Publications by authors named "Fernando Collado-Mesa"

21 Publications

  • Page 1 of 1

Convolutional neural networks for breast cancer detection in mammography: A survey.

Comput Biol Med 2021 Apr 9;131:104248. Epub 2021 Feb 9.

University of Miami, Department of Electrical and Computer Engineering, Memorial Dr, Coral Gables, FL, 33146, USA. Electronic address:

Despite its proven record as a breast cancer screening tool, mammography remains labor-intensive and has recognized limitations, including low sensitivity in women with dense breast tissue. In the last ten years, Neural Network advances have been applied to mammography to help radiologists increase their efficiency and accuracy. This survey aims to present, in an organized and structured manner, the current knowledge base of convolutional neural networks (CNNs) in mammography. The survey first discusses traditional Computer Assisted Detection (CAD) and more recently developed CNN-based models for computer vision in mammography. It then presents and discusses the literature on available mammography training datasets. The survey then presents and discusses current literature on CNNs for four distinct mammography tasks: (1) breast density classification, (2) breast asymmetry detection and classification, (3) calcification detection and classification, and (4) mass detection and classification, including presenting and comparing the reported quantitative results for each task and the pros and cons of the different CNN-based approaches. Then, it offers real-world applications of CNN CAD algorithms by discussing current Food and Drug Administration (FDA) approved models. Finally, this survey highlights the potential opportunities for future work in this field. The material presented and discussed in this survey could serve as a road map for developing CNN-based solutions to improve mammographic detection of breast cancer further.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.compbiomed.2021.104248DOI Listing
April 2021

Breast implant-associated anaplastic large cell lymphoma: Brief overview of current data and imaging findings.

Breast Dis 2021 Jan 29. Epub 2021 Jan 29.

Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Miami, FL, USA.

In 2016, the World Health Organization added Breast Implant-Associated Anaplastic Large Cell lymphoma as a provisionally recognized lymphoma to the family of existing Anaplastic Large Cell lymphomas. Current estimates of the lifetime risk of the disease in women with textured breast implants range from 1:1,000 to 1:30,000. The mean interval from implant placement to diagnosis is 10.7 ± 4.6 years and the most common clinical symptom at presentation is breast swelling. A high level of clinical suspicion is recommended in patients presenting with breast symptoms and/or peri-implant fluid collection occurring more than 1 year after breast implant placement. Ultrasound is the imaging modality of choice, with a high sensitivity for peri-implant fluid and a high specificity for peri-implant mass. When ultrasound is inconclusive, breast MRI is indicated. As of today, all confirmed cases have tested positive for CD30 immunohistochemistry and the disease has shown to have an excellent prognosis when it is diagnosed earlier (localized disease), and when complete surgery, consisting of explantation, capsulectomy, and removal of any associated capsule mass, is performed. This overview summarizes the available epidemiological and clinical data of Breast Implant-Associated Anaplastic Large Cell lymphoma, with an emphasis on imaging features.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3233/BD-201017DOI Listing
January 2021

Impact of COVID-19 on breast imaging case volumes in South Florida: A multicenter study.

Breast J 2020 11 9;26(11):2316-2319. Epub 2020 Aug 9.

Department of Radiology, University of Miami Miller School of Medicine, Miami, Florida, USA.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/tbj.14011DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7436315PMC
November 2020

DU-Net: Convolutional Network for the Detection of Arterial Calcifications in Mammograms.

IEEE Trans Med Imaging 2020 10 23;39(10):3240-3249. Epub 2020 Apr 23.

