Dissertations / Theses: 'United States. Cancer'

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Raymonvil, Aleeshaia Danner. "Serum Iron Concentration and Prostate Cancer in the United States." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3257.

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Over 2 million adult men in the United States have been diagnosed with prostate cancer, with nearly 200,000 new diagnoses each year. This type of cancer is the leading cause of mortality in U.S. men. One possible risk factor for prostate cancer is a high level of iron in the body, but the association has yet to be confirmed. This study was an investigation of the relationship between serum iron concentration and prostate cancer using data obtained from the 2009-2012 National Health and Nutrition Examination Surveys. This quantitative study involved 1,850 men in the U.S. aged 51 to 70 years. The framework for this research was based on the exposure-disease model. Participants' data were analyzed using chi-squared independence tests and hierarchical logistic regression, while controlling for demographic variables (body mass index, age, ethnicity, poverty-to-income ratio, educational attainment, and hours worked in the last week) to account for potential confounding effects. Serum iron concentration was not found to be significantly associated with prostate cancer diagnosis in this sample. Additional results indicated a significant association between age and prostate cancer, and between ethnicity and prostate cancer, confirming previous research findings. This study contributes to positive social change by confirming the importance of screening for prostate cancer among high-risk populations and by suggesting that it is premature to use serum iron concentration as a screening tool to detect prostate cancer.

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Asamu, Olufunmiso Oyetunde. "Early Radiation Therapy and Cervical Cancer Survival in the United States." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5969.

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A paucity of information exists on the benefits of using radiation therapy for treating women with early cervical cancer detection. The purpose of this cross-sectional study was to investigate the association between early versus late testing of Human papilloma virus (HPV), age, race, radiation therapy, and regions in United States, and survival rates among women diagnosed with early cervical cancer. The epidemiological triad of person, time, and space guided this study to explain the regional spread of cervical cancer, and the effect of early testing. Secondary data from Surveillance, Epidemiology, and End Results (SEER) were used (N= 520,153). Statistical analyses included descriptive statistics as well as binary and multiple logistic regression. According to multiple logistic regression tests early testing for HPV saved more women from cervical cancer death (Odds ratio = .917, CI = .896 - .939, P = .000), and women with radiation therapy had increase likelihood of dying (Odds ratio = 1.646, CI = 1.626 – 1.667, P = .000). Older Women had increased likelihood of dying when diagnosed with cervical cancer (Odds ratio = 1.043, CI = 1.042 – 1.044, P = .000).Whites had a reduced likelihood of dying when diagnosed with cervical cancer (Odds ratio = .735, CI = .722 - .748, P = .000) compared to non-Whites with increased likelihood of dying when diagnosed with cervical cancer (Odds ratio = 1.3605, CI = .722 - .748). Alaskans had a reduced likelihood of dying compared to women living in the Pacific Coast (Odds ratio = .714, CI = .598 -.853, P = .000). Increased awareness among women on radiation therapy for early detection of cervical cancer can improve survival and lead to positive social change.

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Hollings, Jerrelee, and Rebecca Zullo. "The Burden of Illness for Inpatient Testicular Cancer in the United States." The University of Arizona, 2010. http://hdl.handle.net/10150/623793.

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Class of 2010 Abstract
OBJECTIVES: The purpose of this study was to determine the number of inpatient discharges and burden of illness due to testicular cancer with data from the national database Healthcare Cost and Utilization Project (HCUP). METHODS: This retrospective study looked at hospital discharge records to obtain information regarding the inpatient burden of illness of testicular cancer patients. The study looked at procedures, co-‐morbidities, hospital characteristics, case-‐mix control, and the Deyo-‐Charlson to see how they were associated with the charges, length of stay, and inpatient mortality. Also included in the study was information regarding patient age, method of payment, and hospital type and size. A linear multivariate regression was performed to estimate determinates of hospital costs. RESULTS: During the 5-‐year time frame of the study, 28,985 inpatient admissions with testicular cancer were identified. For the overall sample, the average total charges per hospitalization were $29,857. For the 717 patients that died while receiving inpatient treatment, the associated charges averaged $73,800, more than double that associated with the overall sample. The gamma regression of charges for the overall sample showed an association between increased charges and age, length of stay, number of procedures, all admission years in reference to 2002, admission to a large-‐sized hospital in reference to a small hospital, admission to an urban hospital in reference to a rural hospital, admission to a teaching in reference to a nonteaching hospital and the Deyo-‐Charlson score. CONCLUSIONS: Testicular cancer is on the rise worldwide and is associated with a high inpatient burden of illness.

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Sirjoosingh, Candace. "Racial and socioeconomic disparities in cervical cancer survival in the United States." Thesis, McGill University, 2011. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=97130.

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Within the United States, cervical cancer morbidity, mortality and survival are experienced differently among women of varying races and socioeconomic status. Non-Hispanic black women have higher rates of incidence and mortality, as compared to non-Hispanic white women.Using the Surveillance Epidemiology and End Results database, United States Census data and Area Resource Files, a survival analysis was conducted to identify socioeconomic factors related to cervical cancer survival, as well as factors that mediated the racial disparities in survival.Socioeconomic factors, measured at the US county level, that were associated with cervical cancer survival included unemployment rates, poverty level, percentage of white collar individuals, and educational attainment. An empirical search for confounders of the relationship between race and survival was conducted, and after adjustment for these confounders, non-Hispanic black women were found to have significantly poorer survival than non-Hispanic white women, with a 17% increased risk of death.
Aux États-Unis, les femmes noires non hispaniques ont des taux plus élevés d'incidence et de mortalité que les femmes blanches non hispaniques. En utilisant la base des données "Surveillance, Epidemiology and End Results," une analyse a été réalisée pour identifier les facteurs socio-économiques liés à la survie du cancer du col de l'utérus, ainsi que les facteurs qui affectent les disparités raciales en matière de survie. Les facteurs socioéconomiques communautaires qui ont été associés à la survie au cancer du col utérin incluent le taux de chômage, le niveau de pauvreté, le pourcentage d'individuels professionnels, et le niveau de scolarité. Une recherche empirique des facteurs de relation entre la race et la survie a été effectuée. Après l'ajustement de ces facteurs, les femmes noires d'origine non hispanique ont été retrouvées à avoir une risque de mortalité qui était 17% plus haut que celles des femmes blanches d'origine non hispaniques.

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Shi, Fan. "Cancer incidence and survival patterns among Chinese immigrants in the United States." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp01/MQ58504.pdf.

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Gray, Natallia. "Social Interactions In Breast Cancer Prevention Among Women In The United States." Scholar Commons, 2014. https://scholarcommons.usf.edu/etd/5228.

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This dissertation contributes to the field of health economics, which, in the past couple of decades, has substantially increased our understanding of the determinants of human health, health-related behavior, and health care choices. A large body of literature has documented the influence of peer group behavior on individual choices. The purpose of my research is to examine the extent of such a phenomenon in breast cancer preventive behavior. Using Behavioral Risk Factors Surveillance System (BRFSS) surveys from 1993-2008, I measured the effect of other female screening behavior on an individual's decision to have a routine breast cancer screening by calculating the size of a so called social multiplier in mammography. I estimated a vector of social multipliers in the use of annual mammograms by taking the ratio of group-level effects of exogenous explanatory variables to individual-level effects of the same variables. Peer groups are defined as same-aged women living in the same geographical area: county or state. Several econometric methods were used to analyze the effect of social interactions on decision to undergo mammography, including ordinary least squares, fixed effects, the split sample instrumental variable approach, and a falsification test. My results supported the hypothesis that social interactions have an impact on the decision to have a mammogram. For all women over age 40, I found strong evidence of social interactions being associated with individual's education and ethnicity. In addition, the decision for women ages 40-49 to have a screening was subject to peer influence through their place of employment and ownership of health insurance. Finally, for women age 75 and older, being married and aging were the most important channels through which peer group influenced the decision to have a mammogram. This research has important policy implications in the presence of current health care reform that reimburses breast cancer screening at 100%, while rates of mammography receipt remain below the policy goal. Furthermore, I examined the effect of the 2009 United States Preventive Services Task Force change in screening recommendations on screening behavior. I demonstrated an immediate reduction in the receipt of mammography among women of all age groups following the revision of screening guidelines. I found that in 2010, the twelve month mammography receipt decreased by 1.97 (women ages 40-49), 2.20 (ages 50-74), and 3.61 (age 75 and older) percentage points, and the twenty-four months mammography receipt decreased by 1.47 (women ages 40-49), 1.05 (ages 50-74), and 1.92 (age 75 and older) percentage points. Analysis using a two-year follow up period after the revision of screening recommendations provided further support to this conclusion.

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Ilouno, Benedicta Ngozi. "Predictors of Cervical Cancer Screening Among Hispanic Women in the United States." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/1784.

