@article {12159, title = {Does a Cancer Diagnosis in Mid-to-Later Life Modify Racial Disparities in Memory Aging?}, journal = {Alzheimer Disease \& Associated Disorders}, volume = {36}, year = {2022}, pages = {140-147}, abstract = {

BACKGROUND: It is unknown whether an incident cancer diagnosis differentially impacts acute and long-term memory aging between older White and Black Americans.

METHODS: Incident cancer diagnoses and memory (immediate and delayed recall, combined with proxy-reported memory) were assessed at biennial study interviews in the US Health and Retirement Study (N=14,235, 1998-2016). We used multivariable segmented linear mixed-effects models to evaluate the rate of change in standardized memory score (SD/decade) in the years before, acutely at the time of, and in the years following an incident cancer diagnosis, compared to cancer-free adults, by race.

RESULTS: Black participants experienced faster memory decline than White participants (cancer-free group: -1.211 vs. -1.077; P<0.0001). An incident cancer diagnosis was associated with an acute memory drop in White, but not Black participants (-0.065 vs. 0.024; P<0.0001). However, White cancer survivors experienced slower memory decline than cancer-free White adults before and after diagnosis, but this memory advantage was not observed among Black cancer survivors.

CONCLUSIONS: Racial disparities in memory aging are not modified by an incident cancer diagnosis. The acute cancer-related memory decline and long-term memory advantage experienced by White, but not Black, cancer survivors relative to cancer-free older adults, requires further investigation.

}, keywords = {cancer diagnosis, Memory, Racial Disparities}, issn = {1546-4156}, doi = {10.1097/WAD.0000000000000493}, author = {Eastman, Marisa R and Ospina-Romero, Monica and Westrick, Ashly C and Jasdeep S Kler and M. Maria Glymour and Abdiwahab, Ekland and Lindsay C Kobayashi} } @article {11960, title = {Validation of self-reported cancer diagnoses using Medicare diagnostic claims in the U.S. Health and Retirement Study, 2000-2016.}, journal = {Cancer Epidemiology, Biomarkers \& Prevention}, volume = {31}, year = {2022}, pages = {287-292}, abstract = {

BACKGROUND: The US Health Retirement Study (HRS) is an ongoing population-representative cohort of US adults aged >50 with rich data on health during aging. Self-reported cancer diagnoses have been collected since 1998, but they have not been validated. We compared self-reported cancer diagnoses in HRS interviews against diagnostic claims from linked Medicare records.

METHODS: Using HRS-Medicare linked data, we examined the validity of first incident cancer diagnoses self-reported in biennial interviews from 2000-2016 against ICD-9 and ICD-10 diagnostic claim records as the gold standard. Data were from 8,242 HRS participants aged {greater than or equal to}65 with 90\% continuous enrollment in fee-for-service Medicare. We calculated the sensitivity, specificity, and k for first incident invasive cancer diagnoses (all cancers combined, and each of bladder, breast, colorectal/anal, uterine, kidney, lung, and prostate cancers) cumulatively over the follow-up and at each biennial study interview.

RESULTS: Overall, self-reports of first incident cancer diagnoses from 2000-2016 had 73.2\% sensitivity and 96.2\% specificity against Medicare claims (k=0.73). For specific cancer types, sensitivities ranged from 44.7\% (kidney) to 75.0\% (breast), and specificities ranged from 99.2\% (prostate) and 99.9\% (bladder, uterine, and kidney). Results were similar in sensitivity analyses restricting to individuals with 100\% continuous fee-for-service Medicare enrollment and when restricting to individuals with at least 24 months of Medicare enrollment.

CONCLUSION: Self-reported cancer diagnoses in the HRS have reasonable validity for use in population-based research that is maximized with linkage to Medicare.

IMPACT: These findings inform the use of the HRS for population-based cancer and aging research.

}, keywords = {cancer diagnoses, medicare diagnostic claims, Self-reported health}, issn = {1538-7755}, doi = {10.1158/1055-9965.EPI-21-0835}, author = {Megan Mullins and Jasdeep S Kler and Eastman, Marisa R and Mohammed U Kabeto and Lauren P Wallner and Lindsay C Kobayashi} } @article {doi:10.1200/JCO.2020.39.28_suppl.312, title = {Validation of self-reported incident cancer diagnoses in the U.S. Health and Retirement Study: A tool for population-based cancer and aging research.}, journal = {Journal of Clinical Oncology}, volume = {39}, year = {2021}, pages = {312}, abstract = {Background: Population aging and improving cancer survival rates are resulting in a growing population of older cancer survivors in the United States (US). As a result, there is an increasing need for longitudinal, population-representative data for interdisciplinary cancer research among older adults. The US Health Retirement Study (HRS) is an ongoing population-representative cohort of US adults over age 50 that contains rich interview and biomarker data on health during aging. Interviews have collected self-reported cancer diagnoses since 1998, but these self-reports have not been validated. We compared first incident cancer diagnoses self-reported in HRS interviews against diagnostic claims from linked Medicare records. Methods: We examined the validity of first incident cancer diagnoses self-reported in biennial HRS interviews from 2000 through 2016 against ICD-9 and ICD-10 diagnostic claim records among 8,242 HRS participants aged >=65 with 90\% continuous enrollment in fee-for-service Medicare, using the claim records as the gold standard. We calculated the sensitivity, specificity, and k for first incident cancer diagnoses (all cancers combined, excluding non-melanoma skin cancer, and each of bladder, breast, colorectal/anal, uterine, kidney/renal, lung/bronchus, and prostate cancers) cumulatively over the follow-up, and at each biennial study interview. Results: Self-reports of first incident cancer diagnosis (agnostic of site) between 2000 and 2016 had 73.2\% sensitivity and 96.2\% specificity against Medicare claims (k = 0.73). For site-specific self-reports, sensitivities ranged from 44.7\% (kidney) to 75.0\% (breast), and specificities ranged from 99.2\% (prostate) to 99.9\% (bladder, uterine, and kidney). Results were similar in sensitivity analyses restricting to individuals with 100\% continuous fee-for-service Medicare enrollment and when restricting to individuals with at least 24 months of Medicare enrollment. Conclusions: Self-reported cancer diagnoses in the HRS have reasonable validity for population-based research on cancer and aging across cancer types. Apart from breast cancer, cancer site specific analyses will greatly benefit from the improved validity of self-report with Medicare claim linkage.}, keywords = {biomarker data, cancer diagnoses, Medicare, self-report}, doi = {10.1200/JCO.2020.39.28_suppl.312}, author = {Megan Mullins and Jasdeep S Kler and Eastman, Marissa and Mohammed U Kabeto and Lauren P Wallner and Lindsay C Kobayashi} }