2025
Cardiovascular risk in long-term survivors of breast, prostate, colon, and rectal cancer
Westvold S, Long J, Fan J, Kc M, Hyslop T, Conlin K, Jacobson S, Silber A, Wang S, Leapman M, Leeds I, Spees L, Wheeler S, Gross C, Oeffinger K, Dinan M. Cardiovascular risk in long-term survivors of breast, prostate, colon, and rectal cancer. Journal Of The National Cancer Institute 2025, djaf243. PMID: 41069232, DOI: 10.1093/jnci/djaf243.Peer-Reviewed Original ResearchThis study investigates cardiovascular risk in older long-term cancer survivors, showing non-cancer factors, rather than cancer-specific ones, predict late-onset cardiovascular disease.Digital breast tomosynthesis and breast cancer detection in older women: Smaller tumors and more invasive lobular carcinomas.
Huang S, Westvold S, Soulos P, Winer E, Lewin J, Lustberg M, Zhan H, Richman I, Robinson T, Dinan M. Digital breast tomosynthesis and breast cancer detection in older women: Smaller tumors and more invasive lobular carcinomas. JCO Oncology Practice 2025, 21: 285-285. DOI: 10.1200/op.2025.21.10_suppl.285.Peer-Reviewed Original ResearchInvasive lobular carcinomaDigital breast tomosynthesisOlder womenBreast cancer detectionDigital mammographyLobular carcinomaCohort study of womenScreen-detected casesStudy of womenClaims-based algorithmER+/HER2- breast cancerBreast tomosynthesisTrial of womenCancer detectionScreening modalitiesPrimary exposureBreast cancerWomenEarly detectionCarcinomaTumorBreastTomosynthesisMammographyOpioid prescribing trends and pain scores among adult patients with cancer in a large health system
Baum L, Soulos P, Kc M, Jeffery M, Ruddy K, Lerro C, Lee H, Graham D, Rivera D, Liberatore M, Leapman M, Jairam V, Dinan M, Gross C, Park H. Opioid prescribing trends and pain scores among adult patients with cancer in a large health system. Cancer 2025, 131: e70027. PMID: 40977160, PMCID: PMC12451255, DOI: 10.1002/cncr.70027.Peer-Reviewed Original ResearchConceptsOpioid prescribingMetastatic cancerNo painHealth systemPain scoresWidespread policy changeOpioid-naive adultsNewly diagnosed cancerOpioid-related harmsOpioid prescribing trendsPain managementOpioid prescriptionsRetrospective studyAdult patientsClinical strataPrescribingPrescribing trendsSurgical patientsLogistic regressionOpioidPainPatientsCancerStewardship policiesPolicy changesTreatment exposure-based risk-stratification for care of survivors of childhood cancer: a report from the childhood cancer survivor study
Dinan M, Stratton K, Leisenring W, Yasui Y, Chow E, Tonorezos E, Moskowitz C, Yeh J, Noyd D, Armstrong G, Oeffinger K. Treatment exposure-based risk-stratification for care of survivors of childhood cancer: a report from the childhood cancer survivor study. Journal Of The National Cancer Institute 2025, djaf268. PMID: 40971674, DOI: 10.1093/jnci/djaf268.Peer-Reviewed Original ResearchChildhood Cancer Survivor StudyChronic health conditionsHealth conditionsFive-year survivorsCancer survivorsSurvivor StudyChronic conditionsFive-year survivors of childhood cancerNon-Hispanic white survivorsManagement of childhood cancer survivorsLong-term cancer survivorsSurvivors of childhood cancerChildhood cancer survivorsHigh-risk survivorsSevere chronic conditionsCox proportional hazards modelsSurvivorship clinicRisk of late morbidityWhite survivorsProportional hazards modelHealth careHealth-relatedChildhood cancerHigh-risk groupDiverse populationsArea Level Social Deprivation and Use of Prostate MRI Before Prostate Biopsy Among Commercial Insurance Beneficiaries
