Bio


Dr. Divya Parikh is board-certified in both medical oncology and internal medicine. She obtained her medical degree from Boston University School of Medicine and completed both her residency and fellowship through Stanford University. During her fellowship, she simultaneously earned a Master of Science in health policy from Stanford University.

Dr. Parikh specializes in the care of patients with genitourinary cancers. In addition to her clinical responsibilities, she currently is a clinical assistant professor of medical oncology at Stanford School of Medicine. She mentors medical residents and fellows by sharing her insights, knowledge, and expertise.

Dr. Parikh has a strong research background. She has published in multiple academic journals and presented her findings through poster and oral presentations at various medical conferences.

Clinical Focus


  • Medical Oncology

Academic Appointments


Professional Education


  • Board Certification: American Board of Internal Medicine, Medical Oncology (2021)
  • Fellowship: Stanford University Hematology and Oncology Fellowship (2021) CA
  • Board Certification: American Board of Internal Medicine, Internal Medicine (2018)
  • Residency: Stanford University Internal Medicine Residency (2018) CA
  • Medical Education: Boston University School of Medicine (2015) MA

All Publications


  • Lay healthcare worker financial toxicity intervention: a pilot financial toxicity screening and referral program. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer Parikh, D. A., Rodriguez, G. M., Ragavan, M., Kerr, E., Asuncion, M. K., Hansen, J., Srinivas, S., Fan, A. C., Shah, S., Patel, M. I. 2024; 32 (3): 161

    Abstract

    Financial toxicity is a source of significant distress for patients with urologic cancers, yet few studies have addressed financial burden in this patient population.We developed a financial toxicity screening program using a lay health worker (LHW) and social worker (SW) to assess and mitigate financial toxicity in a single academic medical clinic. As part of a quality improvement project, the LHW screened all newly diagnosed patients with advanced stages of prostate, kidney, or urothelial cancer for financial burden using three COST tool questions and referred patients who had significant financial burden to an SW who provided personalized recommendations. The primary outcome was feasibility defined as 80% of patients with financial burden completing the SW consult. Secondary outcomes were patient satisfaction, change in COST Tool responses, and qualitative assessment of financial resources utilized.The LHW screened a total of 185 patients for financial toxicity; 82% (n = 152) were male, 65% (n = 120) White, and 75% (n = 139) reported annual household income >$100,000 US Dollars; 60% (n = 114) had prostate cancer. A total of 18 (9.7%) participants screened positive for significant financial burden and were referred to the SW for consultation. All participants (100%) completed and reported satisfaction with the SW consultation and had 0.83 mean lower scores on the COST Tool post-intervention assessment compared to pre-intervention (95% confidence interval [0.26, 1.41]).This multidisciplinary financial toxicity intervention using an LHW and SW was feasible, acceptable, and associated with reduced financial burden among patients with advanced stages of urologic cancers. Future work should evaluate the effect of this intervention among cancer patients in diverse settings.

    View details for DOI 10.1007/s00520-024-08357-x

    View details for PubMedID 38366165

    View details for PubMedCentralID 6494243

  • Phase 2 open label study of durvalumab with neoadjuvant chemotherapy in variant histology bladder cancer. Khaki, A., Fan, A. C., Shah, S., Parikh, D., Chien, J., Moore, K., Ruiz, S., Haas, D., Fakhoury, L., Del Toro, N., Baker, P., O'Brien, A., Srinivas, S. LIPPINCOTT WILLIAMS & WILKINS. 2023
  • Use of Machine Learning and Lay Care Coaches to Increase Advance Care Planning Conversations for Patients With Metastatic Cancer. JCO oncology practice Gensheimer, M. F., Gupta, D., Patel, M. I., Fardeen, T., Hildebrand, R., Teuteberg, W., Seevaratnam, B., Asuncion, M. K., Alves, N., Rogers, B., Hansen, J., DeNofrio, J., Shah, N. H., Parikh, D., Neal, J., Fan, A. C., Moore, K., Ruiz, S., Li, C., Khaki, A. R., Pagtama, J., Chien, J., Brown, T., Tisch, A. H., Das, M., Srinivas, S., Roy, M., Wakelee, H., Myall, N. J., Huang, J., Shah, S., Lee, H., Ramchandran, K. 2022: OP2200128

