Preoperative experience for public hospital patients with gynecologic cancer: Do structural barriers widen the gap?

Abstract:

BACKGROUND:Widespread disparities in care have been documented in women with gynecologic cancer in the United States. This study was designed to determine whether structural barriers to optimal care were present during the preoperative period for patients with gynecologic cancer. METHODS:A retrospective review was conducted for patients undergoing surgery for a gynecologic malignancy at a public hospital or a private hospital staffed by the same team of gynecologic oncologists between July 1, 2013 and July 1, 2014. RESULTS:Two hundred fifty-seven cases were included for analysis (public hospital, 69; private hospital, 188). Patients treated at the private hospital were older (58 vs 52 years; P = .004) and had similar medical comorbidities (median Charlson comorbidity index at both hospitals, 6) but required fewer hospital visits in preparation for surgery (2 vs 4; P < .001). Public hospital patients had a longer wait time from the diagnosis of disease to surgery (63 vs 34 days; P < .001). According to a multiple linear regression model, the public hospital setting was associated with a longer interval from diagnosis to surgery with adjustments for the insurance status, age at diagnosis, cancer stage, and number of preoperative hospital visits (P < .001). CONCLUSIONS:Patients at the public hospital were subject to a greater number of preoperative visits and had to wait longer for surgery than patients at the private hospital. Attempts to reduce health care disparities should focus on improving efficiency in health care delivery systems once contact has been established.

journal_name

Cancer

journal_title

Cancer

authors

Frey MK,Moss HA,Musa F,Rolnitzky L,David-West G,Chern JY,Boyd LR,Curtin JP

doi

10.1002/cncr.29859

subject

Has Abstract

pub_date

2016-03-15 00:00:00

pages

859-67

issue

6

eissn

0008-543X

issn

1097-0142

journal_volume

122

pub_type

杂志文章

相关文献

CANCER文献大全
  • The prevalence of variant alkaline phosphatase in hepatocellular carcinoma in southern African blacks.

    abstract::The prevalence of variant alkaline phosphatase in the serum of 335 southern African blacks with hepatocellular carcinoma was determined using polyacrylamide gel electrophoresis. The isoenzyme was detected in 2% (seven of 335) of the patients: it could not be found in the serum of 300 matched, healthy individuals or in...

    journal_title:Cancer

    pub_type: 杂志文章

    doi:10.1002/1097-0142(19880901)62:5<978::aid-cncr28206

    authors: Bukofzer S,Kew MC,Rowe P

    更新日期:1988-09-01 00:00:00

  • Antitumor electrochemotherapy: new advances in the clinical protocol.

    abstract:BACKGROUND:Electrochemotherapy (ECT) is a new antitumor approach that combines systemic bleomycin (BLM) with electric pulses (EP) delivered locally at the tumor site. These EP permeabilize the cells in the tissue, allow BLM delivery inside the cells, and increase BLM cytotoxicity. As an extension of our initial Phase I...

    journal_title:Cancer

    pub_type: 临床试验,杂志文章

    doi:10.1002/(sici)1097-0142(19960301)77:5<956::aid-cnc

    authors: Domenge C,Orlowski S,Luboinski B,De Baere T,Schwaab G,Belehradek J Jr,Mir LM

    更新日期:1996-03-01 00:00:00

  • Mammographically guided fine-needle aspiration biopsy of nonpalpable breast lesions. Can it replace open biopsy?

    abstract::The authors report the accuracy of mammographically guided fine-needle aspiration (FNA) for the diagnosis of nonpalpable breast lesions in a series of 71 patients. Each mammographically guided FNA was immediately followed by hookwire localization and open biopsy. Seven malignancies were identified cytologically, but t...

    journal_title:Cancer

    pub_type: 杂志文章

    doi:10.1002/1097-0142(19911101)68:9<2007::aid-cncr2820

    authors: Layfield LJ,Parkinson B,Wong J,Giuliano AE,Bassett LW

    更新日期:1991-11-01 00:00:00

  • Aberrant, highly hyperdiploid cells in human papillomavirus-positive, abnormal cytologic samples are associated with progressive lesions of the uterine cervix.

    abstract:BACKGROUND:Infection with oncogenic-type human papillomavirus (HPV) and consecutive cytologic abnormalities of the uterine cervix precede the evolution of carcinoma. However, the specificity of both changes is too low to predict the true malignant potential of the change in a given time point, because the majority of t...

