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Article ; Online: POSITIVE Results for Breast Cancer Survivors Who Desire Pregnancy.

Giordano, Sharon H

2023 Volume 388, Issue 18, Page(s) 1709–1710

MeSH term(s)	Pregnancy ; Female ; Humans ; Breast Neoplasms/therapy ; Cancer Survivors ; Survivors ; Breast
Language	English
Publishing date	2023-05-03
Publishing country	United States
Document type	Editorial
ZDB-ID	207154-x
ISSN	1533-4406 ; 0028-4793
ISSN (online)	1533-4406
ISSN	0028-4793
DOI	10.1056/NEJMe2301139
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Article ; Online: Breast Cancer in Men.

Giordano, Sharon H

The New England journal of medicine

2018 Volume 379, Issue 14, Page(s) 1385–1386

MeSH term(s)	Breast Neoplasms ; Humans ; Male ; Risk Factors
Language	English
Publishing date	2018-10-03
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	207154-x
ISSN	1533-4406 ; 0028-4793
ISSN (online)	1533-4406
ISSN	0028-4793
DOI	10.1056/NEJMc1809194
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Article ; Online: Disparities in screening mammography utilization among Hispanic women in rural Texas from 2002 to 2018.

Liu, Zhaoli / Kuo, Yong-Fang / Giordano, Sharon H

Cancer causes & control : CCC

2023 Volume 34, Issue 11, Page(s) 963–971

Abstract: Purpose: To examine the trends of racial/ethnic and urban-rural disparities in screening mammography use with a focus on Hispanic women in rural Texas, as well as to further investigate barriers to mammography screening practices.: Methods: A serial ... ...

Abstract	Purpose: To examine the trends of racial/ethnic and urban-rural disparities in screening mammography use with a focus on Hispanic women in rural Texas, as well as to further investigate barriers to mammography screening practices. Methods: A serial cross-sectional study was conducted on screening mammography including eligible female respondents (≥ 40 years) from the Texas Behavioral Risk Factor Surveillance System survey from 2002 to 2018. Findings: Weighted descriptive analyses showed persistent racial/ethnic and urban-rural disparities in mammography screening rates among eligible women (≥ 40 years) in Texas. Overall, the mammography screening rates for women in rural areas were significantly lower than women in urban areas with a mean rate of 64.09% versus 70.89% (p < 0.001). Rural Hispanic women had the lowest mean mammography screening rate (55.98%) among all eligible women which is 16.27% below the mean mammography screening rate of non-Hispanic white women in urban areas. Weighted logistic regression model revealed that women with no health insurance or primary care providers were 52% (95% Confidence Interval [CI] 0.36-0.63, p < 0.001) or 54% (95% CI 0.35-0.6, p < 0.001) less likely having an up-to-date mammography screening compared with women with health insurance or primary care providers, respectively. Conclusions: Our study demonstrated significant and persistent racial and urban-rural disparities in screening mammography utilization among Hispanic women compared with non-Hispanic white women from 2002 to 2018. Healthcare access is a major contributor to these disparities. It highlights the need for wide-scale interventions from public health and policymakers targeting under screened racial minorities and rural regions population to promote screening mammography services among disadvantaged population.
MeSH term(s)	Female ; Humans ; Texas/epidemiology ; Cross-Sectional Studies ; Breast Neoplasms/diagnosis ; Mammography ; Early Detection of Cancer ; Healthcare Disparities ; Mass Screening
Language	English
Publishing date	2023-06-24
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1064022-8
ISSN	1573-7225 ; 0957-5243
ISSN (online)	1573-7225
ISSN	0957-5243
DOI	10.1007/s10552-023-01738-3
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Zs.A 3375: Show issues

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Article ; Online: Breast Cancer in Men.

Giordano, Sharon H

The New England journal of medicine

2018 Volume 378, Issue 24, Page(s) 2311–2320

MeSH term(s)	Aftercare ; Antineoplastic Agents, Hormonal/adverse effects ; Antineoplastic Agents, Hormonal/therapeutic use ; Aromatase Inhibitors/therapeutic use ; Breast Neoplasms, Male/diagnosis ; Breast Neoplasms, Male/drug therapy ; Breast Neoplasms, Male/genetics ; Breast Neoplasms, Male/surgery ; Chemotherapy, Adjuvant ; Diagnosis, Differential ; Genes, BRCA1 ; Genes, BRCA2 ; Humans ; Male ; Mutation ; Prognosis ; Risk Factors ; Tamoxifen/adverse effects ; Tamoxifen/therapeutic use
Chemical Substances	Antineoplastic Agents, Hormonal ; Aromatase Inhibitors ; Tamoxifen (094ZI81Y45)
Language	English
Publishing date	2018-06-13
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	207154-x
ISSN	1533-4406 ; 0028-4793
ISSN (online)	1533-4406
ISSN	0028-4793
DOI	10.1056/NEJMra1707939
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Article ; Online: Breast cancer (BC) and severe COVID-19 (C-19) outcomes: a matched analysis.

