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Wang C, Qiu X, Yang X, Mao J, Li Q. Factors Influencing Social Isolation among Cancer Patients: A Systematic Review. Healthcare (Basel) 2024; 12:1042. [PMID: 38786452 PMCID: PMC11120751 DOI: 10.3390/healthcare12101042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 04/29/2024] [Accepted: 05/14/2024] [Indexed: 05/25/2024] Open
Abstract
(1) Background: Social isolation, which has numerous adverse effects on health status, is prevalent among cancer patients. This review proposes to identify the influencing factors of social isolation among cancer patients. (2) Methods: Articles published in English or Chinese from six electronic databases before December 2023 were identified via a systematic search. A manual search was also performed. (3) Results: Twenty-eight studies were identified in this systematic review. The factors associated with social isolation can be summarized into the following categories: demographic characteristics, having cancer, health status, coping, social support and social interaction. Despite the heterogeneity, 20 factors were significantly associated with social isolation, including age, gender, comorbidity burden, education level, residence, medical insurance, occupation status, personality, race, smoking status, having children, not living alone, household income level, marital status, the role of primary caregiver, physical health status, mental health status, social health status, coping styles, and the level of social support and social interaction. (4) Conclusions: The systematic review showed that cancer patients' social isolation was influenced by their demographic characteristics, cancer-related factors, physical condition, psychological status, social health status, coping styles, and level of social support and social interaction. In addition, future group intervention could be considered to improve social isolation.
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Affiliation(s)
| | | | | | | | - Qiuping Li
- Wuxi School of Medicine, Jiangnan University, Wuxi 214122, China; (C.W.); (X.Q.); (X.Y.); (J.M.)
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2
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Okere CA, Kvist T, Sak-Dankosky N, Yerris V. Spiritual interventions: Improving the lives of colorectal cancer survivors-A systematic literature review. J Adv Nurs 2024. [PMID: 38632872 DOI: 10.1111/jan.16196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 03/21/2024] [Accepted: 04/06/2024] [Indexed: 04/19/2024]
Abstract
AIM To systematically review the types of spiritual interventions available for colorectal cancer survivors and determine if they improve their lives. DESIGN Systematic review. DATA SOURCE A thorough literature search was conducted in July 2023 using PRIMO, PubMed/Medline, Cochrane, CINAHL, Scopus, and EMBASE. REVIEW METHODS As an extension of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist, the Synthesis Without Meta-Analysis reporting guideline was employed. A narrative synthesis was used to analyse the data. RESULTS Thirty-five articles were analysed for this study. The findings suggest that psychoeducational intervention, cognitive behavioural therapy intervention, mindfulness intervention, social intervention, and spiritual counselling improved CRC survivor's coping skills, boosted self-esteem, lessened anxiety, instilled hope, enhanced daily functioning, improved survival rates, improved neurological functional status and quality of life (QoL). CONCLUSION There is proof that spiritual interventions help CRC patients and improve their QoL. It has been discovered that spiritual intervention is helpful in the diagnosis, management, and treatment of CRC conditions. IMPACT CRC survivors may have impairments in their physical ability and daily functioning as a result of many symptoms, such as pain, bowel dysfunction, and exhaustion. Furthermore, individuals may encounter difficulties in several aspects of their psychological, emotional, social, and role functioning due to the presence of dread symptoms. Therefore, these study will help CRC survivors To implement spiritual interventions in the management of their long-term care. To cultivate problem-solving abilities, foster self-assurance, and enhance self-awareness. To alleviate symptoms, enhance everyday functioning, and improve QoL. NO INDUCEMENT No financial incentives were used to compensate patients or members of the public for this review.
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Affiliation(s)
| | - Tarja Kvist
- University of Eastern Finland, Kuopio, Finland
| | | | - Victor Yerris
- Institut Supérieur de Formation Bancaire, Geneva, Switzerland
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3
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Love SAM, Collins JM, Anthony KM, Buchheit SF, Butler EN, Bey GS, Gondalia R, Hayden KM, Zannas AS, Bick AG, Manson JE, Desai PM, Natarajan P, Bhattacharya R, Jaiswal S, Barac A, Reiner A, Kooperberg C, Stewart JD, Whitsel EA. Individual and Neighborhood-level Socioeconomic Status and Somatic Mutations Associated With Increased Risk of Cardiovascular Disease and Mortality: A Cross-Sectional Analysis in the Women's Health Initiative. Womens Health Issues 2024; 34:197-207. [PMID: 38061917 PMCID: PMC10978295 DOI: 10.1016/j.whi.2023.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/19/2023] [Accepted: 10/30/2023] [Indexed: 01/14/2024]
Abstract
BACKGROUND Clonal hematopoiesis of indeterminate potential (CHIP), the expansion of leukemogenic mutations in white blood cells, has been associated with increased risk of atherosclerotic cardiovascular diseases, cancer, and mortality. OBJECTIVE We examined the relationship between individual- and neighborhood-level socioeconomic status (SES) and CHIP and evaluated effect modification by interpersonal and intrapersonal resources. METHODS The study population included 10,799 postmenopausal women from the Women's Health Initiative without hematologic malignancy or antineoplastic medication use. Individual- and neighborhood (Census tract)-level SES were assessed across several domains including education, income, and occupation, and a neighborhood-level SES summary z-score, which captures multiple dimensions of SES, was generated. Interpersonal and intrapersonal resources were self-reports. CHIP was ascertained based on a prespecified list of leukemogenic driver mutations. Weighted logistic regression models adjusted for covariates were used to estimate risk of CHIP as an odds ratio (OR) and 95% confidence interval (95% CI). RESULTS The interval-scale neighborhood-level SES summary z-score was associated with a 3% increased risk of CHIP: OR (95% CI) = 1.03 (1.00-1.05), p = .038. Optimism significantly modified that estimate, such that among women with low/medium and high levels of optimism, the corresponding ORs (95% CIs) were 1.03 (1.02-1.04) and 0.95 (0.94-0.96), pInteraction < .001. CONCLUSIONS Our findings suggest that reduced risk of somatic mutation may represent a biological pathway by which optimism protects contextually advantaged but at-risk women against age-related chronic disease and highlight potential benefits of long-term, positive psychological interventions.
