Dataset Information

Exploring Differences in the Aspirin-Colorectal Cancer Association by Sex and Race/Ethnicity: The Multiethnic Cohort Study.

ABSTRACT: BACKGROUND:Evidence has accumulated that long-term use of aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) protects against colorectal cancer. We tested whether the inverse associations between NSAIDs and colorectal cancer is similarly observed across sexes and five racial/ethnic groups (Japanese, Latino, African American, Native Hawaiian, and white) in the Multiethnic Cohort (MEC) Study. METHODS:During a mean follow-up of 16.1 years, we identified 4,882 invasive incident colorectal cancer cases among 183,199 eligible participants. Cox proportional hazards models were used to calculate HRs and 95% confidence intervals (CI). RESULTS:Use of aspirin and other NSAIDs was associated with a lower incidence of colorectal cancer in men (HR = 0.77; 95% CI, 0.69-0.86 for current vs. never users of aspirin) but not in women (Pinteraction = 0.005). Among male current users, a reduced risk was observed with ?6 years of aspirin or total NSAID use. The inverse association with current NSAID use in men was observed in all racial/ethnic groups, except for Native Hawaiians, and was stronger in whites. CONCLUSIONS:Our findings suggest that the benefit of NSAIDs for colorectal cancer may be strongest for white men and generalizes to African American, Japanese, and Latino, but not to Native Hawaiian men. The lack of inverse association observed in women and Native Hawaiian men in the MEC should be interpreted with caution. IMPACT:As only very few ethnic/racial groups are likely to be represented in trials of NSAIDs and colorectal cancer, it is important to conduct prospective observational studies in various populations to test the generalizability of their results. Cancer Epidemiol Biomarkers Prev; 26(2); 162-9. ©2016 AACR.

SUBMITTER: Park SY

PROVIDER: S-EPMC5296290 | biostudies-literature | 2017 Feb

REPOSITORIES: biostudies-literature

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Exploring Differences in the Aspirin-Colorectal Cancer Association by Sex and Race/Ethnicity: The Multiethnic Cohort Study.

Park Song-Yi SY Wilkens Lynne R LR Kolonel Laurence N LN Monroe Kristine R KR Haiman Christopher A CA Marchand Loïc Le LL

Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology 20161010 2

<h4>Background</h4>Evidence has accumulated that long-term use of aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) protects against colorectal cancer. We tested whether the inverse associations between NSAIDs and colorectal cancer is similarly observed across sexes and five racial/ethnic groups (Japanese, Latino, African American, Native Hawaiian, and white) in the Multiethnic Cohort (MEC) Study.<h4>Methods</h4>During a mean follow-up of 16.1 years, we identified 4,882 invasive in ...[more]

PMID: 27765797

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Project description:ImportanceOur understanding of potential racial/ethnic, sex, and other differences in health care use and treatment for acne is limited.ObjectiveTo identify potential disparities in acne care by evaluating factors associated with health care use and specific treatments for acne.Design, setting, and participantsThis retrospective cohort study used the Optum deidentified electronic health record data set to identify patients treated for acne from January 1, 2007, to June 30, 2017. Patients had at least 1 International Classification of Diseases, Ninth Revision (ICD-9) or International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) code for acne and at least 1 year of continuous enrollment after the first diagnosis of acne. Data analysis was performed from September 1, 2019, to November 20, 2019.Main outcomes and measuresMultivariable regression was used to quantify associations between basic patient demographic and socioeconomic characteristics and the outcomes of health care use and treatment for acne during 1 year of follow-up.ResultsA total of 29 928 patients (median [interquartile range] age, 20.2 [15.4-34.9] years; 19 127 [63.9%] female; 20 310 [67.9%] white) met the inclusion criteria for the study. Compared with non-Hispanic white patients, non-Hispanic black patients were more likely to be seen by a dermatologist (odds ratio [OR], 1.20; 95% CI, 1.09-1.31) but received fewer prescriptions for acne medications (incidence rate ratio, 0.89; 95% CI, 0.84-0.95). Of the acne treatment options, non-Hispanic black patients were more likely to receive prescriptions for topical retinoids (OR, 1.25; 95% CI, 1.14-1.38) and topical antibiotics (OR, 1.35; 95% CI, 1.21-1.52) and less likely to receive prescriptions for oral antibiotics (OR, 0.80; 95% CI, 0.72-0.87), spironolactone (OR, 0.68; 95% CI, 0.49-0.94), and isotretinoin (OR, 0.39; 95% CI, 0.23-0.65) than non-Hispanic white patients. Male patients were more likely to be prescribed isotretinoin than female patients (OR, 2.44; 95% CI, 2.01-2.95). Compared with patients with commercial insurance, those with Medicaid were less likely to see a dermatologist (OR, 0.46; 95% CI, 0.41-0.52) or to be prescribed topical retinoids (OR, 0.82; 95% CI, 0.73-0.92), oral antibiotics (OR, 0.87; 95% CI, 0.79-0.97), spironolactone (OR, 0.50; 95% CI, 0.31-0.80), and isotretinoin (OR, 0.43; 95% CI, 0.25-0.75).Conclusions and relevanceThe findings identify racial/ethnic, sex, and insurance-based differences in health care use and prescribing patterns for acne that are independent of other sociodemographic factors and suggest potential disparities in acne care. In particular, the study found underuse of systemic therapies among racial/ethnic minorities and isotretinoin among female patients with acne. Further study is needed to confirm and understand the reasons for these differences.

