Cultural Adaptation of a Web-Based Ostomy Care Intervention for Hispanic Patients With Cancer and Caregivers: Mixed Methods Study

Clinical Presentation and Induction Outcomes Among Hispanic and Non-Hispanic Patients with Acute Promyelocytic Leukemia

Inpatient outcomes of diffuse large B-cell lymphoma: Racial and socioeconomic disparities in a nationally representative sample

PCN142 Patient and Caregiver Preferences in Treatment Decision Making in Multiple Myeloma — Results of a Targeted Literature Review

Real Word Autologous Transplant Utilization and Outcomes By Race and Ethnicity

In this study, we evaluate how race corresponds to specific complications and costs following total knee arthroplasty (TKA). Our hypothesis was that minority patients, comprising Black, Asian, and Hispanic patients, would have higher complication and revision rates and costs than White patients. Data from 2014 to 2016 were collected from a large commercial insurance database. TKA patients were assigned under Current Procedural Terminology (CPT-27447) and International Statistical Classification of Diseases (ICD-9-P-8154) codes. Minority patients were compared to White patients before and after matching for age, gender, and tobacco use, diabetes, and obesity comorbidities. Standardized complications, revisions, and total costs at 30days, 90days, and 1year were compared between the groups using unequal variance t tests. Overall, 140,601 White (92%), 10,247 Black (6.7%), 1072 Asian (0.67%), and 1725 Hispanic (1.1%) TKA patients were included. At baseline, minority patients had 7-10% longer lengths of stay (p = 0.0001) and Black and Hispanic patients had higher Charlson and Elixhauser comorbidity indices (p = 0.0001), while Asian patients had a lower Elixhauser comorbidity index (p < 0.0001). Black patients had significantly higher complication rates and higher rates of revision (p = 0.03). Minority patients were charged 10-32% more (p < 0.0001). Following matching, all minority patients had lengths of stay 8-10% longer (p = 0.001) and Black patients had higher Charlson and Elixhauser comorbidity indices (p < 0.0001) while Asian patients had a lower Elixhauser comorbidity index (p = 0.0008). Black patients had more equal complication rates and there was no significant difference in revisions in any minority cohort. All minority cohorts had significantly higher total costs at all time points, ranging from 9 to 31% (p < 0.0001). Compared to White patients, Black patients had significantly increased rates of complications, along with greater total costs, but not revisions. Asian and Hispanic patients, however, did not have significant differences in complicationsor revisions yet still had higher costs. As a result, this study corroborates our hypothesis that Black patients have higher rates of complications and costs than White patients following total knee arthroplasty and recommends efforts be taken to tackle health inequities to create more fairness in healthcare. This same hypothesis, however, was not supported when evaluating Asian and Hispanic patients, probably because of the few patients included in the database and deserves further investigation.

Racial and socioeconomic disparities in clinical trial participation and outcomes in systemic peripheral T-cell lymphoma (PTCL): A multicenter retrospective Study

Research Issues for Improving Treatment of U.S. Hispanics With Persistent Mental Disorders