    journal_title:Cancer

    pub_type: 杂志文章

    doi:10.1002/cncr.20848

    authors: Bollmann R,Méhes G,Speich N,Schmitt C,Bollmann M

    更新日期:2005-04-25 00:00:00

  • Tivantinib (ARQ 197), a selective inhibitor of MET, in patients with microphthalmia transcription factor-associated tumors: results of a multicenter phase 2 trial.

    abstract:BACKGROUND:Microphthalmia transcription factor (MITF)-associated (MiT) tumors are a family of rare malignancies, including alveolar soft part sarcoma (ASPS), clear cell sarcoma (CCS), and translocation-associated renal cell carcinoma (tRCC) that have dysregulated expression of oncogenic MITF family proteins. The MET re...

    journal_title:Cancer

    pub_type: 杂志文章,多中心研究

    doi:10.1002/cncr.27582

    authors: Wagner AJ,Goldberg JM,Dubois SG,Choy E,Rosen L,Pappo A,Geller J,Judson I,Hogg D,Senzer N,Davis IJ,Chai F,Waghorne C,Schwartz B,Demetri GD

    更新日期:2012-12-01 00:00:00

  • Mental neuropathy (numb chin syndrome). A harbinger of tumor progression or relapse.

    abstract::The authors report four patients whose initial symptom of tumor recurrence or progression was unilateral numbness of the chin. Two patients had Hodgkin lymphoma, one had malignant melanoma, and one had prostate cancer. Physical examination was notable only for unilateral anesthesia of the chin and lower lip. Diagnosti...

    journal_title:Cancer

    pub_type: 杂志文章

    doi:10.1002/1097-0142(19920815)70:4<877::aid-cncr28207

    authors: Burt RK,Sharfman WH,Karp BI,Wilson WH

    更新日期:1992-08-15 00:00:00

  • Treatment of children with neurogenic sarcoma. Experience at the Children's Hospital of Philadelphia, 1958-1984.

    abstract::Twenty-four children aged 3 months to 18 years (median, 12 years) were treated for neurogenic sarcoma at the Children's Hospital of Philadelphia Cancer Research Center from 1958 through 1984. Sixteen patients had neurofibromatosis (NF). The tumors arose in an extremity or in the trunk (15 patients), the retroperitoneu...

    journal_title:Cancer

    pub_type: 杂志文章

    doi:10.1002/1097-0142(19870101)59:1<1::aid-cncr2820590

    authors: Raney B,Schnaufer L,Ziegler M,Chatten J,Littman P,Jarrett P

    更新日期:1987-01-01 00:00:00

  • The incidence of venous thromboembolism and its effect on survival among patients with primary bladder cancer.

    abstract:BACKGROUND:The incidence, risk factors, time course, and impact on survival of venous thromboembolism (VTE) in a large, population-based study of patients with bladder cancer have not been identified previously. METHODS:The California Cancer Registry was merged with the California Patient Discharge Data Set to determi...

    journal_title:Cancer

    pub_type: 杂志文章

    doi:10.1002/cncr.25004

    authors: Sandhu R,Pan CX,Wun T,Harvey D,Zhou H,White RH,Chew HK

    更新日期:2010-06-01 00:00:00

  • Esophageal dilation in malignant dysphagia.

    abstract::Esophageal dilation by means of guided Neoplex (Medoc) tubes in 38 patients with malignant obstruction of the esophagus was analyzed. Peroral dilation proved to be a simple, well-tolerated primary procedure in the management of malignant strictures. Most patients have a temporary improvement of dysphagic symptoms, but...

    journal_title:Cancer

    pub_type: 杂志文章

    doi:10.1002/1097-0142(19851201)56:11<2713::aid-cncr282

    authors: Aste H,Munizzi F,Martines H,Pugliese V

    更新日期:1985-12-01 00:00:00

  • Combined chemotherapy and surgery in breast cancer: a review.

    abstract::The current results of trials testing combined surgery and chemotherapy in patients with breast cancer is reviewed. Information concerning eight trials utilizing nine single-agent regimens was obtained. The results at this time are conflicting. There appear to be differences among the regimens utilized in the various ...

    journal_title:Cancer

    pub_type: 杂志文章,评审

    doi:10.1002/1097-0142(197509)36:3<881::aid-cncr2820360

    authors: Tormey DC

    更新日期:1975-09-01 00:00:00

  • Prediction of malignant transformation in oral epithelial lesions by image cytometry.

    abstract::The value of image analysis in predicting the malignant potential of oral epithelial lesions showing either hyperplasia or dysplasia was investigated; 5-micron formalin-fixed sections of 16 oral epithelial lesions, of which eight had later transformed to carcinoma and eight had not transformed during a follow-up of 10...