Project description:BACKGROUND:National heart failure (HF) hospitalization rates have not been appropriately age standardized by sex or race/ethnicity. Reporting hospital utilization trends by subgroup is important for monitoring population health and developing interventions to eliminate disparities. METHODS AND RESULTS:The National Inpatient Sample (NIS) was used to estimate the crude and age-standardized rates of HF hospitalization between 2002 and 2013 by sex and race/ethnicity. Direct standardization was used to age-standardize rates to the 2000 US standard population. Relative differences between subgroups were reported. The national age-adjusted HF hospitalization rate decreased 30.8% from 526.86 to 364.66 per 100?000 between 2002 and 2013. Although hospitalizations decreased for all subgroups, the ratio of the age-standardized rate for men compared with women increased from 20% greater to 39% (P trend=0.002) between 2002 and 2013. Black men had a rate that was 229% (P trend=0.141) and black women, 240% (P trend=0.725) with reference to whites in 2013 with no significant change between 2002 and 2013. Hispanic men had a rate that was 32% greater in 2002 and the difference narrowed to 4% (P trend=0.047) greater in 2013 relative to whites. For Hispanic women, the rate was 55% greater in 2002 and narrowed to 8% greater (P trend=0.004) in 2013 relative to whites. Asian/Pacific Islander men had a 27% lower rate in 2002 that improved to 43% (P trend=0.040) lower in 2013 relative to whites. For Asian/Pacific Islander women, the hospitalization rate was 24% lower in 2002 and improved to 43% (P trend=0.021) lower in 2013 relative to whites. CONCLUSIONS:National HF hospitalization rates have decreased steadily during the recent decade. Disparities in HF burden and hospital utilization by sex and race/ethnicity persist. Significant population health interventions are needed to reduce the HF hospitalization burden among blacks. An evaluation of factors explaining the improvements in the HF hospitalization rates among Hispanics and Asian/Pacific Islanders is needed.

Project description:Over 80% of bias-motivated violent victimization is motivated by race or ethnicity and over 50% of bias victimization occurs in non-Hispanic Whites (NHW). Our aim was to determine the risk and health impacts of race/ethnicity-motivated violent victimization by victim race/ethnicity. We examined data from the National Crime Victimization Survey (2003-2015) to estimate violent victimization risk by victim race/ethnicity across race/ethnicity bias victimization, other types of bias victimizations, and non-bias violent victimizations. We examined incident and offender characteristics for race/ethnicity-motivated victimization by victim race/ethnicity. The risk of race/ethnicity-motivated violent victimization was greater for non-Hispanic Blacks (NHB) and Hispanics than for NHWs (incidence rate ratios [IRR] = 1.4; 95% confidence interval [CI] = [1.0, 2.0], and IRR = 1.6; 95% CI = [1.2, 2.1]). This translates into an additional 46.7 incidents per 100,000 person-years (95% CI = [1.4, 92.1]) for the NHB population and an additional 60.3 incidents per 100,000 person-years (95% CI = [20.3, 100.4]) for the Hispanic population. Violent incidents for NHB victims more frequently resulted in injury or medical care. Nearly 40% of NHB victims reported difficulties at school or work related to the incident where only 21.5% of NHWs and 11.7% of Hispanic victims reported similar problems. Roughly 37% of NHB victims identified a NHW offender and 45% of NHW victims identified a NHB offender. Hispanic victims identified NHB or NHW offenders in over 70% of incidents. Although literature suggests that NHWs account for the majority of bias victimizations, the risk of non-fatal violent victimization motivated by race/ethnicity is greater for NHBs and Hispanics. Crimes perpetrated against NHBs are likely more severe and victim/offender racial incongruity is common. Findings provide empiric evidence on race/ethnicity-related structural disadvantage with adverse health consequences.

