677 results on '"Mariotto, Angela"'
Search Results
202. A back-calculation method to estimate the age and period HIV infection intensity, considering the susceptible population
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Verdecchia, Arduino, primary and Mariotto, Angela B., additional
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- 1995
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203. A stochastic model for neuronal bursting
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Frigessi, Arnoldo, primary, Lánský, Petr, additional, and Mariotto, Angela B., additional
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- 1994
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204. Comparing Cancer Care, Outcomes, and Costs Across Health Systems: Charting the Course.
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Lipscomb, Joseph, Yabroff, K. Robin, Hornbrook, Mark C., Gigli, Anna, Francisci, Silvia, Krahn, Murray, Gatta, Gemma, Trama, Annalisa, Ritzwoller, Debra P., Durand-Zaleski, Isabelle, Salloum, Ramzi, Chawla, Neetu, Angiolini, Catia, Crocetti, Emanuele, Giusti, Francesco, Guzzinati, Stefano, Mezzetti, Maura, Miccinesi, Guido, and Mariotto, Angela
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- 2013
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205. Initial Treatment for Newly Diagnosed Elderly Colorectal Cancer Patients: Patterns of Care in Italy and the United States.
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Gigli, Anna, Warren, Joan L., Yabroff, K. Robin, Francisci, Silvia, Stedman, Margaret, Guzzinati, Stefano, Giusti, Francesco, Miccinesi, Guido, Crocetti, Emanuele, Angiolini, Catia, and Mariotto, Angela
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- 2013
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206. Advancing Comparative Studies of Patterns of Care and Economic Outcomes in Cancer: Challenges and Opportunities.
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Yabroff, K. Robin, Francisci, Silvia, Mariotto, Angela, Mezzetti, Maura, Gigli, Anna, and Lipscomb, Joseph
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- 2013
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207. Advancing the science of cancer cost measurement: challenges and opportunities.
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Francisci, Silvia, Yabroff, K. Robin, Gigli, Anna, Mariotto, Angela, Mezzetti, Maura, and Lipscomb, Joseph
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- 2013
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208. Estimation of the Acquired Immunodeficiency Syndrome Incubation Period in Intravenous Drug Users: A Comparison with Male Homosexuals
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Mariotto, Angela B., primary, Mariotti, Sergio, additional, Pezzotti, Patrizio, additional, Rezza, Giovanni, additional, and Verdecchia, Arduino, additional
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- 1992
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209. Improved Estimates of Cancer-Specific Survival Rates From Population-Based Data.
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Howlander, Nadia, Ries, Lynn A. G., Mariotto, Angela B., Reichman, Marsha E., Ruhl, Jennifer, and Cronin, Katheen A.
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CANCER patients ,TUMORS ,CANCER diagnosis ,CAUSES of death ,CANCER prognosis - Abstract
Background Accurate estimates of cancer survival are important for assessing optimal patient care and prognosis. Evaluation of these estimates via relative survival (a ratio of observed and expected survival rates) requires a population life table that is matched to the cancer population by age, sex, race and/or ethnicity, socioeconomic status, and ideally risk factors for the cancer under examination. Because life tables for all subgroups in a study may be unavailable, we investigated whether cause-specific survival could be used as an alternative for relative survival. Methods We used data from the Surveillance, Epidemiology, and End Results Program for 2 330 905 cancer patients from January 1, 1992, through December 31, 2004. We defined cancer-specific deaths according to the following variables: cause of death, only one tumor or the first of multiple tumors, site of the original cancer diagnosis, and comorbidities. Estimates of relative survival and cause-specific survival that were derived by use of an actuarial method were compared. Results Among breast cancer patients who were white, black, or of Asian or Pacific Islander descent and who were older than 65 years, estimates of 5-year relative survival (107.5%, 106.6%, and 103.0%, respectively) were higher than estimates of 5-year cause-specific survival (98.6%, 95% confidence interval [CI] = 98.4% to 98.8%; 97.4%, 95% CI = 96.2% to 98.2%; and 99.2%, 95% CI = 98.4%, 99.6%, respectively). Relative survival methods likely underestimated rates for cancers of the oral cavity and pharynx (eg, for white cancer patients aged ≥65 years, relative survival = 54.2%, 95% CI = 53.1% to 55.3%, and cause-specific survival = 60.1%, 95% CI = 59.1% to 60.9%) and the lung and bronchus (eg, for black cancer patients aged ≥65 years, relative survival = 10.5%, 95% CI = 9.9% to 11.2%, and cause-specific survival = 11.9%, 95% CI = 11.2 % to 12.6%), largely because of mismatches between the population with these diseases and the population used to derive the life table. Socioeconomic differences between groups with low and high status in relative survival estimates appeared to be inflated (eg, corpus and uterus socioeconomic status gradient was 13.3% by relative survival methods and 8.8% by cause-specific survival methods). Conclusion Although accuracy of the cause of death on a death certificate can be problematic for cause-specific survival estimates, cause-specific survival methods may be an alternative to relative survival methods when suitable life tables are not available. [ABSTRACT FROM PUBLISHER]
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- 2010
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210. Improved Survival Time: What Can Survival Cure Models Tell Us About Population-based Survival Improvements in Late-stage Colorectal, Ovarian, and Testicular Cancer?
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Lan Huang, Cronin, Kathleen A., Johnson, Karen A., Mariotto, Angela B., and Feuer, Eric J.
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CANCER treatment ,CANCER patients ,OVARIAN cancer ,COLON cancer ,TESTICULAR cancer ,LIFE expectancy - Abstract
The article discusses the findings of a clinical study that was conducted to examine the effect of treatment advances on the survival of patients with late-stage ovarian, colorectal and testicular cancers. It states that survival cure models were utilized to estimate the gain in life expectancy (GLE) accredited to a rise in the number of cured patients and to the survival of uncured patients. The study found that treatment improvement for ovarian cancer resulted in a total GLE of 2 years while the cure rate in colorectal cancer rose from 29% to 47%.
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- 2008
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211. Estimating complete prevalence of cancers diagnosed in childhood.
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Simonetti, Arianna, Gigli, Anna, Capocaccia, Riccardo, and Mariotto, Angela
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A method of estimating the complete prevalence of cancers diagnosed in childhood called CHILDPREV (CHILDhood PREValence), is presented. It is a semi-parametric method based on cancer registry data and on the completeness index method. It allows estimating prevalence even when no observation is available (typically older patients alive at the prevalence date may have been diagnosed with cancer before the introduction of the registry). The method was validated on Connecticut Tumor Registry data, which has 62 years of follow-up and provides complete prevalence, and compared with the fully parametric PIAMOD method. Results of complete childhood prevalence estimates based on SEER-9 cancer registries data for acute lymphocytic leukemia and all cancer sites combined are presented. Copyright © 2007 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]
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- 2008
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212. Chapter 5: Additional Common Inputs for Analyzing Impact of Adjuvant Therapy and Mammography on U.S. Mortality.
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Cronin, Kathleen A., Mariotto, Angela B., Clarke, Lauren D., and Feuer, Eric J.
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BREAST cancer , *CANCER-related mortality , *ADJUVANT treatment of cancer , *MAMMOGRAMS , *CANCER in women - Abstract
In estimating the impact of mammography and adjuvant treatment on U.S. breast cancer mortality rates, several parameters were common to all the Cancer Intervention and Surveillance Modeling Network (CISNET) models participating in the breast cancer base case. Models either used the parameters directly as input or calibrated their models to reproduce the common set of parameters. This chapter describes the common input parameters that are not specifically discussed elsewhere in the monograph. [ABSTRACT FROM AUTHOR]
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- 2006
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213. Chapter 2: Dissemination of Adjuvant Multiagent Chemotherapy and Tamoxifen for Breast Cancer in the United States Using Estrogen Receptor Information: 1975-1999.
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Mariotto, Angela B., Feuer, Eric J., Harlan, Linda C., and Abrams, Jeffrey
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BREAST cancer , *TAMOXIFEN , *ADJUVANT treatment of cancer , *ESTROGEN receptors , *CANCER chemotherapy - Abstract
Background: Clinical trials have shown tamoxifen to be effective only in women with estrogen receptor (ER)-positive tumors, in a previous model, trends in the utilization of adjuvant therapy were modeled only as a function of age and stage of the disease and not ER status. In this paper, we integrate this previous estimate on the use of adjuvant systemic therapy for breast cancer in the United States with information on ER status from the Patterns of Care (POC) data to estimate the dissemination of adjuvant therapy for women with different ER-status tumors. We also summarize efficacy of adjuvant systemic therapy reported in the over- views of early breast cancer clinical trials. These two inputs, dissemination and efficacy, are key pieces for models that investigate the effect of breast cancer adjuvant therapy on the decline of U.S. breast cancer mortality. Methods: The adjustments to the previous models are calculated using the POC data on 7116 women with breast cancer diagnosed from 1987 to 1991 and in 1995 who were randomly selected from the Surveillance, and Epidemiology, and End Results (SEER) program registries. The POC data provide more accurate information on treatment and clinical variables (e. g., ER status) than the SEER data because medical records are reabstracted and further verified with treating physicians. Results: Use of multiagent chemotherapy is higher for younger women, (<50 years) and for women whose tumors were shown to be ER negative or borderline. The use of tamoxifen is higher among older women and women with ER-positive tumors. After 1980 the combined use of multiagent chemotherapy and tamoxifen for women diagnosed with breast cancer at ages 69 or younger increased more for women whose tumors were ER status positive or unknown than ER status negative. Older women (>69 years) seem to receive almost exclusively tamoxifen irrespective of ER status, except for a small percentage of those with more advanced stages (II- and II+/IIIA) who also receive multiagent chemotherapy. Discussion: The estimated dissemination trends by ER status, based on modeling the POC data, reveal that treatment strategies with demonstrated efficacy in clinical trials have been adopted into practice. The dissemination and efficacy are the two factors necessary to input into models to determine the population impact of these therapies on U.S. breast cancer mortality. The largest decline in mortality would be expected for younger women (<60 years) with ER-positive tumors or whose tumors are of unknown status because of the largest efficacy and dissemination of adjuvant therapy in this group. [ABSTRACT FROM AUTHOR]
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- 2006
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214. Chapter 4: Changing Patterns in Breast Cancer Incidence Trends.