    Abstract

    Patients with metastatic cancer benefit from advance care planning (ACP) conversations. We aimed to improve ACP using a computer model to select high-risk patients, with shorter predicted survival, for conversations with providers and lay care coaches. Outcomes included ACP documentation frequency and end-of-life quality measures.In this study of a quality improvement initiative, providers in four medical oncology clinics received Serious Illness Care Program training. Two clinics (thoracic/genitourinary) participated in an intervention, and two (cutaneous/sarcoma) served as controls. ACP conversations were documented in a centralized form in the electronic medical record. In the intervention, providers and care coaches received weekly e-mails highlighting upcoming clinic patients with < 2 year computer-predicted survival and no prior prognosis documentation. Care coaches contacted these patients for an ACP conversation (excluding prognosis). Providers were asked to discuss and document prognosis.In the four clinics, 4,968 clinic visits by 1,251 patients met inclusion criteria (metastatic cancer with no prognosis previously documented). In their first visit, 28% of patients were high-risk (< 2 year predicted survival). Preintervention, 3% of both intervention and control clinic patients had ACP documentation during a visit. By intervention end (February 2021), 35% of intervention clinic patients had ACP documentation compared with 3% of control clinic patients. Providers' prognosis documentation rate also increased in intervention clinics after the intervention (2%-27% in intervention clinics, P < .0001; 0%-1% in control clinics). End-of-life care intensity was similar in intervention versus control clinics, but patients with ≥ 1 provider ACP edit met fewer high-intensity care measures (P = .04).Combining a computer prognosis model with care coaches increased ACP documentation.

    View details for DOI 10.1200/OP.22.00128

    View details for PubMedID 36395436

  • Patient perspectives on window of opportunity clinical trials in early-stage breast cancer. Breast cancer research and treatment Parikh, D. A., Kody, L., Brain, S., Heditsian, D., Lee, V., Curtis, C., Karin, M. R., Wapnir, I. L., Patel, M. I., Sledge, G. W., Caswell-Jin, J. L. 2022

    Abstract

    Window of opportunity trials (WOT) are increasingly common in oncology research. In WOT participants receive a drug between diagnosis and anti-cancer treatment, usually for the purpose of investigating that drugs effect on cancer biology. This qualitative study aimed to understand patient perspectives on WOT.We recruited adults diagnosed with early-stage breast cancer awaiting definitive therapy at a single-academic medical center to participate in semi-structured interviews. Thematic and content analyses were performed to identify attitudes and factors that would influence decisions about WOT participation.We interviewed 25 women diagnosed with early-stage breast cancer. The most common positive attitudes toward trial participation were a desire to contribute to research and a hope for personal benefit, while the most common concerns were the potential for side effects and how they might impact fitness for planned treatment. Participants indicated family would be an important normative factor in decision-making and, during the COVID-19 pandemic, deemed the absence of family members during clinic visits a barrier to enrollment. Factors that could hinder participation included delay in standard treatment and the requirement for additional visits or procedures. Ultimately, most interviewees stated they would participate in a WOT if offered (N = 17/25).In this qualitative study, interviewees weighed altruism and hypothetical personal benefit against the possibility of side effect from a WOT. In-person family presence during trial discussion, challenging during COVID-19, was important for many. Our results may inform trial design and communication approaches in future window of opportunity efforts.

