This study assessed cancer risk factors and screening in the Cow Creek Band of Umpqua Tribe in Oregon through a survey of 283 tribal members. Compared to non-Hispanic whites in Oregon, tribal members were more likely to be obese and current smokers but had similar or higher rates of cancer screening. Specifically, tribal members were more likely to have received fecal occult blood tests and clinical breast exams recently. While some risk factors were elevated, cancer screening rates were generally favorable and suggested the tribe's health programs were having a positive impact.
This document summarizes a study analyzing media coverage of updated prostate cancer screening guidelines from the USPSTF and AUA. The study found that:
1) 92 news articles were analyzed from 2011-2013 covering the preliminary 2011 USPSTF guidelines, final 2012 guidelines, and 2013 AUA guidelines.
2) Articles frequently emphasized potential downsides of screening and inaccurately summarized guidelines/evidence.
3) Coverage of the USPSTF announcements was more extensive than the AUA guidelines.
4) Urologists were commonly interviewed but articles also cited costs and urologists' financial interests in screening.
5) The study provides insight into how media shapes views of
When reducing cancer risk in our population, let’s not exacerbate disparitiesGraham Colditz
The document discusses reducing cancer disparities through precision prevention approaches. It highlights that while precision medicine focuses on treating existing disease, precision prevention aims to tailor behavioral interventions to individual characteristics to reduce cancer risk. However, efforts to refine prevention strategies could inadvertently worsen disparities if factors like health literacy levels and access to care are not considered. Priorities for avoiding disparities include collaborating with diverse partners to improve communication and applying implementation research approaches to ensure evidence-based programs reach all groups.
As part of the 4th Annual Early Age Onset CRC Summit theNational Colorectal Cancer Roundtable (NCCRT) Family History and Early Onset Task Group hosted a Special Symposium focused on the importance of Family Health History for colorectal cancer, including advanced adenomas, and its importance in preventing colorectal cancer. The Symposium included presentations on the current challenges and opportunities surrounding ascertainment and documentation of actionable family health history information in primary care.
This document summarizes several breast cancer risk assessment models. It discusses two main types of risk assessment: the chances of developing breast cancer over time, and the chances of carrying a mutation in a high-risk gene like BRCA1/2. Several models are described that assess these risks, including the Gail model, Claus model, BRCAPRO, and Cuzick-Tyrer models. Each model incorporates different sets of risk factors and has varying levels of validation and ability to predict cancer risk. The document advocates that improved models integrating more genetic and lifestyle risk factors could achieve more accurate individualized risk prediction.
Characteristics of cases with unknown stage prostate cancerCancer Council NSW
Stage of cancer at diagnosis (e.g. localised, regional involvement, metastatic) is an important predictor of survival. This paper identifies there is cause for concern surrounding the 40% of "unknown" or unrecorded stage of diagnosis on prostate cancer patient records in NSW. This means crucial information is missing from their records. The second stage of this project, scheduled for completion in late 2014, is to identify the reasons for these missing data. Once this has been completed we can inform policy makers to ensure the data completeness can be improved. Studies using cancer staging data can then increase in quality and quantity.
EAOCRC Summit Framing the Conversation: Strategic Challenges in Current Medical Care that Contribute to Young Adult Colorectal Cancer (CRC) Incidence and Mortality. Session I - The Dimensions of the EAOCRC Problem.
Over the past 20 years, improvements in cancer prevention, screening, and treatment in Australia have saved over 61,000 lives according to new Cancer Council research. Key findings include that annual lung cancer deaths have fallen by 2,154, bowel cancer deaths have fallen by 1,797, and breast cancer deaths have fallen by 773. However, cancers of the brain, pancreas, and esophagus have seen relatively small improvements, with 148, 69, and 64 fewer deaths respectively. Continued investment in research is needed to achieve further reductions in cancer deaths. Cancer Council NSW has funded over $120 million in research over the past 20 years, achieving advances such as new treatments for brain and pancreatic cancers and improved cancer survival rates.
This study analyzed the prevalence of BRCA1/2 mutations and risk of secondary malignancies in 333 young women (age <45 years) with breast cancer from racially diverse populations. The key findings were:
1. The frequency of deleterious BRCA1/2 mutations was remarkably similar across Caucasian (17%), African American (14%), and Korean (14%) women.
2. African American women had a higher frequency of variants of uncertain significance in BRCA2 compared to other groups.
3. The risk of secondary malignancies at 10-year follow-up was similar for those with wild-type BRCA1/2 (14%) and variants of uncertain significance (16%), but higher
This document summarizes a study analyzing media coverage of updated prostate cancer screening guidelines from the USPSTF and AUA. The study found that:
1) 92 news articles were analyzed from 2011-2013 covering the preliminary 2011 USPSTF guidelines, final 2012 guidelines, and 2013 AUA guidelines.
2) Articles frequently emphasized potential downsides of screening and inaccurately summarized guidelines/evidence.
3) Coverage of the USPSTF announcements was more extensive than the AUA guidelines.
4) Urologists were commonly interviewed but articles also cited costs and urologists' financial interests in screening.
5) The study provides insight into how media shapes views of
When reducing cancer risk in our population, let’s not exacerbate disparitiesGraham Colditz
The document discusses reducing cancer disparities through precision prevention approaches. It highlights that while precision medicine focuses on treating existing disease, precision prevention aims to tailor behavioral interventions to individual characteristics to reduce cancer risk. However, efforts to refine prevention strategies could inadvertently worsen disparities if factors like health literacy levels and access to care are not considered. Priorities for avoiding disparities include collaborating with diverse partners to improve communication and applying implementation research approaches to ensure evidence-based programs reach all groups.
As part of the 4th Annual Early Age Onset CRC Summit theNational Colorectal Cancer Roundtable (NCCRT) Family History and Early Onset Task Group hosted a Special Symposium focused on the importance of Family Health History for colorectal cancer, including advanced adenomas, and its importance in preventing colorectal cancer. The Symposium included presentations on the current challenges and opportunities surrounding ascertainment and documentation of actionable family health history information in primary care.
This document summarizes several breast cancer risk assessment models. It discusses two main types of risk assessment: the chances of developing breast cancer over time, and the chances of carrying a mutation in a high-risk gene like BRCA1/2. Several models are described that assess these risks, including the Gail model, Claus model, BRCAPRO, and Cuzick-Tyrer models. Each model incorporates different sets of risk factors and has varying levels of validation and ability to predict cancer risk. The document advocates that improved models integrating more genetic and lifestyle risk factors could achieve more accurate individualized risk prediction.
Characteristics of cases with unknown stage prostate cancerCancer Council NSW
Stage of cancer at diagnosis (e.g. localised, regional involvement, metastatic) is an important predictor of survival. This paper identifies there is cause for concern surrounding the 40% of "unknown" or unrecorded stage of diagnosis on prostate cancer patient records in NSW. This means crucial information is missing from their records. The second stage of this project, scheduled for completion in late 2014, is to identify the reasons for these missing data. Once this has been completed we can inform policy makers to ensure the data completeness can be improved. Studies using cancer staging data can then increase in quality and quantity.
EAOCRC Summit Framing the Conversation: Strategic Challenges in Current Medical Care that Contribute to Young Adult Colorectal Cancer (CRC) Incidence and Mortality. Session I - The Dimensions of the EAOCRC Problem.
Over the past 20 years, improvements in cancer prevention, screening, and treatment in Australia have saved over 61,000 lives according to new Cancer Council research. Key findings include that annual lung cancer deaths have fallen by 2,154, bowel cancer deaths have fallen by 1,797, and breast cancer deaths have fallen by 773. However, cancers of the brain, pancreas, and esophagus have seen relatively small improvements, with 148, 69, and 64 fewer deaths respectively. Continued investment in research is needed to achieve further reductions in cancer deaths. Cancer Council NSW has funded over $120 million in research over the past 20 years, achieving advances such as new treatments for brain and pancreatic cancers and improved cancer survival rates.