    journal_title:Cancer

    pub_type: 杂志文章

    doi:10.1002/1097-0142(19881101)62:9<1981::aid-cncr2820

    authors: Abdel-Salam M,Mayall BH,Chew K,Silverman S Jr,Greenspan JS

    更新日期:1988-11-01 00:00:00

  • Restoration of defective EAG-rosetting capacity of cancer patient neutrophils by levamisole.

    abstract::Levamisole, used in vitro at therapeutic concentrations, was found able to restore the defective Fc-receptor activity of cancer patient neutrophils. In addition, the drug prevented the inhibition of normal neutrophils Fc-receptor function by cancer patient sera. The neutrophil Fc-receptor function was also restored in...

    journal_title:Cancer

    pub_type: 杂志文章

    doi:10.1002/1097-0142(19850415)55:8<1668::aid-cncr2820

    authors: Patrone F,Dallegri F,Pistoia V,Ghio R,Sacchetti C

    更新日期:1985-04-15 00:00:00

  • Factor VIII related antigen in adenomatoid tumors: implications for histogenesis.

    abstract::The current study was undertaken to reevaluate the histogenesis of adenomatoid tumor by an immunoperoxidase method of detecting factor VIII related antigen, a tissue specific marker for vascular endothelium. Three of eight adenomatoid tumors showed diffuse cytoplasmic staining of the cells lining the lumina. When thes...

    journal_title:Cancer

    pub_type: 杂志文章

    doi:10.1002/1097-0142(19820901)50:5<932::aid-cncr28205

    authors: Bell DA,Flotte TJ

    更新日期:1982-09-01 00:00:00

  • Predictors and outcomes of surgeons' referral of older breast cancer patients to medical oncologists.

    abstract:BACKGROUND:Older women are less likely than younger women to receive definitive care for a new diagnosis of breast cancer, but the reasons are not well understood. Although coordination of referral among specialists is an important component of quality of care, it has not been studied as a factor that contributes to ob...

    journal_title:Cancer

    pub_type: 杂志文章

    doi:10.1002/cncr.21256

    authors: Thwin SS,Fink AK,Lash TL,Silliman RA

    更新日期:2005-09-01 00:00:00

  • Myeloma of the head of the pancreas. A case report.

    abstract::A 45-year-old man was diagnosed with multiple myeloma, IgA-kappa, in 1975. Thirteen years later he presented with obstructive jaundice. Computed tomography (CT) showed a 6-cm mass in the head of the pancreas. Needle aspiration showed myeloma. The jaundice resolved after treatment with radiotherapy. Extraosseous involv...

    journal_title:Cancer

    pub_type: 杂志文章

    doi:10.1002/1097-0142(19910201)67:3<681::aid-cncr28206

    authors: Fischer A,Suhrland MJ,Vogl SE

    更新日期:1991-02-01 00:00:00

  • Prevalence and clinical implications of cyclin D1 expression in diffuse large B-cell lymphoma (DLBCL) treated with immunochemotherapy: a report from the International DLBCL Rituximab-CHOP Consortium Program.

    abstract:BACKGROUND:Cyclin D1 expression has been reported in a subset of patients with diffuse large B-cell leukemia (DLBCL), but studies have been few and generally small, and they have demonstrated no obvious clinical implications attributable to cyclin D1 expression. METHODS:The authors reviewed 1435 patients who were diag...

    journal_title:Cancer

    pub_type: 杂志文章

    doi:10.1002/cncr.28664

    authors: Ok CY,Xu-Monette ZY,Tzankov A,O'Malley DP,Montes-Moreno S,Visco C,Møller MB,Dybkaer K,Orazi A,Zu Y,Bhagat G,Richards KL,Hsi ED,Han van Krieken J,Ponzoni M,Farnen JP,Piris MA,Winter JN,Medeiros LJ,Young KH

    更新日期:2014-06-15 00:00:00

  • Risk assessment of patients with hematologic malignancies who develop fever accompanied by pulmonary infiltrates: a historical cohort study.

    abstract:BACKGROUND:The mortality rate associated with fever accompanied by pulmonary infiltrates after chemotherapy for hematologic malignancies remains higher than the corresponding rate associated with febrile neutropenia without pulmonary infiltrates. Nonetheless, few studies have focused on the factors that predict outcome...

