Download or read book Examining Disparities in Breast Cancer Screening Rates in a Program Designed to Provide Free Care to Women in the State of Pennsylvania written by Zeinab Mohamad Baba and published by . This book was released on 2014 with total page 244 pages. Available in PDF, EPUB and Kindle. Book excerpt: Background. Female breast cancer is the most diagnosed cancer in women and the second leading cause of cancer death in women (behind lung cancer) (U.S. Cancer Statistics Working Group, 2013b). The purpose of this research was to examine client and provider level characteristics driving the disparities in morbidity and mortality as it relates to breast cancer screening, thus providing a clear indication of what client and provider factors are essential for successfully reducing disparities in breast cancer screening beyond removing barriers of cost. Specific aims include: (1) To characterize the client population utilizing the services of the Healthy Woman Program in Pennsylvania; (2) To Identify client and provider predictive factors that influence women with an initial screening mammogram to return for rescreening within 24 months; and (3) To use a local case study to explore service delivery factors influencing woman with an initial screening mammogram to return for rescreening. Methods. This study was a retrospective analysis of prospective data from the Healthy Woman Program (HWP), investigating women enrolled in the HWP in Pennsylvania and their rescreening rates. As the HWP dataset primarily contained client-level variables, additional structural provider-level variables were derived from Komen Foundation data, and data from the United States Department of Agriculture (USDA) and the Census, to extend the investigation beyond the individual woman to specified contextual effects. A local qualitative case study augmented the quantitative analysis to explore more process-oriented contextual effects, with an emphasis on how services are organized to support client outreach and retention, and promising practices for getting clients to return for rescreening. Results. The major predictors of an abnormal mammogram were having a diagnostic mammogram rather than a screening mammogram, being younger than 40, and living in an urban area. The major predictors of a breast cancer diagnosis were being white, being younger than 40, living in a large rural town, and being a current smoker. The major predictors of dropping out after an abnormal mammogram were being white, and having a diagnostic mammogram rather than a screening mammogram. The major predictors of delay in diagnostic work up were Black race and screening mammogram. The major predictors of returning for screening were living in a large rural town, being a non-smoker, having no symptoms prior to the initial mammogram, having a normal result from the initial mammogram, and living with others. Comprehensive breast cancer education, delivered in community settings, and tailored to cultural, social, and literacy issues, results in a robust referral network. More reminders than mandated by HWP Guidance, through multiple channels, rather than the client alone, increase returns for annual rescreening. Conclusions. Prior investigation of rescreening rates among low-income women has focused on client-level factors, yielding a narrow range of targets for systems change. This study investigated both client and provider level characteristics, analyzing them together and separately, to increase understanding of the multifactorial predictors of rescreening and widen the set of potential targets for change. Instituting a protocol of allowing community groups to organize a few women to have screenings in one day and allowing for interpreters who are family or community members would improve rescreening rates. Methods for ensuring patients return should be modified as the HWP sequence may not be enough.
Download or read book Fulfilling the Potential of Cancer Prevention and Early Detection written by National Research Council and published by National Academies Press. This book was released on 2003-05-07 with total page 564 pages. Available in PDF, EPUB and Kindle. Book excerpt: Cancer ranks second only to heart disease as a leading cause of death in the United States, making it a tremendous burden in years of life lost, patient suffering, and economic costs. Fulfilling the Potential for Cancer Prevention and Early Detection reviews the proof that we can dramatically reduce cancer rates. The National Cancer Policy Board, part of the Institute of Medicine, outlines a national strategy to realize the promise of cancer prevention and early detection, including specific and wide-ranging recommendations. Offering a wealth of information and directly addressing major controversies, the book includes: A detailed look at how significantly cancer could be reduced through lifestyle changes, evaluating approaches used to alter eating, smoking, and exercise habits. An analysis of the intuitive notion that screening for cancer leads to improved health outcomes, including a discussion of screening methods, potential risks, and current recommendations. An examination of cancer prevention and control opportunities in primary health care delivery settings, including a review of interventions aimed at improving provider performance. Reviews of professional education and training programs, research trends and opportunities, and federal programs that support cancer prevention and early detection. This in-depth volume will be of interest to policy analysts, cancer and public health specialists, health care administrators and providers, researchers, insurers, medical journalists, and patient advocates.