Smani S, Wang R, Zhou X, Sprenkle P, Kim I, Dinan M, Gross C, Ma X, Leapman M. Area Level Social Deprivation and Use of Prostate MRI Before Prostate Biopsy Among Commercial Insurance Beneficiaries. Urology 2025 PMID: 40759400, DOI: 10.1016/j.urology.2025.07.070.Peer-Reviewed Original ResearchPre-biopsy magnetic resonance imagingProstate magnetic resonance imagingMagnetic resonance imagingMagnetic resonance imaging useProstate biopsySocial deprivation indexArea-level measuresDynamic cohort studyMRI useMeasure of area-level deprivationSocioeconomic statusArea-level social deprivationArea-level measures of socioeconomic statusMeasures of socioeconomic statusStrata of socioeconomic statusArea-level deprivationCommercial insurance beneficiariesComposite measureBiopsyProstateNon-metropolitan areasDeprivation indexRural/urban statusResonance imagingSociodemographic factorsMachine Learning Risk Stratification for Older Breast Cancer Survivors: Clinical Care Implications
Wheeler S, Rotter J, Spees L, Biddell C, Trogdon J, Alfano C, Mayer D, Dinan M, Nekhlyudov L, Birken S. Machine Learning Risk Stratification for Older Breast Cancer Survivors: Clinical Care Implications. Health Services Research 2025, e70005. PMID: 40671264, DOI: 10.1111/1475-6773.70005.Peer-Reviewed Original ResearchBreast cancer survivorsAdverse health outcomesCancer survivorsHealth outcomesCancer-specific deathOlder breast cancer survivorsClinical care implicationsRisk prediction algorithmsAdverse outcomesHigh riskSEER-CAHPSRisk of all-cause deathPrimary careSurvivorship outcomesClinical risk prediction algorithmsCare implicationsClaims dataAll-cause deathCohen's kappaEnd ResultsSurvivorsCancer recurrenceFollow-up periodLow riskCareBiomarker-Specific Survival and Medication Cost for Patients With Non–Small Cell Lung Cancer
Tan J, Yang S, Dinan M, Chiang A, Gross C, Wang S. Biomarker-Specific Survival and Medication Cost for Patients With Non–Small Cell Lung Cancer. JAMA Network Open 2025, 8: e2514519. PMID: 40493365, PMCID: PMC12152704, DOI: 10.1001/jamanetworkopen.2025.14519.Peer-Reviewed Original ResearchConceptsAdvanced non-small cell lung cancerNon-small cell lung cancerEGFR variationPD-L1ALK rearrangementCell lung cancerDriver alterationsMedical costsLung cancerCohort studyProgrammed cell death 1 ligand 1Cell death 1 ligand 1Biomarker statusMedian overall survivalRetrospective cohort studyLower medical costsOverall survivalTargeted therapyNon-smallPatient cohortMonthly medical costsFollow-upStudy cohortBiomarker testingAssociated with higher costsAdoption of Broad Genomic Profiling in Patients With Cancer
Wang X, Rothen J, Huang S, Long J, Soulos P, Goldberg S, Mamtani R, Presley C, Kunst N, Ma S, Wang S, Gross C, Dinan M. Adoption of Broad Genomic Profiling in Patients With Cancer. JAMA Oncology 2025, 11: 666-668. PMID: 40244595, PMCID: PMC12006912, DOI: 10.1001/jamaoncol.2025.0499.Peer-Reviewed Original ResearchFactors associated with decreased treatment intensity in patients with metastatic colon cancer: A real world analysis.