Sullivan, Marija / Lei, Xiudong / Giordano, Sharon H / Chavez-MacGregor, Mariana

Breast cancer research and treatment

2024

Abstract: Purpose: Patients with cancer receiving anticancer treatment have a higher risk of severe COVID-19 (C-19) outcomes. We examine the association between breast cancer (BC), recent treatment (systemic therapy, surgery, radiation), and C-19 outcomes.: ... ...

Abstract	Purpose: Patients with cancer receiving anticancer treatment have a higher risk of severe COVID-19 (C-19) outcomes. We examine the association between breast cancer (BC), recent treatment (systemic therapy, surgery, radiation), and C-19 outcomes. Methods: Retrospective matched cohort study using the Optum® de-identified C-19 Electronic Health Record dataset (2007-2022). Patients with C-19 were categorized into: no cancer, BC with recent treatment, and BC without recent treatment and matched based on age, C-19 diagnosis date, and comorbidity score. We evaluated 30-day mortality, mechanical ventilation, intensive care unit (ICU) stay, and hospitalization. A composite outcome including all outcomes was analyzed. Multivariable logistic regression models were used. Results: 2200 matched triplets (1:1:10) of patients with BC recently treated, BC not recently treated, and no cancer were included. Rates of adverse outcomes improved in 2021 compared to 2020. Compared to patients without cancer, those with BC recently treated had a similar risk of adverse outcomes, while patients with BC not recently treated had a lower risk of ICU stay and hospitalization. Using the composite variable, BC recently treated had similar outcomes (OR = 1.02; 95%CI 0.93-1.11) to patients without cancer, while BC patients not recently treated had better outcomes (OR = 0.66; 95%CI 0.59-0.74). Among patients with BC, chemotherapy within 3 months was associated with a higher risk of hospitalization (OR = 2.30; 95%CI 1.76-2.99) and composite outcome (OR = 2.11; 95%CI 1.64-2.72). Conclusion: Patients with BC have a similar risk of adverse C-19 outcomes compared to patients without cancer. Among patients with BC, recent chemotherapy was associated with a higher risk of hospitalization.
Language	English
Publishing date	2024-04-06
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	604563-7
ISSN	1573-7217 ; 0167-6806
ISSN (online)	1573-7217
ISSN	0167-6806
DOI	10.1007/s10549-024-07301-1
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Zs.A 1655: Show issues

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Article ; Online: Rural racial disparities and barriers in mammography utilization among Medicare beneficiaries in Texas: A longitudinal study.

Liu, Zhaoli / Shan, Yong / Kuo, Yong-Fang / Giordano, Sharon H

Geriatric nursing (New York, N.Y.)

2023 Volume 55, Page(s) 14–20

Abstract: This study examined rural racial/ethnic disparities in long-term mammography screening practices among Medicare beneficiaries. A retrospective longitudinal study was conducted using 100% Texas Medicare data for women aged 65-74 who enrolled in Medicare ... ...

Abstract	This study examined rural racial/ethnic disparities in long-term mammography screening practices among Medicare beneficiaries. A retrospective longitudinal study was conducted using 100% Texas Medicare data for women aged 65-74 who enrolled in Medicare between 2010-2013. Of the 114,939 eligible women, 21.2% of Hispanics, 33.3% of non-Hispanic Blacks (NHB), and 38.4% non-Hispanic Whites (NHW) in rural areas were regular users of mammography, compared to 33.5%, 44.9%, and 45.3% of their counterparts in urban areas, respectively. Stratification analyses showed rural Hispanics and NHB were 33% (95% CI, 25% - 40%) and 22% (95% CI, 6% - 36%) less likely to be regular users of mammography compared to their urban counterparts. Major barriers to routine mammography screening included the lack of a primary care provider, frequent hospitalization, and comorbidity. The findings of this study highlight the importance of addressing rural racial disparities in mammography utilization among older women to ensure equitable screening practices for all populations.
MeSH term(s)	Aged ; Humans ; Female ; United States ; Medicare ; Texas ; Longitudinal Studies ; Retrospective Studies ; Mammography ; Healthcare Disparities
Language	English
Publishing date	2023-11-13
Publishing country	United States
Document type	Journal Article
ZDB-ID	632559-2
ISSN	1528-3984 ; 0197-4572
ISSN (online)	1528-3984
ISSN	0197-4572
DOI	10.1016/j.gerinurse.2023.10.019
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Zs.B 2789: Show issues

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Article ; Online: Determination of quality of life-related health utilities for surgical complications in ovarian cancer.

