Perceived financial decline related to breast reconstruction following mastectomy in a diverse population‐based cohort

Cancer ◽  
2021 ◽  
Author(s):  
Nicholas L. Berlin ◽  
Paul Abrahamse ◽  
Adeyiza O. Momoh ◽  
Steven J. Katz ◽  
Reshma Jagsi ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Population Based ◽  
Diverse Population ◽  
Financial Decline

scholarly journals Nationwide population‐based study of the impact of immediate breast reconstruction after mastectomy on the timing of adjuvant chemotherapy

2019 ◽  
Vol 106 (12) ◽  
pp. 1640-1648
Author(s):  
E. Heeg ◽  
J. X. Harmeling ◽  
B. E. Becherer ◽  
P. J. Marang‐van de Mheen ◽  
M. T. F. D. Vrancken Peeters ◽  
...  
Keyword(s):  
Adjuvant Chemotherapy ◽  
Breast Reconstruction ◽  
Population Based ◽  
Immediate Breast Reconstruction ◽  
Population Based Study ◽  
The Impact

Patterns and correlates of breast reconstruction: results of a population based study

2004 ◽  
Vol 22 (14_suppl) ◽  
pp. 557-557
Author(s):  
M. Morrow ◽  
P. Lantz ◽  
N. Janz ◽  
A. Fagerlin ◽  
M. Mujahid ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Population Based ◽  
Population Based Study

Adjuvant chemotherapy use in a diverse population-based sample of women with breast cancer

2008 ◽  
Vol 26 (15_suppl) ◽  
pp. 6539-6539
Author(s):  
J. J. Griggs ◽  
P. H. Abrahamse ◽  
A. S. Hamilton ◽  
J. J. Graff ◽  
M. S. Mujahid ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Population Based ◽  
Diverse Population

Financial and employment toxicity related to breast reconstruction following mastectomy in a diverse population-based cohort.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 78-78
Author(s):  
Nicholas L. Berlin ◽  
Adeyiza O. Momoh ◽  
Paul Abrahamse ◽  
Steven J. Katz ◽  
Reshma Jagsi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Reconstruction ◽  
Employment Status ◽  
Early Stage ◽  
Insurance Coverage ◽  
The United States ◽  
Population Based ◽  
Early Stage Breast Cancer ◽  
Financial Barriers ◽  
Spanish Speaking

78 Background: Despite mandated private insurance coverage for breast reconstruction following mastectomy, health care costs are increasingly passed onto women who seek these procedures through cost-sharing arrangements and high-deductible health plans. In this population-based study, we sought to characterize financial and employment toxicities related to pursuing breast reconstruction following mastectomy. Methods: Women (white, African American, and Latina-English and Spanish speaking) with early stage breast cancer (stages 0-II) diagnosed between July 2013 to September 2014 and who underwent mastectomy were identified through the Georgia and Los Angeles Surveillance, Epidemiology, and End Results (SEER) registries and surveyed. Primary outcome measures included patient-reported appraisal of financial toxicity and employment status following breast cancer treatment using previously developed measures. Multivariable models evaluated the association between breast reconstruction and self-reported financial and employment status. Results: Among 868 breast cancer patients who underwent mastectomy, 43.5% (n = 378) did not undergo breast reconstruction and 56.5% (n = 490) underwent reconstruction. 43.4% of the cohort reported being worse off financially since their diagnosis (49.4% with reconstruction vs. 35.0% without reconstruction, P< .001). Among women who were employed at time of breast cancer diagnosis (n = 535), 70.2% who underwent reconstruction reported being worse off regarding employment status compared to 51.1% who did not undergo reconstruction ( P< .001). Receipt of reconstruction was independently associated with a self-reported decline in financial status (Odds Ratio (OR) 2.1, 95% Confidence Interval (CI) 1.4-3.4, P= .001). Similarly, reports of being worse off regarding employment status were also higher in those who underwent reconstruction vs. not (OR 2.2, 95% CI 1.2-3.8, P= .006). Spanish-speaking Latina women more often reported being worse off regarding employment status (OR 4.3, 95% CI 2.1-9.0, P< .001) than white women. Conclusions: In this diverse cohort of women who underwent mastectomy for early stage breast cancer, women who elected to undergo reconstruction experienced more self-reported financial and employment toxicities. Patients should be counseled regarding the potential costs related to these procedures. Policy-makers should be aware of the financial barriers for women who undergo reconstruction despite mandatory insurance coverage in the United States.

scholarly journals Post-acute sequelae of COVID-19 in a non-hospitalized cohort: results from the Arizona CoVHORT

2021 ◽  
Author(s):  
Melanie L Bell ◽  
Collin J Catalfamo ◽  
Leslie V. Farland ◽  
Kacey C Ernst ◽  
Elizabeth T Jacobs ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Severe Disease ◽  
Median Number ◽  
Population Based ◽  
Diverse Population ◽  
Shortness Of Breath ◽  
Persistent Symptoms ◽  
Estimate Prevalence ◽  
Hispanic White

