1
|
You Z, Han B, Shi Z, Zhao M, Du S, Liu H, Hei X, Ren X, Yan Y. Vocal Cord Leukoplakia Classification Using Siamese Network Under Small Samples of White Light Endoscopy Images. Otolaryngol Head Neck Surg 2024; 170:1099-1108. [PMID: 38037413 DOI: 10.1002/ohn.591] [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: 08/08/2023] [Revised: 10/25/2023] [Accepted: 11/02/2023] [Indexed: 12/02/2023]
Abstract
OBJECTIVE Accurate vocal cord leukoplakia classification is instructive for clinical diagnosis and surgical treatment. This article introduces a reliable very deep Siamese network for accurate vocal cord leukoplakia classification. STUDY DESIGN A study of a classification network based on a retrospective database. SETTING Academic university and hospital. METHODS The white light image datasets of vocal cord leukoplakia used in this article were classified into 6 classes: normal tissues, inflammatory keratosis, mild dysplasia, moderate dysplasia, severe dysplasia, and squamous cell carcinoma. The classification performance was assessed by comparing it with 6 classical deep learning models, including AlexNet, VGG Net, Google Inception, ResNet, DenseNet, and Vision Transformer. RESULTS Experiments show the superior classification performance of our proposed network compared to state-of-the-art methods. The overall accuracy is 0.9756. The values of sensitivity and specificity are very high as well. The confusion matrix provides information for the 6-class classification task and demonstrates the superiority of our proposed network. CONCLUSION Our very deep Siamese network can provide accurate classification results of vocal cord leukoplakia, which facilitates early detection, clinical diagnosis, and surgical treatment. The excellent performance obtained in white light images can reduce the cost for patients, especially those living in developing countries.
Collapse
Affiliation(s)
- Zhenzhen You
- Scool of Computer Science and Engineering, Shaanxi Key Laboratory for Network Computing and Security Technology, School of Computer Science and Engineering, Xi'an University of Technology, Xi'an, China
| | - Botao Han
- Scool of Computer Science and Engineering, Shaanxi Key Laboratory for Network Computing and Security Technology, School of Computer Science and Engineering, Xi'an University of Technology, Xi'an, China
| | - Zhenghao Shi
- Scool of Computer Science and Engineering, Shaanxi Key Laboratory for Network Computing and Security Technology, School of Computer Science and Engineering, Xi'an University of Technology, Xi'an, China
| | - Minghua Zhao
- Scool of Computer Science and Engineering, Shaanxi Key Laboratory for Network Computing and Security Technology, School of Computer Science and Engineering, Xi'an University of Technology, Xi'an, China
| | - Shuangli Du
- Scool of Computer Science and Engineering, Shaanxi Key Laboratory for Network Computing and Security Technology, School of Computer Science and Engineering, Xi'an University of Technology, Xi'an, China
| | - Haiqin Liu
- Department of Otorhinolaryngology, Second Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, China
| | - Xinhong Hei
- Scool of Computer Science and Engineering, Shaanxi Key Laboratory for Network Computing and Security Technology, School of Computer Science and Engineering, Xi'an University of Technology, Xi'an, China
| | - Xiaoyong Ren
- Department of Otorhinolaryngology, Second Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, China
| | - Yan Yan
- Department of Otorhinolaryngology, Second Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, China
| |
Collapse
|
2
|
Yamamoto Y, Kamiya T, Yano M, Huyen VT, Oishi M, Nishio M, Suzuki A, Sunami K, Ohtani N. Oral Microbial Profile Analysis in Patients with Oral and Pharyngeal Cancer Reveals That Tumoral Fusobacterium nucleatum Promotes Oral Cancer Progression by Activating YAP. Microorganisms 2023; 11:2957. [PMID: 38138101 PMCID: PMC10746018 DOI: 10.3390/microorganisms11122957] [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: 10/29/2023] [Revised: 12/02/2023] [Accepted: 12/07/2023] [Indexed: 12/24/2023] Open
Abstract
The incidence of oral cancer has recently been increasing worldwide, particularly among young individuals and women. The primary risk factors for head and neck cancers, including oral and pharyngeal cancers, are smoking, alcohol consumption, poor oral hygiene, and repeated exposure to mechanical stimuli. However, approximately one-third of the patients with oral and pharyngeal cancers are neither smokers nor drinkers, which points to the existence of other mechanisms. Recently, human microbes have been linked to various diseases, including cancer. Oral pathogens, especially periodontal pathobionts, are reported to play a role in the development of colon and other types of cancer. In this study, we employed a series of bioinformatics analyses to pinpoint Fusobacterium nucleatum as the predominant oral bacterial species in oral and pharyngeal cancer tissue samples. We successfully isolated Fn. polymorphum from the saliva of patients with oral cancer and demonstrated that Fn. polymorphum indeed promoted oral squamous cell carcinoma development by activating YAP in a mouse tongue cancer model. Our research offers scientific evidence for the role of the oral microbiome in oral cancer progression and provides insights that would help in devising preventative strategies against oral cancer, potentially by altering oral bacterial profiles.