Project description:Importance:Severe morbidity in very preterm infants is associated with profound clinical implications on development and life-course health. However, studies of racial/ethnic disparities in severe neonatal morbidities are scant and suggest that these disparities are modest or null, which may be an underestimation resulting from the analytic approach used. Objective:To estimate racial/ethnic differences in severe morbidities among very preterm infants. Design, Setting, and Participants:This population-based retrospective cohort study was conducted in New York City, New York, using linked birth certificate, mortality data, and hospital discharge data from January 1, 2010, through December 31, 2014. Infants born before 24 weeks' gestation, with congenital anomalies, and with missing data were excluded. Racial/ethnic disparities in very preterm birth morbidities were estimated through 2 approaches, conventional analysis and fetuses-at-risk analysis. The conventional analysis used log-binomial regression to estimate the relative risk of 4 severe neonatal morbidities for the racial/ethnic groups. For the fetuses-at-risk analysis, Cox proportional hazards regression with death as competing risk was used to estimate subhazard ratios associating race/ethnicity with each outcome. Estimates were adjusted for sociodemographic factors and maternal morbidities. Data were analyzed from September 5, 2017, to May 21, 2018. Main Outcomes and Measures:Four morbidity outcomes were defined using International Classification of Diseases, Ninth Revision, diagnosis and procedure codes: necrotizing enterocolitis, intraventricular hemorrhage, bronchopulmonary dysplasia, and retinopathy of prematurity. Results:In total, 582 297 infants were included in this study. Of these infants, 285 006 were female (48.9%) and 297 291 were male (51.0%). Using the conventional approach in the very preterm birth subcohort, black compared with white infants had an increased risk of only bronchopulmonary dysplasia (adjusted risk ratio [aRR], 1.34; 95% CI, 1.09-1.64) and a borderline increased risk of necrotizing enterocolitis (aRR, 1.39; 95% CI, 1.00-1.93). Hispanic infants had a borderline increased risk of necrotizing enterocolitis (aRR, 1.39; 95% CI, 0.98-1.96), and Asian infants had an increased risk of retinopathy of prematurity (aRR, 1.85; 95% CI, 1.15-2.97). In the fetuses-at-risk analysis, black infants had a 4.40 times higher rate of necrotizing enterocolitis (95% CI, 2.98-6.51), a 2.73 times higher rate of intraventricular hemorrhage (95% CI, 1.63-4.57), a 4.43 times higher rate of bronchopulmonary dysplasia (95% CI, 2.88-6.81), and a 2.98 times higher rate of retinopathy of prematurity (95% CI, 2.01-4.40). Hispanic infants had an approximately 2 times higher rate for all outcomes, and Asian infants had increased risk only for retinopathy of prematurity (adjusted hazard ratio, 2.43; 95% CI, 1.43-4.11). Conclusions and Relevance:In this study, racial/ethnic disparities in neonatal morbidities among very preterm infants appear to be sizable, but may have been underestimated in previous studies, and may have implications for the future. Understanding these racial/ethnic disparities is important, as they may contribute to inequalities in health and development later in the child's life.

Dataset Information

Exploring Differences in the Aspirin-Colorectal Cancer Association by Sex and Race/Ethnicity: The Multiethnic Cohort Study.

Publications

Exploring Differences in the Aspirin-Colorectal Cancer Association by Sex and Race/Ethnicity: The Multiethnic Cohort Study.

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