Breast arterial calcifications (BACs) are part of several benign findings present on some mammograms. Previous studies have indicated that BAC may provide evidence of general atherosclerotic vascular disease, and potentially be a useful marker of cardiovascular disease (CVD). Currently, there is no technique in use for the automatic detection of BAC in mammograms. Since a majority of women over the age of 40 already undergo breast cancer screening with mammography, detecting BAC may offer a method to screen women for CVD in a way that is effective, efficient, and broad reaching, at no additional cost or radiation. In this paper, we present a deep learning approach for detecting BACs in mammograms. Inspired by the promising results achieved using the U-Net model in many biomedical segmentation problems and the DenseNet in semantic segmentation, we extend the U-Net model with dense connectivity to automatically detect BACs in mammograms. The presented model helps to facilitate the reuse of computation and improve the flow of gradients, leading to better accuracy and easier training of the model. We evaluate the performance using a set of full-field digital mammograms collected and prepared for this task from a publicly available dataset. Experimental results demonstrate that the presented model outperforms human experts as well as the other related deep learning models. This confirms the effectiveness of our model in the BACs detection task, which is a promising step in providing a cost-effective risk assessment tool for CVD.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1109/TMI.2020.2989737DOI Listing
October 2020

The Role of Artificial Intelligence in Diagnostic Radiology: A Survey at a Single Radiology Residency Training Program.

J Am Coll Radiol 2018 Dec 21;15(12):1753-1757. Epub 2018 Feb 21.

Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida.

Purpose: Advances in artificial intelligence applied to diagnostic radiology are predicted to have a major impact on this medical specialty. With the goal of establishing a baseline upon which to build educational activities on this topic, a survey was conducted among trainees and attending radiologists at a single residency program.

Methods: An anonymous questionnaire was distributed. Comparisons of categorical data between groups (trainees and attending radiologists) were made using Pearson χ analysis or an exact analysis when required. Comparisons were made using the Wilcoxon rank sum test when the data were not normally distributed. An α level of 0.05 was used.

Results: The overall response rate was 66% (69 of 104). Thirty-six percent of participants (n = 25) reported not having read a scientific medical article on the topic of artificial intelligence during the past 12 months. Twenty-nine percent of respondents (n = 12) reported using artificial intelligence tools during their daily work. Trainees were more likely to express doubts on whether they would have pursued diagnostic radiology as a career had they known of the potential impact artificial intelligence is predicted to have on the specialty (P = .0254) and were also more likely to plan to learn about the topic (P = .0401).

Conclusions: Radiologists lack exposure to current scientific medical articles on artificial intelligence. Trainees are concerned by the implications artificial intelligence may have on their jobs and desire to learn about the topic. There is a need to develop educational resources to help radiologists assume an active role in guiding and facilitating the development and implementation of artificial intelligence tools in diagnostic radiology.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jacr.2017.12.021DOI Listing
December 2018

Utility of supplemental screening with breast ultrasound in asymptomatic women with dense breast tissue who are not at high risk for breast cancer.

Indian J Radiol Imaging 2017 Jan-Mar;27(1):52-58

Department of Radiology, Sylvester Comprehensive Cancer Center, University of Miami Hospital and Clinics, Miami, Florida, USA.

Objective: To assess the results of an initial round of supplemental screening with hand-held bilateral breast ultrasound following a negative screening mammogram in asymptomatic women with dense breast tissue who are not at high risk for breast cancer.

Materials And Methods: A retrospective, Health Insurance Portability and Accountability Act compliant, Institutional Research Board approved study was performed at a single academic tertiary breast center. Informed consent was waived. A systematic review of the breast imaging center database was conducted to identify and retrieve data for all asymptomatic women, who were found to have heterogeneously dense or extremely dense breast tissue on screening bilateral mammograms performed from July 1, 2010 through June 30, 2012 and who received a mammographic final assessment American College of Radiology's (ACR) Breast Imaging Reporting and Data System (BI-RADS) category 1 or BI-RADS category 2. Hand-held screening ultrasound was performed initially by a technologist followed by a radiologist. Chi-square and -test were used and statistical significance was considered at < 0.05.

Results: A total of 1210 women were identified. Of these, 394 underwent the offered supplemental screening ultrasound. BI-RADS category 1 or 2 was assigned to 323 women (81.9%). BI-RADS category 3 was assigned to 50 women (12.9%). A total of 26 biopsies/aspirations were recommended and performed in 26 women (6.6%). The most common finding for which biopsy was recommended was a solid mass (88.5%) with an average size of 0.9 cm (0.5-1.7 cm). Most frequent pathology result was fibroadenoma (60.8%). No carcinoma was found.