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Affiliation(s)
- Shelly-Ann M Love
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
| | - Jason M Collins
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Kurtis M Anthony
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Sophie F Buchheit
- Division of Biology and Medicine, Brown University, Providence, Rhode Island
| | - Eboneé N Butler
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Ganga S Bey
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Rahul Gondalia
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Injury Surveillance and Analytics, Real-World Analytics Solutions, IQVIA, Durham, North Carolina
| | - Kathleen M Hayden
- Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Wake Forest University, Winston-Salem, North Carolina
| | - Anthony S Zannas
- Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Genetics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina; Department of Medicine, Institute for Trauma Recovery, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Medicine, Neuroscience Curriculum, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Alexander G Bick
- Division of Genetic Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - JoAnn E Manson
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts; Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Pinkal M Desai
- Division of Hematology and Medical Oncology, Weill Cornell Medical Center, New York, New York
| | - Pradeep Natarajan
- Department of Medicine, Harvard Medical School, Boston, Massachusetts; Program in Medical and Population Genetics and the Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, Massachusetts; Cardiovascular Research Center, Massachusetts General Hospital, Boston, Massachusetts
| | - Romit Bhattacharya
- Department of Medicine, Harvard Medical School, Boston, Massachusetts; Program in Medical and Population Genetics and the Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, Massachusetts; Cardiovascular Research Center, Massachusetts General Hospital, Boston, Massachusetts
| | - Siddhartha Jaiswal
- Department of Pathology, Stanford University School of Medicine, Stanford, California
| | - Ana Barac
- Division of Cardiology, MedStar Washington Hospital Center, MedStar Heart and Vascular Institute, Washington, District of Columbia; Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia
| | - Alex Reiner
- Department of Epidemiology, University of Washington, Seattle, Washington; Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, Washington
| | - Charles Kooperberg
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, Washington
| | - James D Stewart
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Eric A Whitsel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Lee H, Singh GK, Jemal A, Islami F. Living alone and cancer mortality by race/ethnicity and socioeconomic status among US working-age adults. Cancer 2024; 130:86-95. [PMID: 37855867 DOI: 10.1002/cncr.35042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 07/26/2023] [Accepted: 08/28/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND Previous studies have shown an association between living alone and cancer mortality; however, findings by sex and race/ethnicity have generally been inconsistent, and data by socioeconomic status are sparse. The association between living alone and cancer mortality by sex, race/ethnicity, and socioeconomic status in a nationally representative US cohort was examined. METHODS Pooled 1998-2019 data for adults aged 18-64 years at enrollment from the National Health Interview Survey linked to the National Death Index (N = 473,648) with up to 22 years of follow-up were used to calculate hazard ratios (HRs) for the association between living alone and cancer mortality. RESULTS Compared to adults living with others, adults living alone were at a higher risk of cancer death in the age-adjusted model (HR, 1.32; 95% CI, 1.25-1.39) and after additional adjustments for multiple sociodemographic characteristics and cancer risk factors (HR, 1.10; 95% CI, 1.04-1.16). Age-adjusted models stratified by sex, poverty level, and educational attainment showed similar associations between living alone and cancer mortality, but the association was stronger among non-Hispanic White adults (HR, 1.33; 95% CI, 1.25-1.42) than non-Hispanic Black adults (HR, 1.18; 95% CI, 1.05-1.32; p value for difference < .05) and did not exist in other racial/ethnic groups. These associations were attenuated but persisted in fully adjusted models among men (HR, 1.13; 95% CI, 1.05-1.23), women (HR, 1.09; 95% CI, 1.01-1.18), non-Hispanic White adults (HR, 1.13; 95% CI, 1.05-1.20), and adults with a college degree (HR, 1.22; 95% CI, 1.07-1.39). CONCLUSIONS In this nationally representative study in the United States, adults living alone were at a higher risk of cancer death in several sociodemographic groups.