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Minority women groups in the United States have the highest incidence and mortality rates of cervical cancer. Hispanic women have the highest incidence rate and the second highest mortality rate of the disease. Researchers have examined the lower rates of cervical cancer screening among Hispanic women, as compared to other groups of U.S. women, but researchers have not examined the extent to which socioeconomic status, acculturation, and sexual activity impact Hispanic women's compliance with screening. The purpose of this study was to examine the association between compliance with cervical cancer screening and acculturation, socioeconomic status, and sexual activity among U.S. Hispanic women. The framework for investigating the extent of association between these identified barriers and willingness to comply with screening was the behavioral model for vulnerable populations. Chi-square tests and logistic regression were used to analyze data from the National Health Interview Survey for 2011, 2012, and 2013, focusing on U.S. Hispanic women ages 21 - 65 (N = 739). The findings from this study revealed that educational level was significantly associated with U.S. Hispanic women's cervical cancer screening; however, no statistically significant associations were found for socioeconomic status, acculturation, and sexual activity and screening rates for this group. Findings from this study can better inform researchers and others of the lower rate of screening for cervical cancer among U.S. Hispanic women. The findings will also promote positive social change by targeting U.S. Hispanic women and other minority women groups for programs that promote cervical cancer screening.

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Prosper, Marie-Hortence. "Late-Stage Breast Cancer Diagnosis Among Haitian Women in the United States." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6266.

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Breast cancer is the 2nd leading cause of death among women. While a significant amount of research has been done to understand the different disparities related to this disease, there is still more to learn about the relationship between a person's nationality and the staging of breast cancer. Using the Surveillance, Epidemiology, and End Results Program as the data source, this retrospective cohort study was aimed at assessing late-stage breast cancer among Caribbean immigrants, specifically comparing Haitian women with Americans and other immigrant populations in the United States. The research questions addressed the link between nationality and the likelihood of late-stage breast cancer diagnosis as well as the risk factors associated with an advanced stage of breast cancer. Findings from logistic regression analyses indicated no statistically significant difference in Stage IV diagnosis between women born in Haiti and U.S.-born women, while the converse was true for women born in other foreign countries. The results also suggested that race, Hispanic ethnicity, marital status, insurance coverage, being unemployed, and language isolation were significant predictors of late-stage breast cancer diagnosis (p < 0.05). When stratifying the analyses by nationality, marital status and poverty were the common predictors of advanced breast cancer diagnosis among Haitian, foreign-born, and U.S.-born women. The observed disparities confirm the need for additional efforts that seek to improve screening rates among underserved groups and ultimately reduce the burden of late-stage breast cancer.

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Dong, Alex, and Grant Skrepnek. "Impact of Inpatient Metastatic Thyroid Cancer on the United States Healthcare System." The University of Arizona, 2013. http://hdl.handle.net/10150/614256.

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Class of 2013 Abstract
Specific Aims: To assess associations between clinical and economic outcomes of metastatic thyroid cancer within inpatient settings in the United States from 2001-2010. To determine the direct inpatient burden of and describe the characteristics of patients and hospitals associated with metastatic thyroid cancer. Methods: A multivariate retrospective cohort study was performed on the Healthcare Cost and Utilization Project-Nationwide Inpatient Sample database, for the years 2001-2010, focusing on three main outcomes: inpatient mortality, inpatient charges, and inpatient length of stay. Regression analyses controlled for patient demographics, hospital characteristics, payer, clinical comorbidities, and site of metastases. Inclusion criteria included: age ≥ 18 years, any listed diagnosis of thyroid cancer, and any listed secondary malignancy. Main Results: Overall, 84,191 inpatient cases were observed for metastatic thyroid cancer with 3,032 resulting in mortality (3.6%). The total charges were $3.1 billion (USD 2012) for overall inpatient hospitalizations with average inpatient charges at $38,292 (SD±56,135) for each overall case and $80,948 (SD±117,645) for each mortality-only case. Higher inpatient mortality, charges, and length of stay were significantly associated with central nervous system and lung metastatic cancer sites (p < 0.01) and deficiency anemias, coagulopathy, fluid and electrolyte disorders, pulmonary circulation disorders, and weight loss comorbidities (p < 0.01). Conclusion: There is a considerable national inpatient burden of metastatic thyroid cancer. The analyses in this study quantify the associations and outcomes, and as such can be used to assist in the prediction of those outcomes and clinical decision-making.

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Chibundu, Chidoziri. "Factors Affecting Colorectal Cancer Screening Among African-Born Immigrants in the United States." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5312.

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Despite the evidence that colorectal cancer screening is effective in reducing the incidence of and mortality from colorectal cancer, racial and ethnic disparities in colorectal cancer screening persist in the United States. African-born immigrants in the United States have lower colorectal cancer screening rates than native-born Americans. The purpose of this quantitative, retrospective, cross-sectional study was to examine how family income, health insurance status, language of interview, length of stay in the United States, perceived health status, level of education, and having a usual place for medical care affect colorectal cancer screening among African-born immigrants in the United States. The immigrant health services utilization model provided the framework for the study. Secondary data collected in 2010, 2013, and 2015 through the National Health Interview Survey from 349 African-born immigrants age 40 years and above were analyzed using logistic regression and a chi-square test of independence. A stratified multistage sampling procedure was used to select the sample for the study. Results showed a significant association between colorectal cancer screening and health insurance status, length of stay in the United States, perceived health status, and having a usual place for medical care. However, no association was found between colorectal cancer screening and family income, education level, and interview language. Findings may be used to impact positive social change and guide policy decisions on colorectal cancer preventive interventions targeting African-born immigrants living in the United States.

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Adeyemi, Mosunmola. "Factors Affecting Cervical Cancer Screening Among African Women Living in the United States." Thesis, Walden University, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=3605324.

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More than half of the incidents and mortality rates from cervical cancer occur among minority groups, including immigrant women from continental Africa living in the United States. Although researchers have examined cervical cancer screening practices among minority populations, including Black women in Africa and in the United States, there are few studies on cervical cancer screening and associated risk factors, specifically among African women living in the United States. The purpose of this study was to investigate the association between selected factors and cervical cancer screening practices among African immigrant women living in the United States. Using the behavioral model for vulnerable populations as a theoretical basis, this cross-sectional quantitative study was focused on determining the association between family income, level of education, language of interview, insurance status, age, and perceived health status and cancer screening practices. Data on 572 African immigrant women from the National Health Interview Survey in 2005, 2008, and 2010 were used for the study. Chi-square tests and logistic regression were used to analyze the data. Key findings indicate that family income, education level, and age were significantly associated with cervical cancer screening practices among African immigrant women in the United States. Findings from the study support positive social change by targeting at-risk groups for cervical cancer screening programs. The long-term goal of early cervical cancer screening is to lower cervical cancer rates among African immigrant women in the United States. The findings from the study can be used by community health professionals to provide education that can lead to utilization of cervical cancer screening services based on guidelines and recommendations.

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Batcha, Jacqueline. "Assessing Breast Cancer Screening Among Cameroonian Women in the United States of America." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7529.

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Breast cancer is the second leading cause of cancer death among women in the United States. Nonadherence to recommended screening guidelines and lack of screening contribute to late stage diagnosis and increased morbidity and mortality among racial and ethnic women in the United States. The purpose of this study was to assess breast cancer screening practices, knowledge, and beliefs among Cameroonian immigrant women who were 40 years and older living in the metropolitan Washington, D.C. region. This quantitative cross-sectional study was guided by the health belief model and used the revised version of Champion's health belief model scale. A convenience sample (N=267) responded to a 60-item self-administered online survey that assessed knowledge of breast cancer screening, demographic variables, constructs of the health belief model and adherence (defined as obtaining a mammogram within two years). Data analyses performed included descriptive analysis, correlational and multiple linear regression. Results of this study revealed that increased level of education and self-efficacy were associated with greater knowledge of the benefits of mammography. Additionally, women who had more self-efficacy in obtaining a mammogram, perceived less cultural barriers, lived longer in the United States, and who had a regular healthcare provider were more likely to be adherent. Study findings suggest that positive social change can be achieved by empowering women to take control of their health. Efforts promoting awareness of breast cancer screening guidelines and facilitating access to a regular healthcare provider could significantly increase uptake of screening services and lead to better health outcomes and reduced mortality.

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Sumlin, Adam B. "Complexity of Prostate Cancer Diagnosis in African American Men in the United States." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/1983.