Collapse
Affiliation(s)
- Yuki Yamamoto
- Department of Otolaryngology and Head & Neck Surgery, Graduate School of Medicine, Osaka Metropolitan University, Osaka 545-8585, Japan
- Department of Otolaryngology and Head & Neck Surgery, Graduate School of Medicine, Osaka City University, Osaka 545-8585, Japan
| | - Tomonori Kamiya
- Department of Pathophysiology, Graduate School of Medicine, Osaka Metropolitan University, Osaka 545-8585, Japan
| | - Megumu Yano
- Department of Pathophysiology, Graduate School of Medicine, Osaka Metropolitan University, Osaka 545-8585, Japan
| | - Vu Thuong Huyen
- Department of Pathophysiology, Graduate School of Medicine, Osaka Metropolitan University, Osaka 545-8585, Japan
| | - Masahiro Oishi
- Department of Otolaryngology and Head & Neck Surgery, Graduate School of Medicine, Osaka Metropolitan University, Osaka 545-8585, Japan
| | - Miki Nishio
- Division of Molecular and Cellular Biology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Akira Suzuki
- Division of Molecular and Cellular Biology, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
| | - Kishiko Sunami
- Department of Otolaryngology and Head & Neck Surgery, Graduate School of Medicine, Osaka Metropolitan University, Osaka 545-8585, Japan
- Department of Otolaryngology and Head & Neck Surgery, Graduate School of Medicine, Osaka City University, Osaka 545-8585, Japan
| | - Naoko Ohtani
- Department of Pathophysiology, Graduate School of Medicine, Osaka Metropolitan University, Osaka 545-8585, Japan
- AMED-CREST, Japan Agency for Medical Research and Development (AMED), Tokyo 100-0004, Japan
| |
Collapse
|
3
|
Tikka SK, Shukla A, Arora RD, Singh S, Mahant S, Verma S, Singh LK. Brief intervention to enhance cessation of smokeless tobacco use in newly diagnosed patients with head and neck cancers: A randomized controlled trial in patient-relative dyads. Indian J Psychiatry 2023; 65:742-748. [PMID: 37645365 PMCID: PMC10461584 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_578_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 04/24/2023] [Accepted: 05/31/2023] [Indexed: 08/31/2023] Open
Abstract
Introduction Tobacco use is a major causative factor for head and neck cancers (HNC). Continued use of tobacco even after cancer diagnosis is common and is associated with all-cause and cancer-specific mortality, cancer recurrence and poor treatment response. Evidence suggests that behavioral interventions, help achieve greater smoking cessation rates in HNC patients. However, intervention studies focussed on HNC patients using smokeless tobacco, which is more common than smoking in India, are sparse. Materials and Methods We conducted a parallel arm randomized controlled trial (RCT) on dyads of patients with recently diagnosed HNC and a close relative. The experimental arm received a brief tobacco cessation intervention (BTCI) and the control arm received treatment as usual (TAU); 27 and 25 dyads in each arm completed the trial. Results Overall for the dyads using SLT, the relative risk of continuing to use SLT was 3.23 times higher (odds ratio = 7.01) if BTCI was not undertaken at one-month follow-up and 4.43 times higher (odds ratio = 8.65) at 3-months follow-up. For patients only, the relative risk of continuing to use SLT at one-month and 3-months follow-ups was 4.99 and 12.04 times higher, respectively, if BTCI was not undertaken. For relatives only, the corresponding relative risk values were 2.14 and 2.2. Conclusion We conclude that BTCI delivered to patient-relative dyads, compared to TAU, is effective in enhancing the discontinuation rates of the use of SLT in newly diagnosed patients with HNC. This form of intervention is significantly effective for discontinuing SLT use in the relatives too.