Background: Triple-negative breast cancer (TNBC) is an aggressive disease that disproportionately affects Black patients in the U.S. Racial/ethnic minoritized patients are diagnosed at younger ages, later stages, face barriers in accessing oncology care, and overall experience worse outcomes, despite improvements in early detection and treatment. There remains limited data on racial/ethnic and socioeconomic disparities in disease presentation, treatment receipt, and initiation in metastatic TNBC nationally. Methods: Using the National Cancer Database (NCDB), we analyzed a retrospective cohort of patients diagnosed with de novo metastatic TNBC between 2010-2022. We evaluated 3 metastatic sites, including brain, bone only, and visceral (liver and/or lung). Three treatment modalities were assessed: immunotherapy, chemotherapy, and radiation. Immunotherapy use was restricted to patients treated with chemotherapy from 2019-2022, following the initial accelerated approvals for atezolizumab in 2019 and pembrolizumab in 2020 for metastatic TNBC. Treatment initiation delay (i.e., number of days) was defined as the time from initial diagnosis to treatment start and compared by metastatic disease presentation and across racial/ethnic groups. Multiple linear regression was used to examine racial/ethnic differences in treatment initiation, adjusting for clinical and socioeconomic factors. Regression coefficients (β) and 95% CIs were calculated. Results: Of 16,897 patients included, the mean age was 61.6 years; 62.9% were White, 26.3% Black, 6.9% Hispanic, 2.9% Asian or Pacific Islander (API), and 1.0% Other (per self-report); 12.0%, 24.5%, and 57.4% had brain, bone only, and visceral metastases at presentation, respectively; 55.8% received chemotherapy alone, 44.2% chemoimmunotherapy, and 31.8% radiotherapy as their first line of treatment. Higher percentages of White (12.6%) patients were diagnosed with brain metastasis at presentation compared to 9.2% API, 10.8% Black, and 11.4% Hispanic patients (P = .009). A higher proportion of API patients (27.5%) presented with metastatic bone only disease than White (25.7%), Hispanic (23.5%), or Black (21.8%) patients (P &amp;lt;.001). Among patients with visceral metastases, a higher proportion were Black (59.1%) vs White (57.2%), API (56.4%) and Hispanic (53.3%) (P = .008). There was a shorter time to first-line radiotherapy initiation among patients with brain metastases compared to those without (median days: 29.0 vs 140.0; P &amp;lt;.001). Treatment receipt and initiation varied across racial/ethnic groups. In the adjusted models, Black (β = 3.0; 95% CI, 0.6-5.3) and Hispanic (β = 6.8; 95% CI, 2.6-10.9) patients experienced a longer time to chemotherapy initiation than White patients. Immunotherapy was delayed, on average, for 7.8 days (95% CI, 0.6-15.1) in Black and for 16.6 days (95% CI, 6.0-27.2) in Hispanic as compared to White patients; however, these differences were not significant when further controlling for socioeconomic factors. API, Black, and Hispanic patients also had a longer time to radiotherapy initiation. Compared to private insurance, Medicare was associated with chemotherapy initiation delay (β = 3.0; 95% CI, 0.3-5.7) while Medicaid was associated with immunotherapy initiation delay (β = 12.9; 95% CI, 2.0-23.7). A shorter time to immunotherapy initiation was observed in areas with higher levels of education. Conclusions: This NCDB study found notable racial/ethnic and socioeconomic disparities in metastases at presentation and treatment initiation delays among patients diagnosed with de novo metastatic TNBC the U.S. More effort is needed to alleviate these disparities and to improve care equity and treatment outcomes for all patients with metastatic TNBC. Citation Format: J. Q. Freeman, W. Guo, S. Poland, A. Ravichandran, M. Hennessy, R. Nanda. Racial and ethnic differences in site of metastasis at presentation and treatment in de novo metastatic triple-negative breast cancer [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS5-11-30.

The Ethnic Density hypothesis posits that living around others from similar ethnic backgrounds reduces the risk of adverse mental health outcomes such as depression. Contrary to this hypothesis, previous work has shown that Hispanic ethnic density is cross-sectionally associated with increased depressive symptom severity among patients hospitalized with an acute coronary syndrome (ACS; myocardial infarction or unstable angina pectoris). To date, no study has examined the prospective association of Hispanic ethnic density on long-term depressive symptom severity following an acute medical event. We prospectively assessed the impact of Hispanic ethnic density on depressive symptoms, 1-year following an ACS event, among Hispanic adult patients. We tested the non-linear association between ethnic density and depressive symptoms to account for inconsistent findings on the ethnic density hypothesis. At the time of an index ACS event (i.e., baseline, N = 326) and 1-year later (N = 252), Hispanic patients from the Prescription Usage, Lifestyle, and Stress Evaluation prospective cohort study completed the Beck Depression Inventory as a measure of depressive symptom severity. Hispanic ethnic density was defined by the percentage of Hispanic residents within each patient's census tract using data extracted from the American Community Survey Census (2010-2013). Covariates included baseline demographic factors (age, gender, English fluency, education, nativity status), cardiovascular factors (Charlson comorbidity index, left ventricular ejection fraction, Global Registry of Acute Coronary Events 6-month prognostic risk score), and neighborhood factors (residential density, income, and percentage of households receiving public assistance). In an adjusted multivariable linear regression analysis there was a significant curvilinear association between Hispanic ethnic density and depressive symptom severity at 1 year. As Hispanic ethnic density increased from low to moderate density, there was an increase in depressive symptoms, but depressive symptoms slightly declined in census tracts with the highest density of Hispanics. Furthermore, gender significantly moderated the relation between Hispanic ethnic density and 1-year depressive symptom severity, such that Hispanic ethnic density was significantly associated with increased depressive symptom severity for female Hispanic patients with ACS, but not for male Hispanic patients. Previous research suggests that ethnic density may be protective against depression in Hispanic enclaves; however, our findings suggest a non-linear ethnic density effect and an overall more complex association between ethnic density and depression. These data add to a growing body of literature on the effects of sociodemographic and contextual factors on health.