Forman R, Wang R, Yasin F, Kwaramba T, Lacy J, Ma X, Dinan M. Factors associated with decreased treatment intensity in patients with metastatic colon cancer: A real world analysis. Journal Of Clinical Oncology 2025, 43: 11168-11168. DOI: 10.1200/jco.2025.43.16_suppl.11168.Peer-Reviewed Original ResearchMetastatic colon cancerNon-intensive therapyNational Comprehensive Cancer NetworkPoor performance statusIntensive therapyFlatiron Health electronic health record-derived deidentified databaseColon cancerIntensive first-line therapyUndertreatment of older patientsNational Comprehensive Cancer Network guidelinesOdds ratioAssociated with treatment choiceFirst-line therapyAssociated with female sexComprehensive Cancer NetworkRetrospective cohort studyYear of diagnosisShorter overall survivalNon-frail patientsOlder ageNon-frailMultivariate logistic regressionEstimate odds ratiosAssociated with receiptTreatment intensityRisk and predictors of late second primary malignancies in long-term breast, prostate, colon, and rectal cancer survivors.
Kwaramba T, Westvold S, Long J, Hyslop T, Silber A, Lustberg M, Wang S, Leapman M, Leeds I, Cecchini M, Spees L, Wheeler S, Gross C, Dinan M. Risk and predictors of late second primary malignancies in long-term breast, prostate, colon, and rectal cancer survivors. Journal Of Clinical Oncology 2025, 43: 1642-1642. DOI: 10.1200/jco.2025.43.16_suppl.1642.Peer-Reviewed Original ResearchSurvivors of breastRectal cancer survivorsCancer survivorsYears post-diagnosisPost-diagnosisOlder survivorsScreen-detectedSEER-MedicareLong-term cancer survivorsNon-screened cancersLong-term breastStage I-III cancerProstate cancer survivorsIndex cancer diagnosisContinuous Medicare Parts ASEER-Medicare dataModifiable risk factorsMedicare Part ADiagnosis of SPMSurvivorship careSEER-Medicare databaseSurvivorship cohortScreening guidelinesAssociated with shorter timeIndex cancerScreening History, Stage at Diagnosis, and Mortality in Screen-Detected Breast Cancer
Huang S, Westvold S, Soulos P, Fan J, Winer E, Zhan H, Lustberg M, Lewin J, Robinson T, Dinan M. Screening History, Stage at Diagnosis, and Mortality in Screen-Detected Breast Cancer. JAMA Network Open 2025, 8: e255322. PMID: 40232715, PMCID: PMC12000969, DOI: 10.1001/jamanetworkopen.2025.5322.Peer-Reviewed Original ResearchConceptsBreast cancer-specific mortalityBreast cancer mortalityBreast cancer diagnosisCancer-specific mortalityCancer mortalityCancer diagnosisScreening mammographyHazard of breast cancer-specific deathFee-for-service Medicare Parts AAssociated with reduced breast cancer mortalityLower breast cancer mortalityHazard of breast cancer-specific mortalityBreast cancerImprove breast cancer outcomesScreen-detected breast cancerCohort studyBreast cancer-specific deathStudy of older womenBreast cancer outcomesFee-for-serviceDetection of breast cancerMedicare Part ALater-stage diseaseCox proportional hazards modelsAssociated with early stagesOff-Label Use of First-Line Immunotherapy for Metastatic Renal Cell Carcinoma
McManus H, Long J, Westvold S, Leapman M, Hurwitz M, Mitchell A, Pollack C, Gross C, Dinan M. Off-Label Use of First-Line Immunotherapy for Metastatic Renal Cell Carcinoma. Clinical Genitourinary Cancer 2025, 23: 102330. PMID: 40186898, PMCID: PMC12084128, DOI: 10.1016/j.clgc.2025.102330.Peer-Reviewed Original ResearchConceptsMetastatic renal cell carcinomaImmune checkpoint inhibitorsFood and Drug AdministrationRenal cell carcinomaOff-labelCell carcinomaOlder patientsImmune checkpoint inhibitor useFood and Drug Administration approvalFirst-line immunotherapyMultivariate logistic regressionOff-label useCo-morbid conditionsCheckpoint inhibitorsFirst-lineCo-morbiditiesDrug AdministrationPatientsCo-morbidityPostapproval settingLogistic regressionCarcinomaDemographic characteristicsPostapprovalPostapproval periodPersonalized frailty risk assessment in long-term survivors of colorectal cancer.