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Holford, Theodore R., Cronin, Kathleen A., Mariotto, Angela B., and Feuer, Eric J.
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BREAST cancer ,CANCER in women ,CANCER ,CANCER diagnosis ,CANCER-related mortality - Abstract
Incidence rates for breast cancer in U.S. women have steadily increased for decades, but the reasons are not well understood. A recent upturn in these trends suggests that one component may be the effect of more aggressive screening in the population. The age-period-cohort framework, in which the temporal components associated with year of diagnosis and generation are evaluated, can assist in interpreting the elements associated with these trends. A unique approach for exploring other ways of partitioning the contribution of the different temporal components is described and applied to breast cancer incidence data (ICDO 174.0-174.9) from the Surveillance, Epidemiology and End Results (SEER) registries. Single-year intervals for age and year of diagnosis were used to fit models that provide estimates of the trends associated with the individual temporal elements. A log-linear model for age, period, and cohort was fitted using Poisson regression, and estimates of the separate time trends were calculated. The trends with period increased after 1982, when more aggressive screening began, and the trend is steeper for women older than 40 years. Cohort trends have increased steadily, although recent cohorts appear to be somewhat flat for women aged 50 years or younger, whereas the trend for those older than 50 years have continued to increase. Estimates of cohort trends in rates are also provided by extrapolating what would have occurred had there been no period trend before or after 1982, thus providing an estimate of the magnitude of the upturn that occurred after the recent emphasis on screening. [ABSTRACT FROM AUTHOR]
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- 2006
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215. Sensitivity of bayes and empirical bayes estimates
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Mariotto, Angela B., primary
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- 1990
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216. Evolving patterns in systemic treatment utilization and survival among older patients with advanced cutaneous melanoma.
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Hong, Yoon Duk, Enewold, Lindsey, Sharon, Elad, Warner, Jeremy L., Davidoff, Amy J., Zeruto, Chris, and Mariotto, Angela B.
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OLDER patients , *IMMUNE checkpoint inhibitors , *CANCER chemotherapy , *DIAGNOSIS , *CYTOKINES - Abstract
Introduction: In the last decade, melanoma treatment has improved significantly. However, data on population‐level treatment utilization and survival trends among older patients is limited. This study aimed to analyze trends in systemic anticancer therapy (Rx), including the uptake of immune checkpoint inhibitors (ICIs), in conjunction with trends in cause‐specific survival among older patients (66+) diagnosed with advanced melanoma (2008–2019). Methods: We used the Surveillance, Epidemiology, and End Results (SEER)‐Medicare Condensed Resource to assess any Rx utilization among patients first diagnosed with advanced melanoma in 2008–2010, 2011–2014, and 2015–2019, stratified by stage, and type of first‐line Rx among patients receiving Rx. The SEER dataset was used to evaluate trends in cause‐specific survival by year of diagnosis. Results: Rx utilization (any type) almost doubled, from 28.6% (2008–2010) to 55.4% (2015–2019) for stage 3 melanoma, and from 35.5% to 68.0% for stage 4 melanoma. In 2008–2010, the standard first‐line treatment was cytokines/cytotoxic chemotherapy/other. By 2015–2019, only 5.1% (stage 3) and <3.6% (stage 4) of patients receiving Rx received these agents, as ICIs emerged as the dominant treatment. Both 1‐year and 5‐year cause‐specific survival significantly improved since 2010 for stage 4 and since 2013 for stage 3. Conclusions: This study shows a significant rise in Rx utilization and a rapid transition from cytokines/cytotoxic chemotherapy to ICIs, reflecting a rapid uptake of highly effective treatment in a previously challenging disease with limited options before 2011. The documented survival improvement aligns with the adoption of these novel treatments, underscoring their significant impact on real‐world patient outcomes. [ABSTRACT FROM AUTHOR]
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- 2024
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217. Comparisons of colon-cancer survival among european countries: The eurocare study.
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Sant, Milena, Capocaccia, Riccardo, Verdecchia, Arduino, Gatta, Gemma, Micheli, Andrea, Mariotto, Angela, and Hakulinen, Timo
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- 1995
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218. Reply to annual report to the nation on the status of cancer, part II: Recent changes in prostate cancer trends and disease characteristics.
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Negoita, Serban, Mariotto, Angela, Benard, Vicki, Kohler, Betsy A., Jemal, Ahmedin, and Penberthy, Lynne
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PROSTATE cancer , *PROSTATE-specific antigen , *EARLY detection of cancer , *PROSTATE tumors - Published
- 2019
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219. Projecting SEER cancer survival rates to the US: an ecological regression approach
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Mariotto, Angela, Capocaccia, Riccardo, Verdecchia, Arduino, Micheli, Andrea, Feuer, Eric, Pickle, Linda, and Clegg, Limin
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Objectives: Cancer survival information is available only in areas covered by cancer registration. The objective of this study is to project cancer survival for the entire US as well as states from survival data from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program. Methods: Five-year breast, prostate, and colorectal cancer relative survival rates from SEER are regressed on socioeconomic, demographic, and health variables at the county level. These models are first validated by comparing the observed rates with projected rates for counties not used in the estimation process. Results: Education was the best indicator of longer cancer survival. Other important predictors of the geographical variability of survival varied by cancer site. Better survival was predicted for breast and prostate than for colorectal cancer. Conclusions: Data from cancer registries can be used in ecological models to provide national and state estimates of patients' survival rates. These estimates are useful in targeting areas in which to promote earlier diagnosis or improved access to care, and may also aid in monitoring the quality of survival data collected by individual cancer registries.
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- 2002
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220. Comparison of SEER Treatment Data With Medicare Claims
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Lund, Jennifer L., Cronin, Kathleen, McNeel, Timothy, Noone, Anne-Michelle, Mariotto, Angela, Deapen, Dennis, and Warren, Joan L.
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health services administration ,population characteristics ,3. Good health - Abstract
The population-based Surveillance, Epidemiology, and End Results (SEER) registries collect information on first-course treatment, including surgery, chemotherapy, radiation therapy, and hormone therapy. However, the SEER program does not release data on chemotherapy or hormone therapy due to uncertainties regarding data completeness. Activities are ongoing to investigate the opportunity to supplement SEER treatment data with other data sources.
221. Cancer and COVID-19: US cancer incidence rates during the first year of the pandemic.
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Howlader, Nadia, Bhattacharya, Manami, Scoppa, Steve, Miller, Daniel, Noone, Anne-Michelle, Negoita, Serban, Cronin, Kathy, and Mariotto, Angela
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PANDEMICS , *COVID-19 pandemic , *COVID-19 , *RACE , *COLON cancer , *THYROID cancer - Abstract
Background The COVID-19 pandemic has had a profound global impact on health-care systems and patient outcomes. However, the specific effects of the pandemic on cancer incidence rates in the United States during its initial year remain unknown. Methods In this study, we analyzed data from the Surveillance, Epidemiology, and End Results–22 registries, which encompass approximately 50% of the US population. We investigated changes in monthly incidence rates stratified by various factors, including cancer type, stage, age group, sex, race and ethnicity, socioeconomic status, rural-urban status, and registry locations. We compared the incidence rates observed during the pandemic with those from the previous year. Results Our findings revealed a decline in incidence rates for all cancer sites combined starting in March 2020, coinciding with the implementation of stay-at-home orders. This decline reached its lowest point in April 2020 and persisted at a lower level until May 2020. Notably, compared with April 2019, the incidence rates in April 2020 dropped by 48.1% and did not consistently return to prepandemic levels. The reduction in cancer rates was more pronounced in urban and affluent counties. Across all cancer types, there was a statistically significant decrease in incidence rates during the pandemic, with the largest declines observed in thyroid (71.2%), prostate (57.9%), breast (54.9%), and colon and rectum cancers (54.1%). Furthermore, these decreases were primarily observed in early stage rather than late-stage disease. Conclusions The COVID-19 pandemic had a statistically significant impact on cancer outcomes. Monitoring long-term consequences of the pandemic on cancer incidence, stage at diagnosis, and mortality trends will be crucial. [ABSTRACT FROM AUTHOR]
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- 2024
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222. Annual Report to the Nation on the Status of Cancer, 1975-2014, Featuring Survival.