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Researchers have identified higher incidence rates and mortality rates among African American men (AAM) diagnosed with prostate cancer than they have among urban African American men. This quantitative descriptive study was conducted to measure the association between advanced stage and grade of prostate cancer, demographic location, and prostate specific antigen (PSA) levels over a 5-year period in AAM and European American men (EAM) in rural versus urban communities. This study addressed 4 research questions concerning cancer grade, cancer stage, age, geographic location, PSA level, and the impact that each of these variables had on prostate cancer diagnosis in AAM in the United States. Social cognitive theory was used as a conceptual framework, which was to focus on AAM, and their behavior with prostate cancer diagnosis, in rural versus urban communities. The sample was derived from data collected from the Surveillance, Epidemiology, and End Results Program (SEER) database. The population sample size was greater than 20,000. These data were categorically analyzed using a Chi-square test and a t test. Overall, the results of the study showed that there was a statistical difference in rural versus urban populations between AAM and EAM diagnosed with prostate cancer over a 5-year period, and when comparing AAM with EAM in urban versus rural communities over a 5 year period, there was a significant difference in men diagnosed with prostate cancers as well as a significant change among men annually diagnosed with advanced stage prostate cancer. Information provided may have implications for positive social change affecting both rural and urban AAM in reducing fear and promoting prostate cancer awareness. This awareness may reduce advanced stage or grade diagnosis in AAM in both rural and urban communities.

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Adeyemi, Mosunmola. "Factors Affecting Cervical Cancer Screening Among African Women Living in the United States." ScholarWorks, 2011. https://scholarworks.waldenu.edu/dissertations/1105.

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More than half of the incidents and mortality rates from cervical cancer occur among minority groups, including immigrant women from continental Africa living in the United States. Although researchers have examined cervical cancer screening practices among minority populations, including Black women in Africa and in the United States, there are few studies on cervical cancer screening and associated risk factors, specifically among African women living in the United States. The purpose of this study was to investigate the association between selected factors and cervical cancer screening practices among African immigrant women living in the United States. Using the behavioral model for vulnerable populations as a theoretical basis, this cross-sectional quantitative study was focused on determining the association between family income, level of education, language of interview, insurance status, age, and perceived health status and cancer screening practices. Data on 572 African immigrant women from the National Health Interview Survey in 2005, 2008, and 2010 were used for the study. Chi-square tests and logistic regression were used to analyze the data. Key findings indicate that family income, education level, and age were significantly associated with cervical cancer screening practices among African immigrant women in the United States. Findings from the study support positive social change by targeting at-risk groups for cervical cancer screening programs. The long-term goal of early cervical cancer screening is to lower cervical cancer rates among African immigrant women in the United States. The findings from the study can be used by community health professionals to provide education that can lead to utilization of cervical cancer screening services based on guidelines and recommendations.

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Pelletier, Marianne S. "Factors Associated With Late Stage Diagnosis of Cervical Cancer in the United States." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2054.

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Cervical cancer represents a significant public health problem in the United States. According to the Centers for Disease Control and Prevention, the prognosis is related to stage at diagnosis, with the 5-year survival rate being 91.2% for early stage disease and only 17.0% for those with late stage disease. There is a gap in the literature examining the association of insurance status with late stage cervical cancer diagnosis across a large segment of the United States population. There is also a gap in the literature examining women residing in the United States with late stage cervical cancer diagnosis and identifying their country of birth. Guided by Andersen's behavioral model of healthcare utilization, this study used the Surveillance, Epidemiology, and End Results database, which includes over 28% of the United States population. The independent variables used were insurance, country of birth, race/ethnicity, age at diagnosis, and marital status. The dependent variable was stage at diagnosis. This cross sectional study included data from 7,445 women across the United States for the years 2008-2012. Two-way tests of association and logistic regression were used to analyze the data. The logistic regression (full model) was statistically significant and found that women born outside of the United States have a lower risk of late stage cervical cancer diagnosis and that unmarried women have a greater risk of late stage diagnosis. This study should send a signal to healthcare providers, as well as public health organizations, to direct their actions toward targeting groups that are now being diagnosed with late stage disease.

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George, Allison M., and Erin N. Baguley. "Clinical and Economic Characteristics of Inpatient Esophageal Cancer Mortality in the United States." The University of Arizona, 2010. http://hdl.handle.net/10150/623745.

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Class of 2010 Abstract
OBJECTIVES: To assess disease-related and resource consumption characteristics of esophageal cancer mortality within hospital inpatient settings in the United States from 2002 to 2006. METHODS: This retrospective investigation of adults aged 18 years or older with diagnoses of malignant neoplasms of the esophagus (ICD-9: 150.x) utilized nationally-representative hospital discharge records from the Agency for Healthcare Research and Quality (AHRQ) Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample. Cases resulting in inpatient death were analyzed with respect to patient demographics, payer, hospital characteristics, number of procedures and diagnoses, Deyo-Charlson disease-based case-mix risk adjustor, and predominant comorbidities. RESULTS: Overall, 168,450 inpatient admissions for esophageal cancer were observed between 2002 and 2006, averaging 66.3 + or - 11.9 years, length of stay of 10.3 + or - 15.2 days, and charge of $51,600 + or _ 92,377. Predominant comorbidities within these persons included: secondary malignant neoplasms; disorders of fluid, electrolyte, and acid-base balance; pneumonia; respiratory failure/collapse or insufficiency; sepsis; anemia; hypertension; cardiac arrhythmias; obstructive pulmonary disease; acute or chronic renal disease; and heart failure. Significant predictors of increased charges included longer lengths of stay, higher numbers of diagnoses and procedures, median annual family income over $45k, urban hospital location, and presence of heart failure, chronic pulmonary disease, fluid and electrolyte disorders, or metastatic cancers (P< or = 0.05). Longer lengths of stay were associated with higher total charges, female sex, larger number of diagnoses and procedures, Medicaid, black race, increased case-mix severities, and fluid and electolyte disorders (P< or = 0.05). CONCLUSIONS: Patient mortality occurs in over one-tenth of esophageal cancer hospital admission cases. Further research is warranted to understand the impact of various comorbidities or treatment approaches and to assess potential disparities in lengths of stay.

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Erickson, Jeanne. "The education experiences of eight American adolescents in cancer survivorship." Thesis, University of Oxford, 2016. https://ora.ox.ac.uk/objects/uuid:e366e072-075d-4f9f-8a02-308c09d8728e.

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The aim of this thesis is to understand the experiences of eight American high school students who have been diagnosed with cancer. By increasing understanding of the challenges that adolescents in cancer survivorship experience, better support can be identified. The experience of cancer survivorship influences the physical, psychological, and social experiences of patients. As the survival rate of childhood cancers continues to increase, death becomes less likely making the need to maintain educational engagement during survivorship increasingly important. The research questions for this study were designed to address two main gaps in the current field of research. The first research question aims to address how the physical and psychological effects of cancer and treatment impact the participants' engagement with school. The second research question aims to understand the role that school plays for adolescents in cancer survivorship, including how participants experienced supplemental education during and after cancer treatment. This study uses a qualitative research methodology to address the research questions utilizing primarily semi-structured interviews and an adjusted version of the Adolescent Coping Scale. When used in combination with the interviews, the scale provides a picture of what the participants experienced and how they have been able to cope with the challenges they have faced. Interpretive phenomenological analysis was used to provide structure to the interview analysis. The results of this study show that fatigue and a compromised immune system have an impact on school attendance more than other physical effects during cancer treatment. As a result, adolescents are most at-risk of experiencing challenges in educational engagement during treatment. The results of this study also show that the feeling of uncertainty throughout cancer survivorship promotes fear and the feeling of a loss of control. Once treatment ends, fear of relapse is common. Physical and psychological effects were felt to improve as time passed. Another key result of this study is that the cancer experience results in a shift in perspective that becomes incorporated into the formation of identity. Participants feel different from peers as a result of the physical and psychological effects of the cancer experience. The results from the Adolescent Coping Scale indicate that school achievement, relapse and the worsening of physical side effects, and being treated different by peers were common concerns for the participants regarding their school, illness, and social concerns, respectively. Lastly, the participants view supplemental education as successful if it meets their personal academic and physical needs, is implemented consistently, and helps them to feel emotionally supported and socially connected. However, more research is needed that focuses on the implementation of policy at the state and district levels to discern whether this is a common challenge unique to this population of students with a physical or medical disability. The sample available for this research topic is not only limited to an extremely small population, but they are also a highly guarded population, making access for recruitment challenging. However, while generalization is difficult with a study of this size, the evidence collected on the participants' experiences during and after treatment provides valuable data on aspects of supplemental education implementation.

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Utin, Enobong Clement. "Breast Cancer Screening Knowledge and Beliefs of Nigerian Women Living in the United States." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7515.