This study analyzed the prevalence of BRCA1/2 mutations and risk of secondary malignancies in 333 young women (age <45 years) with breast cancer from racially diverse populations. The key findings were:
1. The frequency of deleterious BRCA1/2 mutations was remarkably similar across Caucasian (17%), African American (14%), and Korean (14%) women.
2. African American women had a higher frequency of variants of uncertain significance in BRCA2 compared to other groups.
3. The risk of secondary malignancies at 10-year follow-up was similar for those with wild-type BRCA1/2 (14%) and variants of uncertain significance (16%), but higher
Advancing The Prevention And Cure Of Cancerfondas vakalis
The document discusses the shared missions and collaborations between the American Association for Cancer Research (AACR) and the National Cancer Institute (NCI) to advance cancer research and reduce the burden of cancer. It outlines their joint efforts in conferences, workshops, and think tanks. It also summarizes advances in cancer prevention, early detection, and treatment that have contributed to reduced cancer mortality rates in recent years but challenges remain.
An Examination of Health Care Quality--with a focus on physician rendered caretoabel
This document discusses quality in healthcare and physician-rendered care. It notes that while quality aims to be discernible and reproducible, studies have shown variances in treatment recommendations and outcomes across patient groups. Specifically, a 1999 study found that a patient's race and sex independently influenced physicians' likelihood of recommending cardiac catheterization, indicating potential bias. This raises questions about how physician training and professionalism can allow for differences in care quality among groups. More research is needed to understand what systematic variances in health status are maintained over time for disparate patient populations.
This document discusses a study examining whether race affects survival outcomes for patients with triple negative breast cancer in Louisiana. It provides background on breast cancer subtypes and highlights that triple negative breast cancer is more common and deadly for African American women. The study aims to analyze Louisiana cancer registry data to calculate the frequency of triple negative breast cancer, compare incidence rates by demographics, calculate relative survival rates, and assess the effect of race on survival. Statistical analysis will include frequencies, chi-squared tests, Kaplan-Meier survival curves, and Cox proportional hazards regression.
Colorectal cancer screening and subsequent incidence of colorectal cancer: re...Cancer Council NSW
Colorectal cancer screening and subsequent incidence of colorectal cancer: results from the 45 and Up Study
Annika Steffen, Marianne F Weber, David M Roder and Emily Banks
5th Annual Early Age Onset Colorectal Cancer Summit - Session II: Family History Ascertainment in the US - What Steps are Needed to Improve the Well Documented Less Than Optimal Status of this Situation?
Cancer Council NSW Research Report Newsletter Sept 2014 Cancer Council NSW
The document summarizes several research studies and initiatives. It discusses a study finding lower survival rates for prostate cancer in rural areas compared to cities, and ways for rural men to help themselves through regular doctor visits and screening. It also describes a new potential treatment for triple negative breast cancer developed by combining two existing drugs, and Cancer Council's process for selecting and funding research proposals which involves reviews from scientific and consumer panels. Finally, it encourages registering for their research study database to participate in cancer studies.
Relationship between lifestyle and health factors and severe Lower Urinary Tract Symptoms (LUTS) in 106,435 middle-aged and older Australian men: population-based study
Rodger - Prostate cancer mortality outcomes and patterns of primary treatment...Cancer Council NSW
This document summarizes a study examining differences in prostate cancer mortality and primary treatment between Aboriginal and non-Aboriginal men in New South Wales, Australia. The study found that Aboriginal men were 49% more likely to die of prostate cancer within 5 years of diagnosis compared to non-Aboriginal men, even after adjusting for demographic factors, stage at diagnosis, health access and comorbidities. Aboriginal men were also less likely to receive curative surgery (prostatectomy) for localised or regional prostate cancer. A medical record review of 87 Aboriginal men provided more detailed information on staging and treatment, finding that of those diagnosed with localised disease, 38% had a prostatectomy and radiotherapy, 29% had radiotherapy only, and
The ban on phenacetin is associated with changes in the incidence trends of u...Cancer Council NSW
This study analyzed cancer registry data from Australia to evaluate the long-term impact of banning the analgesic phenacetin on incidence trends of upper-urinary tract (UUT) cancers. The key findings were:
1) Incidence rates of renal pelvis cancer decreased by 52% in women and 39% in men between 1983-1987 and 2003-2007, with a stronger decline in states with historically high phenacetin use.
2) The decline in renal pelvis cancer rates was particularly pronounced in women born after the mid-1910s, suggesting the ban had a beneficial cohort effect.
3) Incidence rates of ureteral cancer remained stable for both sexes throughout the study period and were
1) New research funded by Cancer Council NSW is investigating why overweight Australians have a higher risk of liver cancer and exploring potential treatments. The research is looking at the role of hormones like adiponectin and sugars in liver cancer development and progression.
2) This research is one of 16 projects receiving over $5.4 million in funding from Cancer Council NSW to support cancer research. The projects will run for three years and involve Australian and international research teams.
3) The research aims to find new ways to prevent and treat liver cancer in order to address rising obesity and liver cancer rates in Australia.
Cancer Council NSW Research Report Newsletter - November 2013Cancer Council NSW
Inside you will find:
Forgotten cancers: Bringing research funds and resources to bear on this area
Our Staff: 5 minutes with Dr Lini Nair-Shalliker
Our Insight: TA small change to the Death Registration Notice could save lives
Research Discovery: How cancer cells learn to resist the drug treatments
Join a Research Study - Make yourself available for research and help reduce the burden of cancer by completing a 5 minute questionnaire.
26th International Papillomavirus Conference: Satellite Symposium
Enhancing HPV Prevention among Indigenous Populations: International Perspectives on Health and Well-Being
Montreal, Quebec
July 5, 2010
Panel 2: Primary and Secondary Prevention of HPV Diseases, Cervical and other cancers among Indigenous Populations: Promising Interventions and Wise Practices.
This study analyzed data on 68,686 men diagnosed with prostate cancer in New South Wales, Australia between 1982-2007 to investigate geographic differences in survival rates. The key findings were:
1) Overall 10-year survival rates increased over time but men living outside major cities had higher risks of death even after adjusting for clinical factors.
2) Men in inner regional and rural areas were less likely to have localized disease and more likely to have unknown stage at diagnosis compared to men in cities.
3) Socioeconomic status was also a significant prognostic factor, with men from disadvantaged areas having higher mortality risks than men from affluent areas.
4) Despite increasing awareness and policies aimed at reducing dispar
Aboriginal Patterns of Cancer Care Project Breast Cancer paper BMCCancer 1471...Cancer Council NSW
Aboriginal women in New South Wales, Australia have lower rates of survival from breast cancer than non-Aboriginal women. Aboriginal women were less likely to receive surgical treatment for their breast cancer and were more likely to have other health issues. After accounting for differences in factors like age, disease stage at diagnosis, surgical treatment, and health issues, Aboriginal women still had a 30% higher risk of death from breast cancer. Improving access to surgical treatment and reducing health issues may help increase breast cancer survival rates for Aboriginal women.
Weber - Cancer Screening among Immigrants Living in Urban and Regional Austra...Cancer Council NSW
Cancer Screening among Immigrants Living in Urban and Regional Australia: Results from the 45 and Up Study. This study explored differences in cancer screening participation by place of birth and residence - self-reported use of mammogram, faecal occult blood test (FOBT), and/or prostate specific antigen (PSA) tests
International Journal for Environmental and Research Public Health
Int. J. Environ. Res. Public Health 2014, 11(8), 8251-8266
The document summarizes the Cancer Lifestyle and Evaluation of Risk (CLEAR) study conducted by Cancer Council NSW to research cancer risk factors. It discusses that the CLEAR study has collected lifestyle and health information from over 8,000 cancer patients and 2,000 non-cancer controls. Cancer Council NSW scientists plan to use the CLEAR study data to research risk factors for cancer in six main areas: alcohol consumption, smoking, body mass index and physical activity, infectious agents, hormones, sun exposure and sleep patterns. The CLEAR study saves researchers time by collecting this foundational data on lifestyle factors and biomarkers that can now be analyzed to study cancer risks.
