Cancer Health Disparities
Current Projects
Marijuana use among US adults with cancer - This study aimed to assess the prevalence of current marijuana use and to identify the factors associated with its use among US adults with cancer living in 17 U.S. states and territories.
Marijuana use among US adults with cancer
Background
With more states legalizing recreational and medical marijuana, it is expected that the number of marijuana users will increase in the future. As marijuana use continues to become increasingly prevalent across the country, it is important for studies of its use to expand to more states. Moreover, there is limited knowledge about whether it is primarily used for medical reasons (i.e., to treat or decrease health symptoms) or recreational use (i.e., for pleasure or satisfaction).
Project Lead
Minjee Lee, Ph.D., MPH
PSP Team Members
Wiley Jenkins, Ph.D.
Collaborators
Arun Sharma, MD, MS; Ramzi G Salloum, Ph.D.; Dale Buck Hales, PhD
Goals
In this study, we examined the prevalence of current marijuana use among US adults with a history of cancer living in 17 U.S. states and territories using large, representative, population-based data from the nation’s largest health survey. Additionally, this study identified the characteristics associated with its use among US adults with a history of cancer and described the prevalence of each mode of marijuana use across the sample, and by primary reason for use.
Presentations
Lee M, Salloum RG, Sharma A. Marijuana use among US adults with cancer: Findings from the 2018-2019 Behavioral Risk Factor Surveillance System. Annual Meeting of American Society of Clinical Oncology (ASCO), June 4-8, 2021.
Lee M, Adjei Boakye E. State variation in marijuana use among U.S. adults with cancer. Annual Meeting of American Society of Clinical Oncology (ASCO), June 4-8, 2021.
Lee M, Coniglio C, Rodriguez C, Adjei Boakye E. The association between marijuana use and receipt of influenza vaccination in US adults. 149th Annual Meeting of the American Public Health Association (APHA), Denver, CO, USA, October 24-27, 2021.
Publications
Lee M. Salloum RG. Jenkins WD. Hales DB. Sharma A. Marijuana use among US adults with cancer: Findings from the 2018-2019 Behavioral Risk Factor Surveillance System. J Cancer Surviv. 2021 (forthcoming)
Lee M, Salloum RG, Sharma A. Marijuana use among US adults with cancer: Findings from the 2018-2019 Behavioral Risk Factor Surveillance System. Journal of Clinical Oncology
Lee M, Adjei Boakye E. State variation in marijuana use among U.S. adults with cancer. Journal of Clinical Oncology
Past Projects
Spatial Analysis of Radon Testing and Mitigation in Illinois: A Public Health Perspective - Radon is the second leading cause of lung cancer and the leading cause of lung cancer in non-smokers. It accounts for more than 21,000 deaths every year in the United States. Radon is a naturally occurring, odorless and tasteless gas that can seep into groundwater and into homes through cracks in the foundation or other openings. The risk of radon-attributable lung cancer can be reduced if homeowners and tenants test their homes and install mitigation apparatuses if their radon levels are high. The Environmental Protection Agency (EPA) recommends that all homes be tested for radon and homes with radon values above 4.0 picocuries/L be mitigated. Homes may be tested using either a licensed professional or through the purchase of a home test kit.
Addressing rural cancer health disparities: An SCC-SIUSM Partnership - The P20 grant is a collaboration between SIUSM and Washington University Siteman Cancer Institute (WUSTL) where WUSTL acts as a mentor to SIUSM to help us develop a larger team of cancer health disparities researchers. In exchange, SIUSM gives WUSTL access to rural cancer patients that they may not have been able to reach otherwise. There are 3 components to the grant: admin, training and a pilot research project. There is a call for pilot proposals once a year to be funded through this program. There are also training opportunities available for faculty and other staff.
Spatial Analysis of Rural Disparities in Staging and Oncologic Outcomes for Esophageal and Pancreas Cancer - Esophagectomy and pancreatectomy are complex surgical procedures that have demonstrated strong inverse relationships between hospital and surgeon volume and operative mortality, which has led to the implementation of national quality-improvement and process measures. Centralization of surgical management for esophageal and pancreas cancer has thus been endorsed to promote optimal oncologic care. Despite an impetus towards regionalization, rural access to specialty providers and facilities and disparities in staging and outcomes have yet to be investigated for these two, particularly hard-to-treat cancers.
Spatial Analysis of Radon Testing and Mitigation in Illinois: A Public Health Perspective
Background
Radon is the second leading cause of lung cancer and the leading cause of lung cancer in non-smokers. It accounts for more than 21,000 deaths every year in the United States. Radon is a naturally occurring, odorless and tasteless gas that can seep into groundwater and into homes through cracks in the foundation or other openings. The risk of radon-attributable lung cancer can be reduced if homeowners and tenants test their homes and install mitigation apparatuses if their radon levels are high. The Environmental Protection Agency (EPA) recommends that all homes be tested for radon and homes with radon values above 4.0 picocuries/L be mitigated. Homes may be tested using either a licensed professional or through the purchase of a home test kit.
Project Lead
Tracey Smith, DNP
PSP Team Members
Whitney Zahnd, MS
Collaborators
Kendra Ratnapradipa at St. Louis University and Patrick Daniels and Melinda Lewis at the Illinois Emergency Management Agency’s Radon Program
Goals
In the initial work of this project, we explored radon testing patterns throughout the state of Illinois to help determine where radon awareness intervention should be targeted. In the coming year, we aim to perform the following tasks: 1) assess congruency between tests performed by licensed professionals and home kit tests; 2) evaluate compliance of state-licensed daycare facilities with state radon testing regulations; 3) determine trends in testing concurrent with state regulations.