    View details for DOI 10.1007/s10549-022-06611-6

    View details for PubMedID 35538268

  • Re: Pembrolizumab Monotherapy for the Treatment of High-risk Non-muscle-invasive Bladder Cancer Unresponsive to BCG (KEYNOTE-057): An Open-label, Single-arm, Multicentre, Phase 2 Study EUROPEAN UROLOGY Parikh, D. A., Kaki, A., Williams, S. B. 2022; 81 (4): 429-430
  • Long-term cost comparisons of radical cystectomy versus trimodal therapy for muscle-invasive bladder cancer. Golla, V., Shan, Y., Farran, E., Vu, K., Stewart, C. A., Khaki, A., Keegan, K. A., Kamat, A. M., Tyler, D. S., Freedland, S. J., Williams, S. B. LIPPINCOTT WILLIAMS & WILKINS. 2022
  • Re: Pembrolizumab Monotherapy for the Treatment of High-risk Non-muscle-invasive Bladder Cancer Unresponsive to BCG (KEYNOTE-057): An Open-label, Single-arm, Multicentre, Phase 2 Study. European urology Parikh, D. A., Khaki, A. R., Williams, S. B. 2022

    View details for DOI 10.1016/j.eururo.2022.01.016

    View details for PubMedID 35131115

  • Long term cost comparisons of radical cystectomy versus trimodal therapy for muscle-invasive bladder cancer. Urologic oncology Golla, V., Shan, Y., Farran, E. J., Stewart, C. A., Vu, K., Yu, A., Khaki, A. R., Parikh, D. A., Swanson, T. A., Keegan, K. A., Kamat, A. M., Tyler, D. S., Freedland, S. J., Williams, S. B. 2022

    Abstract

    Earlier studies on the cost of muscle-invasive bladder cancer treatments are limited to short-term costs of care. We determined the 2- and 5-year costs associated with trimodal therapy (TMT) vs. radical cystectomy (RC).We performed a retrospective cohort study using the Surveillance, Epidemiology, and End Results (SEER)-Medicare database. Total Medicare costs at 2 and 5 years following RC vs. TMT were compared using inverse probability of treatment-weighted propensity score models.A total of 2,537 patients aged 66 to 85 years were diagnosed with clinical stage T2-4a muscle-invasive bladder cancer. Total median costs for patients that received no definitive treatment(s) were $73,780 and $88,275 at 2-and 5-years. Costs were significantly higher for TMT than RC at 2-years ($372,839 vs. $191,363, Median Difference $127,815, Hodges-Lehmann Estimate (H-L) 95% Confidence Interval (CI), $112,663-$142,966) and 5-years ($424,570 vs. $253,651, Median Difference $124,466, H-L 95% CI, $105,711-$143,221). TMT had higher outpatient costs than RC (2-years: $318,221 vs. $100,900; 5-years: $367,092 vs. $146,561) with significantly higher costs with radiology, medications, pathology/laboratory, and other professional services. RC had higher inpatient costs than TMT (2-years: $62,240 vs. $33,631, Median Difference $-29,174, H-L 95% CI, $-32,364-$-25,984; 5-years: $75,499 vs. $45,223, Median Difference $-29,843, H-L 95% CI, $-33,905-$-25,781).The excess spending associated with trimodal therapy vs. radical cystectomy was largely driven by outpatient expenditures. The relatively high long-term trimodal therapy costs are prime targets for cost containment strategies to optimize future value-based care.