American journal of epidemiology www.lizettealvarez.comeVerticeHealthTech
This document describes recruitment methods used in a case-control study of lung cancer among African Americans and Latinos in the San Francisco Bay Area from 1998-2001. Rapid case ascertainment through the tumor registry identified eligible lung cancer cases. Random digit dialing and Health Care Financing Administration records were initially used to recruit controls but failed to yield sufficient numbers. Community-based recruitment methods like churches, health fairs, and physicians' offices were more effective at recruiting African American and Latino controls, requiring less than 1 hour per control recruited on average.
Sociocultural and Health Correlates Related to Colorectal Cancer Screening Ad...Kelly Brittain
This study examined factors that influence colorectal cancer (CRC) screening adherence among urban African Americans. The researchers analyzed data from 129 African American participants to identify correlations between CRC screening and cultural identity, social support, CRC beliefs, informed decision making, and health factors. Key findings included: 1) religiosity and having a primary care provider predicted colonoscopy adherence; 2) collectivism, present-time orientation, and informed decision predicted fecal occult blood testing. The results suggest nurses should consider patients' social support, CRC beliefs, and health concerns when discussing CRC screening.
Advancing The Prevention And Cure Of Cancerfondas vakalis
The document discusses the shared missions and collaborations between the American Association for Cancer Research (AACR) and the National Cancer Institute (NCI) to advance cancer research and reduce the burden of cancer. It outlines their joint efforts in conferences, workshops, and think tanks. It also summarizes advances in cancer prevention, early detection, and treatment that have contributed to reduced cancer mortality rates in recent years but challenges remain.
An Examination of Health Care Quality--with a focus on physician rendered caretoabel
This document discusses quality in healthcare and physician-rendered care. It notes that while quality aims to be discernible and reproducible, studies have shown variances in treatment recommendations and outcomes across patient groups. Specifically, a 1999 study found that a patient's race and sex independently influenced physicians' likelihood of recommending cardiac catheterization, indicating potential bias. This raises questions about how physician training and professionalism can allow for differences in care quality among groups. More research is needed to understand what systematic variances in health status are maintained over time for disparate patient populations.
This document discusses a study examining whether race affects survival outcomes for patients with triple negative breast cancer in Louisiana. It provides background on breast cancer subtypes and highlights that triple negative breast cancer is more common and deadly for African American women. The study aims to analyze Louisiana cancer registry data to calculate the frequency of triple negative breast cancer, compare incidence rates by demographics, calculate relative survival rates, and assess the effect of race on survival. Statistical analysis will include frequencies, chi-squared tests, Kaplan-Meier survival curves, and Cox proportional hazards regression.
Colorectal cancer screening and subsequent incidence of colorectal cancer: re...Cancer Council NSW
Colorectal cancer screening and subsequent incidence of colorectal cancer: results from the 45 and Up Study
Annika Steffen, Marianne F Weber, David M Roder and Emily Banks
5th Annual Early Age Onset Colorectal Cancer Summit - Session II: Family History Ascertainment in the US - What Steps are Needed to Improve the Well Documented Less Than Optimal Status of this Situation?
Cancer Council NSW Research Report Newsletter Sept 2014 Cancer Council NSW
The document summarizes several research studies and initiatives. It discusses a study finding lower survival rates for prostate cancer in rural areas compared to cities, and ways for rural men to help themselves through regular doctor visits and screening. It also describes a new potential treatment for triple negative breast cancer developed by combining two existing drugs, and Cancer Council's process for selecting and funding research proposals which involves reviews from scientific and consumer panels. Finally, it encourages registering for their research study database to participate in cancer studies.
Relationship between lifestyle and health factors and severe Lower Urinary Tract Symptoms (LUTS) in 106,435 middle-aged and older Australian men: population-based study
Rodger - Prostate cancer mortality outcomes and patterns of primary treatment...Cancer Council NSW
This document summarizes a study examining differences in prostate cancer mortality and primary treatment between Aboriginal and non-Aboriginal men in New South Wales, Australia. The study found that Aboriginal men were 49% more likely to die of prostate cancer within 5 years of diagnosis compared to non-Aboriginal men, even after adjusting for demographic factors, stage at diagnosis, health access and comorbidities. Aboriginal men were also less likely to receive curative surgery (prostatectomy) for localised or regional prostate cancer. A medical record review of 87 Aboriginal men provided more detailed information on staging and treatment, finding that of those diagnosed with localised disease, 38% had a prostatectomy and radiotherapy, 29% had radiotherapy only, and
The ban on phenacetin is associated with changes in the incidence trends of u...Cancer Council NSW
This study analyzed cancer registry data from Australia to evaluate the long-term impact of banning the analgesic phenacetin on incidence trends of upper-urinary tract (UUT) cancers. The key findings were:
1) Incidence rates of renal pelvis cancer decreased by 52% in women and 39% in men between 1983-1987 and 2003-2007, with a stronger decline in states with historically high phenacetin use.
2) The decline in renal pelvis cancer rates was particularly pronounced in women born after the mid-1910s, suggesting the ban had a beneficial cohort effect.
3) Incidence rates of ureteral cancer remained stable for both sexes throughout the study period and were
1) New research funded by Cancer Council NSW is investigating why overweight Australians have a higher risk of liver cancer and exploring potential treatments. The research is looking at the role of hormones like adiponectin and sugars in liver cancer development and progression.
2) This research is one of 16 projects receiving over $5.4 million in funding from Cancer Council NSW to support cancer research. The projects will run for three years and involve Australian and international research teams.
3) The research aims to find new ways to prevent and treat liver cancer in order to address rising obesity and liver cancer rates in Australia.
Cancer Council NSW Research Report Newsletter - November 2013Cancer Council NSW
Inside you will find:
Forgotten cancers: Bringing research funds and resources to bear on this area
Our Staff: 5 minutes with Dr Lini Nair-Shalliker
Our Insight: TA small change to the Death Registration Notice could save lives
Research Discovery: How cancer cells learn to resist the drug treatments
Join a Research Study - Make yourself available for research and help reduce the burden of cancer by completing a 5 minute questionnaire.
26th International Papillomavirus Conference: Satellite Symposium
Enhancing HPV Prevention among Indigenous Populations: International Perspectives on Health and Well-Being
Montreal, Quebec
July 5, 2010
Panel 2: Primary and Secondary Prevention of HPV Diseases, Cervical and other cancers among Indigenous Populations: Promising Interventions and Wise Practices.
This study analyzed data on 68,686 men diagnosed with prostate cancer in New South Wales, Australia between 1982-2007 to investigate geographic differences in survival rates. The key findings were:
1) Overall 10-year survival rates increased over time but men living outside major cities had higher risks of death even after adjusting for clinical factors.
2) Men in inner regional and rural areas were less likely to have localized disease and more likely to have unknown stage at diagnosis compared to men in cities.
3) Socioeconomic status was also a significant prognostic factor, with men from disadvantaged areas having higher mortality risks than men from affluent areas.
4) Despite increasing awareness and policies aimed at reducing dispar
Aboriginal Patterns of Cancer Care Project Breast Cancer paper BMCCancer 1471...Cancer Council NSW
Aboriginal women in New South Wales, Australia have lower rates of survival from breast cancer than non-Aboriginal women. Aboriginal women were less likely to receive surgical treatment for their breast cancer and were more likely to have other health issues. After accounting for differences in factors like age, disease stage at diagnosis, surgical treatment, and health issues, Aboriginal women still had a 30% higher risk of death from breast cancer. Improving access to surgical treatment and reducing health issues may help increase breast cancer survival rates for Aboriginal women.
