Syed Yousuf Zafar | Scholars@Duke

Syed Yousuf Zafar
Associate Professor of Medicine

Dr. Zafar is a health services researcher with a focus in improving care delivery for patients with advanced cancer. He has obtained advanced training in health services research and has participated in single-institution, multi-institution and national studies focusing on access to care, cost of care, and comparative effectiveness of care delivery between health systems. His primary area of interest is in the cost of cancer care. He has conducted institutional and national studies on how treatment-related costs impact cancer patients' experience. His current work in this arena is focused on patient preferences regarding cost-related communication and decision-making.

A second field of interest is palliative care. Dr. Zafar has collaborated with national and international palliative care leaders to improve the design and delivery of palliative care in cancer clinical trials. Methodologically, this work has centered around systematic literature reviews, iterative surveys, and prospective clinical trials.

Dr. Zafar is a member of the American Society of Clinical Oncology’s Health Disparities and Clinical Practice Guideline Committees. He is a member of the Alliance for Clinical Trials in Oncology's Health Disparities and Health Outcomes Committees. Dr. Zafar's work has been funded by the American Cancer Society, the HealthWell Foundation, the Duke Cancer Prevention and Control Program, the Duke Clinical Research Institute, and the CALGB Foundation.

Current Appointments & Affiliations

Associate Professor of Medicine, Medicine, Medical Oncology, Medicine 2019
Associate Professor in the Sanford School of Public Policy, Sanford School of Public Policy, Duke University 2016
Associate Professor in Population Health Sciences, Population Health Sciences, Basic Science Departments 2018
Member of the Duke Cancer Institute, Duke Cancer Institute, Institutes and Centers 2005
Affiliate, Duke Global Health Institute, Duke Global Health Institute, University Institutes and Centers 2011
Member in the Duke Clinical Research Institute, Duke Clinical Research Institute, Institutes and Centers 2012

Contact Information

Duke Box 3505, Durham, NC 27710
Seeley G. Mudd Building, Rm 43, 10 Bryan Searle Dr., DUMC 3505, Durham, NC 27710
yousuf.zafar@duke.edu (919) 684-8111
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Background
Education, Training, & Certifications
- Fellow in Hematology-Oncology, Medicine, Duke University 2005 - 2008
- Resident, Medicine, University of Cincinnati 2002 - 2005
- M.D., University of Toledo 2002
Duke Appointment History
- Associate Professor of Medicine, Medicine, Medical Oncology, Medicine 2014 - 2019
- Assistant Professor of Medicine, Medicine, Medical Oncology, Medicine 2010 - 2014
- Medical Instructor in the Department of Medicine, Medicine, Medical Oncology, Medicine 2008 - 2010
- Instructor, Temporary in the Department of Medicine, Medicine, Medical Oncology, Medicine 2008
Leadership & Clinical Positions at Duke
- Director, Center for Applied Cancer Health Policy
  Co-Leader, Health Care Delivery Focus Area, Cancer Control and Population Sciences
Recognition
In the News
- AUG 11, 2017 Duke Health News
  
  Out-of-Pocket Costs Exceed What Many Insured Cancer Patients Expect to Pay
- AUG 10, 2017 US News & World Report
  
  Cancer Takes Financial Toll, Even With Insurance
- AUG 10, 2017 Forbes
  
  Even Insured Patients Are Overwhelmed By The Cost Of Cancer Care
- AUG 10, 2017 NPR
  
  Widowed Early, A Cancer Doctor Writes About The Harm Of Medical Debt
- MAY 19, 2017 Duke Research Blog
  
  If the Cancer Doesn't Kill You, the Drug Bill Might
- JUN 6, 2016
  
  Cancer Patients with ACA Policies Swiftly Reach Out-of-Pocket Caps
- JUL 2, 2015 The Daily Mail
  
  How being obese could help you fight cancer
- JUL 1, 2015
  
  Thin Colorectal Cancer Patients Have Shorter Survival Than Obese Patients
- DEC 18, 2014
  
  ‘Financial Toxicity’ Can Lower Cancer Patients' Quality of Life
- JUN 14, 2013 New York Times
  
