QALY benchmark and the WHO endorsed country-specific threshold of $16,026/QALY. However, with a gross domestic product per capita in Bolivia equaling $4800 per year and 30.3% of the population living on less than $2 per day, this cost continues to appear unrealistic. Additionally, the study has several significant limitations, namely its limited sample size, follow-up period, the assumption that patients not receiving surgical intervention would not make any clinical improvement, the reliance on the NGO for patient selection and sustainable practices

CAPABILITIES OF THE NGO “UKRAINIAN ASSEMBLY OF DOCTORSOF SCIENCE IN PUBLIC ADMINISTRATION” TO INNOVATIONS IN UKRAINE

OpenAIRE

DRAHOMYRETSKA NATALIIA MYKHAILIVNA

2017-01-01

This article reveals the possibilities of the NGO “Ukrainian Assembly of Doctors of Science in Public Administration” for the development and introduction of innovations in Ukraine. It demonstrates the potential scientists of the country possess for the introduction of foreign and domestic innovations. It shows the results of the assessment of foreign experts of scholars and students from Ukraine in humanitarian spheres. The article makes it possible to observe the content of the proposals of...

The Lived Experiences of African American Women with Breast Cancer: Implications for Counselors

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Clay, LaTasha K.

2013-01-01

Qualitative phenomenological methodology was used to explore the lived experiences of African American women diagnosed with breast cancer. Phenomenology focuses on the meaning of the lived experiences of individuals experiencing a concept, structure, or phenomenon (Creswell, 2007). The purpose of phenomenological research is to identify phenomena…

Bridge over troubled waters? The state-NGO interface in governing urban environments

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Tropp, H

1998-12-31

Environmental degradation and depletion of natural resources are aggravating problems in many developing countries. A particular case about Non-Governmental Organisations` (NGOs) commitment to river water pollution in Madras (south India) is developed here, mainly with regards to the interface between the state and NGO sector. A significant reason behind environmental problems are insufficient structures of governance. An often proposed solution, by both international and local organisations and governments, is to develop a partnership between the state and local organisations and communities. The arguments here show that such increased cooperation or decentralization may not come easy and is complicated by various meanings of governance, such as discretionary state power, limited transparency of bureaucratic and political processes, red-tapism and different perceptions of causes and solutions to environmental problems 25 refs, 1 fig

Bridge over troubled waters? The state-NGO interface in governing urban environments

Energy Technology Data Exchange (ETDEWEB)

Tropp, H.

1997-12-31

Environmental degradation and depletion of natural resources are aggravating problems in many developing countries. A particular case about Non-Governmental Organisations` (NGOs) commitment to river water pollution in Madras (south India) is developed here, mainly with regards to the interface between the state and NGO sector. A significant reason behind environmental problems are insufficient structures of governance. An often proposed solution, by both international and local organisations and governments, is to develop a partnership between the state and local organisations and communities. The arguments here show that such increased cooperation or decentralization may not come easy and is complicated by various meanings of governance, such as discretionary state power, limited transparency of bureaucratic and political processes, red-tapism and different perceptions of causes and solutions to environmental problems 25 refs, 1 fig

American Society of Clinical Oncology/College Of American Pathologists guideline recommendations for immunohistochemical testing of estrogen and progesterone receptors in breast cancer.

NARCIS (Netherlands)

Hammond, M.E.; Hayes, D.F.; Dowsett, M.; Allred, D.C.; Hagerty, K.L.; Badve, S.; Fitzgibbons, P.L.; Francis, G.; Goldstein, N.S.; Hayes, M.; Hicks, D.G.; Lester, S.; Love, R.; Mangu, P.B.; McShane, L.; Miller, K.; Osborne, C.K.; Paik, S.; Perlmutter, J.; Rhodes, A.; Sasano, H.; Schwartz, J.N.; Sweep, F.C.; Taube, S.; Torlakovic, E.E.; Valenstein, P.; Viale, G.; Visscher, D.; Wheeler, T.; Williams, R.B.; Wittliff, J.L.; Wolff, A.C.

2010-01-01

PURPOSE: To develop a guideline to improve the accuracy of immunohistochemical (IHC) estrogen receptor (ER) and progesterone receptor (PgR) testing in breast cancer and the utility of these receptors as predictive markers. METHODS: The American Society of Clinical Oncology and the College of

American Society of Clinical Oncology/College of American Pathologists guideline recommendations for immunohistochemical testing of estrogen and progesterone receptors in breast cancer.

NARCIS (Netherlands)

Hammond, M.E.; Hayes, D.F.; Dowsett, M.; Allred, D.C.; Hagerty, K.L.; Badve, S.; Fitzgibbons, P.L.; Francis, G.; Goldstein, N.S.; Hayes, M.; Hicks, D.G.; Lester, S.; Love, R.; Mangu, P.B.; McShane, L.; Miller, K.; Osborne, C.K.; Paik, S.; Perlmutter, J.; Rhodes, A.; Sasano, H.; Schwartz, J.N.; Sweep, F.C.; Taube, S.; Torlakovic, E.E.; Valenstein, P.; Viale, G.; Visscher, D.; Wheeler, T.; Williams, R.B.; Wittliff, J.L.; Wolff, A.C.

2010-01-01

PURPOSE: To develop a guideline to improve the accuracy of immunohistochemical (IHC) estrogen receptor (ER) and progesterone receptor (PgR) testing in breast cancer and the utility of these receptors as predictive markers. METHODS: The American Society of Clinical Oncology and the College of

Transmedia storytelling in the NGO communication. Sí me importa by Oxfam Intermón

Directory of Open Access Journals (Sweden)

Laura MARTÍNEZ VALERO

2016-12-01

Full Text Available Traditionally, transmedia storytelling has been used for spreading fiction narrative worlds, such as films and TV series. However, it was a matter of time that its ability for explaining the reality was discovered and utilised by social organizations to explain their causes and to reach new audiences. Moreover, the new mobile environment challenges the creativity of the organizations to develop products that make use of this new form of consumption. The Sí me importa campaign, a transmedia project of the Spanish NGO Oxfam Intermón, reclaimed the importance of the in-ternational cooperation through social networks, comic, theatre, contemporary art and cinema.

Non-Governmental Organization (NGO Libraries for The Visually Impaired in Nigeria: Alternative Format Use and Perception of Information Services

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Adetoro, 'Niran

2015-03-01

Full Text Available Nigeria's non-government organization (NGO libraries for the visually impaired has over the years been at the forefront of information services provision to persons with visual impairment. This study adopted a survey research design to investigate use of alternative formats and perceptions of information services to the visually impaired, focusing on two purposively chosen NGO libraries for the visually impaired in Nigeria. Using a complete enumeration approach, data were gathered from 180 users of the libraries through the use of a structured questionnaire with a reliability score (${\\alpha}=0.74$. Data from 112 (62.2% of the 180 administered copies of a questionnaire that were retrieved were analysed. The study found that Braille materials had a high level of utilization ($\\bar{x}=4.46$ and were the most frequently utilized (90.9%. Perception of information services by the visually impaired was positive while use of alternative formats was significantly and positively related to users' perception of information services (r = .041; p < 0.05. The study recommends improved transcription and investment in alternative formats and in e-resources. It also recommends collaborations to widen access as well as constant evaluation of services.

Electronic nicotine delivery systems: a policy statement from the American Association for Cancer Research and the American Society of Clinical Oncology.

Science.gov (United States)

Brandon, Thomas H; Goniewicz, Maciej L; Hanna, Nasser H; Hatsukami, Dorothy K; Herbst, Roy S; Hobin, Jennifer A; Ostroff, Jamie S; Shields, Peter G; Toll, Benjamin A; Tyne, Courtney A; Viswanath, Kasisomayajula; Warren, Graham W

2015-02-01

Combustible tobacco use remains the number one preventable cause of disease, disability, and death in the United States. Electronic nicotine delivery systems (ENDS), which include e-cigarettes, are devices capable of delivering nicotine in an aerosolized form. ENDS use by both adults and youth has increased rapidly, and some have advocated these products could serve as harm-reduction devices and smoking cessation aids. ENDS may be beneficial if they reduce smoking rates or prevent or reduce the known adverse health effects of smoking. However, ENDS may also be harmful, particularly to youth, if they increase the likelihood that nonsmokers or formers smokers will use combustible tobacco products or if they discourage smokers from quitting. The American Association for Cancer Research (AACR) and the American Society of Clinical Oncology (ASCO) recognize the potential ENDS have to alter patterns of tobacco use and affect the public's health; however, definitive data are lacking. AACR and ASCO recommend additional research on these devices, including assessing the health impacts of ENDS, understanding patterns of ENDS use, and determining what role ENDS have in cessation. Key policy recommendations include supporting federal, state, and local regulation of ENDS; requiring manufacturers to register with the FDA and report all product ingredients, requiring childproof caps on ENDS liquids, and including warning labels on products and their advertisements; prohibiting youth-oriented marketing and sales; prohibiting child-friendly ENDS flavors; and prohibiting ENDS use in places where cigarette smoking is prohibited. ©2015 American Association for Cancer Research and American Society of Clinical Oncology.

Factors Affecting African American Women's Participation in Breast Cancer Screening Programs: A Qualitative Study of Uninsured Low Income Women

National Research Council Canada - National Science Library

Lewis, Frances

2003-01-01

.... The purpose of the current study is to elaborate the beliefs and culturally embedded meanings that a population of low income, uninsured African American women hold toward breast cancer and breast cancer screening...

Factors Affecting African American Women's Participation in Breast Cancer Screening Programs: A Qualitative Study of Uninsured Low Income Women

National Research Council Canada - National Science Library

Lewis, Frances

2002-01-01

The purpose of the current study is to elaborate the beliefs and culturally embedded meanings that a population of low income, uninsured African American women held toward breast cancer and breast cancer screening...

Factors Affecting African American Women's Participation in Breast Cancer Screening Programs: A Qualitative Study of Uninsured Low Income Women

National Research Council Canada - National Science Library

Lewis, Frances

2004-01-01

.... The purpose of the current study was to elaborate the beliefs and culturally embedded meanings that a population of low income, uninsured African American women held toward breast cancer and breast cancer screening...

Factors Affecting African American Women's Participation in Breast Cancer Screening Programs: A Qualitative Study of Uninsured Low Income Women

National Research Council Canada - National Science Library

Lewis, Frances

2001-01-01

.... The purpose of the current study is to elaborate the beliefs and culturally embedded meanings that a population of low income, uninsured African American women hold toward breast cancer and breast cancer screening...

Fluxos informacionais para o monitoramento da Convenção dos Direitos da Criança: a atuação da rede NGO Group for CRCInformation follow and the monitoring process of the convention on the rights of child by NGO Group for CRC network

Directory of Open Access Journals (Sweden)

Maria Guiomar da Cunha Frota

2010-05-01

Full Text Available O presente artigo apresenta os resultados de uma pesquisa que investiga uma rede social internacional denominada NGO Group for CRC. A rede é composta por cerca de noventa organizações não governamentais e foi criada para monitorar a implementação da Convenção dos Direitos da Criança (CRC. A CRC é o principal documento jurídico relativo aos direitos da criança, tendo sido aprovada pela totalidade dos países pertencentes à ONU, com exceção dos EUA. Pretende-se especificamente analisar o fluxo informacional que se estabelece em meio à rede, seus membros e as organizações que a ela se associam. As questões investigadas são as seguintes: 1 Em que medida o fluxo informacional torna-se parte intrínseca da estrutura em rede? 2 Como os fluxos informacionais se configuram e de que modo são apropriados e veiculados pela rede NGO Group for CRC no curso do monitoramento da implementação da Convenção dos Direitos da Criança?This paper presents the research results about the social network NGO Group for CRC which is an articulation of non governmental organizations related to children's rights. This paper analyzes the information flow inside the network, among its members and among the network organizations. The Convention on the Rights of the Child (CRC was approved in 1989 by the General Assembly of the United Nations, being ratified in its totality by the countries members, with the exception of the United States of America. The investigated questions are: 1 How is the role of the information flow in the network structure? 2 How is the information flow configured to support the implementation monitoring process of the Convention on the Rights of the Child?

Hepatitis B and liver cancer knowledge and preventive practices among Asian Americans in the San Francisco Bay Area, California.

Science.gov (United States)

Wu, Charlotte A; Lin, Steven Y; So, Samuel K; Chang, Ellen T

2007-01-01

Chronic hepatitis B virus (HBV) infection causes liver cancer and disproportionately affects the Asian community in the U.S. In order to advance HBV and liver cancer awareness and prevention, it is important to identify existing gaps in knowledge and preventive practices among Asian Americans. Therefore, the authors administered a written questionnaire to 199 adults in the Asian-American community of the San Francisco Bay Area, California. Although the majority of adults had at least a college education, knowledge regarding HBV transmission, prevention, symptoms, risks, and occurrence was low. Fewer than 60% reported having been tested for HBV, only 31% reported having been vaccinated against HBV, and only 44% reported having had their children vaccinated. Asians, especially those born in China or Southeast Asia, had significantly poorer knowledge regarding HBV and liver cancer than non-Asians. Those with higher knowledge levels were significantly more likely to have been tested for HBV and to have had their children vaccinated. Younger adults, women, Caucasians, more highly educated individuals, those not born in China or Hong Kong, and those with a personal or family history of liver disease were more likely to have taken preventive action against HBV. Our results suggest that HBV and liver cancer knowledge among Asian Americans, especially Chinese Americans, is poor, and that better knowledge is associated with increased preventive practices. Thus, there is a need for increased HBV education and improved community-based interventions to prevent HBV-related liver disease in the high-risk Asian-American community.

Is Public Communication about End-of-Life Care Helping to Inform All?: Cancer News Coverage in African American vs. Mainstream Media

Science.gov (United States)

Fishman, Jess M.; Ten Have, Thomas; Casarett, David

2014-01-01

Background Because cancers are a leading cause of death, these diseases receive a great deal of news attention. However, because news media frequently target specific racial or ethnic audiences, some populations may receive different information, and it is unknown whether reporting equally informs all about options for care at the end of life. This study of US news reporting compares “mainstream” (general market) media to African American media, which serves the largest minority group. The specific goal of this study was to determine whether these news media communicate differently about cure-directed cancer treatment and end-of-life alternatives. Methods This content analysis includes 660 cancer news stories from online and print media that target either African American or mainstream audiences. The main outcome measures include whether reporting discussed: adverse events of cancer treatment; cancer treatment failure; cancer death/dying; and end-of-life palliative or hospice care. Results Unadjusted and adjusted analyses indicate that the news stories in the African American media are less likely than those in mainstream media to discuss each of the topics studied. Comparing the proportions of news stories in mainstream vs. African American media , 31.6% vs. 13.6% discussed adverse events (OR 2.92; 95% CI 1.51-5.66; P=0.001); 14.1% vs. 4.2% mentioned treatment failure (OR, 3.79; 95% CI 1.45-9.88; P=0.006); and 11.9% vs. 3.8% focused on death/dying (OR, 3.42; 95% CI 1.39-8.38; P=.007). Lastly, although very few news stories discussed end-of-life hospice or palliative care, all were found in mainstream media (7/396 vs. 0/264). Conclusion The African American news media sampled are less likely than mainstream news media to portray negative cancer outcomes and end-of-life care. Given media's segmented audiences, these findings raise concerns that not all audiences are being informed equally well. Because media content is modifiable, there may be opportunities to

Typology of perceived family functioning in an American sample of patients with advanced cancer.

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Schuler, Tammy A; Zaider, Talia I; Li, Yuelin; Hichenberg, Shira; Masterson, Melissa; Kissane, David W

2014-08-01

Poor family functioning affects psychosocial adjustment and the occurrence of morbidity following bereavement in the context of a family's coping with advanced cancer. Family functioning typologies assist with targeted family-centered assessment and intervention to offset these complications in the palliative care setting. Our objective was to identify the number and nature of potential types in an American palliative care patient sample. Data from patients with advanced cancer (N = 1809) screened for eligibility for a larger randomized clinical trial were used. Cluster analyses determined whether patients could be classified into clinically meaningful and coherent groups, based on similarities in their perceptions of family functioning across the cohesiveness, expressiveness, and conflict resolution subscales of the Family Relations Index. Patients' reports of perceived family functioning yielded a model containing five meaningful family types. Cohesiveness, expressiveness, and conflict resolution appear to be useful dimensions by which to classify patient perceptions of family functioning. "At risk" American families may include those we have called hostile, low-communicating, and less-involved. Such families may benefit from adjuvant family-centered psychosocial services, such as family therapy. Copyright © 2014 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

The association of breast density with breast cancer mortality in African American and white women screened in community practice.

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Zhang, Shengfan; Ivy, Julie S; Diehl, Kathleen M; Yankaskas, Bonnie C

2013-01-01

The effect of breast density on survival outcomes for American women who participate in screening remains unknown. We studied the role of breast density on both breast cancer and other cause of mortality in screened women. Data for women with breast cancer, identified from the community-based Carolina Mammography Registry, were linked with the North Carolina cancer registry and NC death tapes for this study. Cause-specific Cox proportional hazards models were developed to analyze the effect of several covariates on breast cancer mortality-namely, age, race (African American/White), cancer stage at diagnosis (in situ, local, regional, and distant), and breast density (BI-RADS( ® ) 1-4). Two stratified Cox models were considered controlling for (1) age and race, and (2) age and cancer stage, respectively, to further study the effect of density. The cumulative incidence function with confidence interval approximation was used to quantify mortality probabilities over time. For this study, 22,597 screened women were identified as having breast cancer. The non-stratified and stratified Cox models showed no significant statistical difference in mortality between dense tissue and fatty tissue, while controlling for other covariate effects (p value = 0.1242, 0.0717, and 0.0619 for the non-stratified, race-stratified, and cancer stage-stratified models, respectively). The cumulative mortality probability estimates showed that women with dense breast tissues did not have significantly different breast cancer mortality than women with fatty breast tissue, regardless of age (e.g., 10-year confidence interval of mortality probabilities for whites aged 60-69 white: 0.056-0.090 vs. 0.054-0.083). Aging, African American race, and advanced cancer stage were found to be significant risk factors for breast cancer mortality (hazard ratio >1.0). After controlling for cancer incidence, there was not a significant association between mammographic breast density and mortality, adjusting

Important Role of Menarche in Development of Estrogen Receptor-Negative Breast Cancer in African American Women.

Science.gov (United States)

Ambrosone, Christine B; Zirpoli, Gary; Hong, Chi-Chen; Yao, Song; Troester, Melissa A; Bandera, Elisa V; Schedin, Pepper; Bethea, Traci N; Borges, Virginia; Park, Song-Yi; Chandra, Dhyan; Rosenberg, Lynn; Kolonel, Laurence N; Olshan, Andrew F; Palmer, Julie R

2015-09-01

Menarche is a critical time point for diverging fates of mammary cells of origin. African American women have young age at menarche, which could be associated with their high rates of estrogen receptor-negative (ER-) breast cancer. In the AMBER Consortium, using harmonized data from 4426 African American women with breast cancer and 17 474 controls, we used polytomous logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for ages at menarche and first live birth (FLB), and the interval between, in relation to ER+ and ER- breast cancer. All statistical tests were two-sided. Risk of ER- breast cancer was reduced with later age at menarche among both parous and nulliparous women (≥15 vs fashion (OR for 20 year interval = 1.39, 95% CI = 1.08 to 1.79, P trend = .003), ER- risk was only increased for intervals up to 14 years and not beyond (P trend = .33). While ER- breast cancer risk was markedly reduced in women with a late age at menarche, there was not a clear pattern of increased risk with longer interval between menarche and FLB, as was observed for ER+ breast cancer. These findings indicate that etiologic pathways involving adolescence and pregnancy may differ for ER- and ER+ breast cancer. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Health behavior change models and their socio-cultural relevance for breast cancer screening in African American women.

Science.gov (United States)

Ashing-Giwa, K

1999-01-01

Models of health behavior provide the conceptual bases for most of the breast cancer screening intervention studies. These models were not designed for and have not been adequately tested with African American women. The models discussed in this paper are: The Health Belief Model, the Theory of Reasoned Action/Theory of Planned Behavior, and the Transtheoretical Model. This paper will examine the socio-cultural relevance of these health behavior models, and discuss specific socio-cultural dimensions that are not accounted for by these paradigms. It is critical that researchers include socio-cultural dimensions, such as interconnectedness, health socialization, ecological factors and health care system factors into their intervention models with African American women. Comprehensive and socio-culturally based investigations are necessary to guide the scientific and policy challenge for reducing breast cancer mortality in African American women.

Results of a Community-Based Randomized Trial to Increase Colorectal Cancer Screening Among Filipino Americans

Science.gov (United States)

Bastani, Roshan; Danao, Leda L.; Antonio, Cynthia; Garcia, Gabriel M.; Crespi, Catherine M.