Download or read book Breast Cancer Screening Behaviors Among Women in Pennsylvania from 2000 2010 written by Rikita Hatia and published by . This book was released on 2012 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: BACKGROUND: Prevention is instrumental to decreasing the mortality and morbidity of cancer. Since 1991, the National Breast and Cervical Cancer Early Detection Program helps detect breast and cervical cancer early among uninsured and low income women. OBECTIVES: The study aims to examine how health insurance coverage and annual household income have impacted mammography utilization. Furthermore, temporal changes of late stage breast cancer rates in Pennsylvania will be analyzed to assess the impact of the statewide preventive initiatives. METHODS: A multivariate analysis was conducted of mammography screening rates in Pennsylvania from 2002 - 2010 for women aged 40 - 64. Multivariate analysis was also used to analyze breast cancer stage of diagnosis from 2000 - 2009 using Pennsylvania Cancer Registry to determine change over time. RESULTS: Compared to 2002, the rate of mammography utilization has steadily decreased. Mammography utilization is correlated significantly with health insurance and annual household income. Both individual and environmental factors appear associated with breast cancer diagnosis, with African American women having a higher odds of late stage cancer diagnosis, and the southeastern part of Pennsylvania having a higher rate. CONCLUSIONS: The study highlights the critical role of economic disadvantage on detection, and the importance of a program geared to low-income women, such as the HealthyWoman Project (HWP). The decreasing trend in late stage breast cancer diagnosis over time suggests a positive effect of HWP. Future studies should seek to better understand how factors influence the trajectory of breast cancer, and should investigate additional surveillance outcomes of the HWP.
Download or read book Access Standards for Covered Services Within the Pennsylvania Medicaid Program written by Kelly Abraham and published by . This book was released on 2010 with total page 35 pages. Available in PDF, EPUB and Kindle. Book excerpt: Background: Breast cancer is the most common cancer in women aside from non melanoma skin cancer (CDC, 2009a) All women are at risk for cervical cancer, but the disease usually occurs in women 30 years and older (CDC, 2010a). Access standards for breast and cervical cancer screenings in the Medicaid program appear to be limited. The study hopes to address standards that define adequate access to breast and cervical cancer screenings for prevention specifically in the Medicaid program. Objectives: To discern if there are prevailing standards for access for breast and cervical cancer screening, to understand accessibility and its various components more thoroughly, to gain a deeper insight into breast and cervical cancer prevention, and to explore and document methods for research on screening standards in order to guide others who may follow up on research or use for other services. Methods: This study consisted of literature searches and reviews specific to access standards, Medicaid, breast cancer, and cervical cancer. Online searches for specific contracts and contacts were targeted to various state departments of health, medical societies for breast and cervical cancer, and national organizations. For information that could not be searched, emails and phone calls were the best ways to obtain the information needed. Results: Given the research, the hypothesis was proven true. Access standards for breast and cervical cancer prevention do not exist for the organizations and departments researched. The importance of creating standards is that it allows for the measurement of access to care. The primary recommendation from this study is that access standards should be developed to measure the effectiveness of breast and cervical cancer screenings and prevention services. The second major recommendation is to develop access standards by researching the actual experience with wait-times for breast and cervical cancer screening. Since the need for access to care standards for breast and cervical cancer screening is addressed, the next question would be how to go about developing standards. Conclusions: The findings suggest there is a gap in information on breast and cervical cancer preventive services. The main recommendation is that access to care standards for breast and cervical cancer preventive services be developed in order to measure access to care in the Medicaid program. This would allow the Medicaid program's breast and cervical cancer preventive services for women to be assessed.