The Role of Structural Violence in Acute Myeloid Leukemia Outcomes

The Ethnic Density hypothesis posits that living around others from similar ethnic backgrounds reduces the risk of adverse mental health outcomes such as depression. Contrary to this hypothesis, previous work has shown that Hispanic ethnic density is cross-sectionally associated with increased depressive symptom severity among patients hospitalized with an acute coronary syndrome (ACS; myocardial infarction or unstable angina pectoris). To date, no study has examined the prospective association of Hispanic ethnic density on long-term depressive symptom severity following an acute medical event. We prospectively assessed the impact of Hispanic ethnic density on depressive symptoms, 1-year following an ACS event, among Hispanic adult patients. We tested the non-linear association between ethnic density and depressive symptoms to account for inconsistent findings on the ethnic density hypothesis. At the time of an index ACS event (i.e., baseline, N = 326) and 1-year later (N = 252), Hispanic patients from the Prescription Usage, Lifestyle, and Stress Evaluation prospective cohort study completed the Beck Depression Inventory as a measure of depressive symptom severity. Hispanic ethnic density was defined by the percentage of Hispanic residents within each patient's census tract using data extracted from the American Community Survey Census (2010-2013). Covariates included baseline demographic factors (age, gender, English fluency, education, nativity status), cardiovascular factors (Charlson comorbidity index, left ventricular ejection fraction, Global Registry of Acute Coronary Events 6-month prognostic risk score), and neighborhood factors (residential density, income, and percentage of households receiving public assistance). In an adjusted multivariable linear regression analysis there was a significant curvilinear association between Hispanic ethnic density and depressive symptom severity at 1 year. As Hispanic ethnic density increased from low to moderate density, there was an increase in depressive symptoms, but depressive symptoms slightly declined in census tracts with the highest density of Hispanics. Furthermore, gender significantly moderated the relation between Hispanic ethnic density and 1-year depressive symptom severity, such that Hispanic ethnic density was significantly associated with increased depressive symptom severity for female Hispanic patients with ACS, but not for male Hispanic patients. Previous research suggests that ethnic density may be protective against depression in Hispanic enclaves; however, our findings suggest a non-linear ethnic density effect and an overall more complex association between ethnic density and depression. These data add to a growing body of literature on the effects of sociodemographic and contextual factors on health.

The relationship between the Charlson comorbidity index (CCI) and short-term readmission is as yet unknown. Therefore, we aimed to investigate whether the CCI was independently related to short-term readmission in patients with heart failure (HF) after adjusting for other covariates. From December 2016 to June 2019, 2008 patients who underwent HF were enrolled in the study to determine the relationship between CCI and short-term readmission. Patients with HF were divided into 2 categories based on the predefined CCI (low < 3 and high > =3). The relationships between CCI and short-term readmission were analyzed in multivariable logistic regression models and a 2-piece linear regression model. In the high CCI group, the risk of short-term readmission was higher than that in the low CCI group. A curvilinear association was found between CCI and short-term readmission, with a saturation effect predicted at 2.97. In patients with HF who had CCI scores above 2.97, the risk of short-term readmission increased significantly (OR, 2.66; 95% confidence interval, 1.566-4.537). A high CCI was associated with increased short-term readmission in patients with HF, indicating that the CCI could be useful in estimating the readmission rate and has significant predictive value for clinical outcomes in patients with HF.