Forman R, Westvold S, Long J, Fan J, Hyslop T, Yasin F, Conlin K, Jacobson S, Silber A, Wang S, Leapman M, Leeds I, Cecchini M, Spees L, Wheeler S, Gross C, Oeffinger K, Dinan M. Personalized frailty risk assessment in long-term survivors of colorectal cancer. Journal Of Clinical Oncology 2025, 43: 65-65. DOI: 10.1200/jco.2025.43.4_suppl.65.Peer-Reviewed Original ResearchRectal cancer survivorsCancer survivorsElixhauser Comorbidity IndexLong-term survivors of colorectal cancerSurvivors of colorectal cancerClinical prediction modelStage I-III colonCancer diagnosisGastrointestinal cancer survivorsYear 4Area-level povertyAssociated with reduced qualityRisk of frailtyProportion of residentsOnset of frailtyPredictors of frailtyFederal poverty lineIncreased risk of deathAdministrative claims codesSurvivorship managementRisk of deathRetrospective cohort studyAssociated with shorter timePatient raceSevere frailtyPredictors of late recurrence of colorectal cancer (CRC) among older long-term survivors using claims-based evidence.
Yasin F, Westvold S, Long J, Fan J, Hyslop T, Leeds I, Cecchini M, Gross C, Dinan M. Predictors of late recurrence of colorectal cancer (CRC) among older long-term survivors using claims-based evidence. Journal Of Clinical Oncology 2025, 43: 66-66. DOI: 10.1200/jco.2025.43.4_suppl.66.Peer-Reviewed Original ResearchCRC-specific mortalityAll-Cause MortalityCancer diagnosisColorectal cancerLong-term CRC survivorsNon-cancer related conditionsNon-metastatic colorectal cancerSEER-MedicareRisk of all-cause mortalityRecurrence of colorectal cancerColon cancerSEER-Medicare populationYear 5CRC survivorsSEER-Medicare databaseSurvivorship careRectal cancerFollow-up accountsColorectal cancer recurrenceMultiple co-morbiditiesMedicare claimsRetrospective cohort studyFine-Gray modelEstimate cumulative incidencePrimary risk factor
2024
Association between mammographic screening history and stage at diagnosis among women with screen-detected breast cancer.
Huang S, Westvold S, Soulos P, Winer E, Robinson T, Dinan M. Association between mammographic screening history and stage at diagnosis among women with screen-detected breast cancer. Journal Of Clinical Oncology 2024, 20: 145-145. DOI: 10.1200/op.2024.20.10_suppl.145.Peer-Reviewed Original ResearchScreen-detected breast cancerBreast cancer mortalityScreening historyScreening mammographyScreening mammogramsCancer mortalityFee-for-service Medicare Parts ABreast cancerBreast cancer-specific mortalityScreening prior to diagnosisNon-Hispanic black raceNegative screening mammogramCohort study of womenFactors associated with increased oddsAssociated with lower riskRetrospective cohort study of womenRoutine screening mammographyMedicare Part AHigh school educationStudy of womenCancer-specific mortalityMultivariate logistic regressionSEER-Medicare databaseClaims-based algorithmSporadic screeningStrength of evidence underlying the CMS-FDA parallel review of comprehensive genomic profiling tests in the cancer setting
Stackland S, Schnabel D, Dinan M, Presley C, Gross C. Strength of evidence underlying the CMS-FDA parallel review of comprehensive genomic profiling tests in the cancer setting. Journal Of The National Cancer Institute 2024, 117: 144-151. PMID: 39288939, PMCID: PMC11717411, DOI: 10.1093/jnci/djae196.Peer-Reviewed Original ResearchComprehensive genomic profilingComprehensive genomic profiling testCenter for Medical Technology PolicyClinical careClinical outcomesDiagnostic testsAssessed clinical outcomesOutcomes of patientsStrength of evidenceCourse of clinical careEfficacy of diagnostic testsNovel diagnostic testsPeer-reviewed literatureGenomic profiling testsFoundationOne CDxGenomic testingSolid tumorsStudy designGenomic alterationsGenomic profilingF1CDxCancer settingClinical utilityCancer typesCompare groupsCost trends of metastatic renal cell carcinoma therapy: the impact of oral anticancer agents and immunotherapy