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Affiliation(s)
- Hyunjung Lee
- Surveillance and Health Equity Science Department, American Cancer Society, Atlanta, Georgia, USA
| | - Gopal K Singh
- Office of Health Equity, Health Resources and Services Administration, US Department of Health and Human Services, Rockville, Maryland, USA
| | - Ahmedin Jemal
- Surveillance and Health Equity Science Department, American Cancer Society, Atlanta, Georgia, USA
| | - Farhad Islami
- Surveillance and Health Equity Science Department, American Cancer Society, Atlanta, Georgia, USA
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Bekki T, Shimomura M, Saito Y, Nakahara M, Adachi T, Ikeda S, Shimizu Y, Kochi M, Ishizaki Y, Yoshimitsu M, Takakura Y, Shimizu W, Sumitani D, Kodama S, Fujimori M, Oheda M, Kobayashi H, Akabane S, Yano T, Ohdan H. Association between social background and implementation of postoperative adjuvant chemotherapy for older patients undergoing curative resection of colorectal cancers, sub-analysis of the HiSCO-04 study. Int J Colorectal Dis 2023; 39:11. [PMID: 38153518 DOI: 10.1007/s00384-023-04583-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/17/2023] [Indexed: 12/29/2023]
Abstract
PURPOSE Adjuvant chemotherapy is recommended following colorectal cancer resection based on risk of recurrence. In older patients, treatment decisions should consider recurrence rates and tolerability, as well as functional prognosis, residual disease, and social factors. This study aims to investigate factors, including social background, influencing implementation of postoperative adjuvant chemotherapy in older patients undergoing curative resection for colorectal cancer. METHODS This multi-institutional prospective cohort study included 15 institutions belonging to the Hiroshima Surgical study group for Clinical Oncology. We analyzed 159 older patients aged ≥ 80 years, who underwent curative resection for stage III colorectal cancer between December 2013 and June 2018, as sub-analysis of the HiSCO-04 study. RESULTS In total, 62 (39.0%) patients underwent postoperative adjuvant chemotherapy. Four factors were significantly associated with its implementation: performance status < 2, Charlson Comorbidity Index < 2, prognostic nutritional index ≥ 40, and presence of a spouse or siblings as lifestyle supporters. No significant difference was found in the backgrounds between complete and incomplete postoperative adjuvant chemotherapy patients. CONCLUSION Performance status, Charlson Comorbidity Index, nutritional status, and presence of a spouse or siblings as lifestyle supporters are possible factors influencing the implementation of postoperative adjuvant chemotherapy in older patients. To select appropriate treatment options, including postoperative adjuvant chemotherapy, it is essential to consider physical condition and comorbidities of older patients, thoroughly explain the situation to their families, and establish a support system to enhance understanding of the available treatment options.
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Affiliation(s)
- Tomoaki Bekki
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3 Minami-Ku, Hiroshima, Japan
- Department of Surgery, Chugoku Rosai Hospital, Kure, Japan
| | - Manabu Shimomura
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3 Minami-Ku, Hiroshima, Japan.
| | - Yasufumi Saito
- Department of Surgery, Chugoku Rosai Hospital, Kure, Japan
| | | | - Tomohiro Adachi
- Department of Surgery, Hiroshima City North Medical Center Asa Citizens Hospital, Hiroshima, Japan
| | - Satoshi Ikeda
- Department of Surgery, Hiroshima Prefectural Hospital, Hiroshima, Japan
| | - Yosuke Shimizu
- Department of Surgery, National Hospital Organization Kure Medical Center/Chugoku Cancer Center, Institute for Clinical Research, Kure, Japan
| | - Masatoshi Kochi
- Department of Gastroenterological Surgery, National Hospital Organization Higashihiroshima Medical Center, Higashihiroshima, Japan
| | - Yasuyo Ishizaki
- Department of Surgery, National Hospital Organization Hiroshima-Nishi Medical Center, Otake, Japan
| | - Masanori Yoshimitsu
- Department of Surgery, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Yuji Takakura
- Department of Surgery, Chuden Hospital, Hiroshima, Japan
| | - Wataru Shimizu
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3 Minami-Ku, Hiroshima, Japan
| | | | - Shinya Kodama
- Department of Surgery, Yoshida General Hospital, Akitakata, Japan
| | - Masahiko Fujimori
- Department of Surgery, Kure City Medical Association Hospital, Kure, Japan
| | - Mamoru Oheda
- Department of Surgery, Sera Central Hospital, Sera, Japan
| | | | - Shintaro Akabane
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3 Minami-Ku, Hiroshima, Japan
| | - Takuya Yano
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3 Minami-Ku, Hiroshima, Japan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3 Minami-Ku, Hiroshima, Japan
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6