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Jemal, Ahmedin, Ward, Elizabeth M, Johnson, Christopher J, Cronin, Kathleen A, Ma, Jiemin, Ryerson, Blythe, Mariotto, Angela, Lake, Andrew J, Wilson, Reda, Sherman, Recinda L, Anderson, Robert N, Henley, S Jane, Kohler, Betsy A, Penberthy, Lynne, Feuer, Eric J, and Weir, Hannah K
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Background: The American Cancer Society (ACS), the Centers for Disease Control and Prevention (CDC), the National Cancer Institute (NCI), and the North American Association of Central Cancer Registries (NAACCR) collaborate to provide annual updates on cancer occurrence and trends in the United States. This Annual Report highlights survival rates. Data were from the CDC- and NCI-funded population-based cancer registry programs and compiled by NAACCR. Trends in age-standardized incidence and death rates for all cancers combined and for the leading cancer types by sex were estimated by joinpoint analysis and expressed as annual percent change. We used relative survival ratios and adjusted relative risk of death after a diagnosis of cancer (hazard ratios [HRs]) using Cox regression model to examine changes or differences in survival over time and by sociodemographic factors.Results: Overall cancer death rates from 2010 to 2014 decreased by 1.8% (95% confidence interval [CI] = -1.8 to -1.8) per year in men, by 1.4% (95% CI = -1.4 to -1.3) per year in women, and by 1.6% (95% CI = -2.0 to -1.3) per year in children. Death rates decreased for 11 of the 16 most common cancer types in men and for 13 of the 18 most common cancer types in women, including lung, colorectal, female breast, and prostate, whereas death rates increased for liver (men and women), pancreas (men), brain (men), and uterine cancers. In contrast, overall incidence rates from 2009 to 2013 decreased by 2.3% (95% CI = -3.1 to -1.4) per year in men but stabilized in women. For several but not all cancer types, survival statistically significantly improved over time for both early and late-stage diseases. Between 1975 and 1977, and 2006 and 2012, for example, five-year relative survival for distant-stage disease statistically significantly increased from 18.7% (95% CI = 16.9% to 20.6%) to 33.6% (95% CI = 32.2% to 35.0%) for female breast cancer but not for liver cancer (from 1.1%, 95% CI = 0.3% to 2.9%, to 2.3%, 95% CI = 1.6% to 3.2%). Survival varied by race/ethnicity and state. For example, the adjusted relative risk of death for all cancers combined was 33% (HR = 1.33, 95% CI = 1.32 to 1.34) higher in non-Hispanic blacks and 51% (HR = 1.51, 95% CI = 1.46 to 1.56) higher in non-Hispanic American Indian/Alaska Native compared with non-Hispanic whites.Conclusions: Cancer death rates continue to decrease in the United States. However, progress in reducing death rates and improving survival is limited for several cancer types, underscoring the need for intensified efforts to discover new strategies for prevention, early detection, and treatment and to apply proven preventive measures broadly and equitably. [ABSTRACT FROM AUTHOR]- Published
- 2017
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223. Cancer Survival: An Overview of Measures, Uses, and Interpretation
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Mariotto, Angela B., Noone, Anne-Michelle, Howlader, Nadia, Cho, Hyunsoon, Keel, Gretchen E., Garshell, Jessica, Woloshin, Steven, and Schwartz, Lisa M.
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Survival statistics are of great interest to patients, clinicians, researchers, and policy makers. Although seemingly simple, survival can be confusing: there are many different survival measures with a plethora of names and statistical methods developed to answer different questions. This paper aims to describe and disseminate different survival measures and their interpretation in less technical language. In addition, we introduce templates to summarize cancer survival statistic organized by their specific purpose: research and policy versus prognosis and clinical decision making.
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- 2014
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224. Current Estimates of the Cure Fraction: A Feasibility Study of Statistical Cure for Breast and Colorectal Cancer
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Stedman, Margaret R., Feuer, Eric J., and Mariotto, Angela B.
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Background The probability of cure is a long-term prognostic measure of cancer survival. Estimates of the cure fraction, the proportion of patients “cured” of the disease, are based on extrapolating survival models beyond the range of data. The objective of this work is to evaluate the sensitivity of cure fraction estimates to model choice and study design.Methods Data were obtained from the Surveillance, Epidemiology, and End Results (SEER)-9 registries to construct a cohort of breast and colorectal cancer patients diagnosed from 1975 to 1985. In a sensitivity analysis, cure fraction estimates are compared from different study designs with short- and long-term follow-up. Methods tested include: cause-specific and relative survival, parametric mixture, and flexible models. In a separate analysis, estimates are projected for 2008 diagnoses using study designs including the full cohort (1975–2008 diagnoses) and restricted to recent diagnoses (1998–2008) with follow-up to 2009.Results We show that flexible models often provide higher estimates of the cure fraction compared to parametric mixture models. Log normal models generate lower estimates than Weibull parametric models. In general, 12 years is enough follow-up time to estimate the cure fraction for regional and distant stage colorectal cancer but not for breast cancer. 2008 colorectal cure projections show a 15% increase in the cure fraction since 1985.Discussion Estimates of the cure fraction are model and study design dependent. It is best to compare results from multiple models and examine model fit to determine the reliability of the estimate. Early-stage cancers are sensitive to survival type and follow-up time because of their longer survival. More flexible models are susceptible to slight fluctuations in the shape of the survival curve which can influence the stability of the estimate; however, stability may be improved by lengthening follow-up and restricting the cohort to reduce heterogeneity in the data.- Published
- 2014
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225. When Do Changes in Cancer Survival Mean Progress? The Insight From Population Incidence and Mortality
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Cho, Hyunsoon, Mariotto, Angela B., Schwartz, Lisa M., Luo, Jun, and Woloshin, Steven
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Background It is often assumed that increases in cancer survival reflect true progress against cancer. This is true when these increases are accompanied by decreased burden of disease: Fewer people being diagnosed or dying from cancer (ie, decreased incidence and mortality). But increased survival can also occur even when incidence is increasing and mortality is unchanged.Objective To use trends in cancer burden—incidence and mortality—to illustrate when changes in survival reflect true progress.Methods Using data from 1975 to 2010 collected by the Surveillance, Epidemiology, and End Results Program (incidence, survival) and the National Center for Health Statistics (mortality), we analyzed US trends in five-year relative survival, age-adjusted incidence, and mortality for selected cancers to identify patterns that do and do not reflect progress.Results Among the nine common cancers examined, survival increased in seven, and changed little or not at all for two. In some cases, increased survival was accompanied by decreased burden of disease, reflecting true progress. For example, from 1975 to 2010, five-year survival for colon cancer patients improved (from 48% to 68%) while cancer burden fell: Fewer cases (incidence decreased from 60 to 41 per 100000) and fewer deaths (mortality decreased from 28 to 16 per 100000), a pattern explained by both increased early detection (with removal of cancer precursors) and more effective treatment. In other cases, however, increased survival did not reflect true progress. In melanoma, kidney, and thyroid cancer, five-year survival increased but incidence increased with no change in mortality. This pattern suggests overdiagnosis from increased early detection, an increase in cancer burden.Conclusions Changes in survival must be interpreted in the context of incidence and mortality. Increased survival only represents progress when accompanied by a reduction in incidence, mortality, or ideally both.- Published
- 2014
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226. Evaluation of North American Association of Central Cancer Registries' (NAACCR) Data for Use in Population-Based Cancer Survival Studies
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Weir, Hannah K., Johnson, Christopher J., Mariotto, Angela B., Turner, Donna, Wilson, Reda J., Nishri, Diane, and Ward, Kevin C.
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Follow-up procedures vary among cancer registries in North America. US registries are funded by the Surveillance, Epidemiology, and End Results (SEER) Program and/or the National Program of Cancer Registries (NPCR). SEER registries ascertain vital status and date of last contact to meet follow-up standards. NPCR and Canadian registries primarily conduct linkages with local and national death records to ascertain deaths. Data on patients diagnosed between 2002 through 2006 and followed through 2007 were obtained from 51 registries. Registries that met follow-up standards or, at a minimum, conducted linkages with local and national death records had comparable age-standardized five-year survival estimates (all sites and races combined): 63.9% SEER, 63.1% NPCR, and 62.6% Canada. Estimates varied by cancer site. Survival data from registries using different follow-up procedures are comparable if death ascertainment is complete and all nondeceased patients are presumed to be alive to the end of the study period.
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- 2014
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227. Estimation of the Number of Individuals Living With Metastatic Cancer in the United States.