Weber - Cancer Screening among Immigrants Living in Urban and Regional Austra...Cancer Council NSW
Cancer Screening among Immigrants Living in Urban and Regional Australia: Results from the 45 and Up Study. This study explored differences in cancer screening participation by place of birth and residence - self-reported use of mammogram, faecal occult blood test (FOBT), and/or prostate specific antigen (PSA) tests
International Journal for Environmental and Research Public Health
Int. J. Environ. Res. Public Health 2014, 11(8), 8251-8266
The document summarizes the Cancer Lifestyle and Evaluation of Risk (CLEAR) study conducted by Cancer Council NSW to research cancer risk factors. It discusses that the CLEAR study has collected lifestyle and health information from over 8,000 cancer patients and 2,000 non-cancer controls. Cancer Council NSW scientists plan to use the CLEAR study data to research risk factors for cancer in six main areas: alcohol consumption, smoking, body mass index and physical activity, infectious agents, hormones, sun exposure and sleep patterns. The CLEAR study saves researchers time by collecting this foundational data on lifestyle factors and biomarkers that can now be analyzed to study cancer risks.
American journal of epidemiology www.lizettealvarez.comeVerticeHealthTech
This document describes recruitment methods used in a case-control study of lung cancer among African Americans and Latinos in the San Francisco Bay Area from 1998-2001. Rapid case ascertainment through the tumor registry identified eligible lung cancer cases. Random digit dialing and Health Care Financing Administration records were initially used to recruit controls but failed to yield sufficient numbers. Community-based recruitment methods like churches, health fairs, and physicians' offices were more effective at recruiting African American and Latino controls, requiring less than 1 hour per control recruited on average.
Sociocultural and Health Correlates Related to Colorectal Cancer Screening Ad...Kelly Brittain
This study examined factors that influence colorectal cancer (CRC) screening adherence among urban African Americans. The researchers analyzed data from 129 African American participants to identify correlations between CRC screening and cultural identity, social support, CRC beliefs, informed decision making, and health factors. Key findings included: 1) religiosity and having a primary care provider predicted colonoscopy adherence; 2) collectivism, present-time orientation, and informed decision predicted fecal occult blood testing. The results suggest nurses should consider patients' social support, CRC beliefs, and health concerns when discussing CRC screening.
This document describes the development of partnerships and recruitment efforts for a prostate cancer education intervention program for African American men and women. A community-academic-clinical team was formed to guide the project. Focus groups were conducted with 81 African American men and women to understand current knowledge and attitudes about prostate cancer screening and research participation. Based on focus group findings, a four-week education program was developed and implemented for 56 of the original focus group participants. The goal was to assess changes in knowledge and attitudes about prostate cancer and research after the education program. Lessons learned from the recruitment strategies could help promote cancer research participation among minority communities.
Urology practices may be well positioned to serve as medical homes according to a new study. Researchers examined data on urology practices and other specialties and found that urology practices outperformed other surgical and medical specialties on structural elements of the medical home model such as care coordination and quality improvement. Nearly three-quarters of urology practices meet standards for medical home recognition compared to just half of other specialty practices. Additionally, a new care coordination system for patients with hematuria was found to improve quality of care by decreasing time to evaluation completion and increasing efficiency through reducing total urology visits. Finally, regions with lower physician density were found to have higher mortality rates for renal cancer, suggesting decreased access to care impacts
Physician density may correlate to worse urologic cancer outcomes according to a study examining cancer mortality rates. The study analyzed cancer mortality rate data from the CDC and found significantly higher renal cancer mortality rates in areas with low physician density. Additionally, there was a negative association between median family income and bladder and renal cancer mortality rates. The study compared counties with the highest and lowest mortality rates for prostate, bladder, and renal cancers and found those with high rates had significantly lower physician population densities and higher rates of residents without health insurance compared to low mortality rate counties.
Physician density may correlate to worse urologic cancer outcomes according to a study examining cancer mortality rates. The study analyzed cancer mortality rate data from the CDC and found significantly higher renal cancer mortality rates in areas with low physician density. Additionally, there was a negative association between median family income and bladder and renal cancer mortality rates. The study compared counties with the highest and lowest mortality rates for prostate, bladder, and renal cancers and found those with high rates had significantly lower physician population densities and higher rates of residents without health insurance compared to low mortality rate counties.
Physician density may correlate to worse urologic cancer outcomes according to a study examining cancer mortality rates. The study analyzed cancer mortality rate data from the CDC and found significantly higher renal cancer mortality rates in areas with low physician density. Additionally, there was a negative association between median family income and bladder and renal cancer mortality rates. The results suggest that easier access to medical care through higher physician availability may help reduce cancer mortality by enabling earlier detection and treatment.
Leandro Mena, MD, MPH
Chair and Professor of Population Health Science
Department of Population Health Science
University of Mississippi Medical Center
This study examined the association between health behaviors and mortality outcomes in women diagnosed with ductal carcinoma in situ (DCIS). The study analyzed data from 1,925 women in the Wisconsin In Situ Cohort study who were followed for a mean of 6.7 years. Health behaviors like smoking, physical activity, alcohol consumption, and BMI were self-reported at baseline and subsequent interviews. The results found that all-cause mortality was higher in current smokers and lower in women with greater physical activity levels before diagnosis. Moderate physical activity after diagnosis was also linked to lower all-cause mortality. Cancer-specific mortality was higher in smokers, and cardiovascular mortality decreased with increasing physical activity. In conclusion, several health behaviors were associated with mortality
Running Head OBESITY EPIDEMIC IN SOUTH U. S STATES1.docxtoltonkendal
Running Head: OBESITY EPIDEMIC IN SOUTH U. S STATES 1
OBESITY EPIDEMIC IN SOUTH U. S STATES 6
Obesity Epidemic Southern U. S States
Carrington Sherman
Name of Institution
Why are southern who live in the southern states like Texas, Louisiana, Mississippi, Alabama, and Georgia have higher obesity rates compared to other state in different region. Is it because of lack of education for health diets or, does it has to deal with the culture and in environment they reside in? Majority of the population who are overweight live in urban areas where there are predominantly lower income families homes (Obesity Epidemic).
In-text citation
Study design
Sample size and description
Independent and dependent variables
Key findings
Study method strengths
Study method weakness
Further research needs
· Conway et al., 2018).
· The study design in this research is the Cohort Study
· The sample size was 24,000 black Americans and 14,064 white adults sampled
· The individuals’ were of age between 40–79 years
· The samples were from underserved populations in the 12-state span that included Alabama, Florida, Arkansas, Georgia, Louisiana, Kentucky, Mississippi, South Carolina, North Carolina, Tennessee, West Virginia and Virginia.
· The dependent variables included the racial difference in the population in U. S including the blacks Americans and the whites.
· The gaps in diabetes, cardiovascular, cancer and other chronic diseases were also dependent factor on the race, economic status and the age of the participants in the population.
· The independent variables included the races that are the African Americans and whites. Change in time was also independent because it did not rely on any factor in the population to vary but determined the extend of variation of the prevalence of the obesity, physical inactivity and diabetes
· Risk of obesity and diabetes monotonically increased with increasing BMI and varied between blacks and whites.
· Diabetes incidences doubled in black populations than among the whites who had normal BMI.
· Racial difference became weak as the BMI increased among the populations
· The increase in the BMI remained a predominant risk factor among blacks and whites.
· One, cohort study presents a clear temporal Sequence of outcomes against exposures over time
· Two, it allows Calculation of the incidence in terms of absolute and relative risks.
· Three, it facilitates study of rare exposures and multiple effects of an exposure. The study design will be able to single out the effect of every exposure to a factor and also combine the several effects due to every exposure on the factor that causes variation in the variables.
· Time consuming because it involving following up a phenomenon for a long time observing and recording incidences
· It is also very expensive due to the length of time involved and the amount of data collection done.
· It is affected by many unforeseen factors in the field. A ...
Factors Influencing Breast Cancer Screening in Low-Income African Americans i...eawilliams
1) The study examined factors that influence breast cancer screening in low-income African American women in Tennessee.