Conclusion: Our data support the reported occurrence of a relatively high number of false positives at supplemental screening with breast ultrasound following a negative screening mammogram in asymptomatic women with dense breast tissue, who are not at a high risk of developing breast cancer, and suggests that caution is necessary in establishing wide implementation of this type of supplemental screening for all women with dense breast tissue without considering other risk factors for breast cancer.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/0971-3026.202962DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5385776PMC
May 2017

Time Spent by Breast Imaging Radiologists to Perform Value-Added Activities at an Academic Cancer Center.

Cancer Control 2017 Apr;24(2):120-124

University of Miami Miller School of Medicine, Miami, FL.

Background: Health care reform in the United States has generated a paradigm shift in the practice of radiology aimed at increasing the degree of patient-centered care. We conducted a study to quantify the amount of time breast imaging radiologists spend on value-added activities at an academic comprehensive cancer center located in Miami, Florida, and accredited by the American College of Radiology as a Breast Imaging Center of Excellence.

Methods: A prospective, observational study was conducted during a period of 20 consecutive workdays. Three participating breast imaging radiologists maintained a real-time log of each activity performed. A generalized linear model was used to perform a 1-way analysis of variance. An alpha level of .05 was used to determine statistical significance.

Results: The average daily time dedicated to these activities was 92.1 minutes (range, 56.4-132.2). The amount of time significantly differed among breast imaging radiologists and correlated with their assigned daily role (P < .001 for both) but was independent of their years of experience. The daily role that required the most time was the interpretation of diagnostic imaging studies, which is when most interactions with patients, their relatives, and referring physicians occurred. The specific activity that required the most time was preparing for and participating in tumor boards.

Conclusions: Our findings suggest that the breast imaging radiologists who participated in this study dedicated a significant amount of their time to value-added activities to help improve patients' experience across the continuity of their care. We propose that similar studies be conducted at other institutions to better assess the magnitude of this finding across different breast imaging care settings.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/107327481702400204DOI Listing
April 2017

Primary neuroendocrine carcinoma of the breast: report of 2 cases and literature review.

Radiol Case Rep 2017 Mar 5;12(1):1-12. Epub 2017 Jan 5.

Department of Radiology, University of Miami Miller School of Medicine, 1611 NW 12 Ave, West Wing 279, Miami, FL 33136, USA.

Neuroendocrine tumors of the breast are very rare accounting for less than 0.1% of all breast cancers and less than 1% of all neuroendocrine tumors. Focal neuroendocrine differentiation can be found in different histologic types of breast carcinoma including in situ and invasive ductal or invasive lobular. However, primary neuroendocrine carcinoma of the breast requires the expression of neuroendocrine markers in more than 50% of the cell population, the presence of ductal carcinoma in situ, and the absence of clinical evidence of concurrent primary neuroendocrine carcinoma of any other organ. Reports discussing the imaging characteristics of this rare carcinoma in different breast imaging modalities are scarce. We present 2 cases of primary neuroendocrine carcinoma of the breast for which mammography, ultrasound, and magnetic resonance imaging findings and pathology findings are described. A review of the medical literature on this particular topic was performed, and the results are presented.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.radcr.2016.12.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5310536PMC
March 2017

Resident and fellow education feature: US evaluation of axillary lymph nodes.

Radiographics 2014 Nov-Dec;34(7):1817-8

From the Breast Imaging Section, Department of Radiology, University of Miami Sylvester Comprehensive Cancer Center, 1475 NW 12th Ave, Miami, FL 33136.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1148/rg.347140081DOI Listing
November 2015

Can mammographic and sonographic imaging features predict the Oncotype DX™ recurrence score in T1 and T2, hormone receptor positive, HER2 negative and axillary lymph node negative breast cancers?

Breast Cancer Res Treat 2014 Nov 28;148(1):117-23. Epub 2014 Sep 28.