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Gallicchio, Lisa, Devasia, Theresa P, Tonorezos, Emily, Mollica, Michelle A, and Mariotto, Angela
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MELANOMA , *DISEASE incidence , *COLORECTAL cancer , *SECONDARY primary cancer ,BLADDER tumors - Abstract
Background: The purpose of this study was to estimate the number of individuals living with metastatic breast, prostate, lung, colorectal, or bladder cancer or metastatic melanoma in the United States using population-based data.Methods: A back-calculation method was used to estimate the number of individuals living with metastatic cancer for each cancer type from US cancer mortality and survival statistics from the Surveillance, Epidemiology, and End Results registries. The percentages of those living with metastatic cancer who advanced to metastatic disease from early stage cancer vs who were diagnosed with metastatic cancer de novo were calculated. One- and 5-year relative survival rates for de novo metastatic cancer were compared by year of diagnosis to assess time trends in survival.Results: It is estimated that, in 2018, 623 405 individuals were living with metastatic breast, prostate, lung, colorectal, or bladder cancer, or metastatic melanoma in the United States. This number is expected to increase to 693 452 in 2025. In 2018, the percentage of metastatic cancer survivors who were initially diagnosed with early stage cancer and advanced to metastatic cancer ranged from 30% for lung cancer to 72% for bladder cancer.Conclusions: This study demonstrates increasing numbers of individuals living with metastatic cancer of the 6 most common cancer types in the United States. This information is critical for informing the allocation of research efforts and healthcare infrastructure needed to address the needs of these individuals. [ABSTRACT FROM AUTHOR]- Published
- 2022
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228. Limited validity of diagnosis codes in Medicare claims for identifying cancer metastases and inferring stage.
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Chawla, Neetu, Yabroff, K. Robin, Mariotto, Angela, McNeel, Timothy S., Schrag, Deborah, and Warren, Joan L.
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CANCER patients , *CANCER diagnosis , *METASTASIS , *MEDICARE , *EPIDEMIOLOGY , *SURVEILLANCE detection , *MEDICAL registries , *GOLD standard - Abstract
Purpose Researchers are using diagnosis codes from health claims to identify metastatic disease in cancer patients. The validity of this approach has not been established. Methods We used the linked 2005-2007 Surveillance, Epidemiology and End Results (SEER)-Medicare data to assess the validity of metastasis codes at diagnosis from claims compared with stage reported by SEER cancer registries. The cohort included 80,052 incident breast, lung, and colorectal cancer patients aged 65 years and older. Using gold-standard SEER data, we evaluated sensitivity, specificity, positive predictive value, and negative predictive value of claims-based stage, survival by stage classification, and patient factors associated with stage misclassification using multivariable regression. Results For patients with a registry report of distant metastatic cancer, the sensitivity, specificity, and positive predictive value of claims never simultaneously exceeded 80% for any cancer: lung (42.7%, 94.8%, and 88.1%), breast (51.0%, 98.3%, and 65.8%), and colorectal (72.8%, 93.8%, and 68.5%). Misclassification of stage from Medicare claims was significantly associated with inaccurate estimates of stage-specific survival (P < .001). In adjusted analysis, patients who were older, black, or living in low-income areas were more likely to have their stage misclassified in claims. Conclusions Diagnosis codes in Medicare claims have limited validity for inferring cancer stage and metastatic disease. [ABSTRACT FROM AUTHOR]
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- 2014
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229. Estimating life expectancy adjusted by self-rated health status in the United States: national health interview survey linked to the mortality.
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Cho, Hyunsoon, Wang, Zhuoqiao, Yabroff, K. Robin, Liu, Benmei, McNeel, Timothy, Feuer, Eric J., and Mariotto, Angela B.
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LIFE expectancy , *PATIENT-centered care , *HEALTH surveys , *MORTALITY , *HEALTH status indicators - Abstract
Background: Life expectancy is increasingly incorporated in evidence-based screening and treatment guidelines to facilitate patient-centered clinical decision-making. However, life expectancy estimates from standard life tables do not account for health status, an important prognostic factor for premature death. This study aims to address this research gap and develop life tables incorporating the health status of adults in the United States.Methods: Data from the National Health Interview Survey (1986-2004) linked to mortality follow-up through to 2006 (age ≥ 40, n = 729,531) were used to develop life tables. The impact of self-rated health (excellent, very good, good, fair, poor) on survival was quantified in 5-year age groups, incorporating complex survey design and weights. Life expectancies were estimated by extrapolating the modeled survival probabilities.Results: Life expectancies incorporating health status differed substantially from standard US life tables and by health status. Poor self-rated health more significantly affected the survival of younger compared to older individuals, resulting in substantial decreases in life expectancy. At age 40 years, hazards of dying for white men who reported poor vs. excellent health was 8.5 (95% CI: 7.0,10.3) times greater, resulting in a 23-year difference in life expectancy (poor vs. excellent: 22 vs. 45), while at age 80 years, the hazards ratio was 2.4 (95% CI: 2.1, 2.8) and life expectancy difference was 5 years (5 vs. 10). Relative to the US general population, life expectancies of adults (age < 65) with poor health were approximately 5-15 years shorter.Conclusions: Considerable shortage in life expectancy due to poor self-rated health existed. The life table developed can be helpful by including a patient perspective on their health and be used in conjunction with other predictive models in clinical decision making, particularly for younger adults in poor health, for whom life tables including comorbid conditions are limited. [ABSTRACT FROM AUTHOR]- Published
- 2022
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230. Machine Learning Methods to Identify Missed Cases of Bladder Cancer in Population-Based Registries.
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Noone, Anne-Michelle, Lam, Clara J. K., Smith, Angela B., Nielsen, Matthew E., Boyd, Eric, Mariotto, Angela B., and Banerjee, Mousumi
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BLADDER cancer , *SUPERVISED learning , *MACHINE learning , *NAIVE Bayes classification , *RANDOM forest algorithms , *HEALTH insurance claims , *MEDICAL registries , *SUPPORT vector machines - Abstract
PURPOSE: Population-based cancer incidence rates of bladder cancer may be underestimated. Accurate estimates are needed for understanding the burden of bladder cancer in the United States. We developed and evaluated the feasibility of a machine learning–based classifier to identify bladder cancer cases missed by cancer registries, and estimated the rate of bladder cancer cases potentially missed. METHODS: Data were from population-based cohort of 37,940 bladder cancer cases 65 years of age and older in the SEER cancer registries linked with Medicare claims (2007-2013). Cases with other urologic cancers, abdominal cancers, and unrelated cancers were included as control groups. A cohort of cancer-free controls was also selected using the Medicare 5% random sample. We used five supervised machine learning methods: classification and regression trees, random forest, logic regression, support vector machines, and logistic regression, for predicting bladder cancer. RESULTS: Registry linkages yielded 37,940 bladder cancer cases and 766,303 cancer-free controls. Using health insurance claims, classification and regression trees distinguished bladder cancer cases from noncancer controls with very high accuracy (95%). Bacille Calmette-Guerin, cystectomy, and mitomycin were the most important predictors for identifying bladder cancer. From 2007 to 2013, we estimated that up to 3,300 bladder cancer cases in the United States may have been missed by the SEER registries. This would result in an average of 3.5% increase in the reported incidence rate. CONCLUSION: SEER cancer registries may potentially miss bladder cancer cases during routine reporting. These missed cases can be identified leveraging Medicare claims and data analytics, leading to more accurate estimates of bladder cancer incidence. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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231. The efficacy of prostate-specific antigen screening: Impact of key components in the ERSPC and PLCO trials.
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de Koning, Harry J., Gulati, Roman, Moss, Sue M., Hugosson, Jonas, Pinsky, Paul F., Berg, Christine D., Auvinen, Anssi, Andriole, Gerald L., Roobol, Monique J., Crawford, E. David, Nelen, Vera, Kwiatkowski, Maciej, Zappa, Marco, Luján, Marcos, Villers, Arnauld, de Carvalho, Tiago M., Feuer, Eric J., Tsodikov, Alex, Mariotto, Angela B., and Heijnsdijk, Eveline A. M.
- Subjects
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PROSTATE cancer treatment , *PROSTATE cancer & genetics , *CANCER treatment , *CANCER genetics , *RANDOMIZED controlled trials - Abstract
Background: The European Randomized Study of Screening for Prostate Cancer (ERSPC) demonstrated that prostate-specific antigen (PSA) screening significantly reduced prostate cancer mortality (rate ratio, 0.79; 95% confidence interval, 0.69-0.91). The US Prostate, Lung, Colorectal, and Ovarian (PLCO) trial indicated no such reduction but had a wide 95% CI (rate ratio for prostate cancer mortality, 1.09; 95% CI, 0.87-1.36). Standard meta-analyses are unable to account for key differences between the trials that can impact the estimated effects of screening and the trials' point estimates.Methods: The authors calibrated 2 microsimulation models to individual-level incidence and mortality data from 238,936 men participating in the ERSPC and PLCO trials. A cure parameter for the underlying efficacy of screening was estimated by the models separately for each trial. The authors changed step-by-step major known differences in trial settings, including enrollment and attendance patterns, screening intervals, PSA thresholds, biopsy receipt, control arm contamination, and primary treatment, to reflect a more ideal protocol situation and differences between the trials.Results: Using the cure parameter estimated for the ERSPC, the models projected 19% to 21% and 6% to 8%, respectively, prostate cancer mortality reductions in the ERSPC and PLCO settings. Using this cure parameter, the models projected a reduction of 37% to 43% under annual screening with 100% attendance and biopsy compliance and no contamination. The cure parameter estimated for the PLCO trial was 0.Conclusions: The observed cancer mortality reduction in screening trials appears to be highly sensitive to trial protocol and practice settings. Accounting for these differences, the efficacy of PSA screening in the PLCO setting is not necessarily inconsistent with ERSPC results. Cancer 2018;124:1197-206. © 2017 American Cancer Society. [ABSTRACT FROM AUTHOR]- Published
- 2018
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232. The history and use of cancer registry data by public health cancer control programs in the United States.
