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  1. Article ; Online: Examination of prostate-specific antigen (PSA) screening in military and civilian men: analysis of the 2018 behavioral risk factor surveillance system.

    Hoffman, Susan S / Smith, Ashley W / Kent, Erin E / Doria-Rose, V Paul / Kobrin, Sarah C / Mollica, Michelle A

    Cancer causes & control : CCC

    2022  Volume 33, Issue 3, Page(s) 393–402

    Abstract: Purpose: To determine whether military men report different prostate-specific antigen (PSA) screening rates than civilian men and if shared decision-making (SDM) is associated with PSA screening.: Methods: We used data from the 2018 Behavioral Risk ... ...

    Abstract Purpose: To determine whether military men report different prostate-specific antigen (PSA) screening rates than civilian men and if shared decision-making (SDM) is associated with PSA screening.
    Methods: We used data from the 2018 Behavioral Risk Factor Surveillance System and included 101,901 men (26,363 military and 75,538 civilian men) in the analysis conducted in 2021. We conducted binomial logistic regression analyses to determine covariate-adjusted associations between military status and receiving a PSA test in the last 2 years. We then added patient reports of SDM to the model. Finally, we looked at the joint effects of military status and SDM on the receipt of a PSA test in the last 2 years.
    Results: Military men had 1.1 times the odds of PSA testing compared to civilian men (95% CI 1.1, 1.2) after adjusting for SDM and sociodemographic and health covariates. When examining the joint effect of military status and SDM, military and civilian men had over three times the odds of receiving a PSA test in the last 2 years if they had reported SDM (OR 3.5 and OR 3.4, respectively) compared to civilian men who did not experience SDM.
    Conclusion: Military men are slightly more likely to report receiving a PSA test in the last 2 years compared to civilian men. Additionally, results show SDM plays a role in the receipt of a PSA test in both populations. These findings can serve as a foundation for tailored interventions to promote appropriate SDM for PSA screening in civilian, active duty, and veteran healthcare systems.
    MeSH term(s) Behavioral Risk Factor Surveillance System ; Decision Making ; Early Detection of Cancer ; Humans ; Male ; Mass Screening ; Military Personnel ; Prostate-Specific Antigen ; Prostatic Neoplasms/diagnosis ; Prostatic Neoplasms/epidemiology
    Chemical Substances Prostate-Specific Antigen (EC 3.4.21.77)
    Language English
    Publishing date 2022-01-16
    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/s10552-021-01533-y
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  2. Article ; Online: Informative Presence in Electronic Health Record Data: A Challenge in Implementing Study Exclusion Criteria.

    Chubak, Jessica / Dalmat, Ronit R / Weiss, Noel S / Doria-Rose, V Paul / Corley, Douglas A / Kamineni, Aruna

    Epidemiology (Cambridge, Mass.)

    2022  Volume 34, Issue 1, Page(s) 29–32

    MeSH term(s) Humans ; Electronic Health Records
    Language English
    Publishing date 2022-09-20
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 1053263-8
    ISSN 1531-5487 ; 1044-3983
    ISSN (online) 1531-5487
    ISSN 1044-3983
    DOI 10.1097/EDE.0000000000001542
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  3. Article ; Online: Rates of Downstream Procedures and Complications Associated With Lung Cancer Screening in Routine Clinical Practice : A Retrospective Cohort Study.

    Rendle, Katharine A / Saia, Chelsea A / Vachani, Anil / Burnett-Hartman, Andrea N / Doria-Rose, V Paul / Beucker, Sarah / Neslund-Dudas, Christine / Oshiro, Caryn / Kim, Roger Y / Elston-Lafata, Jennifer / Honda, Stacey A / Ritzwoller, Debra / Wainwright, Jocelyn V / Mitra, Nandita / Greenlee, Robert T

    Annals of internal medicine

    2024  Volume 177, Issue 1, Page(s) 18–28

    Abstract: Background: Lung cancer screening (LCS) using low-dose computed tomography (LDCT) reduces lung cancer mortality but can lead to downstream procedures, complications, and other potential harms. Estimates of these events outside NLST (National Lung ... ...