2010-01-01

Objectives. We conducted 1 of the first community-based trials to develop a multicomponent intervention that would increase colorectal cancer screening among an Asian American population. Methods. Filipino Americans (n = 548) nonadherent to colorectal cancer (CRC) screening guidelines were randomized into an intervention group that received an education session on CRC screening and free fecal occult blood test (FOBT) kits; a second intervention group that received an education session but no free FOBT kits; and a control group that received an education session on the health benefits of physical activity. Results. Self-reported CRC screening rates during the 6-month follow-up period were 30%, 25%, and 9% for participants assigned to intervention with FOBT kit, intervention without the kit, and control group, respectively. Participants in either of the 2 intervention groups were significantly more likely to report screening at follow-up than were participants in the control group. Conclusions. A multicomponent intervention that includes an educational group session in a community setting can significantly increase CRC screening among Filipino Americans, even when no free FOBT kits are distributed. PMID:20864724

Guideline-Concordant Cancer Care and Survival Among American Indian/Alaskan Native Patients

Science.gov (United States)

Javid, Sara H.; Varghese, Thomas K.; Morris, Arden M.; Porter, Michael P.; He, Hao; Buchwald, Dedra; Flum, David R.

2014-01-01

BACKGROUND American Indians/Alaskan Natives (AI/ANs) have the worst 5-year cancer survival of all racial/ethnic groups in the United States. Causes for this disparity are unknown. The authors of this report examined the receipt of cancer treatment among AI/AN patients compared with white patients. METHODS This was a retrospective cohort study of 338,204 patients who were diagnosed at age ≥65 years with breast, colon, lung, or prostate cancer between 1996 and 2005 in the Surveillance, Epidemiology, and End Results-Medicare database. Nationally accepted guidelines for surgical and adjuvant therapy and surveillance were selected as metrics of optimal, guideline-concordant care. Treatment analyses compared AI/ANs with matched whites. RESULTS Across cancer types, AI/ANs were less likely to receive optimal cancer treatment and were less likely to undergo surgery (P ≤ .025 for all cancers). Adjuvant therapy rates were significantly lower for AI/AN patients with breast cancer (P <.001) and colon cancer (P = .001). Rates of post-treatment surveillance also were lower among AI/ANs and were statistically significantly lower for AI/AN patients with breast cancer (P = .002) and prostate cancer (P <.001). Nonreceipt of optimal cancer treatment was associated with significantly worse survival across cancer types. Disease-specific survival for those who did not undergo surgery was significantly lower for patients with breast cancer (hazard ratio [HR], 0.62), colon cancer (HR, 0.74), prostate cancer (HR, 0.52), and lung cancer (HR, 0.36). Survival rates also were significantly lower for those patients who did not receive adjuvant therapy for breast cancer (HR, 0.56), colon cancer (HR, 0.59), or prostate cancer (HR, 0.81; all 95% confidence intervals were <1.0). CONCLUSIONS Fewer AI/AN patients than white patients received guideline-concordant cancer treatment across the 4 most common cancers. Efforts to explain these differences are critical to improving cancer care and

Gender roles and acculturation: relationships with cancer screening among Vietnamese American women.

Science.gov (United States)

Nguyen, Anh B; Clark, Trenette T; Belgrave, Faye Z

2014-01-01

The aim of this study was to examine the influence of demographic variables and the interplay between gender roles and acculturation on breast and cervical cancer screening outcomes among Vietnamese American women. Convenience sampling was used to recruit 100 Vietnamese women from the Richmond, VA, metropolitan area. Women were recruited to participate in a larger cancer screening intervention. All participants completed measures on demographic variables, gender roles, acculturation, and cancer screening variables. Findings indicated that traditional masculine gender roles were associated with increased self-efficacy for breast and cervical cancer screening. Higher levels of acculturation were associated with higher probability of having had a Papanicolaou test. In addition, acculturation moderated the relationship between traditional female gender roles and cancer screening variables. For highly acculturated women, higher levels of feminine gender roles predicted higher probability of having had a previous clinical breast exam and higher levels of self-efficacy for cervical cancer screening, while the opposite was true for lower acculturated women. The findings of this study indicate the important roles that sociodemographic variables, gender roles, and acculturation play in affecting health attitudes and behaviors among Vietnamese women. These findings also help to identify a potentially high-risk subgroup and existing gaps that need to be targeted by preventive interventions.

Gender Roles and Acculturation: Relationships With Cancer Screening Among Vietnamese American Women

Science.gov (United States)

Nguyen, Anh B.; Clark, Trenette T.; Belgrave, Faye Z.

2017-01-01

The aim of this study was to examine the influence of demographic variables and the interplay between gender roles and acculturation on breast and cervical cancer screening outcomes among Vietnamese American women. Convenience sampling was used to recruit 100 Vietnamese women from the Richmond, VA, metropolitan area. Women were recruited to participate in a larger cancer screening intervention. All participants completed measures on demographic variables, gender roles, acculturation, and cancer screening variables. Findings indicated that traditional masculine gender roles were associated with increased self-efficacy for breast and cervical cancer screening. Higher levels of acculturation were associated with higher probability of having had a Papanicolaou test. In addition, acculturation moderated the relationship between traditional female gender roles and cancer screening variables. For highly acculturated women, higher levels of feminine gender roles predicted higher probability of having had a previous clinical breast exam and higher levels of self-efficacy for cervical cancer screening, while the opposite was true for lower acculturated women. The findings of this study indicate the important roles that sociodemographic variables, gender roles, and acculturation play in affecting health attitudes and behaviors among Vietnamese women. These findings also help to identify a potentially high-risk subgroup and existing gaps that need to be targeted by preventive interventions. PMID:24491129

Leveraging the Family Influence of Women in Prostate Cancer Efforts Targeting African American Men.

Science.gov (United States)

Okoro, O N; Rutherford, C A; Witherspoon, S F

2017-08-25

Incidence rate of prostate cancer among African American (AA) men is 1.6 times that in White men. Prevention efforts in this population have typically been through faith-based organizations and barber shops, with a few including significant others. Culturally, women are known to have a strong influence in the AA family. The current study assessed prostate cancer knowledge and explored perceptions on the roles of women in prostate cancer prevention. To assess prostate cancer knowledge, a 25-item questionnaire was administered to convenience samples of AA women (n = 297) and men (n = 199). Four focus groups were conducted to explore perceptions on the role of women in prostate cancer prevention. Men had a higher mean score (13.2; max of 25) than women (11.4) for knowledge of prostate cancer. For the men, higher knowledge scores were associated with having a family member diagnosed with prostate cancer and likelihood to engage healthcare providers about prostate cancer (p men to seek regular primary care. This affords men opportunities for dialog with healthcare providers about prostate cancer and informed decision making regarding screening.

Neighborhood disadvantage, physical activity barriers, and physical activity among African American breast cancer survivors

Directory of Open Access Journals (Sweden)

Antwan Jones

2015-01-01

Higher renter rates and individual barriers both contribute to lower levels of physical activity in African American breast cancer survivors. These data suggest that the potential for constant residential turnover (via rentership and perceived barriers may increase physical inactivity even where facilities may be available.

Male role norms, knowledge, attitudes, and perceptions of colorectal cancer screening among young adult African American men

Directory of Open Access Journals (Sweden)

Charles R. Rogers, Ph.D., CHES

2014-11-01

Full Text Available Racial disparities in health among African American men in the United States are extensive. In contrast to their White counterparts, African American men have more illnesses and die younger. African American men have colorectal cancer (CRC incidence and mortality rates 25% and 50% higher, respectively, than White men. Due to CRC’s younger age at presentation and high incidence among African American men, CRC screening is warranted at the age of 45 rather than 50, but little is known about younger African American men’s views of CRC screening. Employing survey design, the purpose of the study was to describe the male role norms, knowledge, attitudes, perceived subjective norms, and perceived barriers associated with screening for CRC among a non-random sample of 157 young adult African American men (ages 19-45. Sixty-seven percent of the study sample received a passing knowledge score (85% or better, yet no significant differences were found among the three educational levels (i.e., low, medium, high. More negative attitudes towards CRC screening correlated with the participants’ strong perceptions of barriers, but no extremely negative or positive male role norms and perceived subjective norms were found. The factors significantly associated with attitudes were family history of cancer (unsure, work status, and perceived barriers. Findings from this study provide a solid basis for developing structured health education interventions that address the salient factors shaping young adult African American men's view of CRC and early detection screening behaviors.

Acculturation and cancer screening among Asian Americans: role of health insurance and having a regular physician.

Science.gov (United States)

Lee, Sunmin; Chen, Lu; Jung, Mary Y; Baezconde-Garbanati, Lourdes; Juon, Hee-Soon

2014-04-01

Cancer is the leading cause of death among Asian Americans, but screening rates are significantly lower in Asians than in non-Hispanic Whites. This study examined associations between acculturation and three types of cancer screening (colorectal, cervical, and breast), focusing on the role of health insurance and having a regular physician. A cross-sectional study of 851 Chinese, Korean, and Vietnamese Americans was conducted in Maryland. Acculturation was measured using an abridged version of the Suinn-Lew Asian Self-Identity Acculturation Scale, acculturation clusters, language preference, length of residency in the US, and age at arrival. Age, health insurance, regular physician, gender, ethnicity, income, marital status, and health status were adjusted in the multivariate analysis. Logistic regression analysis showed that various measures of acculturation were positively associated with the odds of having all cancer screenings. Those lived for more than 20 years in the US were about 2-4 times [odds ratio (OR) and 95 % confidence interval (CI) colorectal: 2.41 (1.52-3.82); cervical: 1.79 (1.07-3.01); and breast: 2.11 (1.25-3.57)] more likely than those who lived for less than 10 years to have had cancer screening. When health insurance and having a regular physician were adjusted, the associations between length of residency and colorectal cancer [OR 1.72 (1.05-2.81)] was reduced and the association between length of residency and cervical and breast cancer became no longer significant. Findings from this study provide a robust and comprehensive picture of AA cancer screening behavior. They will provide helpful information on future target groups for promoting cancer screening.

Older Korean American men's prostate cancer screening behavior: the prime role of culture.

Science.gov (United States)

Lee, Hee Yun; Jung, Yunkyung

2013-12-01

East and South Asian male immigrants show markedly low odds of prostate cancer screening as compared to U.S.-born men. However, knowledge about these immigrants' culture-based screening behavior and barriers to screening is extremely limited. This study investigates factors influencing receipt of prostate cancer screening among Korean American immigrant men, particularly investigating culture's impact on screening behaviors. Data were collected through a convenience and purposive sampling technique from 134 Korean American males aged 50 and older recruited in New York City. A structured questionnaire was used and cultural variables were measured by adopting items from Tang and colleagues' work. Approximately 60 % of the sample had received a prostate-specific antigen (PSA) test in their lifetime, and of these, about 66 % reported having done so in the previous 12 months. Logistic regression analysis revealed that a crisis-oriented intervention approach was associated with a substantially reduced likelihood of screening. A positive correlation was noted between the use of Eastern medicine and PSA test receipt. Further analysis revealed a significant interaction effect between use of Eastern medicine and age in predicting PSA test uptake. Culture-specific intervention strategies for increasing prostate cancer screening in this group are discussed, with particular attention to increasing pertinent health literacy. Health professionals should consider the cultural domain when working with Korean immigrant men in order to provide culturally competent care.

African-American Men with Gleason Score 3+3=6 Prostate Cancer Produce Less Prostate Specific Antigen than Caucasian Men: A Potential Impact on Active Surveillance.

Science.gov (United States)

Kryvenko, Oleksandr N; Balise, Raymond; Soodana Prakash, Nachiketh; Epstein, Jonathan I

2016-02-01

We assess the difference in prostate specific antigen production between African-American and Caucasian men with Gleason score 3+3=6 prostate cancer. We measured tumor volume in 414 consecutive radical prostatectomies from men with National Comprehensive Cancer Network(®) low risk prostate cancer (348 Caucasian, 66 African-American) who had Gleason score 3+3=6 disease at radical prostatectomy. We then compared clinical presentation, pathological findings, prostate specific antigen, prostate specific antigen density and prostate specific antigen mass (an absolute amount of prostate specific antigen in patient's circulation) between African-American and Caucasian men. The t-test and Wilcoxon rank sum were used for comparison of means. African-American and Caucasian men had similar clinical findings based on age, body mass index and prostate specific antigen. There were no statistically significant differences between the dominant tumor nodule volume and total tumor volume (mean 0.712 vs 0.665 cm(3), p=0.695) between African-American and Caucasian men. Prostates were heavier in African-American men (mean 55.4 vs 46.3 gm, p prostate tissue contributing to prostate specific antigen in African-American men, prostate specific antigen mass was not different from that of Caucasian men (mean 0.55 vs 0.558 μg, p=0.95). Prostate specific antigen density was significantly less in African-American men due to larger prostates (mean 0.09 vs 0.105, p prostate cancer produce less prostate specific antigen than Caucasian men. African-American and Caucasian men had equal serum prostate specific antigen and prostate specific antigen mass despite significantly larger prostates in African-American men with all other parameters, particularly total tumor volume, being the same. This finding has practical implications in T1c cases diagnosed with prostate cancer due to prostate specific antigen screening. Lowering the prostate specific antigen density threshold in African-American men may

Cost recovery of NGO primary health care facilities: a case study in Bangladesh

Directory of Open Access Journals (Sweden)

Alam Khurshid

2010-06-01

Full Text Available Abstract Background Little is known about the cost recovery of primary health care facilities in Bangladesh. This study estimated the cost recovery of a primary health care facility run by Building Resources Across Community (BRAC, a large NGO in Bangladesh, for the period of July 2004 - June 2005. This health facility is one of the seven upgraded BRAC facilities providing emergency obstetric care and is typical of the government and private primary health care facilities in Bangladesh. Given the current maternal and child mortality in Bangladesh and the challenges to addressing health-related Millennium Development Goal (MDG targets the financial sustainability of such facilities is crucial. Methods The study was designed as a case study covering a single facility. The methodology was based on the 'ingredient approach' using the allocation techniques by inpatient and outpatient services. Cost recovery of the facility was estimated from the provider's perspective. The value of capital items was annualized using 5% discount rate and its market price of 2004 (replacement value. Sensitivity analysis was done using 3% discount rate. Results The cost recovery ratio of the BRAC primary care facility was 59%, and if excluding all capital costs, it increased to 72%. Of the total costs, 32% was for personnel while drugs absorbed 18%. Capital items were17% of total costs while operational cost absorbed 12%. Three-quarters of the total cost was variable costs. Inpatient services contributed 74% of total revenue in exchange of 10% of total utilization. An average cost per patient was US$ 10 while it was US$ 67 for inpatient and US$ 4 for outpatient. Conclusion The cost recovery of this NGO primary care facility is important for increasing its financial sustainability and decreasing donor dependency, and achieving universal health coverage in a developing country setting. However, for improving the cost recovery of the health facility, it needs to increase

Understanding the social and community support networks of American Indian women cancer survivors.

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Burnette, Catherine E; Liddell, Jessica; Roh, Soonhee; Lee, Yeon-Shim; Lee, Hee Yun

2018-04-02

Cancer is the leading cause of death among American Indian and Alaska Native (AI/AN) women, and although cancer disparities among AI women are alarming, there is little research focused on the topic of social support and cancer treatment and outcomes. A community advisory board was used to develop and administer the project, and a qualitative descriptive study methodology was used. This research was conducted in partnership with two community-based hospitals in the Northern Plains. The sample included 43 AI female cancer survivors who were interviewed with a semi-structured interview guide. The data were analyzed using content analysis. Emergent themes revealed that AI cancer survivors' non-familial support systems included friends (n = 12), support groups (n = 6), churches (n = 10), co-workers (n = 5), communities (n = 4), support from health practitioners (n = 3) and additional forms of support. Results indicate that survivors' networks are diverse, and support broad prevention programs that reach out to churches, community groups, and online forums. These sources of supports can be enhanced through sustainable community-based infrastructures.

Effect of tribal language use on colorectal cancer screening among American Indians.

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Gonzales, Angela A; Garroutte, Eva; Ton, Thanh G N; Goldberg, Jack; Buchwald, Dedra

2012-12-01

American Indians have one of the lowest colorectal cancer (CRC) screening rates for any racial/ethnic group in the U.S., yet reasons for their low screening participation are poorly understood. We examine whether tribal language use is associated with knowledge and use of CRC screening in a community-based sample of American Indians. Using logistic regression to estimate the association between tribal language use and CRC test knowledge and receipt we found participants speaking primarily English were no more aware of CRC screening tests than those speaking primarily a tribal language (OR = 1.16 [0.29, 4.63]). Participants who spoke only a tribal language at home (OR = 1.09 [0.30, 4.00]) and those who spoke both a tribal language and English (OR = 1.74 [0.62, 4.88]) also showed comparable odds of receipt of CRC screening. Study findings failed to support the concept that use of a tribal language is a barrier to CRC screening among American Indians.

Factors That Impact End-of-Life Decision Making in African Americans With Advanced Cancer

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Campbell, Cathy L.; Williams, Ishan C.; Orr, Tamara

2013-01-01

Significance African Americans with cancer are less likely to use hospice services and more likely to die in the hospital than white patients with the same diagnosis. However, there is much that is not understood about the factors that lead African Americans to choose options for end-of-life care. Design A qualitative, descriptive design was used in this pilot study. Methods Interviews were conducted with two groups of African Americans with advanced-stage cancer (people enrolled in hospice and those who were not under hospice care). Findings End-of-life decisions were primarily guided by clinical factors, the patient-related physical, emotional, and cognitive symptoms that are sequelae of the underlying disease or medical treatments. The physician was the healthcare provider most likely to be involved in decision making with patients, family members, and caregivers. Individual factors, such as personal beliefs, influenced end-of-life decision making. Religion and spirituality were a topic in many interviews, but they did not consistently influence decision making. Discussion Future studies should include interviews with family members, caregivers, and healthcare professionals so that factors that impact end-of-life decision making can be fully described. Strategies to facilitate recruitment will need to be added to future protocols. PMID:23645999

The role of acculturation and collectivism in cancer screening for Vietnamese American women.

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Nguyen, Anh B; Clark, Trenette T

2014-01-01

The aim of this study was to examine the influence of demographic variables and the interplay between collectivism and acculturation on breast and cervical cancer screening outcomes among Vietnamese American women. Convenience sampling was used to recruit 111 Vietnamese women from the Richmond, VA, metropolitan area, who participated in a larger cancer screening intervention. All participants completed measures on demographic variables, collectivism, acculturation, and cancer-screening-related variables (i.e., attitudes, self-efficacy, and screening behavior). Findings indicated that collectivism predicted both positive attitudes and higher levels of self-efficacy with regard to breast and cervical cancer screening. Collectivism also moderated the relationship between acculturation and attitudes toward breast cancer screening such that for women with low levels of collectivistic orientation, increasing acculturation predicted less positive attitudes towards breast cancer screening. This relationship was not found for women with high levels of collectivistic orientation. The current findings highlight the important roles that sociodemographic and cultural variables play in affecting health attitudes, self-efficacy, and behavior among Vietnamese women. The findings potentially inform screening programs that rely on culturally relevant values in helping increase Vietnamese women's motivation to screen.

Lower Breast Cancer Risk among Women following the World Cancer Research Fund and American Institute for Cancer Research Lifestyle Recommendations: EpiGEICAM Case-Control Study.

Directory of Open Access Journals (Sweden)

Adela Castelló

Full Text Available According to the "World Cancer Research Fund" and the "American Institute of Cancer Research" (WCRF/AICR one in four cancer cases could be prevented through a healthy diet, weight control and physical activity.To explore the association between the WCRF/AICR recommendations and risk of breast cancer.During the period 2006 to 2011 we recruited 973 incident cases of breast cancer and 973 controls from 17 Spanish Regions. We constructed a score based on 9 of the WCRF/AICR recommendations for cancer prevention:: 1Maintain adequate body weight; 2Be physically active; 3Limit the intake of high density foods; 4Eat mostly plant foods; 5Limit the intake of animal foods; 6Limit alcohol intake; 7Limit salt and salt preserved food intake; 8Meet nutritional needs through diet; S1Breastfeed infants exclusively up to 6 months. We explored its association with BC by menopausal status and by intrinsic tumor subtypes (ER+/PR+ & HER2-; HER2+; ER&PR-&HER2- using conditional and multinomial logistic models respectively.Our results point to a linear association between the degree of noncompliance and breast cancer risk. Taking women who met 6 or more recommendations as reference, those meeting less than 3 showed a three-fold excess risk (OR=2.98(CI95%:1.59-5.59, especially for postmenopausal women (OR=3.60(CI95%:1.24;10.47 and ER+/PR+&HER2- (OR=3.60(CI95%:1.84;7.05 and HER2+ (OR=4.23(CI95%:1.66;10.78 tumors. Noncompliance of recommendations regarding the consumption of foods and drinks that promote weight gain in premenopausal women (OR=2.24(CI95%:1.18;4.28; p for interaction=0.014 and triple negative tumors (OR=2.93(CI95%:1.12-7.63; the intake of plant foods in postmenopausal women (OR=2.35(CI95%:1.24;4.44 and triple negative tumors (OR=3.48(CI95%:1.46-8.31; and the alcohol consumption in ER+/PR+&HER2- tumors (OR=1.52 (CI95%:1.06-2.19 showed the strongest associations.Breast cancer prevention might be possible by following the "World Cancer Research Fund" and the

Parity and breastfeeding among African-American women: differential effects on breast cancer risk by estrogen receptor status in the Women's Circle of Health Study.