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Jones JM, Howell D, Longo C, Olson K, Bedard P, Amir E, Zheng S, Chow B, Avery L. The association of cancer-related fatigue on the social, vocational and healthcare-related dimensions of cancer survivorship. J Cancer Surviv 2023:10.1007/s11764-023-01451-9. [PMID: 37644355 DOI: 10.1007/s11764-023-01451-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 08/14/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Cancer-related fatigue (CRF) is well documented in cancer survivors, but little is known about the personal and societal impact of CRF. This study aimed to examine the impact of CRF in relation to social and vocational functioning and health care utilization in a large sample of post-treatment cancer survivors. METHODS We conducted a cross-sectional descriptive study of early stage breast and colorectal cancer survivors (n = 454) who were within 5 years from treatment completion. Social difficulties (SDI-21), work status, absenteeism and presenteeism (WHO-HPQ) and healthcare utilization (HSUQ) were compared in those with (CFR +) and without (CRF -) clinically significant fatigue (FACT-F ≤ 34). RESULTS A total of 32% met the cut-off criteria for CRF (≤ 34). Participants with CRF + had significantly higher scores on the SDI-21 across all domains and 55% of CRF + vs. 11% in CRF - was above the SDI cut-off (> 10) for significant social difficulties. Participants with CRF + were 2.74 times more likely to be unemployed or on leave (95% CI 1.62, 4.61, p < 0.001). In the subgroup of participants who were currently working (n = 249), those with CRF + reported working on average 27.4 fewer hours in the previous 4 weeks compared to CRF - (p = 0.05), and absolute presenteeism was on average 13% lower in the CRF + group (95% CI 8.0, 18.2, p < 0.001). Finally, individuals with CRF + reported significantly more physician (p < 0.001), other health care professional (p = 0.03) and psychosocial visits (p = 0.002) in the past month. CONCLUSIONS AND IMPLICATIONS FOR CANCER SURVIVORS CRF is associated with substantial disruption in social and work role functioning in the early transitional phase of cancer survivorship. Better management of persistent CRF and funding for the implementation of existing guidelines and recommended evidence-based interventions are urgently needed.
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Affiliation(s)
- Jennifer M Jones
- Cancer Rehabilitation and Survivorship Program, Princess Margaret Cancer Centre and Department of Psychiatry, University of Toronto, 200 Elizabeth Street, B-PMB-045, Toronto, ON, M5G 2C4, Canada.
| | - Doris Howell
- Department of Supportive Care, Princess Margaret Cancer Centre and Lawrence Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | - Christopher Longo
- Health Policy and Management, DeGroote School of Business, McMaster University, Hamilton, Canada
| | - Karin Olson
- Faculty of Nursing, University of Alberta, and Edmonton Clinic Health Academy, Edmonton, Canada
| | - Philippe Bedard
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre and Department of Medicine, University of Toronto, Toronto, Canada
| | - Eitan Amir
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre and Department of Medicine, University of Toronto, Toronto, Canada
| | - Shiyu Zheng
- MD Program, University of Toronto, Toronto, Canada
| | - Brittany Chow
- Department of Family and Community Medicine, University of Toronto, Toronto, Canada
| | - Lisa Avery
- Department of Biostatistics, Princess Margaret Cancer Centre, and Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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Doyle C, Ko E, Lemus H, Hsu FC, Pierce JP, Wu T. Living Alone, Physical Health, and Mortality in Breast Cancer Survivors: A Prospective Observational Cohort Study. Healthcare (Basel) 2023; 11:2379. [PMID: 37685413 PMCID: PMC10486593 DOI: 10.3390/healthcare11172379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/16/2023] [Accepted: 08/17/2023] [Indexed: 09/10/2023] Open
Abstract
Living alone, particularly for individuals with poor physical health, can increase the likelihood of mortality. This study aimed to explore the individual and joint associations of living alone and physical health with overall mortality among breast cancer survivors in the Women's Healthy Eating and Living (WHEL). We collected baseline, 12-month and 48-month data among 2869 women enrolled in the WHEL cohort. Living alone was assessed as a binary variable (Yes, No), while scores of physical health were measured using the RAND Short Form-36 survey (SF-36), which include four domains (physical function, role limitation, bodily pain, and general health perceptions) and an overall summary score of physical health. Cox proportional hazard models were used to evaluate associations. No significant association between living alone and mortality was observed. However, several physical health measures showed significant associations with mortality (p-values < 0.05). For physical function, the multivariable model showed a hazard ratio (HR) of 2.1 (95% CI = 1.02-4.23). Furthermore, the study examined the joint impact of living alone and physical health measures on overall mortality. Among women with better physical function, those living alone had a 3.6-fold higher risk of death (95% CI = 1.01-12.89) compared to those not living alone. Similar trends were observed for pain. However, regarding role limitation, the pattern differed. Breast cancer survivors living alone with worse role limitations had the highest mortality compared to those not living alone but with better role limitations (HR = 2.6, 95% CI = 1.11-5.95). Similar trends were observed for general health perceptions. Our findings highlight that living alone amplifies the risk of mortality among breast cancer survivors within specific health groups.