2) It found that marital status and having health insurance were predictors of breast cancer screening.
3) Geographic differences existed in obstacles to screening, with transportation and lack of information about screenings being issues in some regions.
The National Cancer Institute (NCI) conducts and supports cancer research, including utilizing national survey data. The Division of Cancer Control and Population Sciences (DCCPS) aims to reduce cancer risk, incidence, and mortality, as well as improve quality of life for cancer survivors. DCCPS conducts behavioral, epidemiological, and health services research using major national surveys. These include the National Health Interview Survey, Behavioral Risk Factor Surveillance System, National Health and Nutrition Examination Survey, and Tobacco Use Supplement-Current Population Survey. DCCPS also supports cancer surveillance through the Surveillance, Epidemiology, and End Results program.
Participation of the population in decisions about their health and in the pr...Pydesalud
Póster presentado por Lilisbeth Perestelo en el congreso Summer Institute for Informed Patient Choice (SIIPC14) celebrado del 25 al 27 de junio de 2014 en Dartmouth, Hanover (EEUU). Web: http://siipc.org
Contacto: lperperr@gobiernodecanarias.org
1. The document discusses anal cancer prevention in HIV patients, including the epidemiology of anal cancer, current screening guidelines, and treatment options.
2. Rates of anal cancer are increasing, especially among HIV-positive men who have sex with men, due to higher rates of HPV infection. Screening is recommended for high-risk groups but guidelines are based on expert opinion rather than evidence.
3. Screening involves anal cytology and visual inspection, with follow up such as high resolution anoscopy for abnormal results. Treatment options depend on the grade of anal dysplasia or cancer found. Vaccination and condoms may help reduce HPV transmission and anal cancer risk.
This study assessed factors influencing adherence to pre-exposure prophylaxis (PrEP) among key populations in Matayos Sub-County, Kenya. The study found that 37% of key populations showed adherence to PrEP based on the Morisky Medical Adherence Scale-4. Adherence varied among different key populations, with 36% for commercial sex workers, 37% for men who have sex with men, and 52% for people who inject drugs. Statistical analysis revealed that education level, marital status, key population category, occupation, stigma, perceptions of side effects, facility accessibility, actual side effects experienced, and condom use were associated with adherence to PrEP. The study concluded that socio-demographic factors, individual characteristics
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Similar to Bitsie, K. (2015). Cancer Risk and Cancer Screening in a Pacific Northwest Tribe (20)
The prevalence, patterns of usage and people's attitude towards complementary...
Bitsie, K. (2015). Cancer Risk and Cancer Screening in a Pacific Northwest Tribe
1. October 2015 Volume 40 Number 10
Cancer Risk and Cancer Screening in a Pacific
Northwest Tribe
Kevin Bitsie, MPH, Northwest Tribal Epidemiology Center,
Northwest Portland Area Indian Health Board, Portland,
OR, Nicole H. Smith, MPH, Sharon Stanphill, DrPH, Kerri
Lopez, BA, Thomas M. Becker, MD Corresponding
author:TM Becker: tbecker@npaihb.org
Abstract
Objectives. American Indians and Alaskan Natives
(AI/ANs) in the Northwest United States have different
cancer rates, risks, and screening-related behavior when
compared to Non-Hispanic Whites (NHW) in this region.
However, few tribes have had adequate assessments related
to cancer risks and cancer screenings.
Design. We conducted a survey among Cow Creek tribal
members using a modified Behavioral Risk Factor
Surveillance System (BRFSS) questionnaire.
Participants. Working in partnership with the Cow Creek
Band of Umpqua tribe, we assessed the health status,
behavioral risk factors, and use of cancer screenings for this
Pacific Northwest AI Tribe.
Main Outcome Measures. Using data from the 2012
National BRFSS, we compared the prevalence of cancer risk
factors and screening for Cow Creek Tribal members to
NHWs in Oregon.
Results. Compared with NHWs, Cow Creek tribal members
were less likely to self-report their health status as
excellent/very good (47.1% vs. 59.2%, p<0.001), have no
health insurance (70.3% vs. 84.0%, p<0.001), BMI as obese
(34.3% vs. 25.9%, p<0.001), and be a current smoker
(34.3% vs. 25.9%, p<0.001). Cow Creek tribal members
were more likely to have taken a fecal occult blood test
(18.7% vs. 9.0%, p<0.001) and a clinical breast exam
(65.7% vs. 50.2%, p<0.001) within the past year than
NHWs.
Conclusions. Although disparities were observed in some
cancer risk factors and cancer screening among AI/ANs, the
Cow Creek Band of Umpqua tribe shows satisfactory levels
of cancer screening when compared to NHWs in Oregon.
Introduction
Cancer remains one of the leading causes of death for
American Indians and Alaskan Natives nationwide.1, 2, 3
However, cancer incidence and mortality rates differ widely
among American Indian/Alaskan Native (AI/AN)
populations within geographic regions and by tribal groups
throughout the United States.4, 5, 6
Consistent with the
disparate cancer incidence and mortality data in different
regions of the country and among different tribes, cancer risk
factor prevalence data show great variability among tribes
by geographic area. Furthermore, screening for cancer by
site shows widely divergent patterns by tribe, and often are
low compared to non-Hispanic Whites (NHWs) in the same
geographic areas.7, 8
Depending on region in the United
States, gender-specific cancer screening data for AI/ANs
reveal that both genders had lower prevalence of screening
than their NHW counterparts.9
Federal efforts to implement nationwide surveillance
for cancer incidence were broadened over the previous
decade, and with the advent of data linkage studies to
In this Issue…
95 Cancer Risk and Cancer Screening in a
Pacific Northwest Tribe
94 Electronic Subscriptions Available
October 2015 IHS PROVIDER 95
2. improve identification of American Indian and Alaska
Native racial/ethnic status in various statewide registries and
other data bases, tribal cancer incidence data by state and by
region have much improved.7, 10, 11
In a similar vein, cancer
mortality rates among tribal people are also more accurate
as a result of data linkages. With many tribes operating their
own health care clinics, cancer screening and reporting of
cancer cases is often implemented at a tribe-specific level.
Tribal health planners address various risk factors for
cancer at the local level. For these reasons, tribes need their
own tribe-specific data to guide and evaluate their efforts.
Tribes would benefit from surveys like the CDC-initiated,
nationwide Behavioral Risk Factor Surveillance System
(BRFSS) that addresses health issues within particular
populations. However, very few tribes have been able to
implement cancer risk factor surveys to help illuminate
health priorities and tailor interventions to decrease cancer
risks and incidence and mortality rates. Among Northwest
tribes, we earlier (1998-2001) conducted a series of tribal
behavioral risk factor surveys based on the CDC risk factor
survey model, but to date, have collected and analyzed data
from only eight of the 43 federally recognized tribes in this
region. Before this study, Northwest tribes utilized the data
from the BRFSS project 1998-2001; however, the report is
over a decade old. At the request of the Cow Creek Band of
Umpqua tribe, we initiated another tribal BRFSS in 2011-
2012 to help the tribe define health priorities and allow tribal
health leaders to implement interventions to address cancer-
related risk factors among tribal members. This report
summarizes key data that we found from this tribal
telephone survey.
Methods
Setting. We surveyed members from the Cow Creek
Band of Umpqua tribe, located primarily in Oregon, using
an adapted CDC BRFSS telephone-administered
questionnaire in 2011-2012 (Cow Creek BRFSS Project
2010-2012). Cow Creek is a non-reservation based tribe that
recently regained federal recognition and had 1,169 enrolled
members at the time of initiation of our survey. Cow Creek
provides health care to AI/ANs in the Northwest through
Direct Care Services, a type of health care model offered
through the Indian Health Service (IHS). Sixty-three percent
(63%) of the tribe’s population lives in Oregon and the
remaining 37% live in various parts of the US. The study
was supported by the Northwest Portland Area Indian Health
Board (NPAIHB) and Oregon Health and Science
University (OHSU). The protocol was approved by
Institutional Review Boards at NPAIHB and OHSU, and by
tribal leadership. Researchers were committed to following
the principles of community-based participatory research
and involved the Cow Creek Health & Wellness Center at
each step of the project. Tribal health officials approved this
manuscript before submission.
