Cancer Informatics for Cancer Centers (CI4CC): Building a Community Focused on Sharing Ideas and Best Practices to Improve Cancer Care and Patient Outcomes.

Cancer Informatics for Cancer Centers (CI4CC) is a grassroots, nonprofit 501c3 organization intended to provide a focused national forum for engagement of senior cancer informatics leaders, primarily aimed at academic cancer centers anywhere in the world but with a special emphasis on the 70 National Cancer Institute-funded cancer centers. Although each of the participating cancer centers is structured differently, and leaders' titles vary, we know firsthand there are similarities in both the issues we face and the solutions we achieve. As a consortium, we have initiated a dedicated listserv, an open-initiatives program, and targeted biannual face-to-face meetings. These meetings are a place to review our priorities and initiatives, providing a forum for discussion of the strategic and pragmatic issues we, as informatics leaders, individually face at our respective institutions and cancer centers. Here we provide a brief history of the CI4CC organization and meeting highlights from the latest CI4CC meeting that took place in Napa, California from October 14-16, 2019. The focus of this meeting was "intersections between informatics, data science, and population science." We conclude with a discussion on "hot topics" on the horizon for cancer informatics.

Human Subjects Protection and Cancer Surveillance Research: Revised Regulations, Expanded Opportunities.

On January 19, 2017, the United States federal government issued revisions to the Common Rule under which scientists who receive federal funding conduct research involving human subjects. The revised Common Rule expressly addresses public health surveillance in relation to scientific research and the protection of human subjects, and its impacts are anticipated to contribute to the efficiency of activities, including cancer registration and surveillance, and research that uses cancer registry data. Cancer Res; 77(12); 3140-3. ©2017 AACR.

Age, period, and cohort effects in adult lifetime asthma prevalence in California: an application of hierarchical age-period-cohort analysis.

PURPOSE: Using 27 years of survey data, the contributions of age, period, and cohort effects on the increase in adult lifetime asthma prevalence in California were examined. METHODS: Lifetime asthma diagnosis for adults was assessed in 1984-1992 and 1995-2011 through the California Behavioral Risk Factor Surveillance System, an annual, cross-sectional, population-based survey (n = 144,100). Using date of survey and date of birth, we classified 18,305 adult respondents with lifetime asthma into 7 age groups, 6 periods, and 17 cohorts. Using hierarchical, cross-classified random effects models, birth cohort, period, and age patterns in adult lifetime asthma prevalence were analyzed. RESULTS: After adjusting for sex, ethnicity, education, and smoking, age effects peak in young adulthood, flatten from 40 to 60 years old, and then decrease in older adulthood. A significant positive trend in asthma prevalence was observed in the two earliest survey periods (1984-1993; P value < .0001). Survey period trends appear to flatten beginning in 2004. Although the overall birth cohort effect was statistically significant, the magnitude of the effect for each birth cohort category was small (P value = .0005). CONCLUSIONS: We observed that strong age and period effects have been driving the increase in lifetime asthma prevalence in California over the past 3 decades.

Prevalence of medical marijuana use in California, 2012.

INTRODUCTION AND AIMS: The US Drug Enforcement Agency classifies marijuana as an illegal substance, yet in 22 states marijuana is legal for medicinal use. In 1996, California legalised the use of marijuana for medicinal purposes, but population-based data describing medical marijuana users in the state has not been available. Our aim was to examine the demographic differences between users and non-users of medical marijuana in California utilising population-based data. DESIGN AND METHODS: We used data from the California Behavioral Risk Factor Surveillance System 2012, an annual, random-digit-dial state-wide telephone survey that collects health data from a representative adult sample (n = 7525). Age-adjusted prevalence rates were estimated. RESULTS: Five percent of adults in California reported ever using medical marijuana, and most users believed that medical marijuana helped alleviate symptoms or treat a serious medical condition. Prevalence was similar when compared by gender, education and region. Prevalence of ever using medical marijuana was highest among white adults and younger adults ages 18-24 years, although use was reported by every racial/ethnic and age group examined in our study and ranged from 2% to 9%. CONCLUSIONS: Our study's results lend support to the idea that medical marijuana is used equally by many groups of people and is not exclusively used by any one specific group. As more states approve marijuana use for medical purposes, it is important to track medical marijuana use as a health-related behaviour and risk factor.

Chronic disease burden among cancer survivors in the California Behavioral Risk Factor Surveillance System, 2009-2010.

