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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 13 of 13 Research Studies DisplayedGupta N, Kucirka L, Semerjian A
Practice patterns regarding female reproductive organ-sparing and nerve-sparing radical cystectomy among urologic oncologists in the United States.
The purpose of this study was to describe practice patterns regarding female reproductive organ-sparing (ROS) and nerve-sparing radical cystectomy nerve-sparing radical cystectomy (RC) among US urologists. The researchers conducted a cross-sectional survey of members of the Society of Urologic Oncology to evaluate provider-reported frequency of ROS and nerve-sparing RC in premenopausal and postmenopausal patients with non-muscle-invasive bladder cancer that failed intravesical therapy or clinically localized muscle-invasive bladder cancer. The study found that among 101 urologists, 79.2% reported that they routinely resect the uterus/cervix, 67.3% the neurovascular bundle, 48.5% the ovaries, and 18.8% a portion of the vagina when performing RC in premenopausal patients with organ-confined disease. When asked about changes to approach in postmenopausal patients, 70.3% reported that they were less likely to spare the uterus/cervix, 43.6% were less likely to spare the neurovascular bundle, 69.3% were less likely to spare the ovaries, and 22.8% were less likely to spare a portion of the vagina.
AHRQ-funded; HS026120.
Citation: Gupta N, Kucirka L, Semerjian A .
Practice patterns regarding female reproductive organ-sparing and nerve-sparing radical cystectomy among urologic oncologists in the United States.
Clin Genitourin Cancer 2023 Aug; 21(4):e236-e41. doi: 10.1016/j.clgc.2023.01.010..
Keywords: Practice Patterns, Women, Sexual Health, Surgery, Cancer
Estenson L, Kim N, Jacobson M
Do age-based discontinuation recommendations influence cervical cancer screening rates? Evidence from the United States' Behavioral Risk Factor Surveillance System, 2016 and 2018.
The purpose of this study was to determine how the United States Preventive Services Task Force (USPSTF) recommendation of discontinuing routine cervical cancer screening for certain women after age 65 affects Papanicolaou (Pap) test rates among women at age 66 in the United States. The researchers utilized nationally representative 2016 and 2018 Behavioral Risk Factor Surveillance System (BRFSS) data for 226,031 women ages 56-76 to calculate changes in annual Pap test rates at age 66. Among women 66-76, 22.5% indicated they had received a Pap test within the past year. At age 66, annual Pap rates decreased by 5.9 percentage points (p.p.) off a pre-66 rate of 39 percent. The change differed by race/ethnicity, education, and marital status. Pap rates did not change discretely for non-Hispanic Black women but did change for women from other racial/ethnic groups. The decrease was larger for women who graduated college than for women without a college degree and for women who were never married than for women who were married/partnered or divorced/separated. The USPSTF recommendation to stop cervical cancer screening after the age of 65 resulted in a substantial decrease in the rate of Pap tests at age 66 but disparately affects women based on marital status, education and race.
AHRQ-funded; HS026488.
Citation: Estenson L, Kim N, Jacobson M .
Do age-based discontinuation recommendations influence cervical cancer screening rates? Evidence from the United States' Behavioral Risk Factor Surveillance System, 2016 and 2018.
Prev Med 2023 Jul; 172:107543. doi: 10.1016/j.ypmed.2023.107543..
Keywords: U.S. Preventive Services Task Force (USPSTF), Cancer: Cervical Cancer, Cancer, Screening, Prevention, Evidence-Based Practice, Women, Sexual Health
Gupta N, Zebib L, Wittmann D
Understanding the sexual health perceptions, concerns, and needs of female partners of prostate cancer survivors.