Download or read book Mammography and Beyond written by National Research Council and published by National Academies Press. This book was released on 2001-07-23 with total page 311 pages. Available in PDF, EPUB and Kindle. Book excerpt: Each year more than 180,000 new cases of breast cancer are diagnosed in women in the U.S. If cancer is detected when small and local, treatment options are less dangerous, intrusive, and costly-and more likely to lead to a cure. Yet those simple facts belie the complexity of developing and disseminating acceptable techniques for breast cancer diagnosis. Even the most exciting new technologies remain clouded with uncertainty. Mammography and Beyond provides a comprehensive and up-to-date perspective on the state of breast cancer screening and diagnosis and recommends steps for developing the most reliable breast cancer detection methods possible. This book reviews the dramatic expansion of breast cancer awareness and screening, examining the capabilities and limitations of current and emerging technologies for breast cancer detection and their effectiveness at actually reducing deaths. The committee discusses issues including national policy toward breast cancer detection, roles of public and private agencies, problems in determining the success of a technique, availability of detection methods to specific populations of women, women's experience during the detection process, cost-benefit analyses, and more. Examining current practices and specifying research and other needs, Mammography and Beyond will be an indispensable resource to policy makers, public health officials, medical practitioners, researchers, women's health advocates, and concerned women and their families.
Download or read book Communities in Action written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2017-04-27 with total page 583 pages. Available in PDF, EPUB and Kindle. Book excerpt: In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.
Download or read book Recommendations for a Statewide Plan for the Early Detection of Breast Cancer written by and published by . This book was released on 1991 with total page 54 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Improving Breast Imaging Quality Standards written by National Research Council and published by National Academies Press. This book was released on 2005-09-27 with total page 240 pages. Available in PDF, EPUB and Kindle. Book excerpt: Mammography is an important tool for detecting breast cancer at an early stage. When coupled with appropriate treatment, early detection can reduce breast cancer mortality. At the request of Congress, the Food and Drug Administration (FDA) commissioned a study to examine the current practice of mammography and breast cancer detection, with a focus on the FDA's oversight via the Mammography Quality Standards Act (MQSA), to identify areas in need of improvement. Enacted in 1993, MQSA provides a general framework for ensuring national quality standards in facilities performing screening mammography, requires that each mammography facility be accredited and certified, and mandates that facilities will undergo annual inspections. This book recommends strategies for achieving continued progress in assuring mammography quality, including changes to MQSA regulation, as well as approaches that do not fall within the purview of MQSA. Specifically, this book provides recommendations aimed at improving mammography interpretation; revising MQSA regulations, inspections, and enforcement; ensuring an adequate workforce for breast cancer screening and diagnosis; and improving breast imaging quality beyond mammography.
Download or read book Tele oncology written by Giovanna Gatti and published by Springer. This book was released on 2015-06-09 with total page 91 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book explains how telemedicine can offer solutions capable of improving the care and survival rates of cancer patients and can also help patients to live a normal life in spite of their condition. Different fields of application – community, hospital and home based – are examined, and detailed attention is paid to the use of tele-oncology in rural/extreme rural settings and in developing countries. The impact of new technologies and the opportunities afforded by the social web are both discussed. The concluding chapters consider eLearning in relation to cancer care and assess the scope for education to improve prevention. No medical condition can shatter people’s lives as cancer does today and the need to develop strategies to reduce the disease burden and improve quality of life is paramount. Readers will find this new volume in Springer’s TELe Health series to be a rich source of information on the important contribution that can be made by telemedicine in achieving these goals.
Download or read book A Socioecological View Of Attitudes And Perceptions Towards Uptake Of Breast Cancer Screening In Multicultural Populations written by Bilikisu Elewonibi and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Individual attitudes and perceptions are seen as the basis for determining health screening behavior. Preventive behavior is also influenced by factors acting at the individual and community levels. Interventions are likely to be more effective when they address determinants at all levels because significant and dynamic interrelationships exist among different levels of health determinants. The following papers identify structural, organizational, and sociocultural influences that may preclude women from using preventive health care, specifically breast-screening services, and affect individual attitudes toward breast cancer screening. The Evaluation of a Breast Cancer Screening Program in Nigeria examines the objectives and resources of a nonprofits breast cancer screening program to determine if its expectations are realistic and achievable within its current in the context. The Association of Chronic Diseases and Mammography among Medicare Beneficiaries Living in Appalachia examines the associations between the number and prevalence of chronic health conditions and adherence to breast screening guidelines among Medicare beneficiaries in four Appalachian states. Breast Cancer Screening and Health Care System Distrust by Race and Nativity in Philadelphia examines the influence of health care system distrust on breast cancer screening utilization among residents of southeast Pennsylvania by race and nativity. These studies offer a socioecological view of attitudes and perceptions toward uptake of mammograms in three different populations. These attitudes, whether perceived or actual, act as barriers that prevent vulnerable women in multicultural societies from using breast cancer screening services. A better understanding of these womens perceptions and beliefs allows for sustainable macro and micro level approaches to lowering barriers and achieving greater participation of women from minority or other disadvantaged social groups in breast cancer programs.
