Tailored community cancer education programs: Pawsox and prostates.

To assess the prostate cancer screening practices in Rhode Island, we designed a questionnaire which was sent to 150 primary care physicians. A population-based survey was distributed to 194 men over 40 asking about screening history and risk factors. Eighty-five percent of primary care physicians reported performing annual prostate-specific antigen tests (PSAs) and digital rectal exams, 63% recognized family history as a risk factor, and 14% identified African Americans as a high-risk population. The survey found that 48% of men recognized family history as a risk factor and 6% understood that African Americans were at high risk. Each year, 200 men, primarily SED, are invited to a PawSox baseball game where physicians provide information on prostate cancer risk, treatment options, and outcomes. Free PSAs are provided. The questionnaire and survey demonstrate a need for more public education regarding prostate cancer in high-risk populations. Tailored community-based interventions, such as the Pawsox & Prostate program, can be effective professional and public education strategies to increase screening in high-risk populations.

Socioeconomic correlates of current and regular smoking among college students in Rhode Island.

OBJECTIVE: The objective of this study was to determine how sociodemographic variables, in particular socioeconomic status, correlate with current and regular smoking among college students in Rhode Island. PARTICIPANTS AND METHODS: Over a 4-year period (academic year 2000--2001 to 2003--2004), the authors examined sociodemographic correlates of cigarette use among 3,984 students aged 17 to 24 years from 10 colleges and universities in Rhode Island. RESULTS: One-third of participants (32.0%) had smoked a cigarette in the 30 days preceding the questionnaire. Findings from a pair of logistic regression models indicated that participants from upper-income families were more likely to be current smokers--although not regular smokers--suggesting that the effect of socioeconomic status on smoking is partly dependent on the level of addiction. In addition, freshmen were more likely to be current and regular smokers than were upperclassmen, and white students were most likely to be regular smokers. CONCLUSIONS: The frequency of college students who reported that they first tried smoking and first smoked regularly while in college increased from freshman to senior year, indicating that the college years are a vulnerable period for smoking initiation and habituation.

Metachronous cancer.

Metachronous cancer (multiple primary tumors developing at intervals) will appear more commonly as cancer patients live longer lives. In this report, we use data from the Rhode Island Cancer Registry to look at commonly occurring metachronous cancers, their frequency over time, and the implications for cancer survivorship. Sequence two (refers to the chronologically second primary tumor diagnosed for a given patient) and higher primary malignant neoplasms were identified in cancer case reports made to the Rhode Island Cancer Registry, 1987-2009, and used to construct annual, age-adjusted, sequence-specific incidence rates for all cancers combined, and age-adjusted, site-specific incidence rates for common second and higher-order primary malignant neoplasms over the entire observational period. During the period of observation, the proportion of all cancers diagnosed as sequence two and higher primary tumors among males increased steadily from 11.5 to 20.3 percent, while the proportion of all cancers diagnosed as sequence two and higher primary tumors among females increased from 12.8 to 20.7 percent. A mere four cancer types--lung (and bronchus), colon (and rectum), breast, and prostate--account for over half of all sequence two and higher cancer diagnoses (54.3 percent). The average interval between first cancers and second cancers is 6.5 years for men and 4.8 years for women. Such is the "career" of a cancer survivor today that he or she has about a one in four chance of developing a second cancer. This statistic suggests the need for strong and lasting social support networks. Furthermore, the average interval between first and second cancers is substantial, and suggests opportunities for interventions (prevention and screening) that might reduce the burden of sequence two and higher cancers.

Impact of high-dose chemotherapy on the ability to deliver subsequent local-regional radiotherapy for breast cancer: analysis of Cancer and Leukemia Group B Protocol 9082.

PURPOSE: To report, from Cancer and Leukemia Group B Protocol 9082, the impact of high-dose cyclophosphamide, cisplatin, and BCNU (HD-CPB) vs. intermediate-dose CPB (ID-CPB) on the ability to start and complete the planned course of local-regional radiotherapy (RT) for women with breast cancer involving >or=10 axillary nodes. METHODS AND MATERIALS: From 1991 to 1998, 785 patients were randomized. The HD-CPB and ID-CPB arms were balanced regarding patient characteristics. The HD-CPB and ID-CPB arms were compared on the probability of RT initiation, interruption, modification, or incompleteness. The impact of clinical variables and interactions between variables were also assessed. RESULTS: Radiotherapy was initiated in 82% (325 of 394) of HD-CPB vs. 92% (360 of 391) of ID-CPB patients (p = 0.001). On multivariate analyses, RT was less likely given to patients who were randomized to HD treatment (odds ratio [OR] = 0 .38, p < 0.001), older (p = 0.005), African American (p = 0.003), postmastectomy (p = 0.02), or estrogen receptor positive (p = 0.03). High-dose treatment had a higher rate of RT interruption (21% vs. 12%, p = 0.001, OR = 2.05), modification (29% vs. 14%, p = 0.001, OR = 2.46), and early termination of RT (9% vs. 2%, p = 0.0001, OR = 5.35), compared with ID. CONCLUSION: Treatment arm significantly related to initiation, interruption, modification, and early termination of RT. Patients randomized to HD-CPB were less likely to initiate RT, and of those who did, they were more likely to have RT interrupted, modified, and terminated earlier than those randomized to ID-CPB. The observed lower incidence of RT usage in African Americans vs. non-African Americans warrants further study.