    Abstract Background: Lung cancer screening (LCS) using low-dose computed tomography (LDCT) reduces lung cancer mortality but can lead to downstream procedures, complications, and other potential harms. Estimates of these events outside NLST (National Lung Screening Trial) have been variable and lacked evaluation by screening result, which allows more direct comparison with trials.
    Objective: To identify rates of downstream procedures and complications associated with LCS.
    Design: Retrospective cohort study.
    Setting: 5 U.S. health care systems.
    Patients: Individuals who completed a baseline LDCT scan for LCS between 2014 and 2018.
    Measurements: Outcomes included downstream imaging, invasive diagnostic procedures, and procedural complications. For each, absolute rates were calculated overall and stratified by screening result and by lung cancer detection, and positive and negative predictive values were calculated.
    Results: Among the 9266 screened patients, 1472 (15.9%) had a baseline LDCT scan showing abnormalities, of whom 140 (9.5%) were diagnosed with lung cancer within 12 months (positive predictive value, 9.5% [95% CI, 8.0% to 11.0%]; negative predictive value, 99.8% [CI, 99.7% to 99.9%]; sensitivity, 92.7% [CI, 88.6% to 96.9%]; specificity, 84.4% [CI, 83.7% to 85.2%]). Absolute rates of downstream imaging and invasive procedures in screened patients were 31.9% and 2.8%, respectively. In patients undergoing invasive procedures after abnormal findings, complication rates were substantially higher than those in NLST (30.6% vs. 17.7% for any complication; 20.6% vs. 9.4% for major complications).
    Limitation: Assessment of outcomes was retrospective and was based on procedural coding.
    Conclusion: The results indicate substantially higher rates of downstream procedures and complications associated with LCS in practice than observed in NLST. Diagnostic management likely needs to be assessed and improved to ensure that screening benefits outweigh potential harms.
    Primary funding source: National Cancer Institute and Gordon and Betty Moore Foundation.
    MeSH term(s) Humans ; Lung Neoplasms ; Retrospective Studies ; Early Detection of Cancer/adverse effects ; Early Detection of Cancer/methods ; Lung/diagnostic imaging ; Tomography, X-Ray Computed/methods ; Mass Screening/adverse effects ; Mass Screening/methods
    Language English
    Publishing date 2024-01-02
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 336-0
    ISSN 1539-3704 ; 0003-4819
    ISSN (online) 1539-3704
    ISSN 0003-4819
    DOI 10.7326/M23-0653
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  4. Article ; Online: Outcomes From More Than 1 Million People Screened for Lung Cancer With Low-Dose CT Imaging.

    Silvestri, Gerard A / Goldman, Lenka / Tanner, Nichole T / Burleson, Judy / Gould, Michael / Kazerooni, Ella A / Mazzone, Peter J / Rivera, M Patricia / Doria-Rose, V Paul / Rosenthal, Lauren S / Simanowith, Michael / Smith, Robert A / Fedewa, Stacey

    Chest

    2023  Volume 164, Issue 1, Page(s) 241–251

    Abstract: Background: Lung cancer screening (LCS) with low-dose CT (LDCT) imaging was recommended in 2013, making approximately 8 million Americans eligible for LCS. The demographic characteristics and outcomes of individuals screened in the United States have ... ...