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Breast cancer is one of the leading causes of death and disability globally. Although mammogram has been identified as a significant breast screening tool in the United States, researchers have indicated that African-born women in the United States are diagnosed with advanced stages of breast cancer because of underutilization of mammogram from diverse reasons. The purpose of this quantitative study was to determine the association of demographic factors, breast cancer knowledge, health beliefs, and the utilization of mammogram among Nigerian women, 40 years and older in the United States (N=200). The study was guided by the health belief model and questionnaire was the data collection instrument used. Logistic regression analysis revealed that demographic variables, specifically age and length of residency in the United States have statistically significant effect on the odds of utilization of mammogram among the Nigerian women in the U.S. at p < 0.05. Also, according to the study results, breast cancer knowledge has a statistically significant effect on the utilization of mammogram at p <0.05. Additionally, health beliefs regarding breast cancer have significant effect on utilization of mammogram among Nigerian women 40 years and older in the U.S at p <0.05. The study findings will help in developing breast health programs for immigrant women, especially Nigerians in the U.S. to make informed decisions about timely utilization of mammographic services. Furthermore, the outcome of this study could enhance research, enlighten the health providers, and policymakers to develop culture sensitive preventive breast health programs that are appropriate to diverse women populations in the United States.

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Sunkara, Ranga Rao. "Comparative study of breast cancer in the United States, India, and South Africa: 1996- present." DigitalCommons@Robert W. Woodruff Library, Atlanta University Center, 2001. http://digitalcommons.auctr.edu/dissertations/1693.

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This study identifies forces that prevent or contribute to women's participation in breast cancer screening and other breast cancer prevention activities. The study was based on the premise that women from the lower socioeconomic groups in India, South Africa, and the United States had a higher rate of breast cancer because they are diagnosed at the more advanced stages of the disease and do not engage in breast screening opportunities. Moreover, there is limited access to services and transportation, and there is little faith in the professional health care provider and the treatment received from the health care provider. Surveys and interviews were used to assess the women's level of involvement in breast cancer related prevention programs. Similar methods were used to assess the level of involvement by health care professionals in providing breast cancer prevention activities. The researcher found that the issues related to breast cancer are comparable in South Africa, India, and the United States. Further, it was found that, for the women in all three countries, there was a lack of access to health care; thus, women were not receiving the medical treatment they needed; the women were diagnosed at the more advanced stages of the disease; there was a lack of available transportation to the sites where they could participate in health prevention programs; there was a lack of information about breast cancer made available to women of color; and the level of participation in health care programs is related to the socioeconomic conditions and to the cultural aspects of some women's lives and the long waiting periods for medical services. The conclusion drawn from the findings suggests that a culture-sensitive model is needed for women of color, and health care professionals need to be more sensitive to the needs of women regardless of socioeconomic level. The three countries should consider holding global workshops on breast cancer, and health clinics and other medical facilities should send reminder cards to female patients or have health care workers do home visits to remind patients of the need for mammogram.

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Minter, Anne Ridgely. "Predictors of Sun Protection Practices Among Adult Women in the United States." VCU Scholars Compass, 2005. http://hdl.handle.net/10156/2194.

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Pellegrino-Peard, Patricia L. "A review of research and literature linking breast cancer to pesticides." CSUSB ScholarWorks, 1995. https://scholarworks.lib.csusb.edu/etd-project/1216.

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Rollins, Judy Ann. "A comparison of the nature of stress and coping for children with cancer in the United States and the United Kingdom." Thesis, De Montfort University, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.273692.

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Blackley, David, Shimin Zheng, and Winn Ketchum. "Implementing a Spatial Smoothing Algorithm to Help Identify a Lung Cancer Belt in the United States." Digital Commons @ East Tennessee State University, 2012. https://dc.etsu.edu/etsu-works/81.

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Disease mapping is used to identify high risk areas, inform resource allocation and generate hypotheses. The stroke and diabetes belts in the U.S. have encouraged public dialogue and spurred research. Lung cancer is the leading cause of U.S. cancer mortality, accounting for 158135 deaths in 2010 compared to 129180 from cerebrovascular disease and 68905 from diabetes mellitus. If one exists, defining a distinct pattern of high lung cancer mortality could increase public awareness of the disease and facilitate investigation of its determinants. To begin our inquiry, we generated a map and observed an area of high lung cancer mortality, primarily in the Southeast. However, variability in county rates, likely due to small populations, made determining patterns difficult. Spatial smoothing can clarify obscured patterns. We downloaded county lung cancer mortality rates, population sizes and death counts. Concurrent incidence and mortality rates for lung cancer were nearly equivalent, so mortality was used as a proxy for risk. After downloading county population centroids with latitudes and longitudes, we implemented a median-based, weighted, two-dimensional smoothing algorithm to enhance spatial patterns by borrowing strength from neighbor counties. The algorithm selected three proximate centroids, forming a “triple,” anchored by the centroid of the county to be smoothed. The parameter for nearest neighbor (NN) counties was set to NN=10, with the number of triples (NTR) for each county NTR=(2/3)*NN, producing seven collinear triples for each county with a center angle ≥135°. Median rates for the top and bottom 50% of neighbor counties were calculated and weighted by 1/SE, creating a “window,” whereby if the original rate was between the two medians, or if the county population was sufficiently large, it was not smoothed. If the original rate was outside the window, it was adjusted according to the corresponding neighbor median. Ten iterations of this process were conducted for each county. Smoothed rates were imported to ArcGIS and joined to a U.S. counties layer. Congruent counties in or near the Southeast with rates above 64 per 100,000 were defined as one class. We observed clustering of high lung cancer mortality, comprising 724 counties and forming an arc not evident in the unsmoothed data. This area, which we define as the lung cancer belt, included nearly all of Arkansas, Kentucky and Tennessee, and portions of 16 other states. Heavily affected regions include much of the Ohio Valley, Central Appalachia, the Tennessee Valley, the Ozarks, the Mississippi Delta and the northern Gulf Coast. Smoking, a modifiable behavior, causes the majority of lung cancer deaths, and is the single leading cause of mortality in the United States. Lung cancer mortality rates presented at the state level obscure differences within states. The lung cancer belt may provide a tool to identify areas in greatest need of resources. National survey data could be utilized to determine demographic, socioeconomic and behavioral differences between the lung cancer belt and the rest of the nation.

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Blackley, David, Shimin Zheng, and Winn Ketchum. "Implementing a Weighted Spatial Smoothing Algorithm to Identify a Lung Cancer Belt in the United States." Digital Commons @ East Tennessee State University, 2012. https://dc.etsu.edu/etsu-works/42.

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Lung cancer is the leading cause of cancer death in the United States, but a large fraction of cases is preventable. We use a spatial smoothing algorithm to identify a geographic pattern of high lung cancer mortality, primarily in the Southeast, which we call a lung cancer belt. Disease belts are an effective mode for conveying patterns of high incidence or mortality; formally defining this lung cancer belt may encourage increased public dialogue and more focused research. Public health officials could complement existing population lung cancer data with this information to help inform resource allocation decisions.

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Ray, Debabrata. "Disparities in Health Care Resource Utilization and Expenditures in Prostate Cancer Patients in the United States." University of Toledo Health Science Campus / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=mco1321955553.

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26

Garrett, Giorgia L., Paul D. Blanc, John Boscardin, Amanda Abramson Lloyd, Rehana L. Ahmed, Tiffany Anthony, Kristin Bibee, et al. "Incidence of and Risk Factors for Skin Cancer in Organ Transplant Recipients in the United States." AMER MEDICAL ASSOC, 2017. http://hdl.handle.net/10150/623191.

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IMPORTANCE Skin cancer is the most common malignancy occurring after organ transplantation. Although previous research has reported an increased risk of skin cancer in solid organ transplant recipients (OTRs), no study has estimated the posttransplant population-based incidence in the United States. OBJECTIVE To determine the incidence and evaluate the risk factors for posttransplant skin cancer, including squamous cell carcinoma (SCC), melanoma (MM), and Merkel cell carcinoma (MCC) in a cohort of US OTRs receiving a primary organ transplant in 2003 or 2008. DESIGN, SETTING, AND PARTICIPANTS This multicenter retrospective cohort study examined 10 649 adult recipients of a primary transplant performed at 26 centers across the United States in the Transplant Skin Cancer Network during 1 of 2 calendar years (either 2003 or 2008) identified through the Organ Procurement and Transplantation Network (OPTN) database. Recipients of all organs except intestine were included, and the follow-up periods were 5 and 10 years. MAIN OUTCOMES AND MEASURES Incident skin cancerwas determined through detailed medical record review. Data on predictors were obtained from the OPTN database. The incidence rates for posttransplant skin cancer overall and for SCC, MM, and MCC were calculated per 100 000 person-years. Potential risk factors for posttransplant skin cancer were tested using multivariate Cox regression analysis to yield adjusted hazard ratios (HR). RESULTS Overall, 10 649 organ transplant recipients (mean [SD] age, 51 [12] years; 3873 women [36%] and 6776 men [64%]) contributed 59 923 years of follow-up. The incidence rates for posttransplant skin cancer was 1437 per 100 000 person-years. Specific subtype rates for SCC, MM, and MCC were 812, 75, and 2 per 100 000 person-years, respectively. Statistically significant risk factors for posttransplant skin cancer included pretransplant skin cancer (HR, 4.69; 95% CI, 3.26-6.73), male sex (HR, 1.56; 95% CI, 1.34-1.81), white race (HR, 9.04; 95% CI, 6.20-13.18), age at transplant 50 years or older (HR, 2.77; 95% CI, 2.20-3.48), and being transplanted in 2008 vs 2003 (HR, 1.53; 95% CI, 1.22-1.94). CONCLUSIONS AND RELEVANCE Posttransplant skin cancer is common, with elevated risk imparted by increased age, white race, male sex, and thoracic organ transplantation. A temporal cohort effect was present. Understanding the risk factors and trends in posttransplant skin cancer is fundamental to targeted screening and prevention in this population.

