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Claudia Allemani - One of the best experts on this subject based on the ideXlab platform.
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Disparities in Breast Cancer Survival in the United States (2001-2009): Findings from the CONCORD-2 study.
Cancer, 2017Co-Authors: Jacqueline W. Miller, Judith Lee Smith, A. Blythe Ryerson, Thomas C. Tucker, Claudia AllemaniAbstract:Reducing Breast Cancer incidence and achieving equity in Breast Cancer outcomes remains a priority for public health practitioners, health care providers, policy makers, and health advocates. Monitoring Breast Cancer Survival can help evaluate the effectiveness of health services, quantify inequities in outcomes between states or population subgroups, and inform efforts to improve the effectiveness of Cancer management and treatment. We analyzed Breast Cancer Survival using individual patient records from 37 statewide registries that participated in the CONCORD-2 study, covering approximately 80% of the US population. Females were diagnosed between 2001 and 2009 and were followed through December 31, 2009. Age-standardized net Survival at 1 year, 3 years, and 5 years after diagnosis was estimated by state, race (white, black), stage at diagnosis, and calendar period (2001-2003 and 2004-2009). Overall, 5-year Breast Cancer net Survival was very high (88.2%). Survival remained remarkably high from 2001 through 2009. Between 2001 and 2003, Survival was 89.1% for white females and 76.9% for black females. Between 2004 and 2009, Survival was 89.6% for white females and 78.4% for black females. Breast Cancer Survival was more than 10 percentage points lower for black females than for white females, and this difference persisted over time. Reducing racial disparities in Survival remains a challenge that requires broad, coordinated efforts at the federal, state, and local levels. Monitoring trends in Breast Cancer Survival can highlight populations in need of improved Cancer management and treatment. Cancer 2017;123:5100-18. Published 2017. This article is a U.S. Government work and is in the public domain in the USA. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.
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Disparities in Breast Cancer Survival in the United States (2001-2009): Findings from the CONCORD-2 study.
Cancer, 2017Co-Authors: Jacqueline W. Miller, Judith Lee Smith, A. Blythe Ryerson, Thomas C. Tucker, Claudia AllemaniAbstract:BACKGROUND Reducing Breast Cancer incidence and achieving equity in Breast Cancer outcomes remains a priority for public health practitioners, health care providers, policy makers, and health advocates. Monitoring Breast Cancer Survival can help evaluate the effectiveness of health services, quantify inequities in outcomes between states or population subgroups, and inform efforts to improve the effectiveness of Cancer management and treatment. METHODS We analyzed Breast Cancer Survival using individual patient records from 37 statewide registries that participated in the CONCORD-2 study, covering approximately 80% of the US population. Females were diagnosed between 2001 and 2009 and were followed through December 31, 2009. Age-standardized net Survival at 1 year, 3 years, and 5 years after diagnosis was estimated by state, race (white, black), stage at diagnosis, and calendar period (2001-2003 and 2004-2009). RESULTS Overall, 5-year Breast Cancer net Survival was very high (88.2%). Survival remained remarkably high from 2001 through 2009. Between 2001 and 2003, Survival was 89.1% for white females and 76.9% for black females. Between 2004 and 2009, Survival was 89.6% for white females and 78.4% for black females. CONCLUSIONS Breast Cancer Survival was more than 10 percentage points lower for black females than for white females, and this difference persisted over time. Reducing racial disparities in Survival remains a challenge that requires broad, coordinated efforts at the federal, state, and local levels. Monitoring trends in Breast Cancer Survival can highlight populations in need of improved Cancer management and treatment. Cancer 2017;123:5100-18. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.