Collapse
Affiliation(s)
- Sai Krishna Tikka
- Department of Psychiatry, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India
| | - Avinash Shukla
- Department of Psychiatry, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Ripu D. Arora
- Department of Otorhinolaryngology and Head and Neck Surgery, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Sharda Singh
- Department of Psychiatry, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Supriya Mahant
- Department of Psychiatry, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Sachin Verma
- Department of Psychiatry, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Lokesh K. Singh
- Department of Psychiatry, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| |
Collapse
|
4
|
Denissoff A, Huusko T, Ventelä S, Niemelä S, Routila J. Exposure to alcohol and overall survival in head and neck cancer: A regional cohort study. Head Neck 2022; 44:2109-2117. [PMID: 35713171 PMCID: PMC9545212 DOI: 10.1002/hed.27125] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 03/24/2022] [Accepted: 06/01/2022] [Indexed: 12/02/2022] Open
Abstract
Background There is a paucity of knowledge regarding the association of alcohol use with overall survival (OS) of patients with head and neck squamous cell carcinoma (HNSCC). Methods All 1033 patients treated for new HNSCC in Southwest Finland regional referral center of Turku University Hospital in 2005–2015. Cox regression analysis was used. Tumor TNM classification, age at baseline and tobacco smoking status were assessed as potential confounders. Results A history of severe harmful alcohol use with major somatic complications (HR: 1.41; 95%CI: 1.06–1.87; p = 0.017) as well as current use of at least 10 units per week (HR: 1.44, 95%CI: 1.16–1.78; p = 0.001) were associated with OS. Conclusions Alcohol consumption of 10–20 units/week, often regarded as moderate use, was found to increase risk of mortality independent of other prognostic variables. Systematic screening of risk level alcohol use and prognostic evaluation of alcohol brief intervention strategies is highly recommended.
Collapse
Affiliation(s)
- Alexander Denissoff
- Department of Psychiatry, Faculty of Medicine, University of Turku, Turku, Finland.,Addiction Psychiatry Unit, Department of Psychiatry, Turku University Hospital, Turku, Finland
| | - Teemu Huusko
- Department for Otorhinolaryngology - Head and Neck Surgery, University of Turku, Turku, Finland.,Department for Otorhinolaryngology - Head and Neck Surgery, Turku University Hospital, Turku, Finland
| | - Sami Ventelä
- Department for Otorhinolaryngology - Head and Neck Surgery, University of Turku, Turku, Finland.,Department for Otorhinolaryngology - Head and Neck Surgery, Turku University Hospital, Turku, Finland
| | - Solja Niemelä
- Department of Psychiatry, Faculty of Medicine, University of Turku, Turku, Finland.,Addiction Psychiatry Unit, Department of Psychiatry, Turku University Hospital, Turku, Finland
| | - Johannes Routila
- Department for Otorhinolaryngology - Head and Neck Surgery, University of Turku, Turku, Finland.,Department for Otorhinolaryngology - Head and Neck Surgery, Turku University Hospital, Turku, Finland
| |
Collapse
|
5
|
Van Heest T, Rubin N, Khariwala SS. Persistent Tobacco Use After Treatment for Head and Neck Cancer. JAMA Otolaryngol Head Neck Surg 2022; 148:597-603. [PMID: 35551592 PMCID: PMC9100463 DOI: 10.1001/jamaoto.2022.0810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Smoking during and after treatment has been linked to increased morbidity and mortality in patients with head and neck squamous cell carcinoma (HNSCC). Posttreatment tobacco use patterns and the appropriate timing for cessation interventions are understudied. Objective To determine the frequency and patterns of posttreatment smoking cessation in smokers with HNSCC. Design, Setting, and Participants This prospective cohort study assessed smoking status after a new diagnosis of HNSCC among daily smokers who were treated at a tertiary care center at an academic institution between January 1, 2009, and December 31, 2017. Exposures Being current daily cigarette smoker at the time of diagnosis of HNSCC and having smoked at least 5 cigarettes per day for at least 5 years. Main Outcomes and Measures Patients provided data indicating smoking intensity, duration of tobacco use, number of cessation attempts, number of successful cessation days, and symptoms during cessation attempts, as well as demographic and clinical information at the time of diagnosis, as well as smoking and disease status at 6 months, 12 months, 18 months, and 24 months after treatment. Results Eighty-nine smokers with HNSCC (mean [SD] age at enrollment, 60.1 [9.2] years; 74 [83.1%] male and 15 [16.9%] female; 2 [2.2%] American Indian or Alaska Native, 1 [1.1%] Asian, 3 [3.4%] Black, 71 [79.8%] White, and 12 [13.5%] of unknown race and ethnicity or whose race and ethnicity were not reported) completed 24 months of posttreatment follow-up and were included in the study. Fifty-two patients (58.4%) continued to smoke at 6 months after treatment, 47 patients (52.8%) smoked at 12 months after treatment, 41 patients (46.1%) smoked at 18 months after treatment, and 40 patients (44.9%) smoked at 24 months after treatment. The probability of smoking cessation was highest during the first 6 months after treatment, at 0.36. Mean (SD) number of cigarettes per day (17.8 [9.6] vs 12.4 [10.0], mean difference, 5.1 [95% CI, 0.2 to 10.6]), duration of tobacco use (28.2 [18.1] vs 16.4 [17.4] years, mean difference, 11.8 [1.9 to 21.7] years), and lower number of prior quit attempts (5.3 [5.9] vs 10.4 [22.9], mean difference, -5.2 [95% CI, -15.7 to 5.4]) were all associated with persistent tobacco use at 24 months after treatment vs those who successfully quit. Conclusions and Relevance The results of this cohort study suggest that a significant proportion of patients with HNSCC who are daily smokers at the time of diagnosis continue to smoke after treatment. Smokers with HNSCC who successfully quit smoking were most likely to do so in the first 6 months after treatment, which could potentially serve as a preferred window for smoking cessation interventions. These data highlight the need for inclusion of aggressive smoking cessation intervention in head and neck cancer care pathways.