The adverse effects of prostate cancer (PCa) and its treatment can critically undermine the sexual well-being of patients and couples. However, limited research has been dedicated to understanding the influence of PCa-induced sexual dysfunction on the female partners of survivors. The purpose of this study was to carry out a qualitative investigation to comprehensively capture the perceptions of female partners regarding the repercussions of PCa on their sex lives, and their partners’ sexual health concerns and unfulfilled needs. The researchers conducted semi-structured telephonic interviews concerning sexual health and unfulfilled needs with female partners of PCa survivors. Participants were recruited from multiple clinical sites and PCa caregivers' support groups from September 2021 to March 2022. Interviews were recorded, transcribed, and independently coded. The study outcomes were on the sexual health concerns and unfulfilled needs of the female partners. Of the 12 participants, the median age was 65 (between 53 and 81), nine identified as White, the median duration since their partner's PCa diagnosis was 2.25 years (ranging from 11 months to 20 years), and most reported their partner had undergone radical prostatectomy, radiation, and/or hormonal therapy. Major themes emerging from the study concerned the substantial effect of age- and PCa-related sexual dysfunction on the sexual quality of life for women, the joint nature of sexual dysfunction and recovery, the partner's role in managing and adapting to sexual dysfunction, communication barriers regarding sexual dysfunction within an intimate relationship, the absence of sexual health counseling and support from physicians, and the advantage of peer interactions and proactive information seeking in addressing unfulfilled sexual health needs. The study concluded that female partners perceive PCa-related sexual dysfunction as a shared issue for couples, express sorrow due to age- and PCa-related sexual losses, and experience a void in physician-led sexual health counseling and information.
AHRQ-funded; HS026120.
Citation: Gupta N, Zebib L, Wittmann D .
Understanding the sexual health perceptions, concerns, and needs of female partners of prostate cancer survivors.
J Sex Med 2023 Apr 27; 20(5):651-60. doi: 10.1093/jsxmed/qdad027..
Keywords: Cancer: Prostate Cancer, Cancer, Sexual Health, Women
Li R, Wittmann D, Nelson CJ
Unmet sexual health needs of patients and female partners following diagnosis and treatment for prostate cancer.
This study’s objective was to perform a qualitative study to identify unmet sexual needs of patients and female partners after prostate cancer diagnosis. The authors conducted a qualitative study of posts to the Inspire Us TOO Prostate Cancer Online Support and Discussion Community. They identified 6,192 posts in the Sexual Health & Intimacy forum of the community, of which 661 posts were from female authors. A random sample of 10% of posts from female partners and an equal number of randomly selected posts from male patients were analyzed. Multiple themes emerged that were unique to female partners of prostate cancer survivors including included expanding the sexual repertoire, feeling invisible, contextualizing sexual intimacy within the broader picture of survival, and addressing relationship concerns. Patients and their partners had common concerns, including not receiving sufficient information from healthcare providers regarding sexual side effects from prostate cancer and its treatment. A limitation may be that members of the online community may not be representative of all couples facing prostate cancer. This study also does not examine sexual health needs among gay and bisexual couples.
AHRQ-funded; HS026120.
Citation: Li R, Wittmann D, Nelson CJ .
Unmet sexual health needs of patients and female partners following diagnosis and treatment for prostate cancer.
J Sex Med 2022 Dec; 19(12):1797-803. doi: 10.1016/j.jsxm.2022.08.195..
Keywords: Sexual Health, Cancer: Prostate Cancer, Cancer
Joyce DD, Wallis CJD, Luckenbaugh AN
Sexual function outcomes of radiation and androgen deprivation therapy for localized prostate cancer in men with good baseline function.
This retrospective review study sought to compare sexual function through 5 years for men undergoing radiation treatment for localized prostate cancer with and without systemic androgen deprivation therapy. Out of a cohort of 167 patients, 73 underwent radiation alone and 94 received androgen therapy deprivation therapy plus radiation. Androgen deprivation therapy was associated with worse sexual function through the first year regardless of disease risk. By 3 years the difference was no longer significant for the 51 patients with intermediate-risk disease. Worse sexual function for high-risk disease patients who received androgen deprivation therapy was shown at 3 years but not at 5 years.
