Browsing by Author "Chattopadhyay, Amit"

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Between-ward disparities in colorectal cancer incidence and screening in Washington DC
(2015-09-04) Chattopadhyay, Amit
Abstract This study aims to investigate the incidence and determinants of colorectal cancer (CRC) and its screening in District of Columbia (DC), and identify modifiable risk factors. Data (2000–2009) from the DC Cancer Registry, Behavioral Risk Factor Surveillance System (BRFSS-DC) and Surveillance Epidemiology and End Results (SEER) were used to estimate CRC incidence in eight DC Wards. Risk factors and CRC screening were analyzed using uni-, bi-, and multivariable statistical methods with survey procedures in SAS (version 9.2) including binary, unconditional multivariable logistic regression analysis. Factors measured included stage of diagnosis, age, gender, race/ethnicity, smoking, alcohol, exercise, body weight, health insurance, education, employment, and income. Over the study time, CRC screening increased from 48.4% to 68.6%. Mean age at diagnosis was 67 years. CRC incidence is high in DC. Furthermore, CRC incidence rates in DC below 50 years age were higher than the SEER18 average. Disparities exist between CRC incidence and screening among DC Wards. Identified risk factors for CRC are smoking, obesity, and low physical activity; screening was less prevalent among the uninsured and low socio-economic group. Local variations in CRC occurrence exist and may vary from average national experiences. Identification of local regions which vary from national trends in disease occurrence is important for comprehensive understanding of the disease in the community.
Cross-Nation Comparison of Oral Cancer in the Eastern Mediterranean Region: an Ecological Overview
(2015) Chattopadhyay, Amit
Abstract: Eastern Mediterranean (EM) region countries include countries from the Mediterranean region and North Africa representing regions with wide variations in their politics, economy, peaceful status, and healthcare infrastructure. Commonly known lip and oral cancer risk factors such as consumption of tobacco and alcohol are widely prevalent in the region. Globocan data suggests that age-standardized incidence rates and age-adjusted mortality rates are higher in the region compared to world averages whereas 1-, 2-, and 3-year prevalence proportions are lower. These statistical profiles are generally similar for men and women. Within the region, in general, incidence, mortality, and prevalence is greater in men than women. However, there are important differences in overall incidence, prevalence, and mortality; differences between genders in these statistics which vary between countries. This manuscript describes and compares oral cancer statistics of the countries in the EM region.
Oral cavity and oropharyngeal cancer incidence trends and disparities in the United States: 2000–2010
(2015-05-11) Chattopadhyay, Amit
Background: Changes in the incidence of oral cancer based on anatomic location and demographic factors over time have been reported in the United States. The purpose of this study was to use recent data to examine oral cancer incidence trends and disparities by demographic factors and anatomic location. Methods: Surveillance, Epidemiology, and End Results (SEER) incidence data from 2000 to 2010 were used to characterize and analyze oral cancer incidence trends by anatomic region and subsite, age at diagnosis, gender, race/ethnicity, and stage at diagnosis. Poisson regression was used to compare incidence risk by select demographic factors. Results: About 75,468 incident oral cancer cases were diagnosed from 2000 to 2010. The tonsil was the most frequently diagnosed anatomic subsite (23.1%) and the subsite with the greatest contribution to the overall, age-standardized cumulative incidence rate of 8.4 cases per 100,000 (95% confidence interval (CI): 8.3, 8.4). An increasing incidence trend was observed for cancers in the oropharyngeal region, in contrast to a decreasing trend seen in the oral cavity region. In the Poisson regression model, all race/ ethnicity groups showed a lower incidence risk relative to whites for oral cavity and oropharyngeal cancer, and white males displayed the highest incidence rate of all race/ethnicity-gender groups during the study period (14.1 per 100,000; 95% CI: 14.0, 14.2). Conclusions: This study’s epidemiological findings are especially important for oral health care providers, patient education, and the identification of risk profiles associated with oral cancer. The distinct epidemiological trends of oral cavity and oropharyngeal cancers dictate that oral cancer can no longer be viewed as a discrete entity. Oral health providers should have a strong understanding of the different risk factors associated with oral cavity and oropharyngeal cancers and educate their patients accordingly.
Trends in income-related inequality in untreated caries among children in the United States: findings from NHANES I, NHANES III, and NHANES 1999–2004
(2015) Chattopadhyay, Amit
Objective: The goal of this analysis was to describe income-related inequality in untreated caries among children in the United States over time. Methods: The analysis focuses on children ages 2–12 years in three nationally representative U.S. surveys: the National Health and Nutrition Examination Survey (NHANES) 1971–1974, NHANES 1988–1994, and NHANES 1999–2004. The outcome of interest is untreated dental caries. Various methods are employed to measure absolute and relative inequality within each survey such as pair-wise comparisons, measures of association (odds ratios), and three summary measures of overall inequality: the slope index of inequality, the relative index of inequality, and the concentration index. Inequality trends are then assessed by comparing these estimates across the three surveys. Results: Inequality was present in each of the three surveys analyzed. Whether measured on an absolute or relative scale, untreated caries disproportionately affected those with lower income. Trend analysis shows that, despite population-wide reductions in untreated caries between NHANES I and NHANES III, overall absolute inequality slightly increased, while overall relative inequality significantly increased. Between NHANES III and NHANES 1999–2004, both absolute and relative inequality tended to decrease; however, these changes were not statistically significant. Conclusions: Socioeconomic inequality in oral health is an important measure of progress in overall population health and a key input to inform health policies. This analysis shows the presence of socioeconomic inequality in oral health in the American child population, as well as changes in its magnitude over time. Further research is needed to determine the factors related to these changes and their relative contribution to inequality trends.