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Ambrosone, Christine B; Zirpoli, Gary; Ruszczyk, Melanie; Shankar, Jyoti; Hong, Chi-Chen; McIlwain, Demetra; Roberts, Michelle; Yao, Song; McCann, Susan E; Ciupak, Gregory; Hwang, Helena; Khoury, Thaer; Jandorf, Lina; Bovbjerg, Dana H; Pawlish, Karen; Bandera, Elisa V

2014-02-01

It has long been held that parity reduces risk of breast cancer. However, accumulating evidence indicates that the effects of parity, as well as breastfeeding, may vary according to estrogen receptor (ER) status. We evaluated these associations in a case-control study among African-American women in New York City and New Jersey. In the Women's Circle of Health Study, including 786 African-American women with breast cancer and 1,015 controls, data on reproductive histories were collected from in-person interviews, with tumor characteristics abstracted from pathology reports. We calculated number of live births and months breastfeeding for each child, and examined each in relation to breast cancer by ER status, and for triple-negative (TN) breast cancer. Although associations were not statistically significant, having children was associated with reduced risk of ER+ breast cancer [odds ratio (OR) 0.82, 95 % confidence interval (CI) 0.58-1.16], but increased risk of ER- tumors, with associations most pronounced for TN breast cancer (OR 1.81, 95 % CI 0.93-3.51). Breastfeeding gave no additional benefit for ER+ cancer, but reduced the risk of ER- disease associated with parity. Accumulating data from a number of studies, as well as our own in African-American women, indicate that the effects of parity and breastfeeding differ by ER status. African-American women are more likely to have children and not to breastfeed, and to have ER- and TN breast cancer. It is possible that breastfeeding in this population could reduce risk of more aggressive breast cancers.

American Society of Clinical Oncology/College of American Pathologists guideline recommendations for immunohistochemical testing of estrogen and progesterone receptors in breast cancer (unabridged version).

NARCIS (Netherlands)

Hammond, M.E.; Hayes, D.F.; Dowsett, M.; Allred, D.C.; Hagerty, K.L.; Badve, S.; Fitzgibbons, P.L.; Francis, G.; Goldstein, N.S.; Hayes, M.; Hicks, D.G.; Lester, S.; Love, R.; Mangu, P.B.; McShane, L.; Miller, K.; Osborne, C.K.; Paik, S.; Perlmutter, J.; Rhodes, A.; Sasano, H.; Schwartz, J.N.; Sweep, F.C.; Taube, S.; Torlakovic, E.E.; Valenstein, P.; Viale, G.; Visscher, D.; Wheeler, T.; Williams, R.B.; Wittliff, J.L.; Wolff, A.C.

2010-01-01

PURPOSE: To develop a guideline to improve the accuracy of immunohistochemical (IHC) estrogen receptor (ER) and progesterone receptor (PgR) testing in breast cancer and the utility of these receptors as predictive markers. METHODS: The American Society of Clinical Oncology and the College of

Disparities in Prostate, Lung, Breast, and Colorectal Cancer Survival and Comorbidity Status among Urban American Indians and Alaskan Natives.

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Emerson, Marc A; Banegas, Matthew P; Chawla, Neetu; Achacoso, Ninah; Alexeeff, Stacey E; Adams, Alyce S; Habel, Laurel A

2017-12-01

Cancer is the second leading cause of death among American Indians and Alaskan Natives (AIAN), although cancer survival information in this population is limited, particularly among urban AIAN. In this retrospective cohort study, we compared all-cause and prostate, breast, lung, and colorectal cancer-specific mortality among AIAN ( n = 582) and non-Hispanic white (NHW; n = 82,696) enrollees of Kaiser Permanente Northern California (KPNC) diagnosed with primary invasive breast, prostate, lung, or colorectal cancer from 1997 to 2015. Tumor registry and other electronic health records provided information on sociodemographic, comorbidity, tumor, clinical, and treatment characteristics. Cox regression models were used to estimate adjusted survival curves and hazard ratios (HR) with 95% confidence intervals (CI). AIAN had a significantly higher comorbidity burden compared with NHW ( P cancer-specific mortality were significantly higher for AIAN than NHW patients with breast cancer (HR, 1.47; 95% CI, 1.13-1.92) or with prostate cancer (HR, 1.87; 95% CI, 1.14-3.06) but not for AIAN patients with lung and colorectal cancer. Despite approximately equal access to preventive services and cancer care in this setting, we found higher mortality for AIAN than NHW with some cancers, and a greater proportion of AIAN cancer patients with multiple comorbid conditions. This study provides severely needed information on the cancer experience of the 71% of AIANs who live in urban areas and access cancer care outside of the Indian Health Services, from which the vast majority of AIAN cancer information comes. Cancer Res; 77(23); 6770-6. ©2017 AACR . ©2017 American Association for Cancer Research.

Side effects of radiotherapy in breast cancer patients : The Internet as an information source.

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Janssen, S; Käsmann, L; Fahlbusch, F B; Rades, D; Vordermark, D

2018-02-01

Breast cancer is the most common cancer type among women necessitating adjuvant radiotherapy. As the Internet has become a major source of information for cancer patients, this study aimed to evaluate the quality of websites giving information on side effects of radiotherapy for breast cancer patients. A patients' search for the English terms "breast cancer - radiotherapy - side effects" and the corresponding German terms "Brustkrebs - Strahlentherapie - Nebenwirkungen" was carried out twice (5 months apart) using the search engine Google. The first 30 search results each were evaluated using the validated 16-question DISCERN Plus instrument, the Health on the Net Code of Conduct (HONcode) certification and the Journal of the American Medical Association (JAMA) benchmark criteria. The overall quality (DISCERN score) of the retrieved websites was further compared to queries via Bing and Yahoo search engines. The DISCERN score showed a great range, with the majority of websites ranking fair to poor. Significantly superior results were found for English websites, particularly for webpages run by hospitals/universities and nongovernmental organizations (NGO), when compared to the respective German categories. In general, only a minority of websites met all JAMA benchmarks and was HONcode certified (both languages). We did not determine a relevant temporal change in website ranking among the top ten search hits, while significant variation occurred thereafter. Mean overall DISCERN score was similar between the various search engines. The Internet can give breast cancer patients seeking information on side effects of radiotherapy an overview. However, based on the currently low overall quality of websites and the lack of transparency for the average layperson, we emphasize the value of personal contact with the treating radio-oncologist in order to integrate and interpret the information found online.

Side effects of radiotherapy in breast cancer patients. The Internet as an information source

International Nuclear Information System (INIS)

Janssen, S.; Kaesmann, L.; Rades, D.; Fahlbusch, F.B.; Vordermark, D.

2018-01-01

Breast cancer is the most common cancer type among women necessitating adjuvant radiotherapy. As the Internet has become a major source of information for cancer patients, this study aimed to evaluate the quality of websites giving information on side effects of radiotherapy for breast cancer patients. A patients' search for the English terms ''breast cancer - radiotherapy - side effects'' and the corresponding German terms ''Brustkrebs - Strahlentherapie - Nebenwirkungen'' was carried out twice (5 months apart) using the search engine Google. The first 30 search results each were evaluated using the validated 16-question DISCERN Plus instrument, the Health on the Net Code of Conduct (HONcode) certification and the Journal of the American Medical Association (JAMA) benchmark criteria. The overall quality (DISCERN score) of the retrieved websites was further compared to queries via Bing and Yahoo search engines. The DISCERN score showed a great range, with the majority of websites ranking fair to poor. Significantly superior results were found for English websites, particularly for webpages run by hospitals/universities and nongovernmental organizations (NGO), when compared to the respective German categories. In general, only a minority of websites met all JAMA benchmarks and was HONcode certified (both languages). We did not determine a relevant temporal change in website ranking among the top ten search hits, while significant variation occurred thereafter. Mean overall DISCERN score was similar between the various search engines. The Internet can give breast cancer patients seeking information on side effects of radiotherapy an overview. However, based on the currently low overall quality of websites and the lack of transparency for the average layperson, we emphasize the value of personal contact with the treating radio-oncologist in order to integrate and interpret the information found online. (orig.) [de

Evaluating the knowledge of breast cancer screening and prevention among Arab-American women in Michigan.

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Arshad, Samia; Williams, Karen Patricia; Mabiso, Athur; Dey, Subhojit; Soliman, Amr S

2011-03-01

Arab-American women are more likely to be diagnosed with advanced staged breast cancer. We analyzed data from 100 women utilizing a breast cancer literacy assessment tool aimed at understanding functional literacy levels about breast-self exams (BSE), clinical breast exams (CBE), and mammograms. The educational program improved women's knowledge of BSE (OR = 0.15; 95% CI = 0.04, 0.50) and CBE (OR = 0.15; 95% CI = 0.04, 0.54), more for women with higher education. Consideration of women's educational status is an important factor in planning educational programs to improve knowledge on breast cancer screening and prevention in this minority population.

American Thyroid Association statement on preoperative imaging for thyroid cancer surgery.

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Yeh, Michael W; Bauer, Andrew J; Bernet, Victor A; Ferris, Robert L; Loevner, Laurie A; Mandel, Susan J; Orloff, Lisa A; Randolph, Gregory W; Steward, David L

2015-01-01

The success of surgery for thyroid cancer hinges on thorough and accurate preoperative imaging, which enables complete clearance of the primary tumor and affected lymph node compartments. This working group was charged by the Surgical Affairs Committee of the American Thyroid Association to examine the available literature and to review the most appropriate imaging studies for the planning of initial and revision surgery for thyroid cancer. Ultrasound remains the most important imaging modality in the evaluation of thyroid cancer, and should be used routinely to assess both the primary tumor and all associated cervical lymph node basins preoperatively. Positive lymph nodes may be distinguished from normal nodes based upon size, shape, echogenicity, hypervascularity, loss of hilar architecture, and the presence of calcifications. Ultrasound-guided fine-needle aspiration of suspicious lymph nodes may be useful in guiding the extent of surgery. Cross-sectional imaging (computed tomography with contrast or magnetic resonance imaging) may be considered in select circumstances to better characterize tumor invasion and bulky, inferiorly located, or posteriorly located lymph nodes, or when ultrasound expertise is not available. The above recommendations are applicable to both initial and revision surgery. Functional imaging with positron emission tomography (PET) or PET-CT may be helpful in cases of recurrent cancer with positive tumor markers and negative anatomic imaging.

Atlas of prostate cancer heritability in European and African-American men pinpoints tissue-specific regulation

DEFF Research Database (Denmark)

Gusev, Alexander; Shi, Huwenbo; Kichaev, Gleb

2016-01-01

Although genome-wide association studies have identified over 100 risk loci that explain ∼33% of familial risk for prostate cancer (PrCa), their functional effects on risk remain largely unknown. Here we use genotype data from 59,089 men of European and African American ancestries combined...... with cell-type-specific epigenetic data to build a genomic atlas of single-nucleotide polymorphism (SNP) heritability in PrCa. We find significant differences in heritability between variants in prostate-relevant epigenetic marks defined in normal versus tumour tissue as well as between tissue and cell...... lines. The majority of SNP heritability lies in regions marked by H3k27 acetylation in prostate adenoc7arcinoma cell line (LNCaP) or by DNaseI hypersensitive sites in cancer cell lines. We find a high degree of similarity between European and African American ancestries suggesting a similar genetic...

Innate immunity pathways and breast cancer Risk in African American and European-American women in the Women's Circle of Health Study (WCHS.

Directory of Open Access Journals (Sweden)

Zhihong Gong

Full Text Available African American (AA women are more likely than European American (EA women to be diagnosed with early, aggressive breast cancer. Possible differences in innate immune pathways (e.g., inflammatory responses have received little attention as potential mechanisms underlying this disparity. We evaluated distributions of selected genetic variants in innate immune pathways in AA and EA women, and examined their associations with breast cancer risk within the Women's Circle of Health Study (WCHS. In stage I of the study (864 AA and 650 EA women we found that genotype frequencies for 35 of 42 tested SNPs (18 candidate genes differed between AAs and EAs (corroborated by ancestry informative markers. Among premenopausal AA women, comparing variant allele carriers to non-carriers, reduced breast cancer risk was associated with CXCL5-rs425535 (OR=0.61, P=0.02, while among EA women, there were associations with TNFA-rs1799724 (OR =2.31, P =0.002 and CRP-rs1205 (OR=0.54, P=0.01. For postmenopausal women, IL1B-rs1143627 (OR=1.80, P=0.02 and IL1B-rs16944 (OR=1.85, P =0.02 were associated with risk among EA women, with significant associations for TNFA-rs1799724 limited to estrogen receptor (ER positive cancers (OR=2.0, P =0.001. However, none of the SNPs retained significance after Bonferroni adjustment for multiple testing at the level of P0.0012 (0.05/42 except for TNFA-rs1799724 in ER positive cancers. In a stage II validation (1,365 AA and 1,307 EA women, we extended evaluations for four SNPs (CCL2-rs4586, CRP-rs1205, CXCL5-rs425535, and IL1RN-rs4251961, which yielded similar results. In summary, distributions of variants in genes involved in innate immune pathways were found to differ between AA and EA populations, and showed differential associations with breast cancer according to menopausal or ER status. These results suggest that immune adaptations suited to ancestral environments may differentially influence breast cancer risk among EA and AA women.

Lay health educators and print materials for the promotion of colorectal cancer screening among Korean Americans: A randomized comparative effectiveness study.

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Jo, Angela M; Nguyen, Tung T; Stewart, Susan; Sung, Min J; Gildengorin, Ginny; Tsoh, Janice Y; Tong, Elisa K; Lo, Penny; Cuaresma, Charlene; Sy, Angela; Lam, Hy; Wong, Ching; Jeong, Matthew; Chen, Moon S; Kagawa-Singer, Marjorie

2017-07-15

Colorectal cancer (CRC) is the second most commonly diagnosed cancer among Korean American men and women. Although CRC screening is effective in reducing the burden of this disease, studies have shown that Korean Americans have low screening rates. The authors conducted a 2-arm cluster randomized controlled trial comparing a brochure (print) with a brochure and lay health educator (LHE) outreach (print + LHE) in increasing CRC screening rates among Korean American individuals. Self-administered written surveys at baseline and at 6 months assessed knowledge of CRC and its screening, ever screening, and being up to date with screening. A total of 28 LHEs recruited 348 participants aged 50 to 75 years from their social networks. Significant percentages of participants reported not having health insurance (29.3%) or a usual source of care (35.6%). At 6 months postintervention, the print + LHE participants had a greater increase in knowledge compared with those in the print arm (P = .0013). In multivariable analyses, both groups had significant increases in ever screening (print plus LHE: odds ratio [OR], 1.60 [95% confidence interval (95% CI), 1.26-2.03] and print: OR, 1.42 [95% CI, 1.10-1.82]) and being up to date with screening (print plus LHE: OR, 1.63 [95% CI, 1.23-2.16] and print: OR, 1.40 [95% CI, 1.04-1.89]). However, these increases did not differ significantly between the study arms. Having insurance and having seen a provider within the past year were found to be positively associated with screening. Compared with a brochure, LHE outreach yielded greater increases in knowledge but resulted in similar increases in CRC screening in a Korean American population with barriers to health care access. More work is needed to appropriately address logistical and system barriers in this community. Cancer 2017;123:2705-15. © 2017 American Cancer Society. © 2017 American Cancer Society.

Expressive writing among Chinese American breast cancer survivors: A randomized controlled trial.

Science.gov (United States)

Lu, Qian; Wong, Celia Ching Yee; Gallagher, Matthew W; Tou, Reese Y W; Young, Lucy; Loh, Alice

2017-04-01

Despite the significant size of the Asian American population, few studies have been conducted to improve cancer survivorship in this underserved group. Research has demonstrated that expressive writing interventions confer physical and psychological benefits for a variety of populations, including Non-Hispanic White cancer survivors. The study aims to evaluate the health benefits of an expressive writing intervention among Chinese-speaking breast cancer survivors in the U.S. It was hypothesized that expressive writing would increase health-related quality of life (HRQOL). Ninety-six Chinese breast cancer survivors were randomly assigned to 1 of 3 writing conditions: a self-regulation group, an emotional disclosure group, or a cancer-fact group. The self-regulation group wrote about one's deepest feelings and coping efforts in addition to finding benefits from their cancer experience. The emotional disclosure group wrote about one's deepest thoughts and feelings. The cancer-fact group wrote about facts relevant to their cancer experience. HRQOL was assessed by FACT-B at baseline, 1, 3, and 6-month follow-ups. Effect sizes and residual zed change models were used to compare group differences in HRQOL. Contrary to expectations, the cancer-fact group reported the highest level of overall quality of life at the 6-month follow-up. The self-regulation group had higher emotional well-being compared to the emotional disclosure group. The study challenges the implicit assumption that psychosocial interventions validated among Non-Hispanic Whites could be directly generalized to other populations. It suggests that Asians may benefit from writing instructions facilitating more cognitive than emotional processes. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Differential gene expression between African American and European American colorectal cancer patients.

Directory of Open Access Journals (Sweden)

Biljana Jovov

Full Text Available The incidence and mortality of colorectal cancer (CRC is higher in African Americans (AAs than other ethnic groups in the U. S., but reasons for the disparities are unknown. We performed gene expression profiling of sporadic CRCs from AAs vs. European Americans (EAs to assess the contribution to CRC disparities. We evaluated the gene expression of 43 AA and 43 EA CRC tumors matched by stage and 40 matching normal colorectal tissues using the Agilent human whole genome 4x44K cDNA arrays. Gene and pathway analyses were performed using Significance Analysis of Microarrays (SAM, Ten-fold cross validation, and Ingenuity Pathway Analysis (IPA. SAM revealed that 95 genes were differentially expressed between AA and EA patients at a false discovery rate of ≤5%. Using IPA we determined that most prominent disease and pathway associations of differentially expressed genes were related to inflammation and immune response. Ten-fold cross validation demonstrated that following 10 genes can predict ethnicity with an accuracy of 94%: CRYBB2, PSPH, ADAL, VSIG10L, C17orf81, ANKRD36B, ZNF835, ARHGAP6, TRNT1 and WDR8. Expression of these 10 genes was validated by qRT-PCR in an independent test set of 28 patients (10 AA, 18 EA. Our results are the first to implicate differential gene expression in CRC racial disparities and indicate prominent difference in CRC inflammation between AA and EA patients. Differences in susceptibility to inflammation support the existence of distinct tumor microenvironments in these two patient populations.

2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer

Science.gov (United States)

Alexander, Erik K.; Bible, Keith C.; Doherty, Gerard M.; Mandel, Susan J.; Nikiforov, Yuri E.; Pacini, Furio; Randolph, Gregory W.; Sawka, Anna M.; Schlumberger, Martin; Schuff, Kathryn G.; Sherman, Steven I.; Sosa, Julie Ann; Steward, David L.; Tuttle, R. Michael; Wartofsky, Leonard

2016-01-01

Background: Thyroid nodules are a common clinical problem, and differentiated thyroid cancer is becoming increasingly prevalent. Since the American Thyroid Association's (ATA's) guidelines for the management of these disorders were revised in 2009, significant scientific advances have occurred in the field. The aim of these guidelines is to inform clinicians, patients, researchers, and health policy makers on published evidence relating to the diagnosis and management of thyroid nodules and differentiated thyroid cancer. Methods: The specific clinical questions addressed in these guidelines were based on prior versions of the guidelines, stakeholder input, and input of task force members. Task force panel members were educated on knowledge synthesis methods, including electronic database searching, review and selection of relevant citations, and critical appraisal of selected studies. Published English language articles on adults were eligible for inclusion. The American College of Physicians Guideline Grading System was used for critical appraisal of evidence and grading strength of recommendations for therapeutic interventions. We developed a similarly formatted system to appraise the quality of such studies and resultant recommendations. The guideline panel had complete editorial independence from the ATA. Competing interests of guideline task force members were regularly updated, managed, and communicated to the ATA and task force members. Results: The revised guidelines for the management of thyroid nodules include recommendations regarding initial evaluation, clinical and ultrasound criteria for fine-needle aspiration biopsy, interpretation of fine-needle aspiration biopsy results, use of molecular markers, and management of benign thyroid nodules. Recommendations regarding the initial management of thyroid cancer include those relating to screening for thyroid cancer, staging and risk assessment, surgical management, radioiodine remnant ablation and therapy

AIDSCAP initiative. Innovation in NGO capacity building: Tanzania AIDS project.

