Journal of Preventive Medicine and Public Health

James R. Langabeer II

2 Articles

Demographic and Survivorship Disparities in Non–muscle-invasive Bladder Cancer in the United States: Munseok Seo, James R. Langabeer II; J Prev Med Public Health. 2018;51(5):242-247. Published online August 23, 2018; DOI: https://doi.org/10.3961/jpmph.18.092

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Objectives
To examine survivorship disparities in demographic factors and risk status for non–muscle-invasive bladder cancer (NMIBC), which accounts for more than 75% of all urinary bladder cancers, but is highly curable with early identification and treatment. Methods: We used the US National Cancer Institute’s Surveillance, Epidemiology, and End Results registries over a 19-year period (1988-2006) to examine survivorship disparities in age, sex, race/ethnicity, and marital status of patients and risk status classified by histologic grade, stage, size of tumor, and number of multiple primary tumors among NMIBC patients (n=29 326). We applied Kaplan-Meier (K-M) and Cox proportional hazard methods for survival analysis. Results: Among all urinary bladder cancer patients, the majority of NMIBCs were in male (74.1%), non-Latino white (86.7%), married (67.8%), and low-risk (37.6%) to intermediate-risk (44.8%) patients. The mean age was 68 years. Survivorship (in median life years) was highest for non-Latino white (5.4 years), married (5.4 years), and low-risk (5.7 years) patients (K-M analysis, p<0.001). We found significantly lower survivorship for elderly, male (female hazard ratio [HR], 0.96), Latino (HR, 1.20), and unmarried (married HR, 0.93) patients. Conclusions: Survivorship disparities were ubiquitous across age, sex, race/ethnicity, and marital status groups. Non-white, unmarried, and elderly patients had significantly shorter survivorship. The implications of these findings include the need for a heightened focus on health policy and more organized efforts to improve access to care in order to increase the chances of survival for all patients.

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A Propensity Score-Based Comparison regarding Renal, Functional, and Surgical Outcome of Continent Cutaneous Urinary Diversions in Patients with Benign Chronic Bladder Diseases and Patients with Bladder Cancer
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The impact of the social construct of race on outcomes among bacille Calmette‐Guérin‐treated patients with high‐risk non‐muscle–invasive bladder cancer in an equal‐access setting
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Determinants of Potentially Unnecessary Cervical Cancer Screenings in American Women: Munseok Seo, James R. Langabeer II; J Prev Med Public Health. 2018;51(4):181-187. Published online June 7, 2018; DOI: https://doi.org/10.3961/jpmph.18.023

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Abstract PDF

Objectives
To identify factors responsible for potentially clinically unnecessary cervical cancer screenings in women with prior hysterectomy.
Methods
A retrospective cross-sectional study was conducted using the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System (BRFSS). This study targeted adult women and examined whether they received a both a Papanicolaou (Pap) test and undergone a hysterectomy in the last three years. We conducted multivariate analyses, including weighted proportions and odds ratios (ORs), based on the modified BRFSS weighting method (raking). The inclusion criteria were adult women (>18 years old) who reported having received a Pap test within the last 3 years.
Results
Of all women (n=252 391), 72 366 had received a Pap test, and 32 935 of those women (45%, or 12.5 million, weighted) had a prior hysterectomy. We found that age, race/ethnicity, marital status, family income, health status, time since last routine checkup, and health insurance coverage were all significant predictors. Black, non-Hispanic women were 2.23 times more likely to receive Pap testing after a hysterectomy than white women (OR, 2.23; 95% confidence interval [CI], 1.99 to 2.50). Similarly, the odds for Hispanic women were 2.34 times higher (OR, 2.34; 95% CI, 1.97 to 2.80). The odds were also higher for those who were married (OR, 1.17; 95% CI, 1.08 to 1.27), healthier (OR, 1.24; 95% CI, 1.14 to 1.35), and had health insurance (OR, 1.54; 95% CI, 1.28 to 1.84), after controlling for confounders.
Conclusions
We conclude that women may potentially receive Pap tests even if they are not at risk for cervical cancer, and may not be adequately informed about the need for screenings. We recommend strategies to disseminate recommendations and information to patients, their families, and care providers.

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Three large scale surveys highlight the complexity of cervical cancer under-screening among women 45–65 years of age in the United States
Diane M. Harper, Melissa Plegue, Kathryn M. Harmes, Masahito Jimbo, Sherri SheinfeldGorin
Preventive Medicine.2020; 130: 105880. CrossRef
Socio-demographic Characteristics and Use of Pap Smear for Cervical Cancer Screening Among Women of Eastern Part of India
Dipanwita Ghosh, Sutapa Mahata, Pranab Kumar Sahoo, Sinjini Sarkar, Asoke Roy, Karabi Datta, Manisha Vernekar, Syamsundar Mandal, Vilas D. Nasare
Indian Journal of Gynecologic Oncology.2019;[Epub] CrossRef
2019 Update on Medical Overuse
Daniel J. Morgan, Sanket S. Dhruva, Eric R. Coon, Scott M. Wright, Deborah Korenstein
JAMA Internal Medicine.2019; 179(11): 1568. CrossRef

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