ABSTRACT
BACKGROUND: Data-linkage studies have reported an association between congenital anomalies and childhood cancer. However, few studies have focused on the differences in the effect of congenital anomalies on cancer as a function of attained age. We aimed to examine associations between anomalies and childhood cancer as a function of attained age among children born in Oklahoma. METHODS: Data were obtained from the Oklahoma State Department of Health from 1997 to 2009 (n = 591,235). We linked Vital Statistics records for singleton deliveries to the Oklahoma Birth Defects Registry and the Oklahoma Central Cancer Registry using name and birth date. To assess the relation between anomalies and childhood cancer, we used Cox regression analysis allowing for a nonproportional hazards for anomalies as a function of age. RESULTS: There were 23,368 (4.0%) children with anomalies and 531 (0.1%) children with cancer. When considering 3-year age intervals, we detected an increased hazard of any childhood cancer in children with anomalies compared with those without anomalies before 1 year of age (hazard ratio, 14.1; 95% confidence interval, 8.3-23.7) and at 3 years of age (hazard ratio, 2.3; 95% confidence interval, 1.6-3.2). The increased hazard declined with increasing time since birth, with the effect diminished by 6 years of age. CONCLUSION: Our results were consistent with previous studies indicating an increased rate of childhood cancer among children with anomalies at younger ages. Furthermore, our study added a methodological refinement of assessing the effect of anomalies as a function of attained age. Birth Defects Research (Part A) 106:633-642, 2016. © 2016 Wiley Periodicals, Inc.
Subject(s)
Congenital Abnormalities/epidemiology , Neoplasms/epidemiology , Age Factors , Child , Child, Preschool , Female , Follow-Up Studies , Humans , Infant , Infant, Newborn , Male , Oklahoma/epidemiology , Retrospective StudiesABSTRACT
BACKGROUND: This study describes overall and site specific cancer incidence among AI/ANs compared to whites in Oklahoma and differences in cancer staging. METHODS: Age-adjusted incidence rates obtained from the Oklahoma Central Cancer Registry are presented for all cancer sites combined and for the most common cancer sites among AI/ANs with comparisons to whites. Percentages of late stage cancers for breast, colorectal, and melanoma cancers are also presented. RESULTS: AI/ANs had a significantly higher overall cancer incidence rate compared to whites (629.8/100,000 vs. 503.3/100,000), with a rate ratio of 1.25 (95% CI: 1.22, 1.28). There was a significant disparity in the percentage of late stage melanoma cancers between 2005 and 2009, with 14.0% late stage melanoma for whites and 20.0% for AI/ANs (p-value:0.03). CONCLUSIONS: Overall, there were cancer disparities between AI/ANs and whites in Oklahoma. Incidence rates were higher among AI/ANs for all cancers and many site specific cancers.
Subject(s)
Indians, North American/statistics & numerical data , Neoplasms/ethnology , Neoplasms/pathology , White People/statistics & numerical data , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Health Status Disparities , Humans , Incidence , Infant , Infant, Newborn , Male , Middle Aged , Neoplasm Staging , Oklahoma/epidemiology , Population Surveillance , Young AdultABSTRACT
The purpose of this study was to explore the impact of Medicaid on changes in coverage among women with newly diagnosed breast cancers, in the first years of program implementation. Women and their providers used the program, with nearly double the number of women covered by Medicaid in the three years after implementation. The treatment program, as implemented in Oklahoma, reached the target population and provided coverage to women who previously had none. The study found a promising, though nonsignificant, reduction in the time between diagnosis and treatment among women diagnosed with breast cancer when Medicaid was their primary payer.
