Background: Despite being the second leading cause of death in the United States, cancer disproportionately affects underserved communities due to multiple social factors like economic instability and limited healthcare access, leading to worse survival outcomes. This cross-sectional database study involves real-world data to explore the relationship between the Social Vulnerability Index (SVI), a measure of community resilience to disasters, and disparities in screening, incidence, and mortality rates of breast, colorectal, and lung cancer. The SVI encompasses four themes: socioeconomic status, household composition & disability, minority status & language, and housing type & transportation.Materials and methods: Using county-level data, this study compared cancer metrics in U.S. counties and the impact of high and low SVI. Two-sided statistical analysis was performed to compare SVI tertiles and cancer screening, incidence, and mortality rates. The outcomes were analyzed with logistic regression to determine the odds ratio of SVI counties having cancer metrics at or above the median.Results: Our study encompassed 3,132 United States counties. From publicly available SVI data, we demonstrated that high SVI scores correlate with low breast and colorectal cancer screening rates, along with high incidence and mortality rates for all three types of cancers. County level SVI has impact on incidence rates of cancers; breast cancer rates were lowest in high SVI counties, while colorectal and lung cancer rates were highest in the same counties. Age-adjusted mortality rates for all three cancers increased across SVI tertiles. After risk adjustment, a 10-point SVI increase correlated with lower screening and higher mortality rates.Conclusion: In conclusion, our study establishes a significant correlation between SVI and cancer metrics, highlighting the potential to identify marginalized communities with health disparities for targeted healthcare initiatives. It underscores the need for further longitudinal studies on bridging the gap in overall cancer care in the United States.

Background/Objectives: Multicentric Castleman Disease (MCD) is a rare lymphoproliferative disorder that can mimic IgG4-related disease (IgG4-RD), particularly in patients presenting with elevated serum IgG4. Accurate diagnosis is crucial given differing treatments and prognoses. Case Presentation: We describe a 76-year-old male with fever, lymphadenopathy, and elevated inflammatory markers. Labs revealed an elevated IgG4 of 133 mg/dL and total IgG of 1410 mg/dL, yielding an IgG4/IgG ratio of 9.43%. Lymph node biopsy showed nodular sclerosing classical Hodgkin lymphoma, for which he received five cycles of A + AVD. Persistent symptoms, elevated IL-6, and HHV8 viremia prompted repeat biopsy, which demonstrated HHV8-positive MCD. Rituximab was initiated, which resulted in clinical and radiographic resolution. Methods: We performed a systematic review of the English-language literature from 2000 to 2025, identifying 23 studies that contained MCD cases with individual-level serum IgG4 and IgG data. A total of 36 unique cases were included. Results: The mean IgG4/IgG ratio was 14.61%, which is substantially lower than ratios typically seen in IgG4-RD. To our knowledge, our case is the only reported instance of HHV8-associated MCD with elevated IgG4. Conclusions: A mildly elevated IgG4/IgG ratio may favor the diagnosis of MCD over IgG4-RD. Serum IgG4 and total IgG should be considered when suspecting Castleman Disease.

Background: Painful vaso-occlusive episodes (VOEs) are the hallmark of sickle cell disease (SCD) and account for frequent visits to the emergency department (ED) or urgent care (UC). Currently, the early administration of analgesics is recommended as initial management; however, there is a need for further understanding of the effect of prompt analgesics and hydration during VOEs. The objective of this study is to analyze the factors associated with the rate of hospital admission in the setting of time to intravenous (IV) analgesics and hydration. Method: This retrospective single-institution study reviewed adult and pediatric patients with SCD who presented with VOEs from January 2018 to August 2023. Results: Of 303 patient encounters, the rates of admission for the overall group, the subgroup which received IV hydration within 60 min of arrival, and the subgroup which received both IV analgesics and hydration within 60 min were 51.8%, 25.6% (RR = 0.46), and 18.2% (RR = 0.33), respectively. Further, factors such as gender and the use of hydroxyurea were found to be significantly associated with the rate of admission. Conclusions: This signifies the importance of standardizing the management of VOEs through the timely administration of IV analgesics and hydration in both adult and pediatric ED/UC.