    Abstract Background: Lung cancer screening (LCS) with low-dose CT (LDCT) imaging was recommended in 2013, making approximately 8 million Americans eligible for LCS. The demographic characteristics and outcomes of individuals screened in the United States have not been reported at the population level.
    Research question: What are the outcomes among people screened and entered in the American College of Radiology's Lung Cancer Screening Registry compared with those of trial participants?
    Study design and methods: This was a cohort study of individuals undergoing baseline LDCT imaging for LCS between 2015 and 2019. Predictors of adherence to annual screening were computed. LDCT scan interpretations by Lung Imaging Reporting and Data System (Lung-RADS) score, cancer detection rates (CDRs), and stage at diagnosis were compared with National Lung Cancer Screening Trial data.
    Results: Adherence was 22.3%, and predictors of poor adherence included current smoking status and Hispanic or Black race. On baseline screening, 83% of patients showed negative results and 17% showed positive screening results. The overall CDR was 0.56%. The percentage of people with cancer detected at baseline was higher in the positive Lung-RADS categories at 0.4% for Lung-RADS category 3, 2.6% for Lung-RADS category 4A, 11.1% for Lung-RADS category 4B, and 19.9% for Lung-RADS category 4X. The cancer stage distribution was similar to that observed in the National Lung Cancer Screening Trial, with 53.5% of patients receiving a diagnosis of stage I cancer and 14.3% with stage IV cancer. Underreporting into the registry may have occurred.
    Interpretation: This study revealed both the positive aspects of CT scan screening for lung cancer and the challenges that remain. Findings on CT imaging were correlated accurately with lung cancer detection using the Lung-RADS system. A significant stage shift toward early-stage lung cancer was present. Adherence to LCS was poor and likely contributes to the lower than expected cancer detection rate, all of which will impact the outcomes of patients undergoing screening for lung cancer.
    MeSH term(s) Humans ; United States/epidemiology ; Lung Neoplasms/diagnostic imaging ; Lung Neoplasms/epidemiology ; Tomography, X-Ray Computed/methods ; Cohort Studies ; Early Detection of Cancer/methods ; Lung ; Mass Screening/methods
    Language English
    Publishing date 2023-02-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1032552-9
    ISSN 1931-3543 ; 0012-3692
    ISSN (online) 1931-3543
    ISSN 0012-3692
    DOI 10.1016/j.chest.2023.02.003
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  5. Article ; Online: Comparing Colorectal Cancer Screening Outcomes in the International Cancer Screening Network: A Consortium Proposal.

    Segnan, Nereo / Dekker, Evelien / Doria-Rose, V Paul / Senore, Carlo / Rabeneck, Linda / Lansdorp-Vogelaar, Iris

    Gastroenterology

    2021  Volume 162, Issue 3, Page(s) 668–674

    MeSH term(s) Colonoscopy ; Colorectal Neoplasms/diagnosis ; Early Detection of Cancer ; Humans ; Information Dissemination ; Internationality ; Middle Aged ; Occult Blood ; Outcome and Process Assessment, Health Care/methods ; Patient Compliance ; Quality Indicators, Health Care
    Language English
    Publishing date 2021-10-21
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 80112-4
    ISSN 1528-0012 ; 0016-5085
    ISSN (online) 1528-0012
    ISSN 0016-5085
    DOI 10.1053/j.gastro.2021.10.012
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  6. Article ; Online: The National Cancer Institute's Role in Advancing Health-Care Delivery Research.

    Jacobsen, Paul B / de Moor, Janet / Doria-Rose, V Paul / Geiger, Ann M / Kobrin, Sarah C / Sampson, Annie / Smith, Ashley Wilder

    Journal of the National Cancer Institute

    2021  Volume 114, Issue 1, Page(s) 20–24

    Abstract: Improvements in cancer care delivery have the potential to reduce morbidity and mortality from cancer, however, challenges to delivery of recommended care limit progress. These challenges include growing demands for care, increasing treatment complexity, ...

