Author Interviews, Cancer Research, Cost of Health Care, JNCI / 15.03.2013

Gabriel Brooks MD Fellow, Medical Oncology Dana-Farber Cancer Interview with Gabriel Brooks MD Fellow, Medical Oncology Dana-Farber Cancer Institute What are the main findings of the study? Dr. Brooks: First, we found that there is substantial regional variation in Medicare spending for patients with advanced cancer.  For patients with a new diagnosis of advanced stage cancer, spending in the six months following diagnosis varied by 32% between regions in the highest and lowest quintiles of spending.  And for patients who died from cancer, spending in the last six months of life varied by 41% between the highest and lowest spending regions. Second, we tested the association between area-level spending and survival from the time of advanced cancer diagnosis.  We found that there was no consistent association between increasing spending and survival for any of the five cancer sites included in our study (non-small cell lung cancer, colorectal cancer, pancreas cancer, breast cancer and prostate cancer). (more…)
Author Interviews, Cancer Research, JNCI, Lung Cancer, NEJM / 08.03.2013

Dr. Martin C. Tammemägi  Professor (Epidemiology) Brock University Department of Community Health Sciences Walker Complex – Academic South, Room 306 St. Catharines, Ontario, Canada L2S 3A1Medical Author Interview: Dr. Martin C. Tammemägi Professor (Epidemiology) Brock University Department of Community Health Sciences St. Catharines, Ontario, Canada L2S 3A1 Medical What are the main findings of the study?  Dr. Tammemägi: Our study accomplished three things: 1. We presented an updated Lung Cancer Risk Prediction Model, which compared to our previously JNCI-published model, incorporates more predictors but is simpler to use because we changed the way we modeled nonlinear effects. 2. We demonstrated that using the Lung Cancer Risk Prediction Model to select individuals for lung cancer screening was much more effective than using the National Lung Screening Trial (NLST) enrolment criteria.  41.3% fewer lung cancers were missed.  Sensitivity and positive predictive value of identifying individuals who develop lung cancer were significantly improved.  Shortly after our NEJM paper was published, Ma et al published in CANCER their findings that 8.6 million Americans are NLST-criteria positive and if they were CT screened under ideal conditions 12,000 lung cancer deaths would be averted.  Our NEJM article findings indicate that an additional 2,764 lives would be saved if the selection criteria had enrolled 8.6 million individuals for screening based on highest risk by our Lung Cancer Risk Prediction Model. 3. Importantly, using NLST data we demonstrated that the beneficial effect of CT screening did not vary by model predicted lung cancer risk. (more…)