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Browsing by Subject "Cancer Screening"
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Item Cancer Screening in the United States and Europe(2012) Cronan, Terry A.; Santoro, Maya; Van Liew, Charles; Bigatti, Silvia M.Item The health disparities cancer collaborative: a case study of practice registry measurement in a quality improvement collaborative(BMC, 2010-06-04) Haggstrom, David A.; Clauser, Steven B.; Taplin, Stephen H.; Medicine, School of MedicineBackground Practice registry measurement provides a foundation for quality improvement, but experiences in practice are not widely reported. One setting where practice registry measurement has been implemented is the Health Resources and Services Administration's Health Disparities Cancer Collaborative (HDCC). Methods Using practice registry data from 16 community health centers participating in the HDCC, we determined the completeness of data for screening, follow-up, and treatment measures. We determined the size of the change in cancer care processes that an aggregation of practices has adequate power to detect. We modeled different ways of presenting before/after changes in cancer screening, including count and proportion data at both the individual health center and aggregate collaborative level. Results All participating health centers reported data for cancer screening, but less than a third reported data regarding timely follow-up. For individual cancers, the aggregate HDCC had adequate power to detect a 2 to 3% change in cancer screening, but only had the power to detect a change of 40% or more in the initiation of treatment. Almost every health center (98%) improved cancer screening based upon count data, while fewer (77%) improved cancer screening based upon proportion data. The aggregate collaborative appeared to increase breast, cervical, and colorectal cancer screening rates by 12%, 15%, and 4%, respectively (p < 0.001 for all before/after comparisons). In subgroup analyses, significant changes were detectable among individual health centers less than one-half of the time because of small numbers of events.Conclusions The aggregate HDCC registries had both adequate reporting rates and power to detect significant changes in cancer screening, but not follow-up care. Different measures provided different answers about improvements in cancer screening; more definitive evaluation would require validation of the registries. Limits to the implementation and interpretation of practice registry measurement in the HDCC highlight challenges and opportunities for local and aggregate quality improvement activities.Item Lung cancer screening and stigma: Do smoking-related differences in perceived lung cancer stigma emerge prior to diagnosis?(APA, 2021) Williamson, Timothy J.; Rawl, Susan M.; Kale, Minal S.; Carter-Harris, Lisa; School of NursingBackground: Most lung cancer patients report experiencing stigma (i.e., devaluation based on one’s lung cancer diagnosis), which is associated with adverse health outcomes. Lung cancer is stigmatized due to its robust association with smoking and the perception of the disease as self inflicted. Purpose: Identifying sociodemographic and smoking-related correlates of perceived stigma among lung cancer screening-eligible adults (early in the cancer care trajectory) is needed to guide proactive psycho social interventions to reduce stigma and improve health for patients newly diagnosed with lung cancer. Methods: A national sample of lung cancer screening eligible adults (N = 515; 64.9% female) completed questionnaires on sociodemographic information, smoking-related characteristics, and perceived smoking-related lung cancer stigma. Zero-order and multivariate relationships between sociodemographic variables, smoking-related characteristics, and stigma were evaluated using Pearson’s correlations, t-tests, ANOVAs, and multivariable regression. Results: The multivariable regression demonstrated that younger age (b = -0.05, p = .047) was associated significantly with higher stigma. Additionally, women (b = 0.63, p = .015), participants who reported Hispanic/Latino ethnicity (b = 1.07, p = .049), and those with a college degree or higher (all p < .029) reported significantly higher stigma, compared to men, those who did not report Hispanic/Latino ethnicity, and other education categories, respectively. None of the smoking-related characteristics were associated significantly with perceived stigma (all p > .12). Conclusions: Sociodemographic variables (rather than smoking-related characteristics) significantly and uniquely differentiated lung cancer screening-eligible adults’ perception of lung cancer stigma. Smoking-related differences in lung cancer stigma may emerge following rather than prior to diagnosis.Item Rates of Depression and Anxiety in Cancer Patients: A Review of Cross-National Findings(Pabst Publishers, 2012) Bigatti, Silvia M.; Steiner, Jennifer L.; Cronan, Terry A.Cancer is the leading cause of death worldwide. In this paper, we examine the similarities and differences between the United States (US) and the European Union (EU-27) in the incidences, deaths, types of screening, and screening rates for breast, cervical, colorectal, prostate, and lung cancers. We highlight the differences between the health care, economic, and sociopolitical systems in the US and EU-27 that result in different types of coverage, access to health care, and cancer screening. Finally, we discuss patient-directed, provider-directed, community-directed, and system-directed interventions and the outcomes of these approaches.