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White, Mary C., Babcock, Frances, Hayes, Nikki S., Mariotto, Angela B., Wong, Faye L., Kohler, Betsy A., and Weir, Hannah K.
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MEDICAL registries , *CANCER prevention , *EARLY detection of cancer , *PUBLIC health surveillance , *EPIDEMIOLOGY of cancer , *PUBLIC health administration - Abstract
Because cancer registry data provide a census of cancer cases, registry data can be used to: 1) define and monitor cancer incidence at the local, state, and national levels; 2) investigate patterns of cancer treatment; and 3) evaluate the effectiveness of public health efforts to prevent cancer cases and improve cancer survival. The purpose of this article is to provide a broad overview of the history of cancer surveillance programs in the United States, and illustrate the expanding ways in which cancer surveillance data are being made available and contributing to cancer control programs. The article describes the building of the cancer registry infrastructure and the successful coordination of efforts among the 2 federal agencies that support cancer registry programs, the Centers for Disease Control and Prevention and the National Cancer Institute, and the North American Association of Central Cancer Registries. The major US cancer control programs also are described, including the National Comprehensive Cancer Control Program, the National Breast and Cervical Cancer Early Detection Program, and the Colorectal Cancer Control Program. This overview illustrates how cancer registry data can inform public health actions to reduce disparities in cancer outcomes and may be instructional for a variety of cancer control professionals in the United States and in other countries. Cancer 2017;123:4969-76. Published 2017. This article is a U.S. Government work and is in the public domain in the USA. [ABSTRACT FROM AUTHOR]
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- 2017
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233. Number needed to screen—How can we project outside context?
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Auvinen, Anssi, Gulati, Roman, Mariotto, Angela B, Chen, Shu, Gore, John L, and Etzioni, Ruth
- Abstract
Objective: To project long-term estimates of the number needed to screen (NNS) and the additional number needed to treat (NNT) to prevent one prostate cancer death with prostate-specific antigen (PSA) screening in Europe and in the United States.Study Design and Setting: A mathematical model of disease-specific deaths in screened and unscreened men given information on overdiagnosis, disease-specific survival in the absence of screening, screening efficacy, and other-cause mortality is presented. A simulation framework is used to incorporate competing causes of death.Results: Assuming overdiagnosis and screening efficacy consistent with European Randomized study of Screening for Prostate Cancer (ERSPC) results, we project that, after 25 years, 262 men need to be screened and nine additional men need to be screen detected to prevent one prostate cancer death. Corresponding estimates of the NNS and the additional NNT under a range of overdiagnosis rates that are consistent with U.S. incidence are 186-220 and 2-5.Conclusions: Long-term estimates of the NNS and the additional NNT are an order of magnitude lower than the short-term estimates published with the results of the ERSPC trial and may be consistent with cost-effective PSA screening in the general U.S. population. [ABSTRACT FROM AUTHOR]- Published
- 2011
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234. Real-world lessons: combining cancer registry and retail pharmacy data for oral cancer drugs.
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Howlader N, Lund JL, Enewold L, Stevens J, McNeel T, Rivera D, Mariotto A, and Cronin KA
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- Humans, Female, Aged, United States epidemiology, Middle Aged, Male, Adult, Administration, Oral, Pharmacies statistics & numerical data, Aged, 80 and over, Antineoplastic Agents therapeutic use, Medicare Part D statistics & numerical data, Neoplasms epidemiology, Neoplasms drug therapy, Breast Neoplasms epidemiology, Breast Neoplasms drug therapy, Young Adult, Registries, SEER Program statistics & numerical data
- Abstract
Background: Recent cancer care advances have introduced new oral therapies, and yet population registries lack detailed treatment data, hampering investigations into therapy uptake, adherence, and outcomes., Objective: This study aimed to assess the representativeness and completeness of linking Surveillance, Epidemiology, and End Results (SEER) cancer registry data with data from two major retail pharmacy chains, collectively covering a large segment of the US market., Methods: A deterministic data linkage between 11 SEER cancer registries and retail pharmacy data (excluding mail order fills) was conducted for individuals diagnosed with selected cancers from 2013 to 2017, with follow-up through 2019. Descriptive characteristics of the linked and unlinked populations were examined. In a selected subcohort of older women (aged ≥65) with first and only primary breast cancer who had Medicare Part D claims for tamoxifen, we further validated the linkage using Medicare Part D event data as the reference standard., Results: Among 758 068 eligible individuals, only 6.4% were linked to CVS/Walgreens data; the linkage percentage varied by age, sex, race, ethnicity, registry, and cancer type. Within the subcohort of 5963 older women with breast cancer and a claim for tamoxifen in Part D data, 25% were identified as tamoxifen users in retail pharmacy data. Out of these 1490 women, 749 (50.3%) had complete longitudinal tamoxifen dispensing information from retail pharmacy data., Conclusion: Retail pharmacy data show promise in identifying oral anticancer treatments, enhancing SEER registry efforts, but they require further validation. We propose an evaluation framework, sharing insights and potential use cases for this resource., (Published by Oxford University Press 2024.)
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- 2024
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235. Prevalence of cancer survivors in the United States.
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Tonorezos E, Devasia T, Mariotto AB, Mollica MA, Gallicchio L, Green P, Doose M, Brick R, Streck B, Reed C, and de Moor JS
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Background: With aging of the population and improvements in diagnosis, treatment, and supportive care, the number of cancer survivors in the United States (US) has increased; updated prevalence estimates are needed., Methods: Cancer prevalence on January 1, 2022 was estimated using the Prevalence Incidence Approach Model, utilizing incidence, survival, and mortality. Prevalence by age decade, sex, and time from diagnosis were calculated. The percentage of cancer survivors in the projected US population by age and sex was calculated as the ratio of the sex-specific projected prevalence to the sex-specific projected US population., Results: There were an estimated 18.1 million US cancer survivors as of January 1, 2022. From 2022 to 2030, the number of US cancer survivors is projected to increase to 21.6 million; by 2040, the number is projected to be 26 million. Long-term survivors are highly prevalent; in 2022, 70% of cancer survivors survived 5 years or more after diagnosis, and 11% of cancer survivors survived 25 years or more after diagnosis. Among all US females aged 40-54, 3.6% were cancer survivors; among females aged 65-74, 14.5% were cancer survivors; among females aged 85 and older, 36.4% were cancer survivors. Among all US males aged 40-54, 2.1% were cancer survivors; among males aged 65-74, 16% were cancer survivors; among those aged 85 and older, 48.3% were cancer survivors., Conclusions: Cancer survivors are growing in number. In the US, most cancer survivors are long-term and very long-term survivors, representing a significant proportion of the US population., (Published by Oxford University Press 2024.)
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- 2024
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236. Time-varying associations of patient and tumor characteristics with cancer survival: an analysis of SEER data across 14 cancer sites, 2004-2017.
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Roberts EK, Luo L, Mondul AM, Banerjee M, Veenstra CM, Mariotto AB, Schipper MJ, He K, Taylor JMG, and Brouwer AF
- Abstract
Purpose: Surveillance, Epidemiology, and End Results (SEER) cancer registries provides information about survival duration and cause of death for cancer patients. Baseline demographic and tumor characteristics such as age, sex, race, year of diagnosis, and tumor stage can inform the expected survival time of patients, but their associations with survival may not be constant over the post-diagnosis period., Methods: Using SEER data, we examined if there were time-varying associations of patient and tumor characteristics on survival, and we assessed how these relationships differed across 14 cancer sites. Standard Cox proportional hazards models were extended to allow for time-varying associations and incorporated into a competing-risks framework, separately modeling cancer-specific and other-cause deaths. For each cancer site and for each of the five factors, we estimated the relative hazard ratio and absolute hazard over time in the presence of competing risks., Results: Our comprehensive consideration of patient and tumor characteristics when estimating time-varying hazards showed that the associations of age, tumor stage at diagnosis, and race/ethnicity with risk of death (cancer-specific and other-cause) change over time for many cancers; characteristics of sex and year of diagnosis exhibit some time-varying patterns as well. Stage at diagnosis had the largest associations with survival., Conclusion: These findings suggest that proportional hazards assumptions are often violated when examining patient characteristics on cancer survival post-diagnosis. We discuss several interesting results where the relative hazards are time-varying and suggest possible interpretations. Based on the time-varying associations of several important covariates on survival after cancer diagnosis using a pan-cancer approach, the likelihood of the proportional hazards assumption being met or corresponding interpretation should be considered in survival analyses, as flawed inference may have implications for cancer care and policy., (© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)
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- 2024
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237. Association of Major Adverse Financial Events and Later-Stage Cancer Diagnosis in the United States.