  Life, interrupted: The cost of cancer
Awards & Honors
Expertise
Subject Headings
Global Scholarship
- Research
  - United Republic of Tanzania (Country)
Research
Selected Grants
- Using Modifiable Risk Factors to Predict Inferior Care and Survival after Breast Cancer Diagnosis: A Novel Approach to Addressing Health Disparities awarded by National Institutes of Health 2019 - 2024
- Examining Best Practices for Factoring Out-Of-Pocket Expenses into Patients' Health Care Decisions 2018 - 2020
- Couple Communication in Cancer: A Multi-method Examination awarded by Arizona State University 2016 - 2019
- Improving Advance Care Planning in Oncology: A Pragmatic, Cluster-Randomized Trial Integrating Patient Videos and Clinician Communication Training awarded by Dana Farber Cancer Institute 2018 - 2019
- PAPNavigator STTR (Fast-Track) 2016 - 2019
- Using AACT - to answer Oncology landscape portfolio of open trials 2017 - 2018
- Financial Assistance, Navigation, and Communication Education (FinANCE): Development awarded by Brigham and Women's Hospital 2013 - 2015
- Does Comparative Effectiveness Research Promote Rationing or Rational Cancer Care? awarded by Greenwall Foundation 2013 - 2014
- CTSA KL2 awarded by National Institutes of Health 2006 - 2013
- Duke CTSA-KL2 awarded by National Institutes of Health 2006 - 2012
Industry Relationships
- AIM Specialty Health
- Copernicus Group IRB
- Discern LLC
- McKesson Corporation
- Quintiles
- Shattuck Labs
Publications & Artistic Works
Selected Publications
- Academic Articles
  - Clarke, J. M., Blobe, G. C., Strickler, J. H., Uronis, H. E., Zafar, S. Y., Morse, M., … Hurwitz, H. I. (2019). A phase Ib study of the combination regorafenib with PF-03446962 in patients with refractory metastatic colorectal cancer (REGAL-1 trial).. Cancer Chemother Pharmacol, 84(4), 909–917. https://doi.org/10.1007/s00280-019-03916-0
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  - Greenup, R. A., Rushing, C., Fish, L., Campbell, B. M., Tolnitch, L., Hyslop, T., … Hwang, E. S. (2019). Financial Costs and Burden Related to Decisions for Breast Cancer Surgery.. J Oncol Pract, 15(8), e666–e676. https://doi.org/10.1200/JOP.18.00796
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  - Chino, F., Kamal, A. H., Leblanc, T. W., Zafar, S. Y., Suneja, G., & Chino, J. P. (2018). Place of death for patients with cancer in the United States, 1999 through 2015: Racial, age, and geographic disparities.. Cancer, 124(22), 4408–4419. https://doi.org/10.1002/cncr.31737
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  - Zafar, S. Y., Polite, B. N., & McClellan, M. (2018). Engaging Patients in Value-Based Cancer Care: A Missed Opportunity.. Jama Oncol, 4(11), 1479–1480. https://doi.org/10.1001/jamaoncol.2018.2826
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  - Sitlinger, A., & Zafar, S. Y. (2018). Health-Related Quality of Life: The Impact on Morbidity and Mortality.. Surg Oncol Clin N Am, 27(4), 675–684. https://doi.org/10.1016/j.soc.2018.05.008
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  - Chino, F., Peppercorn, J. M., Rushing, C., Nicolla, J., Kamal, A. H., Altomare, I., … Zafar, S. Y. (2018). Going for Broke: A Longitudinal Study of Patient-Reported Financial Sacrifice in Cancer Care.. J Oncol Pract, 14(9), e533–e546. https://doi.org/10.1200/JOP.18.00112
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  - Hastert, T. A., Young, G. S., Pennell, M. L., Padamsee, T., Zafar, S. Y., DeGraffinreid, C., … Paskett, E. D. (2018). Financial burden among older, long-term cancer survivors: Results from the LILAC study.. Cancer Med, 7(9), 4261–4272. https://doi.org/10.1002/cam4.1671
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  - Leopold, C., Peppercorn, J. M., Zafar, S. Y., & Wagner, A. K. (2018). Defining Value of Cancer Therapeutics-A Health System Perspective.. J Natl Cancer Inst, 110(7), 699–703. https://doi.org/10.1093/jnci/djy079
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  - Vlahovic, G., Meadows, K. L., Hatch, A. J., Jia, J., Nixon, A. B., Uronis, H. E., … Hurwitz, H. I. (2018). A Phase I Trial of the IGF-1R Antibody Ganitumab (AMG 479) in Combination with Everolimus (RAD001) and Panitumumab in Patients with Advanced Cancer.. Oncologist, 23(7), 782–790. https://doi.org/10.1634/theoncologist.2016-0377
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  - Chan, R. J., Gordon, L., Zafar, S. Y., & Miaskowski, C. (2018). Financial toxicity and symptom burden: what is the big deal?. Support Care Cancer, 26(5), 1357–1359. https://doi.org/10.1007/s00520-018-4092-6
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  - Tran, G., & Zafar, S. Y. (2018). Financial toxicity and implications for cancer care in the era of molecular and immune therapies.. Ann Transl Med, 6(9). https://doi.org/10.21037/atm.2018.03.28
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  - Shih, Y.-C., Nasso, S. F., & Zafar, S. Y. (2018). Price Transparency for Whom? In Search of Out-of-Pocket Cost Estimates to Facilitate Cost Communication in Cancer Care.. Pharmacoeconomics, 36(3), 259–261. https://doi.org/10.1007/s40273-018-0613-x
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  - Moss, H. A., Havrilesky, L. J., Zafar, S. Y., Suneja, G., & Chino, J. (2018). Trends in Insurance Status Among Patients Diagnosed With Cancer Before and After Implementation of the Affordable Care Act.. J Oncol Pract, 14(2), e92–e102. https://doi.org/10.1200/JOP.2017.027102
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  - Tran, G., & Zafar, S. Y. (2018). Price of Cancer Care and Its Tax on Quality of Life.. J Oncol Pract, 14(2), 69–71. https://doi.org/10.1200/JOP.2017.028498