PURPOSE: The California Behavioral Risk Factor Surveillance System estimates that 56.6 % of cancer survivors report ever being diagnosed with a chronic disease. Few studies have assessed potential variability in comorbidity by cancer type. METHODS: We used data collected from a representative sample of adult participants in the 2009 and 2010 California Behavioral Risk Factor Surveillance System (n = 18,807). Chronic diseases were examined with cancer survivorship in case/non-case and case/case analyses. Prevalence ratios (PR) and corresponding 95 % confidence intervals (95 % CI) were estimated using Cox proportional hazards models, with adjustment on race, sex, age, education, smoking, and drinking. RESULTS: Obesity was associated with gynecological cancers (PR 1.74; 95 % CI 1.26-2.41), and being overweight was associated with gynecological (PR 1.40; 95 % CI 1.05-1.86) and urinary (PR 2.19; 95 % CI 1.21-3.95) cancers. Arthritis was associated with infection-related (PR 1.78; 95 % CI 1.12-2.83) and hormone-related (PR 1.20; 95 % CI 1.01-1.42) cancers. Asthma was associated with infection- (PR 2.26; 95 % CI 1.49-3.43), hormone- (PR 1.46; 95 % CI 1.21-1.77), and tobacco- (PR 1.86; 95 % CI 1.25-2.77) related cancers. Chronic obstructive pulmonary disease (COPD) was associated with infection- (PR 2.16; 95 % CI 1.22-3.83) and tobacco-related (PR 2.24; 95 % CI 1.37-3.66) cancers and with gynecological cancers (PR 1.60; 95 % 1.00-2.56). CONCLUSIONS: This is the first study to examine chronic disease burden among cancer survivors in California. Our findings suggest that the chronic disease burden varies by cancer etiology. IMPLICATIONS FOR CANCER SURVIVORS: A clear need has emerged for future biological and epidemiological studies of the interaction between chronic disease and cancer etiology in survivors.

Current depression among women in California according to residence in the California—Mexico border region / Depresión actual en las mujeres en California según el lugar de residencia en la región fronteriza entre California y México

Objective. To estimate the prevalence of current depression; examine the relationshipbetween current depression and immigration, health status, health care access, and healthbehaviors; and assess differences by California–Mexico border region (Imperial and San DiegoCounties) among women in California.Methods. Using a cross-sectional, representative sample of adult women from the CaliforniaWomen’s Health Survey (n = 13 454), a statewide telephone survey, prevalence of currentdepression and predictors of depression were examined in California and according to borderregion residence. Depression was assessed with the eight-item Patient Health Questionnaire.Results. The prevalence of current depression for women in California was 12.0%. It wassimilar in the border (13.0%) and the nonborder (11.9%) regions. Odds of current depressionin women were lower among recent immigrants (< 5 years or 5 to < 10 years in the UnitedStates) than in women born in the United States and in immigrants who had been living inthe United States for 10 to < 15 years or longer (P < 0.05). Odds ratios for current depressionand health status, health care access, and binge drinking were larger in the border region thanoutside the border region.Conclusions. Similar prevalences of current depression were observed among those wholive in the border region of California and in those who do not, but the relationship betweendepression and health status, health care access, and binge drinking varied by border regionresidence. Ideally, future surveillance of depression and its predictors along the Mexico–California border will be conducted binationally to inform interventions and tracking such asthe Healthy Border Program’s objectives.

Patterns of clinically significant symptoms of depression among heavy users of alcohol and cigarettes.

INTRODUCTION: Depression is among the most prevalent and treatable diseases, and it is associated with cigarette smoking and heavy alcohol use. This study estimates the prevalence of depression, its variation among demographic subgroups, and its association with heavy alcohol use and cigarette smoking in California. METHODS: The 2006 California Behavioral Risk Factor Surveillance System (BRFSS) includes the 8-item Patient Health Questionnaire, a standardized instrument used to measure depressive symptoms. We used findings from the 2006 BRFSS to calculate the prevalence of depression in California; we used logistic models to explore the relationships between depression, alcohol use, and smoking. RESULTS: We found that 9.2% of adults in California had clinically significant depressive symptoms. Logistic models indicated that daily smokers were more than 3 times more likely to have clinically significant depressive symptoms than were nonsmokers, and heavy drinkers were approximately 3 times more likely to have clinically significant depressive symptoms than were nondrinkers. CONCLUSION: Because heavy alcohol use and daily smoking are each associated with depression, people who do both may be at an increased risk for depression. This is a public health issue because people who drink alcohol often also smoke and vice versa. Intervention efforts might target persons who are users of both these drugs, and practitioners should be aware that smokers who are heavy alcohol users are at an increased risk for depression.