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Affiliation(s)
- Cassie Doyle
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, CA 92182, USA; (C.D.); (H.L.)
| | - Eunjeong Ko
- School of Social Work, San Diego State University, San Diego, CA 92182, USA;
| | - Hector Lemus
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, CA 92182, USA; (C.D.); (H.L.)
| | - Fang-Chi Hsu
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC 27101, USA;
| | - John P. Pierce
- Moores Cancer Center, School of Medicine, University of California, San Diego, CA 92037, USA;
| | - Tianying Wu
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, CA 92182, USA; (C.D.); (H.L.)
- Moores Cancer Center, School of Medicine, University of California, San Diego, CA 92037, USA;
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8
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Wang F, Gao Y, Han Z, Yu Y, Long Z, Jiang X, Wu Y, Pei B, Cao Y, Ye J, Wang M, Zhao Y. A systematic review and meta-analysis of 90 cohort studies of social isolation, loneliness and mortality. Nat Hum Behav 2023; 7:1307-1319. [PMID: 37337095 DOI: 10.1038/s41562-023-01617-6] [Citation(s) in RCA: 38] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 04/27/2023] [Indexed: 06/21/2023]
Abstract
The associations between social isolation, loneliness and the risk of mortality from all causes, cardiovascular disease (CVD) and cancer are controversial. We systematically reviewed prospective studies on the association between social isolation, loneliness and mortality outcomes in adults aged 18 years or older, as well as studies on these relationships in individuals with CVD or cancer, and conducted a meta-analysis. The study protocol was registered with PROSPERO (reg. no. CRD42022299959). A total of 90 prospective cohort studies including 2,205,199 individuals were included. Here we show that, in the general population, both social isolation and loneliness were significantly associated with an increased risk of all-cause mortality (pooled effect size for social isolation, 1.32; 95% confidence interval (CI), 1.26 to 1.39; P < 0.001; pooled effect size for loneliness, 1.14; 95% CI, 1.08 to 1.20; P < 0.001) and cancer mortality (pooled effect size for social isolation, 1.24; 95% CI, 1.19 to 1.28; P < 0.001; pooled effect size for loneliness, 1.09; 95% CI, 1.01 to 1.17; P = 0.030). Social isolation also increased the risk of CVD mortality (1.34; 95% CI, 1.25 to 1.44; P < 0.001). There was an increased risk of all-cause mortality in socially isolated individuals with CVD (1.28; 95% CI, 1.10 to 1.48; P = 0.001) or breast cancer (1.51; 95% CI, 1.34 to 1.70; P < 0.001), and individuals with breast cancer had a higher cancer-specific mortality owing to social isolation (1.33; 95% CI, 1.02 to 1.75; P = 0.038). Greater focus on social isolation and loneliness may help improve people's well-being and mortality risk.
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Affiliation(s)
- Fan Wang
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, P. R. China
- NHC Key Laboratory of Etiology and Epidemiology, Harbin Medical University, Harbin, P. R. China
| | - Yu Gao
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, P. R. China
| | - Zhen Han
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, P. R. China
| | - Yue Yu
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, P. R. China
| | - Zhiping Long
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, P. R. China
| | - Xianchen Jiang
- Department of Chronic Disease Prevention and Control, Quzhou Center for Disease Control and Prevention, Quzhou, P. R. China
| | - Yi Wu
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, P. R. China
| | - Bing Pei
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, P. R. China
| | - Yukun Cao
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, P. R. China
| | - Jingyu Ye
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, P. R. China
| | - Maoqing Wang
- National Key Disciplines of Nutrition and Food Hygiene, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, P. R. China.
| | - Yashuang Zhao
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, P. R. China.
- NHC Key Laboratory of Etiology and Epidemiology, Harbin Medical University, Harbin, P. R. China.
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9
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Yang J, Zhang X, Yu M, Fisher JL, Paskett ED. Associations between cancer history, social distancing behaviors, and loneliness in adults during the COVID-19 pandemic. PLoS One 2023; 18:e0281713. [PMID: 36795688 PMCID: PMC9934343 DOI: 10.1371/journal.pone.0281713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 01/29/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND During the COVID-19 pandemic, enforced social distancing initiatives have highlighted differences in social distancing practices and the resulting loneliness in various populations. The objective of this study was to examine how cancer history and social distancing practices relate to loneliness during COVID-19. METHODS AND FINDINGS Participants from previous studies (N = 32,989) with permission to be re-contacted were invited to complete a survey online, by phone, or by mail between June and November 2020. Linear and logistic regression models were used to determine the associations between cancer history, social distancing, and loneliness. RESULTS Among the included participants (n = 5729), the average age was 56.7 years, 35.6% were male, 89.4% were White, and 54.9% had a cancer history (n = 3147). Individuals with a cancer history were more likely to not contact people outside of their household (49.0% vs. 41.9%, p<0.01), but were less likely to feel lonely (35.8% vs. 45.3%, p<0.0001) compared to those without a cancer history. Higher adherence to social distancing behaviors was associated with higher odds of loneliness among individuals with (OR = 1.27, 95% CI: 1.17-1.38) and without a cancer history (OR = 1.15, 95% CI: 1.06-1.25). CONCLUSIONS Findings from this study can inform efforts to support the mental health of individuals susceptible to loneliness during the COVID-19 pandemic.
