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author:("Yin, caixin")
1.  “Racial and social class gradients in life expectancy in contemporary California” 
Social science & medicine (1982)  2010;70(9):1373-1380.
Life expectancy, or the estimated average age of death, is among the most basic measures of a population's health. However, monitoring differences in life expectancy among sociodemographically defined populations has been challenging, at least in the United States (US), because death certification does not include collection of markers of socioeconomic status (SES). In order to understand how SES and race/ethnicity independently and jointly affected overall health in a contemporary US population, we assigned a small area-based measure of SES to all 689,036 deaths occurring in California during a three-year period (1999-2001) overlapping the most recent US census. Residence at death was geocoded to the smallest census area available (block group) and assigned to a quintile of a multifactorial SES index. We constructed life tables using mortality rates calculated by age, sex, race/ethnicity and neighborhood SES quintile, and produced corresponding life expectancy estimates. We found a 19.6 (±0.6) year gap in life expectancy between the sociodemographic groups with the longest life expectancy (highest SES quintile of Asian females; 84.9 years) and the shortest (lowest SES quintile of African-American males; 65.3 years). A positive SES gradient in life expectancy was observed among whites and African-Americans but not Hispanics or Asians. Age-specific mortality disparities varied among groups. Race/ethnicity and neighborhood SES had substantial and independent influences on life expectancy, underscoring the importance of monitoring health outcomes simultaneously by these factors. African-American males living in the poorest 20% of California neighborhoods had life expectancy comparable to that reported for males living in developing countries. Neighborhood SES represents a readily available metric for ongoing surveillance of health disparities in the US.
doi:10.1016/j.socscimed.2010.01.003
PMCID: PMC2849870  PMID: 20171001
racial disparities; social class disparities; life expectancy; California; population-based; USA; socioeconomic status (SES)
2.  Does socioeconomic disparity in cancer incidence vary across racial/ethnic groups? 
Cancer Causes & Control  2010;21(10):1721-1730.
Objective
Very few studies have simultaneously examined incidence of the leading cancers in relation to socioeconomic status (SES) and race/ethnicity in populations including Hispanics and Asians. This study aims to describe SES disparity in cancer incidence within each of four major racial/ethnic groups (non-Hispanic white, black, Hispanic, and Asian/Pacific Islander) for five major cancer sites, including female breast cancer, colorectal cancer, cervical cancer, lung cancer, and prostate cancer.
Methods
Invasive cancers of the five major sites diagnosed from 1998 to 2002 (n = 376,158) in California were included in the study. Composite area-based SES measures were used to quantify SES level and to calculate cancer incidence rates stratified by SES. Relative index of inequality (RII) was generated to measure SES gradient of cancer incidence within each racial/ethnic group.
Results
Significant variations were detected in SES disparities across the racial/ethnic groups for all five major cancer sites. Female breast cancer and prostate cancer incidence increased with increased SES in all groups, with the trend strongest among Hispanics. Incidence of cervical cancer increased with decreased SES, with the largest gradient among non-Hispanic white women. Lung cancer incidence increased with decreased SES with the exception of Hispanic men and women, for whom SES gradient was in the opposite direction. For colorectal cancer, higher incidence was associated with lower SES in non-Hispanic whites but with higher SES in Hispanics and Asian/Pacific Islander women.
Conclusions
Examining SES disparity stratified by race/ethnicity enhances our understanding of the complex relationships between cancer incidence, SES, and race/ethnicity.
doi:10.1007/s10552-010-9601-y
PMCID: PMC2941051  PMID: 20567897
Cancer incidence; Socioeconomic status; Disparity; Race/ethnicity
3.  Benefit of Postoperative Adjuvant Therapy for Pancreatic Cancer: A Population-Based Analysis 
Cancer  2009;115(11):2420-2429.
BACKGROUND
Despite recent completion of several trials of adjuvant therapy after resection for pancreatic adenocarcinoma, the absolute impact on survival and the identification of appropriate patients for treatment remains controversial.
OBJECTIVE
We sought to identify the impact of adjuvant therapy and factors associated with any improvement in survival after resection of pancreatic cancer.
METHODS
Through the California Cancer Registry, we identified all California residents diagnosed with pancreatic cancer between 1994 and 2002. Factors potentially impacting survival were analyzed, including: patient demographics, tumor characteristics, and treatment provided. Univariate and multivariate survival analyses were performed by Kaplan-Meier and Cox regression methods.
RESULTS
26,518 patients were identified; 3,196 (12.1%) underwent resection as their primary treatment. The median overall survival was 16 months for resected patients. Prognostic factors associated with better survival included: negative lymph node status, well differentiated tumors, younger age, female gender, and receipt of any adjuvant therapy. On multivariate analysis, adjuvant therapy demonstrated a statistically significant, though modest, impact on survival with a hazard ratio of 0.79 (95% CI 0.72 – 0.87, p<0.001). The benefit of adjuvant therapy was only apparent in those patients with lymph node positive or poorly differentiated tumors.
CONCLUSIONS
Adjuvant therapy provides for a modest improvement in overall survival following surgical resection of pancreatic cancer. The absolute effect is most pronounced in those with poor prognostic indicators. In order to identify effective systemic therapy for this deadly cancer, future clinical trials of adjuvant therapy should focus on these groups of patients.
doi:10.1002/cncr.24269
PMCID: PMC2748401  PMID: 19301434
Pancreatic Cancer; Outcomes; Adjuvant treatment

Results 1-3 (3)