Download or read book Impact of Context on Breast Cancer Screening and Treatment written by Katelyn Holmes and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Understanding the nature of breast cancer disparities is vital to reducing inequalities related to breast cancer outcomes. Disparities are known to be linked to multiple individual characteristics, but can also be influenced by the context in which an individual is situated. This dissertation is comprised of three empirical studies that examine the impact of context on womens breast cancer screening and the unique lived experience of young breast cancer survivors. The first paper examines whether family structure impacts a womens self-reported mammography utilization using data from the National Health Interview Survey. This study found a significant association between family structure and guideline-concordant mammography screening behaviors. Women living with a partner and no children were most likely to report mammography receipt. The second study examines the lived experiences of younger women with breast cancer. During qualitative interviews, participants mentioned the uniqueness of their individual experience, that surviving breast cancer means different things to each survivor, and that they wished additional resources were available for their children. The third study of this dissertation explores the feasibility of using a breast cancer risk screening tool as part of an existing mHealth tool in rural Kenya. The increasing rates of breast cancer in low resource countries increases the need for breast cancer screening and treatment. While this study identified challenges for implementing a breast cancer risk metric in a rural Kenyan community, the results of this study can inform the design of additional interventions.
Download or read book Health United States 2016 with Chartbook on Long Term Trends in Health written by National Center for Health Statistics and published by Government Printing Office. This book was released on 2017-08-16 with total page 494 pages. Available in PDF, EPUB and Kindle. Book excerpt: This annual overview report of national trends in health statistics contains a Chartbook that assesses the nation's health by presenting trends and current information on selected measures of morbidity, mortality, health care utilization and access, health risk factors, prevention, health insurance, and personal health-care expenditures. Chapters devoted to population characteristics, prevention, health risk factors, health care resources, personal health care expenditures, health insurance, and trend tables may provide the health/medical statistician, data analyst, biostatistician with additional information to complete experimental studies or provide necessary research for pharmaceutical companies to gain data for modeling and sampling. Undergraduate students engaged in applied mathematics or statistical compilations to graduate students completing biostatistics degree programs to include statistical inference principles, probability, sampling methods and data analysis as well as specialized medical statistics courses relating to epidemiology and other health topics may be interested in this volume. Related products: Your Guide to Choosing a Nursing Home or Other Long-Term Services & Supports available here: https://bookstore.gpo.gov/products/your-guide-choosing-nursing-home-or-other-long-term-services-supports Health Insurance Coverage in the United States, 2014 available here: https://bookstore.gpo.gov/products/health-insurance-coverage-united-states-2014 "Some System of the Nature Here Proposed": Joseph Lovell's Remarks on the Sick Report, Northern Department, U.S. Army, 1817, and the Rise of the Modern US Army Medical Department can be found here: https://bookstore.gpo.gov/products/some-system-nature-here-proposed-joseph-lovells-remarks-sick-report-northern-department-us Guide to Clinical Preventive Services 2014: Recommendations of the U.S. Preventive Services Task Force (ePub) -Free digital eBook download available at the US Government Online Bookstore here: https://bookstore.gpo.gov/products/guide-clinical-preventive-services-2014-recommendations-us-preventive-services-task-force --Also available for FREE digital eBook download from Apple iBookstore, BarnesandNoble.com (Nook Bookstore), Google Play eBookstore, and Overdrive -Please use ISBN: 9780160926426 to search these commercial platforms.