AHRQ-funded; HS019356; HS022640.
Citation: Joyce DD, Wallis CJD, Luckenbaugh AN .
Sexual function outcomes of radiation and androgen deprivation therapy for localized prostate cancer in men with good baseline function.
Prostate Cancer Prostatic Dis 2022 Feb;25(2):238-47. doi: 10.1038/s41391-021-00405-5..
Keywords: Cancer: Prostate Cancer, Cancer, Sexual Health, Men's Health
Cunningham-Erves J, Campbell L, Barlow C
Reducing HPV associated cancers and disparities: engaging African American men to develop a culturally-appropriate program that addresses their needs.
Reducing HPV associated cancers and disparities: engaging African American men to develop a culturally-appropriate program that addresses their needs.
Am J Health Educ 2021;52(4):194-206. doi: 10.1080/19325037.2021.1930614.
This paper discusses the results of the Healthy Men, Healthy Communities program that aims to improve preventive behaviors among African American men to reduce HPV-related cancer disparities. An educational intervention was developed using cultural-targeting strategies such as linguistics, peripherals, evidence, socio-culture, and constituent-involving. Research team members were recruited from community-based (CBO) leaders. Three focus groups, 30 surveys, and a community review and program evaluation with African American men were conducted. The five focus group themes were: 1) The Known and Unknown of Cancer, HPV, and the vaccine; (2) Personal experiences with cancer were commonplace; (3) Barriers to Engaging HPV Cancer Preventive Behaviors; (4) Multi-Modal Strategies are needed to improve preventive behaviors; and (5) Actual versus Preferred Sources of Information. Survey data showed men desired information on penile (52%) and oral cancer (48%). A speaker summit on various topics was the preferred education format (96%). A post-summit evaluation indicated most males intended to get screened (73%), eat healthier (77%), and exercise more (65%). After these interventions the HPV vaccine was administered to about 40% of the men, and their children and grandchildren.
Am J Health Educ 2021;52(4):194-206. doi: 10.1080/19325037.2021.1930614.
This paper discusses the results of the Healthy Men, Healthy Communities program that aims to improve preventive behaviors among African American men to reduce HPV-related cancer disparities. An educational intervention was developed using cultural-targeting strategies such as linguistics, peripherals, evidence, socio-culture, and constituent-involving. Research team members were recruited from community-based (CBO) leaders. Three focus groups, 30 surveys, and a community review and program evaluation with African American men were conducted. The five focus group themes were: 1) The Known and Unknown of Cancer, HPV, and the vaccine; (2) Personal experiences with cancer were commonplace; (3) Barriers to Engaging HPV Cancer Preventive Behaviors; (4) Multi-Modal Strategies are needed to improve preventive behaviors; and (5) Actual versus Preferred Sources of Information. Survey data showed men desired information on penile (52%) and oral cancer (48%). A speaker summit on various topics was the preferred education format (96%). A post-summit evaluation indicated most males intended to get screened (73%), eat healthier (77%), and exercise more (65%). After these interventions the HPV vaccine was administered to about 40% of the men, and their children and grandchildren.
AHRQ-funded; HS022990.
Citation: Cunningham-Erves J, Campbell L, Barlow C .
Reducing HPV associated cancers and disparities: engaging African American men to develop a culturally-appropriate program that addresses their needs.
Am J Health Educ 2021;52(4):194-206. doi: 10.1080/19325037.2021.1930614..
Keywords: Sexual Health, Infectious Diseases, Cancer, Disparities, Racial and Ethnic Minorities, Men's Health, Prevention, Health Promotion, Education: Patient and Caregiver
Glenn BA, Nonzee NJ, Tieu L
Human papillomavirus (HPV) vaccination in the transition between adolescence and adulthood.