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Zahedi, Bita. "HPV Vaccination Acceptability Among Immigrant and Ethnic Minorities in the United States: Systematic Review." Thesis, The University of Arizona, 2017. http://hdl.handle.net/10150/623562.

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A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine.
To systematically review all studies examining HPV vaccination acceptability among immigrant and ethnic minority parents and eligible individuals for cervical cancer prevention in the Unites states. MEDLINE/PubMed, Cumulative Index to Nursing and Allied Health Literature, EMBASE, and Cochrane database searches were conducted searching for English language, US‐based studies to examine immigrant and ethnic minority population’s acceptability of HPV vaccination. Thirteen of more than 3,098 potentially relevant articles were included in the final analysis. Results. Latinos were statistically more likely to accept vaccination for both their daughters and sons. Foreign‐born adult Latinas were more accepting of the vaccine than U.S.‐born Latinas after controlling for other variables. Overall African American and Asian American parents were less likely to accept HPV vaccination for their daughters than Hispanic and White parents. Of the African American parents who intended to vaccinate their children the majority were significantly non‐Baptist and had higher levels of education. The majority of Haitian immigrants intended to vaccinate daughters and the rest agreed that they would most likely have their daughters vaccinated if their daughters’ physicians recommended it. More research is needed, particularly in the context of health care provider HPV vaccination recommendation to immigrant and ethnic‐minority populations. Acceptance figures so far suggest that the vaccine is generally well received among Hispanic/Latin and Haitian immigrants, but details of ethnic variations among these groups and a qualitative understanding of lower rates of acceptability among African American and Asian American communities are still being awaited. Despite advances in cervical cancer screening rates in the US, cervical cancer remains disproportionately high among low‐income immigrant and minority women, making this subgroup particularly vulnerable to disparities in screening and its detection. The purpose of this study is to examine the qualitative aspects of institutional and community level interventions of Cervical Intraepithelial Neoplasia (CIN) within the immigrant and refugee populations and the use of HPV vaccination as a prevention method. Combinations of the following keywords/phrases will be used: CIN‐ Cervical Intraepithelial Neoplasia, Cervical diseases, Cervical dysplasia, Refugees, Pap smear, Cervical Cancer Screening, HPV‐ Human Papillomavirus, HPV vaccination, Ethnic minorities, Immigrants. Independent reviews of each article will be conducted to assess the study quality and confirm the accuracy, completeness, and consistency of the abstracted data.

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Zielinski, Nicholas C., and Grant Skrepek. "Mortality and Cost Outcomes of Emergency Department Visits Associated with Primary or Disseminated Liver Cancer in the United States; 2009." The University of Arizona, 2012. http://hdl.handle.net/10150/614537.

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Class of 2012 Abstract
Specific Aims: To evaluate associations between hospital and patient characteristics and mortality and economic outcomes. Included records were of adult patients age 18 years or older with a diagnosis of primary or disseminated liver cancer. Methods: This study was a retrospective cohort design that utilized emergency department discharge records from the Agency for Healthcare Research and Quality (AHRQ) Healthcare Cost and Utilization Project (HCUP) National Emergency Department Sample (NEDS). Generalized linear models were used for analyses to assess outcomes of mortality and total charges. Logistic regression was utilized for mortality; gamma regression with log-link was utilized for charges. Main Results: Overall, 239,895 adult records were included in the study with diagnoses of ICD-9 155.x or 197.7. Total charges for all records were over $8.23 billion in 2009. The average age of the case was 65.07 (±13.8) years with 48.7% being female. Mortality (either in the ED or hospital) was 11.1% (n=26,701). The mean length of stay was 6.47 (±6.05) days. Charges for each record were $42,874.50 (±53,956.34). Increased mortality was associated the most with hospital teaching status and primary payer. Increased charges were associated with hospitals located in the Western region. Conclusions: The differences in clinical outcomes were primarily from different payers and economical outcomes differed greatly by the Western region hospital location. Data taken from the nationally-representative investigation reveals that primary and disseminated liver cancer still remains a clinical high burden-of-illness with an 11.1% mortality rate and total charges approaching $10.3 billion dollars.

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Reilly, Gretchen A. "Commies, Cancer, and Cavities: The Conflict Over Fluoridation." W&M ScholarWorks, 1992. https://scholarworks.wm.edu/etd/1539625762.

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30

Erdey, Nancy Carol. "Armor of patience : the National Cancer Institute and the development of medical research policy in the United States, 1937-1971 /." Diss., Case Western Reserve University School of Graduate Studies / OhioLINK, 1995. http://www.ohiolink.edu/etd/view.cgi?acc%5Fnum=case1058363714.

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Samuel, Vincy. "Predictors of Cervical Cancer Screening and Physician Recommendations among Women in the United States using Current Screening Guidelines." FIU Digital Commons, 2018. https://digitalcommons.fiu.edu/etd/3901.

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In 2015, there were 257,524 women with cervical cancer (CC) in the United States (U.S.). CC is preventable; screening detects early-stage cancer when treatment is most successful. This study aimed to identify predictors for CC screening adherence among U.S. women, describe predictors for screening adherence by marital status, and examine physician recommendation for CC screening and adherence to those recommendations. Predictors were grouped as demographic, acculturation, access to care, chronic conditions, and health behaviors. Descriptive analyses were performed on a sample of 10,667 women from the 2015 National Health Interview Survey, and multiple logistic regression models determined predictors of CC screening adherence, physician recommendations, and adherence to physician recommendations. Overall, 81.7% (95%CI=80.7-82.7%) of U.S. women adhered to CC screening guidelines. Adherence declined with increasing age after 39 years old. Never married women (adjusted odds ratio[aOR]=0.67, CI=0.56-0.79) or current smokers (aOR=0.70, CI=0.59-0.84) had lower odds, while college-educated women had greater odds (aOR=1.38, CI=1.14-1.67) of CC screening adherence. Among unmarried women, 78.6% adhered to CC screening. Unmarried women who were unemployed (aOR=0.48, CI=0.38-0.62), had no physician visits (aOR=0.58, CI=0.40-0.85), no usual source of care (aOR=0.67, CI=0.50-0.89), never heard of HPV (aOR=0.59, CI=0.46-0.76), never received HPV vaccine (aOR=0.50, CI=0.34-0.75), no birth control use (aOR=0.33, CI=0.23-0.47), no flu shot (aOR=0.62, CI=0.48-0.80), and perceived low breast cancer risk (aOR=0.66, CI=0.47-0.92) had lower odds of adherence. Among women with a physician, 55.6% received screening recommendations. Race/ethnicity, access to care, HPV knowledge and vaccine receipt, age when first child was born, and flu shot were significant predictors of physician recommendation for CC screening. Significant predictors of adherence to physician recommendation included education, employment, English proficiency, outpatient clinic visits, usual source of care, age when first child was born, birth control, alcohol use, smoking status, flu shot, and health status. Based on our results, two levels of intervention should be explored. First, targeted interventions are needed for women who are unmarried, have low socio-economic status, and limited access to care to reduce cervical cancer risk. Second, interventions for physicians to increase screening recommendations to all eligible women are needed to improve national screening rates.

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Sagiraju, Hari Krishna Raju. "Female invasive breast cancer mortality trends among Hispanic population in the United States from 1990 to 2012." Thesis, The University of Texas School of Public Health, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10183280.

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Introduction: Analyzing trends in breast cancer mortality can ensure a precise characterization of changes over time and can be important in public health decision making. Most reported trends are limited to incidence and mortality rates among Whites and Blacks, without categorization regarding tumor clinical characteristics. This study analyzed breast cancer mortality trends among different race-ethnic groups using various approaches such as partitioning rates by factors associated at the time of diagnosis; taking into consideration age, cohort and period effects; and by evaluating geographical variations.