Download or read book Breast Cancer Metastasis and Drug Resistance written by Aamir Ahmad and published by Springer Nature. This book was released on 2019-08-27 with total page 427 pages. Available in PDF, EPUB and Kindle. Book excerpt: Resistance to therapies, both targeted and systemic, and metastases to distant organs are the underlying causes of breast cancer-associated mortality. The second edition of Breast Cancer Metastasis and Drug Resistance brings together some of the leading experts to comprehensively understand breast cancer: the factors that make it lethal, and current research and clinical progress. This volume covers the following core topics: basic understanding of breast cancer (statistics, epidemiology, racial disparity and heterogeneity), metastasis and drug resistance (bone metastasis, trastuzumab resistance, tamoxifen resistance and novel therapeutic targets, including non-coding RNAs, inflammatory cytokines, cancer stem cells, ubiquitin ligases, tumor microenvironment and signaling pathways such as TRAIL, JAK-STAT and mTOR) and recent developments in the field (epigenetic regulation, microRNAs-mediated regulation, novel therapies and the clinically relevant 3D models). Experts also discuss the advances in laboratory research along with their translational and clinical implications with an overarching goal to improve the diagnosis and prognosis, particularly that of breast cancer patients with advanced disease.
Download or read book Breast Cancer Screening written by Nehmat Houssami and published by Academic Press. This book was released on 2016-04-05 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Breast Cancer Screening: Making Sense of Complex and Evolving Evidence covers broad aspects of breast cancer screening specifically focusing on current evidence, emerging evidence, and issues that will be critical for future breast screening practice such as tailored screening and shared decision-making in breast screening. The scope of the book is relevant to a global audience. This book provides balanced perspectives on this increasingly controversial topic, using scientific evidence to explain the evolution of knowledge relating to breast cancer screening. Breast Cancer Screening covers the key points related to this debate including the context of increasingly complex and conflicting evidence, divergent opinions on the benefits and harms of breast screening, and variability in screening practice and outcomes across settings around the world.
Download or read book Contrast Enhanced Mammography written by Marc Lobbes and published by Springer. This book was released on 2019-04-29 with total page 161 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book is a comprehensive guide to contrast-enhanced mammography (CEM), a novel advanced mammography technique using dual-energy mammography in combination with intravenous contrast administration in order to increase the diagnostic performance of digital mammography. Readers will find helpful information on the principles of CEM and indications for the technique. Detailed attention is devoted to image interpretation, with presentation of case examples and highlighting of pitfalls and artifacts. Other topics to be addressed include the establishment of a CEM program, the comparative merits of CEM and MRI, and the roles of CEM in screening populations and monitoring of response to neoadjuvant chemotherapy. CEM became commercially available in 2011 and is increasingly being used in clinical practice owing to its superiority over full-field digital mammography. This book will be an ideal source of knowledge and guidance for all who wish to start using the technique or to learn more about it.
Download or read book Systems Practices for the Care of Socially At Risk Populations written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2016-05-07 with total page 95 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Centers for Medicare & Medicaid Services (CMS) have been moving from volume-based, fee-for-service payment to value-based payment (VBP), which aims to improve health care quality, health outcomes, and patient care experiences, while also controlling costs. Since the passage of the Patient Protection and Affordable Care Act of 2010, CMS has implemented a variety of VBP strategies, including incentive programs and risk-based alternative payment models. Early evidence from these programs raised concerns about potential unintended consequences for health equity. Specifically, emerging evidence suggests that providers disproportionately serving patients with social risk factors for poor health outcomes (e.g., individuals with low socioeconomic position, racial and ethnic minorities, gender and sexual minorities, socially isolated persons, and individuals residing in disadvantaged neighborhoods) may be more likely to fare poorly on quality rankings and to receive financial penalties, and less likely to receive financial rewards. The drivers of these disparities are poorly understood, and differences in interpretation have led to divergent concerns about the potential effect of VBP on health equity. Some suggest that underlying differences in patient characteristics that are out of the control of providers lead to differences in health outcomes. At the same time, others are concerned that differences in outcomes between providers serving socially at-risk populations and providers serving the general population reflect disparities in the provision of health care. Systems Practices for the Care of Socially At-Risk Populations seeks to better distinguish the drivers of variations in performance among providers disproportionately serving socially at-risk populations and identifies methods to account for social risk factors in Medicare payment programs. This report identifies best practices of high-performing hospitals, health plans, and other providers that serve disproportionately higher shares of socioeconomically disadvantaged populations and compares those best practices of low-performing providers serving similar patient populations. It is the second in a series of five brief reports that aim to inform the Office of the Assistant Secretary of Planning and Evaluation (ASPE) analyses that account for social risk factors in Medicare payment programs mandated through the Improving Medicare Post-Acute Care Transformation (IMPACT) Act.