Data collection. Eligibility for study participation
included being an enrolled member of Cow Creek with a
working telephone number, and participants had to be at
least 18 years of age. We attempted to reach all adult tribal
members via telephone to arrange phone BRFSS interviews
at a scheduled time. Tribal staff members were instructed to
contact all adult tribal members to schedule telephone
interviews at a later date. Interviews were then conducted by
trained research assistants at the NPAIHB after tribal staff
members scheduled the interviews. A maximum of three
calls and one telephone message were attempted. Only 20
eligible tribal members who were successfully contacted by
the Cow Creek staff refused to participate in the phone
BRFSS interviews. After survey personnel successfully
contacted potential respondents, all agreed to participate in
the interviews. Thus, the response proportion was 100%
among tribal members who had earlier agreed to participate
in the survey via the introductory phone invitation per tribal
staff.
Telephone interviews were conducted by trained
personnel following a pre-approved script. Interviews
ranged between 20-60 minutes in duration. Rights as a
participant and privacy were reviewed before obtaining
verbal consent. We sent information forms to participants at
the completion of the interview, as well as a 15 dollar gift
card for compensation for their time. Telephone interviews
were randomly monitored for quality and adherence to the
script, and paper surveys were reviewed by another member
of the interview team during the months of active
interviewing to address inconsistencies or missed questions.
We recorded responses on paper copies of the survey that
were later entered into Access software.
Questionnaire. The questionnaire utilized in this study
had 22 sections. We used 10 core sections from the CDC’s
2012 BRFSS form. Twelve more modules were created for
the use in this study. Survey format and questions were
approved by the NPAIHB, Institutional Review Board, and
tribal administration. Overall, the questionnaire consisted of
193 questions.
Measurement. Demographic variables included age,
sex, marital status, employment status, education level, state
of residence, and annual household income. Health status
variables included self-reported health status, healthcare
coverage, type of healthcare coverage, private vs. public
insurance, and usual place of health care. We included four
behavioral risk factors that have been strongly associated
with cancer of various sites, including: obesity, smoking,
alcohol consumption, lack of physical activity, and lack of
screening.9, 12
We also assessed the use of cancer screening
tests at recommended age of screening and different time
October 2015 IHS PROVIDER 96
3. frames by cancer site: respondents aged 50 years and older
who have had a fecal occult blood test within the past year;
respondents aged 50 years and older who have had a
sigmoidoscopy or colonoscopy within the past five years;
females aged 40 years and older who have had a
mammogram within the past year; females aged 40 years
and older who have had a mammogram within the past two
years; females aged 40 years and older who have had a
clinical breast exam with the past year; females aged 50
years and older who have had a mammogram within the past
year; females aged 50 years and older who have had a
mammogram within the past two years; females aged 50
years and older who have had a clinical breast exam within
the past year; females aged 50 years and older who have had
a clinical breast exam with the past two years; males aged
40 years and older who have had a prostate specific antigen
within the past two years; females aged 21 to 64 years old
who have had a pap smear within the past years; and females
aged 21 to 64 years old who have had a pap smear within
three years.
Analysis. For our descriptive analyses, we included all
tribal members age 18 years and older (N= 283) whom we
could contact by phone. Weighted proportions from the
Oregon State BRFSS 2012 survey were used to compare the
raw proportions from the Cow Creek Tribal BRFSS survey
for demographics, health status variables, behavioral risk
factors, and screenings.
For comparison purposes, we accessed on-line data for
the weighted Oregon State BRFSS 2012 via the CDC
website for each state.14
All NHW respondents from the
2012 BRFSS Questionnaire were residents of Oregon. We
examined similar demographic and cancer-related variables
and compared findings using chi-square tests between tribal
and non-Hispanic white groups. All quantitative analysis
was conducted using SAS.
Results
Demographics. Demographic characteristics for Cow
Creek tribal members and Oregon Non-Hispanic Whites are
presented in Table 1.
Our Cow Creek sample included 128 men and 155
women, with 59.7% aged 18 to 49 years and 40.2 % aged 50
years and older. The NHW comparison group included 1736
men and 2667 women, with 28.5% aged 18 to 49 years and
71.6% aged 50 years and older. Because of the age
differences in these populations, we report both crude and
age-adjusted percentages for various risk factor data. When
compared with AI/AN, NHWs had a significantly greater
percentage for being widowed, retired or unable to work,
and a higher percent reported additional years of higher
education compared to AI/ANs. Cow Creek respondents
lived in different states across the nation with the highest
percentage in Oregon, but for the analysis they were
stratified as either Oregon or other (62.9% vs. 37.1%,
respectively).
Health status. Crude and age-adjusted percentages for
health status variables among Cow Creek tribal members
and Oregon NHW participants are shown in Table 2 and are
summarized briefly.
After adjusting for age, AI/ANs participants reported
significantly lower in Excellent/Very Good health than
NHWs (47.1% vs. 59.2%, p<0.001). In addition, a smaller
proportion of AI/AN participants also reported having
healthcare coverage than NHWs (70.3% vs. 84.0%,
p<0.001). Variables, “type of healthcare coverage” and
“healthcare source for Cow Creek tribal members”, are
provided for descriptive purposes with no comparisons to
Oregon NHW because our questions were tailored for the
tribe’s use.
Behavioral risk factors. Crude and age-adjusted
percentages for behavior risk factors associated with cancer
for Cow Creek tribal members and Oregon Non-Hispanic
White participants are shown in Table 3.
We compared body mass index and former/current
smoker status between the two groups. The age-adjusted
proportion of obese tribal members was significantly higher
when compared to NHWs (34.3% vs. 25.9%, p<0.001). In
addition, tribal members were more likely to report as being
current smokers than NHWs (25.7% vs. 16.1%, p<0.001).
When compared with NHWs in Oregon, no significant
differences were noted between overweight, former smoker,
binge drinking, and any physical activity.
Cancer screening. Crude and age-adjusted percentages
for prevalence of Cow Creek tribal members and Oregon
Non-Hispanic White participants who report selected cancer
screenings are shown in Table 4 and are summarized briefly.
Results are presented with the appropriate sex and age
for each recommended cancer screening, including the
appropriate intent for screening. Among respondents aged
50 years and older, AI/ANs were more likely to have taken
a fecal occult blood test within the past year than Oregon
NHWs. In addition, Cow Creek female respondents aged 50
years and older were more likely to have a clinical breast
exam within the past year than Oregon NHW female
respondents.
Discussion
This study is the first to be tailored to Cow Creek Band
of Umpqua Tribe of Indians and compared with NHWs
within the state of Oregon. Our study’s most important
findings included: Cow Creek tribal members self-reported
poorer health, had a higher proportion of obesity, and were
October 2015 IHS PROVIDER 97
4. more likely to be current smokers than NHWs in Oregon.
However, Cow Creek tribal members had favorable cancer
screening histories when compared to NHWs in Oregon. Of
note, two out of 14 cancer screening practices were
statistically significantly different between groups, with
more favorable data observed for the tribe. Overall, we did
not observe substantial health disparities or risk behaviors
among tribal participants compared to NHWs in Oregon.
Our behavioral risk factor data do show major
differences compared to three Northwest tribes that
surveyed randomly selected respondents from their
respective tribal enrollment rosters ten years earlier as
reported by the Northwest Tribal BRFSS 2003 by
NPAIHB.14
When compared with this current study, tribal
data from the NW Tribal BRFSS in 2003 were generally less
favorable compared to Cow Creek tribal data. Modifiable
risk factors for cancer observed in our Cow Creek data that
were statistically significant included obesity and cigarette
smoking. As reported in the earlier NW Tribal BRFSS 2003
report, obesity (47.4%) and current smoking (41.8%) figures
from three randomly selected tribes were much higher than
Cow Creek tribal members and NHWs. These comparisons
suggest that tribes such as Cow Creek may have developed
and implemented health promotion programs over the past
decade to improve cancer risk factor prevalence compared
to the 2003 figures.
