Publications

Lee Argov EJ, Rodriguez CB, Agovino M, Schmitt KM, Desperito E, Karr AG, Wei Y, Terry MB, Tehranifar P. Cancer Causes Control. 2024 Aug;35(8):1133-1142. doi: 10.1007/s10552-024-01871-7. Epub 2024 Apr 12.PMID: 38607569

Public Abstract: Purpose: Dense breast notification (DBN) laws inform women about their breast density and how it affects their breast cancer risk and mammogram results. However, it's unclear how these notifications affect whether women keep getting mammograms. This study looked at how DBN in New York State (NYS) influenced future mammogram screenings in a mostly Hispanic/Latina group of women. Methods: From 2016 to 2018, women aged 40-60 were surveyed in either English or Spanish (33% in English, 67% in Spanish) when they came in for a mammogram. We used their mammogram records from 2013 (when NYS started DBN) to the time they joined the study to see if they had received a DBN before. We then categorized them into six groups based on whether and when they received DBN, and compared how many mammograms they had (0, 1, or more than 2) between 10 and 30 months after they joined the study. We analyzed this data using a statistical method. Results: In a group of 728 women (78% born outside the U.S., 72% Hispanic, 46% with a high school education or less), women who were getting screened for the first time and those who received DBN for the first time after having non-dense mammograms had significantly fewer mammograms in the following 30 months compared to women who had prior mammograms but never received DBN. There were no differences in future mammogram frequency between women who had received multiple DBNs and those who had never received one. These results were consistent across different age groups, languages, levels of health literacy, and education. Conclusion: Women who received their first DBN after previously having non-dense mammograms were less likely to continue with regular mammograms within the next 2.5 years. DBN did not significantly affect mammogram participation for first-time screeners or those with consistently dense breasts.

Acheampong T, Kehm RD, Terry MB, Argov EL, Tehranifar P.JAMA Netw Open. 2020 Aug 3;3(8):e2013226. doi: 10.1001/jamanetworkopen.2020.13226.PMID: 32804214 Free PMC article.

Public Abstract: Importance: Breast cancer rates in the U.S. vary by age and race/ethnicity, but it's less clear if these differences apply to specific breast cancer subtypes, which have their own risk factors and outcomes.

Objective: This study aimed to estimate the yearly changes and trends in breast cancer subtype rates based on age and race/ethnicity.

Design, Setting, and Participants: This study analyzed data from 18 cancer registries in the SEER database, covering 27.8% of the U.S. population. It included Hispanic and non-Hispanic White, Black, and Asian/Pacific Islander women aged 25 to 84 diagnosed with invasive breast cancer between 2010 and 2016. Data analysis occurred between September 2019 and February 2020.

Exposures: The study focused on differences in breast cancer rates based on age and race/ethnicity.

Main Outcomes and Measures: Researchers calculated the yearly percentage change (APC) and confidence intervals (CIs) for breast cancer rates, grouped by 15-year age ranges and race/ethnicity.

Results: The study included 320,124 women diagnosed with breast cancer between 2010 and 2016. Key findings include:

• Luminal B breast cancer rates increased across all age groups for non-Hispanic White women, Hispanic women, and for non-Hispanic Asian/Pacific Islander women aged 55 to 69.
• ERBB2-enriched breast cancer rates rose in young non-Hispanic White women aged 25 to 39.
• Triple-negative breast cancer rates decreased among non-Hispanic White women aged 40 to 69 and non-Hispanic Black women aged 55 to 69.

Conclusions and Relevance: Between 2010 and 2016, rates of luminal A and B breast cancers increased in many racial/ethnic and age groups, with the biggest rise in luminal B cases. ERBB2-enriched cancer rates went up among young non-Hispanic White women, while triple-negative cancer rates decreased in middle-aged non-Hispanic White and Black women. These trends may show changes in breast cancer risk factors across different age and racial/ethnic groups.

Tehranifar P, Neugut AI, Phelan JC, Link BG, Liao Y, Desai M, Terry MB. Cancer Epidemiol Biomarkers Prev. 2009 Oct;18(10):2701-8. doi: 10.1158/1055-9965.EPI-09-0305. Epub 2009 Sep 29.PMID: 19789367 Free PMC article.

Public Abstract: Background: Advances in early cancer detection and treatment have improved overall survival rates, but not all racial and ethnic groups benefit equally. This can lead to growing survival differences between these groups.

Methods: This study looked at cancer cases from the SEER program, focusing on adults aged 20 and older who were diagnosed with one invasive cancer between 1995 and 1999 (580,225 cases). The researchers used 5-year survival rates to create an "amenability index," which measures how well different cancers can be treated (reflecting advances in screening and treatment). They then compared survival rates between racial and ethnic minority patients and white patients, considering factors like gender, age, stage of disease, and poverty levels in the counties where patients lived. Cancers were grouped into three categories based on how treatable they were: non-amenable (less than 40% 5-year survival), partly amenable (40-69% 5-year survival), and mostly amenable (70% or higher 5-year survival).

Results: As cancers became more treatable, the survival gap between racial/ethnic minority patients and white patients grew larger, especially for African American, American Indian/Native Alaskan, and Hispanic adults. For example, compared to white patients, African American patients had worse survival rates as cancers became more treatable, with hazard ratios (a measure of risk) of 1.05 for non-amenable cancers, 1.38 for partly amenable cancers, and 1.41 for mostly amenable cancers. Asian/Pacific Islander patients generally had similar or better survival rates than white patients, though some Asian/Pacific Islander subgroups saw their survival rates worsen as cancers became more treatable.

Conclusions: The survival differences between most racial/ethnic minority groups and white adults become more noticeable as cancers become more treatable. This suggests that efforts to improve cancer care need to also focus on ensuring that advancements benefit all groups equally.