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Warren JL, Mariotto AB, Stevens J, Davidoff AJ, Shankaran V, Ward KC, Wu XC, Schwartz SM, Penberthy L, and Yabroff KR
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- Adult, Aged, Female, Humans, Male, Middle Aged, Young Adult, Georgia epidemiology, Registries, United States epidemiology, Neoplasms diagnosis, Neoplasms epidemiology, Black or African American
- Abstract
Purpose: This study assessed the prevalence of specific major adverse financial events (AFEs)-bankruptcies, liens, and evictions-before a cancer diagnosis and their association with later-stage cancer at diagnosis., Methods: Patients age 20-69 years diagnosed with cancer during 2014-2015 were identified from the Seattle, Louisiana, and Georgia SEER population-based cancer registries. Registry data were linked with LexisNexis consumer data to identify patients with a history of court-documented AFEs before cancer diagnosis. The association of AFEs and later-stage cancer diagnoses (stages III/IV) was assessed using separate sex-specific multivariable logistic regression., Results: Among 101,649 patients with cancer linked to LexisNexis data, 36,791 (36.2%) had a major AFE reported before diagnosis. The mean and median timing of the AFE closest to diagnosis were 93 and 77 months, respectively. AFEs were most common among non-Hispanic Black, unmarried, and low-income patients. Individuals with previous AFEs were more likely to be diagnosed with later-stage cancer than individuals with no AFE (males-odds ratio [OR], 1.09 [95% CI, 1.03 to 1.14]; P < .001; females-OR, 1.18 [95% CI, 1.13 to 1.24]; P < .0001) after adjusting for age, race, marital status, income, registry, and cancer type. Associations between AFEs prediagnosis and later-stage disease did not vary by AFE timing., Conclusion: One third of newly diagnosed patients with cancer had a major AFE before their diagnosis. Patients with AFEs were more likely to have later-stage diagnosis, even accounting for traditional measures of socioeconomic status that influence the stage at diagnosis. The prevalence of prediagnosis AFEs underscores financial vulnerability of patients with cancer before their diagnosis, before any subsequent financial burden associated with cancer treatment.
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- 2024
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238. Increase in the Life Expectancy of Patients with Cancer in the United States.
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Devasia TP, Howlader N, Dewar RA, Stevens JL, Mittu K, and Mariotto AB
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- Humans, Female, United States epidemiology, Life Expectancy, Melanoma epidemiology, Breast Neoplasms, Leukemia, Myelogenous, Chronic, BCR-ABL Positive, Lung Neoplasms, Rectal Neoplasms
- Abstract
Background: Cancer is becoming more of a chronic disease due to improvements in treatment and early detection for multiple cancer sites. To gain insight on increased life expectancy due to these improvements, we quantified trends in the loss in expectation of life (LEL) due to a cancer diagnosis for six cancer sites from 1975 through 2018., Methods: We focused on patients diagnosed with female breast cancer, chronic myeloid leukemia (CML), colon and rectum cancer, diffuse large B-cell lymphoma (DLBCL), lung cancer, or melanoma between 1975 and 2018 from nine Surveillance, Epidemiology, and End Results cancer registries. Life expectancies for patients with cancer ages 50+ were modeled using flexible parametric survival models. LEL was calculated as the difference between general population life expectancy and life expectancy for patients with cancer., Results: Over 2 million patients were diagnosed with one of the six cancers between 1975 and 2018. Large increases in life expectancy were observed between 1990 and 2010 for female breast, DLBCL, and CML. Patients with colon and rectum cancer and melanoma had more gradual improvements in life expectancy. Lung cancer LEL only began decreasing after 2005. Increases in life expectancy corresponded with decreases in LEL for patients with cancer., Conclusions: The reported gains in life expectancy largely correspond to progress in the screening, management, and treatment of these six cancers since 1975., Impact: LEL provides an important public health perspective on how improvements in treatment and early detection and their impacts on survival translate into changes in cancer patients' life expectancy., (©2023 American Association for Cancer Research.)
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- 2024
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239. Use of pembrolizumab among older adults with cancer in the United States, before and after FDA approval of its tumor-agnostic indication.
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Hong YD, Enewold L, Halpern MT, Zeruto C, and Mariotto AB
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- Humans, Aged, United States epidemiology, Adult, Middle Aged, United States Food and Drug Administration, Medicare, Antibodies, Monoclonal, Humanized therapeutic use, Drug Approval, Antineoplastic Agents therapeutic use, Brain Neoplasms drug therapy, Neoplastic Syndromes, Hereditary, Colorectal Neoplasms
- Abstract
Introduction: Pembrolizumab, an anticancer immunotherapy agent, has received multiple approvals since its first approval by the U.S. Food and Drug Administration (FDA) in 2014. Limited data exist on its real-world use and shifts post tumor-agnostic approval in 2017 for the treatment of patients with any microsatellite instability-high/mismatch repair deficient (MSI-H/dMMR) solid tumors. This study analyzes pembrolizumab's pre and post-tumor-agnostic approval use among older U.S. adults, revealing its evolving role in oncology practice., Methods: Using the Surveillance, Epidemiology and End Results (SEER)-Medicare data (2014-2019), we examined the cancer sites of pembrolizumab recipients before and after tumor-agnostic approval. Cancer sites were classified based on the timing of site-specific approvals (before/after tumor-agnostic approval) or no site-specific approval, and inclusion in MSI-H/dMMR clinical trials., Results: The total number of pembrolizumab recipients increased from 4221 in the pre-agnostic period to 20 479 in the post-agnostic period. Pembrolizumab was used for a broad range of cancer types, including cancers that had no FDA-approved site-specific indications at the time of use (25.8% in pre- and 24.6% in post-agnostic periods). The proportion of pembrolizumab recipients receiving pembrolizumab for cancers with site-specific approvals before tumor-agnostic approval decreased from 77.3% to 70.8%. The proportion of pembrolizumab recipients receiving pembrolizumab for cancers that gained site-specific approvals following tumor-agnostic approval almost doubled (6.8% to 13.0%). The proportion of pembrolizumab recipients with cancers included in MSI-H/dMMR trials also doubled (12.3% to 25.5%) following tumor-agnostic approval., Conclusions: Pembrolizumab use has expanded over time among older adults with cancer, extending beyond those with FDA-approved site-specific indications., (© 2023 John Wiley & Sons Ltd. This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA.)
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- 2024
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240. Prediction of Risk of Metastatic Recurrence for Female Breast Cancer Patients in the Presence of Competing Causes of Death.
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Mariotto AB, Botta L, Bernasconi A, Zou Z, Gatta G, and Capocaccia R
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- Humans, Female, Aged, Cause of Death, Registries, Neoplasm Staging, Risk Factors, Breast Neoplasms epidemiology
- Abstract
Background: To estimate risk of recurrence for women diagnosed with nonmetastatic breast cancer considering the risks of other causes mortality., Methods: We extend a method based on the diagnosis-metastasis-death pathway to include risks of other causes mortality. We estimate three probabilities as cumulative incidence of: (i) being alive and recurrence-free, (ii) death for other causes before a recurrence, and (iii) recurrence. We apply the method to female breast cancer relative survival from the Surveillance, Epidemiology, and End Results Program registries (2000-2018) data., Results: The cumulative incidence of recurrence shows a higher increase with more advanced cancer stage and is less influenced by age at diagnosis. At 5 years from diagnosis, the cumulative incidence of recurrence is less than 3% for those diagnosed with stage I, 10% to 13% for those diagnosed with stage II, and 37% to 47% for those diagnosed with stage III breast cancer. The estimates of recurrence considering versus ignoring the risks of dying from other causes were generally consistent, except for older women with more advanced stage, and longer time since diagnosis. In these groups, the net probability of recurrence, excluding the risks of dying from other causes, were overestimated., Conclusions: For patients with cancer who are older or long-term survivors, it is important to include the risks of other cause mortality as the crude cumulative incidence of recurrence is a more appropriate measure., Impact: These estimates are important in clinical decision making, as higher competing mortality may preclude the benefits of aggressive treatments., (©2023 American Association for Cancer Research.)
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- 2023
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241. Evaluation of the Completeness of Managed Care Data to Identify Cancer Diagnoses and Treatments for Patients in the SEER-Medicare Data.