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Breast Cancer Survival in the US and Europe: a CONCORD high-resolution study
International journal of cancer, 2012Co-Authors: Claudia Allemani, Milena Sant, Hannah K. Weir, Lisa C. Richardson, Paolo Baili, Hans H. Storm, Sabine Siesling, Ana Torrella-ramos, Adri C. Voogd, Tiiu AareleidAbstract:Breast Cancer Survival is reportedly higher in the US than in Europe. The first worldwide study (CONCORD) found wide international differences in age-standardized Survival. The aim of this study is to explain these Survival differences. Population-based data on stage at diagnosis, diagnostic procedures, treatment and follow-up were collected for about 20,000 women diagnosed with Breast Cancer aged 15-99 years during 1996-98 in 7 US states and 12 European countries. Age-standardized net Survival and the excess hazard of death up to 5 years after diagnosis were estimated by jurisdiction (registry, country, European region), age and stage with flexible parametric models. Breast Cancers were generally less advanced in the US than in Europe. Stage also varied less between US states than between European jurisdictions. Early, node-negative tumors were more frequent in the US (39%) than in Europe (32%), while locally advanced tumors were twice as frequent in Europe (8%), and metastatic tumors of similar frequency (5-6%). Net Survival in Northern, Western and Southern Europe (81-84%) was similar to that in the US (84%), but lower in Eastern Europe (69%). For the first 3 years after diagnosis the mean excess hazard was higher in Eastern Europe than elsewhere: the difference was most marked for women aged 70-99 years, and mainly confined to women with locally advanced or metastatic tumors. Differences in Breast Cancer Survival between Europe and the US in the late 1990s were mainly explained by lower Survival in Eastern Europe, where low healthcare expenditure may have constrained the quality of treatment.
Johan P. Mackenbach - One of the best experts on this subject based on the ideXlab platform.
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Socioeconomic status and Breast Cancer Survival in the southeastern Netherlands, 1980-1989
European Journal of Cancer, 1995Co-Authors: Carola T. M. Schrijvers, Jan Willem Coebergh, L. Van Der Heijden, Johan P. MackenbachAbstract:Socioeconomic differences in Breast Cancer Survival in the southeastern Netherlands between 1980 and 1989 were studied (n = 3928), as was the impact of prognostic factors (stage at diagnosis, morphology, and treatment) on such differences. An area-based measure of Socioeconomic status (SES) in five groups, based on the postcode of residence at the time of diagnosis, was used. In univariate analyses the relative Survival rate was used to correct for causes of death other than Breast Cancer. The measure of outcome in multivariate analyses was the hazard ratio. The results of both univariate and multivariate analyses suggested a small Survival advantage for the higher SES groups. In a model with follow-up period, SES and age, the hazard ratios with 95% confidence intervals (CI) for SES groups from high to low were: 1.00,1.06 (0.84–1.33), 1.04 (0.86–1.26), 1.15 (0.96–1.38), 1.18 (0.99–1.42). After a correction for stage at diagnosis, differences in Survival were reduced substantially. Morphology and treatment were not important explanatory factors of the SES Survival association. We conclude that small Socioeconomic differences in Breast Cancer Survival exist in The Netherlands and that stage at diagnosis is the most important determinant of such differences.
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Original Paper Socioeconomic Status and Breast Cancer Survival in the Southeastern Netherlands, 19804989
1995Co-Authors: Carola T. M. Schrijvers, Jan Willem Coebergh, L. H. Van Der Heijden, Johan P. MackenbachAbstract:Socioeconomic differences in Breast Cancer Survival in the southeastern Netherlands between 1980 and 1989 were studied (n = 3928), as was the impact of prognostic factors (stage at diagnosis, morphology, and treatment) on such differences. An area-based measure of socioeconomic status (SES) in five groups, based on the postcode of residence at the time of diagnosis, was used. In univariate analyses the relative Survival rate was used to correct for causes of death other than Breast Cancer. The measure of outcome in multivariate analyses was the hazard ratio. The results of both univariate and multivariate analyses suggested a small Survival advantage for the higher SES groups. In a model with follow-up period, SES and age, the hazard ratios with 95% confidence intervals (CI) for SES groups from high to low were: 1.00,1.06 (O&l-1.33), 1.04 (O&-1.26), 1.15 (0.961.38), 1.18 (0.99-1.42). After a correction for stage at diagnosis, differences in Survival were reduced substantially. Morphology and treatment were not important explanatory factors of the SES Survival association. We conclude that small socioeconomic differences in Breast Cancer Survival exist in The Netherlands and that stage at diagnosis is the most important determinant of such differences.