AbstractClinical presentation, outcomes, and duration of COVID-19 has ranged dramatically. While some individuals recover quickly, others suffer from persistent symptoms, collectively known as post-acute sequelae of SAR-CoV-2 (PASC). Most PASC research has focused on hospitalized COVID-19 patients with moderate to severe disease. We used data from a diverse population-based cohort of Arizonans to estimate prevalence of various symptoms of PASC, defined as experiencing at least one symptom 30 days or longer. There were 303 non-hospitalized individuals with a positive lab-confirmed COVID-19 test who were followed for a median of 61 days (range 30-250). COVID-19 positive participants were mostly female (70%), non-Hispanic white (68%), and on average 44 years old. Prevalence of PASC at 30 days post-infection was 68.7% (95%CI 63.4, 73.9). The most common symptoms were fatigue (37.5%), shortness-of-breath (37.5%), brain fog (30.8%), and stress (30.8%). The median number of symptoms was 3 (range 1-20). Amongst 157 participants with longer follow-up (≥60 days), PASC prevalence was 77.1%.

scholarly journals Identifying rare, medically-relevant genetic variation in a diverse population: opportunities and pitfalls

2020 ◽  
Author(s):  
Kevin M. Bowling ◽  
Michelle L. Thompson ◽  
David E. Gray ◽  
James M.J. Lawlor ◽  
Kelly Williams ◽  
...  
Keyword(s):  
Sanger Sequencing ◽  
Population Based ◽  
Return Of Results ◽  
Disease Genes ◽  
Clinical Validation ◽  
Diverse Population ◽  
Diverse Populations ◽  
Direct To Consumer ◽  
Health Initiative ◽  
Genomic Screening

ABSTRACTPurposeTo evaluate the effectiveness and specificity of population-based genomic screening in Alabama.MethodsThe Alabama Genomic Health Initiative (AGHI) has enrolled and evaluated 5,369 participants for the presence of pathogenic/likely pathogenic (P/LP) variants using the Illumina Global Screening Array (GSA), with validation of all P/LP variants via Sanger sequencing in a CLIA-certified laboratory before return of results.ResultsAmong 131 variants identified by the GSA that were evaluated by Sanger sequencing, 67 (51%) were false positives (FP). For 39 of the 67 FP variants, a benign/likely benign variant was present at or near the targeted P/LP variant. Importantly, African-Americans were significantly enriched for FP variants, likely due to a higher rate of non-targeted alternative alleles close to array-targeted P/LP variants.ConclusionIn AGHI, we have implemented an array-based process to screen for highly penetrant genetic variants in actionable disease genes. We demonstrate the need for clinical validation of array-identified variants in direct-to-consumer or population testing, especially for diverse populations.

Incidence and characteristics of cancer-associated thrombosis in a racially diverse population: A population-based study.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e13088-e13088
Author(s):  
Gary E. Raskob ◽  
Aaron M. Wendelboe ◽  
John Grady Heller ◽  
Kai Ding ◽  
Nimia L. Reyes ◽  
...  
Keyword(s):  
Risk Factors ◽  
Adult Population ◽  
Tertiary Care ◽  
Population Based ◽  
Incidence Rates ◽  
Diverse Population ◽  
Racially Diverse ◽  
Imaging Results ◽  
History Of ◽  
History Of Cancer

e13088 Background: Venous thromboembolism (VTE) is a common complication in cancer patients, but contemporary data on the incidence and characteristics of cancer-associated VTE in different racial populations is limited. We sought to measure the incidence rate and characteristics of cancer-associated VTE in a racially diverse population. Methods: We performed a prospective, population–based cohort study of VTE in Oklahoma County, OK during April 1, 2012–March 31, 2014. Surveillance staff regularly visited all tertiary care and relevant outpatient facilities in the county and reviewed the text from all imaging results of chest computed tomography or magnetic resonance imaging, lung perfusion scans, and ultrasound of the extremities to identify cases of VTE. Data on patient characteristics were collected from the electronic medical record. VTE was considered cancer-associated if the patient had a history of cancer other than basal or squamous cell skin cancer. Cancer was defined as “active” if metastatic or diagnosed within 6 months prior to VTE. Associations and incidence were calculated using the chi-square test and Poisson regression, respectively. Results: Of 3,255 patients with ≥1 VTE event (deep-vein thrombosis and/or pulmonary embolism), 732 (23%) had a history of cancer, of whom 309 had active cancer. The types of cancer varied widely. The age-adjusted incidence of cancer-associated VTE was 648 per 100,000 adult population (age ≥ 18). Incidence increased with each decade of age. The racial/ethnic-specific incidence rates were as follows (each per 100,000): Whites non-hispanic (607), Blacks non-Hispanic (557), Native Americans (128), Asian/Pacific Islanders (113) and Hispanics (70). Risk factors for VTE among the 732 with cancer-associated VTE included previous VTE (19%), hospitalization (37%), surgery (33%), and central venous catheter (22%). Of those with a history of cancer ≥ 6 months previously, 32% had no other identifiable VTE risk factor. Conclusions: Cancer-associated VTE comprised about 20-25% of the total population burden of VTE. The incidence varied substantially by race/ethnicity. An appreciable proportion of those with a history of cancer ≥ 6 months previously subsequently developed VTE in the absence of other risk factors.

scholarly journals Effects of antihypertensive drugs on surgical outcomes of breast reconstruction: a nationwide population-based claim study

Gland Surgery ◽  
2021 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
Jin-Woo Park ◽  
Hae Yeon Park ◽  
Minsu Park ◽  
Mi Yang ◽  
Goo-Hyun Mun
Keyword(s):  
Breast Reconstruction ◽  
Surgical Outcomes ◽  
Antihypertensive Drugs ◽  
Population Based
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