Being age 50 or older is a significant risk factor for the development of many types of cancer (Deyo & Diehl, 1988; Goodman et al., 2018). In contrast, the occurrence of certain types of cancer (e.g., testicular cancer) is highest among patients who are between 19 and 40 years of age, and the risk decreases with advancing age (Holmes et al., 2008). Cancer is the second leading cause of death in children age 1 to 14 years, and the most common types of cancer in this group are leukemia, CNS tumors, and non-Hodgkin lymphoma (Linabery & Ross, 2008). The risk and incidence of prostate, ovarian, and colorectal cancers is low in children, but the risk begins to increase significantly after the age of 25 (Goodman et al., 2018). As a result, advancing age should be considered to be a significant risk factor for overall cancer occurrence, but the level of risk varies with the specific type of cancer. Racial and socioeconomic disparities There are significant racial and socioeconomic disparities in the incidence of and mortality from cancer (ACS, 2012, 2013a, 2013b; Jemal, Siegel, Xu, & Ward, 2010; National Cancer Institute [NCI], 2017a; Office of Minority Health [OMH], 2017; O’Keefe, Meltzer, & Bethea, 2015; Ward et al., 2004). The astute therapist will use this information and the information on racial and socioeconomic disparities that follows to increase use of specific screening techniques when working with people from these underserved groups to improve detection and treatment of possible oncological conditions. The reader is cautioned that measurement of any disparity is complicated since a disparity is not measured directly. A disparity is the difference found after variables have been controlled and accounted for in the analysis. This process, including the selection of variables, can lead to significant bias when interpreting the results (O’Keefe et al., 2015). African American males have the highest overall incidence rate for all forms of cancer combined compared to any other racial or ethnic group (NCI, 2017a; OMH, 2017; O’Keefe, 2015). African American males are 1.3 and 1.7 times more likely to have newly diagnosed cases of lung and prostate cancer, respectively, compared to non-Hispanic white males (Esnaola & Ford, 2012; OMH, 2017). African Americans have the highest death rate and the shortest survival rate from cancer of any ethnic or racial group in the United States (ACS, 2013a; NCI, 2017a; OMH, 2017; O’Keefe et al., 2015). The death rate for all cancers combined is 25% higher in African Americans compared to Caucasian Americans (ACS, 2013a; NCI, 2017a; OMH, 2017; O’Keefe et al., 2015). Breast/prostate, lung/bronchus and colon/rectal cancers are the three most common forms of cancer diagnosed in the U.S. However, African Americans have a higher incident rate for each of those forms of cancer except breast cancer compared with Caucasians (Esnaola & Ford, 2012; NCI, 2017a; OMH, 2017; O’Keefe et al., 2015). While the incidence of breast cancer is comparable, African American females are 40% more likely to be die from breast cancer (Esnaola & Ford, 2012; OMH, 2017). Recent research suggests that aggressive breast tumors occur more frequently in younger African American and Hispanic/ Physical activity and nutrition A healthy lifestyle and healthy behaviors are recommended to reduce the risk of cancer and cancer mortality (ACS, 2016). Multiple studies have shown that adherence to these recommendations or comparable guidelines is associated with a 17% lower incidence of any cancer and 20% decrease in cancer-specific mortality (Cerhan et al., 2004; McCullough et al., 2011; Romaguera et al., 2012; Thomson et al., 2014) and that a
As noted earlier, the investigation of symptoms should include a discussion of the 24-hour pattern of symptom presentation. The presence of night pain as an isolated finding is not strongly associated with the presence of cancer (Ross & Boissonnault, 2010). In addition, not all patients with musculoskeletal cancer exhibit night pain, while some patients with osteoarthritis in the low back or mechanical low back pain are known to have night pain (Slipman et al., 2003). However, if night pain is the worst pain during a 24-hour period, and the patient cannot find any means to reduce the pain, the significance of the finding is dramatically elevated. In addition, if the pain is constant in intensity, nothing aggravates or relieves the pain, and the patient fails to respond to conservative therapy, then the therapist should consider a referral to a physician (Ross & Boissonnault, 2010). Latino females living in areas with low socioeconomic status (SES; OMH, 2017). Prostate cancer is the most common new cancer diagnosis in African American males and Caucasian males in the U.S. However, African Americans have an incidence rate that is 1.7 times higher than the general population and one in five African American males will be diagnosed with prostate cancer (OMH, 2017). The mortality rate for prostate cancer is 2.5 times higher in African Americans compared to Caucasians (O’Keefe et al., 2015). African American males and females have the highest incident rate of cancer in the lung/bronchus compared to the general population and African American males have the highest mortality rate for cancer of the lung/bronchus of any racial/ethnic group (Esnaola & Ford, 2012; O’Keefe et al., 2015). Colon/rectal cancer is the third most common cancer diagnosis in the U.S. The incidence rate for colorectal cancer in African Americans is about 23% higher compared to Caucasians and the mortality rate is 1.5 times higher than found in the general population as well (Esnaola & Ford, 2012; O’Keefe et al., 2015). People with lower SES have disproportionately higher mortality rates from cancer than people living with a higher SES (OMH, 2017). The higher mortality rate for people with low SES persists even when race/ethnicity and other demographic factors (e.g., education, health insurance, and living conditions, are considered) (OMH, 2017). In addition, lower SES appears to be negatively correlated with a higher incidence of behavioral risk factors for cancer (e.g., tobacco use, sedentary behavior, obesity, poor health status, and not following cancer screening recommendations) (OMH, 2017). Self-reported health status is considered to be a strong and independent risk factor for functional limitations (Galenkamp et al., 2013) and mortality (Schnittker & Bacak, 2014). People who rate their health status as poor are twice as likely to die as those people reporting their health as excellent (Schnittker & Bacak, 2014). Approximately 56% of people over 50 years of age with incomes of $100,000 or more state that their health is excellent or good while only 24% of adults with incomes below $40,000 state their health is excellent or good (American Association of Retired Persons Research [AARP], 2016). lack of adherence is associated with a 35% elevation in risk and mortality from cancer (Cerhan et al., 2004). The incidence of breast and colon/rectal cancer was found to be 22% and 52% lower, respectively, with high adherence to the guidelines (Thomson et al., 2014). Death from cancer and all- cause mortality was 20% and 27% lower, respectively, in people who most closely adhered to the guidelines while the risk of
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Book Code: PTOH1324
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