    View details for DOI 10.1016/j.urolonc.2022.01.007

    View details for PubMedID 35168881

  • Use of a computer model and care coaches to increase advance care planning conversations for patients with metastatic cancer Gupta, D., Fardeen, T., Teuteberg, W., Seevaratnam, B., Asuncion, M., Alves, N., Rogers, B., Neal, J. W., Fan, A. C., Parikh, D., Patel, M. I., Shah, S., Srinivas, S., Huang, J. E., Reddy, S. A., Ganjoo, K. N., Bui, N., Hansen, J., Gensheimer, M. F., Ramchandran, K. LIPPINCOTT WILLIAMS & WILKINS. 2021
  • Coaches Activating Reaching and Engaging Patients (CAREPlan): A randomized controlled trial combining two evidence-based interventions to improve goals of care documentation Parikh, D., Asuncion, M., Hansen, J., Seevaratnam, B., Khateeb, S., Rosenthal, E., Teuteberg, W., Patel, M. I. LIPPINCOTT WILLIAMS & WILKINS. 2021
  • Evolving oncology provider perspectives on care delivery during the COVID-19 pandemic. Parikh, D., Ragavan, M., Srinivas, S., Garrigues, S., Rosenthal, E., Patel, M. I. LIPPINCOTT WILLIAMS & WILKINS. 2021
  • Financial Toxicity of Cancer Care: An Analysis of Financial Burden in Three Distinct Health Care Systems. JCO oncology practice Parikh, D. A., Ragavan, M., Dutta, R., Garnet Edwards, J., Dickerson, J., Maitra, D., Aggarwal, S., Lee, F., Patel, M. I. 2021: OP2000890

    Abstract

    PURPOSE: The financial toxicity of cancer care is a source of significant distress for patients with cancer. The purpose of this study is to understand factors associated with financial toxicity in three distinct care systems.METHODS: We conducted a cross-sectional survey of patients in three care systems, Stanford Cancer Institute (SCI), VA Palo Alto Health Care System (VAPAHCS), and Santa Clara Valley Medical Center (SCVMC), from October 2017 to May 2019. We assessed demographic factors, employment status, and out-of-pocket costs (OOPCs) and administered the validated COmprehensive Score for financial Toxicity tool. We calculated descriptive statistics and conducted linear regression models to analyze factors associated with financial toxicity.RESULTS: Four hundred forty-four of 578 patients (77%) completed the entire COmprehensive Score for financial Toxicity tool and were included in the analysis. Most respondents at SCI were White, with annual household income (AHI) > $50,000 USD and Medicare insurance. At the VAPAHCS, most were White, with AHI ≤ $50,000 USD and insured by the Veterans Administration. At SCVMC, most were Asian and/or Pacific Islander, with AHI ≤ $25,000 USD and Medicaid insurance. Low AHI (P < .0001), high OOPCs (P = .003), and employment changes as a result of cancer diagnosis (P < .0001) were associated with financial toxicity in the pooled analysis. There was variation in factors associated with financial toxicity by site, with employment changes significant at SCI, OOPCs at SCVMC, and no significant factors at the VAPAHCS.CONCLUSION: Low AHI, high OOPCs, and employment changes contribute to financial toxicity; however, there are variations based on site of care. Future studies should tailor financial toxicity interventions within care delivery systems.

    View details for DOI 10.1200/OP.20.00890

    View details for PubMedID 33826366

  • Addressing financial toxicity in urologic oncology patients. Parikh, D., Srinivas, S., Kerr, E., Patel, M. LIPPINCOTT WILLIAMS & WILKINS. 2021
  • Defining the clinician's role in mitigating financial toxicity: an exploratory study. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer Ragavan, M., Parikh, D., Patel, M. 2021

    Abstract

    BACKGROUND: Financial toxicity describes the financial burden imposed onto patients by a cancer diagnosis and is a growing concern. Many clinicians do not currently address financial toxicity despite patients' desire for them to do so. Current literature explores physicians' perspectives but does not clearly define an actionable role clinicians can take to address financial toxicity. We sought to fill this gap by first assessing clinicians' perspective on their role in alleviating financial toxicity at our institution. We subsequently aimed to identify current barriers to mitigating financial toxicity and to garner feedback on clinician-oriented interventions to address this growing problem.METHODS: We developed an 18-item electronic, anonymous survey through Redcap. We invited all oncology clinicians including attending physicians, advance practice providers, and trainees at our institution to participate.RESULTS: A total of 72 clinicians (30%) completed the survey. The majority agreed that clinicians have a role in addressing cost. The top three barriers to discussing cost with patients were knowledge of out of pocket costs, time, and awareness of resources. Less than half of respondents used an existing comparative cost tool to incorporate cost consciousness into treatment decisions. The most desired intervention was an institutional resource guide. In open-ended comments, the most common barrier described was transparency of out of pocket costs, and the most common solution proposed was a multi-disciplinary approach to addressing financial concerns patient face.DISCUSSION: Improving price transparency, incorporating existing resources into clinical practice, and streamlining multi-disciplinary support may help overcome barriers to addressing financial toxicity.