Prevalence, Risk Factors, and Outcomes of Hospitalized Patients With Coronavirus Disease 2019 Presenting as Acute Pancreatitis

This qualitative study explored patient, caregiver, and prescriber preferences for long-acting injectable (LAI) dosing frequency, and factors influencing preferences for a hypothetical LAI administered once every 2 months for the treatment of schizophrenia. This single-person interview study recruited people living with schizophrenia, caregivers, and prescribers across France, Germany, Italy, Spain, and the UK. Semi-structured interviews were conducted in which participants were asked about their treatment experiences, views on an ideal treatment, and preferences on LAI dosing frequency. A qualitative analysis of interview transcripts was performed to identify key themes. Fifteen people living with clinically stable schizophrenia, 11 caregivers, and 13 prescribers were interviewed. When talking about current treatment (a once-monthly LAI), people living with schizophrenia and caregivers expressed mixed views, with some describing treatment as "easy", whilst others described a fear that treatment will stop working or are frustrated with the frequency of appointments. When asked about treatment goals, a common theme was wishing for the person living with schizophrenia to be clinically stable, leading to a reduction in symptoms and emotional outbursts. When asked about an LAI administered once every 2 months, people living with schizophrenia and caregivers expressed positive views, and perceived that such a treatment would be less burdensome than current treatment. Prescribers were open to recommending an LAI given once every 2 months to clinically stable patients, or those expressing a preference for a decreased dosing frequency or for LAIs in general. In this qualitative study, participants expressed overall positive views on a potential transition to an LAI given once every 2 months, due to the advantages of greater freedom and less treatment burden. Selection of a specific LAI should acknowledge individual patient and caregiver preferences regarding formulation and frequency, to ensure that targeted disease management goals are met.

Introduction: Crohn's disease patients are at high risk of undergoing abdominal surgeries. Previous studies have demonstrated that there are significant racial and demographic differences in the rates of abdominal surgeries in hospital-admitted IBD patients. Our aim is to determine if there are similar differences in ICR rates among hospitalized CD patients. Methods: We queried the NIS (National inpatient Sample) for the years 2010-2014 for patients hospitalized with CD (ICD-9 555.0-9). Rates of ICR were analyzed based on race, age, gender, geographic location, hospital type, insurance type and Charlson comorbidity index. Individual variables were assessed for their impact using univariate logistic regression and multivariable logistic regression models using STATA 16 software. Results: In univariate analysis, Black and Hispanic patients were both noted to be less likely to undergo ICR compared to non-Hispanic white patients. Additionally, Hispanic patients were found to have the lowest ICR rates, 45% less likely to undergo ICR, while Black patients were 31% less likely to undergo ICR. After adjustment for insurance type, geographical location, comorbidities, and other variables, Black and Hispanic CD patients remained at a significantly lower likelihood to undergo colectomy with hospital teaching status and bed size becoming significant. Age, gender, comorbidity and hospital bed size, hospital type were also significant predictors of ICR rates. Females are 25% less likely to undergo ICR compared to males. There was no significant association between the ICR rates and geographic location. Another important finding is that CD patients in the urban hospital were more likely to undergo ICR than patients in rural hospitals independent of other variables with urban teaching hospitals are almost twice likely than the rural hospital. These associations remained significant in multivariable modeling. The results are presented in Table 1. Conclusion: NIS data indicate that Black and Hispanic patients remain less likely to undergo ICR after adjusting for age, sex, comorbidity, insurance type, and hospital type. Underlying reasons for this persistent disparity remain unclear and warrant additional study.Table 1.: Results of Multicenter Study from the NIS database between 2010-2014.