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  - Williams, G. R. (2018). Geriatric Assessment: Precision Medicine for Older Adults With Cancer. Journal of Oncology Practice, 14(2), 97–98. https://doi.org/10.1200/jop.18.00010
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  - Langer, S. L., Romano, J. M., Todd, M., Strauman, T. J., Keefe, F. J., Syrjala, K. L., … Porter, L. S. (2018). Links Between Communication and Relationship Satisfaction Among Patients With Cancer and Their Spouses: Results of a Fourteen-Day Smartphone-Based Ecological Momentary Assessment Study.. Front Psychol, 9. https://doi.org/10.3389/fpsyg.2018.01843
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  - Sitlinger, A. P., & Zafar, S. Y. (2018). With Colorectal Cancer Treatment, Physical Toxicity Is Not the Only Concern.. Dis Colon Rectum, 61(1), 4–5. https://doi.org/10.1097/DCR.0000000000000922
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  - Sloan, C., & Zafar, S. Y. (2018). Ask Early and Ask Often: How Discussing Costs Could Save Your Patient's Life.. N C Med J, 79(1), 39–42. https://doi.org/10.18043/ncm.79.1.39
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  - Chino, F., Peppercorn, J. M., Rushing, C., Kamal, A. H., Altomare, I., Samsa, G., & Zafar, S. Y. (2017). Out-of-Pocket Costs, Financial Distress, and Underinsurance in Cancer Care.. Jama Oncol, 3(11), 1582–1584. https://doi.org/10.1001/jamaoncol.2017.2148
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  - Hunter, W. G., Zafar, S. Y., Hesson, A., Davis, J. K., Kirby, C., Barnett, J. A., & Ubel, P. A. (2017). Discussing Health Care Expenses in the Oncology Clinic: Analysis of Cost Conversations in Outpatient Encounters.. J Oncol Pract, 13(11), e944–e956. https://doi.org/10.1200/JOP.2017.022855
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  - Porter, L. S., Keefe, F. J., Baucom, D. H., Olsen, M., Zafar, S. Y., & Uronis, H. (2017). A randomized pilot trial of a videoconference couples communication intervention for advanced GI cancer.. Psychooncology, 26(7), 1027–1035. https://doi.org/10.1002/pon.4121
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  - Zafar, S. Y., & Peppercorn, J. M. (2017). Patient Financial Assistance Programs: A Path to Affordability or a Barrier to Accessible Cancer Care?. J Clin Oncol, 35(19), 2113–2116. https://doi.org/10.1200/JCO.2016.71.7280
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  - Mowery, Y. M., Salama, J. K., Zafar, S. Y., Moore, H. G., Willett, C. G., Czito, B. G., … Palta, M. (2017). Neoadjuvant long-course chemoradiation remains strongly favored over short-course radiotherapy by radiation oncologists in the United States.. Cancer, 123(8), 1434–1441. https://doi.org/10.1002/cncr.30461
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  - Zullig, L. L., Wolf, S., Vlastelica, L., Shankaran, V., & Zafar, S. Y. (2017). The Role of Patient Financial Assistance Programs in Reducing Costs for Cancer Patients.. J Manag Care Spec Pharm, 23(4), 407–411. https://doi.org/10.18553/jmcp.2017.23.4.407
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  - Zafar, S. Y., Peppercorn, J., Asabere, A., & Bastian, A. (2017). Transparency of Industry-Sponsored Oncology Patient Financial Assistance Programs Using a Patient-Centered Approach.. J Oncol Pract, 13(3), e240–e248. https://doi.org/10.1200/JOP.2016.017509
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  - Zafar, S. Y., Newcomer, L. N., McCarthy, J., Fuld Nasso, S., & Saltz, L. B. (2017). How Should We Intervene on the Financial Toxicity of Cancer Care? One Shot, Four Perspectives.. Am Soc Clin Oncol Educ Book, 37, 35–39. https://doi.org/10.1200/EDBK_174893
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  - Zullig, L. L., Schroeder, K., Nyindo, P., Namwai, T., Silayo, E., Msomba, A., … Zafar, S. Y. (2016). Validation and Quality Assessment of the Kilimanjaro Cancer Registry.. J Glob Oncol, 2(6), 381–386. https://doi.org/10.1200/JGO.2015.002873
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  - Chino, F., Peppercorn, J. M., Rushing, C., Samsa, G., Nicolla, J., Altomare, I., & Zafar, S. Y. (2016). "Going for Broke": Out-of-Pocket Costs, Financial Distress, and Patient-Reported Willingness to Pay and Sacrifice in Cancer Care.. Int J Radiat Oncol Biol Phys, 96(2S), S135–S136. https://doi.org/10.1016/j.ijrobp.2016.06.330
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  - Mowery, Y. M., Salama, J. K., Zafar, S. Y., Moore, H. G., Willett, C. G., Czito, B., … Palta, M. (2016). Radiation Oncologists' Practice Patterns and Attitudes Regarding Neoadjuvant Short-Course Radiation Therapy for Rectal Cancer in the United States.. Int J Radiat Oncol Biol Phys, 96(2S). https://doi.org/10.1016/j.ijrobp.2016.06.505
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  - Wollins, D. S., & Zafar, S. Y. (2016). A Touchy Subject: Can Physicians Improve Value by Discussing Costs and Clinical Benefits With Patients?. Oncologist, 21(10), 1157–1160. https://doi.org/10.1634/theoncologist.2016-0207
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  - Hochman, M. J., Wolf, S., Zafar, S. Y., Portman, D., Bull, J., & Kamal, A. H. (2016). Comparing Unmet Needs to Optimize Quality: Characterizing Inpatient and Outpatient Palliative Care Populations.. J Pain Symptom Manage, 51(6), 1033-1039.e3. https://doi.org/10.1016/j.jpainsymman.2015.12.338
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  - Nipp, R. D., Zullig, L. L., Samsa, G., Peppercorn, J. M., Schrag, D., Taylor, D. H., … Zafar, S. Y. (2016). Identifying cancer patients who alter care or lifestyle due to treatment-related financial distress.. Psychooncology, 25(6), 719–725. https://doi.org/10.1002/pon.3911
