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Biomedical subjects

T C Tucker

Publications and source records attributed to T C Tucker.

9 recordsLinked to original sources
PubMed1995

The costs of cancer care in the United States: implications for action.

The total annual cost of cancer care in the United States (including direct and indirect costs) has been estimated at more than $96 billion. Although third-party payers have led the effort to reduce these costs, such high expenditures must concern society as a whole, since money spent on cancer care, whether through insurance premiums, taxes to support Medicare, or payouts from family savings, could be used for other purposes. In the future, attention may be shifted to more cost-effective strategies, including greater prevention efforts and development of better diagnostic tools to permit early detection. Improved diagnosis, however, presents an anomaly in that with earlier detection, survival is greater but the overall direct treatment costs are higher. This is why when making decisions about allocation of medical resources, the indirect costs of morbidity and mortality (which are reduced with early diagnosis) must be considered as well as the direct cost.

Health Care Costs↗
PubMed1993

The 1990/91 Kentucky hospital smoking policy survey: a follow-up.

We surveyed all Kentucky hospitals regarding smoking policies iin 1989, 1990, and 1991. There were statistically significant increases in the numbers of hospitals which developed smoking policies and became smoke free between 1990 and 1991. The sale of tobacco in hospitals declined significantly between 1989 and 1991, as did the number of institutions providing smoking areas within the hospital. Survey respondents indicated that the JCAHO mandate prompted changes in smoking policies. Kentucky hospitals are leading the way in developing smoke-free environments, but externally imposed regulations have played a major role in promoting this progress.

Health Policy↗
PubMed1992

Incidence of dysplasia and carcinoma of the uterine cervix in an Appalachian population.

BACKGROUND: Cervical cancer mortality rates in the Appalachian population of southeastern Kentucky have been shown to be unusually high. To better understand the high cervical cancer death rate in this area, we developed a population-based cervical disease registry. PURPOSE: This study describes the incidence of cervical dysplasia, carcinoma in situ, and invasive cervical cancer in 1986 and 1987 among White women in a 36-county area of Appalachian Kentucky based on histologic diagnoses. METHODS: We compared average annual age-adjusted incidence rates for carcinoma in situ and invasive cervical cancer in the study area with those for women in the Surveillance, Epidemiology, and End Results (SEER) Program. RESULTS: The incidence rate of invasive cervical cancer for women in the study area (14.9 per 100,000) was nearly twice that for White women in the SEER population (7.8 per 100,000), but it was similar to that for Black women in the SEER population (15.3 per 100,000). The incidence of carcinoma in situ for women in the study population (38.2 per 100,000) was 21% higher than that for White women (31.5 per 100,000) or for Black women (31.2 per 100,000) in the SEER population. The average annual age-adjusted incidence rate for all grades of dysplasia among women in the study population was 194.6 per 100,000. No comparable population-based incidence rates for dysplasia could be identified. CONCLUSIONS: Cervical cancer incidence rates are higher in Appalachian Kentucky than in the SEER population. Poverty appears to be a factor associated with these rates. IMPLICATIONS: Low-density populations such as those in rural Appalachia deserve greater attention in cancer control research. The population-based cervical dysplasia rates reported here may be useful for comparisons in future investigations.

Appalachian Region↗
PubMed1990

Use of snuff, chewing tobacco, and cigarettes among adolescents in a tobacco-producing area.

This study describes the prevalence and patterns of smokeless tobacco and cigarette use among adolescents with a specific focus on those living in a high tobacco production area. The subjects were 582 male and 485 female students in grades 7 through 12, with 54% living in a rural (nonmetro) area and the remainder living in an urban (metro) area. Self-reports of tobacco usage were validated using biochemical tests. High smokeless tobacco usage rates were found among nonmetro males--90% had tried one or more smokeless tobacco products and 33% had used at least one of the products in the last 6 days. Students' tobacco usage increased dramatically as the degree of personal involvement in raising tobacco increased. Of senior high boys who had household involvement in tobacco, 100% had tried snuff and 42% had used it in the last 6 days; 80% had tried cigarettes and 53% had used them in the last 6 days. Some other results were: (1) use of snuff was more popular than chewing tobacco, (2) the average grade for initiation to tobacco was the fourth grade for nonmetro students and the fifth grade for metro students, and (3) a large number of male smokeless users also reported cigarette use. Students from tobacco-raising households are at high risk for tobacco use. Future research should focus on effective prevention methods for high-risk students.

Adolescent↗
PubMed1988

Saliva cotinine and thiocyanate: chemical indicators of smokeless tobacco and cigarette use in adolescents.

Recent attempts to measure smoking behavior using chemical tests may have been confounded by the use of smokeless tobacco. An objective measure of smokeless tobacco use is needed, particularly among adolescents who may not provide accurate self-reports of tobacco usage. Saliva cotinine was used to distinguish self-reported tobacco users from nonusers and a combination of saliva cotinine and thiocyanate (SCN) tests was used to distinguish smokers from smokeless tobacco users. The subjects were 471 students in grades 7 through 11 who lived in a high-tobacco production area. Approximately 89% of reported nonusers had no detectable cotinine and 99% of nonusers had levels less than 25 ng/ml. Of those who had used tobacco within the last 12 hr, 95% had detectable levels of cotinine. Samples that tested positive for cotinine were also tested for SCN. Eighty-six percent of smokers and 74% of mixed users had SCN values of greater than 1000 mumol/liter, while only 14% of smokeless users had SCN values at that level. The combination of cotinine and SCN was effective in distinguishing smokers from smokeless users but was not effective in distinguishing mixed use from the other two types of use.

Adolescent↗
PubMed1983

Comparison of data elements in guidelines developed independently in community hospital oncology programs.

In summary we would like to thank the communities that participated in this study. A comparison of data elements in the guidelines developed by these communities demonstrated similarity in areas of diagnosis, pretreatment evaluation and staging. In the area of treatment it was apparent that physicians writing these guidelines were less autocratic in that more flexibility, more options and less specificity in recommendations was found. That this is not necessarily unfavorable is reflected in the fact that variations existed where the cancer literature is unsettled.

Community Health Services↗
PubMedDate not supplied

Relationship of personal tobacco-raising, parental smoking, and other factors to tobacco use among adolescents living in a tobacco-producing region.

This study examined factors related to tobacco use among youth from tobacco-raising (TRH) and nonraising households (NRH). The subjects were 3,851 seventh-grade students from 19 middle schools located in a tobacco-raising region. Valid self-reports of tobacco use were encouraged by the use of a test for carbon monoxide in expired air. Cigarette use was higher when (a) at least one parent smoked, and/or (b) the student personally raised tobacco. A boy who personally raised tobacco and had at least one parent who smoked was 10.2 times more likely to have smoked in the last 7 days than a boy from a nonraising household in which neither parent smoked. For girls, the odds ratio was 5.6:1. Tobacco use among students in this high-risk group was higher than rates reported in national or regional studies. Other results were: (1) use began very early--16% of the students had tried cigarettes and 13% of the boys had tried smokeless tobacco (SLT) in Grade 3 or earlier; and (2) users reported more lenient rules at home regarding tobacco use than did nonusers. Years from now, these high-risk students are likely to be major contributors to increased morbidity and mortality due to tobacco use. Implications for tobacco prevention in tobacco-raising areas are discussed.

Adolescent↗