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Dadian, M J

1998-01-01

Tanzania has since the mid-1980s experienced some of the highest rates of HIV infection in the world, with data now showing the mean levels of HIV seroprevalence nationwide to be greater than 13%, and even higher than 30% in some districts. By 2000, as many as 2.4 million Tanzanians will be infected with HIV and more than 850,000 Tanzanian children will be orphaned by the epidemic. The Tanzania AIDS Project (TAP), funded by the US Agency for International Development (USAID), was implemented through the AIDS Control and Prevention (AIDSCAP) Project by Family Health International (FHI) during 1993-97. TAP will receive support throughout 1998 through a cooperative agreement between USAID and FHI. Nongovernmental organization (NGO) representatives meet on a regular basis in Dar es Salaam and in 8 other regions of the country to plan and coordinate the major aspects of TAP's HIV/AIDS prevention activities in each area. The author describes the evolution of the idea to bring NGOs together into geographic clusters, the diversity of talents enjoyed from using the cluster concept, building institutional capacity, the challenges facing TAP's 9 clusters, and working with traditional communities.

Managing One's Symptoms: A Qualitative Study of Low-Income African Americans With Advanced Cancer.

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Yeager, Katherine A; Sterk, Claire E; Quest, Tammie E; DiIorio, Colleen; Vena, Catherine; Bauer-Wu, Susan

2016-01-01

African Americans endure disproportionately high advanced cancer rates and also are disproportionately represented in the lower socioeconomic strata. These individuals work to manage symptoms in order to function and have a satisfactory quality of life. The purpose of this study was to discover what low-income African American adults with advanced cancer do on a day-to-day basis to relieve and manage symptoms. This study viewed the individuals as experts and asked them not what they are told to do, but rather what they actually do. A purposive sample of 27 individuals participated in semistructured interviews conducted by 2 research interviewers. This qualitative descriptive approach used content analysis to develop themes to describe symptom self-management. Participants described 2 approaches: making continual adjustments and finding stability through spirituality. In seeking comfort from the distress of their symptoms, they were constantly altering their activities and fine-tuning strategies. They adjusted medical regimens and changed the speed and selection of daily activities, including comfort measures and diet modifications. In contrast, their spirituality was a consistent presence in their lives that provided balance to their unstable symptom experience. This study illustrates that people with advanced cancer actively engage in multiple complex self-management strategies in response to symptoms. As providers assess how individuals manage their symptoms, they must find ways to support those efforts. Providers then will recognize the challenges faced by advanced cancer patients in obtaining the best quality of life while managing multiple symptoms, activities, and family responsibilities.

Quality of Life in Community-Dwelling Chinese American Patients with Cancer Pain.

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Barrett, Malcolm; Chu, Alice; Chen, Jack; Lam, Kin Yui; Portenoy, Russell; Dhingra, Lara

2017-12-01

Although pain can be a powerful influence on health-related quality of life (HRQL) in cancer populations, culturally-based beliefs and behaviors may directly impact HQRL or modify the association between pain and HQRL. Studies of well-defined ethnic groups may clarify these relationships and inform culturally competent clinical practices intended to reduce illness burden. We evaluated HRQL in 121 non-English-speaking Chinese immigrants with cancer pain using the Functional Assessment of Cancer Therapy-General (FACT-G) scale. Overall, 91.2 % were born in China and 86.0 % were Cantonese-speaking; 50.8 % had no formal education (mean age = 63.2 years; 68.6 % women). Although the mean FACT-G score did not differ from U.S. population norms, most subscale scores for Chinese immigrants were lower and the score for social/family well-being was higher (all p social/family well-being is preserved. Future studies in the growing population of Chinese Americans with cancer are needed to evaluate various aspects of social/family well-being and determine whether they modify the association between pain and HRQL.

The Meaning of Incontinence and Impotence for Low Income African-American and Latino Men with Prostate Cancer

National Research Council Canada - National Science Library

Maliski, Sally L; Litwin, Mark S

2006-01-01

.... Preliminary common categories between the Latino and African American men included erectile dysfunction and incontinence were the price that had to be paid to cure cancer, trusting God as a means...

The Meaning of Incontinence and Impotence for Low Income African-American and Latino Men with Prostate Cancer

National Research Council Canada - National Science Library

Maliski, Sally L; Litwin, Mark S

2005-01-01

.... Preliminary common categories between the Latino and African American men included erectile dysfunction and incontinence were the price that had to be paid to cure cancer, trusting God as a means...

Genetic Alterations in Prostate Cancers among African American Men and Comparisons with Cancers from European and Asian Patients

Science.gov (United States)

2016-10-01

ERG (T_E) that creates the fusion of these two genes. Preliminary result analysis suggests that the tumor genome of African American PCa may harbor a...Table 1) that creates the fusion of these two genes, as this fusion is one of the most common somatically acquired changes of genomic structure in...based molecular markers for predication of cancer progression. To evaluate the feasibility of using DNA from FFPE samples, we performed exploratory

Prostate cancer screening practices of African-American and non-African-American US primary care physicians: a cross-sectional survey

Directory of Open Access Journals (Sweden)

Richards TB

2012-09-01

Full Text Available Thomas B Richards,1 Sun Hee Rim,1 Ingrid J Hall,1 Lisa C Richardson,1 Louie E Ross21Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA; 2North Carolina A and T State University, Greensboro, NC, USAPurpose: We explored whether African-American (AA primary care physicians (PCPs have different prostate cancer screening practices compared to non-AA PCPs, after adjustment for potential confounding factors such as the proportion of AA patients in PCP practices.Methods: We used SAS/SUDAAN to compare weighted responses from AA PCPs (n = 604 with those from non-AA PCPs (n = 647 in the 2007–2008 National Survey of Primary Care Physician Practices Regarding Prostate Cancer Screening. We used multivariate logistic regression to calculate the weighted odds ratios (OR and 95% confidence intervals (CI.Results: We found that AA PCPs had higher odds of working in practices with above-the-median (≥21% proportions of AA male patients (OR, 9.02; 95% CI: 5.85–13.91. A higher proportion of AA PCPs (53.5%; 95% CI: 49.5–57.4 reported an above-the-median proportion (≥91% of PSA testing during health maintenance exams as compared to non-AA PCPs (39.4%; 95% CI: 35.5–43.4; P < 0.0002. After adjusting for the proportion of AA patients and other factors, we found that AA PCPs had higher odds of using PSA tests to screen men (OR, 1.74; 95% CI: 1.11–2.73.Conclusion: This study quantifies the magnitude of the differences reported in previous focus group studies. Our results may be helpful in hypothesis generation and in planning future research studies.Keywords: African-American, physician practice patterns, prostate-specific antigen, screening tests

Screening for ATM Mutations in an African-American Population to Identify a Predictor of Breast Cancer Susceptibility

National Research Council Canada - National Science Library

Rosenstein, Barry S

2006-01-01

The hypothesis being tested in this project is that a greater proportion of African-Americans with breast cancer harbor a specific germline genetic alteration in the ATM gene or possess a particular...

Conference Report: "Health Policy and Programs Evaluative Research for Social Change". An Ibero-American Symposium

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Francisco Mercado-Martínez

2008-05-01

Full Text Available This is a report of the "Health Policy and Programs Evaluative Research for Social Change" Ibero-American Symposium held in Guadalajara, Mexico November 1-3, 2006. Attendees represented eight countries, and were associated with NGO's and academic and health services organizations. The most important themes included in the debates were the meaning of qualitative and evaluative health research for social change, the challenges of teaching for change, ethical challenges, and possibilities for making the findings of qualitative research available to different groups or stakeholders (users, policy makers, professionals, and the population as a whole. URN: urn:nbn:de:0114-fqs0802194

Using Cognitive Testing to Develop Items for Surveying Asian American Cancer Patients and Their Caregivers as a Pathway to Culturally Competent Care.

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Bolcic-Jankovic, Dragana; Lu, Fengxin; Colten, Mary Ellen; McCarthy, Ellen P

2016-02-01

We report the results from cognitive interviews with Asian American patients and their caregivers. We interviewed seven caregivers and six patients who were all bilingual Asian Americans. The main goal of the cognitive interviews was to test a survey instrument developed for a study about perspectives of Asian American patients with advanced cancer who are facing decisions around end-of-life care. We were particularly interested to see whether items commonly used in White and Black populations are culturally meaningful and equivalent in Asian populations, primarily those of Chinese and Vietnamese ethnicity. Our exploration shows that understanding respondents' language proficiency, degree of acculturation, and cultural context of receiving, processing, and communicating information about medical care can help design questions that are appropriate for Asian American patients and caregivers, and therefore can help researchers obtain quality data about the care Asian American cancer patients receive. © The Author(s) 2016.

2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer

OpenAIRE

Haugen, Bryan R; Alexander, Erik K; Bible, Keith C; Doherty, Gerard M; Mandel, Susan J; Nikiforov, Yuri E; Pacini, Furio; Randolph, Gregory W; Sawka, Anna M; Schlumberger, Martin; Schuff, Kathryn G; Sherman, Steven I; Sosa, Julie Ann; Steward, David L; Tuttle, R. Michael

2016-01-01

Background: Thyroid nodules are a common clinical problem, and differentiated thyroid cancer is becoming increasingly prevalent. Since the American Thyroid Association's (ATA's) guidelines for the management of these disorders were revised in 2009, significant scientific advances have occurred in the field. The aim of these guidelines is to inform clinicians, patients, researchers, and health policy makers on published evidence relating to the diagnosis and management of thyroid nodules and d...

Unintended effects of emphasizing disparities in cancer communication to African-Americans.

Science.gov (United States)

Nicholson, Robert A; Kreuter, Matthew W; Lapka, Christina; Wellborn, Rachel; Clark, Eddie M; Sanders-Thompson, Vetta; Jacobsen, Heather M; Casey, Chris

2008-11-01

Little is known about how minority groups react to public information that highlights racial disparities in cancer. This double-blind randomized study compared emotional and behavioral reactions to four versions of the same colon cancer (CRC) information presented in mock news articles to a community sample of African-American adults (n = 300). Participants read one of four articles that varied in their framing and interpretation of race-specific CRC mortality data, emphasizing impact (CRC is an important problem for African-Americans), two dimensions of disparity (Blacks are doing worse than Whites and Blacks are improving, but less than Whites), or progress (Blacks are improving over time). Participants exposed to disparity articles reported more negative emotional reactions to the information and were less likely to want to be screened for CRC than those in other groups (both P emotional reactions and participants were more likely to want to be screened. Moreover, negative emotional reaction seemed to mediate the influence of message type on individuals wanting to be screened for CRC. Overall, these results suggest that the way in which disparity research is reported in the medium can influence public attitudes and intentions, with reports about progress yielding a more positive effect on intention. This seems especially important among those with high levels of medical mistrust who are least likely to use the health care system and are thus the primary target of health promotion advertising.

Innate Immunity Pathways and Breast Cancer Risk in African American and European-American Women in the Women’s Circle of Health Study (WCHS)

Science.gov (United States)

Gong, Zhihong; Quan, Lei; Yao, Song; Zirpoli, Gary; Bandera, Elisa V.; Roberts, Michelle; Coignet, Jean-Gabriel; Cabasag, Citadel; Sucheston, Lara; Hwang, Helena; Ciupak, Gregory; Davis, Warren; Pawlish, Karen; Jandorf, Lina; Bovbjerg, Dana H.; Ambrosone, Christine B.; Hong, Chi-Chen

2013-01-01

African American (AA) women are more likely than European American (EA) women to be diagnosed with early, aggressive breast cancer. Possible differences in innate immune pathways (e.g., inflammatory responses) have received little attention as potential mechanisms underlying this disparity. We evaluated distributions of selected genetic variants in innate immune pathways in AA and EA women, and examined their associations with breast cancer risk within the Women’s Circle of Health Study (WCHS). In stage I of the study (864 AA and 650 EA women) we found that genotype frequencies for 35 of 42 tested SNPs (18 candidate genes) differed between AAs and EAs (corroborated by ancestry informative markers). Among premenopausal AA women, comparing variant allele carriers to non-carriers, reduced breast cancer risk was associated with CXCL5-rs425535 (OR=0.61, P=0.02), while among EA women, there were associations with TNFA-rs1799724 (OR =2.31, P =0.002) and CRP-rs1205 (OR=0.54, P=0.01). For postmenopausal women, IL1B-rs1143627 (OR=1.80, P=0.02) and IL1B-rs16944 (OR=1.85, P =0.02) were associated with risk among EA women, with significant associations for TNFA-rs1799724 limited to estrogen receptor (ER) positive cancers (OR=2.0, P =0.001). However, none of the SNPs retained significance after Bonferroni adjustment for multiple testing at the level of P0.0012 (0.05/42) except for TNFA-rs1799724 in ER positive cancers. In a stage II validation (1,365 AA and 1,307 EA women), we extended evaluations for four SNPs (CCL2-rs4586, CRP-rs1205, CXCL5-rs425535, and IL1RN-rs4251961), which yielded similar results. In summary, distributions of variants in genes involved in innate immune pathways were found to differ between AA and EA populations, and showed differential associations with breast cancer according to menopausal or ER status. These results suggest that immune adaptations suited to ancestral environments may differentially influence breast cancer risk among EA and AA women

Dietary Fat and Vitamin E in Prostate Cancer Risk Among African Americans and Africans: A Case-Control Study

National Research Council Canada - National Science Library

Ukoli, Flora A; Smith, Ernest; Malin, Alecia; Zhao, Barbara; Osime, Usifo; Stain, Steven

2006-01-01

The role of dietary fat and vitamin E in prostate cancer risk among African-Americans, African migrants and Africans is being investigated using a dietary assessment tool and by measuring plasma fatty...

Cervical cancer incidence and mortality among American Indian and Alaska Native women, 1999-2009.

Science.gov (United States)

Watson, Meg; Benard, Vicki; Thomas, Cheryll; Brayboy, Annie; Paisano, Roberta; Becker, Thomas

2014-06-01

We analyzed cervical cancer incidence and mortality data in American Indian and Alaska Native (AI/AN) women compared with women of other races. We improved identification of AI/AN race, cervical cancer incidence, and mortality data using Indian Health Service (IHS) patient records; our analyses focused on residents of IHS Contract Health Service Delivery Area (CHSDA) counties. Age-adjusted incidence and death rates were calculated for AI/AN and White women from 1999 to 2009. AI/AN women in CHSDA counties had a death rate from cervical cancer of 4.2, which was nearly twice the rate in White women (2.0; rate ratio [RR] = 2.11). AI/AN women also had higher incidence rates of cervical cancer compared with White women (11.0 vs 7.1; RR = 1.55) and were more often diagnosed with later-stage disease (RR = 1.84 for regional stage and RR = 1.74 for distant stage). Death rates decreased for AI/AN women from 1990 to 1993 (-25.8%/year) and remained stable thereafter. Although rates decreased over time, AI/AN women had disproportionately higher cervical cancer incidence and mortality. The persistently higher rates among AI/AN women compared with White women require continued improvements in identifying and treating cervical cancer and precancerous lesions.

Reference values of the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being: a report from the American Cancer Society's studies of cancer survivors.

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Munoz, Alexis R; Salsman, John M; Stein, Kevin D; Cella, David

2015-06-01

Health-related quality of life measures are common in oncology research, trials, and practice. Spiritual well-being has emerged as an important aspect of health-related quality of life and the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being; The 12-item Spiritual Well-Being Scale (FACIT-Sp-12) is the most widely used measure of spiritual well-being among those with cancer. However, there is an absence of reference values with which to facilitate the interpretation of scores in research and clinical practice. The objective of the current study was to provide FACIT-Sp-12 reference values from a representative sample of adult cancer survivors. As part of the American Cancer Society's Study of Cancer Survivors-II, a national cross-sectional study of cancer survivors (8864 survivors) completed questionnaires assessing demographic characteristics, clinical information, and the FACIT-Sp-12. Scores were calculated and summarized by FACIT-Sp-12 subscale and total scores across age, sex, race/ethnicity, time after treatment, and cancer type. Student t tests for independent samples found that women reported significantly higher FACIT-Sp-12 scores (P<.001). Analyses of variance found significant main effects for FACIT-Sp-12 scores by age (P<.01), race/ethnicity (P<.05), and cancer type (P<.001). Post hoc comparisons revealed that older adults (those aged 60-69 years and 70-79 years) and black non-Hispanic individuals reported the highest FACIT-Sp-12 scores compared with those aged 18 to 39 years (P<.05; Cohen d [an effect size used to indicate the standardized difference between 2 means], 0.20-0.50) and white non-Hispanic individuals (P<.05; Cohen d, 0.02-0.62), respectively. All other significant main effects were small in magnitude (effect size range, 0.001-0.032). These data will aid in the interpretation of the magnitude and meaning of FACIT-Sp-12 scores, and allow for comparisons of scores across studies. © 2015 American Cancer Society.

A novel genomic alteration of LSAMP associates with aggressive prostate cancer in African American men

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Gyorgy Petrovics

2015-12-01

Full Text Available Evaluation of cancer genomes in global context is of great interest in light of changing ethnic distribution of the world population. We focused our study on men of African ancestry because of their disproportionately higher rate of prostate cancer (CaP incidence and mortality. We present a systematic whole genome analyses, revealing alterations that differentiate African American (AA and Caucasian American (CA CaP genomes. We discovered a recurrent deletion on chromosome 3q13.31 centering on the LSAMP locus that was prevalent in tumors from AA men (cumulative analyses of 435 patients: whole genome sequence, 14; FISH evaluations, 101; and SNP array, 320 patients. Notably, carriers of this deletion experienced more rapid disease progression. In contrast, PTEN and ERG common driver alterations in CaP were significantly lower in AA prostate tumors compared to prostate tumors from CA. Moreover, the frequency of inter-chromosomal rearrangements was significantly higher in AA than CA tumors. These findings reveal differentially distributed somatic mutations in CaP across ancestral groups, which have implications for precision medicine strategies.

Genetic variations in vitamin D-related pathways and breast cancer risk in African American women in the AMBER consortium

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Yao, Song; Haddad, Stephen A.; Hu, Qiang; Liu, Song; Lunetta, Kathryn L.; Ruiz-Narvaez, Edward A.; Hong, Chi-Chen; Zhu, Qianqian; Sucheston-Campbell, Lara; Cheng, Ting-Yuan David; Bensen, Jeannette T.; Johnson, Candace S.; Trump, Donald L.; Haiman, Christopher A.; Olshan, Andrew F.; Palmer, Julie R.; Ambrosone, Christine B.

2016-01-01

Studies of genetic variations in vitamin D-related pathways and breast cancer risk have been conducted mostly in populations of European ancestry, and only sparsely in African Americans (AA), who are known for a high prevalence of vitamin D deficiency. We analyzed 24,445 germline variants in 63 genes from vitamin D-related pathways in the African American Breast Cancer Epidemiology and Risk (AMBER) consortium, including 3,663 breast cancer cases and 4,687 controls. Odds ratios (OR) were derived from logistic regression models for overall breast cancer, by estrogen receptor (ER) status (1,983 ER positive and 1,098 ER negative), and for case-only analyses of ER status. None of the three vitamin D-related pathways were associated with breast cancer risk overall or by ER status. Gene-level analyses identified associations with risk for several genes at a nominal p ≤ 0.05, particularly for ER− breast cancer, including rs4647707 in DDB2. In case-only analyses, vitamin D metabolism and signaling pathways were associated with ER− cancer (pathway-level p = 0.02), driven by a single gene CASR (gene-level p = 0.001). The top SNP in CASR was rs112594756 (p = 7 × 10−5, gene-wide corrected p = 0.01), followed by a second signal from a nearby SNP rs6799828 (p = 1 × 10−4, corrected p = 0.03). In summary, several variants in vitamin D pathways were associated with breast cancer risk in AA women. In addition, CASR may be related to tumor ER status, supporting a role of vitamin D or calcium in modifying breast cancer phenotypes. PMID:26650177

A culturally adapted family intervention for African American families coping with parental cancer: outcomes of a pilot study.

Science.gov (United States)

Davey, Maureen P; Kissil, Karni; Lynch, Laura; Harmon, La-Rhonda; Hodgson, Nancy

2013-07-01

The primary objective of this 2-year pilot study was to evaluate the effectiveness of a culturally adapted family intervention in improving family communication among African American parents coping with cancer and their school-age children. A secondary objective was to determine its impact on other symptoms of psychosocial distress (depression and anxiety). The third objective was to assess for acceptability and feasibility. Using a two-arm pre-intervention and post-intervention prospective design, 12 African American families received five bi-monthly sessions of either a culturally adapted family intervention (n=7 families) or psycho-education treatment (n=5 families). Parents and their children completed pre-intervention and post-intervention questionnaires assessing perceptions of family communication, quality of their relationship, and symptoms of depression. School-age children additionally completed a questionnaire assessing their levels of anxiety. Consumer satisfaction was also evaluated at post-intervention. Parents and school-age children who completed the culturally adapted family intervention reported significantly better communication with each other and were more satisfied compared with the psycho-education control group. No changes were noted in symptoms of anxiety or depression. The culturally adapted family intervention was acceptable based on our findings, families' feedback, and rates of retention. Feasibility is uncertain because our oncology clinic approach to recruitment was slower than expected. Providing culturally adapted family intervention programs to African American families who are coping with parental cancer may result in improved family communication. This pilot study serves as the first step in the development of culturally adapted family intervention programs to help African American families cope with parental cancer. Copyright © 2012 John Wiley & Sons, Ltd.