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  - Lathan, C. S., Cronin, A., Tucker-Seeley, R., Zafar, S. Y., Ayanian, J. Z., & Schrag, D. (2016). Association of Financial Strain With Symptom Burden and Quality of Life for Patients With Lung or Colorectal Cancer.. J Clin Oncol, 34(15), 1732–1740. https://doi.org/10.1200/JCO.2015.63.2232
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  - Zafar, S. Y. (2016). Financial Toxicity of Cancer Care: It's Time to Intervene.. J Natl Cancer Inst, 108(5). https://doi.org/10.1093/jnci/djv370
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  - Altomare, I., Irwin, B., Zafar, S. Y., Houck, K., Maloney, B., Greenup, R., & Peppercorn, J. (2016). Physician Experience and Attitudes Toward Addressing the Cost of Cancer Care.. J Oncol Pract, 12(3), e281-248. https://doi.org/10.1200/JOP.2015.007401
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  - Roe, M. T., Cyr, D. D., Eckart, D., Schulte, P. J., Morse, M. A., Blackwell, K. L., … TRILOGY ACS Investigators. (2016). Ascertainment, classification, and impact of neoplasm detection during prolonged treatment with dual antiplatelet therapy with prasugrel vs. clopidogrel following acute coronary syndrome.. Eur Heart J, 37(4), 412–422. https://doi.org/10.1093/eurheartj/ehv611
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  - Kircher, S. M., Meeker, C. R., Nimeiri, H., Geynisman, D. M., Zafar, S. Y., Shankaran, V., … Wong, Y.-N. (2016). The Parity Paradigm: Can Legislation Help Reduce the Cost Burden of Oral Anticancer Medications?. Value Health, 19(1), 88–98. https://doi.org/10.1016/j.jval.2015.10.005
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  - Deming, D., Uboha, N., Zafar, S. Y., Rosenberg, S., Bassetti, M., Glasgow, S., … Lubner, S. (2015). Adjuvant Chemotherapy for Stage II Rectal Cancer.. Semin Oncol, 42(6), e99-107. https://doi.org/10.1053/j.seminoncol.2015.09.033
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  - Zafar, S. Y., Chino, F., Ubel, P. A., Rushing, C., Samsa, G., Altomare, I., … Peppercorn, J. M. (2015). The utility of cost discussions between patients with cancer and oncologists.. Am J Manag Care, 21(9), 607–615.
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  - Nipp, R. D., Currow, D. C., Cherny, N. I., Strasser, F., Abernethy, A. P., & Zafar, S. Y. (2015). Best supportive care in clinical trials: review of the inconsistency in control arm design.. Br J Cancer, 113(1), 6–11. https://doi.org/10.1038/bjc.2015.192
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  - Kutner, J. S., Blatchford, P. J., Taylor, D. H., Ritchie, C. S., Bull, J. H., Fairclough, D. L., … Abernethy, A. P. (2015). Safety and benefit of discontinuing statin therapy in the setting of advanced, life-limiting illness: a randomized clinical trial.. Jama Intern Med, 175(5), 691–700. https://doi.org/10.1001/jamainternmed.2015.0289
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  - Zafar, S. Y., Ubel, P. A., Tulsky, J. A., & Pollak, K. I. (2015). Cost-related health literacy: a key component of high-quality cancer care.. J Oncol Pract, 11(3), 171–173. https://doi.org/10.1200/JOP.2015.004408
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  - Zafar, S. Y., McNeil, R. B., Thomas, C. M., Lathan, C. S., Ayanian, J. Z., & Provenzale, D. (2015). Population-based assessment of cancer survivors' financial burden and quality of life: a prospective cohort study.. J Oncol Pract, 11(2), 145–150. https://doi.org/10.1200/JOP.2014.001542
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  - Corrigendum. (2015). Future Oncology, 11(3), 544–544. https://doi.org/10.2217/fon.14.304
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  - Kasi, P. M., Zafar, S. Y., & Grothey, A. (2015). Is obesity an advantage in patients with colorectal cancer?. Expert Rev Gastroenterol Hepatol, 9(11), 1339–1342. https://doi.org/10.1586/17474124.2015.1089170
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  - Bestvina, C. M., Zullig, L. L., & Yousuf Zafar, S. (2014). The implications of out-of-pocket cost of cancer treatment in the USA: a critical appraisal of the literature.. Future Oncol, 10(14), 2189–2199. https://doi.org/10.2217/fon.14.130
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  - Taylor, D. H., Danis, M., Zafar, S. Y., Howie, L. J., Samsa, G. P., Wolf, S. P., & Abernethy, A. P. (2014). There is a mismatch between the medicare benefit package and the preferences of patients with cancer and their caregivers.. J Clin Oncol, 32(28), 3163–3168. https://doi.org/10.1200/JCO.2013.54.2605
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  - Smith, S. K., Nicolla, J., & Zafar, S. Y. (2014). Bridging the gap between financial distress and available resources for patients with cancer: a qualitative study.. J Oncol Pract, 10(5), e368–e372. https://doi.org/10.1200/JOP.2013.001342
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  - Rangwala, F., Bendell, J. C., Kozloff, M. F., Arrowood, C. C., Dellinger, A., Meadows, J., … Hurwitz, H. I. (2014). Phase I study of capecitabine, oxaliplatin, bevacizumab, and everolimus in advanced solid tumors.. Invest New Drugs, 32(4), 700–709. https://doi.org/10.1007/s10637-014-0089-2
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  - Danis, M., Abernethy, A. P., Zafar, S. Y., Samsa, G. P., Wolf, S. P., Howie, L., & Taylor, D. H. (2014). A decision exercise to engage cancer patients and families in deliberation about Medicare coverage for advanced cancer care.. Bmc Health Serv Res, 14. https://doi.org/10.1186/1472-6963-14-315