Michelle D. Holmes - One of the best experts on this subject based on the ideXlab platform.
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Particulate Matter and Traffic-Related Exposures in Relation to Breast Cancer Survival.
Cancer epidemiology biomarkers & prevention : a publication of the American Association for Cancer Research cosponsored by the American Society of Pre, 2019Co-Authors: Natalie Dupre, Michelle D. Holmes, Jaime E. Hart, Elizabeth M. Poole, Peter James, Peter Kraft, Francine Laden, Rulla M TamimiAbstract:Background: Although particulate matter (PM) has not been consistently associated with Breast Cancer risk, two studies have reported harmful associations for Breast Cancer Survival. We examined PM exposures and Breast Cancer Survival in two U.S.-based prospective cohort studies. Methods: The Nurses9 Health Study (NHS) and NHSII are cohorts with detailed data on medical history, lifestyle factors, and causes of death. Women with Stage I–III Breast Cancer (n = 8,936) were followed through June 2014. Residential PM was estimated using spatio-temporal models. We performed Cox regression to estimate hazard ratios (HR) of Breast Cancer–specific mortality and all-cause mortality for 10 μg/m3 increases in post-diagnosis PM. Results: There were 1,211 Breast Cancer–specific deaths. Overall, PM was not associated with Breast Cancer–specific mortality [PM2.5: HR, 1.09; 95% confidence interval (CI), 0.87–1.36; PM2.5-10: HR, 1.03; 95% CI, 0.85–1.24; PM10: HR, 1.05; 95% CI, 0.89–1.24], but was associated with modest increases in all-cause mortality (PM2.5: HR, 1.12; 95% CI, 0.96–1.30; PM2.5-10: HR, 1.12; 95% CI, 1.00–1.24; PM10: HR, 1.09; 95% CI, 1.01–1.18). However, among participants with Stage I disease, PM2.5 was associated with higher Breast Cancer–specific mortality (HR, 1.64; 95% CI, 1.11–2.43). Conclusions: PM was not associated with Breast Cancer–specific death overall; however, higher PM was associated with all-cause mortality. Higher PM2.5 was associated with higher Breast Cancer–specific mortality among patients with Stage I Breast Cancer even after adjustment. Impact: Studies on ambient PM and Breast Cancer Survival demonstrate that PM2.5 may have broader health effects than previously recognized and warrants further research on Breast tumor progression.
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Role of Aspirin in Breast Cancer Survival.
Current oncology reports, 2017Co-Authors: Wendy Y. Chen, Michelle D. HolmesAbstract:Chemotherapy and hormonal therapy have significantly decreased Breast Cancer mortality, although with considerable side effects and financial costs. In the USA, over three million women are living after a Breast Cancer diagnosis and are eager for new treatments that are low in toxicity and cost. Multiple observational studies have reported improved Breast Cancer Survival with regular aspirin use. Furthermore, pooled data from five large randomized trials of aspirin for cardiovascular disease showed that subjects on aspirin had decreased risk of Cancer mortality and decreased risk of metastatic Cancer. Although the potential mechanism for aspirin preventing Breast Cancer is not known, possible pathways may involve platelets, inflammation, cyclooxygenase (COX) 2, hormones, or PI3 kinase. This review article summarizes the current epidemiologic and clinical trial evidence as well as possible underlying mechanisms that justify current phase III randomized trials of aspirin to improve Breast Cancer Survival.