    Abstract Improvements in cancer care delivery have the potential to reduce morbidity and mortality from cancer, however, challenges to delivery of recommended care limit progress. These challenges include growing demands for care, increasing treatment complexity, inadequate care coordination, dramatic increases in costs, persistent disparities in care, and insufficient use of evidence-based guidelines. Recognizing the important role of research in understanding and addressing these challenges, the National Cancer Institute created the Healthcare Delivery Research Program (HDRP) in 2015 as a catalyst for expanding work in this area. Health-care delivery research is a multidisciplinary effort which recognizes that care delivery occurs in a multilevel system encompassing individuals, health-care systems, and communities. HDRP staff use a range of activities to fulfill the program's mission of advancing innovative research to improve delivery of care across the cancer control continuum. In addition to developing funding opportunities, HDRP staff; support and facilitate the use of research infrastructure for conducting health-care delivery research; oversee publicly available data that can be used to evaluate patterns, costs, and patient experiences of care; contribute to development and dissemination of standardized health measurement tools for public use; and support professional development and training to build capacity within the field and grow the workforce. As HDRP enters its sixth year, we appreciate the opportunity to reflect on the program's progress in advancing the science of health-care delivery. At the same time, we recognize the need for the program to evolve and develop additional resources and opportunities to address new and emerging challenges.
    MeSH term(s) Health Services Research ; Humans ; National Cancer Institute (U.S.) ; Neoplasms/therapy ; United States
    Language English
    Publishing date 2021-05-13
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2992-0
    ISSN 1460-2105 ; 0027-8874 ; 0198-0157
    ISSN (online) 1460-2105
    ISSN 0027-8874 ; 0198-0157
    DOI 10.1093/jnci/djab096
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  7. Article ; Online: Case-Control Studies of the Efficacy of Screening Tests That Seek to Prevent Cancer Incidence: Results of an Approach That Utilizes Administrative Claims Data That Do Not Provide Information Regarding Test Indication.

    Doria-Rose, V Paul / Kamineni, Aruna / Barrett, Michael J / Ko, Cynthia W / Weiss, Noel S

    American journal of epidemiology

    2019  Volume 188, Issue 4, Page(s) 703–708

    Abstract: Case-control studies evaluating a screening test's efficacy in reducing cancer mortality require accurate classification of test indication to obtain a valid result. However, for analogous studies of cancer incidence, determination of test indication is ... ...

    Abstract Case-control studies evaluating a screening test's efficacy in reducing cancer mortality require accurate classification of test indication to obtain a valid result. However, for analogous studies of cancer incidence, determination of test indication is not as critical because, to define exposure, we need consider only tests that can identify precursor lesions whose treatment might prevent cancer, not tests leading to cancer diagnosis. This study utilizes US Surveillance, Epidemiology, and End Results (SEER)-Medicare data, which do not include information about colonoscopy indication, to evaluate the efficacy of colonoscopy in preventing colorectal cancer (CRC) incidence. Cases were Medicare enrollees diagnosed with CRC between 1996 and 2013; up to 3 controls were matched to each case. Colonoscopy receipt prior to presumed onset of occult cancer was associated with an approximately 60% reduction in CRC incidence (odds ratio = 0.41, 95% confidence interval: 0.40, 0.42). The association was robust to differing exposure windows and estimates of occult cancer duration and is similar to those from CRC incidence studies in which exam indication was available. Our results suggest that, when it is impractical/impossible to determine whether tests were conducted for screening, the efficacy of a test in preventing cancer incidence can still be estimated using a case-control study design.
    MeSH term(s) Aged ; Case-Control Studies ; Colonoscopy/statistics & numerical data ; Colorectal Neoplasms/epidemiology ; Colorectal Neoplasms/prevention & control ; Early Detection of Cancer/statistics & numerical data ; Female ; Humans ; Incidence ; Male ; Medicare/statistics & numerical data ; Middle Aged ; Odds Ratio ; SEER Program/statistics & numerical data ; United States/epidemiology
    Language English
    Publishing date 2019-01-30
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 2937-3
    ISSN 1476-6256 ; 0002-9262
    ISSN (online) 1476-6256
    ISSN 0002-9262
    DOI 10.1093/aje/kwy274
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  8. Article ; Online: Evaluating Lung Cancer Screening Uptake, Outcomes, and Costs in the United States: Challenges With Existing Data and Recommendations for Improvement.

    Rai, Ashish / Doria-Rose, V Paul / Silvestri, Gerard A / Yabroff, K Robin

    Journal of the National Cancer Institute

    2019  Volume 111, Issue 4, Page(s) 342–349

    Abstract: The National Lung Screening Trial (NLST) reported substantial reduction in lung cancer mortality among high-risk individuals screened annually with low-dose helical computed tomography (LDCT). As a result, the US Preventive Services Task Force issued a B ...