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  - Zafar, S. Y., Tulsky, J. A., & Abernethy, A. P. (2014). It's time to have 'the talk': cost communication and patient-centered care.. Oncology (Williston Park), 28(6), 479–480.
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  - De Boer, C., Niyonzima, N., Orem, J., Bartlett, J., & Zafar, S. Y. (2014). Prognosis and delay of diagnosis among Kaposi's sarcoma patients in Uganda: A cross-sectional study. Infectious Agents and Cancer, 9(1). https://doi.org/10.1186/1750-9378-9-17
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  - Bestvina, C. M., Zullig, L. L., Rushing, C., Chino, F., Samsa, G. P., Altomare, I., … Zafar, S. Y. (2014). Patient-oncologist cost communication, financial distress, and medication adherence.. J Oncol Pract, 10(3), 162–167. https://doi.org/10.1200/JOP.2014.001406
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  - Chino, F., Peppercorn, J., Taylor, D. H., Lu, Y., Samsa, G., Abernethy, A. P., & Zafar, S. Y. (2014). Self-reported financial burden and satisfaction with care among patients with cancer.. Oncologist, 19(4), 414–420. https://doi.org/10.1634/theoncologist.2013-0374
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  - Strickler, J. H., McCall, S., Nixon, A. B., Brady, J. C., Pang, H., Rushing, C., … Hurwitz, H. I. (2014). Phase I study of dasatinib in combination with capecitabine, oxaliplatin and bevacizumab followed by an expanded cohort in previously untreated metastatic colorectal cancer.. Invest New Drugs, 32(2), 330–339. https://doi.org/10.1007/s10637-013-0042-9
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  - van Ryn, M., Phelan, S. M., Arora, N. K., Haggstrom, D. A., Jackson, G. L., Zafar, S. Y., … Clauser, S. B. (2014). Patient-reported quality of supportive care among patients with colorectal cancer in the Veterans Affairs Health Care System.. J Clin Oncol, 32(8), 809–815. https://doi.org/10.1200/JCO.2013.49.4302
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  - Peppercorn, J., Zafar, S. Y., Houck, K., Ubel, P., & Meropol, N. J. (2014). Does comparative effectiveness research promote rationing of cancer care?. Lancet Oncol, 15(3), e132–e138. https://doi.org/10.1016/S1470-2045(13)70597-7
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  - Bartley, A. N., Hamilton, S. R., Alsabeh, R., Ambinder, E. P., Berman, M., Collins, E., … Members of the Cancer Biomarker Reporting Workgroup, College of American Pathologists. (2014). Template for reporting results of biomarker testing of specimens from patients with carcinoma of the colon and rectum.. Arch Pathol Lab Med, 138(2), 166–170. https://doi.org/10.5858/arpa.2013-0231-CP
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  - De Boer, C., Niyonzima, N., Orem, J., Bartlett, J., & Zafar, S. Y. (2014). Prognosis and delay of diagnosis among Kaposi's sarcoma patients in Uganda: a cross-sectional study.. Infect Agent Cancer, 9. https://doi.org/10.1186/1750-9378-9-17
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  - Hirsch, B. R., & Zafar, S. Y. (2014). Comparative effectiveness research: moving medical oncology forward.. Semin Radiat Oncol, 24(1), 49–53. https://doi.org/10.1016/j.semradonc.2013.08.005
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  - Peppercorn, J., Zafar, S. Y., Houck, K., Ubel, P., & Meropol, N. J. (2014). Does comparative effectiveness research promote rationing of cancer care?. The Lancet Oncology, 15(3), e132–e138.
  - Yousuf Zafar, S., Tulsky, J. A., & Abernethy, A. P. (2014). It's time to have 'The talk': Cost communication and patient-centered care. Oncology (United States), 28(6).
  - Zullig, L. L., Peppercorn, J. M., Schrag, D., Taylor, D. H., Lu, Y., Samsa, G., … Zafar, S. Y. (2013). Financial Distress, Use of Cost-Coping Strategies, and Adherence to Prescription Medication Among Patients With Cancer.. J Oncol Pract, 9(6S), 60s-63s. https://doi.org/10.1200/JOP.2013.000971
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  - Ubel, P. A., Abernethy, A. P., & Zafar, S. Y. (2013). Full disclosure--out-of-pocket costs as side effects.. N Engl J Med, 369(16), 1484–1486. https://doi.org/10.1056/NEJMp1306826
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  - Jackson, G. L., Zullig, L. L., Zafar, S. Y., Powell, A. A., Ordin, D. L., Gellad, Z. F., … Provenzale, D. (2013). Using NCCN clinical practice guidelines in oncology to measure the quality of colorectal cancer care in the veterans health administration.. J Natl Compr Canc Netw, 11(4), 431–441. https://doi.org/10.6004/jnccn.2013.0058
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  - Zafar, S. Y., & Abernethy, A. P. (2013). Financial toxicity, Part II: how can we help with the burden of treatment-related costs?. Oncology (Williston Park), 27(4), 253–256.
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  - Fouad, M. N., Lee, J. Y., Catalano, P. J., Vogt, T. M., Zafar, S. Y., West, D. W., … Kiefe, C. I. (2013). Enrollment of patients with lung and colorectal cancers onto clinical trials.. J Oncol Pract, 9(2), e40–e47. https://doi.org/10.1200/JOP.2012.000598
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  - Zafar, S. Y., Malin, J. L., Grambow, S. C., Abbott, D. H., Kolimaga, J. T., Zullig, L. L., … Cancer Care Outcomes Research & Surveillance CanCORS Consortium. (2013). Chemotherapy use and patient treatment preferences in advanced colorectal cancer: a prospective cohort study.. Cancer, 119(4), 854–862. https://doi.org/10.1002/cncr.27815
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  - Zafar, S. Y., & Abernethy, A. P. (2013). Financial toxicity, Part I: a new name for a growing problem.. Oncology (Williston Park), 27(2), 80–149.