Context matters in NGO-government contracting for health service delivery: a case study from Pakistan.

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Zaidi, Shehla; Mayhew, Susannah H; Cleland, John; Green, Andrew T

2012-10-01

Contracting non-governmental organizations (NGOs) for health service provision is gaining increasing importance in low- and middle-income countries. However, the role of the wider context in influencing the effectiveness of contracting is not well studied and is of relevance given that contracting has produced mixed results so far. This paper applies a policy analysis approach to examine the influence of policy and political factors on contracting origin, design and implementation. Evidence is drawn from a country case study of Pakistan involving extensive NGO contracting for human immunodeficiency virus (HIV) prevention services supported by international donor agencies. A multilevel study was conducted using 84 in-depth interviews, 22 semi-structured interviews, document review and direct observation to examine the national policy design, provincial management of contracting and local contract implementation. There were three main findings. First, contracting origin and implementation was an inherently political process affected by the wider policy context. Although in Pakistan a combination of situational events successfully managed to introduce extensive and sophisticated contracting, it ran into difficulties during implementation due to ownership and capacity issues within government. Second, wide-scale contracting was mis-matched with the capacity of local NGOs, which resulted in sub-optimal contract implementation challenging the reliance on market simulation through contracting. Third, we found that contracting can have unintended knock-on effects on both providers and purchasers. As a result of public sector contracts, NGOs became more distanced from their grounded attributes. Effects on government purchasers were more unpredictable, with greater identification with contracting in supportive governance contexts and further distancing in unsupportive contexts. A careful approach is needed in government contracting of NGOs, taking into account acceptance of

Pathological and Biochemical Outcomes among African-American and Caucasian Men with Low Risk Prostate Cancer in the SEARCH Database: Implications for Active Surveillance Candidacy.

Science.gov (United States)

Leapman, Michael S; Freedland, Stephen J; Aronson, William J; Kane, Christopher J; Terris, Martha K; Walker, Kelly; Amling, Christopher L; Carroll, Peter R; Cooperberg, Matthew R

2016-11-01

Racial disparities in the incidence and risk profile of prostate cancer at diagnosis among African-American men are well reported. However, it remains unclear whether African-American race is independently associated with adverse outcomes in men with clinical low risk disease. We retrospectively analyzed the records of 895 men in the SEARCH (Shared Equal Access Regional Cancer Hospital) database in whom clinical low risk prostate cancer was treated with radical prostatectomy. Associations of African-American and Caucasian race with pathological biochemical recurrence outcomes were examined using chi-square, logistic regression, log rank and Cox proportional hazards analyses. We identified 355 African-American and 540 Caucasian men with low risk tumors in the SEARCH cohort who were followed a median of 6.3 years. Following adjustment for relevant covariates African-American race was not significantly associated with pathological upgrading (OR 1.33, p = 0.12), major upgrading (OR 0.58, p = 0.10), up-staging (OR 1.09, p = 0.73) or positive surgical margins (OR 1.04, p = 0.81). Five-year recurrence-free survival rates were 73.4% in African-American men and 78.4% in Caucasian men (log rank p = 0.18). In a Cox proportional hazards analysis model African-American race was not significantly associated with biochemical recurrence (HR 1.11, p = 0.52). In a cohort of patients at clinical low risk who were treated with prostatectomy in an equal access health system with a high representation of African-American men we observed no significant differences in the rates of pathological upgrading, up-staging or biochemical recurrence. These data support continued use of active surveillance in African-American men. Upgrading and up-staging remain concerning possibilities for all men regardless of race. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

"No God and no Norway": collective resource loss among members of Tamil NGO's in Norway during and after the last phase of the civil war in Sri Lanka.

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Guribye, Eugene

2011-08-17

Studies on the mental health of refugees have tended to focus upon the impact of traumatic experiences in the country of origin, and acculturation processes in exile. The effects of crises in the country of origin on refugees living in exile have been little studied. This article examines how the final stages of the civil war in Sri Lanka in 2009 influenced members of pro-LTTE Tamil NGO's in Norway. Ethnographic fieldwork methods were employed within Tamil NGO's in the two largest cities in Norway between November 2008 and June 2011. The findings suggest that collective resources became severely drained as a result of the crisis, severely disrupting the fabric of social life. Public support from the majority community remained scarce throughout the crisis. The study suggests that there is a need for public support to exile groups indirectly affected by man-made crises in their country of origin.

Results of a lay health education intervention to increase colorectal cancer screening among Filipino Americans: A cluster randomized controlled trial.

Science.gov (United States)

Cuaresma, Charlene F; Sy, Angela U; Nguyen, Tung T; Ho, Reginald C S; Gildengorin, Ginny L; Tsoh, Janice Y; Jo, Angela M; Tong, Elisa K; Kagawa-Singer, Marjorie; Stewart, Susan L

2018-04-01

Filipino colorectal cancer (CRC) screening rates fall below Healthy People 2020 goals. In this study, the authors explore whether a lay health educator (LHE) approach can increase CRC screening among Filipino Americans ages 50 to 75 years in Hawai'i. A cluster randomized controlled trial from 2012 through 2015 compared an intervention, which consisted of LHEs delivering 2 education sessions and 2 telephone follow-up calls on CRC screening plus a CRC brochure versus an attention control, in which 2 lectures and 2 follow-up calls on nutrition and physical activity plus a CRC brochure were provided. The primary outcome was change in self-reported ever receipt of CRC screening at 6 months. Among 304 participants (77% women, 86% had > 10 years of residence in the United States), the proportion of participants who reported ever having received CRC screening increased significantly in the intervention group (from 80% to 89%; P = .0003), but not in the control group (from 73% to 74%; P = .60). After covariate adjustment, there was a significant intervention effect (odds ratio, 1.9; 95% confidence interval, 1.0-3.5). There was no intervention effect on up-to-date screening. This first randomized controlled trial for CRC screening among Hawai'i's Filipinos used an LHE intervention with mixed, but promising, results. Cancer 2018;124:1535-42. © 2018 American Cancer Society. © 2018 American Cancer Society.

Dietary Fat and Vitamin E in Prostate Cancer Risk Among African Americans and Africans: A Case-Control Study

National Research Council Canada - National Science Library

Ukoli, Flora A. M

2007-01-01

.... In 2002 the scope of the study was expanded to include African-Americans and African migrants in the United States so as to investigate the role of dietary nutrients associated with increased prostate cancer risk (fatty acids...

Effects of Perceived Discrimination and Trust on Breast Cancer Screening among Korean American Women.

Science.gov (United States)

Hong, Hye Chong; Ferrans, Carol Estwing; Park, Chang; Lee, Hyeonkyeong; Quinn, Lauretta; Collins, Eileen G

Korean American (KA) women continue to have lower breast cancer screening rates than other racial groups. Perceived discrimination and trust have been associated with breast cancer screening adherence, but little is known about the associations in KA women. Surveys were completed by 196 KA women in the Chicago metropolitan area. Multiple and Firth logistic regression analyses were performed to identify factors (perceived discrimination, trust, acculturation, cultural beliefs, health care access) influencing breast cancer screening adherence (mammogram). In addition, SPSS macro PROCESS was used to examine the mediating role of trust between perceived discrimination and breast cancer screening adherence. Ninety-three percent of the women surveyed had health insurance and 54% reported having a mammogram in the past 2 years. Predictors of having a mammogram were knowing where to go for a mammogram, having a regular doctor or usual place for health care, greater trust in health care providers, and lower distrust in the health care system. Perceived discrimination had an indirect effect on breast cancer screening through trust. The breast cancer screening rate among KA women is low. Perceived discrimination in health care, trust in health care providers, and distrust in the health care system directly or indirectly influenced breast cancer screening adherence in KA women. Trust is a factor that can be strengthened with educational interventions. Copyright © 2017 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Obstacles to the Primary and Secondary Prevention of Breast Cancer in African-American Women.

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1997-10-01

Lauver, D. (1994). Care-seeking behavior with breast cancer symptoms in Caucasian and African-American women. Research in Nursing and Health, 17, 421...Disorders the Journal of Treatment and Prevention, 4, 47-5 8. 181. Waller, G. & Hodgson, S. (1996). Body image distortion in anorexia and bulimia ...1996). Body image distortion in anorexia and bulimia nervosa: the role of perceived and actual control. Journal of Nervous and Mental Disease, 184

Dietary Fat and Vitamin E in Prostate Cancer Risk Among African Americans and West Africans: A Case-Control Study

National Research Council Canada - National Science Library

Ukoli, Flora A; Smith, Ernest; Malin, Alecia; Zhao, Barbara; Osime, Usifo; Stain, Steven

2005-01-01

The role of dietary fat and vitamin E in prostate cancer risk among African-Americans, African migrants and Africans is being investigated using a dietary assessment tool and by measuring plasma fatty...

Perceived experiences of discrimination in health care: a barrier for cancer screening among American Indian women with type 2 diabetes.

Science.gov (United States)

Gonzales, Kelly L; Harding, Anna K; Lambert, William E; Fu, Rongwei; Henderson, William G

2013-01-01

Breast and cervical cancer-mortality disparities are prominent among American Indian women. These disparities, in part, may result from patients perceived experiences of discrimination in health care. This report evaluates the impact of perceived discrimination on screening for breast and cervical cancer in a sample of 200 American Indian women with type 2 diabetes. Data were collected from patient report and medical records. Prevalence of breast and cervical cancer screening were assessed. Unadjusted and adjusted logistic regression analyses were used to assess associations between perceived discrimination, cancer screening status, and patients' health care-seeking behaviors. Substantial proportions of AI women in our sample were behind the recommended schedules of screening for breast and cervical cancer. Adjusted estimates revealed that perceived discrimination was significantly associated with not being current for clinical breast examination and Pap test, and was close to statistical significance with not being current for mammography. The number of suboptimal health care-seeking behaviors increased with higher mean levels of perceived discrimination. Among AI women, perceived discrimination in health care may negatively influence use of breast and cancer screening services, and health care-seeking behaviors. More research is needed among AIs to examine features of health care systems related to the phenomenon patients perceived experience of discrimination. Copyright © 2013 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

The influence of mistrust, racism, religious participation, and access to care on patient satisfaction for African American men: the North Carolina-Louisiana Prostate Cancer Project.

Science.gov (United States)

Moore, Angelo D; Hamilton, Jill B; Knafl, George J; Godley, P A; Carpenter, William R; Bensen, Jeannette T; Mohler, James L; Mishel, Merle

2013-01-01

The purpose of this study was to explore whether a particular combination of individual characteristics influences patient satisfaction with the health care system among a sample of African American men in North Carolina with prostate cancer. Patient satisfaction may be relevant for improving African American men's use of regular care, thus improving the early detection of prostate cancer and attenuating racial disparities in prostate cancer outcomes. This descriptive correlation study examined relationships of individual characteristics that influence patient satisfaction using data from 505 African American men from North Carolina, who prospectively enrolled in the North Carolina-Louisiana Prostate Cancer Project from September 2004 to November 2007. Analyses consisted of univariate statistics, bivariate analysis, and multiple regression analysis. The variables selected for the final model were: participation in religious activities, mistrust, racism, and perceived access to care. In this study, both cultural variables, mistrust (p=racism (p=racism are cultural factors that are extremely important and have been negatively associated with patient satisfaction and decreased desires to utilize health care services for African American men. To overcome barriers in seeking health care services, health care providers need to implement a patient-centered approach by creating a clinical environment that demonstrates cultural competence and eliminating policies, procedures, processes, or personnel that foster mistrust and racism.

Novel Recruitment Techniques for a Study of Culture-Specific Diet, Metabolic Variability, and Breast Cancer Risk in African-American Women

National Research Council Canada - National Science Library

Ambrosone, Christine

2000-01-01

Little is known regarding explanations for racial disparities in breast cancer incidence among younger women and tumor aggressiveness, perhaps because of the difficulty in enrolling African-Americans...

Novel Recruitment Techniques for a Study of Culture-Specific Diet, Metabolic Variability and Breast Cancer Risk in African-American Women

National Research Council Canada - National Science Library

Ambrosone, Christine

1999-01-01

Little is known regarding explanations for racial disparities in breast cancer incidence among younger women and tumor agressiveness, perhaps because of the difficulty in enrolling African-Americans...

Employing the church as a marketer of cancer prevention: a look at a health promotion project aimed to reduce colorectal cancer among African Americans in the Midwest.

Science.gov (United States)

Lumpkins, Crystal Y; Coffey, Candice R; Daley, Christine M; Greiner, K Allen

2013-01-01

Health promotion programs designed to address colorectal cancer disparities among African Americans are increasing. Unfortunately, this group still shoulders a disproportionate mortality burden in the United States; these numbers are also reflective of colorectal cancer (CRC) disparities in the Midwest. The purpose of this study was to extrapolate results from in-depth interviews and brief surveys on the effectiveness of the church as a social marketer of CRC-prevention messages. Results show that pastors believe the congregation has limited knowledge about CRC risk and prevention; they also believe the church can improve cancer-prevention communication among members and those affiliated with the church.

"No God and no Norway": collective resource loss among members of Tamil NGO's in Norway during and after the last phase of the civil war in Sri Lanka

Directory of Open Access Journals (Sweden)

Guribye Eugene

2011-08-01

Full Text Available Abstract Background Studies on the mental health of refugees have tended to focus upon the impact of traumatic experiences in the country of origin, and acculturation processes in exile. The effects of crises in the country of origin on refugees living in exile have been little studied. This article examines how the final stages of the civil war in Sri Lanka in 2009 influenced members of pro-LTTE Tamil NGO's in Norway. Method Ethnographic fieldwork methods were employed within Tamil NGO's in the two largest cities in Norway between November 2008 and June 2011. Results The findings suggest that collective resources became severely drained as a result of the crisis, severely disrupting the fabric of social life. Public support from the majority community remained scarce throughout the crisis. Conclusions The study suggests that there is a need for public support to exile groups indirectly affected by man-made crises in their country of origin.

Optimism, Social Support, and Adjustment in African American Women with Breast Cancer

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Shelby, Rebecca A.; Crespin, Tim R.; Wells-Di Gregorio, Sharla M.; Lamdan, Ruth M.; Siegel, Jamie E.; Taylor, Kathryn L.

2013-01-01

Past studies show that optimism and social support are associated with better adjustment following breast cancer treatment. Most studies have examined these relationships in predominantly non-Hispanic White samples. The present study included 77 African American women treated for nonmetastatic breast cancer. Women completed measures of optimism, social support, and adjustment within 10-months of surgical treatment. In contrast to past studies, social support did not mediate the relationship between optimism and adjustment in this sample. Instead, social support was a moderator of the optimism-adjustment relationship, as it buffered the negative impact of low optimism on psychological distress, well-being, and psychosocial functioning. Women with high levels of social support experienced better adjustment even when optimism was low. In contrast, among women with high levels of optimism, increasing social support did not provide an added benefit. These data suggest that perceived social support is an important resource for women with low optimism. PMID:18712591

Assessing the impact of cancer among Dutch non-Hodgkin lymphoma survivors compared with their American counterparts: a cross-national study.

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Oerlemans, Simone; Smith, Sophia K; Crespi, Catherine M; Zimmerman, Sheryl; van de Poll-Franse, Lonneke V; Ganz, Patricia A

2013-06-01

To understand cultural differences in the impact of cancer (IOC) by (i) performing an independent psychometric evaluation of the Dutch version of the Impact of Cancer Scale version 2 (IOCv2) in a non-Hodgkin lymphoma (NHL) sample and (ii) examining differences between Dutch and American NHL survivors in perceived IOC and identifying associations with socio-demographic and clinical characteristics. Data collected from 491 Dutch and 738 American NHL survivors were used in this study. IOCv2 responses were obtained from all survivors; the Dutch survivors also completed the European Organization for Research and Treatment of Cancer Quality of Life Core questionnaire, which measures quality of life. Exploratory factor analysis of the Dutch version yielded a factor solution similar to the American structure but with some subscales merging into single factors. Internal consistency was good; Cronbach's alpha was 0.88 for the Positive and 0.94 for the Negative summary scales. Large differences were observed between survivors, whereby Dutch survivors reported fewer Positive (Δ -0.4, p Dutch sample, providing evidence that IOCv2 scales measure common and important survivor concerns across two different Western nations. Higher positive impacts for US survivors might be explained by more personal control and availability of supportive services. Future research should focus on determinants of the IOC in both Dutch and American survivors to gain better understanding of the factors that might improve it and suggest how health care may be modified toward that end. Copyright © 2012 John Wiley & Sons, Ltd.

ANALYSIS OF KEY-MOTIVATORS IN THE ROMANIAN-NGO ENVIRONMENT

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Mihaela Pacesila

2014-12-01

Full Text Available Purpose: The purpose of this paper is to analyse the ways to motivate volunteers and employees or members from non-governmental sector in order to find out which are the most effective of them and to see if there are differences regarding the motivation depending on the type of organization and the field of activity. The reason for investigating the literature in the field is to see how the contemporary authors have defined the term NGO as well as the concept of motivation.Methodology: The research described in this paper is based on qualitative research method. Data gathering methods included the document analysis in order to bring some important clarifications on the concept of non-governmental organizations and motivation as well as semi-structured interview in order to identify the ways to motivate human resources from nongovernmental sector.Findings: The analysis and interpretation of the data highlight that there are differences in the ways of motivating non-governmental sector human resources depending on the field of activity, but not depending on the type of organization. Despite the obstacles encountered, the management of NGOs uses the most effective ways in order to increase the motivation level of volunteers, employees or members.Research limitation: The limits of this paper come once with the limited number of the interviewees, as well as the types of non-governmental organizations surveyed.Value of paper: The paper has both theoretical and practical importance, explaining the concepts of NGOs and motivation and analysing the ways of motivating human resources in the non-governmental organizations.

Solar-energy an American India (SAI) partnership: The Ramakrishna Mission PV Project

Energy Technology Data Exchange (ETDEWEB)

Ullal, H.S.; Stone, J.L. [National Renewable Energy Lab., Golden, CO (United States)

1997-12-01

This paper describes a cooperative program which was established in 1993 by the Minister of the Indian Ministry of Non-Conventional Energy Sources (MNES) and the Secretary of the U.S. Department of Energy (USDOE). Eventually it fielded one project, funded 50-50 for a total of 500k dollars. The project selected was a sustainable rural economic development initiative with Ramakrishna Mission in West Bengal, India, as the nongovernment organization (NGO). The objectives of the program were to establish the economic viability of photovoltaic power in the Sundarbans region of West Bengal. To have the project self-sustaining with minimal subsidies to the beneficiaries. To establish the infrastructure for financing, training, installation and maintenance with the NGO taking the lead. To work with the NGO to expand utilization of photovoltaics in the region. To perform a before and after social, economic, and environmental impact study with the Tata Energy Research Institute.

Contemporary review on the inequities in the management of lung cancer among the African-American population.

Science.gov (United States)

Kim, Anthony W; Liptay, Michael J; Higgins, Robert S D

2008-06-01

Lung cancer is the leading cause of cancer-related mortality. Nonsmall-cell lung cancer (NSCLC) constitutes approximately 80% of all the lung cancers observed. Despite the aggressive nature of this disease, totally adequate and fully comprehensive treatment yielding outstanding outcomes and survival has yet to be discovered. A uniform means by which to manage NSCLC is only in evolution. Without a universally accepted algorithm upon which clinical decisions can be referenced or compared, differences in the treatment of this disease process can and will exist. Racial bias in the management of NSCLC is being realized as a cause of a substandard delivery of adequate care. Whether this is a newly emerging phenomenon or simply one that is being exposed is unclear. Nevertheless, this inequity in management ranges from the early-to-late stages of NSCLC. The purpose of this manuscript is to explore the reasons behind the differences in the receipt of care for NSCLC that exists between the African-American and Caucasian population.

Differential Splicing of Oncogenes and Tumor Suppressor Genes in African- and Caucasian-American Populations: Contributing Factor in Prostate Cancer Disparities

Science.gov (United States)

2016-10-01

for this collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data...Olender (PhD graduate student) 5d. PROJECT NUMBER 5e. TASK NUMBER E-Mail: nhlee@gwu. edu 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION...inhibitory effects of idelalisib. 15. SUBJECT TERMS prostate cancer, cancer health disparities, alternative splicing, African American, European

Perceptions of Nongovernmental Organization (NGO Staff about Water Privatization in Developing Countries

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Ellis A. Adams

2014-11-01

Full Text Available Almost a billion people globally lack access to potable water. In the early 1990’s, attempts to improve potable water access in the global south included a massive push for water services privatization, often involving the transfer of public water services to private companies. Critics of water privatization claim it rarely improves access to water, and in most cases, unfairly affect poor people. Proponents on the other hand argue that it is necessary for efficient management and capital investment in the water sector. Although development NGOs play an important role in developing country water provision, hardly any studies have sought to understand their perceptions about the potential role of water privatization towards improving access to potable water in developing countries. We interviewed the key staff among 28 international and national NGO staff about water privatization, its opportunities and constraints. Their perceptions were mixed. While most criticized water privatization as increasing water costs to the poor, some noted that privatization is necessary for improving water access through increased capital investment. We present the findings and discuss larger implications for water policies and reforms in developing countries.