    View details for DOI 10.1007/s00520-021-05984-6

    View details for PubMedID 33544246

  • Comparison of perspectives and practices to mitigate financial toxicity between advance practice providers and attending oncologists. Ragavan, M., Parikh, D., Patel, M. AMER SOC CLINICAL ONCOLOGY. 2020
  • Understanding patient perspectives on window of opportunity clinical trials. Parikh, D., Kody, L., Brain, S., Heditsian, D., Lee, V., Curtis, C., Sledge, G. W., Caswell-Jin, J. AMER SOC CLINICAL ONCOLOGY. 2020
  • Healthcare delivery interventions to reduce cancer disparities worldwide. World journal of clinical oncology Dickerson, J. C., Ragavan, M. V., Parikh, D. A., Patel, M. I. 2020; 11 (9): 705–22

    Abstract

    Globally, cancer care delivery is marked by inequalities, where some economic, demographic, and sociocultural groups have worse outcomes than others. In this review, we sought to identify patient-facing interventions designed to reduce disparities in cancer care in both high- and low-income countries. We found two broad categories of interventions that have been studied in the current literature: Patient navigation and telehealth. Navigation has the strongest evidence base for reducing disparities, primarily in cancer screening. Improved outcomes with navigation interventions have been seen in both high- and low-income countries. Telehealth interventions remain an active area of exploration, primarily in high income countries, with the best evidence being for the remote delivery of palliative care. Ongoing research is needed to identify the most efficacious, cost-effective, and scalable interventions to reduce barriers to the receipt of cancer care globally.

    View details for DOI 10.5306/wjco.v11.i9.705

    View details for PubMedID 33033693

  • Cost-effectiveness of first-line therapy for advanced renal cell carcinoma in the immunotherapy era. Parikh, D., Serrato, P., Srinivas, S., Ryckman, T., Salomon, J., Goldhaber-Fiebert, J. D. LIPPINCOTT WILLIAMS & WILKINS. 2020
  • Health Disparities in Germline Genetic Testing for Cancer Susceptibility Current Breast Cancer Reports Parikh, D. A., Dickerson, J. C., Kurian, A. W. 2020
  • Financial toxicity among veterans with cancer. Parikh, D., Ragavan, M., Khateeb, S., Patel, M. I. AMER SOC CLINICAL ONCOLOGY. 2019
  • Perspectives and practices of oncology providers in addressing financial toxicity. Ragavan, M., Parikh, D., Patel, M. I. AMER SOC CLINICAL ONCOLOGY. 2019
  • Demographic factors associated with financial toxicity: Results from the multisite cost study. Parikh, D., Ragavan, M., Dutta, R., Edwards, J., Maitra, D., Patel, M. I. AMER SOC CLINICAL ONCOLOGY. 2019
  • To Take or Not to Take a Side: That Is the Question. Journal of clinical oncology : official journal of the American Society of Clinical Oncology Parikh, D. A., Lin, A. Y. 2019: JCO1801767

    View details for PubMedID 31046550

  • Characteristics of Patients With ROS1+ Cancers: Results From the First Patient-Designed, Global, Pan-Cancer ROS1 Data Repository. Journal of oncology practice Parikh, D. A., Walia, G. n., Freeman-Daily, J. n., Hennink, M. n., Tomalia, T. n., Buonanno, L. n., Goldman, L. n., Addario, B. n., Patel, M. I. 2019: JOP1900135