Methods: Incidence and mortality data from 1990 to 2012 of female invasive breast cancer among women aged 18-84 years in United States (U.S.) was provided by the National Cancer Institute. The following analyses were conducted: (1) calculation of incidence based mortality (IBM) rates by estrogen receptor (ER) status according to race-ethnicity; (2) examination of temporal trends using age-period-cohort (APC) analysis on incidence and mortality rates; and, (3) spatiotemporal analysis of the county level age-standardized breast cancer mortality rates to identify significant geographical areas with higher risk.

Results: IBM rates for ER+ tumors increased while those of ER- tumors decreased among all race-ethnic groups. APC analysis showed that race-ethnic disparities were largely among the ER- tumors and temporal trends of the ER+ tumors were similar across the race-ethnic groups, with identical effects across the various birth cohorts. Geographical variation in the breast cancer county-level mortality rate was mostly explained by age-standardization and county level risk factors, although the effect of these factors was greater in rural areas of western U.S.

Conclusion: Temporal trends in the IBM rates were more reflective of the recent changes in the incidence trends of female invasive breast cancer. Trends of ER+ tumors were similar across all race-ethnic groups suggesting a common risk factor for the persistent increase in the incidence and mortality of these tumors. Spatial analysis shows that the higher mortality risk in certain rural counties of western U.S. might be due to poor survival than an elevated incidence and the need for better health care access in these medically underserved areas. These results might explain the observed ethnic and geographic variations in breast cancer mortality, and in turn, could support a stronger theoretical basis for public health policy.

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Anticoli, Rahel. "Cultural Adaptation of Cancer Campaign Films : A comparison made between beauty commercials; United States ofAmerica and India." Thesis, Högskolan Dalarna, Bildproduktion, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:du-27472.

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Uppsatsens syfte är att göra en filmanalys av kampanjfilmer om bröstcancer som var skapade av kosmetiska företag i Indien och U.S.A. I uppsatsen undersöks hur semiotiska resurser var påverkade av kulturen och hur kampanjerna har använt kulturell adaption i marknadsföringssyfte. Jag beskriver en denotation av två filmer från varje land följd utav en konnotation som stödjs av artiklar och böcker om respektive kultur. Avslutningsvis tar jag upp och diskuterar de olika teorierna om hur kulturell adaption kan påverka en människa ur ett marknadsföringsperspektiv. Slutsatsen är att nationalism och appropriation är några av de viktiga elementen i kulturell adaption som förstärker marknadsföring. Dessa element skapar självidentitet och förtrogenhet hos individen som tittar på filmen. Några semiotiska resurser som hade förändrats i kulturell adaption och som hälpte till att skapa de elementen var etnicitet, gester, kläder, miljö, och symboler.

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Armin, Julie. "Organizing Care: U.S. Health Policy, Social Inequality, and the Work of Cancer Treatment." Diss., The University of Arizona, 2015. http://hdl.handle.net/10150/556839.

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In the United States, concern about breast cancer has generated policies and programs aimed at increasing screening mammography and treatment access for the uninsured and underinsured. Oriented toward the importance of early detection and the state's responsibility to ensure health care access to its citizens, these policies and programs reflect and reinforce a moral economy of disease management that shapes the ethical behavior of patients, providers, and advocates. In contrast, the moral economy of market-based health care generates norms and assumptions about individual responsibility for health and limits expectations of the state in providing access to health care. Using breast cancer care for structurally vulnerable women as a focal point, this dissertation examines the social effects of intersecting moral economies of breast cancer management and market-based health care. It describes the relationships between public policies, social and economic marginalization, and gaps in health care access. Based on 18 months of ethnographic field work in Southern Arizona, I report findings from interviews with physicians, nurses, advocates, clinic office staff, and community health workers; from recurring discussions with women undergoing treatment for breast cancer; and from participant-observation in cancer-focused events and activities. This dissertation explores how policies that extend low-cost or free health care to broad populations also reproduce social exclusion and complicate what it means to be uninsured in America. I describe how everyday practices of health care, including determinations of eligibility for public insurance, reflect and reinforce social inequities based on citizenship status, gender, and occupational status. I conclude that the organization of cancer care for structurally vulnerable women effectively directs the focus away from the state's responsibility to provide health care access and instead privatizes that responsibility so that it resides with structurally vulnerable clinics and non-licensed health care staff. Furthermore, a charity approach to managing cancer care for unauthorized U.S. residents diverts public responsibility for their social exclusion to private entities. Finally, the findings of this dissertation contribute to debates about health reform efforts, such as the Affordable Care Act, by outlining the relationship between moral worth and government entitlements.

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Housel, Rebecca Anne Languages &amp Linguistics Faculty of Arts &amp Social Sciences UNSW. "My truth: women speak cancer." Publisher:University of New South Wales. Languages & Linguistics, 2007. http://handle.unsw.edu.au/1959.4/40732.

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1) My Truth: Women Speak Cancer is a creative nonfiction based on three years of interviews with twelve survivors told through the lens of the author's experience as a three-time, sixteen-year survivor of multiple cancers. Each chapter features a different survivor and her story; the cancers discussed include non-Hodgkin's lymphoma, Osteosarcoma, Melanoma, as well as brain, ovarian, breast, and thyroid cancers. Current definitions, treatments and statistics are included at the end of each chapter. The book ends with a comprehensive After Words, combining poetry and prose, taking the reader on a further journey of introspection on life, love, friendship, and loss. 2) The Narrative of Pathogynography is a critical exegesis using established theory in the fields of creative writing, sociology, ethnography, literature, and medicine to examine and further define the sub genre of the theoria, poiesis and praxis involved in creating women's illness narrative, or what Housel terms, pathogynography. Housel develops original terminology to define yet undiscovered spaces based on her work in My Truth: Women Speak Cancer.

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Newransky, Chrisann. "Investigation of Disparities in Cervical Cancer Prevention in the United States: HPV Vaccination and PAP Screening in 18-30 Year Old Women." Thesis, Boston College, 2013. http://hdl.handle.net/2345/3709.

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Thesis advisor: James Lubben
In 2011, an estimated 12,710 women suffered from cervical cancer and 4,290 died from it in the U.S. HPV vaccination (HPV-V) and PAP screening (PAP-S) could reduce this burden. Using 2010 National Health Interview Survey data, current disparities in the use of PAP-S and HPV-V in U.S. women aged 18-30 years were investigated. An adapted Behavioral Model of Health Care Utilization guided the study. Main outcomes were PAP-S in prior year and ever-HPV-V, both initiation and completion. Adjusted predictor estimates were obtained through multivariate logistic regressions with appropriate statistical procedures and weights for complex survey design. A sub-analysis focused on unvaccinated women. The sample had 3,129 women aged 18-30 years, representing about 27 million women of similar age in the U.S. PAP-S, HPV-V initiation and completion rates were 53.5%, 17.9%, and 10.3%, respectively. Hispanics were 33% less likely than Non-Hispanic-Whites to initiate HPV-V. Non-Hispanic-Blacks were 55% more likely and 57% less likely than Non-Hispanic-Whites to receive PAP-S and complete HPV-V, respectively. Non-Hispanic Asians were 36% less likely than Non-Hispanic-Whites to receive PAP-S, but this result was borderline significant. Younger age and being unmarried were predictors of lower PAP-S but higher HPV-V. Ever gave birth was a predictor of higher PAP-S but lower HPV-V. Preventative behaviors (PAP-S and flu vaccination) were predictors of higher HPV-V. STI-history was a predictor of higher HPV-V and PAP-S. Not having health insurance for over one year or recent health provider visit were predictors of lower PAP-S and HPV-V. Living in the South was a predictor of lower HPV-V. Household income was not a predictor of any outcomes. Most common reported reason for no HPV-V was "no need." Study findings indicate interventions to mitigate disparities in cervical cancer prevention are needed. Tailored education interventions for both women and health care providers along with opportunities associated with the 2010 Affordable Care Act, such as broader access to health care, emphasis on health information technology, and initiatives with PAP screening and adult vaccination as potential quality indicators for performance/payment, can reduce these disparities. Future research should focus on the feasibility of alternative venues for receiving HPV-V and PAP-S
Thesis (PhD) — Boston College, 2013
Submitted to: Boston College. Graduate School of Social Work
Discipline: Social Work

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Loncke, Bernadette Serena. "Perceptions and Behaviors of Caribbean and South American Women of Color Living in the United States Towards Breast Cancer." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2295.