Genetic and Molecular Differences in Prostate Carcinogenesis between African American and Caucasian American Men

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Shiv Srivastava

2013-07-01

Full Text Available Prostate cancer is the most common non-skin cancer and the second leading cause of cancer-related death for men in the United States. Prostate cancer incidence and associated mortality are highest in African American men in comparison to other races. The observed differences in incidence and disease aggressiveness at presentation support a potential role for different pathways of prostate carcinogenesis between African American and Caucasian men. This review focuses on some of the recent molecular biology discoveries, which have been investigated in prostate carcinogenesis and their likely contribution to the known discrepancies across race and ethnicity. Key discussion points include the androgen receptor gene structure and function, genome-wide association studies and epigenetics. The new observations of the ethnic differences of the ERG oncogene, the most common prostate cancer gene, are providing new insights into ERG based stratification of prostate cancers in the context of ethnically diverse patient populations. This rapidly advancing knowledge has the likely potential to benefit clinical practice. Current and future work will improve the ability to sub-type prostate cancers by molecular alterations and lead to targeted therapy against this common malignancy.

Cancer Prevention Recommendations: Impact of Adherence.

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Maresso, Karen Colbert; Hawk, Ernest

2016-08-01

To review the relationship between adherence to cancer prevention guidelines published by the American Cancer Society and the World Cancer Research Fund/American Institute for Cancer Research and reductions in cancer incidence, cancer mortality, cardiovascular mortality, and overall mortality. Current cancer prevention guidelines published by the American Cancer Society and the American Institute for Cancer Research, journal articles published between 2004 and 2016, and internet resources. Evidence from a number of large observational studies indicates that following current cancer prevention recommendations in a comprehensive manner results in significant reductions in both cancer risk and cancer mortality, as well as in cardiovascular mortality and overall mortality. Nurses can take the lead in familiarizing patients and families with established cancer prevention recommendations and resources that may assist patients in implementing them comprehensively in their daily lives, as well as in discussing the substantial health benefits of adhering to the recommendations. Copyright © 2016 Elsevier Inc. All rights reserved.

Breast Cancer Mortality Among American Indian and Alaska Native Women, 1990–2009

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White, Arica; Richardson, Lisa C.; Li, Chunyu; Ekwueme, Donatus U.; Kaur, Judith S.

2014-01-01

Objectives. We compared breast cancer death rates and mortality trends among American Indian/Alaska Native (AI/AN) and White women using data for which racial misclassification was minimized. Methods. We used breast cancer deaths and cases linked to Indian Health Service (IHS) data to calculate age-adjusted rates and 95% confidence intervals (CIs) by IHS-designated regions from 1990 to 2009 for AI/AN and White women; Hispanics were excluded. Mortality-to-incidence ratios (MIR) were calculated for 1999 to 2009 as a proxy for prognosis after diagnosis. Results. Overall, the breast cancer death rate was lower in AI/AN women (21.6 per 100 000) than in White women (26.5). However, rates in AI/ANs were higher than rates in Whites for ages 40 to 49 years in the Alaska region, and ages 65 years and older in the Southern Plains region. White death rates significantly decreased (annual percent change [APC] = −2.1; 95% CI = −2.3, −2.0), but regional and overall AI/AN rates were unchanged (APC = 0.9; 95% CI = 0.1, 1.7). AI/AN women had higher MIRs than White women. Conclusions. There has been no improvement in death rates among AI/AN women. Targeted screening and timely, high-quality treatment are needed to reduce mortality from breast cancer in AI/AN women. PMID:24754658

Cervical Cancer Incidence and Mortality Among American Indian and Alaska Native Women, 1999–2009

Science.gov (United States)

Benard, Vicki; Thomas, Cheryll; Brayboy, Annie; Paisano, Roberta; Becker, Thomas

2014-01-01

Objectives. We analyzed cervical cancer incidence and mortality data in American Indian and Alaska Native (AI/AN) women compared with women of other races. Methods. We improved identification of AI/AN race, cervical cancer incidence, and mortality data using Indian Health Service (IHS) patient records; our analyses focused on residents of IHS Contract Health Service Delivery Area (CHSDA) counties. Age-adjusted incidence and death rates were calculated for AI/AN and White women from 1999 to 2009. Results. AI/AN women in CHSDA counties had a death rate from cervical cancer of 4.2, which was nearly twice the rate in White women (2.0; rate ratio [RR] = 2.11). AI/AN women also had higher incidence rates of cervical cancer compared with White women (11.0 vs 7.1; RR = 1.55) and were more often diagnosed with later-stage disease (RR = 1.84 for regional stage and RR = 1.74 for distant stage). Death rates decreased for AI/AN women from 1990 to 1993 (−25.8%/year) and remained stable thereafter. Conclusions. Although rates decreased over time, AI/AN women had disproportionately higher cervical cancer incidence and mortality. The persistently higher rates among AI/AN women compared with White women require continued improvements in identifying and treating cervical cancer and precancerous lesions. PMID:24754650

Using Comics to Promote Colorectal Cancer Screening in the Asian American and Pacific Islander Communities.

Science.gov (United States)

Wang, Jiayan Linda; Acevedo, Nazia; Sadler, Georgia Robins

2017-06-23

There are unaesthetic aspects in teaching people about the early detection of colorectal cancer using the fecal immunochemical test. Comics were seen as a way to overcome those unaesthetic aspects. This study used the Asian grocery store-based cancer education venue to pilot-test the clarity, cultural acceptability, and alignment of five colorectal cancer education comics intended for publication in Asian American and Pacific Islander (API) community newspapers. After developing the colorectal cancer education comics, API students asked shoppers to review a comic from their collection and provide feedback on how to make the comic clearer and more culturally pertinent to API readers. To evaluate viewers' responses, the students gathered such unobtrusive data as: (1) how many of the predetermined salient information points were discussed as the student educators interacted with shoppers and (2) how many comics the shoppers were willing to review. Shoppers were also asked to evaluate how effective the comics would be at motivating colorectal cancer screening among APIs. The students were able to cover all of the salient information points with the first comic. As evidence of the comics' capacity to engage shoppers' interest, shoppers willingly evaluated all five comics. Using multiple comics enabled the educators to repeatedly address the four salient colorectal cancer information points. Thus, the comics helped student educators to overcome the unesthetic elements of colorectal cancer discussions, while enabling them to engage shoppers in animated discussions, for far more time than with their conventional didactic educational methods.

Breast Cancer and Risk Factors Among African-American Women Aged 20-54: A Case-Control Study According to Estrogen Receptor Status

National Research Council Canada - National Science Library

Zhu, Kangmin

1999-01-01

...) status among African-American women. During the period of the project, we established collaborations with the Tennessee Cancer Reporting System, hospitals in the study areas, and basic science researchers...

Korean American women's perceptions about physical examinations and cancer screening services offered in Korea: the influences of medical tourism on Korean Americans.

Science.gov (United States)

Oh, Kyeung Mi; Jun, Jungmi; Zhou, Qiuping; Kreps, Gary

2014-04-01

Cancer is the leading cause of death for Korean-Americans (KAs), while cancer screening rates among KAs have been consistently low. Seven semi-structured focus group interviews with 34 KA women aged 40 or older in the Washington, DC metropolitan area were conducted to explore the perceptions of KA women about seeking physical examinations and cancer screening services in Korea. Data were analyzed using a framework approach. Informants positively perceived the use of health screening services in Korea in comparison to seeking such services in the US. Decision-making factors included cost benefits, high quality services, and more convenient screening procedures in Korea. These benefits outweighed the risks of delaying health care and travelling a vast distance with incurring additional travel costs. Motivations to seek these services in Korea included opportunities to visit their homeland and to enjoy comfortable communication with their native language. The increase of available information about Korean medical services due to the industry's aggressive marketing/PR was identified as a facilitator. Most informants did not recognize possible negative health outcomes of obtaining services in Korea such as inappropriate follow up care if having abnormal findings. Educational programs are needed to educate KAs about the benefits and risks of getting the services in Korea and proper follow up care in the US. Health care providers need to know the different cancer risks and screening needs for this population.

A Retrospective Survival Analysis of Anatomic and Prognostic Stage Group Based on the American Joint Committee on Cancer 8th Edition Cancer Staging Manual in Luminal B Human Epidermal Growth Factor Receptor 2-negative Breast Cancer

OpenAIRE

Xu, Ling; Li, Jiang-Hong; Ye, Jing-Ming; Duan, Xue-Ning; Cheng, Yuan-Jia; Xin, Ling; Liu, Qian; Zhou, Bin; Liu, Yin-Hua

2017-01-01

Background: Current understanding of tumor biology suggests that breast cancer is a group of diseases with different intrinsic molecular subtypes. Anatomic staging system alone is insufficient to provide future outcome information. The American Joint Committee on Cancer (AJCC) expert panel updated the 8th edition of the staging manual with prognostic stage groups by incorporating biomarkers into the anatomic stage groups. In this study, we retrospectively analyzed the data from our center in ...

Diet and cancer

Science.gov (United States)

Fiber and cancer; Cancer and fiber; Nitrates and cancer; Cancer and nitrates ... DIET AND BREAST CANCER The link between nutrition and breast cancer has been well studied. To reduce risk of breast cancer the American ...

American Society for Radiation Oncology (ASTRO) and American College of Radiology (ACR) Practice Guideline for the Transperineal Permanent Brachytherapy of Prostate Cancer

International Nuclear Information System (INIS)

Rosenthal, Seth A.; Bittner, Nathan H.J.; Beyer, David C.; Demanes, D. Jeffrey; Goldsmith, Brian J.; Horwitz, Eric M.; Ibbott, Geoffrey S.; Lee, W. Robert; Nag, Subir; Suh, W. Warren; Potters, Louis

2011-01-01

Transperineal permanent prostate brachytherapy is a safe and efficacious treatment option for patients with organ-confined prostate cancer. Careful adherence to established brachytherapy standards has been shown to improve the likelihood of procedural success and reduce the incidence of treatment-related morbidity. A collaborative effort of the American College of Radiology (ACR) and American Society for Therapeutic Radiation Oncology (ASTRO) has produced a practice guideline for permanent prostate brachytherapy. The guideline defines the qualifications and responsibilities of all the involved personnel, including the radiation oncologist, physicist and dosimetrist. Factors with respect to patient selection and appropriate use of supplemental treatment modalities such as external beam radiation and androgen suppression therapy are discussed. Logistics with respect to the brachtherapy implant procedure, the importance of dosimetric parameters, and attention to radiation safety procedures and documentation are presented. Adherence to these practice guidelines can be part of ensuring quality and safety in a successful prostate brachytherapy program.

The American Society of Clinical Oncology's Efforts to Support Global Cancer Medicine

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El-Saghir, Nagi S.; Cufer, Tanja; Cazap, Eduardo; de Guzman, Roselle; Othieno-Abinya, Nicholas Anthony; Sanchez, Jose Angel; Pyle, Doug

2016-01-01

Despite much progress in the management of malignant diseases, the number of new cases and cancer-related deaths continues to rise around the world. More than half of new cases occur in economically developing countries, where more than two thirds of cancer deaths are expected. However, implementation of all necessary steps to accomplish the dissemination of state-of-the-art prevention, diagnosis, and management will require increased allocation of resources, and, more importantly, harmonization of the efforts of hundreds of national and international public health agencies, policy-setting bodies, governments, pharmaceutical companies, and philanthropic organizations. More than 30% of the members of the American Society of Clinical Oncology (ASCO) reside and practice outside US borders, and more than half of attendees at all of the scientific congresses and symposia organized by ASCO are international. As cancer has become an increasingly global disease, ASCO has evolved as a global organization. The ASCO Board of Directors currently includes members from France, Brazil, and Canada. In 2013, the ASCO Board of Directors identified a number of strategic priorities for the future. Recognizing the importance of non-US members to the society, their first strategic priority was improving the society's service to non-US members and defining these members' identity in the international oncology community. This article reviews current ASCO activities in the international arena and its future plans in global oncology. PMID:26578614

Summary of presentations from the 46th Annual Meeting of the American Society of Clinical Oncology: focus on non-small cell lung cancer (2010).

Science.gov (United States)

Stinchcombe, Thomas E; Baggstrom, Maria Q; Somaiah, Neeta; Simon, George R; Govindan, Ramaswamy

2011-01-01

The promising results of crizotinib in molecularly selected patients with advanced non-small cell lung cancer (NSCLC) whose tumor cells had a novel fusion protein involving anaplastic lymphoma kinase presented at the 2010 American Society of Clinical Oncology reinforce once again the importance of understanding molecular heterogeneity of lung cancer and careful patient selection. Several other important issues were the subject of presentations related to lung cancer at the recently concluded American Society of Clinical Oncology annual meeting. The articles covered a wide variety of topics including optimal staging techniques to detect mediastinal nodal involvement, the role of platinum-based doublet chemotherapy in the management of elderly patients with advanced NSCLC, use of maintenance therapy with gemcitabine, and the impact of early introduction of organized palliative care in improving the quality of life of patients with advanced NSCLC. This report provides a brief overview of the presentations related to lung cancer that are relevant to clinical practice and future research.

Adherence to the World Cancer Research Fund/American Institute for Cancer Research cancer prevention recommendations and breast cancer risk in the Cancer de Màma (CAMA) study.

Science.gov (United States)

Fanidi, Anouar; Ferrari, Pietro; Biessy, Carine; Ortega, Carolina; Angeles-Llerenas, Angélica; Torres-Mejia, Gabriella; Romieu, Isabelle

2015-12-01

We investigated the association between adherence to the recommendations of the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) and breast cancer (BC) risk in the Cancer de Màma (CAMA) study in a Mexican population. Population-based case-control study. Incident BC cases (n 1000) and controls (n 1074) matched on age, region and health-care system were recruited. In-person interviews were conducted to assess BC risk factors and habitual diet was assessed with an FFQ. Conformity to the WCRF/AICR recommendations was evaluated through a score incorporating seven WCRF/AICR components (body fatness, physical activity, foods and drinks that promote weight gain, plant foods, animal foods, alcoholic drinks and breast-feeding), with high scores indicating adherence to the WCRF/AICR recommendations. No statistically significant associations between WCRF/AICR score and risk of BC were observed. After excluding BMI from the WCRF/AICR score, the top quartile was associated with a decreased BC risk overall, with ORQ4-Q1=0.68 (95% CI 0.49, 0.92, P trend=0.03), and among postmenopausal women, with ORQ4-Q1=0.60 (95% CI 0.39, 0.94, P trend=0.03). Inverse associations were observed between BMI and risk of BC overall and among premenopausal women, with OR=0.57 (95% CI 0.42, 0.76, P trend <0.01) and 0.48 (95% CI 0.31, 0.73, P trend<0.01), respectively. Physical activity level was inversely associated with BC risk. The WCRF/AICR index was not related with BC risk in the CAMA study. A combination of six components excluding BMI showed strong protective associations, particularly in postmenopausal women. Further prospective studies are required to clarify the role of adherence to WCRF/AICR recommendations, particularly with respect to BMI, in the Mexican population.

Role of Private Enterprise in Cancer Control in Low to Middle Income Countries

International Nuclear Information System (INIS)

Nwogu, C. E.

2016-01-01

About 65% of cancer deaths globally occur in low to middle income countries (LMICs) where prioritization and allocation of resources to cancer care are often quite poor. In the absence of governmental focus on this problem, public-private partnerships may be an avenue to provide effective cancer control. Methods. This manuscript highlights the establishment of a non governmental organization (NGO) to stimulate the development of partnerships between oncology professionals, private enterprise, and academic institutions, both locally and internationally. Examples of capacity building, grant support, establishment of collaborative networks, and the development of a facility to provide clinical care are highlighted. Results. Collaborations were established between oncology professionals at academic institutions in the US and Nigeria. Cancer control workshops were conducted in Nigeria with grant support from the Union for International Cancer Control (UICC). A monthly tumor board conference was established at LASUTH in Lagos, and further capacity building is underway with grant support from the United States NCI. An outpatient, privately funded oncology clinic in Lagos has been launched. Conclusion. In LMICs, effective partnership between public and private institutions can lead to tangible strides in cancer control. The use of creative healthcare financing models can also support positive change

Primary Prevention of Cervical Cancer: American Society of Clinical Oncology Resource-Stratified Guideline

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Silvina Arrossi

2017-10-01

Full Text Available Purpose: To provide resource-stratified (four tiers, evidence-based recommendations on the primary prevention of cervical cancer globally. Methods: The American Society of Clinical Oncology convened a multidisciplinary, multinational panel of oncology, obstetrics/gynecology, public health, cancer control, epidemiology/biostatistics, health economics, behavioral/implementation science, and patient advocacy experts. The Expert Panel reviewed existing guidelines and conducted a modified ADAPTE process and a formal consensus-based process with additional experts (consensus ratings group for one round of formal ratings. Results: Existing sets of guidelines from five guideline developers were identified and reviewed; adapted recommendations formed the evidence base. Five systematic reviews, along with cost-effectiveness analyses, provided evidence to inform the formal consensus process, which resulted in agreement of ≥ 75%. Recommendations: In all resource settings, two doses of human papillomavirus vaccine are recommended for girls age 9 to 14 years, with an interval of at least 6 months and possibly up to 12 to 15 months. Individuals with HIV positivity should receive three doses. Maximal and enhanced settings: if girls are age ≥ 15 years and received their first dose before age 15 years, they may complete the series; if no doses were received before age 15 years, three doses should be administered; in both scenarios, vaccination may be through age 26 years. Limited and basic settings: if sufficient resources remain after vaccinating girls age 9 to 14 years, girls who received one dose may receive additional doses between age 15 and 26 years. Maximal, enhanced, and limited settings: if ≥ 50% coverage in the priority female target population, sufficient resources, and cost effectiveness, boys may be vaccinated to prevent other noncervical human papillomavirus–related cancers and diseases. Basic settings: vaccinating boys is not recommended

Primary Prevention of Cervical Cancer: American Society of Clinical Oncology Resource-Stratified Guideline.

Science.gov (United States)

Arrossi, Silvina; Temin, Sarah; Garland, Suzanne; Eckert, Linda O'Neal; Bhatla, Neerja; Castellsagué, Xavier; Alkaff, Sharifa Ezat; Felder, Tamika; Hammouda, Doudja; Konno, Ryo; Lopes, Gilberto; Mugisha, Emmanuel; Murillo, Rául; Scarinci, Isabel C; Stanley, Margaret; Tsu, Vivien; Wheeler, Cosette M; Adewole, Isaac Folorunso; de Sanjosé, Silvia

2017-10-01

To provide resource-stratified (four tiers), evidence-based recommendations on the primary prevention of cervical cancer globally. The American Society of Clinical Oncology convened a multidisciplinary, multinational panel of oncology, obstetrics/gynecology, public health, cancer control, epidemiology/biostatistics, health economics, behavioral/implementation science, and patient advocacy experts. The Expert Panel reviewed existing guidelines and conducted a modified ADAPTE process and a formal consensus-based process with additional experts (consensus ratings group) for one round of formal ratings. Existing sets of guidelines from five guideline developers were identified and reviewed; adapted recommendations formed the evidence base. Five systematic reviews, along with cost-effectiveness analyses, provided evidence to inform the formal consensus process, which resulted in agreement of ≥ 75%. In all resource settings, two doses of human papillomavirus vaccine are recommended for girls age 9 to 14 years, with an interval of at least 6 months and possibly up to 12 to 15 months. Individuals with HIV positivity should receive three doses. Maximal and enhanced settings: if girls are age ≥ 15 years and received their first dose before age 15 years, they may complete the series; if no doses were received before age 15 years, three doses should be administered; in both scenarios, vaccination may be through age 26 years. Limited and basic settings: if sufficient resources remain after vaccinating girls age 9 to 14 years, girls who received one dose may receive additional doses between age 15 and 26 years. Maximal, enhanced, and limited settings: if ≥ 50% coverage in the priority female target population, sufficient resources, and cost effectiveness, boys may be vaccinated to prevent other noncervical human papillomavirus-related cancers and diseases. Basic settings: vaccinating boys is not recommended. It is the view of the American Society of Clinical Oncology that

Impact of NGO training and support intervention on diarrhoea management practices in a rural community of Bangladesh: an uncontrolled, single-arm trial.