Recent incidence and mortality data for Oregon tribes (nine
federally recognized tribes total) showed excesses compared
to NHWs for lung and bronchus, colorectal, pancreas, and
liver cancers.15
Our risk factor data show that cigarette use,
in particular, must be addressed as a public health priority
for Cow Creek tribal members. Approximately one fourth of
Cow Creek adults were current smokers, and about one third
were former smokers. The NPAIHB collaborates with all
NW tribes and has a Northwest Tribal Comprehensive
Cancer Control (NTCCC) grant with Centers for Diseases
Control and Prevention (CDC) that is addressing this
disparity, as well as other cancer disparities among tribes.
Cancer screening data for Cow Creek tribal members
revealed that tribal members had favorable screening
statistics for fecal occult blood tests, sigmoidoscopy,
colonoscopy, as well as for mammograms, clinical breast
exams, pap smears and PSA tests compared to NHW’s;
although, only two screening sites were statistically
significantly different than for NHWs. Our data are
encouraging and suggest that the Cow Creek Tribe and
hopefully, the broader NTCCC program are having success
in improvement of cancer screening among tribal people.
Limitations
Several potential limitations in this study may have
influenced our results and our data interpretation. We were
only able to contact a limited number of adult tribal
members, despite repeated attempts to make contact to
schedule and administer the interviews. However, the
number of potential respondents who clearly refused to
participate was small (n=20). We may have sampled Cow
Creek tribal members who were more economically
advantaged to have telephone service. We were not able to
access medical records or other data sources to validate the
responses to questions that we asked of study participants.
Furthermore, tribal members may not have wanted to release
personal information to outsiders. We reassured respondents
that their answers were confidential and that publication of
their responses would not be linked to their data.
Respondents who did agree to the questionnaire may not
have provided accurate information due to modesty and
reluctance to discuss their personal health. We used several
different interviewers to collect questionnaire data;
however, all were trained by the same two key investigators
involved in the study and the interviewers were required to
perform at a high standard before they began collecting data
from respondents. In addition, the introduction to the survey
was scripted as were all of the questions asked of the
participants, so that inter-observer variability would be
minimized. The population structures between the Cow
Creek Tribe and Oregon non-Hispanic whites differed, with
the tribe showing higher proportions of younger
respondents. Thus, any crude prevalence of chronic
conditions would be influenced by age as a confounding
factor.
Conclusions
The purpose of this study was to gain a better
perspective of Cow Creek tribal health by utilizing tribally
modified BRFSS data to evaluate the prevalence of
modifiable behavioral factors associated with cancer and
their prevalence estimates for cancer screenings. A few
disparities persist in cancer screening, but the Cow Creek
Band of Umpqua tribe has achieved satisfactory levels of
screening success when compared to NHWs. Despite some
excesses in behavioral risks that influence cancer
occurrence, Cow Creek provides a good example for other
regional tribes related to cancer risk factor prevalence and
cancer prevention. Such favorable results can be attributed
to the efforts of the Cow Creek Tribal Clinic, the Northwest
Tribal Comprehensive Cancer Program, and other cancer
prevention programs within the tribe. Programs that improve
cancer screening and other prevention and control efforts
will remain imperative to this tribe’s success.
Acknowledgements
The authors thank the members of Cow Creek Band of
Umpqua Tribe for their participation in the survey, the Cow
Creek Health and Wellness Center staff, and the Tribal
Board of Directors for permission in facilitating the
October 2015 IHS PROVIDER 98
5. implementation of the survey. We thank research assistants
Hanna Nelson, Natalie Chin, Breannon Babbel, Elizabeth
Viles, and Siena Lopez-Johnston for their hard work in
conducting the surveys among Cow Creek participants. Ms.
Nelson also assisted with interviewer training, data editing,
and data cleaning in preparation for analysis. We recognize
the federal program, Native American Research Centers for
Health, and grant number U261IHS0074-02-01, for support
of the summer interns who helped with this survey. Larissa
Nez also provided insightful and thorough help in writing
assistance and general support. Lastly, we thank the staff at
the Northwest Portland Area Indian Health Board for
providing space, telephone access, and other resources that
allowed us to complete this survey.
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3. Maly, A.G., Steel, T.L., Fu, R., Lieberman, D.A., Becker,
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7. Perdue, D.G., Perkins, C., Jackson-Thompson, J., et al.
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10. Hoopes, M.J., Petersen, P., Vinson, E., Lopez, K.
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11. Hoopes, M.J. Taualii, M., Weiser, T.M., Brucker, R.,
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13. Center for Diseases Control and Prevention. BRFSS
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14. Romero F.C., Hasty F., Rose R., et al. Northwest Tribal
Behavioral Risk Factor Surveillance System (BRFSS)
Project, Aggregate Final Project Report. Portland, OR:
Northwest Portland Area Indian Health Board, 2003.
15. Northwest Portland Area Indian Health Board. American
Indian & Alaska Native Community Health Profile –
Oregon. Portland, OR; Northwest Tribal Epidemiology
Center, 2014.
October 2015 IHS PROVIDER 99
6. Table 1. Demographic Characteristics for Cow Creek Tribal Members and Oregon State Non-Hispanic Whites
(NHW), Cow Creek Tribal BRFSS 2011-2012 and Oregon State BRFSS 2012.
Total Surveyed Population
Cow Creek Tribe NHW
(n = 283) (n=4403)
Demographic Characteristic N (Percent) N (Percent)
Age (in years)
18-29 63 (22.4%) 343 (7.9%)
30-39 58 (20.6) 400 (9.2)
40-49 47 (16.7) 497 (11.4)
50-59 54 (19.2) 868 (19.9)
60-69 32 (11.4) 1145 (26.3)
≥70 27 (9.6) 1107 (25.4)
Sex
Male 128 (45.4%) 1736 (39.4%)
Female 155 (54.6) 2667 (60.6)
Marital Status
Married or Living with a Partner or Member of an
Unmarried Couple
183 (64.9%) 2552 (58.4%)
Separated or Divorced 50 (17.7) 728 (16.7)
Widowed 7 (2.5) 574 (13.1)
Never Married or Lived with a Partner 42 (14.9) 516 (11.8)
Employment Status
Employed or Self-Employed 142 (50.4%) 1918 (43.6%)
Unemployed 26 (9.2) 263 (6.0)
Homemaker or Student 31 (11.0) 419 (9.6)
Retired or Unable to Work 83 (29.4) 1784 (40.7)
Education Level
<High School 42 (15.0%) 196 (4.5%)
High School Graduate 83 (29.5) 1082 (24.7)
Additional Years of Higher Education 156 (55.5) 3112 (70.9)
State
Oregon 180 (62.9%) 4403 (100.0%)
Other 106 (37.1) 0 (0)
Some categories do not equal to a full 100% due to rounding, missing and/or refusal/don’t know answers.