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androgen receptor expression and Breast Cancer Survival in postmenopausal women
Clinical Cancer Research, 2011Co-Authors: Rong Hu, Michelle D. Holmes, Shaheenah Dawood, Laura C Collins, Stuart J Schnitt, Kimberley Cole, Jonathan Marotti, Susan E Hankinson, Graham A Colditz, Rulla M TamimiAbstract:Purpose: Androgen receptor (AR) is commonly expressed in Breast Cancers. However, the association between tumor AR status and Breast Cancer Survival is uncertain. Hence, we examined the association between AR status and Breast Cancer Survival in the Nurses9 Health Study (NHS). Experimental Design: It was a prospective study of postmenopausal women enrolled in the Nurses9 Health Study with stage I to III Breast Cancer diagnosed between 1976 and 1997 and followed from the date of diagnosis until January 1, 2008 or death. Analyses were conducted using Kaplan–Meier methods and Cox proportional hazard models, to determine the association of AR status with Survival outcomes adjusting for covariates. Results: Among 1467 Breast Cancers, 78.7% were AR-positive (AR+). Among 1,164 estrogen receptor (ER)-positive cases, 88.0% were AR+. AR positivity was associated with a significant reduction in Breast Cancer mortality (HR, 0.68; 95% CI, 0.47–0.99) and overall mortality (HR, 0.70; 95% CI, 0.53–0.91) after adjustment for covariates. In contrast, among women with ER-negative tumors (303 cases), 42.9% were AR+. There was a nonsignificant association between AR status and Breast Cancer death (HR, 1.59; 95% CI, 0.94–2.68). Conclusions: The association of AR status and Breast Cancer Survival is dependent on ER status. In particular, AR expression was associated with a more favorable prognosis among women with ER-positive tumors. Thus, determination of AR status may provide additional information on prognosis for postmenopausal women with Breast Cancer, and provide novel opportunities for targeted therapy. Clin Cancer Res; 17(7); 1867–74. ©2011 AACR .
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diet quality indices and postmenopausal Breast Cancer Survival
Nutrition and Cancer, 2011Co-Authors: Walter C Willett, Teresa T Fung, Bernard Rosner, Michelle D. HolmesAbstract:Research on diet in Breast Cancer Survival has been focused on single nutrients or foods, particularly dietary fat, fruits, vegetables, fiber, and alcohol. We hypothesized that diet quality indices decrease the risk of total and non-Breast-Cancer-related deaths in women diagnosed with Breast Cancer. We evaluated 4 dietary quality scores: Alternate Healthy Eating Index (AHEI), Diet Quality Index—Revised (DQIR), Recommended Food Score (RFS), and the alternate Mediterranean Diet Score (aMED), among 2,729 women from the Nurses’ Health Study with invasive Stage 1–3 Breast Cancer diagnosed between 1978 and 1998 with follow-up through 2004. In multivariate adjusted analyses, no association was found between diet quality indices and either total or non-Breast-Cancer-related deaths. However, a higher aMED score was associated with a lower risk of non-Breast-Cancer death in women with low physical activity; the RR comparing the highest to lowest tertile was 0.39 (95% CI, 0.20–0.75, P trend = 0.0004). Our results su...
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Androgen Receptor Expression and Breast Cancer Survival in Postmenopausal Women
Clinical cancer research : an official journal of the American Association for Cancer Research, 2011Co-Authors: Shaheenah Dawood, Michelle D. Holmes, Laura C Collins, Stuart J Schnitt, Kimberley Cole, Jonathan Marotti, Susan E Hankinson, Graham A Colditz, Rulla M TamimiAbstract:Purpose: Androgen receptor (AR) is commonly expressed in Breast Cancers. However, the association between tumor AR status and Breast Cancer Survival is uncertain. Hence, we examined the association between AR status and Breast Cancer Survival in the Nurses9 Health Study (NHS). Experimental Design: It was a prospective study of postmenopausal women enrolled in the Nurses9 Health Study with stage I to III Breast Cancer diagnosed between 1976 and 1997 and followed from the date of diagnosis until January 1, 2008 or death. Analyses were conducted using Kaplan–Meier methods and Cox proportional hazard models, to determine the association of AR status with Survival outcomes adjusting for covariates. Results: Among 1467 Breast Cancers, 78.7% were AR-positive (AR+). Among 1,164 estrogen receptor (ER)-positive cases, 88.0% were AR+. AR positivity was associated with a significant reduction in Breast Cancer mortality (HR, 0.68; 95% CI, 0.47–0.99) and overall mortality (HR, 0.70; 95% CI, 0.53–0.91) after adjustment for covariates. In contrast, among women with ER-negative tumors (303 cases), 42.9% were AR+. There was a nonsignificant association between AR status and Breast Cancer death (HR, 1.59; 95% CI, 0.94–2.68). Conclusions: The association of AR status and Breast Cancer Survival is dependent on ER status. In particular, AR expression was associated with a more favorable prognosis among women with ER-positive tumors. Thus, determination of AR status may provide additional information on prognosis for postmenopausal women with Breast Cancer, and provide novel opportunities for targeted therapy. Clin Cancer Res; 17(7); 1867–74. ©2011 AACR .
