Hysterectomy-corrected incidence rates of cervical and uterine cancers in Massachusetts, 1995 to 2010.

PURPOSE: The aim was to provide ethnicity-specific incidence trends of cervical and uterine cancers uncorrected and corrected for the prevalence of hysterectomy in Massachusetts. METHODS: We used incidence data of invasive cervical (International Classification of Diseases for Oncology, Third Edition: C53) and uterine cancer (International Classification of Diseases for Oncology, Third Edition: C54-C55) diagnosed from 1995 to 2010 from the Massachusetts Cancer Registry. Data from the Behavioral Risk Factor Surveillance Survey for Massachusetts were used to model the ethnicity-specific prevalence of hysterectomy. We standardized rates by the US 2000 population standard for the periods 1995 to 1998, 1999 to 2002, 2003 to 2006, and 2007 to 2010. RESULTS: Depending on the period, corrected cervical cancer rates increased by 1.2 to 2.8, 5.6 to 8.3, and 3.2 to 8.2 per 100,000 person-years, and uterine cancer rates increased by 14.3 to 16.7, 14.8 to 29.3, and 6.7 to 15.4 per 100,000 person-years among white non-Hispanic women, black non-Hispanic women, and Hispanic women, respectively. Corrected estimated annual percentage changes increased for uterine cancer among black non-Hispanic women aged 60 years and older. Ethnic disparities between white non-Hispanic women and the other groups became smaller for uterine cancer and larger for cervical cancer after correction. DISCUSSION: Corrections of cervical and uterine cancer rates for hysterectomy prevalence are important as ethnic disparities, age patterns and time trends of cervical and uterine cancer incidence rates change.

Unhealthy weight control behaviors and related risk factors in Massachusetts middle and high school students.

Unhealthy weight control behaviors may be precursors to clinical eating disorders; therefore, it is important to identify these actions, and what may trigger them, as early as possible. We used 2009 and 2011 Massachusetts Youth Health Survey data for middle and high school students. We studied age, sex, and race disparities related to unhealthy weight control behaviors in conjunction with other risk factors such as body mass index (BMI), body weight perception, involvement in bullying, and depressive symptoms. The surveys were completed in public schools. Bivariate and multinomial regression analyses were conducted to assess associations between weight control behaviors and BMI categories, body weight perception, bullying involvement, and depressive symptoms. Poor body weight perception, bullying involvement, and depressive symptoms were associated with significantly elevated odds of reporting unhealthy weight control behaviors in both middle and high school students. Most patterns were consistent for middle and high school students, with obesity and bullying involvement being prevailing risks for high school students. Though females were more likely to report unhealthy weight control behaviors we also showed the rarely presented prevalence of male involvement in disordered eating behaviors including those who perceived themselves to be underweight. Health education classes and school-based interventions may be two strategies to help prevent the development of unhealthy weight control behaviors. Continuation of youth surveys that gather data on weight control behaviors and known risk factors is essential for observing changes in behaviors over time.

Perceived reactions to race and health status in the Massachusetts Behavioral Risk Factor Surveillance System Survey.

OBJECTIVES: Evaluate the relationship between race, perceptions of personally mediated racism and health outcomes in the Massachusetts Behavioral Risk Factor Surveillance System (BRFSS). METHODS: Regression analysis of 8,266 respondents to the Reactions to Race module in 2006 and 2008. Questions assessing personally mediated racism were combined to measure perceptions of reactions to race. OUTCOME MEASURES: Adjusted odds ratios and 95% CI of perceived personally mediated racism, self-reported overall health, life satisfaction, health risks (smoking status, obesity, binge and heavy drinking), and preventive services (colonoscopy, flu vaccine). RESULTS: Black non-Hispanic respondents are 10.4 times (95% CI: 6.3-17.3; P<.001) and Hispanics 5.8 times (95% CI: 3.6-9.4; P<.001) more likely to report being treated worse than other races compared to White non-Hispanic respondents. Respondents of all races reporting being treated worse than other races are 3.2 times (95% CI: 1.9-5.4; P<.001) more likely to have fair/poor health and 4.1 times (95% CI: 2.1-7.9; P<.001) more likely to report life dissatisfaction than those treated the same or better than other races. There is no statistically significant association between perceived personally mediated racism and health risks or preventive services tested. CONCLUSIONS: Perceptions of personally mediated racism are significantly associated with fair/poor overall health and life dissatisfaction, but none of the health risks or preventive services tested.

Health behaviors and quality of life of cancer survivors in Massachusetts, 2006: data use for comprehensive cancer control.

INTRODUCTION: Nearly 12 million cancer survivors are living in the United States. Few state-based studies have examined the health status and health-related quality of life (HRQOL) of this growing population. The objective of this study was to use Massachusetts Behavioral Risk Factor Surveillance System (BRFSS) data to describe cancer survivors' demographics, health behaviors, quality of life, use of preventive care services, and influenza vaccination rates. METHODS: The demographic characteristics of cancer survivors and respondents without cancer were estimated on the basis of responses to questions in the 2006 Massachusetts BRFSS. We used multivariate logistic regression to compare health behaviors, comorbidities, quality of life, and cancer screening and influenza vaccination rates for cancer survivors compared with respondents who did not have cancer. RESULTS: Cancer survivors and respondents who did not have cancer had similar rates of health behavioral risk factors including smoking, obesity, and physical activity. Rates of chronic disease (eg, heart disease, asthma) and disability were higher among cancer survivors. Cancer survivors reported higher rates of influenza vaccination and breast, colorectal, and cervical cancer screening than did respondents who did not have cancer. Survivors' self-reported health status and HRQOL (physical and mental health) improved as length of survivorship increased. CONCLUSION: This state-based survey allowed Massachusetts to assess health-related issues for resident cancer survivors. These findings will help state-based public health planners develop interventions to address the long-term physical and psychosocial consequences of cancer diagnosis and treatment.

The effects of a National Breast and Cervical Cancer Early Detection Program on social disparities in breast cancer diagnosis and treatment in Massachusetts.

OBJECTIVE: To assess social disparities in breast cancer diagnosis and treatment by comparing the stage at diagnosis and treatment of women diagnosed with breast cancer through a National Breast and Cervical Cancer Early Detection Program (NBCCEDP) for low income and uninsured women in Massachusetts, the Women's Health Network (WHN), to other breast cancer patients in the state. METHODS: We linked data from the WHN and the Massachusetts Cancer Registry (MCR). We compared 331 WHN women and 13,372 other breast cancer patients in Massachusetts diagnosed from 1995 to 1999. We used logistic regression, controlling for age, race/ethnicity, marital status, region of residence, and stage, where appropriate. RESULTS: Compared to other breast cancer patients reported to the MCR, WHN women were just as likely to be diagnosed at an advanced stage (III or IV), treated with surgery, chemotherapy, and hormone therapy, and treated with complete mastectomy versus partial mastectomy. WHN women were less likely to receive radiation therapy (odds ratio = 0.7; 95% confidence interval = 0.6-0.9), particularly after partial mastectomy, and had a slightly longer time from diagnosis to treatment than other breast cancer patients (p < 0.01). CONCLUSIONS: Women diagnosed with breast cancer through a NBCCEDP in Massachusetts had similar stage and treatment patterns as other breast cancer patients in the state, except for the use of radiation therapy.