Suidan, Rudy S / Sun, Charlotte C / Schneider, Amy K / Lu, Karen H / Giordano, Sharon H / Meyer, Larissa A

Gynecologic oncology

2024 Volume 185, Page(s) 101–107

Abstract: ... patients during the shared decision-making process. ...

Abstract	Objective: To assess the health state utilities of ovarian cancer patients, clinicians, and non-cancer controls regarding surgical complications in ovarian cancer. Methods: Utilities for 14 surgical complications were assessed from patients with recently diagnosed or recurrent ovarian cancer, clinicians, and non-cancer controls using the visual analog scale (VAS) and time trade-off (TTO) methods. Health state utilities were converted to a 0-to-1 scale, where 0 represents the least favorable outcome and 1 represents the most favorable outcome. Results: Fifty patients, 50 clinicians, and 50 controls participated. Median VAS scores were lower than TTO scores across all groups (p < 0.01). Patients viewed 'bleeding requiring transfusion' most favorably (VAS utility 0.75), followed in order by less favorable utility scores for hernia, thromboembolism, pleural effusion, abscess, ileus/bowel obstruction, wound infection, bowel obstruction requiring surgery, anastomotic leak requiring drain, temporary ostomy, anastomotic leak requiring surgery, genito-urinary fistula, permanent ostomy, and genito-intestinal fistula (VAS utility 0.2). Overall, clinicians perceived complications more favorably than patients by VAS (overall utility score 0.49 vs 0.43, p < 0.01), but not by the TTO. There were no differences in overall utility scores between patients and controls. Patients who had not experienced certain surgical complications had less favorable scores than patients who did (utility score for ostomy = 0.2 for patients without ostomy vs. 0.7 for patients with ostomy, p = 0.02). Conclusions: This study establishes health state utilities for surgical complications associated with ovarian cancer. These utilities can be used in future cost-effectiveness evaluations to determine quality-adjusted outcomes and may help in counseling patients during the shared decision-making process.
Language	English
Publishing date	2024-02-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	801461-9
ISSN	1095-6859 ; 0090-8258
ISSN (online)	1095-6859
ISSN	0090-8258
DOI	10.1016/j.ygyno.2024.01.041
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Zs.A 885: Show issues

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Article ; Online: Utilization of Biologic Disease-Modifying Antirheumatic Therapy in Patients With Rheumatoid Arthritis and Recently Diagnosed Breast Cancer.

Ruiz, Juan I / Lei, Xiudong / Wu, Chi-Fang / Zhao, Hui / Giordano, Sharon H / Rajan, Suja S / Suarez-Almazor, Maria E

Arthritis care & research

2024

Abstract: Objective: Biologic disease-modifying antirheumatic drugs (bDMARDs) are immunosuppressants, and there have been concerns that they might impact tumor immunity in patients with cancer with rheumatoid arthritis (RA). The purpose of this study was to ... ...

Abstract	Objective: Biologic disease-modifying antirheumatic drugs (bDMARDs) are immunosuppressants, and there have been concerns that they might impact tumor immunity in patients with cancer with rheumatoid arthritis (RA). The purpose of this study was to describe the utilization trends of bDMARD in patients with RA after breast cancer (BC) diagnosis. Methods: We performed a retrospective cohort study of adults with RA and BC (2008 onward) from Optum's de-identified Clinformatics® Data Mart Database (CDM); the Surveillance, Epidemiology, and End Results Program (SEER) Medicare; and the Texas Cancer Registry (TCR) Medicare databases. We evaluated bDMARD utilization trends during the first three years after BC. We conducted multivariable logistic regression to evaluate the association of utilization with patient characteristics. Results: A total 1,412 patients were identified in CDM and 1,439 patients in SEER/TCR-Medicare. During the three months before BC diagnosis, 28.2% (CDM) and 26.9% (SEER/TCR-Medicare) patients had received bDMARDs. Within the first three years after diagnosis, 24.1% (CDM) and 26.4% (SEER/TCR-Medicare) were receiving bDMARDs. About 70% of the patients in the two cohorts received glucocorticoids with no significant time trend increases. The largest predictor of bDMARD utilization was prior use before BC (CDM: odds ratio [OR] 27.15, 95% confidence interval [CI] 19.29-38.19; SEER/TCR: OR 18.98, 95% CI 13.72-26.26). Regional and distant BC compared to in situ or localized were also associated with lower bDMARDs utilization in SEER/TCR-Medicare (OR 0.54, 95% CI 0.36-0.82; OR 0.31, 95% CI 0.13-0.77, respectively). Conclusion: The utilization of tumor necrosis factor inhibitors and other bDMARDs in patients with RA and recent BC has not increased since 2008. Glucocorticoids utilization remained high. The largest predictor of bDMARD utilization was prior use before BC.
Language	English
Publishing date	2024-01-25
Publishing country	United States
Document type	Journal Article
ZDB-ID	645059-3
ISSN	2151-4658 ; 0893-7524 ; 2151-464X
ISSN (online)	2151-4658
ISSN	0893-7524 ; 2151-464X
DOI	10.1002/acr.25306
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Article ; Online: Comparison of Comorbidity Models Within a Population-Based Cohort of Older Adults With Non-Hodgkin Lymphoma.