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  - Phelan, S. M., Griffin, J. M., Jackson, G. L., Zafar, S. Y., Hellerstedt, W., Stahre, M., … van Ryn, M. (2013). Stigma, perceived blame, self-blame, and depressive symptoms in men with colorectal cancer.. Psychooncology, 22(1), 65–73. https://doi.org/10.1002/pon.2048
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  - Uronis, H. E., Bendell, J. C., Altomare, I., Blobe, G. C., Hsu, S. D., Morse, M. A., … Hurwitz, H. I. (2013). A phase II study of capecitabine, oxaliplatin, and bevacizumab in the treatment of metastatic esophagogastric adenocarcinomas.. Oncologist, 18(3), 271–272. https://doi.org/10.1634/theoncologist.2012-0404
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  - Zafar, S. Y., & Abernethy, A. P. (2013). Financial toxicity, Part I: a new name for a growing problem.. Oncology (Williston Park, N.Y.), 27(2).
  - Zafar, S. Y., & Abernethy, A. P. (2013). Financial toxicity, Part II: how can we help with the burden of treatment-related costs?. Oncology (Williston Park, N.Y.), 27(4).
  - Zafar, S. Y., Peppercorn, J. M., Schrag, D., Taylor, D. H., Goetzinger, A. M., Zhong, X., & Abernethy, A. P. (2013). The financial toxicity of cancer treatment: a pilot study assessing out-of-pocket expenses and the insured cancer patient's experience.. Oncologist, 18(4), 381–390. https://doi.org/10.1634/theoncologist.2012-0279
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  - Zullig, L. L., Muiruri, C., Abernethy, A., Weiner, B. J., Bartlett, J., Oneko, O., & Zafar, S. Y. (2013). Cancer registration needs assessment at a tertiary medical centre in Kilimanjaro, Tanzania.. World Health Popul, 14(2), 12–23.
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  - Roe, M. T., Armstrong, P. W., Fox, K. A. A., White, H. D., Prabhakaran, D., Goodman, S. G., … TRILOGY ACS Investigators. (2012). Prasugrel versus clopidogrel for acute coronary syndromes without revascularization.. N Engl J Med, 367(14), 1297–1309. https://doi.org/10.1056/NEJMoa1205512
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  - Strickler, J. H., Starodub, A. N., Jia, J., Meadows, K. L., Nixon, A. B., Dellinger, A., … Hurwitz, H. I. (2012). Phase I study of bevacizumab, everolimus, and panobinostat (LBH-589) in advanced solid tumors.. Cancer Chemother Pharmacol, 70(2), 251–258. https://doi.org/10.1007/s00280-012-1911-1
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  - Vlahovic, G., Meadows, K. L., Uronis, H. E., Morse, M. A., Blobe, G. C., Riedel, R. F., … Hurwitz, H. I. (2012). A phase I study of bevacizumab, everolimus and panitumumab in advanced solid tumors.. Cancer Chemother Pharmacol, 70(1), 95–102. https://doi.org/10.1007/s00280-012-1889-8
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  - Currow, D. C., Tieman, J. J., Greene, A., Zafar, S. Y., Wheeler, J. L., & Abernethy, A. P. (2012). Refining a checklist for reporting patient populations and service characteristics in hospice and palliative care research.. J Pain Symptom Manage, 43(5), 902–910. https://doi.org/10.1016/j.jpainsymman.2011.05.015
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  - Palta, M., Patel, P., Broadwater, G., Willett, C., Pepek, J., Tyler, D., … Czito, B. (2012). Carcinoma of the ampulla of Vater: patterns of failure following resection and benefit of chemoradiotherapy.. Ann Surg Oncol, 19(5), 1535–1540. https://doi.org/10.1245/s10434-011-2117-1
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  - Rangwala, F., Zafar, S. Y., & Abernethy, A. P. (2012). Gastrointestinal symptoms in cancer patients with advanced disease: new methodologies, insights, and a proposed approach.. Curr Opin Support Palliat Care, 6(1), 69–76. https://doi.org/10.1097/SPC.0b013e32834f689d
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  - Zafar, S. Y., Currow, D. C., Cherny, N., Strasser, F., Fowler, R., & Abernethy, A. P. (2012). Consensus-based standards for best supportive care in clinical trials in advanced cancer.. Lancet Oncol, 13(2), e77–e82. https://doi.org/10.1016/S1470-2045(11)70215-7
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  - Zafar, S. Y., Malin, J. L., Grambow, S. C., Abbott, D. H., Schrag, D., Kolimaga, J. T., … Cancer Care and Outcomes Research and Surveillance (CanCORS) Consortium. (2011). Early dissemination of bevacizumab for advanced colorectal cancer: a prospective cohort study.. Bmc Cancer, 11. https://doi.org/10.1186/1471-2407-11-354
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  - Bullock, K. E., Petros, W. P., Younis, I., Uronis, H. E., Morse, M. A., Blobe, G. C., … Bendell, J. C. (2011). A phase I study of bevacizumab (B) in combination with everolimus (E) and erlotinib (E) in advanced cancer (BEE).. Cancer Chemother Pharmacol, 67(2), 465–474. https://doi.org/10.1007/s00280-010-1507-6
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  - Currow, D. C., Foley, K., Zafar, S. Y., Wheeler, J. L., & Abernethy, A. P. (2011). The need for a re-evaluation of best supportive care studies reported to date.. Br J Cancer, 104(3), 390–391. https://doi.org/10.1038/sj.bjc.6606081
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  - Altomare, I., Bendell, J. C., Bullock, K. E., Uronis, H. E., Morse, M. A., Hsu, S. D., … Hurwitz, H. I. (2011). A phase II trial of bevacizumab plus everolimus for patients with refractory metastatic colorectal cancer.. Oncologist, 16(8), 1131–1137. https://doi.org/10.1634/theoncologist.2011-0078