This study looked at the barriers to human papillomavirus (HPV) vaccination among young adults receiving care at the student health center of a large public university. The authors conducted semi-structured interviews (n=27) and four focus groups with undergraduate and graduate students (n=18) and semi-structured interviews with 6 health care providers. The interviews and focus groups explored perceived risk of HPV infection, benefits of the HPV vaccine, and motivations for and barriers to HPV vaccination. Many students cited their parents’ views and recommendations from their medical providers as influential on their decision-making process. Cervical cancer prevention was considered the main benefit of the HPV vaccine and sexual activity was a risk factor for HPV infection. Students often lacked knowledge about the vaccine’s benefit for males. Safety and side effects of the vaccine perceived as new were also cited. Providers’ vaccine recommendations were impacted by health system factors including clinical infrastructure, office visit priorities, and processes for recommending and documentation vaccination. Providers suggested various promotion strategies including improving the timing and messaging of outreach efforts on campus and bolstering clinical infrastructure.
AHRQ-funded; HS000046.
Citation: Glenn BA, Nonzee NJ, Tieu L .
Human papillomavirus (HPV) vaccination in the transition between adolescence and adulthood.
Vaccine 2021 Jun 8;39(25):3435-44. doi: 10.1016/j.vaccine.2021.04.019..
Keywords: Young Adults, Sexual Health, Infectious Diseases, Vaccination, Prevention, Cancer: Cervical Cancer, Cancer, Women
Asti L, Hopley C, Avelis C
The potential clinical and economic value of a human papillomavirus primary screening test that additionally identifies genotypes 31, 45, 51, and 52 individually.
This study looked at the potential clinical and economic value of a human papillomavirus (HPV) primary screening test that additionally identified genotypes 31,45,51, and 52 along with genotypes 16 and 18. The authors developed a Markov model of the HPV disease course and evaluated the clinical and economic value of HPV primary screening with Onclarity. Currently HPV primary screening results in 25,194 invasive procedures and 48 invasive cervical cancer (ICC) cases per 100,000 women. Screening with extended genotyping and later screening women with certain genotypes averted 903 to 3163 invasive procedures and results in 0 to 3 more ICC cases compared with current primary screening tests. Extended genotyping was cost effective when costing $75 and cost saving when costing $43. When the probabilities of disease progression increased 2-4 times, it was not cost-effective because it resulted in more ICC cases and accrued fewer quality-adjusted life-years.
AHRQ-funded; HS023317.
Citation: Asti L, Hopley C, Avelis C .
The potential clinical and economic value of a human papillomavirus primary screening test that additionally identifies genotypes 31, 45, 51, and 52 individually.
Sex Transm Dis 2021 May;48(5):370-80. doi: 10.1097/olq.0000000000001327.
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Keywords: Sexual Health, Infectious Diseases, Screening, Diagnostic Safety and Quality, Genetics, Cancer: Cervical Cancer, Cancer, Women
Mullins BT, Basak R, Broughman JR
Patient-reported sexual quality of life after different types of radical prostatectomy and radiotherapy: analysis of a population-based prospective cohort.
This study compares the effects of different types of radical prostatectomy and radiotherapy on sexual function. A population-based cohort of 835 men with newly diagnosed prostate cancer from 2011 through 2013 was recruited in collaboration with the Rapid Case Ascertainment system of the North Carolina Central Cancer Registry. They were enrolled prior to treatment and followed retrospectively using the validated Prostate Cancer Symptom Indices (PCSI) instrument. The sexual function scores were compared among patients who received the following treatment types: external-beam RT (EBRT), EBRT with androgen deprivation therapy (ADT), brachytherapy, nerve-sparing radical prostatectomy (RP), and non-nerve-sparing RP. The cohort was surveyed at 24 months post-therapy, and RT alone was found to result in the best preservation of sexual function with brachytherapy, RT with ADT, and nerve-sparing RP yielding similar outcomes. Patients treated with non-nerve-sparing RP experienced the worst sexual function outcome.