    Abstract The National Lung Screening Trial (NLST) reported substantial reduction in lung cancer mortality among high-risk individuals screened annually with low-dose helical computed tomography (LDCT). As a result, the US Preventive Services Task Force issued a B recommendation for annual LDCT in high-risk individuals, which requires private insurers to cover it without cost-sharing. The Medicare program also covers LDCT for high-risk beneficiaries without cost-sharing. However, the NLST findings may not be generalizable to the community setting because of differences in patients, providers, and practices participating in the NLST. Thus, examining uptake of LDCT screening in community practice is critical, as is evaluating the immediate and downstream outcomes of screening, including false-positive scans, follow-up examinations and adverse events, costs, stage of disease at diagnosis, and survival. This commentary presents an overview of the landscape of the data resources currently available to evaluate the uptake, outcomes, and costs of LDCT screening in the United States. We describe the strengths and limitations of existing data sources, including administrative databases, surveys, and registries. Thereafter, we provide recommendations for improving the data infrastructure pertaining to three overarching research areas: receipt of guideline-consistent screening and follow-up, weighing benefits and harms of screening, and costs of screening.
    MeSH term(s) Cost-Benefit Analysis ; Early Detection of Cancer/economics ; Electronic Health Records/statistics & numerical data ; Humans ; Lung Neoplasms/diagnosis ; Lung Neoplasms/diagnostic imaging ; Lung Neoplasms/economics ; Practice Guidelines as Topic/standards ; Preventive Health Services/standards ; Prognosis ; Quality Improvement ; Registries/statistics & numerical data ; Tomography, X-Ray Computed/economics ; United States
    Language English
    Publishing date 2019-01-30
    Publishing country United States
    Document type Evaluation Study ; Journal Article
    ZDB-ID 2992-0
    ISSN 1460-2105 ; 0027-8874 ; 0198-0157
    ISSN (online) 1460-2105
    ISSN 0027-8874 ; 0198-0157
    DOI 10.1093/jnci/djy228
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  9. Article ; Online: Risk of Colorectal Cancer and Colorectal Cancer Mortality Beginning One Year after a Negative Fecal Occult Blood Test, among Screen-Eligible 76- to 85-Year-Olds.

    Dalmat, Ronit R / Ziebell, Rebecca A / Kamineni, Aruna / Phipps, Amanda I / Weiss, Noel S / Breslau, Erica S / Burnett-Hartman, Andrea N / Corley, Douglas A / Doria-Rose, V Paul / Green, Beverly B / Halm, Ethan A / Levin, Theodore R / Schottinger, Joanne E / Chubak, Jessica

    Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology

    2023  Volume 32, Issue 10, Page(s) 1382–1390

    Abstract: Background: Colorectal cancer screening is universally recommended for adults ages 45 to 75 years. Noninvasive fecal occult blood tests are effective screening tests recommended by guidelines. However, empirical evidence to inform older adults' ... ...

    Abstract Background: Colorectal cancer screening is universally recommended for adults ages 45 to 75 years. Noninvasive fecal occult blood tests are effective screening tests recommended by guidelines. However, empirical evidence to inform older adults' decisions about whether to continue screening is sparse, especially for individuals with prior screening.
    Methods: This study used a retrospective cohort of older adults at three Kaiser Permanente integrated healthcare systems (Northern California, Southern California, Washington) and Parkland Health. Beginning 1 year following a negative stool-based screening test, cumulative risks of colorectal cancer incidence, colorectal cancer mortality (accounting for deaths from other causes), and non-colorectal cancer mortality were estimated.
    Results: Cumulative incidence of colorectal cancer in screen-eligible adults ages 76 to 85 with a negative fecal occult blood test 1 year ago (N = 118,269) was 0.23% [95% confidence interval (CI), 0.20%-0.26%] after 2 years and 1.21% (95% CI, 1.13%-1.30%) after 8 years. Cumulative colorectal cancer mortality was 0.03% (95% CI, 0.02%-0.04%) after 2 years and 0.33% (95% CI, 0.28%-0.39%) after 8 years. Cumulative risk of death from non-colorectal cancer causes was 4.81% (95% CI, 4.68%-4.96%) after 2 years and 28.40% (95% CI, 27.95%-28.85%) after 8 years.
    Conclusions: Among 76- to 85-year-olds with a recent negative stool-based test, cumulative colorectal cancer incidence and mortality estimates were low, especially within 2 years; death from other causes was over 100 times more likely than death from colorectal cancer.
    Impact: These findings of low absolute colorectal cancer risk, and comparatively higher risk of death from other causes, can inform decision-making regarding whether and when to continue colorectal cancer screening beyond age 75 among screen-eligible adults.
    MeSH term(s) Humans ; Aged ; Occult Blood ; Retrospective Studies ; Colorectal Neoplasms/diagnosis ; Colorectal Neoplasms/epidemiology ; Colonoscopy ; Mass Screening ; Early Detection of Cancer
    Language English
    Publishing date 2023-07-13
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 1153420-5
    ISSN 1538-7755 ; 1055-9965
    ISSN (online) 1538-7755
    ISSN 1055-9965
    DOI 10.1158/1055-9965.EPI-23-0265
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  10. Article ; Online: Test performance metrics for breast, cervical, colon, and lung cancer screening: a systematic review.

