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Hartford, Connecticut, United States

Viola K.V.,Yeshiva University | Rezzadeh K.S.,Rutgers University | Gonsalves L.,Connecticut Tumor Registry | Patel P.,Yeshiva University | And 4 more authors.
Journal of the American Academy of Dermatology | Year: 2015

Background Although wide local excision continues to be commonly used for melanoma treatment, Mohs micrographic surgery (MMS) for the treatment of melanomas remains controversial. Objective We sought to determine national utilization patterns for MMS in the treatment of invasive melanoma and melanoma in situ. Methods A retrospective analysis of patients receiving surgical excision (MMS or wide local excision) for the treatment of invasive melanoma and melanoma in situ was performed using data from the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) program. Results A total of 195,768 melanomas were diagnosed from 2003 through 2009 from the 17 SEER registries. Utilization of MMS for invasive melanoma and melanoma in situ increased by 60% from 2003 to 2008. Of all SEER-captured lesions treated by surgical excision in this time period, 3.5% (6872) were excised by MMS. Limitations Patient insurance status, physician reimbursement practices, and health care provider type were not addressed in this article. Conclusion Use of MMS for melanoma appears to be increasing. Future studies should explore whether this is associated with better outcomes. © 2015 American Academy of Dermatology, Inc. Source


Polednak A.P.,Connecticut Tumor Registry
Journal of registry management | Year: 2010

Comorbid diabetes mellitus has been shown to be associated with outcomes among cancer patients, but population-based data have been limited to elderly patients through linkages between the US National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Program database and Medicare databases. Reporting of comorbidity to the population-based Connecticut SEER registry is not required, but the extent of voluntary reporting of comorbid diabetes was assessed in this preliminary study. Of 15,145 Connecticut residents diagnosed at age 20+ years with invasive cancer in 2006, who were ascertained from 33 registry sources, 8688 (57.4%) from 21 sources were included in the analysis of comorbid diabetes. The prevalence of comorbid diabetes was 12.5%, and was lowest for patients with prostate cancer (8.5%) and highest for with liver-pancreas cancer (25.9%), consistent with the literature. Diabetes prevalence was substantial (9.5%) within the non-elderly subgroup aged 20-64 years at cancer diagnosis who comprised 45% of the 8688 patients. These results indicate an opportunity for future large-scale studies of the impact of diabetes on outcomes among all newly diagnosed cancer patients (both non-elderly and elderly) in the Connecticut SEER registry and other US central cancer registries. Source


Abrams J.A.,Columbia University | Sharaiha R.Z.,Columbia University | Gonsalves L.,Connecticut Tumor Registry | Lightdale C.J.,Columbia University | And 2 more authors.
Cancer Epidemiology Biomarkers and Prevention | Year: 2011

Background: The timing of onset of the rise in incidence of esophageal adenocarcinoma (EAC) has not been clearly defined, and doing so may provide clues with regard to exposures associated with the changed epidemiology of this malignancy. We therefore aimed to investigate historical trends in the incidence of EAC and other upper gastrointestinal malignancies. Methods: We did a population-based study using Connecticut Tumor Registry (1940-2007) and Surveillance, Epidemiology, and End Results (SEER; 1973-2007) data. Age-adjusted incidence rates (per 100,000 person-years) were calculated for EAC and other upper gastrointestinal malignancies. Results: The incidence of EAC remained relatively constant until 1965-69, and then rose from 0.41 (95%CI, 0.26-0.56) to 1.31 (95%CI 1.07-1.54) in 1978-82 and 5.31 (95%CI 4.89-5.73) in 2003-07. The incidence of gastric cardia cancer began to rise in the 1950s and plateaued in the 1990s. The incidence of esophageal squamous cell carcinoma began to decrease around 1980. The trends from Connecticut Tumor Registry data closely mirrored those from SEER data. Conclusions: The incidence of EAC began to rise in the late 1960s, predating the rise in obesity by a decade. Reduced infection rates of Helicobacter pylori, changes in microbiome, or other exposures may have contributed to the changed epidemiology of this malignancy. ©2011 American Association for Cancer Research. Source


Clairwood M.,University of Connecticut | Ricketts J.,University of Connecticut | Grant-Kels J.,University of Connecticut | Gonsalves L.,Connecticut Tumor Registry
International Journal of Dermatology | Year: 2014

Background: The incidence of melanoma is increasing in Caucasians and in Hispanic subgroups in California and Florida. There is a paucity of information regarding melanoma incidence, stage at diagnosis, and other patient and tumor factors among minority subgroups in the northeast USA. This report examines melanoma in non-Hispanic white, non-Hispanic black, and Hispanic residents of Connecticut. Methods: Trends in age-adjusted melanoma incidence rates (1992-2007) and the corresponding annual percentage changes in rates were calculated for Connecticut residents by race and Hispanic ethnicity. The racial/ethnic variation was evaluated for a number of patient and tumor characteristics: gender, age at diagnosis, marital status, anatomic site, histology, ulceration, Breslow thickness, and stage at diagnosis. Statistical significance at the 95% level was assessed using confidence intervals (95% CIs) and Pearson's chi-squared tests. Results: Between 1992 and 2007, melanoma incidence increased by 4.1% per year in non-Hispanic whites in Connecticut (95% CI 3.1-5.1%; P < 0.05). Melanoma incidence remained relatively stable for Hispanics and non-Hispanic blacks over the same period. A significantly higher proportion of advanced (regional and distant) melanomas were diagnosed in non-Hispanic blacks (19.1%) and Hispanics (17.1%) than in non-Hispanic whites (8.7%) (P < 0.001). Conclusions: A significantly higher proportion of advanced melanomas were diagnosed in non-Hispanic blacks and Hispanics than in non-Hispanic whites. There is a growing need to educate patients and healthcare providers of the necessity for skin cancer surveillance regardless of the race of the patient. © 2013 The International Society of Dermatology. Source


Polednak A.P.,Connecticut Tumor Registry
Cancer Epidemiology | Year: 2012

Background: Myeloproliferative neoplasms (MPNs) are classified as neoplasms of uncertain or unknown behavior in the International Classification of Diseases (ICD) Version 10 and can contribute to risk of death from complications (especially thrombosis). Methods: U.S age-standardized death rates using ICD-Version 10 codes relevant to classical MPN (i.e., polycythemia vera, essential thrombocythemia, and " chronic myeloproliferative disease" ) were examined for 1999-2006. The underlying cause of death and also all causes (" multiple causes" or " mentions" ) coded on death certificates were considered. Trends were assessed by using percentage change (PC) in rate between 1999 and 2006, and annual percentage change (APC) estimated from linear regression. Results: The decline in death rates was large for MPN, whether based only the underlying cause (PC. =. -19.7%, APC. =. -3.4%) or on the substantially higher rates based on any cause (PC. =. -24.1%, APC. =. -3.8%), and was consistent by gender and age group (<65 and 65+ years). For deaths with MPN coded as other than the underlying cause, cardiovascular diseases were the most common underlying cause and the ASR for these deaths declined substantially (PC. =. -40.0%). Conclusions: Use of the underlying cause of death in surveillance will considerably underestimate MPN-related mortality rates in the population. Studies are needed on treatment in random samples of MPN patients from population-based cancer registries. Continued surveillance of MPN-related mortality rates in the population is needed in view of recent attempts (including the use of aspirin) to control cardiovascular complications of MPN. © 2011 Elsevier Ltd. Source

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