    journal_title:Cancer

    pub_type: 杂志文章

    doi:10.1002/cncr.20406

    authors: Offidani M,Corvatta L,Malerba L,Marconi M,Bichisecchi E,Cecchini S,Manso E,Principi T,Gasparini S,Leoni P

    更新日期:2004-08-01 00:00:00

  • P-glycoprotein expression in canine lymphoma: a relevant, intermediate model of multidrug resistance.

    abstract:BACKGROUND:Despite extensive investigation, the role of MDR of human cancer remains unclear. Canine lymphoma is a spontaneously arising correlate of human non-Hodgkin's lymphoma that may complement other in vivo models for investigation of issues related to MDR. METHODS:Immunoreactivity of primary antibodies to the hu...

    journal_title:Cancer

    pub_type: 杂志文章

    doi:10.1002/(SICI)1097-0142(19960501)77:9<1892::AID-CN

    authors: Lee JJ,Hughes CS,Fine RL,Page RL

    更新日期:1996-05-01 00:00:00

  • Cost effectiveness of proton therapy compared with photon therapy in the management of pediatric medulloblastoma.

    abstract:BACKGROUND:Proton therapy has been a hotly contested issue in both scientific publications and lay media. Proponents cite the modality's ability to spare healthy tissue, but critics claim the benefit gained from its use does not validate its cost compared with photon therapy. The objective of this study was to evaluate...

    journal_title:Cancer

    pub_type: 杂志文章

    doi:10.1002/cncr.28322

    authors: Mailhot Vega RB,Kim J,Bussière M,Hattangadi J,Hollander A,Michalski J,Tarbell NJ,Yock T,MacDonald SM

    更新日期:2013-12-15 00:00:00

  • Spontaneous regression of a small non-cleaved cell malignant lymphoma (non-Burkitt's lymphoblastic lymphoma). Morphologic, immunohistological, and immunoglobulin gene analysis.

    abstract::Complete spontaneous regression of high-grade malignant non-Hodgkin's lymphoma is extremely unusual. In this report the authors describe a complete spontaneous remission after surgical excisional biopsy of a small noncleaved cell malignant lymphoma (non-Burkitt's lymphoblastic lymphoma) of the tonsil in a 12-year-old ...

    journal_title:Cancer

    pub_type: 杂志文章

    doi:10.1002/1097-0142(19880815)62:4<791::aid-cncr28206

    authors: Poppema S,Postma L,Brinker M,de Jong B

    更新日期:1988-08-15 00:00:00

  • Overexpression of p53 and prognosis in breast cancer.

    abstract:BACKGROUND:Assessment of prognostic markers in breast cancer independent of the axillary lymph node status is of major concern for the application of adjuvant treatment regimens. The current treatment decision is based mainly on the axillary lymph node status. Because of improved screening methods, the number and propo...

    journal_title:Cancer

    pub_type: 杂志文章

    doi:10.1002/1097-0142(19931215)72:12<3641::aid-cncr282

    authors: Friedrichs K,Gluba S,Eidtmann H,Jonat W

    更新日期:1993-12-15 00:00:00

  • Cytologic features of renal medullary carcinoma.

    abstract:BACKGROUND:Renal medullary carcinoma is a rare tumor that is most common in young black men with sickle cell disease or trait. Patients often present with advanced disease at the time of diagnosis, and their prognosis is poor, even with aggressive therapy. The clinical and pathologic features of renal medullary carcino...

    journal_title:Cancer

    pub_type: 杂志文章

    doi:10.1002/cncr.20764

    authors: Assad L,Resetkova E,Oliveira VL,Sun W,Stewart JM,Katz RL,Caraway NP

    更新日期:2005-02-25 00:00:00

  • A phase II trial of dexamethasone, vitamin D, and carboplatin in patients with hormone-refractory prostate cancer.

    abstract:BACKGROUND:A Phase II prospective trial was performed to study the efficacy of combination therapy with dexamethasone, calcitriol (1,25-dihydroxyvitamin D3), and carboplatin in patients with hormone-refractory prostate cancer (HRPC). Preclinical data from prostate cancer cell lines suggested a synergistic effect of the...

    journal_title:Cancer

    pub_type: 杂志文章

    doi:10.1002/cncr.21982

    authors: Flaig TW,Barqawi A,Miller G,Kane M,Zeng C,Crawford ED,Glodé LM

    更新日期:2006-07-15 00:00:00

  • Oncofertility and preservation of reproductive capacity in children and young adults.