AHRQ-funded.
Citation: Mullins BT, Basak R, Broughman JR .
Patient-reported sexual quality of life after different types of radical prostatectomy and radiotherapy: analysis of a population-based prospective cohort.
Cancer 2019 Oct 15;125(20):3657-65. doi: 10.1002/cncr.32288..
Keywords: Quality of Life, Sexual Health, Surgery, Treatments, Comparative Effectiveness, Patient-Centered Outcomes Research, Outcomes, Cancer: Prostate Cancer, Cancer, Evidence-Based Practice
Haidari LA, Brown ST, Constenla D
Geospatial planning and the resulting economic impact of human papillomavirus vaccine introduction in Mozambique.
Researchers developed the Strategic Integrated Geo-temporal Mapping Application) to determine the potential economic impact of HPV immunization in Mozambique. If each health center covers a catchment area with a 5-km radius, then 40 percent of the target population could be reached to prevent 50 cases, 178 disability-adjusted life years, and US $202,854 in health care costs and lost productivity.
AHRQ-funded; HS023317.
Citation: Haidari LA, Brown ST, Constenla D .
Geospatial planning and the resulting economic impact of human papillomavirus vaccine introduction in Mozambique.
Sex Transm Dis 2017 Apr;44(4):222-26. doi: 10.1097/olq.0000000000000574.
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Keywords: Cancer, Healthcare Costs, Infectious Diseases, Sexual Health, Vaccination
Rhoten BA
Head and neck cancer and sexuality: a review of the literature.
The author analyzed nine publications to present a review of the literature on head and neck cancer and sexuality, concluding that existing studies indicate that sexuality is of considerable significance, particularly after treatment for head and neck cancer. She recommended that oncology nurses be aware that this topic is of importance to many patients, and that they should familiarize themselves with available resources.
AHRQ-funded; HS022990.
Citation: Rhoten BA .
Head and neck cancer and sexuality: a review of the literature.
Cancer Nurs 2016 Jul-Aug;39(4):313-20. doi: 10.1097/ncc.0000000000000289.
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Keywords: Cancer, Sexual Health, Quality of Life
Khan MJ, Massad LS, Kinney W
A common clinical dilemma: Management of abnormal vaginal cytology and human papillomavirus test results.
The researchers reviewed the literature on vaginal cytology and high-risk HPV testing and developed guidance for the management of abnormal vaginal screening tests. Since vaginal cancer is rare, the authors suggested that asymptomatic low-risk women not be screened. They further proposed an algorithm based on expert opinion for managing women with abnormal vaginal test results.
AHRQ-funded; HS023009.
Citation: Khan MJ, Massad LS, Kinney W .
A common clinical dilemma: Management of abnormal vaginal cytology and human papillomavirus test results.
J Low Genit Tract Dis 2016 Apr;20(2):119-25. doi: 10.1097/lgt.0000000000000185.
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Keywords: Cancer, Care Management, Infectious Diseases, Sexual Health, Women
Resnick MJ, Barocas DA, Morgans AK
The evolution of self-reported urinary and sexual dysfunction over the last two decades: implications for comparative effectiveness research.
This study evaluated differences in pretreatment urinary and sexual function in two population-based cohorts of men with prostate cancer enrolled nearly 20 yrs. apart. It concluded that reporting of pretreatment urinary incontinence and erectile dysfunction has increased over the past two decades. These findings may reflect sociological changes including heightened media attention and direct-to-consumer marketing, among other potential explanations.
AHRQ-funded; HS019356; HS022640; HS022990.
Citation: Resnick MJ, Barocas DA, Morgans AK .
The evolution of self-reported urinary and sexual dysfunction over the last two decades: implications for comparative effectiveness research.
Eur Urol 2015 Jun;67(6):1019-25. doi: 10.1016/j.eururo.2014.08.035..
Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Cancer, Cancer: Prostate Cancer, Sexual Health