(Press-News.org) Nearly a third of breast cancer survivors in Appalachia are not taking the critical, potentially life-saving follow-up treatment - despite having insurance that would pay for it, a troubling new study has found.
Researchers cross-examined cancer registries with Medicare claims data and determined that of 428 women, approximately 30 percent failed to follow through with their prescribed adjuvant hormone therapy, a treatment to prevent the cancer's recurrence.
"Almost a third of the prescriptions for adjuvant hormone therapy were not filled, which is much, much higher compared to what we usually see in commercially insured populations," said Rajesh Balkrishnan, PhD, of the University of Virginia School of Medicine's Department of Public Health Sciences. "Usually it ranges from about 10 [percent] to 15 percent, so this is almost double that. A third of the women going without adjuvant hormone therapy - that is a scary prospect."
Findings Published Online
The findings highlight a major problem in Appalachia, a region where cancer is a leading cause of death and access to healthcare can be a challenge. "This study was one of the first of its kind looking at this region, with not only severe socioeconomic deprivation but geographical barriers to care," Balkrishnan said. "Women often have to drive many miles to get to the nearest tertiary cancer center or the pharmacy."
Notably, the researchers found that women were more likely to stick with an older drug, tamoxifen, than with newer aromatase inhibitors. Balkrishnan said he suspects the findings speak to circumstances specific to the region. "One, the diffusion of newer technologies is much slower in Appalachia. Also, the other issue that comes to the forefront is that many of these medications have pretty severe side effects," he said. "I think what is also happening here is that there are high rates of discontinuance of the medication because a lot of patients are not counseled properly on how to manage the side effects of these medications and how to take medications in conjunction with other aspects of their lifestyles and daily living."
"Just having insurance doesn't seem to be enough," Balkrishnan said. "All the women we followed had Medicare Part D insurance [covering prescription medications]. But clearly in spite of insurance, the use and continuation of these medications, which is recommended at a level of 80 percent or higher, is not there in a third of the population."
Next Steps
The study is but the first step in a larger research project Balkrishnan plans to carry out. "Future studies need to tease out why these factors exist and maybe focus a little bit on intervention to improve access and use of essential, life-prolonging medication," he said.
He noted that the study used data collected before the implementation of the federal Affordable Care Act. "We need to see if policies which are being put in place to increase affordability and access to care are actually making a difference," he said.
INFORMATION:
The study results have been published by the scientific journal Medicine. The article was authored by Xi Tan, Vincent D. Marshall, Roger T. Anderson, Joseph Donohoe, Fabian Camacho and Balkrishnan.
ATLANTA--States' regulations of health insurance and practitioners significantly influence when patients receive colorectal or breast cancer diagnoses, especially among people younger than the Medicare-eligible age of 65, according to a new study by researchers at Georgia State University's School of Public Health and the University of North Carolina at Chapel Hill.
The study suggests that where people live is a strong predictor of whether they will receive potentially life-saving cancer screenings.
Dr. Lee Rivers Mobley, associate professor of spatial science and health ...
Oceans have absorbed up to 30 percent of human-made carbon dioxide around the world, storing dissolved carbon for hundreds of years. As the uptake of carbon dioxide has increased in the last century, so has the acidity of oceans worldwide. Since pre-industrial times, the pH of the oceans has dropped from an average of 8.2 to 8.1 today. Projections of climate change estimate that by the year 2100, this number will drop further, to around 7.8 -- significantly lower than any levels seen in open ocean marine communities today.
Now a team of researchers from MIT, the University ...
Marine species that already roam far and wide throughout our oceans are extending their territories further and faster in response to climate change, according to new research involving the University of Southampton and an international team of biodiversity experts.
The study found that while species that have large ranges are able to make their way to cooler waters, small-ranging species are in increased jeopardy as our planet's oceans continue to warm.
"Our findings indicate that animals which already have wide-latitudinal ranges, habitat generalists, and species with ...
New Haven, Conn. -- Researchers at Yale School of Medicine have successfully treated patients with moderate to severe eczema using a rheumatoid arthritis drug recently shown to reverse two other disfiguring skin conditions, vitiligo and alopecia areata. The study is evidence of a potential new era in eczema treatment, they report.
The research findings are published early online in the Journal of the American Academy of Dermatology.
Eczema (atopic dermatitis) is a chronic condition that causes severe itching and leaves the skin red and thickened. It can adversely affect ...
A slow-down in global warming is not a sign that climate change is ending, but a natural blip in an otherwise long-term upwards trend, research shows.
In a detailed study of more than 200 years' worth of temperature data, results backed previous findings that short-term pauses in climate change are simply the result of natural variation.
The findings support the likelihood that a current hiatus in the world's year-on-year temperature increases - which have stalled since 1998 - is temporary.
Scientists from the University of Edinburgh analysed real-world historic ...
Research findings obtained over the past decades increasingly indicate that stored memories are coded as permanent changes of neuronal communciation and the strength of neuronalinterconnections. The learning process evokes a specific pattern of electrical activity in these cells, which influences the response behavior to incoming signals, the expression of genes and the cellular morphology beyond the learning process itself.
"You might say that these changes define the cellular correlate of the memory engram" says Friedrich Johenning, researcher at the Neuroscience Research ...
Researchers from the Institute and Department of Psychiatry, Faculty of Medicine, University of São Paulo, (Brazil); the Imperial College of London, (UK); the University of Western Australia (Australia) and the University of Toronto (Canada) have just published a study in the Journal of Psychopharmacology suggesting that what had been clustered as anxiety disorders is not homogenous in terms of functioning of the serotonergic system.
The researchers reanalyzed the results of six other studies that had evaluated the effects of the acute reduction of tryptophan, the ...
Microbial ecosystems such as biological wastewater treatment plants and the human gastrointestinal tract are home to a vast diversity of bacterial species. Scientists of the Luxembourg Centre for Systems Biomedicine (LCSB) and the Life Science Research Unit (LSRU) of the University of Luxembourg, in collaboration with US researchers, have now succeeded for the first time in determining key functional genes and the organisms encoding these in such ecological systems, working from extensive data of bacterial genetics and bacterial metabolism.
Keystone species are species ...
The term intellectual disability covers a large number of clinical entities, some with known cause and others of uncertain origin. For example Down syndrome is due to an extra copy of chromosome 21 and Rett syndrome is in part caused by a mutation in the control switch gene called MeCP2.
In other cases the mechanisms by which they are produced are not clearly identified. It is the case of most of those disorders classified under the large umbrella of autism. An study published in the journal Genetics in Medicine, by Manel Esteller, director of the Program Epigenetics ...
Barbara Hinney and her colleagues from the Institute for Parasitology at the University of Veterinary Medicine, Vienna, screened 298 faecal samples taken from cats across Austria for single-cell intestinal parasites, so called enteric protozoa. The samples came from private households, catteries and animal shelters. Of the 298 cats sampled, 56 tested positive with at least one intestinal parasite.
Multi-cat households often affected
A significantly higher rate of positive samples was registered in households with more than one cat. Households with kittens are also ...