Gordon, Max J / Duan, Zhigang / Zhao, Hui / Nastoupil, Loretta / Iyer, Swaminathan / Ferrajoli, Alessandra / Danilov, Alexey V / Giordano, Sharon H

JCO clinical cancer informatics

2024 Volume 8, Page(s) e2300223

Abstract: Purpose: Compare the association of individual comorbidities, comorbidity indices, and survival in older adults with non-Hodgkin lymphoma (NHL), including in specific NHL subtypes.: Methods: Data source was SEER-Medicare, a population-based registry ... ...

Abstract	Purpose: Compare the association of individual comorbidities, comorbidity indices, and survival in older adults with non-Hodgkin lymphoma (NHL), including in specific NHL subtypes. Methods: Data source was SEER-Medicare, a population-based registry of adults age 65 years and older with cancer. We included all incident cases of NHL diagnosed during 2008-2017 who met study inclusion criteria. Comorbidities were classified using the three-factor risk estimate scale (TRES), Charlson comorbidity index (CCI), and National Cancer Institute (NCI) comorbidity index categories and weights. Overall survival (OS) and lymphoma-specific survival, with death from other causes treated as a competing risk, were estimated using the Kaplan-Meier method from time of diagnosis. Multivariable Cox models were constructed, and Harrel C-statistics were used to compare comorbidity models. A two-sided Results: A total of 40,486 patients with newly diagnosed NHL were included. Patients with aggressive NHL had higher rates of baseline comorbidity. Despite differences in baseline comorbidity between NHL subtypes, cardiovascular, pulmonary, diabetes, and renal comorbidities were frequent and consistently associated with OS in most NHL subtypes. These categories were used to construct a candidate comorbidity score, the non-Hodgkin lymphoma 5 (NHL-5). Comparing three validated comorbidity scores, TRES, CCI, NCI, and the novel NHL-5 score, we found similar associations with OS and lymphoma-specific survival, which was confirmed in sensitivity analyses by NHL subtypes. Conclusion: The optimal measure of comorbidity in NHL is unknown. Here, we demonstrate that the three-category TRES and five-category NHL-5 scores perform as well as the 14-16 category CCI and NCI scores in terms of association with OS and lymphoma-specific survival. These simple scores could be more easily used in clinical practice without prognostic loss.
MeSH term(s)	Humans ; Lymphoma, Non-Hodgkin/epidemiology ; Lymphoma, Non-Hodgkin/mortality ; Comorbidity ; Aged ; Male ; Female ; SEER Program ; Aged, 80 and over ; United States/epidemiology ; Proportional Hazards Models ; Prognosis ; Cohort Studies ; Kaplan-Meier Estimate ; Medicare
Language	English
Publishing date	2024-04-29
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Comparative Study ; Research Support, Non-U.S. Gov't
ISSN	2473-4276
ISSN (online)	2473-4276
DOI	10.1200/CCI.23.00223
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Article ; Online: Comparative effectiveness research in cancer with observational data.

Giordano, Sharon H

American Society of Clinical Oncology educational book. American Society of Clinical Oncology. Annual Meeting

2016 , Page(s) e330–5

Abstract: Observational studies are increasingly being used for comparative effectiveness research. These studies can have the greatest impact when randomized trials are not feasible or when randomized studies have not included the population or outcomes of ... ...

Abstract	Observational studies are increasingly being used for comparative effectiveness research. These studies can have the greatest impact when randomized trials are not feasible or when randomized studies have not included the population or outcomes of interest. However, careful attention must be paid to study design to minimize the likelihood of selection biases. Analytic techniques, such as multivariable regression modeling, propensity score analysis, and instrumental variable analysis, also can also be used to help address confounding. Oncology has many existing large and clinically rich observational databases that can be used for comparative effectiveness research. With careful study design, observational studies can produce valid results to assess the benefits and harms of a treatment or intervention in representative real-world populations.
MeSH term(s)	Bias ; Comparative Effectiveness Research/methods ; Data Collection/methods ; Databases as Topic ; Humans ; Neoplasms ; Observational Studies as Topic/methods ; Outcome Assessment (Health Care) ; Research Design ; SEER Program
Language	English
Publishing date	2016-07-10
Publishing country	United States
Document type	Journal Article ; Review
ISSN	1548-8756 ; 1092-9118 ; 1548-8748
ISSN (online)	1548-8756
ISSN	1092-9118 ; 1548-8748
DOI	10.14694/EdBook_AM.2015.35.e330
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