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Affiliation(s)
- Jenny Yang
- Medical Student Research Program, College of Medicine, The Ohio State University, Columbus, OH, United States of America
- * E-mail:
| | - Xiaochen Zhang
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, United States of America
| | - Mengda Yu
- Center for Biostatistics, The Ohio State University, Columbus, OH, United States of America
| | - James L. Fisher
- James Cancer Hospital and Solove Research Institute, Columbus, OH, United States of America
- College of Public Health, The Ohio State University, Columbus, OH, United States of America
| | - Electra D. Paskett
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, United States of America
- College of Public Health, The Ohio State University, Columbus, OH, United States of America
- College of Medicine, The Ohio State University, Columbus, OH, United States of America
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10
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Bashkin O, Nahmias R, Attar S, Moshe R, Asna N. Perspectives of cancer patients during the COVID-19 outbreak in Israel: The long-term implications on support and well-being in an exploratory qualitative study. Eur J Cancer Care (Engl) 2022; 31:e13657. [PMID: 35838182 PMCID: PMC9350153 DOI: 10.1111/ecc.13657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 06/01/2022] [Accepted: 07/05/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The COVID-19 pandemic's ongoing effects and long-term implications for the mental and social state of cancer patients are not yet fully known. The current study examined cancer patients' feelings about the pandemic's long-term impact on daily life 1 year after its outbreak in Israel and after the patient's vaccination against the virus. METHODS Ten in-depth semi-structured interviews were conducted with cancer patients between February and April 2021. RESULTS AND CONCLUSIONS Findings indicated four main themes: (1) managing medical care and support from the medical staff, (2) the effect of the pandemic on social interactions; (3) the impact of the pandemic on family and social support and (4) the patients' psychological well-being. Despite the patients being vaccinated, the full impact of the pandemic on cancer patients' mental and social states is still fully apparent. The findings reflect the need to assess and monitor the patients' mental state and social and medical needs during this complex time and the importance of developing external support networks.
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Affiliation(s)
- Osnat Bashkin
- Department of Public Health, Ashkelon Academic College, Ashkelon, Israel
| | - Roni Nahmias
- Department of Public Health, Ashkelon Academic College, Ashkelon, Israel
| | - Sarah Attar
- Department of Public Health, Ashkelon Academic College, Ashkelon, Israel
| | - Reut Moshe
- Department of Public Health, Ashkelon Academic College, Ashkelon, Israel
| | - Noam Asna
- Oncology Department, Shaare Zedek Medical Center, Jerusalem, Israel
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11
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Religiosity, Emotions and Health: The Role of Trust/Mistrust in God in People Affected by Cancer. Healthcare (Basel) 2022; 10:healthcare10061138. [PMID: 35742189 PMCID: PMC9222636 DOI: 10.3390/healthcare10061138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/16/2022] [Accepted: 06/17/2022] [Indexed: 11/18/2022] Open
Abstract
Trust in God implies the conviction that God looks after a person’s own interests. The first evidence of a relationship between this construct and people’s psychological and emotional health dates back several centuries. However, the literature on this is limited, especially for people with physical health conditions, such as cancer. Therefore, the purpose of this study is to test the relationships between trust/mistrust in God, social support and emotions in people affected by cancer. The sample consisted of 177 women and men in Spain diagnosed with cancer. The instruments used were the Trust/Mistrust in God Scale, the Positive and Negative Affect Schedule and the Multidimensional Scale of Perceived Social Support. Correlation analysis and hierarchical regression analysis were performed to compare several explanatory models for the dependent variables: positive and negative emotions. The results show significant relationships between all variables. It was observed that, when trust/mistrust in God is included in the model, only mistrust in God predicts both types of emotions. In addition, both social support and some sociodemographic variables help to predict the dependent variables. This study shows that valuing the religiosity and spirituality of oncology patients in healthcare settings can have a significant positive impact on the health of these individuals. Moreover, it represents an important approach to the study of trust/mistrust in God in the context of a traditionally Catholic country.