    Selby, Kevin / Sedki, Mai / Levine, Emma / Kamineni, Aruna / Green, Beverly B / Vachani, Anil / Haas, Jennifer S / Ritzwoller, Debra P / Croswell, Jennifer M / Ohikere, Kabiru / Doria-Rose, V Paul / Rendle, Katharine A / Chubak, Jessica / Lafata, Jennifer Elston / Inadomi, John / Corley, Douglas A

    Journal of the National Cancer Institute

    2023  Volume 115, Issue 4, Page(s) 375–384

    Abstract: Background: Multiple quality metrics have been recommended to ensure consistent, high-quality execution of screening tests for breast, cervical, colorectal, and lung cancers. However, minimal data exist evaluating the evidence base supporting these ... ...

    Abstract Background: Multiple quality metrics have been recommended to ensure consistent, high-quality execution of screening tests for breast, cervical, colorectal, and lung cancers. However, minimal data exist evaluating the evidence base supporting these recommendations and the consistency of definitions and concepts included within and between cancer types.
    Methods: We performed a systematic review for each cancer type using MEDLINE, Embase, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) from 2010 to April 2020 to identify guidelines from screening programs or professional organizations containing quality metrics for tests used in breast, cervical, colorectal, and lung cancer screening. We abstracted metrics' definitions, target performance levels, and related supporting evidence for test completeness, adequacy (sufficient visualization or collection), accuracy, and safety.
    Results: We identified 11 relevant guidelines with 20 suggested quality metrics for breast cancer, 5 guidelines with 9 metrics for cervical cancer, 13 guidelines with 18 metrics for colorectal cancer (CRC), and 3 guidelines with 7 metrics for lung cancer. These included 54 metrics related to adequacy (n = 6), test completeness (n = 3), accuracy (n = 33), and safety (n = 12). Target performance levels were defined for 30 metrics (56%). Ten (19%) were supported by evidence, all from breast and CRC, with no evidence cited to support metrics from cervical and lung cancer screening.
    Conclusions: Considerably more guideline-recommended test performance metrics exist for breast and CRC screening than cervical or lung cancer. The domains covered are inconsistent among cancers, and few targets are supported by evidence. Clearer evidence-based domains and targets are needed for test performance metrics.
    Registration: PROSPERO 2020 CRD42020179139.
    MeSH term(s) Female ; Humans ; Early Detection of Cancer ; Lung Neoplasms/diagnosis ; Colorectal Neoplasms/diagnosis ; Uterine Cervical Neoplasms/diagnosis ; Mass Screening
    Language English
    Publishing date 2023-02-04
    Publishing country United States
    Document type Systematic Review ; Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 2992-0
    ISSN 1460-2105 ; 0027-8874 ; 0198-0157
    ISSN (online) 1460-2105
    ISSN 0027-8874 ; 0198-0157
    DOI 10.1093/jnci/djad028
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