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Background: Heterogeneous Black populations encounter significant obstacles in accessing cancer care, yet research on lung cancer treatment disparities remains limited. This study investigates whether the disparity in receiving curative‐intent treatment (curative‐intent surgery and/or stereotactic body radiation therapy [SBRT]) for early‐stage non‐small cell lung cancer (NSCLC) between non‐Hispanic Whites (NHWs) and total Blacks extends to diverse Black populations, including US‐born, Afro‐Haitian, West Indian Black, and Hispanic Black individuals. Methods: This cross‐sectional study included all Florida cancer registry early‐stage NSCLC cases 2005–2017, linked to individual‐level discharge data containing comorbidity and specific treatment details (surgery and/or SBRT). Multivariable logistic regression assessed the association between race/ethnicity and the receipt of curative‐intent treatment, while accounting for sociodemographic factors (poverty, age, insurance, and smoking status) and clinical variables. Results: Among 55,655 early‐stage NSCLC patients, 71.1% received curative‐intent treatment: 72.1% NHW and 59.7% Black (non‐Hispanic and Hispanic) individuals. Black patients had 35% lower odds (ORadj, 0.65; 95% CI, 0.59–0.70) of receiving curative‐intent treatment compared to NHW patients. ORs varied from 0.57 (95% CI, 0.59–0.70) for Hispanic Black to 0.76 (95% CI, 0.56–1.02) for West Indian Black. Remarkably, Black‐White disparities persisted despite the availability of curative treatment options (SBRT) for both high Charlson Comorbidity Index (CCI) observed among US‐born Blacks and surgery for low CCI patients among all other Black subgroups. Conclusions: Pronounced disparities in accessing curative‐intent treatments for early‐stage NSCLC were evident across all Black subgroups, regardless of treatment availability and comorbidity profile. These findings underscore the need to address Black heterogeneity and prompt further research to rectify treatment disparities in early‐stage NSCLC. [ABSTRACT FROM AUTHOR]

Objective: Anorexia nervosa (AN) and atypical AN are conceptualized as distinct illnesses, despite similar characteristics and sequelae. Whereas DSM‐5 differentiates youth with AN and atypical AN by the presence of clinical 'underweight' (i.e., 5th BMI percentile for age‐and‐sex (BMI%)), we hypothesized that using this weight cut‐off to discern diagnoses creates a skewed distribution for premorbid weight. Method: Participants included hospitalized youth with AN (n = 165, 43.1%) and atypical AN (n = 218, 56.9%). Frequency analyses and chi‐square tests assessed the distribution of premorbid BMI z‐scores (BMIz) for diagnosis. Non‐parametric Spearman correlations and Stepwise Linear regressions examined relationships between premorbid BMIz, admission BMIz, and weight loss in kg. Results: Premorbid BMIz distributions differed significantly for diagnosis (p <.001), with an underrepresentation of 'overweight/obesity' (i.e., BMI% ≥ 85th) in AN. Despite commensurate weight loss in AN and atypical AN, patients with premorbid 'overweight/obesity' were 8.31 times more likely to have atypical AN than patients with premorbid BMI% < 85th. Premorbid BMIz explained 57% and 39% of the variance in admission BMIz and weight loss, respectively. Discussion: Findings support a homogenous model of AN and atypical AN, with weight loss predicted by premorbid BMI in both illnesses. Accordingly, premorbid BMI and weight loss (versus presenting BMI) may better denote the presence of an AN‐like phenotype across the weight spectrum. Findings also suggest that differentiating diagnoses with BMI% < 5th requires that youth with higher BMIs lose disproportionately more weight for an AN diagnosis. This is problematic given unique treatment barriers experienced in atypical AN. Public significance: Anorexia nervosa (AN) and atypical AN are considered distinct conditions in youth, with differential diagnosis hinging upon a presenting weight status of 'underweight' (i.e., BMI percentile for age‐and‐sex (BMI%) < 5th). In our study, youth with premorbid 'overweight/obesity' (BMI% ≥ 85th) disproportionately remained above this threshold, despite similar weight loss. Coupled with prior evidence for commensurate characteristics and sequelae in both diagnoses, we propose that DSM‐5 differentiation of AN and atypical AN inadvertently reinforces weight stigma and may contribute to treatment disparities in atypical AN. [ABSTRACT FROM AUTHOR]

Objective: The incidence and mortality rates of breast cancer in individuals with pre‐existing severe mental illness (SMI), such as schizophrenia, bipolar disorder, and major depression, are higher than in the general population. Reduced screening is one factor but there is less information on possible barriers to subsequent treatment following diagnosis. Methods: We undertook a systematic review and meta‐analysis on access to guideline‐appropriate care following a diagnosis of breast cancer in people with SMI including the receipt of surgery, endocrine, chemo‐ or radiotherapy. We searched for full‐text articles indexed by PubMed, EMBASE, PsycInfo and CINAHL that compared breast cancer treatment in those with and without pre‐existing SMI. Study designs included population‐based cohort or case‐control studies. Results: There were 13 studies included in the review, of which 4 contributed adjusted outcomes to the meta‐analyses. People with SMI had a reduced likelihood of guideline‐appropriate care (RR = 0.83, 95% CI = 0.77–0.90). Meta‐analyses were not possible for the other outcomes but in adjusted results from a single study, people with SMI had longer wait‐times to receiving guideline‐appropriate care. The results for specific outcomes such as surgery, hormone, radio‐ or chemotherapy were mixed, possibly because results were largely unadjusted for age, comorbidities, or cancer stage. Conclusions: People with SMI receive less and/or delayed guideline‐appropriate care for breast cancer than the general population. The reasons for this disparity warrant further investigation, as does the extent to which differences in treatment access or quality contribute to excess breast cancer mortality in people with SMI. [ABSTRACT FROM AUTHOR]

The authors comment on the study "Using a cascade of care framework to identify gaps in access to medications for alcohol use disorder in British Columbia (BC), Canada" by M. E. Socias and colleagues, which uses administrative health records for 2015-19 from BC to describe the alcohol use disorder (AUD) care cascade. Topics discussed include percentage of specialty substance use disorder treatment programs that offered oral naltrexone for AUD, and benefits of telemedicine.