University of Miami School of Medicine, Miami, FL, USA,

To determine whether mammographic or sonographic features can predict the Oncotype DX™ recurrence scores (RS) in patients with TI-II, hormone receptor (HR) positive, HER2/neu negative and node negative breast cancers. Institutional board review was obtained and informed consent was waived for this retrospective study. Seventy-eight patients with stage I-II invasive breast cancer that was HR positive, HER2 negative, and lymph node negative for whom mammographic and or sonographic imaging and Oncotype DX™ assay scores were available were included in the study Four breast dedicated radiologists blinded to the RS retrospectively described the lesions according to BI-RADS lexicon descriptors. Multivariable logistic regression was used to test for significant independent predictors of low (<18) versus intermediate to high range (≥18). Two imaging features reached statistical significance in predicting low from intermediate or high risk RS: pleomorphic microcalcifications within a mass (P = 0.017); OR 8.37, 95 % CI (1.47-47.79) on mammography and posterior acoustic enhancement in a mass on ultrasound (P = 0.048); OR 4.35, 95 % CI (1.01-18.73) on multivariable logistic regression. A mass with pleomorphic microcalcifications on mammography or the presence of posterior acoustic enhancement on ultrasound may predict an intermediate to high RS as determined by the Oncotype DX(TM) assay in patients with stage I-II HR positive, HER2 negative, and lymph node negative invasive breast cancer.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10549-014-3143-zDOI Listing
November 2014

Diagnostic performance of CT attenuation values of focal 18F-FDG avid breast lesions detected on whole-body PET-CT in postoperative breast cancer patients.

Breast J 2014 May-Jun;20(3):235-42

Department of Radiology, University of Miami Miller School of Medicine, Miami, Florida.

To assess whether CT attenuation values help in differentiating benign from malignant etiology of focal (18) F-FDG avid breast lesions detected on whole-body PET/CT exam in postoperative breast cancer patients. Institutional review board approval and waived informed consent were obtained for this HIPAA-compliant retrospective study. Between January 2009 and July 2011, a total of 85 patients had 97 focal (18) F-FDG avid breast lesions on whole-body PET/CT. Of these, 54 (56%) lesions were biopsy-proven primary invasive breast carcinoma that had not undergone treatment at the time of PET/CT, 35 (36%) were benign lesions, and 8 were locally recurrent breast carcinoma. Mean attenuation values were retrospectively measured in Hounsfield units (HU) for the correlative lesion on the CT portion of the exam. Receiver-operating characteristic curves (ROC) were calculated to determine the optimal cutoff values of HU that would best discriminate between benign and malignant lesions. Interobserver agreement for measured mean attenuation values was assessed by calculating the intraclass correlation coefficient (ICC). Mean HU for the benign lesions group and the local recurrence lesions group was -11.0 ± 30.3 versus 32.9 ± 6.87 (p < 0.0002). ROC curve analysis comparing benign breast lesions to local recurrence lesions found an optimal cutoff value of 17 HU (area under curve = 0.982, p < 0.0001, Sensitivity = 100%, Specificity = 89%). ICC with regard to interobserver agreement in measuring the mean HU of the benign lesions was 0.84 (95% confidence interval 0.64-0.93) and for the malignant lesions was 0.88 (95% confidence interval 0.77-0.94). A CT attenuation threshold value of less than 17 HU suggests benign etiology of focal (18) FDG avid breast lesions in postoperative breast cancer patients. If confirmed by additional studies, these findings may provide additional information to guide the treating physician regarding decisions for supplementary imaging or the need to biopsy.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/tbj.12262DOI Listing
May 2015

Contralateral intramammary silicone lymphadenitis in a patient with an intact standard dual-lumen breast implant in the opposite reconstructed breast.

J Radiol Case Rep 2013 Nov 1;7(11):24-31. Epub 2013 Nov 1.

Department of Radiology, University of Miami Miller School of Medicine, Miami, FL, USA.