    Abstract

    The discovery of driver oncogenes, such as ROS1, has led to the development of targeted therapies. Despite clinical advancements, gaps remain in our understanding of characteristics of patients with ROS1-positive (ROS1+) cancers. The purpose of this study was to comprehensively assess demographic, clinical, and environmental characteristics associated with ROS1+ cancers worldwide.In collaboration with a panel of patients with ROS1+ cancer, we designed and conducted a 204-question online assessment regarding the demographic, clinical, and environmental factors of patients with ROS1+ cancers. We invited patients with ROS1+ cancers to participate in the study from May 2016 to December 2018.A total of 277 patients from 18 countries worldwide responded and completed at least 90% of the survey. The majority of respondents were female (n = 191; 69%), non-Hispanic white (n = 202; 73%), never-smokers (n = 180/240; 75%). Most were diagnosed with lung cancer (n = 261/277; 94%) and stage IV disease (n = 201/277; 76%). The majority received chemotherapy in first (n = 137/199; 69%) and second (n = 103/199; 52%) lines of therapy. For patients diagnosed with lung cancer after the availability of crizotinib (n = 199), only a minority (n = 55/199; 28%) reported receiving crizotinib in the first line of therapy.This study is the first global, patient-designed approach, to our knowledge, to comprehensively assess demographic, clinical, and environmental characteristics associated with ROS1+ cancers. Future efforts include assessing these characteristics as well as patient-reported outcomes and treatment responses longitudinally.

    View details for DOI 10.1200/JOP.19.00135

    View details for PubMedID 31880972

  • Pathogenic Variants in Less Familiar Cancer Susceptibility Genes: What Happens After Genetic Testing? JCO precision oncology Hall, E. T., Parikh, D., Caswell-Jin, J. L., Gupta, T., Mills, M. A., Kingham, K. E., Koff, R., Ford, J. M., Kurian, A. W. 2018; 2: 1-10

    Abstract

    As genetic testing expands, patients are increasingly found to carry pathogenic variants in cancer susceptibility genes that are less familiar to most clinicians, specifically genes other than those causing hereditary breast ovarian cancer syndrome (BRCA1 and BRCA2) and Lynch syndrome. Little is known about the subsequent behaviors of such patients in terms of managing cancer risks and informing relatives.All adult patients who were counseled and tested at the Stanford Cancer Genetics Clinic from January 2013 to July 2015 and had a pathogenic variant in a non-BRCA1/2, non-Lynch syndrome gene were invited to participate in a telephone interview about adherence to risk-reducing recommendations, genetic testing by relatives, and new cancer incidence.Fifty-seven (40%) of 142 eligible patients were successfully contacted, and all 57 patients participated; median follow-up was 677 days (range, 247 to 1,401 days). Most patients (82%; 95% CI, 70% to 90%) recalled that a risk-reducing intervention (screening, medication, or surgery) was recommended, and most patients (85%; 95% CI, 72% to 93%) adhered to the recommendation. Nearly all patients (91%; 95% CI, 81% to 97%) shared results with relatives, and most patients (78%; 95% CI, 64% to 88%) reported that a relative was subsequently tested. During the follow-up period, 9% of patients (95% CI, 3% to 19%) developed second cancers, and in 14% of patients (95% CI, 7% to 26%), a first-degree relative developed cancer, some of which were detected by recommended screening.Patients with a pathogenic variant in a less familiar cancer susceptibility gene report high adherence to risk-reducing interventions. Furthermore, in the 57 carriers and subsequently tested relatives with two years of follow-up, a total of three cancers (one in a proband and two in relatives) were detected through interventions recommended on the basis of the pathogenic variant. These results suggest a potential benefit of genetic counseling and testing for pathogenic variants in less familiar genes.