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Breast cancer is a global public health issue, and even though the incidence and mortality rates for this disease have declined, a substantial gap in mortality rates between U.S. women of color and European American women remains. Strategies have been initiated to decrease this gap, but they have not addressed the special needs of women of color residing in the United States, who tend to be diagnosed only after they have developed late-stage breast cancer. The purpose of this phenomenological study was to understand the perceptions and behaviors of 20 first-generation Caribbean and South American-born women of color living in Atlanta, Georgia, related to breast cancer awareness, screening, treatment, and follow-up care. Qualitative data analysis was used to identify themes that included, but were not limited to, the role of genes in breast cancer, lifestyle influences and risk of breast cancer, environmental factors, positive perceptions of foods and their impact on breast health, the role of culture on health care decisions, fear of harm from radiation exposure, familial relationships, understanding why they sought screening and/or treatment, and familial health histories and increased risk of breast cancer. The participants' cues to take action were influenced by knowledge, health insurance coverage, confidence, educational attainment, age, income, family support, and self-motivation. Culture, race, or ethnicity had little to no effect on whether the women received breast cancer screening or mammography. The findings could facilitate social change by educating Caribbean and South American women of color in the United States about breast cancer and the need for screening, to reduce the incidence of breast cancer and the mortality rates among the target population and improving their quality of life.

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Márquez, Jose Angel 1971. "A comparative analysis of age-dependent and birth year cohort-specific cancer mortality data between Japan and the United States." Thesis, Massachusetts Institute of Technology, 1999. http://hdl.handle.net/1721.1/84748.

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Thesis (S.M.)--Massachusetts Institute of Technology, Division of Bioengineering and Environmental Health, 1999.
Includes bibliographical references (leaves 57-62).
by Jose Angel Márquez, Jr.
S.M.

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Alhassani, Ali K. "Nervous system cancer : analysis of historical mortality rates in the United States and Japan indicate sudden increases in environmental risk." Thesis, Massachusetts Institute of Technology, 2008. http://hdl.handle.net/1721.1/45459.

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Thesis (S.B.)--Massachusetts Institute of Technology, Dept. of Mechanical Engineering, 2008.
"June 2008."
Includes bibliographical references.
Nervous System cancer age-specific mortality rates began being recorded for European and Non-European Americans in 1930 and for Japanese in 1952. All ethnic groups show significant historical increases in mortality rates. For the two American data sets, the age- specific pattern for mortality seems to have stabilized starting with the birth cohort of the decade of the 1900s. For the Japanese data set, the pattern stabilizes starting with the birth cohorts of the 1910s and 1920s. These stabilized patterns of NS cancer incidence are similar to the age-specific mortality rates for many other cancers. That is, the rates are higher in the first five years of life then in the next five years, then the rates rise rapidly above the neonatal rate until the age of maturity. During maturity, the rate increases as a constant exponential function and reaches a maximum at around the ages 80-85 years old. Changes in cancer incidence can only be caused by two factors, environmental and genetic effects. Given the suddenness of the change in NS cancer mortality rates, we can rule out the contribution of a possible genetic effect and focus on characterizing a possible environmental risk factor. Herein the possibility of electromagnetic waves from power-grid systems increasing risk for NS cancer is considered, and using the data and historical evidence this possibility is ruled out. In order to understand the relationship between the molecular mechanisms of mutagenesis and the incidence of cancer, a physiologically based quantitative model which includes the processes of mutation, cell proliferation and death. We use the two-stage model of cancer of Armitage and Doll (1957), whereby the first stage is initiation, where "n" events occur to create the first preneoplastic cell which grows slowly at the juvenile rate. The second stage takes place when a preneoplastic cell experiences "m" events which lead to promotion, after which the neoplastic cell will grow rapidly as a tumor. This model has been adjusted by Moolgavkar and Knudson (1981) and Herrero-Jimenez et al. (2000) to take into account cell growth rate and human heterogeneity respectively.
(cont.) This model is applied to the birth cohort of 1920 in order to demonstrate how we can calculate the fraction of the population at primary risk for NS cancer, and how this has changed over time.
by Ali K. Alhassani.
S.B.

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Forjaz, Maria João. "Comparing Quality of Life: American and Portuguese Cancer Patients with Hematological Malignancies." Thesis, University of North Texas, 1997. https://digital.library.unt.edu/ark:/67531/metadc278317/.

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The purpose of this study is to investigate the differences and similarities of quality of life (QoL) in American and Portuguese cancer patients with hematological malignancies as well as the robustness of the measures cross-culturally. Portuguese participants were 98 patients and 49 accompanying persons and the American participants were 55 patients and 22 accompanying persons. Fifty (Portuguese sample) to 40% (American sample) of the patients came with an accompanying person who answered the questionnaire concerning the patient's QoL. The two cultural groups were characterized in terms of QoL (measured by the SF-36 and the FLIC), social support (Social Support Scale), socio-demographic and clinical variables. Portuguese patients reported a higher QoL. However, this result could be attributable to the fact that the two cultural samples differ in socio-economic status. The measures seem to be comparable for the Portuguese and American samples, at least in what concerns reliability and concurrent validity.

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Agarwal, Rishi. "Advanced Biliary Tract Cancer: Clinical Outcomes with ABC-02 Regimen and Analysis of Prognostic Factors in a Tertiary Care Center in the United States." University of Cincinnati / OhioLINK, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1470757699.

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42

Almostadi, Doaa. "The Moderating Effect of Religion on Death Distress and Quality of Life between Christian Cancer patients in the United States with Muslim cancer patients in Saudi Arabia." Scholar Commons, 2018. https://scholarcommons.usf.edu/etd/7601.

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Cancer is an illness that knows no international boundaries. There are more than eight million global cancer deaths each year. A life-threatening diagnosis generates significant emotional problems for many patients across cultures. Death distress—consisting of death depression, death anxiety and death obsession—often results in poorer treatment adherence and lower overall health and quality of life. The purpose of this study was to determine whether religiosity has a moderating effect on the relationship between death distress and quality of life among patients facing a life-threatening cancer diagnosis. The study sample consisted of 118 cancer patients: 82 cancer patients from a National Guard hospital in Saudi Arabia and 36 cancer patients from H. Lee Moffitt Cancer Center, Tampa, Florida. Three validated scales were used to obtain data from study participants: the Death Distress Scale, the Belief into Action Scale; and the Functional Assessment of Cancer Therapy Scale. After a Pearson correlation were conducted and results indicated a moderately strong inverse relationship between death distress and quality of life among both the Christian (r=-.45, p <.001) and Muslim (r=-.39, p <.001) patient samples. The degree of religiosity among study participants did not alter the effect of death distress on quality of life. Results reveal that the interaction term was not statistically significant (b=.005, p=.32). However, quality of life correlated with degree of religiosity in both the Christian(r=.39, p=.018) and Muslim patient groups ( r=.24, p=0.034)). This finding reinforces the importance of religious involvement among cancer patients found in earlier research. The current study highlights the importance of a holistic treatment approach that includes a spiritual component for these vulnerable individuals and their loved ones. This holistic emphasis is particularly important for nurses, who often spend more time with cancer patients than other health care professionals. By proactively discussing common issues surrounding death distress with patients and families, nurses can provide much needed education and emotional support and make appropriate referral. Given that death distress appears to be a nearly universal experience among cancer patients regardless of religious affiliation, future research should develop evidence-based nursing protocols to address this vital topic.

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Alsultan, Mohammed. "Health Services Utilization and Associated Predictors Among Prostate Cancer Patients With and Without Depression in the United States From 2010 to 2015: A Propensity Score-Matched Cross-Sectional Study." University of Cincinnati / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1562674032866434.

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Kidder, Elizabeth O. "Self-administered HPV Testing as a Cervical Cancer Screening Option| Exploring the Perspectives of Hispanic and Arab Women in the United States." Thesis, The George Washington University, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=3630899.

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BACKGROUND: Though significant gains have been made in preventing cervical cancer over the past 30 years, it continues to cause morbidity and mortality among women in the United States, particularly among those women who are screened infrequently or not at all. More than half of cervical cancer deaths in the U.S. are among immigrants, and the incidence and mortality from cervical cancer is increasing among foreign-born women. Arab and Hispanic women living in the U.S. continue to have cervical cancer screening rates that are lower than the general population. Understanding what factors influence their cervical cancer screening practices and what new screening options may overcome their barriers to preventive screening may be effective in reducing disparities in the disease burden of cervical cancer.

HPV DNA testing has taken on a larger role in cervical cancer screening, and there is increasing evidence and support for the use of HPV testing alone as a primary cervical cancer screening test. Novel health screening devices have been developed that allow women to self-screen for HPV, which may offer opportunity to simplify the cervical cancer screening protocol and reach women who are not receiving recommended cervical cancer screening services.

OBJECTIVE: Because self-administered screening devices are not yet available and most women have not had exposure to them, there are limited quantitative and qualitative assessments of women's attitudes towards and likelihood to use such devices, particularly in the U.S. This study informs the development of culturally appropriate interventions and policies intended to improve cervical cancer screening rates among Arab and Hispanic women in the United States, and discusses implementation challenges and policy implications associated with incorporating self-administered HPV testing into the cervical cancer screening protocol in the U.S.

