Prospective evidence on associations between diet quality indices and lung cancer risk is limited, particularly among older women. We investigated associations between 4 diet quality indices [Healthy Eating Index-2015 (HEI-2015), Alternate Healthy Eating Index 2010 (AHEI-2010), alternate Mediterranean Diet (aMED), and Dietary Approaches to Stop Hypertension (DASH)] and lung cancer incidence and mortality in the Women's Health Initiative Observational Study. Postmenopausal women aged 50–79 y at baseline (1993–1998) self reported their diet intake and information on relevant covariates. We used Cox proportional hazards regression models to estimate HRs and 95% CIs after controlling for age, smoking, and other relevant covariates. During ∼17 y of follow-up among 86,090 participants, 1491 lung cancer cases and 1393 lung cancer deaths were documented. Dietary indices were not associated with overall lung cancer incidence but were protective against squamous cell carcinoma (12.8% of total lung cancer) cases (HEI-2015: HR: 0.85; 95% CI: 0.76, 0.96; AHEI-2010: HR: 0.87; 95% CI: 0.78, 0.98; aMED: HR: 0.90; 95% CI: 0.81, 0.99; DASH: HR: 0.87; 95% CI: 0.77, 0.98). Among the indices, only HEI-2015 showed an inverse trend (P-trend = 0.02) with overall lung cancer mortality. Smoking status or participant age at baseline did not modify the association between dietary indices and lung cancer incidence or mortality. After comprehensive control of smoking exposure, we found that diet quality was not associated with overall lung cancer among postmenopausal women. However, a high-quality diet was inversely related to incident lung cancer of the squamous cell subtype. Future studies in populations with diverse age, smoking history, and dietary intake may further elucidate the relation between diet quality indices and lung cancer, especially by histological subtype.

Background: Considerable evidence links pharmaceutical industry payments to health providers’ over-prescribing behavior. In response, public policies were enacted to mitigate this effect. However, there is limited evidence examining surgical device industry payments and surgeons’ utilization of robot-assisted surgeries (RAS). This study assessed the relationship between industry payments to healthcare providers and the usage of RAS. Methods: Using 2015–2020 data from the CMS “Sunshine” Open Payments Database and New York State’s (NYS) Statewide hospital discharge databases, we assessed temporal and spatial relationships between industry payments to hospitals and surgeons and volumes of RAS. Results: During 2015–2020, general surgery robotic device manufacturers paid providers more than $236 M nationwide. The highest proportion of payments was made toward “Education and training” (66.6%) and “Food and travel” (20.6%). In NYS, gastrointestinal (GI) RAS volume steadily increased by 182% (2015–2019, p < 0.01), while there was a 150% increase in general surgeon payments. Genitourinary (GU) and gynecological (GYN) surgeon payments remained unchanged but GU and GYN RAS volume increased by 17% and 75%, respectively, during this period (p < 0.05). Approximately, 93% of payments and 98% of abdomen and pelvic RAS in NYS were concentrated in metropolitan or non-rural counties. Conclusions: With increasing payments from robotic device companies toward surgeon education and training, the use of RAS is likely to continue to rise in the long term. Unbiased and non-industry-funded studies examining RAS effect on surgeon behavior and patient outcomes are imperative to ensure system efficiency and patient safety.

Background: Although metabolic and bariatric surgery (MBS) is a safe and effective procedure to reduce severe obesity and is covered by most health insurance plans, utilization of MBS is significantly lower among men compared to women. This study identifies unique factors that explain men’s attitude towards MBS. Methods: The study survey (paper/online) included 129 Black and White men with severe obesity from metropolitan communities in Western New York. Bivariate and multivariate analyses were used to evaluate participants’ personal and community factors influencing their consideration of MBS. Results: Men willing to undergo MBS had lower education (38% vs. 21% ≤ high school, p < 0.05), were less likely to be satisfied with their body weight (27% vs. 48%, p < 0.05), more likely to have a physician supporting their weight loss efforts (55% vs. 32%, p = 0.03) and discussing MBS treatment (39% vs. 19%, p = 0.02), believed that community role models who underwent MBS “lost weight and looked great” (66% vs. 40%, p = 0.02) and that MBS was safe and effective (40% vs. 13%, p < 0.01), compared to men unwilling to undergo MBS. When adjusted for education level, dissatisfaction with body size (odds ratio, OR = 4.56, 95% confidence interval, CI: 1.16, 18.01) and physician support (OR = 3.71, 95% CI: 1.17, 11.78) remained significantly associated with men’s willingness to undergo MBS. Race and BMI were not associated with willingness to undergo MBS. Conclusions: Positive attitude toward MBS among men is influenced by self-perception of excess weight, strong physician support and community role models. Improving patient-provider communication about MBS and awareness from community role models may improve MBS utilization among men.