    View details for DOI 10.1200/PO.18.00167

    View details for PubMedID 35135157

  • Financial toxicity of cancer treatment at a diverse county hospital. Parikh, D., Ragavan, M., Maitra, D., Aggarwal, S., Patel, M. I. AMER SOC CLINICAL ONCOLOGY. 2018
  • Pathogenic variants in less familiar cancer susceptibility genes: what happens after genetic testing? JCO Precision Oncology Hall, E. T., Parikh, D., Caswell-Jin, J. L., Gupta, T., Mills, M. A., Kingham, K. E., Koff, R., Ford, J. M., Kurian, A. W. 2018

    View details for DOI 10.1200/PO.18.00167

  • Impact of patient demographics, tumor characteristics, and treatment type on treatment delay throughout breast cancer care at a diverse academic medical center. International journal of women's health Khanna, S., Kim, K. N., Qureshi, M. M., Agarwal, A., Parikh, D., Ko, N. Y., Rand, A. E., Hirsch, A. E. 2017; 9: 887-896

    Abstract

    The aim of this study was to examine the impact of patient demographics, tumor characteristics, and treatment type on time to treatment (TTT) in patients with breast cancer treated at a safety net medical center with a diverse patient population.A total of 1,130 patients were diagnosed and treated for breast cancer between 2004 and 2014 at our institution. We retrospectively collected data on patient age at diagnosis, race/ethnicity, primary language spoken, marital status, insurance coverage, American Joint Committee on Cancer (AJCC) stage, hormone receptor status, and treatment dates. TTT was determined from the date of breast cancer biopsy to treatment start date. Nonparametric Mann-Whitney U-test (or Kruskal-Wallis test when appropriate) and multivariable quantile regression models were employed to assess for significant differences in TTT associated with each factor.Longer median TTT was noted for Black (P=0.002) and single (P=0.002) patients. AJCC stage IV patients had shorter TTT (27.5 days) compared to earlier AJCC patients (36, 35, 37, 37 days for stage 0, I, II, III, respectively), P=0.028. Age, primary language spoken, insurance coverage, and hormone receptor status had no significant impact on TTT. On multivariate analysis, race/ethnicity remained the only significant factor with Black reporting longer TTT, P=0.025. However, race was not a significant factor for time from first to second treatment. More Black patients were noted to be single (P<0.0001) and received chemotherapy as first treatment (P=0.008) compared to White, Hispanic, or other race/ethnicity patients.In this retrospective analysis, Black patients had longer TTT, were more likely to receive chemotherapy as first treatment, and have a single marital status. These patient factors will help identify vulnerable patients and guide further research to understand the barriers to care and the impact of treatment delays on outcomes.

    View details for DOI 10.2147/IJWH.S150064

    View details for PubMedID 29255374

    View details for PubMedCentralID PMC5723124

  • Pathogenic germline mutations in emerging cancer genes: What happens after panel testing? Hall, E., Parikh, D., Gupta, T., Caswell, J., Mills, M., Kingham, K., Koff, R., Ford, J. M., Kurian, A. W. AMER SOC CLINICAL ONCOLOGY. 2017
  • Race/Ethnicity, Primary Language, and Income Are Not Demographic Drivers of Mortality in Breast Cancer Patients at a Diverse Safety Net Academic Medical Center. International journal of breast cancer Parikh, D. A., Chudasama, R., Agarwal, A., Rand, A., Qureshi, M. M., Ngo, T., Hirsch, A. E. 2015; 2015: 835074

    Abstract

    Objective. To examine the impact of patient demographics on mortality in breast cancer patients receiving care at a safety net academic medical center. Patients and Methods. 1128 patients were diagnosed with breast cancer at our institution between August 2004 and October 2011. Patient demographics were determined as follows: race/ethnicity, primary language, insurance type, age at diagnosis, marital status, income (determined by zip code), and AJCC tumor stage. Multivariate logistic regression analysis was performed to identify factors related to mortality at the end of follow-up in March 2012. Results. There was no significant difference in mortality by race/ethnicity, primary language, insurance type, or income in the multivariate adjusted model. An increased mortality was observed in patients who were single (OR = 2.36, CI = 1.28-4.37, p = 0.006), age > 70 years (OR = 3.88, CI = 1.13-11.48, p = 0.014), and AJCC stage IV (OR = 171.81, CI = 59.99-492.06, p < 0.0001). Conclusions. In this retrospective study, breast cancer patients who were single, presented at a later stage, or were older had increased incidence of mortality. Unlike other large-scale studies, non-White race, non-English primary language, low income, or Medicaid insurance did not result in worse outcomes.