Forman R, Long J, Westvold S, Agnish K, McManus H, Leapman M, Hurwitz M, Spees L, Wheeler S, Gross C, Dinan M. Cost trends of metastatic renal cell carcinoma therapy: the impact of oral anticancer agents and immunotherapy. JNCI Cancer Spectrum 2024, 8: pkae067. PMID: 39133171, PMCID: PMC11376369, DOI: 10.1093/jncics/pkae067.Peer-Reviewed Original ResearchMetastatic renal cell carcinomaOral anticancer agentsOAA useAssociated with decreased adherenceRenal cell carcinomaAnticancer agentsDays of treatmentCombination therapyCell carcinomaStudy patientsInitial treatmentReal-world costsCombination groupImmunotherapyPatientsOOP costsTherapyTreatment typePercent daysPerspective of payersTreatmentClaims dataMedicare patientsAnalyzed differencesFee-for-service MedicareChanges in Facility Share of Medicaid-insured Patients With Urologic Cancers Following Implementation of the Patient Protection and Affordable Care Act
Demkowicz P, Buck M, Nie J, Marks V, Wheeler S, Dinan M, Gross C, Leapman M. Changes in Facility Share of Medicaid-insured Patients With Urologic Cancers Following Implementation of the Patient Protection and Affordable Care Act. Urology 2024, 192: 19-27. PMID: 38901803, DOI: 10.1016/j.urology.2024.06.003.Peer-Reviewed Original ResearchFacility-level changesAffordable Care ActNon-expansion statesUrological cancer patientsProportion of patientsExpansion statesBaseline proportion of patientsUrologic cancer careHigh-income zip codesCancer patientsFactors associated with changesPre-post designCancer care centerPost-ACA periodMedicaid expansion statesMultivariate logistic regressionMedicaid-insured patientsCancer careUrological cancersZip codesCare ActMedicaid patientsMedicaidLogistic regressionCare centerCharacterization of time toxicity in older patients with metastatic breast cancer
Atre S, Soulos P, Kuderer N, Gross C, Baum L, Dinan M, Lustberg M. Characterization of time toxicity in older patients with metastatic breast cancer. Breast Cancer Research And Treatment 2024, 207: 541-550. PMID: 38816556, DOI: 10.1007/s10549-024-07379-7.Peer-Reviewed Original ResearchMetastatic breast cancerBone-modifying agentsComorbid medical conditionsOlder patientsBreast cancerRetrospective cohort studySEER-Medicare databaseTreatment typeCancer treatment modalityTreatment modalitiesSEER-MedicareCohort studyUnadjusted analysisPatientsAge-related impactCancer treatmentComorbiditiesDay patientsCancerRadiotherapyOlder ageMedical conditionsToxicityTreatmentSociodemographic factorsPersonalized risk assessment of new onset depression in long-term cancer survivors.
Taylor M, Westvold S, Long J, Hyslop T, Wang S, Cecchini M, Leapman M, Leeds I, Lustberg M, Spees L, Wheeler S, Gross C, Oeffinger K, Dinan M. Personalized risk assessment of new onset depression in long-term cancer survivors. Journal Of Clinical Oncology 2024, 42: e13798-e13798. DOI: 10.1200/jco.2024.42.16_suppl.e13798.Peer-Reviewed Original ResearchHistory of depressionIncidence of depressionCumulative incidence of depressionRisk of developing depressionLong-term survivorsPredictors of depressionCancer survivorsDisease specific factorsCumulative incidenceNon-HispanicHigher risk of developing depressionRectal cancerLong-term cancer survivorsBreast cancer survivorsCensus tract povertyColon cancerEpisodes of bipolar I disorderPrevalence of depressionMean survival time modelsDiagnosis of depressionReceipt of treatmentAssociated with prior historyHormone receptor statusPatients aged <Adjuvant endocrine therapy
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