Science.gov (United States)

Rahman, Ahmed S; Islam, Mohammad Rafiqul; Koehlmoos, Tracey P; Raihan, Mohammad Jyoti; Hasan, Mohammad Mehedi; Ahmed, Tahmeed; Larson, Charles P

2014-01-01

The evolving Non-Governmental Organization (NGO) sector in Bangladesh provides health services directly, however some NGOs indirectly provide services by working with unlicensed providers. The primary objective of this study was to examine the impact of NGO training of unlicensed providers on diarrhoea management and the scale up of zinc treatment in rural populations. An uncontrolled, single-arm trial for a training and support intervention on diarrhoea outcomes was employed in a rural sub-district of Bangladesh during 2008. Two local NGOs and their catchment populations were chosen for the study. The intervention included training of unlicensed health care providers in the management of acute childhood diarrhoea, particularly emphasizing zinc treatment. In addition, community-based promotion of zinc treatment was carried out. Baseline and endline ecologic surveys were carried out in intervention and control villages to document changes in treatments received for diarrhoea in under-five children. Among surveyed household with an active or recent acute childhood diarrhoea episode, 69% sought help from a health provider. Among these, 62.8% visited an unlicensed private provider. At baseline, 23.9% vs. 22% of control and intervention group children with diarrhoea had received zinc of any type. At endline (6 months later) this had changed to 15.3% vs. 30.2%, respectively. The change in zinc coverage was significantly higher in the intervention villages (pmanagement of under-five children in rural Bangladesh households. ClinicalTrials.gov NCT02143921.

Patient and provider characteristics associated with colorectal, breast, and cervical cancer screening among Asian Americans

Science.gov (United States)

Thompson, Caroline A.; Gomez, Scarlett Lin; Chan, Albert; Chan, John K.; McClellan, Sean R.; Chung, Sukyung; Olson, Cliff; Nimbal, Vani; Palaniappan, Latha P.

2014-01-01

BACKGROUND Routinely recommended screening for breast, cervical, and colorectal cancers can significantly reduce mortality from these types of cancer, yet screening is underutilized among Asians. Surveys rely on self-report and often are underpowered for analysis by Asian ethnicities. Electronic health records include validated (as opposed to recall-based) rates of cancer screening. In this paper we seek to better understand cancer screening patterns in a population of insured Asian Americans. METHODS We calculated rates of compliance with cervical, breast, and colorectal cancer screening among Asians from an EHR population, and compared them to non-Hispanic whites. We performed multivariable modeling to evaluate potential predictors (at the provider- and patient- level) of screening completion among Asian patients. RESULTS Aggregation of Asian subgroups masked heterogeneity in screening rates. Asian Indians and Native Hawaiians and Pacific Islanders had the lowest rates of screening in our sample, well below that of non-Hispanic whites. In multivariable analyses, screening completion was negatively associated with patient-physician language discordance for mammography (OR:0.81 95% CI:0.71–0.92) and colorectal cancer screening (OR:0.79 CI:0.72–0.87) and positively associated with patient-provider gender concordance for mammography (OR:1.16 CI:1.00–1.34) and cervical cancer screening (OR:1.66 CI:1.51–1.82). Additionally, patient enrollment in online health services increased mammography (OR:1.32 CI:1.20–1.46) and cervical cancer screening (OR:1.31 CI:1.24–1.37). CONCLUSIONS Language- and gender- concordant primary care providers, and culturally tailored online health resources may help improve preventive cancer screening in Asian patient populations. IMPACT This study demonstrates how use of EHR data can inform investigations of primary prevention practices within the healthcare delivery setting. PMID:25368396

Genomic Characterization of Non–Small-Cell Lung Cancer in African Americans by Targeted Massively Parallel Sequencing

Science.gov (United States)

Araujo, Luiz H.; Timmers, Cynthia; Bell, Erica Hlavin; Shilo, Konstantin; Lammers, Philip E.; Zhao, Weiqiang; Natarajan, Thanemozhi G.; Miller, Clinton J.; Zhang, Jianying; Yilmaz, Ayse S.; Liu, Tom; Coombes, Kevin; Amann, Joseph; Carbone, David P.

2015-01-01

Purpose Technologic advances have enabled the comprehensive analysis of genetic perturbations in non–small-cell lung cancer (NSCLC); however, African Americans have often been underrepresented in these studies. This ethnic group has higher lung cancer incidence and mortality rates, and some studies have suggested a lower incidence of epidermal growth factor receptor mutations. Herein, we report the most in-depth molecular profile of NSCLC in African Americans to date. Methods A custom panel was designed to cover the coding regions of 81 NSCLC-related genes and 40 ancestry-informative markers. Clinical samples were sequenced on a massively parallel sequencing instrument, and anaplastic lymphoma kinase translocation was evaluated by fluorescent in situ hybridization. Results The study cohort included 99 patients (61% males, 94% smokers) comprising 31 squamous and 68 nonsquamous cell carcinomas. We detected 227 nonsilent variants in the coding sequence, including 24 samples with nonoverlapping, classic driver alterations. The frequency of driver mutations was not significantly different from that of whites, and no association was found between genetic ancestry and the presence of somatic mutations. Copy number alteration analysis disclosed distinguishable amplifications in the 3q chromosome arm in squamous cell carcinomas and pointed toward a handful of targetable alterations. We also found frequent SMARCA4 mutations and protein loss, mostly in driver-negative tumors. Conclusion Our data suggest that African American ancestry may not be significantly different from European/white background for the presence of somatic driver mutations in NSCLC. Furthermore, we demonstrated that using a comprehensive genotyping approach could identify numerous targetable alterations, with potential impact on therapeutic decisions. PMID:25918285

NGO management and health care financing approaches in the Eastern Democratic Republic of the Congo.

Science.gov (United States)

Dijkzeul, D; Lynch, C A

2006-01-01

The role of cost-sharing in health care is a crucial, yet contentious issue. In conflict situations, cost-sharing becomes even more controversial as health and other institutions are failing. In such situations, NGOs manage health programmes which aim to aid populations in crisis and improve or at least sustain a deteriorating health system. This study looks at the issue of cost-sharing in the wider context of utilization rates and management approaches of three NGOs in the chronic, high-mortality crisis of the eastern DRC. Approaches to increase access to health care were found to exist, yet cost-recovery, even on the basis of maximum utilization rates, would only partially sustain the health system in the eastern DRC. Factors external to the direct management of NGO health programs, such as the wider economic and security situation, local management structures, and international donor policies, need to be taken into account for establishing more integrated management and financing approaches.

Mortality rates among Arab Americans in Michigan.

Science.gov (United States)

Dallo, Florence J; Schwartz, Kendra; Ruterbusch, Julie J; Booza, Jason; Williams, David R

2012-04-01

The objectives of this study were to: (1) calculate age-specific and age-adjusted cause-specific mortality rates for Arab Americans; and (2) compare these rates with those for blacks and whites. Mortality rates were estimated using Michigan death certificate data, an Arab surname and first name list, and 2000 U.S. Census data. Age-specific rates, age-adjusted all-cause and cause-specific rates were calculated. Arab Americans (75+) had higher mortality rates than whites and blacks. Among men, all-cause and cause-specific mortality rates for Arab Americans were in the range of whites and blacks. However, Arab American men had lower mortality rates from cancer and chronic lower respiratory disease compared to both whites and blacks. Among women, Arab Americans had lower mortality rates from heart disease, cancer, stroke, and diabetes than whites and blacks. Arab Americans are growing in number. Future study should focus on designing rigorous separate analyses for this population.

A Pan American Health Organization strategy for cervical cancer prevention and control in Latin America and the Caribbean.

Science.gov (United States)

Luciani, Silvana; Andrus, Jon Kim

2008-11-01

Cervical cancer is the leading cause of cancer deaths among women in Latin America and the Caribbean, and disproportionately affects poorer women. Mortality rates in the region are seven times greater than in North America. In light of the significant public health burden, the Pan American Health Organization has drafted a Regional Strategy for Cervical Cancer Prevention and Control. The Strategy calls for increased action to strengthen programmes through an integrated package of services: health information and education; screening and pre-cancer treatment; invasive cervical cancer treatment and palliative care; and evidence-based policy decisions on whether and how to introduce human papillomavirus (HPV) vaccines. It calls for a seven-point plan of action: conduct a situation analysis; intensify information, education and counselling; scale up screening and link to pre-cancer treatment; strengthen information systems and cancer registries; improve access to and quality of cancer treatment and palliative care; generate evidence to facilitate decision-making regarding HPV vaccine introduction; and advocate for equitable access and affordable HPV vaccines. This proposed strategy, approved by the PAHO Directing Council on 1 October 2008, has the possibility of stimulating and accelerating the introduction of new screening technology and HPV vaccines into programmes throughout Latin America and the Caribbean.

Coverage of skin cancer and recreational tanning in North American magazines before and after the landmark 2006 International Agency for Research on Cancer report.

Science.gov (United States)

McWhirter, Jennifer E; Hoffman-Goetz, Laurie

2015-02-21

Skin cancer is an increasingly important global public health problem. Mass media is a key source of skin cancer information. We examined how media coverage of skin cancer has changed over time as a consequence of the release of a key public health report from the International Agency for Research on Cancer (IARC) in 2006, which linked ultraviolet (UV) radiation from indoor tanning and skin cancer. A directed content analysis of skin cancer and tanning coverage in 29 popular North American magazines (2001-2012) examined reporting of skin cancer risk factors, UV behaviors, and early detection in article text (n = 761) and images (n = 1267). Chi-square and correlational analyses were used determine whether coverage changed in relation to the 2006 IARC report. The total volume of articles about skin cancer and tanning increased modestly after the IARC report (χ (2) = 4.57, df = 1, p tanning, UV as a risk factor) were no more likely to be reported after compared to before the report. There were virtually no changes in the percentage of coverage for both risk factors and early detection information over time. There were some changes in the percentage of coverage about UV behaviors after the IARC report, but these variables were not directly related to the report. Magazines were more likely to encourage sunscreen use (χ (2) = 11.55, df = 1, p tanned look as attractive (χ (2) = 9.72, df = 1, p skin cancer and tanning.

Association between Plasma 25-Hydroxyvitamin D, Ancestry and Aggressive Prostate Cancer among African Americans and European Americans in PCaP.

Directory of Open Access Journals (Sweden)

Susan E Steck

Full Text Available African Americans (AAs have lower circulating 25-hydroxyvitamin D3 [25(OHD3] concentrations and higher prostate cancer (CaP aggressiveness than other racial/ethnic groups. The purpose of the current study was to examine the relationship between plasma 25(OHD3, African ancestry and CaP aggressiveness among AAs and European Americans (EAs.Plasma 25(OHD3 was measured using LC-MS/MS (Liquid Chromatography Tandem Mass Spectrometry in 537 AA and 663 EA newly-diagnosed CaP patients from the North Carolina-Louisiana Prostate Cancer Project (PCaP classified as having either 'high' or 'low' aggressive disease based on clinical stage, Gleason grade and prostate specific antigen at diagnosis. Mean plasma 25(OHD3 concentrations were compared by proportion of African ancestry. Logistic regression was used to calculate multivariable adjusted odds ratios (OR and 95% confidence intervals (95%CI for high aggressive CaP by tertile of plasma 25(OHD3.AAs with highest percent African ancestry (>95% had the lowest mean plasma 25(OHD3 concentrations. Overall, plasma 25(OHD3 was associated positively with aggressiveness among AA men, an association that was modified by calcium intake (ORT 3vs.T1: 2.23, 95%CI: 1.26-3.95 among men with low calcium intake, and ORT 3vs.T1: 0.19, 95%CI: 0.05-0.70 among men with high calcium intake. Among EAs, the point estimates of the ORs were <1.0 for the upper tertiles with CIs that included the null.Among AAs, plasma 25(OHD3 was associated positively with CaP aggressiveness among men with low calcium intake and inversely among men with high calcium intake. The clinical significance of circulating concentrations of 25(OHD3 and interactions with calcium intake in the AA population warrants further study.

In Asian americans, is having a family member diagnosed with cancer associated with fatalistic beliefs?

Directory of Open Access Journals (Sweden)

Carolee Polek

2016-01-01

Full Text Available Objective: Cancer can evoke long-held cultural beliefs which either facilitate or impede efforts to expand the health literacy of families. Among these beliefs is fatalism which holds that controlling ones′ outcome is not possible, and that ones′ outcome is predestined. Some fatalistic beliefs are broadly held within the Asian American (AA community and may be challenged or reinforced by the experience of having a family member diagnosed with cancer. This study evaluated the relationship between having a family member diagnosed with cancer and selected demographics in AAs on fatalistic beliefs. Methods: Data from 519 AA subjects from the Centers for Disease Control and Prevention Health Information Trends Survey were used to complete a secondary analysis. Descriptive statistics characterize fatalistic beliefs. Four models using four questions assessed fatalistic beliefs as dependent variables and independent variables of having or not having a family member diagnosed with cancer, completing college or not, sex, and age were assessed using ordinal regression. Results: All of the fatalistic beliefs examined were endorsed by large portions of the subjects. When considering the role of being exposed to having a family member with cancer, it was associated with an increase in the likelihood in a belief that one is likely to get cancer, and everything can cause cancer. Being exposed to a family member diagnosed with cancer was not significantly associated with believing, there was little one could do to control their cancer risk. This belief was broadly rejected. While the belief that there are so many different recommendations about preventing cancer, it is hard to know what to do, was broadly endorsed and not associated with having a family member diagnosed with cancer. Conclusions: The major practice implications within oncology nursing suggest the importance in assessing cancer health literacy and providing corrective knowledge in families

Risk factors of breast cancer and knowledge about the disease: an integrative revision of Latin American studies

Directory of Open Access Journals (Sweden)

Aline Ferreira de Araújo Jerônimo

Full Text Available Abstract The aim of this integrative review was to compare Latin American literature about risk and knowledge on breast cancer. Of 47 studies selected, 20 were about knowledge or awareness and 27 about risk of breast cancer. English was the dominant language in studies about risk, whereas studies about knowledge were mainly written in Spanish or Portuguese. Studies about knowledge were all cross- sectional, whereas case- control studies dominated authors’ interest about risk of breast cancer. Studies about knowledge were mainly focused on early detection of the disease and the most common study objective was breast self- examination (N = 14. In contrast, few studies about risk of breast cancer focused on early detection (N = 5. Obesity and overweight (N = 14, family history (N = 13, decreased parity (N = 12, and short breastfeeding duration (N = 10 were among the most frequent identified risk factors. Socio- economic factors such as income and educational level had variable effects on breast cancer risk and affected also knowledge of women about risk factors and early detection. Present results indicated that studies about risk of breast cancer were more often based on a better sound analytical background, compared to studies about knowledge, which were mostly descriptive.

American Society of Clinical Oncology Policy Statement: The Role of the Oncologist in Cancer Prevention and Risk Assessment

Science.gov (United States)

Zon, Robin T.; Goss, Elizabeth; Vogel, Victor G.; Chlebowski, Rowan T.; Jatoi, Ismail; Robson, Mark E.; Wollins, Dana S.; Garber, Judy E.; Brown, Powel; Kramer, Barnett S.

2009-01-01

Oncologists have a critical opportunity to utilize risk assessment and cancer prevention strategies to interrupt the initiation or progression of cancer in cancer survivors and individuals at high risk of developing cancer. Expanding knowledge about the natural history and prognosis of cancers positions oncologists to advise patients regarding the risk of second malignancies and treatment-related cancers. In addition, as recognized experts in the full spectrum of cancer care, oncologists are afforded opportunities for involvement in community-based cancer prevention activities. Although oncologists are currently providing many cancer prevention and risk assessment services to their patients, economic barriers exist, including inadequate or lack of insurance, that may compromise uniform patient access to these services. Additionally, insufficient reimbursement for existing and developing interventions may discourage patient access to these services. The American Society of Clinical Oncology (ASCO), the medical society representing cancer specialists involved in patient care and clinical research, is committed to supporting oncologists in their wide-ranging involvement in cancer prevention. This statement on risk assessment and prevention counseling, although not intended to be a comprehensive overview of cancer prevention describes the current role of oncologists in risk assessment and prevention; provides examples of risk assessment and prevention activities that should be offered by oncologists; identifies potential opportunities for coordination between oncologists and primary care physicians in prevention education and coordination of care for cancer survivors; describes ASCO's involvement in education and training of oncologists regarding prevention; and proposes improvement in the payment environment to encourage patient access to these services. PMID:19075281

National Native American Breast Cancer Survivor's Network

National Research Council Canada - National Science Library

Burhansstipanov, Linda

2002-01-01

.... The purpose of this project is to improve the survival from breast cancer and quality of life after being diagnosed with breast cancer for both the patient and loved ones of the cancer patient...

National Native American Breast Cancer Survivor's Network

National Research Council Canada - National Science Library

Burhansstipanov, Linda

2003-01-01

.... The purpose of this project is to improve the survival from breast cancer and quality of life after being diagnosed with breast cancer for both the patient and loved ones of the cancer patient...

American brachytherapy society (ABS) consensus guidelines for brachytherapy of esophageal cancer

International Nuclear Information System (INIS)

Gaspar, Laurie E.; Nag, Subir; Herskovic, Arnold; Mantravadi, Rao; Speiser, Burton

1997-01-01

Introduction: There is wide variation in the indications, treatment regimens, and dosimetry for brachytherapy in the treatment of cancer of the esophagus. No guidelines for optimal therapy currently exist. Methods and Materials: Utilizing published reports and clinical experience, representatives of the Clinical Research Committee of the American Brachytherapy Society (ABS) formulated guidelines for brachytherapy in esophageal cancer. Results: Recommendations were made for brachytherapy in the definitive and palliative treatment of esophageal cancer. (A) Definitive treatment: Good candidates for brachytherapy include patients with unifocal thoracic adeno- or squamous cancers ≤ 10 cm in length, with no evidence of intra-abdominal or metastatic disease. Contraindications include tracheal or bronchial involvement, cervical esophagus location, or stenosis that cannot be bypassed. The esophageal brachytherapy applicator should have an external diameter of 6-10 mm. If 5FU-based chemotherapy and 45-50-Gy external beam are used, recommended brachytherapy is either: (i) HDR 10 Gy in two weekly fractions of 5 Gy each; or (ii) LDR 20 Gy in a single course at 0.4-1 Gy/hr. All doses are specified 1 cm from the midsource or middwell position. Brachytherapy should follow external beam radiation therapy and should not be given concurrently with chemotherapy. (B) Palliative treatment: Patients with adeno- or squamous cancers of the thoracic esophagus with distant metastases or unresectable local disease progression/recurrence after definitive radiation treatment should be considered for brachytherapy with palliative intent. After limited dose (30 Gy) EBRT, the recommended brachytherapy is either: (i) HDR 10-14 Gy in one or two fractions; or (ii) LDR 20-25 Gy in a single course at 0.4-1 Gy/hr. The need for external beam radiation in newly diagnosed patients with a life expectancy of less than 3 months is controversial. In these cases, HDR of 15-20 Gy in two to four fractions or

Lack of access to chemotherapy for colon cancer: multiplicative disadvantage of being extremely poor, inadequately insured and African American.

Science.gov (United States)

Gorey, Kevin M; Haji-Jama, Sundus; Bartfay, Emma; Luginaah, Isaac N; Wright, Frances C; Kanjeekal, Sindu M

2014-03-22

Despite evidence of chemotherapy's ability to cure or comfort those with colon cancer, nearly half of such Americans do not receive it. African Americans (AA) seem particularly disadvantaged. An ethnicity by poverty by health insurance interaction was hypothesized such that the multiplicative disadvantage of being extremely poor and inadequately insured is worse for AAs than for non-Hispanic white Americans (NHWA). California registry data were analyzed for 459 AAs and 3,001 NHWAs diagnosed with stage II to IV colon cancer between 1996 and 2000 and followed until 2011. Socioeconomic data from the 2000 census categorized neighborhoods: extremely poor (≥ 30% of households poor), middle (5-29% poor) and low poverty (Primary health insurers were Medicaid, Medicare, private or none. Chemotherapy rates were age and stage-adjusted and comparisons used standardized rate ratios (RR). Logistic and Cox regressions, respectively, modeled chemotherapy receipt and long term survival. A significant 3-way ethnicity by poverty by health insurance interaction effect on chemotherapy receipt was observed. Among those who did not live in extremely poor neighborhoods and were adequately insured privately or by Medicare, chemotherapy rates did not differ significantly between AAs (37.7%) and NHWAs (39.5%). Among those who lived in extremely poor neighborhoods and were inadequately insured by Medicaid or uninsured, AAs (14.6%) were nearly 60% less likely to receive chemotherapy than were NHWAs (25.5%, RR = 0.41). When the 3-way interaction effect as well as the main effects of poverty, health insurance and chemotherapy was accounted for, survival rates of AAs and NHWAs were the same. The multiplicative barrier to colon cancer care that results from being extremely poor and inadequately insured is worse for AAs than it is for NHWAs. AAs are more prevalently poor, inadequately insured, and have fewer assets so they are probably less able to absorb the indirect and direct, but uncovered

Asian Americans and Cancer Clinical Trials: A Mixed-Methods Approach to Understanding Awareness and Experience

Science.gov (United States)

Paterniti, Debora A.; Chen, Moon S.; Chiechi, Christine; Beckett, Laurel A.; Horan, Nora; Turrell, Corinne; Smith, Ligaya; Morain, Claudia; Montell, Lisa; Gonzalez, Jose Luis; Davis, Sharon; Lara, Primo N.