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12
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Rogers CR, Korous KM, Brooks E, De Vera MA, Tuuhetaufa F, Lucas T, Curtin K, Pesman C, Johnson W, Gallagher P, Moore JX. Early-Onset Colorectal Cancer Survival Differences and Potential Geographic Determinants Among Men and Women in Utah. Am Soc Clin Oncol Educ Book 2022; 42:1-16. [PMID: 35522914 DOI: 10.1200/edbk_350241] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
By 2030, early-onset colorectal cancer (EOCRC) is expected to become the leading cancer-related cause of death for people age 20 to 49. To improve understanding of this phenomenon, we analyzed the geographic determinants of EOCRC in Utah by examining county-level incidence and mortality. We linked data from the Utah Population Database to the Utah Cancer Registry to identify residents (age 18-49) diagnosed with EOCRC between 2000 and 2020, and we used spatial empirical Bayes smoothing to determine county-level hotspots. We identified 1,867 EOCRC diagnoses (52.7% in male patients, 69.2% in non-Hispanic White patients). Ten counties (34%) were classified as hotspots, with high EOCRC incidence or mortality. Hotspot status was unrelated to incidence rates, but non-Hispanic ethnic-minority men (incidence rate ratio, 1.49; 95% CI, 1.15-1.91), Hispanic White men and women (incidence rate ratio, 2.24; 95% CI, 2.00-2.51), and Hispanic ethnic-minority men and women (incidence rate ratio, 4.59; 95% CI, 3.50-5.91) were more likely to be diagnosed with EOCRC. After adjustment for income and obesity, adults living in hotspots had a 31% higher hazard for death (HR, 1.31; 95% CI, 1.02-1.69). Survival was poorest for adults with a late-stage diagnosis living in hotspots (chi square (1) = 4.0; p = .045). Adults who were married or who had a life partner had a lower hazard for death than single adults (HR, 0.73; 95% CI, 0.58-0.92). The risk for EOCRC is elevated in 34% of Utah counties, warranting future research and interventions aimed at increasing screening and survival in the population age 18 to 49.
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Affiliation(s)
- Charles R Rogers
- Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT
| | - Kevin M Korous
- Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT
| | - Ellen Brooks
- Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT
| | - Mary A De Vera
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Fa Tuuhetaufa
- Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT
| | - Todd Lucas
- Division of Public Health, Michigan State University College of Human Medicine, Flint, MI
| | - Karen Curtin
- Department of Internal Medicine, Huntsman Cancer Institute, Utah Population Database Shared Resource, University of Utah School of Medicine, Salt Lake City, UT
| | | | - Wenora Johnson
- Patient-Centered Outcomes Research Institute, Chicago, IL
| | | | - Justin X Moore
- Medical College of Georgia, Georgia Cancer Center, Cancer Prevention, Control, & Population Health, Augusta University, Augusta, GA
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13
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Anisman H, Kusnecov AW. Adopting healthy behaviors: Toward prevention and cures. Cancer 2022. [DOI: 10.1016/b978-0-323-91904-3.00019-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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14
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Eckerling A, Ricon-Becker I, Sorski L, Sandbank E, Ben-Eliyahu S. Stress and cancer: mechanisms, significance and future directions. Nat Rev Cancer 2021; 21:767-785. [PMID: 34508247 DOI: 10.1038/s41568-021-00395-5] [Citation(s) in RCA: 88] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/23/2021] [Indexed: 02/08/2023]
Abstract
The notion that stress and cancer are interlinked has dominated lay discourse for decades. More recent animal studies indicate that stress can substantially facilitate cancer progression through modulating most hallmarks of cancer, and molecular and systemic mechanisms mediating these effects have been elucidated. However, available clinical evidence for such deleterious effects is inconsistent, as epidemiological and stress-reducing clinical interventions have yielded mixed effects on cancer mortality. In this Review, we describe and discuss specific mediating mechanisms identified by preclinical research, and parallel clinical findings. We explain the discrepancy between preclinical and clinical outcomes, through pointing to experimental strengths leveraged by animal studies and through discussing methodological and conceptual obstacles that prevent clinical studies from reflecting the impacts of stress. We suggest approaches to circumvent such obstacles, based on targeting critical phases of cancer progression that are more likely to be stress-sensitive; pharmacologically limiting adrenergic-inflammatory responses triggered by medical procedures; and focusing on more vulnerable populations, employing personalized pharmacological and psychosocial approaches. Recent clinical trials support our hypothesis that psychological and/or pharmacological inhibition of excess adrenergic and/or inflammatory stress signalling, especially alongside cancer treatments, could save lives.
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Affiliation(s)
- Anabel Eckerling
- Sagol School of Neuroscience and School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Itay Ricon-Becker
- Sagol School of Neuroscience and School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Liat Sorski
- Sagol School of Neuroscience and School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Elad Sandbank
- Sagol School of Neuroscience and School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Shamgar Ben-Eliyahu
- Sagol School of Neuroscience and School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel.
