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Relationship between genetic-related objectives among state cancer control plans and colorectal cancer incidence and mortality

Gyurisin, Emma (2019) Relationship between genetic-related objectives among state cancer control plans and colorectal cancer incidence and mortality. Master Essay, University of Pittsburgh.

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Introduction: Colorectal cancer is the third most deadly cancer in the United States and Lynch syndrome (LS) is the most common hereditary colorectal cancer, therefore identifying interventions that reduce the incidence and mortality is a critical public health issue. Current guidelines recommend screening all individuals with newly diagnosed colorectal cancer tumors for LS to reduce morbidity and mortality among relatives. However, states vary in their inclusion of genetic-related strategies in their cancer control plans and the relationship between these strategies and incidence, and incidence-based mortality for LS is unclear.
Methods: I categorized 51 state cancer control plans by five levels of evidence-based genetic strategies. For each state, I obtained incidence and Incidence-based mortality for colorectal cancers diagnosed before age 50 through the National Program of Cancer Registries (NPCR) and Surveillance, Epidemiology, and the End Results (SEER) program from 2001-2015. I next assessed possible relationships between cancer control plan categories and each state’s incidence of colorectal cancer and incidence-based mortality for LS.
Results: Seven states (14%) had no genetics mentioned in their plan, 9 (18%) state plans included a genetics-related term, 13 (25%) plans had a genetics-related objective, 16 (31%) plans had a LS specific objective, and 6 (12%) of state plans had an objective related to screening all individuals with newly diagnosed colorectal cancers for Lynch syndrome. Overall, the inclusion of genetics in a state cancer control plan was not related to colorectal cancer incidence (p=0.90) nor incidence-based mortality (p=0.50) of colorectal cancer diagnosed before age 50.
Conclusion: I observed no relationship between measures of colorectal cancer incidence or mortality and state cancer control plan objectives, most likely because most state cancer plans that incorporated genetic screening were only developed within the past 10 years. However, 68% of states included a genetics-related goal in their cancer control plans. Furthermore, plans developed after 2015 were more likely to include goals related to universal screening, genetic testing, or genetic counseling. Future analyses should focus on evaluating shorter term outcomes such as earlier age of colorectal cancer diagnosis, as well as the number of at-risk individuals identified via cascade screening of relatives.


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Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Gyurisin, Emmaekg11@pitt.eduekg11
ContributionContributors NameEmailPitt UsernameORCID
Committee ChairKammerer, Candacecmk3@pitt.eduUNSPECIFIEDUNSPECIFIED
Committee MemberBarron, Geraldgbarron@pitt.eduUNSPECIFIEDUNSPECIFIED
Date: 18 April 2019
Date Type: Submission
Number of Pages: 42
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Public Health Genetics
Degree: MPH - Master of Public Health
Thesis Type: Master Essay
Refereed: No
Date Deposited: 15 Oct 2019 16:27
Last Modified: 15 Oct 2019 16:27


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