The increasing relevance of substance use disorder (SUD) within the Asian American, Native Hawaiian, and Pacific Islander (AA&NH/PI) communities, particularly amidst rising anti-Asian hate incidents and the disproportionate health and economic challenges faced by the NH/PI community during the COVID-19 pandemic, underscores the urgency of understanding substance use patterns, treatment disparities, and outcomes. Following PRISMA guidelines, 37 out of 231 studies met the search criteria. Study characteristics, study datasets, substance use rates, SUD rates, treatment disparities, treatment quality, completion rates, and analyses disaggregated by the most specific AA&NH/PI ethnic group reported were examined. Despite increased treatment admissions over the past two decades, AA&NH/PI remain underrepresented in treatment facilities and underutilize SUD care services. Treatment quality and completion rates are also lower among AA&NH/PI. Analyses that did not disaggregate AA and NHPI as distinct groups from each other or that presented aggregate data only within AA or NHPI as a whole were common, but available disaggregated analyses reveal variations in substance use and treatment disparities among ethnic groups. There is also a lack of research in exploring within-group disparities, including specific case of older adults and substance use. To address disparities in access to substance use treatment and improve outcomes for AA&NH/PI populations, targeted interventions and strategic data collection methods that capture diverse ethnic groups and languages are crucial. Acknowledging data bias and expanding data collection to encompass multiple languages are essential for fostering a more inclusive approach to addressing SUD among AA&NH/PI populations. • Underrepresentation of AA&NH/PI in substance use treatment facilities persists. • Treatment quality and completion rates are lower among AA&NH/PI. • Limited culturally competent treatment options are available for AA&NH/PI. [ABSTRACT FROM AUTHOR]

The article focuses on the federal civil rights policy and mental health treatment access for individuals with limited English proficiency. It provides an overview of the policy designed to provide effective action to language barrier issues in the U.S. Civil Rights Act of 1964 and the significance of the English proficiency to health services for mental health care access and quality. The federal policy faces two concerns that limit its implementation such as the inability to establish language assistance and the inadequate financial help for language assistance services.

It is necessary to consider substance user treatment and derived health disparities in terms of: historical perspectives, stereotyping and "homogenization"; mystification; institutionalized disinformation; institutional myopia; institutionally created and maintained paradoxes; organizational, systemic, and human failure; the status of facts; environmental considerations; conceptual masking and overloading; fictions and fantasies; policy models and policy perversion; resource ignorance; slogans; de facto realities; the phenomenon of "lifeless lucidity" when statistical significance is not matched by substantive significance, problem definitions, and current unresolved critical issues that merit attention. The article's central thesis is that substance user treatment failure and derived health disparities are built into this complex, chaotic, nonlinear, multidimensional, highly politicalized, arbitrary, but institutionalized and "ghettoized" field that is also faulted by human, systemic, and organizational errors and that is removed from the "normed," mainstream of intervention and innovation. [ABSTRACT FROM AUTHOR]

Purpose: We evaluated sociodemographic and economic differences in overall survival (OS) of patients with penile SCC using the National Cancer Data Base (NCDB).Methods: We identified 5,412 patients with a diagnosis of penile squamous cell carcinoma from 1998 to 2011 with clinically nonmetastatic disease and available pathologic tumor and nodal staging. OS was estimated using the Kaplan-Meier method, and differences were determined using the log-rank test. Cox proportional hazard regression was performed to identify independent predictors of OS.Results: Estimated median OS was 91.9 months (interquartile range: 25.8-not reached) at median follow-up of 44.7 months (interquartile range: 17.2-81.0). Survival did not change over the study period (P = 0.28). Black patients presented with a higher stage of disease (pT3/T4: 16.6 vs. 13.2%, P = 0.027) and had worse median OS (68.6 vs. 93.7 months, P<0.01). Patients with private insurance and median income≥$63,000 based on zip code presented with a lower stage of disease (pT3/T4: 11.6 vs. 14.7%, P = 0.002 and 12.0 vs. 14.0%, P = 0.042, respectively) and had better median OS (163.2 vs. 70.8 months, P<0.01 and 105.3 vs. 86.4 months, p = 0.001, respectively). On multivariate analysis, black race (hazard ratio [HR]: 1.39, 95% confidence interval [CI]: 1.21-1.58; P<0.01) was independently associated with worse OS, whereas private insurance (HR = 0.79, 95% CI: 0.63-0.98; P = 0.028) and higher median income≥$63,000 (HR = 0.82; 95% CI: 0.72-0.93; P = 0.001) were independently associated with better OS.Conclusions: Racial and economic differences in the survival of patients with penile cancer exist. An understanding of these differences may help minimize disparities in cancer care. [ABSTRACT FROM AUTHOR]