Silicone lymphadenopathy is a recognized complication of silicone gel implant rupture; the ipsilateral axillary lymph nodes are most commonly involved. We report imaging findings on a range of different imaging modalities and biopsy results in a case of biopsy-proven silicone lymphadenitis involving contralateral intramammary and axillary lymph nodes in a patient with an intact standard dual-lumen breast implant in the opposite reconstructed breast. This case demonstrates that in a patient with disrupted lymph drainage due to prior mastectomy and axillary node dissection for breast cancer treatment, silicone particles can migrate in a retrograde fashion via the ipsilateral internal mammary lymph nodes and reach not only the contralateral axilla but also the outer quadrants of the contralateral breast, even in the presence of an intact breast implant.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3941/jrcr.v7i11.1562DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3888334PMC
November 2013

Solitary neurofibroma of the breast.

Radiol Case Rep 2012 7;7(4):462. Epub 2015 Dec 7.

Neurofibromas are slow-growing, painless, benign nerve-sheath tumors. They occur most commonly in the dermis and subcutis and are rarely found in the breast. We report a rare case of a solitary neurofibroma of the breast in a 61-year-old asymptomatic woman.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2484/rcr.v7i4.462DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4899552PMC
June 2016

Unusual presentation of tubular carcinoma of the breast.

Breast J 2011 Jul-Aug;17(4):422-3. Epub 2011 Jun 17.

Mount Sinai Medical Center, Radiology, Miami Beach, FL 33140, USA.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/j.1524-4741.2011.01106.xDOI Listing
November 2011

Skin cancer awareness and sun protection behaviors in white Hispanic and white non-Hispanic high school students in Miami, Florida.

Arch Dermatol 2007 Aug;143(8):983-8

Department of Dermatology, University of Miami Miller School of Medicine, 1201 NW 16th St, Miami, FL 33125, USA.

Objective: To examine skin cancer awareness and behavior in white Hispanic (WH) and white non-Hispanic (WNH) high school students because increasing incidence and delayed diagnosis of skin cancer in the growing Hispanic population in the United States represent an emerging health issue.

Design: Pilot survey study.

Setting: A high school in Miami, Florida.

Participants: A total of 369 high school students (221 WHs and 148 WNHs) were surveyed in the study.

Main Outcome Measures: Survey data were collected regarding skin cancer knowledge, perceived risk, and sun protection behaviors. Differences between the 2 groups were compared with chi(2) tests.

Results: White Hispanic students were more likely to tan deeply (P = .04) but less likely to have heard of (P < .01) or been told how to perform (P < .01) skin self-examination. White Hispanics were less likely to wear sun-protective clothing or to use sunscreen with a sun protection factor of 15 or higher and reported a greater use of tanning beds. White Hispanic students also thought their chance of developing skin cancer was less than that of WNH students (P < .01), which remained significant after adjustment for age, sex, family history, and skin sensitivity to sun. After adjustment, WHs were 2.5 times more likely than WNHs to have used a tanning bed in the past year. White Hispanics were also 60% less likely to have heard of skin self-examination (P < .01) and 70% less likely than WNHs to have ever been told to perform the examination (P = .03). White Hispanics are about 1.8 and 2 times more likely to never or rarely wear protective clothing (P < .01) and to use sunscreen (P = .01), respectively.

Conclusion: There are disparities in knowledge, perceived risk of skin cancer, and sun-protective behaviors among WH and WNH high school students.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1001/archderm.143.8.983DOI Listing
August 2007

The prevalence of human immunodeficiency virus type 1 and hepatitis C virus among injection drug users who use high risk inner-city locales in Miami, Florida.

Mem Inst Oswaldo Cruz 2004 Dec 4;99(8):789-93. Epub 2005 Mar 4.

Department of Epidemiology and Public Health, University of Miami School of Medicine, Highland Professional Building, 801 NW 9th Avenue, Miami, FL 33136, USA.