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15
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Evans LA, Go R, Warsame R, Nandakumar B, Buadi FK, Dispenzieri A, Dingli D, Lacy MQ, Hayman SR, Kapoor P, Leung N, Fonder A, Hobbs M, Hwa YL, Muchtar E, Kourelis TV, Russell S, Lust JA, Lin Y, Siddiqui M, Kyle RA, Gertz MA, Rajkumar SV, Kumar S, Gonsalves WI. The Impact of Socioeconomic Risk Factors on the Survival Outcomes of Patients With Newly Diagnosed Multiple Myeloma: A Cross-analysis of a Population-based Registry and a Tertiary Care Center. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2021; 21:451-460.e2. [PMID: 33785296 DOI: 10.1016/j.clml.2021.02.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 01/25/2021] [Accepted: 02/10/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Multiple myeloma (MM) is a heterogeneous clonal plasma cell disorder leading to differences in clinical outcomes such as overall survival (OS) among patients. We hypothesized that with expensive, novel therapeutic agents and paradigm shifts to maintain continuous therapy and improvement in OS, patients with MM are subject to the pressures of financial toxicity and the need for social support, which may be of prognostic importance. MATERIALS AND METHODS In this study, we examined the records of 122,458 patients from the National Cancer Database (NCDB) to determine the significance of socioeconomic factors such as estimated annual household income and education level, which were based on the patient's ZIP Code and the United States Census Bureau's 5-year report from 2008 to 2012. These socioeconomic factors, in addition to marital status, were then assessed individually and as a cumulative socioeconomic score for prognostic significance in a cohort of 2543 patients treated at a tertiary care center utilizing known biologic risk factors, such as cytogenetic risk, International Staging System classification, and serum lactate dehydrogenase levels. RESULTS Only marital status and estimated annual household income at diagnosis negatively impacted OS in a univariate analysis, but not in the context of a multivariable analysis incorporating known biologic risk factors. CONCLUSION Future analyses in other academic and non-academic centers located in urban and rural regions are required to understand the socioeconomic drivers of OS disparity among patients with MM observed nationally.
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Affiliation(s)
- Laura A Evans
- Division of Hematology, Mayo Clinic, Rochester, MN; Department of Biology, Johns Hopkins University, Baltimore, MD
| | - Ronald Go
- Division of Hematology, Mayo Clinic, Rochester, MN
| | | | | | | | | | - David Dingli
- Division of Hematology, Mayo Clinic, Rochester, MN
| | | | | | | | - Nelson Leung
- Division of Hematology, Mayo Clinic, Rochester, MN; Department of Nephrology and Hypertension, Mayo Clinic, Rochester, MN
| | - Amie Fonder
- Division of Hematology, Mayo Clinic, Rochester, MN
| | - Miriam Hobbs
- Division of Hematology, Mayo Clinic, Rochester, MN
| | - Yi Lisa Hwa
- Division of Hematology, Mayo Clinic, Rochester, MN
| | - Eli Muchtar
- Division of Hematology, Mayo Clinic, Rochester, MN
| | | | | | - John A Lust
- Division of Hematology, Mayo Clinic, Rochester, MN
| | - Yi Lin
- Division of Hematology, Mayo Clinic, Rochester, MN
| | | | | | | | | | - Shaji Kumar
- Division of Hematology, Mayo Clinic, Rochester, MN
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16
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Diao Y, Li X, Huo Y, Li Z, Yang Q, Huang Y, Wang L. Epidemiological Analysis and Prognosis of Conjunctival Cancer in the Past Twenty Years: A Population-Based Retrospective Study Using SEER Data. BIOMED RESEARCH INTERNATIONAL 2020; 2020:1203938. [PMID: 32724792 PMCID: PMC7366169 DOI: 10.1155/2020/1203938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 06/24/2020] [Indexed: 11/17/2022]
Abstract
Epidemiological studies of malignant primary conjunctival tumors are rare. We extracted data pertaining to primary site-labeled conjunctival cancer patients present within the Surveillance, Epidemiology, and End Results (SEER) database from 1992 to 2001 and from 2002 to 2011. The Kaplan-Meier approach was used for comparisons of overall survival (OS) between patients, while OS-related risk factors were identified via a Cox proportional hazards regression approach. We then constructed a nomogram that could be used to predict the 3- and 5-year OS, with the accuracy of this predictive model based on receiver operating characteristic (ROC) curve. We observed a significant reduction in age-adjusted incidence of conjunctival cancer in the 50-69-year-old age group of the 2002-2011 cohort relative to the 1992-2001 cohort (APC, P < 0.05). There were no significant differences in OS between the 1992-2001 and 2002-2011 conjunctival cancer patient cohorts. Being ≥30 years old (P < 0.05), male (P < 0.001), single (P < 0.05), divorced (P < 0.001), or widowed (P < 0.001) were all associated with an increased OS-related risk of primary conjunctival cancer (1992-2011). Our nomogram was able to accurately predict 3- and 5-year OS in conjunctival cancer patients. In verification mode, the 3-year area under the curve (AUC) was 0.697 and the 5-year AUC was 0.752. We found that age, sex, and marital status were all associated with primary conjunctival cancer survival. Our results further suggest that conjunctival cancer incidence and survival rates have been relatively stable over the last two decades, and using these data, we were able to generate a satisfactory risk prediction model for this disease.
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Affiliation(s)
- Yumei Diao
- Department of Ophthalmology, The 1st Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Xiaoqi Li
- Department of Ophthalmology, The 1st Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Yan Huo
- Department of Ophthalmology, The PLA Second Artillery General Hospital, Beijing 100088, China
| | - Zongyuan Li
- Department of Ophthalmology, The 1st Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Qinghua Yang
- Department of Ophthalmology, The 1st Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Yifei Huang
- Department of Ophthalmology, The 1st Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Liqiang Wang
- Department of Ophthalmology, The 1st Medical Center of Chinese PLA General Hospital, Beijing 100853, China
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