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Warren JL, Parsons HM, Mariotto AB, Boyd E, and Enewold L
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- Male, Humans, Aged, United States, Medicare, SEER Program, Managed Care Programs, Breast Neoplasms diagnosis, Breast Neoplasms therapy, Breast Neoplasms epidemiology, Lung Neoplasms epidemiology
- Abstract
Background: The utility of codes on Medicare Advantage (MA) data to capture cancer diagnoses and treatment for cancer patients is unknown., Objective: This study compared cancer diagnoses and treatments on MA encounter data (MA data) with the Surveillance, Epidemiology, and End-Results (SEER) data., Subjects: Subjects were patients enrolled in either MA or Medicare fee-for-service (MFFS) when diagnosed with incident breast, colorectal, prostate, or lung cancer, 2015-2017, in a SEER cancer registry., Measures: MA data, from 2 months before to 12 months following SEER diagnosis, were reviewed to identify cancer diagnoses, surgery, chemotherapy, and radiotherapy (RT). MA data were compared with SEER to determine their sensitivity to capture cancer diagnoses and sensitivity/specificity to identify surgeries. The agreement between SEER and Medicare data regarding receipt of chemotherapy and RT was measured by Kappa statistics. A similar comparison to SEER diagnoses/treatments was made using MFFS claims to provide context for the SEER-MA comparison., Results: The study included 186,449 patients, 38% in MA. MA data had 92%+ sensitivity to identify SEER cancer diagnosis and 90%+ sensitivity for cancer surgery. Specificity for surgery was >84%, except for breast cancer (52%). Kappa statistics for agreement between SEER and MA data regarding chemotherapy varied by cancer, 0.61-0.82, and for receipt of RT exceeded 0.75 for all cancers. Results observed for MFFS claims were similar to those in MA data., Conclusion: For 4 common cancers, MA data included most cancer diagnoses and general types of cancer treatment reported in the SEER data. More research is needed to assess additional cancers and detailed treatments., Competing Interests: The authors declare no conflict of interest., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
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- 2023
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242. Long-term Cancer Survival Trends by Updated Summary Stage.
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Forjaz G, Ries L, Devasia TP, Flynn G, Ruhl J, and Mariotto AB
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- Humans, Incidence, Longitudinal Studies, Neoplasm Staging, SEER Program, Melanoma, Skin Neoplasms
- Abstract
Background: Stage is the most important prognostic factor for understanding cancer survival trends. Summary stage (SS) classifies cancer based on the extent of spread: In situ, Localized, Regional, or Distant. Continual updating of staging systems poses challenges to stage comparisons over time. We use a consistent summary stage classification and present survival trends for 25 cancer sites using the joinpoint survival (JPSurv) model., Methods: We developed a modified summary stage variable, Long-Term Site-Specific Summary Stage, based on as consistent a definition as possible and applied it to a maximum number of diagnosis years, 1975-2019. We estimated trends by stage by applying JPSurv to relative survival data for 25 cancer sites in SEER-8, 1975-2018, followed through December 31, 2019. To help interpret survival trends, we report incidence and mortality trends using the joinpoint model., Results: Five-year relative survival improved for nearly all sites and stages. Large improvements were observed for localized pancreatic cancer [4.25 percentage points annually, 2007-2012 (95% confidence interval, 3.40-5.10)], distant skin melanoma [2.15 percentage points annually, 2008-2018 (1.73-2.57)], and localized esophagus cancer [1.18 percentage points annually, 1975-2018 (1.11-1.26)]., Conclusions: This is the first analysis of survival trends by summary stage for multiple cancer sites. The largest survival increases were seen for cancers with a traditionally poor prognosis and no organized screening, which likely reflects clinical management advances., Impact: Our study will be particularly useful for understanding the population-level impact of new treatments and identifying emerging trends in health disparities research., (©2023 American Association for Cancer Research.)
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- 2023
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243. Interpreting cancer incidence trends: challenges due to the COVID-19 pandemic.
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Mariotto AB, Feuer EJ, Howlader N, Chen HS, Negoita S, and Cronin KA
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- Humans, United States epidemiology, Incidence, Pandemics, SEER Program, COVID-19 epidemiology, Thyroid Neoplasms epidemiology
- Abstract
The considerable deficit in cancer diagnoses in 2020 due to COVID-19 pandemic disruptions in health care can pose challenges in the estimation and interpretation of long-term cancer trends. Using Surveillance, Epidemiology, and End Results (SEER) (2000-2020) data, we demonstrate that inclusion of the 2020 incidence rates in joinpoint models to estimate trends can result in a poorer fit to the data and less accurate or less precise trend estimates, providing challenges in the interpretation of the estimates as a cancer control measure. To measure the decline in 2020 relative to 2019 cancer incidence rates, we used the percent change of rates in 2020 compared with 2019. Overall, SEER cancer incidence rates dropped approximately 10% in 2020, but for thyroid cancer the decrease was as large as 18% after adjusting for reporting delay. The 2020 SEER incidence data are available in all SEER released products, except for joinpoint estimates of trends and lifetime risk of developing cancer., (Published by Oxford University Press 2023.)
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- 2023
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244. Breast and colorectal cancer recurrence-free survival estimates in the US: Modeling versus active data collection.
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Mariotto AB, Thompson TD, Johnson C, Wu XC, and Pollack LA
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- Humans, Female, SEER Program, Registries, Breast Neoplasms epidemiology, Colonic Neoplasms pathology, Rectal Neoplasms
- Abstract
Background: A modeling method was developed to estimate recurrence-free survival using cancer registry survival data. This study aims to validate the modeled recurrence-free survival against "gold-standard" estimates from data collected by the National Program of Cancer Registries (NPCR) Patient-Centered Outcomes Research (PCOR) project., Methods: We compared 5-year metastatic recurrence-free survival using modeling and empirical estimates from the PCOR project that collected disease-free status, tumor progression and recurrence for colorectal and female breast cancer cases diagnosed in 2011 in 5 U.S. state registries. To estimate empirical recurrence-free survival, we developed an algorithm that combined disease-free, recurrence, progression, and date information from NPCR-PCOR data. We applied the modeling method to relative survival for patients diagnosed with female breast and colorectal cancer in 2000-2015 in the SEER-18 areas., Results: When grouping patients with stages I-III, the 5-year metastatic recurrence-free modeled and NPCR-PCOR estimates are very similar being respectively, 90.2 % and 88.6 % for female breast cancer, 74.6 % and 75.3 % for colon cancer, and 68.8 % and 68.5 % for rectum cancer. In general, the 5-year recurrence-free NPCR-PCOR and modeled estimates are still similar when controlling by stage. The modeled estimates, however, are not as accurate for recurrence-free survival in years 1-3 from diagnosis., Conclusions: The alignment between NPCR-PCOR and modeled estimates supports their validity and provides robust population-based estimates of 5-year metastatic recurrence-free survival for female breast, colon, and rectum cancers. The modeling approach can in principle be extended to other cancer sites to provide provisional population-based estimates of 5-year recurrence free survival., Competing Interests: Declaration of Competing Interest The authors have no conflicts of interest to declare. All co-authors have seen and agree with the contents of the manuscript and there is no financial interest to report. We certify that the submission is original work and is not under review at any other publication., (Published by Elsevier Ltd.)
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- 2023
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245. The Impact of Improved Treatments on Survival of Adult U.S. Leukemia Patients: 1990-2018.
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Howlader N, Sharon E, Bhattacharya M, Ehrlich LA, Richardson NC, Gormley NJ, de Claro RA, Wood AE, Mariotto AB, and Cronin KA
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- Adult, Humans, Imatinib Mesylate therapeutic use, Registries, Leukemia, Lymphocytic, Chronic, B-Cell epidemiology, Leukemia, Myelogenous, Chronic, BCR-ABL Positive drug therapy, Leukemia, Myelogenous, Chronic, BCR-ABL Positive epidemiology
- Abstract
Introduction: Molecularly targeted therapies such as tyrosine kinase inhibitors (TKI) are effective treatments for B-cell receptor (BCR)-ABL-bearing leukemias. We evaluated the impact of TKIs on historical chronic myeloid leukemia (CML) mortality trends compared with acute lymphoblastic leukemia (ALL) and chronic lymphoblastic leukemia (CLL)., Methods: Because mortality trends reflect combined effects of leukemia incidence and survival, we also evaluated the contribution of incidence and survival trends to mortality trends by subtypes. We used data from 13 U.S. (SEER) registries (1992-2017) among U.S. adults. We utilized histology codes to identify cases of CML, ALL, and CLL and death certificate data to calculate mortality. We used Joinpoint to characterize incidence (1992-2017) and mortality (1992-2018) trends by subtype and diagnosis year., Results: For CML, mortality rates started declining in 1998 at an average rate of 12% annually. Imatinib was approved by the FDA for treating CML and ALL in 2001, leading to clear benefits for patients with CML. Five-year CML survival increased dramatically over time, especially between 1996 to 2011, 2.3% per year on average. ALL incidence increased 1.5% annually from 1992 to 2017. ALL mortality decreased 0.6% annually during 1992 to 2012 and then stopped declining. CLL incidence fluctuated during 1992 to 2017 while mortality decreased 1.1% annually during 1992 to 2011 and at a faster rate of 3.6% per year from 2011. Five-year survival increased 0.7% per year on average during 1992 to 2016., Conclusions: Survival benefit from TKIs and other novel therapies for treating leukemia subtypes has been demonstrated in clinical trials., Impact: Our study highlights the impact of molecularly targeted therapies at the population level., (©2023 American Association for Cancer Research.)
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- 2023
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246. Estimating the Number of Men Living with Metastatic Prostate Cancer in the United States.
