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  • Yabroff, Robin  (4)
  • Zhao, Jingxuan  (4)
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Subjects(RVK)
  • 1
    Online Resource
    Online Resource
    Associations of cancer history, food insecurity, and nonmedical financial worry and mortality risk in the US.
    American Society of Clinical Oncology (ASCO) ; 2023
    In:  Journal of Clinical Oncology Vol. 41, No. 16_suppl ( 2023-06-01), p. 6537-6537
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 41, No. 16_suppl ( 2023-06-01), p. 6537-6537
    Abstract: 6537 Background: Cancer survivors often face substantial out-of-pocket medical costs, which can adversely affect their financial well-being. Cutting expenses on food and housing to save money are common coping strategies. However, little is known about the extent to which food insecurities and non-medical financial worries affect mortality risk after consideration of medical financial hardship. Methods: The 2013-2018 National Health Interview Survey (NHIS) and the NHIS linked mortality files with vital status through December 31, 2019 were used to identify cancer survivors (ages 18-64: n=5,110; ages 65-79: n=4,949) and individuals without a cancer history (ages 18-64: n=115,643; ages 65-79: n=24,785). Medical financial hardship included 3 domains: material, psychological, and behavioral. Food insecurity (e.g., worry about food running out) and non-medical financial worries (e.g., paying for monthly bills and housing) were separately summarized and categorized as severe, moderate, and minor/none levels. Using age as the time scale, associations of cancer history, food insecurity and non-medical financial worry and mortality risk were examined with weighted Cox proportional hazards models. Adjusted models included medical financial hardship, sex, educational attainment, marital status, health insurance, comorbid conditions, and survey year. All estimates accounted for complex survey design. Results: In our sample, about 13.8% (ages 18-64) and 7.9% (ages 65-79) reported moderate to severe levels of food insecurity, respectively; 32.1% (ages 18-64) and 19.2% (ages 65-79) reported moderate to severe levels of non-medical financial worries, respectively. In adjusted analyses, cancer survivors had increased mortality risk. After controlling for medical financial hardship, food insecurity was associated with higher mortality risk in both age groups, following a dose-response relationship (Table); Non-medical financial worry was associated with higher mortality risk in the 65-79 age group (Table). Conclusions: Standardized and comprehensive assessment of financial hardship and other social needs, such food insecurity, is essential to identify and mitigate adverse economic impacts of cancer. [Table: see text]
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2023.41.16_suppl.6537
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2023
    detail.hit.zdb_id: 2005181-5
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  • 2
    Online Resource
    Online Resource
    COVID-19 vaccination, infection, and symptoms among cancer survivors in the United States during 2021.
    American Society of Clinical Oncology (ASCO) ; 2023
    In:  Journal of Clinical Oncology Vol. 41, No. 16_suppl ( 2023-06-01), p. e18786-e18786
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 41, No. 16_suppl ( 2023-06-01), p. e18786-e18786
    Abstract: e18786 Background: The effects of the COVID-19 pandemic on cancer survivorship during 2021, the second year in the US when vaccination became widely available, is largely undocumented. This study reports COVID-19 vaccination, infection, and symptoms among cancer survivors using nationally representative data. Methods: We used the 2021 National Health Interview Survey to identify adults with and without cancer history. Age-adjusted percentages for COVID-19 vaccinations, infection history and symptom severity were calculated among adults with and without a cancer history. We further calculated the percentage of COVID-related outcomes stratifying by sex, age, race/ethnicity, education level, and health insurance coverage among cancer survivors. Results: Compared to adults without a cancer history (n = 26,023), cancer survivors (n = 3,428) were more likely to have two or more COVID-19 vaccines (66.6% v 62.3%, P= 0.003) and as likely to have COVID-19 infection history (14.1% vs 14.2%, P= 0.93), but once infected, face higher likelihood of developing moderate/severe symptoms (62.5% v 54.2%, P= 0.02). Among cancer survivors, older age, higher educational attainment, and having health insurance coverage were significantly associated with higher vaccination rate (all P 〈 0.001). Age was significantly associated with COVID-19 infection history, with the highest percentage of COVID-19 infection history (17.3%) among cancer survivors aged 45-54 years. Among cancer survivors infected with COVID-19, being female and younger age were associated with higher likelihood of developing moderate to severe symptoms (both P 〈 0.05). Moreover, loss of taste or smell were most frequently seen among COVID-19 infected cancer survivors who were female (68.7%), 45-54 years of age (71.1%), Hispanic (73.2%), and survivors younger than 65 years without private insurance (75.1% for publicly insured and 73.1% for uninsured). Conclusions: In 2021, cancer survivors had better COVID-19 vaccine completion than adults without a cancer history. If infected, cancer survivors were more likely to develop moderate/severe symptoms; survivors who were female, younger age, Hispanic or uninsured had worse experiences with COVID-19 infection, suggesting ongoing tailored efforts to prevent infection are warranted as the pandemic evolves.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2023.41.16_suppl.e18786
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2023
    detail.hit.zdb_id: 2005181-5
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Online Resource
    Open Access Request
    Availability (electronic / print)
  • 3
    Online Resource
    Online Resource
    County-level jail incarceration and cancer mortality in the US.