Carola T. M. Schrijvers - One of the best experts on this subject based on the ideXlab platform.
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Socioeconomic status and Breast Cancer Survival in the southeastern Netherlands, 1980-1989
European Journal of Cancer, 1995Co-Authors: Carola T. M. Schrijvers, Jan Willem Coebergh, L. Van Der Heijden, Johan P. MackenbachAbstract:Socioeconomic differences in Breast Cancer Survival in the southeastern Netherlands between 1980 and 1989 were studied (n = 3928), as was the impact of prognostic factors (stage at diagnosis, morphology, and treatment) on such differences. An area-based measure of Socioeconomic status (SES) in five groups, based on the postcode of residence at the time of diagnosis, was used. In univariate analyses the relative Survival rate was used to correct for causes of death other than Breast Cancer. The measure of outcome in multivariate analyses was the hazard ratio. The results of both univariate and multivariate analyses suggested a small Survival advantage for the higher SES groups. In a model with follow-up period, SES and age, the hazard ratios with 95% confidence intervals (CI) for SES groups from high to low were: 1.00,1.06 (0.84–1.33), 1.04 (0.86–1.26), 1.15 (0.96–1.38), 1.18 (0.99–1.42). After a correction for stage at diagnosis, differences in Survival were reduced substantially. Morphology and treatment were not important explanatory factors of the SES Survival association. We conclude that small Socioeconomic differences in Breast Cancer Survival exist in The Netherlands and that stage at diagnosis is the most important determinant of such differences.
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Original Paper Socioeconomic Status and Breast Cancer Survival in the Southeastern Netherlands, 19804989
1995Co-Authors: Carola T. M. Schrijvers, Jan Willem Coebergh, L. H. Van Der Heijden, Johan P. MackenbachAbstract:Socioeconomic differences in Breast Cancer Survival in the southeastern Netherlands between 1980 and 1989 were studied (n = 3928), as was the impact of prognostic factors (stage at diagnosis, morphology, and treatment) on such differences. An area-based measure of socioeconomic status (SES) in five groups, based on the postcode of residence at the time of diagnosis, was used. In univariate analyses the relative Survival rate was used to correct for causes of death other than Breast Cancer. The measure of outcome in multivariate analyses was the hazard ratio. The results of both univariate and multivariate analyses suggested a small Survival advantage for the higher SES groups. In a model with follow-up period, SES and age, the hazard ratios with 95% confidence intervals (CI) for SES groups from high to low were: 1.00,1.06 (O&l-1.33), 1.04 (O&-1.26), 1.15 (0.961.38), 1.18 (0.99-1.42). After a correction for stage at diagnosis, differences in Survival were reduced substantially. Morphology and treatment were not important explanatory factors of the SES Survival association. We conclude that small socioeconomic differences in Breast Cancer Survival exist in The Netherlands and that stage at diagnosis is the most important determinant of such differences.
Ross Lawrenson - One of the best experts on this subject based on the ideXlab platform.
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Ethnic differences in Breast Cancer Survival in New Zealand: contributions of differences in screening, treatment, tumor biology, demographics and comorbidities
Cancer causes & control : CCC, 2015Co-Authors: Sanjeewa Seneviratne, Ian Campbell, Nina Scott, Rachel Shirley, Tamati Peni, Ross LawrensonAbstract:Purpose We investigated the Breast Cancer Survival disparity between Indigenous Māori and non-Indigenous European women in New Zealand, and quantified the relative contributions of patient, tumor and healthcare system factors toward this disparity.