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  - Hirsch, B. R., & Zafar, S. Y. (2011). Capecitabine in the management of colorectal cancer.. Cancer Manag Res, 3, 79–89. https://doi.org/10.2147/CMR.S11250
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  - Abernethy, A. P., Aziz, N. M., Basch, E., Bull, J., Cleeland, C. S., Currow, D. C., … Kutner, J. S. (2010). A strategy to advance the evidence base in palliative medicine: formation of a palliative care research cooperative group.. J Palliat Med, 13(12), 1407–1413. https://doi.org/10.1089/jpm.2010.0261
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  - Abernethy, A. P., Zafar, S. Y., Uronis, H., Wheeler, J. L., Coan, A., Rowe, K., … Herndon, J. E. (2010). Validation of the Patient Care Monitor (Version 2.0): a review of system assessment instrument for cancer patients.. J Pain Symptom Manage, 40(4), 545–558. https://doi.org/10.1016/j.jpainsymman.2010.01.017
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  - Zafar, S. Y., Currow, D. C., Daugherty, C. K., & Abernethy, A. P. (2010). Standards for palliative care delivery in oncology settings.. Cancer J, 16(5), 436–443. https://doi.org/10.1097/PPO.0b13e3181f289f7
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  - Bull, J., Zafar, S. Y., Wheeler, J. L., Harker, M., Gblokpor, A., Hanson, L., … Abernethy, A. P. (2010). Establishing a regional, multisite database for quality improvement and service planning in community-based palliative care and hospice.. J Palliat Med, 13(8), 1013–1020. https://doi.org/10.1089/jpm.2010.0017
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  - Jackson, G. L., Melton, L. D., Abbott, D. H., Zullig, L. L., Ordin, D. L., Grambow, S. C., … Provenzale, D. (2010). Quality of nonmetastatic colorectal cancer care in the Department of Veterans Affairs.. J Clin Oncol, 28(19), 3176–3181. https://doi.org/10.1200/JCO.2009.26.7948
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  - Abernethy, A. P., Ahmad, A., Zafar, S. Y., Wheeler, J. L., Reese, J. B., & Lyerly, H. K. (2010). Electronic patient-reported data capture as a foundation of rapid learning cancer care.. Med Care, 48(6 Suppl), S32–S38. https://doi.org/10.1097/MLR.0b013e3181db53a4
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  - Abernethy, A. P., Wheeler, J. L., & Zafar, S. Y. (2010). Management of gastrointestinal symptoms in advanced cancer patients: the rapid learning cancer clinic model.. Curr Opin Support Palliat Care, 4(1), 36–45. https://doi.org/10.1097/SPC.0b013e32833575fd
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  - Chrischilles, E. A., Pendergast, J. F., Kahn, K. L., Wallace, R. B., Moga, D. C., Harrington, D. P., … Fletcher, R. H. (2010). Adverse events among the elderly receiving chemotherapy for advanced non-small-cell lung cancer.. J Clin Oncol, 28(4), 620–627. https://doi.org/10.1200/JCO.2009.23.8485
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  - Zafar, S. Y., Marcello, J. E., Wheeler, J. L., Rowe, K. L., Morse, M. A., Herndon, J. E., & Abernethy, A. P. (2010). Treatment-related toxicity and supportive care in metastatic colorectal cancer.. J Support Oncol, 8(1), 15–20.
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  - Cherny, N. I., Abernethy, A. P., Strasser, F., Sapir, R., Currow, D., & Zafar, S. Y. (2009). Improving the methodologic and ethical validity of best supportive care studies in oncology: lessons from a systematic review.. J Clin Oncol, 27(32), 5476–5486. https://doi.org/10.1200/JCO.2009.21.9592
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  - Zafar, S. Y., Marcello, J. E., Wheeler, J. L., Rowe, K. L., Morse, M. A., Herndon, J. E., & Abernethy, A. P. (2009). Longitudinal patterns of chemotherapy use in metastatic colorectal cancer.. J Oncol Pract, 5(5), 228–233. https://doi.org/10.1200/JOP.091010
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  - Abernethy, A. P., Barbour, S. Y., Uronis, H., Zafar, S. Y., Coan, A., Rowe, K., … Herndon, J. E. (2009). Quality management of potential chemotherapy-induced neutropenic complications: evaluation of practice in an academic medical center.. Support Care Cancer, 17(6), 735–744. https://doi.org/10.1007/s00520-008-0562-6
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  - Abernethy, A. P., Zafar, S. Y., Coeytaux, R., Rowe, K., Wheeler, J. L., & Lyerly, H. K. (2009). Electronic patient-reported data capture as the foundation of a learning health care system.. J Clin Oncol, 27(15_suppl).
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  - Bullock, K. E., Hurwitz, H. I., Uronis, H. E., Morse, M. A., Blobe, G. C., Hsu, S. D., … Bendell, J. C. (2009). Bevacizumab (B) plus everolimus (E) in refractory metastatic colorectal cancer (mCRC).. J Clin Oncol, 27(15_suppl).
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  - Dupont, A., Wheeler, J., Herndon, J. E., Coan, A., Zafar, S. Y., Hood, L., … Abernethy, A. P. (2009). Use of tablet personal computers for sensitive patient-reported information.. J Support Oncol, 7(3), 91–97.
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  - Abernethy, A. P., Wheeler, J. L., & Zafar, S. Y. (2009). Detailing of gastrointestinal symptoms in cancer patients with advanced disease: new methodologies, new insights, and a proposed approach.. Curr Opin Support Palliat Care, 3(1), 41–49. https://doi.org/10.1097/SPC.0b013e32832531ce
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  - Zafar, S. Y., Abernethy, A. P., & Currow, D. (2009). To the editor. Journal of Clinical Oncology, 27(5). https://doi.org/10.1200/JCO.2008.20.6029
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  - Zafar, S. Y., Alexander, S. C., Weinfurt, K. P., Schulman, K. A., & Abernethy, A. P. (2009). Decision making and quality of life in the treatment of cancer: a review.. Support Care Cancer, 17(2), 117–127. https://doi.org/10.1007/s00520-008-0505-2