    abstract::With increasing numbers of survivors from cancer at a young age, the issue of fertility preservation has assumed greater importance. This review describes normal ovarian and testicular function and summarizes what is known about the effect of chemotherapy and radiotherapy on the gonads and uterus. All young patients w...

    journal_title:Cancer

    pub_type: 杂志文章,评审

    doi:10.1002/cncr.26045

    authors: Wallace WH

    更新日期:2011-05-15 00:00:00

  • Thymoma. Histologic subclassification is an independent prognostic factor.

    abstract:BACKGROUND:Several histologic classifications of thymomas have been proposed, and attempts have been made to correlate the different histologic subtypes to clinical behavior and prognosis. Recently, Marino and Müller-Hermelink and Kirchner et al. proposed a new morphologic classification of thymomas based on the resemb...

    journal_title:Cancer

    pub_type: 杂志文章

    doi:10.1002/1097-0142(19940715)74:2<606::aid-cncr28207

    authors: Quintanilla-Martinez L,Wilkins EW Jr,Choi N,Efird J,Hug E,Harris NL

    更新日期:1994-07-15 00:00:00

  • Atypical squamous cells of undetermined significance: a comparative review of original and automated rescreen diagnosis of cervicovaginal smears with long term follow-up.

    abstract:BACKGROUND:There is an increasing number of articles regarding the long term follow-up of Papanicolaou (Pap) smears with the diagnosis of atypical squamous cells of undetermined significance (ASCUS). Much controversy exists regarding the management of patients with this diagnosis. In a prior study in 1992, the authors ...

    journal_title:Cancer

    pub_type: 杂志文章

    doi:10.1002/(sici)1097-0142(19971225)81:6<348::aid-cnc

    authors: Stastny JF,Remmers RE,London WB,Pedigo MA,Cahill LA,Ryan M,Frable WJ

    更新日期:1997-12-25 00:00:00

  • Correlation between annual volume of cystectomy, professional staffing, and outcomes: a statewide, population-based study.

    abstract:BACKGROUND:The association between high procedure volume and lower perioperative mortality is well established among cancer patients who undergo cystectomy. However, to the authors' knowledge, the association between volume and perioperative complications has not been studied to date and hospital characteristics contri...

    journal_title:Cancer

    pub_type: 杂志文章

    doi:10.1002/cncr.21273

    authors: Elting LS,Pettaway C,Bekele BN,Grossman HB,Cooksley C,Avritscher EB,Saldin K,Dinney CP

    更新日期:2005-09-01 00:00:00

  • A prospective study of immune responsiveness in human melanoma. I. Assessment of initial pretreatment status with stage of disease.

    abstract::The clinical findings in 262 patients with melanoma were correlated with an assessment of their cellular-mediated immunity by delayed-type hypersensitivity (DTH) skin tests, by lymphocyte blastogenesis, and by leukocyte enumerations. Patients with systemic metastases (stage IV) and those with evidence of tumor burden ...

    journal_title:Cancer

    pub_type: 杂志文章

    doi:10.1002/1097-0142(197806)41:6<2165::aid-cncr282041

    authors: Pritchard DJ,Ritts RE Jr,Taylor WF,Miller GC

    更新日期:1978-06-01 00:00:00

  • Tn, a carcinoma-associated antigen, reacts with anti-Tn of normal human sera.

    abstract::Tn antigen is the immediate precursor of the carcinoma (CA)-associated T antigen; both are masked in non-CA tissues. Tn antigen was detected by absorption of human anti-Tn antibody in 46 of 50 primary breast CAs and in all 6 metastases originating from Tn-positive primary CAs. Thirteen of 25 (52%) anaplastic CAs, but ...

    journal_title:Cancer

    pub_type: 杂志文章

    doi:10.1002/1097-0142(19850201)55:3<561::aid-cncr28205

    authors: Springer GF,Taylor CR,Howard DR,Tegtmeyer H,Desai PR,Murthy SM,Felder B,Scanlon EF

    更新日期:1985-02-01 00:00:00

  • Isolated vaginal recurrences of endometrial adenocarcinoma and their management.

    abstract::Eighteen patients with isolated vaginal recurrence of their previously treated endometrial carcinoma were treated with radiation therapy at North Carolina Baptist Hospital, Winston-Salem between 1971 and 1982. Most patients received external beam irradiation which were followed by boost treatments that were delivered ...

    journal_title:Cancer

    pub_type: 杂志文章

    doi:10.1002/1097-0142(19870801)60:3<419::aid-cncr28206

    authors: Greven K,Olds W

    更新日期:1987-08-01 00:00:00