    View details for DOI 10.1155/2015/835074

    View details for PubMedID 26605089

    View details for PubMedCentralID PMC4641184

  • Patient demographic characteristics and disease stage as drivers of disparities in mortality in prostate cancer patients who receive care at a safety net academic medical center. Clinical genitourinary cancer Rand, A. E., Agarwal, A., Ahuja, D., Ngo, T., Qureshi, M. M., Gupta, A., Hirsch, A. E. 2014; 12 (6): 455-60

    Abstract

    The purpose of this study was to examine the effect of patient demographic characteristics and tumor stage at diagnosis on mortality in prostate cancer patients who receive care at a safety net, academic medical center with a diverse patient population.Eight hundred sixty-nine patients were diagnosed with prostate cancer at our institution between August 2004 and October 2011. Patient demographic characteristics were determined as follows: race and/or ethnicity, primary language, insurance type, age at diagnosis, marital status, income (determined by zip code), and American Joint Committee on Cancer (AJCC) tumor stage. Fisher exact or Pearson χ(2) test was used to test for differences in categorical variables. Multivariate logistic regression analysis was performed to identify factors related to mortality recorded at the end of follow-up in March of 2012.Mortality was significantly decreased in patients who spoke Haitian Creole (odds ratio [OR], 0.18; 95% confidence interval [CI], 0.04-0.74; P = .017). Distribution of insurance type, age, income, and prostate-specific antigen level differed between English and Haitian Creole speakers. Increased mortality was observed in patients who were single (OR, 1.99; 95% CI, 1.06-3.73; P = .032), older than 70 (OR, 15.5; 95% CI, 3.03-79.45; P = .001), had Medicaid and/or free care (OR, 4.98; 95% CI, 1.72-14.4; P = .003), or had AJCC stage IV cancer (OR, 9.56; 95% CI, 4.89-18.69; P < .001). There was no significant difference in mortality according to race and/or ethnicity or income in the multivariate-adjusted model.In this retrospective study, prostate cancer patients who spoke Haitian Creole had a lower incidence of mortality compared with English speakers. Consistent with similar large-scale studies, being single or having Medicaid and/or free care insurance predicted worse outcomes, reinforcing their roles as drivers of disparities.

    View details for DOI 10.1016/j.clgc.2014.04.005

    View details for PubMedID 24998045

  • Devising the optimal preclinical oncology curriculum for undergraduate medical students in the United States. Journal of cancer education : the official journal of the American Association for Cancer Education DeNunzio, N. J., Joseph, L., Handal, R., Agarwal, A., Ahuja, D., Hirsch, A. E. 2013; 28 (2): 228-36

    Abstract

    A third of women and a near majority of men in the United States will be diagnosed with cancer in their lifetimes. To prepare future physicians for this reality, we have developed a preclinical oncology curriculum that introduces second-year medical students to essential concepts and practices in oncology to improve their abilities to appropriately care for these patients. We surveyed the oncology and education literature and compiled subjects important to students' education including basic science and clinical aspects of oncology and addressing patients' psychosocial needs. Along with the proposed curriculum content, scheduling, independent learning exercises, and case studies, we discuss practical considerations for curriculum implementation based on experience at our institution. Given the changing oncology healthcare landscape, all (new) physicians must competently address their cancer patients' needs, regardless of chosen specialty. A thorough and logically organized cancer curriculum for preclinical medical students should help achieve these aims. This new model curriculum, with accompanying strategies to evaluate its efforts, is essential to update how medical students are educated about cancer.

    View details for DOI 10.1007/s13187-012-0442-0

    View details for PubMedID 23681770