METHODS: A paper-based survey (n = 476) and individual interviews (n = 31) were used to explore Arab and Hispanic participants' screening behaviors, their likelihood to use HPV self-administered tests to screen for cervical cancer, their perceived self-efficacy in using self-screening tests, and the major concerns they have about self-screening.

RESULTS: Participants who were 1) uninsured, 2) knowledgeable about HPV and cervical cancer, 3) had high self-efficacy in their ability to use a self-screening test; and 4) had no concerns about the self-screening test were significantly more likely to use a self-screening test. Hispanic participants (74.0%) were significantly more likely than Arab participants (43.8%) to report they would be likely to use a self-administered cervical cancer screening test if it were available. Approximately half of uninsured (52.7%) and underscreened (47.1%) participants reported they would be more likely to get screened for cervical cancer if an at-home self-screening test were available.

CONCLUSIONS: A majority of participants responded positively to the option for HPV self-testing as a cervical cancer screening option, suggesting that it may an effective screening modality to reach women who are not accessing routine screening. More research is needed on implementing a self-screening option, particularly among underscreened populations.

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Haber, Gillian. "Use of structural equation modeling to examine the association between breast cancer risk perception and repeat screening mammography among United States woman." FIU Digital Commons, 2010. https://digitalcommons.fiu.edu/etd/3971.

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Breast cancer is the second leading cause of cancer death in United States women, estimated to be diagnosed in 1 out of 8 women in their lifetime. Screening mammography detects breast cancer in its pre-clinical stages when treatment strategies have the greatest chance of success, and is currently the only population-wide prevention method proven to reduce the morbidity and mortality associated with breast cancer. Research has shown that the majority of women are not screened annually, with estimates ranging from 6% - 30% of eligible women receiving all available annual mammograms over a 5-year or greater time frame. Health behavior theorists believe that perception of risk/susceptibility to a disease influences preventive health behavior, in this case, screening mammography. The purpose of this dissertation is to examine the association between breast cancer risk perception and repeat screening mammography using a structural equation modeling (SEM) framework. A series of SEM multivariate regressions were conducted using selfreported, nationally representative data from the 2005 National Health Interview Survey. Interaction contrasts were tested to measure the potential moderating effects of variables which have been shown to be predictive of mammography use (physician recommendation, economic barriers, structural barriers, race/ethnicity) on the association between breast cancer risk perception and repeat mammography, while controlling for the covariates of age, income, region, nativity, and educational level. Of the variables tested for moderation, results of the SEM analyses identify physician recommendation as the only moderator of the relationship between risk perception and repeat mammography, thus the potentially most effective point of intervention to increase mammography screening, and decrease the morbidity and mortality associated with breast cancer. These findings expand the role of the physician from recommendation to one of attenuating the effect of risk perception and increasing repeat screening. The long range application of the research is the use of the SEM methodology to identify specific points of intervention most likely to increase preventive behavior in population-wide research, allowing for the most effective use of intervention funds.

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Yue, Xiaomeng. "Cost-of-Illness and Treatment Patterns of Gynecologic Cancer in the United States: An Empirical Analysis Based on MEPS Database 2007-2014." University of Cincinnati / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1505207327559448.

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Groeben, Christer, Rainer Koch, Martin Baunacke, Angelika Borkowetz, Manfred P. Wirth, and Johannes Huber. "In-Hospital Outcomes after Radical Cystectomy for Bladder Cancer: Comparing National Trends in the United States and Germany from 2006 to 2014." Karger, 2019. https://tud.qucosa.de/id/qucosa%3A71678.

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Background: Radical cystectomy (RC) still poses a significant risk for mortality and morbidity. Objectives: We compared in-hospital outcomes after RC in the United States and Germany using population-based data. Methods: We compared data from the US Nationwide Inpatient Sample to the German hospital billing database. Mortality and transfusion during hospital stay and length of stay (LOS) were evaluated. Results: In all, 17,711 (the United States) and 60,447 (Germany) cases were included. The share of robot-assisted RC increased to 20.5% in the United States vs. 2.3% in Germany (p < 0.001). In-hospital mortality was 1.9% (the United States) vs. 4.6% (Germany), transfusion rates were 34.2% (the United States) vs. 58.7% (Germany), and LOS was 10.7 (the United States) vs. 25.1 days (Germany; all p < 0.001). On multivariate analysis, higher patient age and lower annual hospital caseload were associated with increased mortality and longer LOS. Minimalinvasive surgery was associated with less blood transfusion and shorter LOS in the United States vs. hospital caseload and choice of urinary diversion in Germany. Conclusions: Healthcare systems might exert a relevant impact on outcomes of oncologic surgery. Increased in-hospital mortality rates in Germany seem to be partly explained by much longer LOS compared to those in the United States. Annual caseload seems to be influential on in-hospital outcomes raising the question of centralization of RC.

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Berger, Loretta Kathleen. "The effect of health insurance plan type on initial colorectal cancer screening in the United States since the inception of health care reform in Massachusetts." Thesis, Boston University, 2013. https://hdl.handle.net/2144/21124.

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Thesis (M.S.H.P.) PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you.
The Accountable Care Act (ACA) will expand coverage to millions of Americans. Health insurance plans designed to contain costs and incentivize patients may pose risks that deter members from utilizing recommended services despite provisions such as zero-cost-sharing intended to encourage their use. We evaluated trends (from 2007 to 2011) in health insurance plan type and initial colorectal cancer (CRCA) screening per current guidelines. We hypothesized that consumer-directed and high-deductible health plans (CDHP/HDHP) would be associated with decreased and delayed CRCA screening, and a shift toward lower-cost screening options. Using Thomson MarketScan® data, we analyzed commercial claims for 989,038 American adults (prior colectomy or CRCA excluded) over a full three-year period (starting in January of the fiftieth birthday-year) to assess for CRCA screening (colonoscopy, sigmoidoscopy, or stool test). Using logistic regression, we found that CDHP/HDHP members showed increased likelihood of having had any CRCA screening compared to Preferred Provider Organization (PPO) members, in both Massachusetts (Odds Ratio [OR] 2.321, 95% Confidence Interval [CI] 1.788-3.014) and the Nation (OR 1.640, 95% CI 1.602-1.678). Of those screened, CDHP/HDHP patients were more likely to receive colonoscopy than other recommended alternatives compared to PPO (Massachusetts OR 1.289, 95% CI 1.007-1.651; U.S. OR 1.225, 95% CI 1.192-1.259). Using linear regression, we found that CDHP/HDHP patients were only slightly older at screening compared to PPO, and the difference, while statistically significant, was likely too small to be clinically meaningful. We conclude that contrary to our expectations, CDHP/HDHP members have not been deterred from seeking and obtaining appropriate and timely initial CRCA screening, and they have not chosen lower-cost options. These findings may reflect the newly insured effect, although one limitation of this study was the inability to adjust for selection into CDHP/HDHP. Further study should determine whether CDHP/HDHP members subsequently experience unexpected financial burdens related to CRCA screening that affect future utilization of recommended care. In the pursuit of lower costs through better outcomes, attention should be paid to designing simple and affordable plans with easily understandable features that encourage both patients and providers to follow recommended guidelines while considering the cost-effectiveness of available options.
2031-01-01

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Sveund, Jennifer. "The Experience of Qigong Among Women Cancer Survivors." Antioch University / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=antioch1506194798445608.

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McCoy, Brenda G. ""God will get me through": African American women coping with breast cancer and implications for support groups." Thesis, University of North Texas, 2005. https://digital.library.unt.edu/ark:/67531/metadc4763/.

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This research examines the coping processes of African American women with breast cancer and how those processes relate to low usage of cancer support groups by these women. Prior coping research has utilized predominantly White samples. The limited research on African American coping responses is conflicting and characterized by small samples and non-probability sampling techniques. In this study, 26 respondents from Central and North Texas metropolitan areas were interviewed, including 9 key informants, 9 African American breast cancer survivors, and 8 White survivors. The data suggest that African American and White women cope with breast cancer in significantly different ways. Culture appears to account for the differences. All African American breast cancer survivors identified faith as their primary coping strategy. In contrast, only half of the White survivors claimed faith as their primary coping strategy, but like the other White survivors, tended to rely on multiple coping strategies. The African American survivors conceptualized God as an active member of their support network. Most prayed for healing, and several attributed examples of healing to God's intervention. The White survivors found God's presence in the actions of other people. They prayed for strength, peace, and courage to endure the illness. The use of faith as a coping strategy was the most significant difference between the African American and White breast cancer survivors, but different social support needs were also evident. White survivors readily disclosed the details of their illness and actively sought the assistance of other people. African American women were much less likely to discuss their illness with other persons and expressed a greater inclination to rely on themselves. This study indicates that cancer support groups must be structured to consider cultural coping differences for wider African American usage. Coping research conducted on primarily African American samples is necessary to develop interventions intended to serve African Americans.

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