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  - Yousuf, S. Y., Abernethy, A. P., Abbott, D. H., Grambow, S. C., Marcello, J. E., Herndon, J. E., … Provenzale, D. T. (2008). Comorbidity, age, race and stage at diagnosis in colorectal cancer: A retrospective, parallel analysis of two health systems. Bmc Cancer, 8. https://doi.org/10.1186/1471-2407-8-345
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  - Zafar, S. Y., Abernethy, A. P., Abbott, D. H., Grambow, S. C., Marcello, J. E., Herndon, J. E., … Provenzale, D. T. (2008). Comorbidity, age, race and stage at diagnosis in colorectal cancer: a retrospective, parallel analysis of two health systems.. Bmc Cancer, 8. https://doi.org/10.1186/1471-2407-8-345
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  - Zafar, S. Y., Currow, D., & Abernethy, A. P. (2008). Defining best supportive care.. J Clin Oncol, 26(31), 5139–5140. https://doi.org/10.1200/JCO.2008.19.7491
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  - Zafar, S. Y., Howell, D. N., & Gockerman, J. P. (2008). Malignancy after solid organ transplantation: an overview.. Oncologist, 13(7), 769–778. https://doi.org/10.1634/theoncologist.2007-0251
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  - Zafar, Y., & Hurwitz, H. I. (2007). Monoclonal antibodies to EGFR: What does the future hold?. Oncology, 21(8), 976–977.
- Conference Papers
  - Greenup, R. A., Rushing, C. N., Fish, L. J., Lane, W. O., Peppercorn, J. M., Bellavance, E., … Hwang, E. S. (2019). Perspectives on the Costs of Cancer Care: A Survey of the American Society of Breast Surgeons.. In Ann Surg Oncol (Vol. 26, pp. 3141–3151). United States. https://doi.org/10.1245/s10434-019-07594-3
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  - Chino, F., Suneja, G., Moss, H., Zafar, S. Y., Havrilesky, L., & Chino, J. (2018). Health Care Disparities in Cancer Patients Receiving Radiation: Changes in Insurance Status After Medicaid Expansion Under the Affordable Care Act.. In Int J Radiat Oncol Biol Phys (Vol. 101, pp. 9–20). United States. https://doi.org/10.1016/j.ijrobp.2017.12.006
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  - Coronado, D. Y. S., Hahn, T., Albelda, R., Khera, N., Odejide, O. O., Soiffer, R. J., … Abel, G. A. (2017). Financial Burden and Patient-Reported Outcomes after Hematopoietic Cell Transplantation: Impact of Pre-Treatment Awareness of Transplant-Associated Costs. In Blood (Vol. 130). Atlanta, GA: AMER SOC HEMATOLOGY.
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  - Sitlinger, A., Sachdev, R., Anderson, D., & Zafar, S. Y. (2017). Insurance Design and Out-of-Pocket (OOP) Costs: a Comparison of Oral and Intravenous (IV) Treatment Plans for Chronic Lymphocytic Leukemia (CLL) in the Era of the Affordable Care Act (ACA). In Blood (Vol. 130). Atlanta, GA: AMER SOC HEMATOLOGY.
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  - Chino, F., Peppercorn, J. M., Rushing, C., Samsa, G., Nicolla, J., Altomare, I., & Zafar, S. Y. (2016). "Going for Broke": Out-of-Pocket Costs, Financial Distress, and Patient-Reported Willingness to Pay and Sacrifice in Cancer Care. In International Journal of Radiation Oncology Biology Physics (Vol. 96, pp. S135–S136).
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  - Mowery, Y. M., Salama, J. K., Zafar, S. Y., Moore, H. G., Willett, C. G., Czito, B., … Palta, M. (2016). Radiation Oncologists' Practice Patterns and Attitudes Regarding Neoadjuvant Short-Course Radiation Therapy for Rectal Cancer in the United States. In International Journal of Radiation Oncology Biology Physics (Vol. 96, pp. S203–S203).
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  - Zafar, S. Y. (2016). Abstract IA09: Intervening on the financial toxicity of cancer care. In Health Economics, Outcomes, and Policy Research. American Association for Cancer Research. https://doi.org/10.1158/1538-7755.disp15-ia09
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  - Irwin, B., Kimmick, G., Altomare, I., Marcom, P. K., Houck, K., Zafar, S. Y., & Peppercorn, J. (2014). Patient experience and attitudes toward addressing the cost of breast cancer care.. In Oncologist (Vol. 19, pp. 1135–1140). United States. https://doi.org/10.1634/theoncologist.2014-0117
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  - Zafar, S. Y., Grothey, A., Bekaii-Saab, T., Bendell, J., Sherrill, B., Bennett, L., … Hurwitz, H. I. (2012). SURVIVAL AMONG METASTATIC COLORECTAL CANCER (MCRC) PATIENTS TREATED IN A RANDOMIZED CONTROLLED TRIAL (RCT) VS AN OBSERVATIONAL COHORT STUDY (OCS). In Annals of Oncology (Vol. 23, pp. 191–191). Vienna, AUSTRIA: OXFORD UNIV PRESS.
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  - Abernethy, A. P., Zafar, S. Y., Coeytaux, R., Rowe, K., Wheeler, J. L., & Lyerly, H. K. (2009). Electronic patient-reported data capture as the foundation of a learning health care system. In Journal of Clinical Oncology (Vol. 27). Orlando, FL: AMER SOC CLINICAL ONCOLOGY.
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  - Bullock, K. E., Hurwitz, H. I., Uronis, H. E., Morse, M. A., Blobe, G. C., Hsu, S. D., … Bendell, J. C. (2009). Bevacizumab (B) plus everolimus (E) in refractory metastatic colorectal cancer (mCRC). In Journal of Clinical Oncology (Vol. 27). Orlando, FL: AMER SOC CLINICAL ONCOLOGY.
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Teaching & Mentoring
Recent Courses
- PUBPOL 393: Research Independent Study 2017

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