- Author
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Devasia TP, Mariotto AB, Nyame YA, and Etzioni R
- Subjects
- Humans, Male, Incidence, Prostate pathology, Registries, United States epidemiology, Black or African American, White, Neoplasm Recurrence, Local, Prostatic Neoplasms pathology
- Abstract
Background: Metastatic prostate cancer (MPC) includes metastases detected at diagnosis (de novo) and those occurring after diagnosis with early-stage disease (recurrent). Cancer registries collect data only on de novo MPC, providing a partial picture of the burden of MPC. We use cancer registry data to estimate the number of men living with MPC in the United States including both de novo and recurrent cases., Methods: We apply a back-calculation method to estimate MPC incidence and prevalence from U.S. prostate cancer mortality and de novo MPC relative survival for cases diagnosed between 2000 and 2017 in 18 Surveillance, Epidemiology, and End Results registries. We hold overall prostate cancer mortality and MPC survival constant for future prevalence projections., Results: On January 1, 2018, we estimated 120,400 U.S. men living with MPC (45% de novo, 55% recurrent). The age-adjusted prevalence in 2018 for Black men was over double that of White men (137.1 vs. 62.2 per 100,000 men). By 2030, 192,500 men are expected to be living with MPC, with the increase being driven by population growth projections., Conclusions: The number of men living with MPC in the United States exceeds 100,000 and represents a small fraction of the >3 million men living with a prior diagnosis of prostate cancer., Impact: Relatively similar fractions of de novo and recurrent MPC among prevalent cases highlight opportunities for management of localized disease in reducing the MPC burden. Changes in diagnostic technologies could lead to greater growth in MPC cases in the United States than projected. See related commentary by Stopsack et al., p. 585., (©2023 American Association for Cancer Research.)
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- 2023
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247. Determining Fitness for Use of SEER Cause-Specific Cause of Death in Analyses of Cause-Specific Survival.
- Author
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Morawski BM, Hsieh MC, Wu M, Sherman R, Mariotto AB, and Johnson CJ
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- Humans, Cause of Death, Ethnicity, Registries, SEER Program, United States, Adolescent, Young Adult, Adult, Middle Aged, Aged, Aged, 80 and over, Neoplasms
- Abstract
Background: Net and crude cancer survival statistics can be calculated using cause of death or expected survival from life tables. In some instances, using cause of death information may be advantageous. The Surveillance, Epidemiology, and End Results (SEER) Program cause-specific cause of death variable (North American Association of Central Cancer Registries [NAACCR] item #1914) designates that a patient died of their cancer. We evaluated how miss-ingness in NAACCR item #1914 impacted survival estimates to determine fitness for use in NAACCR Cancer in North America (CiNA) products., Methods: We used CiNA survival and prevalence data (November 2020 submission) to calculate 60-month cause-specific survival among persons aged 15-99 years at time of diagnosis using NAACCR item #1914. We treated missing/unknown causes of death in 3 ways: excluded from analysis, included as dead from this cancer, or included as censored at time of last follow-up. Autopsy/death-certificate-only cases were excluded from survival analyses. We calculated the proportion of deaths with unknown/missing cause of death by registry and demographic variables., Results: Generally, 60-month cause-specific survival estimates differed by <1% between the 3 approaches when NAACCR item #1914 was missing/unknown for <3% of deaths. When applying a <3% fit-for-use standard to SEER cause-specific cause of death, data from 34 registries were included in cause-specific survival analyses. The proportion of deaths with missing/unknown cause of death varied by primary site, age at diagnosis, race/ethnicity, year of diagnosis, and registry., Conclusion: We have identified missingness cut points for NAACCR item #1914, which strike a balance between scientific integrity and registry inclusiveness, to designate data in NAACCR CiNA data products as fit for use in cause-specific survival analyses., (© 2022 National Cancer Registrars Association.)
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- 2022
248. Assessment of Interstate Residential Mobility of SEER Patients: SEER and LexisNexis Residential Address Linkage.
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Tatalovich Z, Stinchcomb DG, Mariotto A, Ng D, Stevens JL, Coyle LM, and Penberthy L
- Subjects
- Humans, United States epidemiology, Registries, Population Dynamics, Ethnicity, SEER Program, Neoplasms epidemiology
- Abstract
The National Cancer Institute (NCI) Surveillance, Epidemiology, and End Results (SEER) program is continuously exploring opportunities to augment its already extensive collection of data, enhance the quality of reported cancer information, and contribute to more comprehensive analyses of cancer burden. This manuscript describes a recent linkage of the LexisNexis longitudinal residential history data with 11 SEER registries and provides estimates of the inter-state mobility of SEER cancer patients. To identify mobility from one state to another, we used state postal abbreviations to generate state-level residential histories. From this, we determined how often cancer patients moved from state-to-state. The results in this paper provide information on the linkage with LexisNexis data and useful information on state-to-state residential mobility patterns of a large portion of US cancer patients for the most recent 1-, 2-, 3-, 4-, and 5-year periods. We show that mobility patterns vary by geographic area, race/ethnicity and age, and cancer patients tend to move less than the general population., (© 2022 National Cancer Registrars Association.)
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- 2022
249. Cancer treatment and survivorship statistics, 2022.
- Author
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Miller KD, Nogueira L, Devasia T, Mariotto AB, Yabroff KR, Jemal A, Kramer J, and Siegel RL
- Subjects
- American Cancer Society, Female, Humans, Male, National Cancer Institute (U.S.), Survivorship, United States epidemiology, Carcinoma, Non-Small-Cell Lung, Lung Neoplasms
- Abstract
The number of cancer survivors continues to increase in the United States due to the growth and aging of the population as well as advances in early detection and treatment. To assist the public health community in better serving these individuals, the American Cancer Society and the National Cancer Institute collaborate triennially to estimate cancer prevalence in the United States using incidence and survival data from the Surveillance, Epidemiology, and End Results cancer registries, vital statistics from the Centers for Disease Control and Prevention's National Center for Health Statistics, and population projections from the US Census Bureau. Current treatment patterns based on information in the National Cancer Database are presented for the most prevalent cancer types by race, and cancer-related and treatment-related side-effects are also briefly described. More than 18 million Americans (8.3 million males and 9.7 million females) with a history of cancer were alive on January 1, 2022. The 3 most prevalent cancers are prostate (3,523,230), melanoma of the skin (760,640), and colon and rectum (726,450) among males and breast (4,055,770), uterine corpus (891,560), and thyroid (823,800) among females. More than one-half (53%) of survivors were diagnosed within the past 10 years, and two-thirds (67%) were aged 65 years or older. One of the largest racial disparities in treatment is for rectal cancer, for which 41% of Black patients with stage I disease receive proctectomy or proctocolectomy compared to 66% of White patients. Surgical receipt is also substantially lower among Black patients with non-small cell lung cancer, 49% for stages I-II and 16% for stage III versus 55% and 22% for White patients, respectively. These treatment disparities are exacerbated by the fact that Black patients continue to be less likely to be diagnosed with stage I disease than White patients for most cancers, with some of the largest disparities for female breast (53% vs 68%) and endometrial (59% vs 73%). Although there are a growing number of tools that can assist patients, caregivers, and clinicians in navigating the various phases of cancer survivorship, further evidence-based strategies and equitable access to available resources are needed to mitigate disparities for communities of color and optimize care for people with a history of cancer. CA Cancer J Clin. 2022;72:409-436., (© 2022 The Authors. CA: A Cancer Journal for Clinicians published by Wiley Periodicals LLC on behalf of American Cancer Society.)
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- 2022
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250. Workforce Caring for Cancer Survivors in the United States: Estimates and Projections of Use.
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Mariotto AB, Enewold L, Parsons H, Zeruto CA, Yabroff KR, and Mayer DK
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- Aged, Humans, Medicare, Survivors, Survivorship, United States epidemiology, Workforce, Cancer Survivors, Neoplasms epidemiology, Neoplasms therapy
- Abstract
Background: This study aims to quantify the extent and diversity of the cancer care workforce, beyond medical oncologists, to inform future demand because the number of cancer survivors is expected to grow in the United States., Methods: Surveillance, Epidemiology, and End Results-Medicare data were used to evaluate health-care use of cancer survivors diagnosed between 2000 and 2014, enrolled in fee-for-service Medicare Parts A and B, and 65 years or older in 2008-2015. We calculated percentage of cancer survivors who saw each clinician specialty and their average annual number of visits in each phase of care. We projected the national number of individuals receiving care and number of annual visits by clinician specialty and phase of care through 2040., Results: Cancer survivors had higher care use in the first year after diagnosis and last year of life phases. During the initial year after cancer diagnosis, most survivors were seen for cancer-related care by a medical oncologist (59.1%), primary care provider (55.9%), and/or other cancer-treating physicians (42.2%). The percentage of survivors with cancer-related visits to each specialty declined after the first year after diagnosis, plateauing after year 6-7. However, at 10 or more years after diagnosis, approximately 20% of cancer survivors had visits to medical oncologists and an average of 4 visits a year., Conclusions: Cancer survivors had higher care use in the first year after diagnosis and last year of life. High levels of care use across specialties in all phases of care have important implications for models of survivorship care coordination and workforce planning., (Published by Oxford University Press 2022. This work is written by US Government employees and is in the public domain in the US.)
- Published
- 2022
- Full Text
- View/download PDF
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