In order to estimate the prevalence of human immunodeficiency virus type 1 (HIV-1) and hepatitis C virus (HCV) co-infection in hard-to-reach intravenous drug users, 199 subjects from high-risk inner-city locales, the so called "shooting galleries", were consented, interviewed, and tested in Miami, FL, US. Positive HIV-1 status was based on repeatedly reactive ELISA and confirmatory Western Blot. Positive HCV status was based on reactive ELISA and confirmatory polymerase chain reaction techniques. Overall, 50 (25%) were not infected with either virus, 61 (31%) were HIV-1/HCV co-infected, 17 (8%) infected by HIV-1 only, and 71 (36%) infected by HCV only. The results of the multivariable analyses showed that more years using heroin was the only significant risk factor for HCV only infection (odds ratio = 1.15; 95% confidence interval = 1.07, 1.24) and for HIV-1/HCV co-infection (odds ratio = 1.17; 95% confidence interval = 1.09, 1.26). This paper demonstrates that HIV-1/HCV co-infection is highly prevalent among so called "shooting galleries".
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1590/s0074-02762004000800002DOI Listing
December 2004

An ecological analysis of childhood-onset type 1 diabetes incidence and prevalence in Latin America.

Rev Panam Salud Publica 2004 Jun;15(6):388-94

University of Miami School of Medicine, Department of Epidemiology and Public Health, Miami, Florida, USA.

Objective: To explore, for Latin America, by means of an ecological correlation analysis, the possible relationships between both the incidence and prevalence of childhood type 1 diabetes and selected hypothesized etiological factors, including race/ethnicity, geographical latitude, breastfeeding rates, per capita milk supply and coffee consumption, and wealth-related indicators such as infant mortality rate, life expectancy at birth, and national human development index.

Methods: Recently published data on incidence and prevalence of type 1 diabetes in children < or = 14 years of age in Latin American countries were utilized. Risk indicators were selected based on existing genetic and environmental hypotheses. Indicator data were obtained from publicly available resources. Spearman correlation coefficients were used to measure the association between both incidence and prevalence of type 1 diabetes and the selected indicators.

Results: A strong negative correlation was found between the proportion of Amerindians in a country's population and both incidence (r = -0.75; P = 0.008) and estimated prevalence (r = -0.78; P < 0.0001) of childhood type 1 diabetes. The per capita supply of milk showed a strong positive correlation with both incidence (r = 0.70; P = 0.025) and prevalence (r = 0.55; P = 0.018). Wealth-related indicators correlated with prevalence but not with incidence.

Conclusions: Our results suggest that the presence of the Amerindian component of the population in Latin America provides protection against childhood-onset type 1 diabetes. Our results also confirm the association previously reported in other countries and regions of the world of type 1 diabetes and milk consumption. Further studies are needed to develop and test potential genetic and environmental hypotheses that could help to better understand the interplay between genetic susceptibility and environment in type 1 diabetes across different ethnic groups.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1590/s1020-49892004000600004DOI Listing
June 2004

UV radiation, latitude, and melanoma in US Hispanics and blacks.

Arch Dermatol 2004 Jul;140(7):819-24

Department of Dermatology and Cutaneous Surgery, and the Sylvester Cancer Center, University of Miami School of Medicine, Miami, FL, USA.

Background: Little information exists on the epidemiology of melanoma and the role of solar radiation in the development of melanoma in pigmented populations.

Objective: To evaluate the relationship between exposure to solar radiation and the incidence of melanoma in US Hispanics and blacks.

Design: Population-based ecological study.

Setting: State cancer registries of New York, New Jersey, Illinois, California, Texas, and Florida. Subjects Patients with invasive melanoma recorded by cancer registries.

Main Outcome Measures: We obtained age-adjusted, race/ethnicity- and sex-specific incidence rates of melanoma from similar time periods from the 6 cancer registries. The incidence rates were correlated with the annual mean UV index and the latitude of residency.

Results: For both Hispanics and blacks, the incidence of melanoma was positively associated with the UV index and negatively associated with the latitude of residency. Statistically significant correlation between melanoma and the UV index (R = 0.93; P =.01) and latitude (R = -0.80; P =.05) was observed in black males. Hispanics and blacks have a significantly lower incidence of melanoma than whites, with blacks having the lowest rates of melanoma.