Findings
In our initial findings, we found that zip codes with higher income, higher home values, and greater urbanicity have higher levels of radon testing. Further, more testing is performed in areas at greater risk for high radon levels, as determined by the EPA. We also found that areas of low testing rates are clustered in southern and west-central Illinois.
Presentations
The 2016 International Radon Symposium
Publications and Citations
Journal of Public Health Management and Practice
Online Module for Continuing Medical Education credit
Addressing rural cancer health disparities: An SCC-SIUSM Partnership
Background
Cancer disparities in the United States exist among distinct community populations most notably categorized by geography, income level, and race/ethnicity, where higher cancer risk and worse outcomes persist. Although poverty is often associated with health disparities, impoverished rural communities are often overlooked and underrepresented in research studies, even in the most economically distressed areas in the nation. Rural counties frequently have worse cancer outcomes and are Medically Underserved Areas (MUAs) and Health Professional Shortage Areas (HPSAs). Rural populations experience lower access to health care along the dimensions of affordability, proximity, and quality, compared with their urban counterparts. They often experience higher rates of cancer, poorer survival, and less utilization of preventive services. Recent data indicate that the health gap between rural and other residents is widening.
The P20 grant is a collaboration between SIUSM and Washington University Siteman Cancer Institute (WUSTL) where WUSTL acts as a mentor to SIUSM to help us develop a larger team of cancer health disparities researchers. In exchange, SIUSM gives WUSTL access to rural cancer patients that they may not have been able to reach otherwise. There are 3 components to the grant: admin, training and a pilot research project. There is a call for pilot proposals once a year to be funded through this program. There are also training opportunities available for faculty and other staff.
Project Lead
Laurent Brard, MD, Ph.D.
PSP Team Members
Wiley Jenkins, Ph.D.; Amanda Fogleman, MEng
Collaborators
Washington University Siteman Cancer Center
Goals
The partnership goals are to 1) build SIUSM cancer research capacity and support SIUSM faculty in transitioning to NIH-funded cancer disparities research, 2) provide opportunities for mid-and senior-level investigators to engage in cross-institutional cancer research and increase the rural cancer research scope and capacity at SCC, and 3) foster the development of postdoctoral scholars and junior faculty at both institutions to develop independent researchers in cancer disparities research.
Findings
N/A
Publications
N/A
Spatial Analysis of Rural Disparities in Staging and Oncologic Outcomes for Esophageal and Pancreas Cancer
Background
Esophagectomy and pancreatectomy are complex surgical procedures that have demonstrated strong inverse relationships between hospital and surgeon volume and operative mortality, which has led to the implementation of national quality improvement and process measures. Centralization of surgical management for esophageal and pancreas cancer has thus been endorsed to promote optimal oncologic care. Despite an impetus towards regionalization, rural access to specialty providers and facilities and disparities in staging and outcomes have yet to be investigated for these two particularly hard-to-treat cancers.
Project Lead
Sabha Ganai, MD, Ph.D.
PSP Team Members
Whitney Zahnd, MS
Collaborator
Min Lian, MD, Ph.D. at Washington University School of Medicine in St. Louis, MO
Goals
Our goal is to examine population-level disparities in esophageal and pancreas cancer staging and outcomes that may be influenced by rurality, socioeconomic deprivation, and distance from providers such as endoscopic ultrasound (EUS)-trained gastroenterologists, specialty surgeons, and high-volume comprehensive cancer centers. This will be accomplished using spatial analysis to explore the influence of provider density and distance on oncologic outcomes.
Findings
To date, we have found a statistically significant inverse relationship between accessibility to EUS providers and the county-level likelihood of having an unstaged pancreas cancer, indicating people who live further from specialty care may not receive the care necessary to improve the prognosis of an already deadly disease. Further, we have been able to develop census-tract level spatial accessibility maps to visualize access to specialty care while accounting for access disparities and socioeconomic factors.
Citations
Sturm EC, Zahnd W, Mellinger JD, Ganai S. Rural-Urban and Regional Differences in Receipt of Esophagectomy for Early-Stage Esophagus Cancer. Society for Surgery of the Alimentary Tract, 58th Annual Meeting, 2017 Digestive Disease Week, Chicago, Illinois, May 6-9, 2017.
MacKinney E, Zahnd W, Khan AA, Sturm E, Mellinger JD, Ganai S. An Exploration of Regional and Rural-Urban Differences in Pancreas Cancer Surgery. Society for Surgery of the Alimentary Tract, 58th Annual Meeting, 2017 Digestive Disease Week, Chicago, Illinois, May 6-9, 2017.
Khan AA, MacKinney E, Buckley EJ, Sturm E, Rejowski B, Mellinger JD, Ganai S. Adjacency of Rural County of Residence to an Urban County May Determine Survival for Stage I Pancreatic Cancer. Society for Surgery of the Alimentary Tract, 58th Annual Meeting, 2017 Digestive Disease Week, Chicago, Illinois, May 6-9, 2017.
Lanzotti NJ, Zahnd WE, Tseng JF, Mellinger JD, Ganai S. Impact of Travel Distance on Survival from Early-Stage Breast and Pancreas Cancer. Academic Surgical Congress 2017, Las Vegas, Nevada, February 2-5, 2017.
Regan J, Zahnd W, Kistner B, Ali A, Mellinger JD, Ganai S. Rural Disparities in Esophageal Cancer Outcomes based on Distance from Endoscopic Ultrasound (EUS)-Trained Gastroenterologists. Illinois Chapter of the American College of Surgeons, 65th Annual Scientific Meeting, Peoria, Illinois, June 18-20, 2015.