    American Society of Clinical Oncology (ASCO) ; 2023
    In:  Journal of Clinical Oncology Vol. 41, No. 16_suppl ( 2023-06-01), p. 6535-6535
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 41, No. 16_suppl ( 2023-06-01), p. 6535-6535
    Abstract: 6535 Background: Incarceration has been linked to poor community health outcomes, such as worse preterm births and mortality in the US, although little research has examined cancer outcomes. This study examined associations of county-level jail incarceration and cancer mortality. Methods: Annual county-level local jail incarceration rates (1990-2018) were obtained from the Vera Institute of Justice. We calculated annual county-level mortality rates (2000 -2019) with invasive cancer as the underlying cause of death (ICD-10 codes: C00-C97) using National Vital Statistics System. Associations of county-level jail incarceration and cancer mortality overall, and by sex, race, and common cancer sites were examined with generalized estimating equations with Poisson distribution and standard errors clustered at county level. To assess the short-, medium-, and long-term associations, we used lagged county-level incarceration rates by 1, 5, and 10 years prior to mortality rates in separate analyses. Results: Over the 20-year study period, each 1 per 1000 increase in county jail incarceration rate was associated with a 1.2% increase in cancer mortality rate in the short-term (model with 1-year lags, rate ratio (RR): 1.012, 95% CI: 1.009–1.015) and 1.1% increase in medium-term (5-year lags (RR: 1.011, 95% CI: 1.008–1.014) and 0.8% increase long-term (10-year lags (RR: 1.008, 95% CI: 1.004–1.012). After adjusting for county-level sociodemographic characteristics, the RRs were attenuated but remained statistically significant. Jail incarceration was associated with higher cancer mortality for all common cancers included in the study (Table) and for White people, but not for Black people. The magnitude of associations was similar for medium- and long-term effects (5- and 10-year lags, respectively). Conclusions: Higher county-level jail incarceration rates were associated with higher county-level cancer mortality rates, underscoring the collateral health consequences of mass incarceration. Efforts to identify interventions to decrease the cancer mortality burden in these communities are warranted. [Table: see text]
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2023.41.16_suppl.6535
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2023
    detail.hit.zdb_id: 2005181-5
    Library Location Call Number Volume/Issue/Year Availability
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  • 4
    Online Resource
    Online Resource
    Associations of employment disruptions and financial hardship among individuals diagnosed with cancer in the US.
    American Society of Clinical Oncology (ASCO) ; 2023
    In:  Journal of Clinical Oncology Vol. 41, No. 16_suppl ( 2023-06-01), p. 12097-12097
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 41, No. 16_suppl ( 2023-06-01), p. 12097-12097
    Abstract: 12097 Background: Financial hardship is experienced by approximately half of working-age individuals diagnosed with cancer. Many working individuals diagnosed with cancer also experience disruptions with their employment. This study examines whether employment disruptions are associated with financial hardship among individuals diagnosed with cancer in the US. Methods: We utilized data from the 2016/2017 Medical Expenditure Panel Survey (MEPS) Experiences with Cancer self-administered questionnaires and identified individuals diagnosed with cancer at age 〉 18 who worked for pay at the time of or following their cancer diagnosis. Employment disruption was defined as taking extended paid time off work; switching to a part time or less demanding job or to a flexible work schedule; and/or retiring early due to cancer, cancer treatment, or late effects. Financial hardship was defined in 3 domains: material (borrowing money, financial sacrifices, or being unable to cover medical costs); psychological (worrying about medical bills, financial stability, keeping job/income, or future earnings); and behavioral (delaying/forgoing medical care because of cost). Multivariable logistic regression analyses adjusting for the MEPS survey design were used to determine associations of employment disruption due to cancer with any financial hardship and with financial hardship intensity while controlling for patient demographic, health insurance, and clinical characteristics. Results: Among 732 individuals with a cancer history, 47.4% experienced employment disruptions and 55.9% experienced any financial hardship. Financial hardship was significantly more common among cancer survivors with employment disruptions than without disruptions (68.7% vs. 44.5%; p-value of difference 〈 0.0001). Findings were consistent across multiple hardship measures/domains and across years since last cancer treatment. In multivariable logistic regression analyses, cancer survivors with employment disruptions were significantly more likely to have greater (OR = 2.8; 95% CI 2.0, 3.9) financial hardship intensity. Individuals of race/ethnicity other than non-Hispanic White; who had Medicare (vs. private) insurance and were age 〈 65 years old at diagnosis; or had breast, colon, or prostate cancer (vs. melanoma reference group) were also more likely to experience financial hardship. Older individuals and those who were married were less likely to experience financial hardship. Conclusions: Employment disruptions are common and significantly associated with multiple types of financial hardship among cancer survivors. Employer workplace accommodation and other policies to minimize disruptions among individuals diagnosed with cancer may reduce financial hardship in this vulnerable population.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2023.41.16_suppl.12097
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2023
    detail.hit.zdb_id: 2005181-5
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Online Resource
    Open Access Request
    Availability (electronic / print)
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