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Grant Details

Grant Number: 5R01CA101835-05 Interpret this number
Primary Investigator: Bradley, Cathy
Organization: Virginia Commonwealth University
Project Title: In-Depth Examination of Disparities in Cancer Outcomes
Fiscal Year: 2007
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Abstract

DESCRIPTION (provided by applicant): This proposed research uses 1996 through 2000 Medicare and Medicaid eligibility and claim files for Michigan residents linked with the Michigan Cancer and Death Certificate Registries to create an inception cohort of newly diagnosed cancer patients. This cohort will be identified by Medicaid eligibility status (dually eligible versus Medicare only). We propose to examine disparities in the incidence of breast, colorectal, lung, and prostate cancer, the stage of these diseases at diagnosis, treatment afforded to patients and associated costs of care, and the survival time following diagnosis. This research seeks to expand knowledge regarding the complex interactions among the social, personal, racial, and health system variables that create and influence disparities along the cancer trajectory. We test a systematically derived set of hypotheses and seek to determine how disparities identified early in the trajectory influence disparities at later points in the trajectory. For example, does later stage at diagnosis lead to less appropriate care that leads to higher costs and shorter survival? An examination of the impact of disparities in cancer detection and/or treatment on survival is one of the significant additions of this research to the state of the science. We have four simply stated aims that are analytically highly complex. Our aims are targeted at two populations of interest--persons dually eligible for Medicare and full Medicaid benefits and persons eligible for Medicare without Medicaid (for the purposes of this application, referred to as "Medicare only.") These aims are: 1) Measure the cancer incidence rates in dually eligible and Medicare only beneficiaries; 2) Compare stage of diagnosis for dually eligible and Medicare only beneficiaries; 3) Compare treatment delivery between the two groups and estimate the cost of care; and 4) Measure survival rates for dually eligible and Medicare only beneficiaries.

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Publications

Cancer diagnosis and outcomes in Michigan EDs vs other settings.
Authors: Sikka V, Ornato JP
Source: Am J Emerg Med, 2012 Feb;30(2), p. 283-92.
EPub date: 2011 Jan 17.
PMID: 21247723
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Treatment disparities following the diagnosis of an astrocytoma.
Authors: Sherwood PR, Dahman BA, Donovan HS, Mintz A, Given CW, Bradley CJ
Source: J Neurooncol, 2011 Jan;101(1), p. 67-74.
EPub date: 2010 May 22.
PMID: 20495849
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Colon cancer treatment costs for Medicare and dually eligible beneficiaries.
Authors: Luo Z, Bradley CJ, Dahman BA, Gardiner JC
Source: Health Care Financ Rev, 2010 Fall;31(1), p. 35-50.
PMID: 20191756
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Surveillance mammography for Medicaid/Medicare breast cancer patients.
Authors: Carcaise-Edinboro P, Bradley CJ, Dahman B
Source: J Cancer Surviv, 2010 Mar;4(1), p. 59-66.
EPub date: 2009 Dec 20.
PMID: 20091247
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Incremental value of using Medicaid claim files to study comorbid conditions and treatments in dually eligible beneficiaries.
Authors: Bradley CJ, Dahman B, Bataki PM, Koroukian S
Source: Med Care, 2010 Jan;48(1), p. 79-84.
PMID: 20050352
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Gastrointestinal malignancies: when does race matter?
Authors: Fitzgerald TL, Bradley CJ, Dahman B, Zervos EE
Source: J Am Coll Surg, 2009 Nov;209(5), p. 645-52.
PMID: 19854407
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The utility of the state buy-in variable in the Medicare denominator file to identify dually eligible Medicare-Medicaid beneficiaries: a validation study.
Authors: Koroukian SM, Dahman B, Copeland G, Bradley CJ
Source: Health Serv Res, 2010 Feb;45(1), p. 265-82.
EPub date: 2009 Oct 15.
PMID: 19840136
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Organizational characteristics and cancer care for nursing home residents.
Authors: Clement JP, Bradley CJ, Lin C
Source: Health Serv Res, 2009 Dec;44(6), p. 1983-2003.
EPub date: 2009 Sep 23.
PMID: 19780848
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Dually eligible and colorectal cancer screening: too little, too late?
Authors: Carcaise-Edinboro P, Bradley CJ, Dahman B
Source: J Health Care Poor Underserved, 2009 Aug;20(3), p. 854-65.
PMID: 19648712
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Inadequate access to surgeons: reason for disparate cancer care?
Authors: Bradley CJ, Dahman B, Given CW
Source: Med Care, 2009 Jul;47(7), p. 758-64.
PMID: 19536001
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Treatment and survival differences in older Medicare patients with lung cancer as compared with those who are dually eligible for Medicare and Medicaid.
Authors: Bradley CJ, Dahman B, Given CW
Source: J Clin Oncol, 2008 Nov 1;26(31), p. 5067-73.
EPub date: 2008 Sep 15.
PMID: 18794546
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Adjuvant chemotherapy after resection in elderly Medicare and Medicaid patients with colon cancer.
Authors: Bradley CJ, Given CW, Dahman B, Fitzgerald TL
Source: Arch Intern Med, 2008 Mar 10;168(5), p. 521-9.
PMID: 18332299
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Absence of cancer diagnosis and treatment in elderly Medicaid-insured nursing home residents.
Authors: Bradley CJ, Clement JP, Lin C
Source: J Natl Cancer Inst, 2008 Jan 2;100(1), p. 21-31.
EPub date: 2007 Dec 25.
PMID: 18159068
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Medicaid, Medicare, and the Michigan Tumor Registry: a linkage strategy.
Authors: Bradley CJ, Given CW, Luo Z, Roberts C, Copeland G, Virnig BA
Source: Med Decis Making, 2007 Jul-Aug;27(4), p. 352-63.
EPub date: 2007 Jul 19.
PMID: 17641138
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