2006-01-01

Cancer clinical trials have been based on low accrual rates. Barriers to recruitment of minority populations affect the generalizability and impact of trial findings for those populations. The authors undertook a mixed-methods approach to understanding levels of awareness and experiences with cancer clinical trials. A survey was administered to new cancer patients and their caretakers (family, close friends, or other social support) at outpatient oncology clinics. Field observations of the trial accrual process also were conducted by employing the grounded theory approach in qualitative methods. Comparison of survey results for Asian-American respondents and non-Asian respondents indicated that Asians were less likely to have heard the term “clinical trial” and were more likely to define a clinical trial as “an experiment” or “a test procedure in a clinic” than non-Asians. Asians were more likely to have employer-based insurance and to report understanding issues related to cost reimbursement. Asians were less likely to have been involved in or to know someone in a trial and reported less willingness than white respondents to consider trial participation. Qualitative observations suggested that Asians who presented for a potential trial were interested in the availability of a novel cancer therapy but were not eligible for available trials. Multiple strategies will be necessary to enhance awareness of and experience with accrual to cancer clinical trials for Asians, including richer understanding and increased involvement of Asians in cancer clinical trials and greater attention to the location and diversity of the Asian population in structuring study centers and evaluating trial results. PMID:16247795

Tissue Microarray Assessment of Novel Prostate Cancer Biomarkers AMACR and EZH2 and Immunologic Response to Them in African-American and Caucasian Men

National Research Council Canada - National Science Library

Mehra, Rohit

2007-01-01

.... We constructed 5 tissue microarrays representing 40 African-American and 159 Caucasian prostate cancer patients and performed immunohistochemistry on these arrays using antibody to AMACR and EZH2...

Tissue Microarray Assessment of Novel Prostate Cancer Biomarkers AMACR and EZH2 and Immunologic Response to them in African-American and Caucasian Men

National Research Council Canada - National Science Library

Mehra, Rohit

2006-01-01

.... We constructed 5 tissue microarrays representing 40 African-American and 159 Caucasian prostate cancer patients and performed immunohistochemistry on these arrays using antibodies to AMACR and EZH2...

Through tobacco industry eyes: civil society and the FCTC process from Philip Morris and British American Tobacco's perspectives.

Science.gov (United States)

Gonzalez, Mariaelena; Green, Lawrence W; Glantz, Stanton A

2012-07-01

To analyse the models Philip Morris (PM) and British American Tobacco (BAT) used internally to understand tobacco control non-governmental organizations (NGOs) and their relationship to the global tobacco control policy-making process that resulted in the Framework Convention for Tobacco Control (FCTC). Analysis of internal tobacco industry documents in the Legacy Tobacco Document Library. PM contracted with Mongoven, Biscoe, and Duchin, Inc. (MBD, a consulting firm specialising in NGO surveillance) as advisors. MBD argued that because NGOs are increasingly linked to epistemic communities, NGOs could insert themselves into the global policy-making process and influence the discourse surrounding the treaty-making process. MBD advised PM to insert itself into the policy-making process, mimicking NGO behaviour. BAT's Consumer and Regulatory Affairs (CORA) department argued that global regulation emerged from the perception (by NGOs and governments) that the industry could not regulate itself, leading to BAT advocating social alignment and self-regulation to minimise the impact of the FCTC. Most efforts to block or redirect the FCTC failed. PM and BAT articulated a global policy-making environment in which NGOs are key, non-state stakeholders, and as a result, internationalised some of their previous national-level strategies. After both companies failed to prevent the FCTC, their strategies began to align. Multinational corporations have continued to successfully employ some of the strategies outlined in this paper at the local and national level while being formally excluded from ongoing FCTC negotiations at the global level.

A computer-tailored intervention to promote informed decision making for prostate cancer screening among African American men.

Science.gov (United States)

Allen, Jennifer D; Mohllajee, Anshu P; Shelton, Rachel C; Drake, Bettina F; Mars, Dana R

2009-12-01

African American men experience a disproportionate burden of prostate cancer (CaP) morbidity and mortality. National screening guidelines advise men to make individualized screening decisions through a process termed informed decision making (IDM). In this pilot study, a computer-tailored decision-aid designed to promote IDM was evaluated using a pre-/posttest design. African American men aged 40 years and older were recruited from a variety of community settings (n = 108). At pretest, 43% of men reported having made a screening decision; at posttest 47% reported this to be the case (p = .39). Significant improvements were observed between pre- and posttest on scores of knowledge, decision self-efficacy, and decisional conflict. Men were also more likely to want an active role in decision making after using the tool. These results suggest that use of a computer-tailored decision aid is a promising strategy to promote IDM for CaP screening among African American men.

A computer-tailored intervention to promote informed decision making for prostate cancer screening among African-American men

Science.gov (United States)

Allen, Jennifer D.; Mohllajee, Anshu P.; Shelton, Rachel C.; Drake, Bettina F.; Mars, Dana R.

2010-01-01

African-American men experience a disproportionate burden of prostate cancer (CaP) morbidity and mortality. National screening guidelines advise men to make individualized screening decisions through a process termed “informed decision making” (IDM). In this pilot study, a computer-tailored decision-aid designed to promote IDM was evaluated using a pre/post test design. African-American men aged 40+ recruited from a variety of community settings (n=108). At pre-test, 43% of men reported having made a screening decision; at post-test 47% reported this to be the case (p=0.39). Significant improvements were observed on scores (0–100%) of knowledge (54% vs 72%; pMen were also more likely to want an active role in decision-making after using the tool (67% vs 75%; p=0.03). These results suggest that use of a computer-tailored decision-aid is a promising strategy to promote IDM for CaP screening among African-American men. PMID:19477736

Chapter 10. Professional migration from Latin America and the Caribbean

OpenAIRE

2013-01-01

From NGO to multilateral organisation and government involvement: three case studiesFernando Lema Executive summary In this chapter we present three case studies of the Latin American diaspora: one on the experience of non-profit organisations (NGO) in France (AFUDEST and ALAS), one on work in an international organisation (UNESCO) and one about field work with a government agency, Argentina's Secretariat for Science, Technology and Productive Innovation (SETCIP). The three experiences took p...

Perceived stress as a mediator between social constraints and sleep quality among Chinese American breast cancer survivors.

Science.gov (United States)

Yeung, Nelson C Y; Ramirez, Jeffrey; Lu, Qian

2017-07-01

Previous studies primarily fo c used on how disease- and treatment-related variables affect cancer survivors' sleep quality. Little is known about the impact of the psychosocial factors on their sleep quality. Social constraints are perceived negative social interactions inhibiting one's disclosure. This study examined the association between social constraints and Chinese American breast cancer survivors' (BCS) sleep quality and tested perceived stress as a mediator explaining the association. Chinese American BCS (n = 94) were recruited from Southern California. Participants' social constraints, perceived stress, and sleep quality were measured in a questionnaire package. Social constraints were associated with higher perceived stress (r = 0.32, p = .002) and poorer sleep quality (r = 0.33, p stress was associated with poorer sleep quality (r = 0.47, p social constraints to poor sleep quality (indicated by the Pittsburgh Sleep Quality Index; PSQI) via perceived stress was significant (β = 0.20; 95% confidence intervals (CI) = 0.06, 0.40). The path coefficient for direct effect from social constraints to PSQI significantly dropped from β = 0.32 (95% CI = 0.11, 0.51) to β = 0.13 (95% CI = -0.12, 0.35) after considering perceived stress as a mediator, suggesting a mediation effect. This study implied that social constraints may worsen sleep quality among Chinese American BCS through increasing perceived stress. Interventions to reduce social constraints and perceived stress may improve sleep quality.

Health hazards and medical treatment of volunteers aged 18-30 years working in international social projects of non-governmental organizations (NGO).

Science.gov (United States)

Küpper, T; Rieke, B; Neppach, K; Morrison, A; Martin, J

2014-01-01

The specific health risk profile and diversity of treatments sought by young volunteers participating in international social projects should differ from those of their older colleagues. In the absence of any data to identify whether this was correct, a retrospective analysis was performed using a standardized questionnaire. Questions included what diseases occurred, and details of the frequency and types of treatment sought during their stay - (e.g. self-treatment, medical/dental intervention, or local healer). The 153 participants were aged 18-30 years and worked in a non-governmental organization for >6 months. The participants were: 53% female, mean age 20 years, and mean duration of stay was 11.2 months. Their NGO placement abroad was in Latin America 65.4%, 14.4% in Africa, and 9.8% in Asia. 83% of the young volunteers had received some advice regarding travel medicine before their departure. However, they suffered from more injuries compared to private travellers, and febrile infections were more common when compared to older studies. 21.2% suffered from dental problems and 50% of them sought medical treatment. This study highlights a previously unreported higher risk profile of specific health problems occurring in young NGO volunteers, including some potentially life-threatening diagnoses that differed from their older colleagues and normal travellers. It is recommended that young volunteers should receive age specific, comprehensive pre-departure training in health and safety, first aid, and management of common health problems. A medical check-up upon returning home should be mandatory. The provision of a basic first aid kit to each volunteer before departure is also recommended. Copyright © 2013 Elsevier Ltd. All rights reserved.

Gain versus loss-framed messaging and colorectal cancer screening among African Americans: A preliminary examination of perceived racism and culturally targeted dual messaging.

Science.gov (United States)

Lucas, Todd; Hayman, Lenwood W; Blessman, James E; Asabigi, Kanzoni; Novak, Julie M

2016-05-01

This preliminary study examined the effect of gain versus loss-framed messaging as well as culturally targeted personal prevention messaging on African Americans' receptivity to colorectal cancer (CRC) screening. This research also examined mechanistic functions of perceived racism in response to message framing. Community samples of African Americans (N = 132) and White Americans (N = 50) who were non-compliant with recommended CRC screening completed an online education module about CRC, and were either exposed to a gain-framed or loss-framed message about CRC screening. Half of African Americans were exposed to an additional and culturally targeted self-control message about personal prevention of CRC. Theory of planned behavior measures of attitudes, normative beliefs, perceived behavioural control, and intentions to obtain a CRC screen served as primary outcomes. The effect of messaging on perceived racism was also measured as an outcome. Consistent with prior research, White Americans were more receptive to CRC screening when exposed to a loss-framed message. However, African Americans were more receptive when exposed to a gain-framed message. The contrary effect of loss-framed messaging on receptivity to screening among African Americans was mediated by an increase in perceived racism. However, including an additional and culturally targeted prevention message mitigated the adverse effect of a loss-framed message. This study identifies an important potential cultural difference in the effect of message framing on illness screening among African Americans, while also suggesting a culturally relevant linking mechanism. This study also suggests the potential for simultaneously presented and culturally targeted messaging to alter the effects of gain and loss-framed messaging on African Americans. What is already known on this subject? African Americans are at an increased risk of both developing and dying from colorectal cancer (CRC). These disparities can be

Addressing Cancer Disparities Among American Indians through Innovative Technologies and Patient Navigation: The Walking Forward Experience

Energy Technology Data Exchange (ETDEWEB)

Petereit, Daniel G. [Department of Oncology, John T. Vucurevich Cancer Care Institute, Rapid City, SD (United States); Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, WI (United States); Guadagnolo, B. Ashleigh [Department of Radiation Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Wong, Rosemary; Coleman, C. Norman, E-mail: dpetereit@regionalhealth.com [Radiation Research Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, Rockville, MD (United States)

2011-06-22

Purpose/Objective(s): American Indians (AIs) present with more advanced stages of cancer and, therefore, suffer from higher cancer mortality rates compared to non-AIs. Under the National Cancer Institute (NCI) Cancer Disparities Research Partnership (CDRP) Program, we have been researching methods of improving cancer treatment and outcomes since 2002, for AIs in Western South Dakota, through the Walking Forward (WF) Program. Materials/Methods: This program consists of (a) a culturally tailored patient navigation program that facilitated access to innovative clinical trials in conjunction with a comprehensive educational program encouraging screening and early detection, (b), surveys to evaluate barriers to access, (c) clinical trials focusing on reducing treatment length to facilitate enhanced participation using brachytherapy and intensity modulated radiotherapy (IMRT) for breast and prostate cancer, as AIs live a median of 140 miles from the cancer center, and (d) a molecular study (ataxia telangiectasia mutated) to address whether there is a specific profile that increases toxicity risks. Results: We describe the design and implementation of this program, summary of previously published results, and ongoing research to influence stage at presentation. Some of the critical outcomes include the successful implementation of a community-based research program, development of trust within tribal communities, identification of barriers, analysis of nearly 400 navigated cancer patients, clinical trial accrual rate of 10%, and total enrollment of nearly 2,500 AIs on WF research studies. Conclusion: This NCI funded pilot program has achieved some initial measures of success. A research infrastructure has been created in a community setting to address new research questions and interventions. Efforts underway to promote cancer education and screening are presented, as well as applications of the lessons learned to other health disparity populations – both nationally and

Addressing Cancer Disparities Among American Indians through Innovative Technologies and Patient Navigation: The Walking Forward Experience

International Nuclear Information System (INIS)

Petereit, Daniel G.; Guadagnolo, B. Ashleigh; Wong, Rosemary; Coleman, C. Norman

2011-01-01

Purpose/Objective(s): American Indians (AIs) present with more advanced stages of cancer and, therefore, suffer from higher cancer mortality rates compared to non-AIs. Under the National Cancer Institute (NCI) Cancer Disparities Research Partnership (CDRP) Program, we have been researching methods of improving cancer treatment and outcomes since 2002, for AIs in Western South Dakota, through the Walking Forward (WF) Program. Materials/Methods: This program consists of (a) a culturally tailored patient navigation program that facilitated access to innovative clinical trials in conjunction with a comprehensive educational program encouraging screening and early detection, (b), surveys to evaluate barriers to access, (c) clinical trials focusing on reducing treatment length to facilitate enhanced participation using brachytherapy and intensity modulated radiotherapy (IMRT) for breast and prostate cancer, as AIs live a median of 140 miles from the cancer center, and (d) a molecular study (ataxia telangiectasia mutated) to address whether there is a specific profile that increases toxicity risks. Results: We describe the design and implementation of this program, summary of previously published results, and ongoing research to influence stage at presentation. Some of the critical outcomes include the successful implementation of a community-based research program, development of trust within tribal communities, identification of barriers, analysis of nearly 400 navigated cancer patients, clinical trial accrual rate of 10%, and total enrollment of nearly 2,500 AIs on WF research studies. Conclusion: This NCI funded pilot program has achieved some initial measures of success. A research infrastructure has been created in a community setting to address new research questions and interventions. Efforts underway to promote cancer education and screening are presented, as well as applications of the lessons learned to other health disparity populations – both nationally and

In an Age of Open Access to Research Policies: Physician and Public Health NGO Staff Research Use and Policy Awareness.

Science.gov (United States)

Moorhead, Laura L; Holzmeyer, Cheryl; Maggio, Lauren A; Steinberg, Ryan M; Willinsky, John

2015-01-01

Through funding agency and publisher policies, an increasing proportion of the health sciences literature is being made open access. Such an increase in access raises questions about the awareness and potential utilization of this literature by those working in health fields. A sample of physicians (N=336) and public health non-governmental organization (NGO) staff (N=92) were provided with relatively complete access to the research literature indexed in PubMed, as well as access to the point-of-care service UpToDate, for up to one year, with their usage monitored through the tracking of web-log data. The physicians also participated in a one-month trial of relatively complete or limited access. The study found that participants' research interests were not satisfied by article abstracts alone nor, in the case of the physicians, by a clinical summary service such as UpToDate. On average, a third of the physicians viewed research a little more frequently than once a week, while two-thirds of the public health NGO staff viewed more than three articles a week. Those articles were published since the 2008 adoption of the NIH Public Access Policy, as well as prior to 2008 and during the maximum 12-month embargo period. A portion of the articles in each period was already open access, but complete access encouraged a viewing of more research articles. Those working in health fields will utilize more research in the course of their work as a result of (a) increasing open access to research, (b) improving awareness of and preparation for this access, and (c) adjusting public and open access policies to maximize the extent of potential access, through reduction in embargo periods and access to pre-policy literature.

American Adults' Knowledge of Exercise Recommendations

Science.gov (United States)

Morrow, James R., Jr.; Krzewinski-Malone, Jeanette A.; Jackson, Allen W.; Bungum, Timothy J.; FitzGerald, Shannon J.

2004-01-01

Physical inactivity is a major risk factor for cardiovascular disease, stroke, hypertension, diabetes, obesity, osteoporosis, and some cancers. Approximately 950,000 Americans die annually from cardiovascular diseases. The purpose of this study was to determine whether American adults know which traditional and lifestyle physical activities affect…

Characterizing inflammatory breast cancer among Arab Americans in the California, Detroit and New Jersey Surveillance, Epidemiology and End Results (SEER) registries (1988-2008).

Science.gov (United States)

Hirko, Kelly A; Soliman, Amr S; Banerjee, Mousumi; Ruterbusch, Julie; Harford, Joe B; Chamberlain, Robert M; Graff, John J; Merajver, Sofia D; Schwartz, Kendra

2013-12-01

Inflammatory breast cancer (IBC) is characterized by an apparent geographical distribution in incidence, being more common in North Africa than other parts of the world. Despite the rapid growth of immigrants to the United States from Arab nations, little is known about disease patterns among Arab Americans because a racial category is rarely considered for this group. The aim of this study was to advance our understanding of the burden of IBC in Arab ethnic populations by describing the proportion of IBC among different racial groups, including Arab Americans from the Detroit, New Jersey and California Surveillance, Epidemiology and End Results (SEER) registries. We utilized a validated Arab surname algorithm to identify women of Arab descent from the SEER registries. Differences in the proportion of IBC out of all breast cancer and IBC characteristics by race and menopausal status were evaluated using chi-square tests for categorical variables, t-tests and ANOVA tests for continuous variables, and log-rank tests for survival data. We modeled the association between race and IBC among all women with breast cancer using hierarchical logistic regression models, adjusting for individual and census tract-level variables. Statistically significant differences in the proportion of IBC out of all breast cancers by race were evident. In a hierarchical model, adjusting for age, estrogen and progesterone receptor, human epidermal growth receptor 2, registry and census-tract level education, Arab-Americans (OR=1.5, 95% CI=1.2,1.9), Hispanics (OR=1.2, 95% CI=1.1,1.3), Non-Hispanic Blacks (OR=1.3, 95% CI=1.2, 1.4), and American Indians/Alaskans (OR=1.9, 95% CI=1.1, 3.4) had increased odds of IBC, while Asians (OR=0.6, 95% CI=0.6, 0.7) had decreased odds of IBC as compared to Non-Hispanic Whites. IBC may be more common among certain minority groups, including Arab American women. Understanding the descriptive epidemiology of IBC by race may generate hypotheses about risk

Stomach Cancer

Science.gov (United States)

... familydoctor.org editorial staff Categories: Men, Seniors, WomenTags: cancer, gastric cancer, stomach cancer May 1, 1999 Copyright © American Academy ... Crisis Situations Pets and Animals myhealthfinder Food and Nutrition Healthy Food Choices Weight Loss and Diet Plans ...

Population-based geographic access to parent and satellite National Cancer Institute Cancer Center Facilities.

Science.gov (United States)

Onega, Tracy; Alford-Teaster, Jennifer; Wang, Fahui

2017-09-01

Satellite facilities of National Cancer Institute (NCI) cancer centers have expanded their regional footprints. This study characterized geographic access to parent and satellite NCI cancer center facilities nationally overall and by sociodemographics. Parent and satellite NCI cancer center facilities, which were geocoded in ArcGIS, were ascertained. Travel times from every census tract in the continental United States and Hawaii to the nearest parent and satellite facilities were calculated. Census-based population attributes were used to characterize measures of geographic access for sociodemographic groups. From the 62 NCI cancer centers providing clinical care in 2014, 76 unique parent locations and 211 satellite locations were mapped. The overall proportion of the population within 60 minutes of a facility was 22% for parent facilities and 32.7% for satellite facilities. When satellites were included for potential access, the proportion of some racial groups for which a satellite was the closest NCI cancer center facility increased notably (Native Americans, 22.6% with parent facilities and 39.7% with satellite facilities; whites, 34.8% with parent facilities and 50.3% with satellite facilities; and Asians, 40.0% with parent facilities and 54.0% with satellite facilities), with less marked increases for Hispanic and black populations. Rural populations of all categories had dramatically low proportions living within 60 minutes of an NCI cancer center facility of any type (1.0%-6.6%). Approximately 14% of the population (n = 43,033,310) lived more than 180 minutes from a parent or satellite facility, and most of these individuals were Native Americans and/or rural residents (37% of Native Americans and 41.7% of isolated rural residents). Racial/ethnic and rural populations showed markedly improved geographic access to NCI cancer center care when satellite facilities were included. Cancer 2017;123:3305-11. © 2017 American Cancer Society. © 2017 American