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Chronic disease outcomes among older women with breast cancer in the united states

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TitleInfo
Title
Chronic disease outcomes among older women with breast cancer in the united states
Name (type = personal)
NamePart (type = family)
Santorelli
NamePart (type = given)
Melissa L.
NamePart (type = date)
1975-
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Melissa L. Santorelli
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RoleTerm (authority = RULIB)
author
Name (type = personal)
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KITAW
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KITAW DEMISSIE
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Advisory Committee
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chair
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Steinberg
NamePart (type = given)
Michael B
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Michael B Steinberg
Affiliation
Advisory Committee
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internal member
Name (type = personal)
NamePart (type = family)
Rhoads
NamePart (type = given)
George G
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George G Rhoads
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Advisory Committee
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internal member
Name (type = personal)
NamePart (type = family)
LIN
NamePart (type = given)
YONG
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YONG LIN
Affiliation
Advisory Committee
Role
RoleTerm (authority = RULIB)
internal member
Name (type = personal)
NamePart (type = family)
Hirshfield
NamePart (type = given)
Kim M
DisplayForm
Kim M Hirshfield
Affiliation
Advisory Committee
Role
RoleTerm (authority = RULIB)
outside member
Name (type = corporate)
NamePart
Rutgers University
Role
RoleTerm (authority = RULIB)
degree grantor
Name (type = corporate)
NamePart
Graduate School - New Brunswick
Role
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school
TypeOfResource
Text
Genre (authority = marcgt)
theses
OriginInfo
DateCreated (qualifier = exact)
2015
DateOther (qualifier = exact); (type = degree)
2015-05
CopyrightDate (encoding = w3cdtf); (qualifier = exact)
2015
Place
PlaceTerm (type = code)
xx
Language
LanguageTerm (authority = ISO639-2b); (type = code)
eng
Abstract (type = abstract)
Context: Improving survival has raised important questions about the long term health of breast cancer patients, particularly for older women who experience the highest incidence and who are more likely to have or develop other chronic health conditions. Specific Aims: The specific aims of this dissertation were to: 1) Examine racial differences in the effects of comorbidity on survival in elderly breast cancer patients (Study 1); 2) Investigate the effects of breast cancer on chronic disease medication adherence in the elderly (Study 2); and 3) Investigate the effects of hormonal therapy for breast cancer on diabetes incidence in postmenopausal women (Study 3). Design, Setting, and Subjects: The Surveillance, Epidemiology and End Results (SEER) – Medicare linked data were used to select stage I-III breast cancer patients for the above retrospective cohort studies. Women from a 5% random sample of Medicare enrollees living in SEER areas were selected as comparison subjects for studies two and three. Results: A competing risk survival analysis in the first study failed to find racial differences in the effects of comorbidity on breast cancer mortality after adjusting for age, year of diagnosis, and tumor characteristics. For other-cause mortality, the magnitude of adverse comorbidity effects were larger for white women overall (p=0.04). The second study showed an elevated risk of diabetes medication non-adherence for breast cancer versus comparison women after adjusting for age and race [Odds Ratio (OR) = 1.41; 95% Confidence Interval (CI) = 1.05 to 1.90]. Women with breast cancer were also more likely to be non-persistent with diabetes medication relative to women without cancer [Hazard Ratio (HR) = 1.29; 95% CI: 1.02 to 1.62]. The third study found no association between aromatase inhibitor use and new onset diabetes in the two years post-treatment initiation after adjusting for age, race, and comorbidity [HR: 0.99; 95% CI: 0.84 to 1.18]. Conclusion: The findings of this dissertation provide evidence that breast cancer affects chronic disease medication adherence and that hormonal therapy was not associated with the development of a new comorbidity. Special attention should be given to following breast cancer patients to ensure treatment of their comorbid conditions.
Subject (authority = RUETD)
Topic
Public Health
Subject (authority = ETD-LCSH)
Topic
Chronic diseases
Subject (authority = ETD-LCSH)
Topic
Breast--Cancer
Subject (authority = ETD-LCSH)
Topic
Older women--Diseases
RelatedItem (type = host)
TitleInfo
Title
Rutgers University Electronic Theses and Dissertations
Identifier (type = RULIB)
ETD
Identifier
ETD_6312
PhysicalDescription
Form (authority = gmd)
electronic resource
InternetMediaType
application/pdf
InternetMediaType
text/xml
Extent
1 online resource (ix, 101 p. : ill.)
Note (type = degree)
Ph.D.
Note (type = bibliography)
Includes bibliographical references
Note (type = statement of responsibility)
by Melissa L. Santorelli
RelatedItem (type = host)
TitleInfo
Title
Graduate School - New Brunswick Electronic Theses and Dissertations
Identifier (type = local)
rucore19991600001
Location
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NjNbRU
Identifier (type = doi)
doi:10.7282/T3KS6TCF
Genre (authority = ExL-Esploro)
ETD doctoral
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Rights

RightsDeclaration (ID = rulibRdec0006)
The author owns the copyright to this work.
RightsHolder (type = personal)
Name
FamilyName
Santorelli
GivenName
Melissa
MiddleName
L.
Role
Copyright Holder
RightsEvent
Type
Permission or license
DateTime (encoding = w3cdtf); (point = start); (qualifier = exact)
2015-04-11 23:38:52
AssociatedEntity
Name
Melissa Santorelli
Role
Copyright holder
Affiliation
Rutgers University. Graduate School - New Brunswick
AssociatedObject
Type
License
Name
Author Agreement License
Detail
I hereby grant to the Rutgers University Libraries and to my school the non-exclusive right to archive, reproduce and distribute my thesis or dissertation, in whole or in part, and/or my abstract, in whole or in part, in and from an electronic format, subject to the release date subsequently stipulated in this submittal form and approved by my school. I represent and stipulate that the thesis or dissertation and its abstract are my original work, that they do not infringe or violate any rights of others, and that I make these grants as the sole owner of the rights to my thesis or dissertation and its abstract. I represent that I have obtained written permissions, when necessary, from the owner(s) of each third party copyrighted matter to be included in my thesis or dissertation and will supply copies of such upon request by my school. I acknowledge that RU ETD and my school will not distribute my thesis or dissertation or its abstract if, in their reasonable judgment, they believe all such rights have not been secured. I acknowledge that I retain ownership rights to the copyright of my work. I also retain the right to use all or part of this thesis or dissertation in future works, such as articles or books.
RightsEvent
DateTime (encoding = w3cdtf); (point = start); (qualifier = exact)
2015-05-31
DateTime (encoding = w3cdtf); (point = end); (qualifier = exact)
2026-03-01
Type
Embargo
Detail
Access to this PDF has been restricted at the author's request. It will be publicly available after March 1, 2026.
Copyright
Status
Copyright protected
Availability
Status
Open
Reason
Permission or license
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ETD
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windows xp
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