Conclusions: Exposure to solar radiation appears to play a role in the development of melanoma in both Hispanics and blacks. Sun protection and melanoma risk education should be performed in these populations.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1001/archderm.140.7.819DOI Listing
July 2004

A community-based breast cancer screening program for medically underserved women: its effect on disease stage at diagnosis and on hazard of death.

Rev Panam Salud Publica 2004 Mar;15(3):160-7

University of Miami School of Medicine, Department of Epidemiology and Public Health, Miami, Florida 33136,

Objective: Earlier studies by this research team found that medically underserved minority women in the Miami-Dade County area of the state of Florida, United States, were in need of breast cancer screening and that there were problems with availability, accessibility, and acceptability of services. In response, a community-based comprehensive breast cancer screening program called the Early Detection Program (EDP) was developed. The specific purpose of this study was to assess the effect that EDP participation had on stage at diagnosis and on hazard of death.

Methods: Existing data from the Florida Cancer Data System (FCDS), a statewide cancer registry, were linked with data from the EDP. In December 1998 we assembled a multiethnic (African-American, black Hispanic, white Hispanic, and white non-Hispanic) retrospective cohort with the following inclusion criteria: all women aged 40 and older with breast cancer diagnosed and staged at University of Miami/Jackson Memorial Medical Center (which is located in the city of Miami, Florida) from January 1987 through December 1997. EDP participants were medically underserved, that is, they resided in lower socioeconomic areas and/or had limited or no health insurance to cover medical costs. Subjects identified as EDP participants were compared to nonparticipants with respect to disease stage at diagnosis and hazard of death. Logistic regression and Cox regression models were used for analysis.

Results: EDP participants were 2.4 times as likely (95% confidence interval = 1.71 to 3.43) to present with a diagnosis of localized cancer as were nonparticipants, even after controlling for race and age at diagnosis. EDP participation was independently associated with both earlier diagnosis and reduced hazard of death.

Conclusions: Participation in the EDP increases the likelihood of early detection of breast cancer and reduces the hazard of death for medically underserved women in the Miami-Dade County area of Florida. Interestingly, white Hispanics showed a better survival than did both African-Americans and white non-Hispanics. Our research also demonstrates the value of utilizing existing cancer registry data to evaluate a community-based program such as the EDP.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1590/s1020-49892004000300004DOI Listing
March 2004

Ultraviolet radiation and incidence of non-Hodgkin's lymphoma among Hispanics in the United States.

Cancer Epidemiol Biomarkers Prev 2004 Jan;13(1):59-64

Department of Dermatology and Cutaneous Surgery, Sylvester Cancer Center, University of Miami School of Medicine, Miami, Florida, USA.

Non-Hodgkin's lymphoma (NHL) is one of the most common cancers among American Hispanics. Several studies suggest that solar UV radiation (UVR) may be an environmental risk contributing to the rise of NHL over the past decades. These studies focused primarily on light-skinned Caucasian populations; it is unknown what role UVR plays in NHL for Hispanics. We described the incidence of NHL in Hispanics from selected states in the United States between 1989 and 2000. To evaluate the role of UVR, we correlated cancer rates with the UV index and latitude of residency. Variations in NHL incidence rates with estimated amount of UVR among whites and blacks from the selected states were also analyzed. We found that NHL occurred less frequently in Hispanics than in whites. Hispanic men had higher incidence of NHL than Hispanic women. Incidence rates of NHL in Hispanics were inversely associated with estimated amount of UVR as an increase in NHL was observed with decreasing UV index (r = -0.7 in men; r = -0.41 in women) or increasing latitude of residency (r = 0.59 in men; r = 0.48 in women). This trend, although it did not reach statistical significance, was also observed in whites and blacks. Our findings do not support previous reports of a positive association between solar radiation and NHL. The inverse relationship between UVR and incidence of NHL is unexplained but presents the need for generation of hypotheses regarding the epidemiology of causal factors for NHL in the United States. Additional studies should be conducted to clarify whether sunlight exposure contributes to the development of NHL.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1158/1055-9965.epi-03-0187DOI Listing
January 2004