BRFSS = Behavioral Risk Factor Surveillance System
October 2015 IHS PROVIDER 100
7. Table 2. Health Status Variables for Cow Creek Tribal Members and Oregon State Non-Hispanic Whites (NHW),
Cow Creek Tribal BRFSS 2011-2012 and Oregon State BRFSS 2012
Total Surveyed Population
Cow Creek Tribe
(Crude)
Cow Creek
Tribe (Age-
Adjusted)a
NHW (Crude) NHW
(Age-
Adjusted)a
P-value
(n = 283) (n=4403)
Health Variable N (Percent) (Percent) N (Percent) (Percent) P
Self-Reported Health
Status
Excellent/Very Good 135 (47.9%) (47.1%) 2444 (55.7%) (59.2%) <0.001
Good 93 (33.0) (34.1) 1210 (27.6) (26.3)
Fair/Poor 54 (19.2) (18.8) 735 (16.8) (14.4)
Healthcare Coverage
Yes 196 (69.8%) (70.3%) 3934 (89.4%) (84.0%) <0.001
No 83 (29.5) (29.0) 454 (10.3) (15.4)
Don't know/Not Sure 2 (0.7) (0.7) 11 (0.3) (0.6)
Type of Healthcare
Coverage of 196
Respondents Covered
Private Insuranceb
161 (81.7%) NA NA NA
Public Insurancec
36 (18.3) NA NA NA
Healthcare Source
Cow Creek Tribal Clinicd
76 (27.7%) NA NA NA
Other Tribal Health
Center/Clinic
24 (8.8) NA NA NA
Private Physician/Clinic 141 (51.5) NA NA NA
Other 33 (12.0) NA NA NA
Some categories do not equal to a full 100% due to rounding, missing and/or refusal/don’t know answers.
a
Age adjusted to the 2000 Standard U.S. Population.
b
Private insurance is comprised of Nesika Health Group and other private insurance.
c
Public insurance is comprised of Medicaid, Medicare/Medicare-Plus, and VA.
d
Cow Creek Health & Wellness Center
October 2015 IHS PROVIDER 101
8. Table 3. Behavioral Risk Factors Associated with Cancer for Cow Creek Tribal Members and Oregon State Non-
Hispanic Whites (NHW), Creek Tribal BRFSS 2011-2012 and Oregon State BRFSS 2012.
Total Surveyed Population
Cow Creek Tribe
(Crude)
Cow Creek
Tribe (Age-
Adjusted)a
NHW (Crude) NHW (Age-
Adjusted)a
P-value
(n = 283) (n=4403)
Behavioral Risk Factor N (Percent) (Percent) N (Percent) (Percent) P
Overweightb 96 (34.5%) (35.6%) 1475 (35.0%) (32.0%) 0.310
Obesec 97 (34.9) (34.3) 1099 (26.1) (25.9) <0.001
Former Smokerd
88 (31.5) (31.0) 1459 (34.0) (26.6) 0.062
Current Smoker 73 (26.2) (25.7) 550 (12.8) (16.1) <0.001
Binge Drinkere
43 (15.4) (15.5) 481 (10.9) (17.3) 0.405
Physical Activity (Any)f 226 (83.1) (83.6) 3679 (83.6) (86.8) 0.098
a
Age adjusted to the 2000 Standard U.S. Population.
b
Overweight is defined as a body mass index of 25.0 to 29.9 kg/m2
.
c
Obese is defined as a body mass index of 30.0 kg/m2
or higher.
d
Former smoker is defined as an individual who has smoked over 100 cigarettes in his/her lifetime but no longer smokes
cigarettes.
e
Binge Drinking is defined as consuming 5 or more drinks on one occasion within the past month for men and 4+ drinks on
one occasion for women for NHW; the Cow Creek questionnaire asked for the frequency of consuming 5 or more drinks on
one occasion for both sexes during the past month.
f
Physical activity is defined as doing physical activity or exercise during the past 30 days other than their regular job
October 2015 IHS PROVIDER 102
9. Table 4. Prevalence of Cow Creek Tribal Members and Oregon State Non-Hispanic Whites (NHW) Who Report
Selected Cancer Screenings, Cow Creek Tribal BRFSS 2011-2012 and Oregon State BRFSS 2012.
Surveyed Population, Respondents age ≥ 50 years
Cow Creek
(Crude)
Cow Creek
(Age-Adjusted)a
NHW (Crude) NHW
(Age-
Adjusted)a
P-value
(n=113) (N=3120)
Fecal Occult Blood Test
within the past year
N (Percent) (Percent) N (Percent) (Percent) P
Yes 20 (18.0%) (18.7%) 284 (9.5%) (9.0%) <0.001
No 84 (75.7) (75.5) 2571 (86.2) (87.1)
Don’t Know/Not
Sure/Refused
7 (6.3) (5.9) 128 (4.3) (3.9)
Sigmoidoscopy or
Colonoscopy within the past
five years
N (Percent) (Percent) N (Percent) (Percent) P
Yes 55 (49.6%) (50.3%) 1485 (49.9%) (48.7%) 0.549
No 55 (49.6) (48.3) 1412 (47.5) (48.8)
Don’t Know/Not
Sure/Refused
1 (0.9) (1.3) 79 (2.7) (2.5)
Surveyed Population, Females age ≥ 40 years
Cow Creek
(Crude)
Cow Creek
(Age-Adjusted)a
NHW (Crude) NHW
(Age-
Adjusted)a
P-value
(n=87) (n=2233)
Mammogram within the past
year
N (Percent) (Percent) N (Percent) (Percent) P
Yes 54 (62.1%) (60.4%) 1217 (56.5%) (53.1%) 0.245
No 32 (36.8) (38.5) 900 (41.8) (45.5)
Don’t Know/Not
Sure/Refused
1 (1.2) (1.1) 38 (1.8) (1.4)
Mammogram within the past
two years
N (Percent) (Percent) N (Percent) (Percent) P
Yes 66 (75.9%) (73.4%) 1579 (70.7%) (68.2%) 0.175
No 20 (23.0) (25.5) 538 (24.1) (27.5)
Don’t Know/Not
Sure/Refused
1 (1.2) (1.1) 116 (5.2) (4.4)
Clinical Breast Exam within
the past year
N (Percent) (Percent) N (Percent) (Percent) P
Yes 55 (65.5%) (65.5%) 1103 (51.3%) (55.8%) 0.074
No 29 (34.5) (34.5) 956 (44.4) (44.2)
Surveyed Population, Females age ≥ 50 years
Cow Creek
(Crude)
Cow Creek
(Age-Adjusted)a
NHW (Crude) NHW
(Age-
Adjusted)a
P-value
(n=65) (n=1936)
Mammogram within the past
year
N (Percent) (Percent) N (Percent) (Percent) P
Yes 44 (67.7%) (68.7%) 1082 (58.1%) (57.1%) 0.223
No 20 (30.8) (29.6) 747 (40.1) (41.2)
October 2015 IHS PROVIDER 103
10. Don’t Know/Not
Sure/Refused
1 (1.5) (1.7) 35 (1.9) (1.7)
Mammogram within the past
two years
N (Percent) (Percent) N (Percent) (Percent) P
Yes 53 (81.5%) (81.8%) 1393 (74.7%) (73.8%) 0.357
No 11 (16.9) (16.5) 436 (23.4) (24.5)
Don’t Know/Not
Sure/Refused
1 (1.5) (1.7) 35 (1.9) (1.7)
Clinical Breast Exam within
the past year
N (Percent) (Percent) N (Percent) (Percent) P
Yes 43 (66.2%) (65.7%) 929 (49.9%) (50.2%) 0.030
No 19 (29.2) (28.0) 843 (45.3) (45.3)
Don’t Know/Not
Sure/Refused
3 (4.6) (6.2) 89 (4.8) (4.5)
Surveyed Population, Males age ≥ 40 years
Cow Creek
(Crude)
Cow Creek
(Age-Adjusted)a
NHW (Crude) NHW
(Age-
Adjusted)a
P-value
(n=73) (n=1384)
Prostate Specific Antigen
within the past two years
N (Percent) (Percent) N (Percent) (Percent) P
Yes 30 (41.7%) (34.1%) 589 (43.6%) (33.8%) 0.227
No 36 (50.0) (56.5) 641 (47.5) (59.9)
Don’t Know/Not
Sure/Refused
6 (8.3) (9.4) 102 (8.9) (6.3)
Some categories do not equal to a full 100% due to rounding, missing and/or refusal/don’t know answers.
a
Age adjusted to the 2000 Standard U.S. Population.
b
Excluded females who had had a hysterectomy.
October 2015 IHS PROVIDER 104
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