Collapse
Affiliation(s)
- Tyler Van Heest
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis
| | - Nathan Rubin
- Biostatistics Core, Masonic Cancer Center, University of Minnesota, Minneapolis
| | - Samir S Khariwala
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis
| |
Collapse
|
6
|
Mujcic A, Blankers M, Boon B, Berman AH, Riper H, van Laar M, Engels R. Effectiveness, Cost-effectiveness, and Cost-Utility of a Digital Alcohol Moderation Intervention for Cancer Survivors: Health Economic Evaluation and Outcomes of a Pragmatic Randomized Controlled Trial. J Med Internet Res 2022; 24:e30095. [PMID: 35103605 PMCID: PMC8848232 DOI: 10.2196/30095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 11/05/2021] [Accepted: 11/15/2021] [Indexed: 11/17/2022] Open
Abstract
Background Alcohol moderation (AM) interventions may contribute to better treatment outcomes and the general well-being of cancer survivors. Objective This study evaluates the effectiveness, cost-effectiveness, and cost-utility of MyCourse, a digital AM intervention, compared with a noninteractive digital information brochure for cancer survivors. Methods A health economic evaluation alongside a pragmatic 2-arm parallel-group randomized controlled trial was conducted with follow-ups at 3, 6, and 12 months after randomization. The study was conducted on the web in the Netherlands from 2016 to 2019. Participants were adult 10-year cancer survivors drinking over the Dutch-recommended drinking guidelines (≤7 standard units [10 g of alcohol] per week) with the intention to moderate or quit drinking. Overall, 103 participants were randomized and analyzed: 53 (51.5%) in the MyCourse group and 50 (48.5%) in the control group. In the MyCourse group, participants had access to a newly developed, digital, minimally guided AM intervention, MyCourse–Moderate Drinking. The primary outcome was the self-reported number of standard drinks (10 g of ethanol) consumed in the past 7 days at the 6-month follow-up. The secondary outcome measures were alcohol-related problems as measured by the Alcohol Use Disorders Identification Test (AUDIT) and treatment satisfaction. For the health economic evaluation, health care costs, costs because of productivity losses, and intervention costs were assessed over a 12-month horizon. Results Alcohol use at the 6-month follow-up decreased by 38% in the MyCourse group and by 33% in the control group. No difference in 7-day alcohol use was found between the groups (B=2.1, 95% CI −7.6 to 3.1; P=.22) at any of the follow-ups. AUDIT scores for alcohol-related problems decreased over time in both groups, showing no significant difference between the groups (Cohen d=0.3, 95% CI −0.1 to 0.6; P=.21). Intervention costs per participant were estimated at US $279 for the MyCourse group and US $74 for the control group. The mean societal costs were US $18,092 (SD 25,662) and US $23,496 (SD 34,327), respectively. The MyCourse group led to fewer gained quality-adjusted life years at lower societal costs in the cost-utility analysis. In the cost-effectiveness analysis, the MyCourse group led to a larger reduction in drinking units over time at lower societal costs (incremental cost-effectiveness ratio per reduced drink: US $ −1158, 95% CI −1609 to −781). Conclusions At 6 months, alcohol use was reduced by approximately one-third in both groups, with no significant differences between the digital intervention MyCourse and a noninteractive web-based brochure. At 12 months, cost-effectiveness analyses showed that MyCourse led to a larger reduction in drinking units over time, at lower societal costs. The MyCourse group led to marginally fewer gained quality-adjusted life years, also at lower societal costs. Trial Registration Netherlands Trial Register NTR6010; https://www.trialregister.nl/trial/5433 International Registered Report Identifier (IRRID) RR2-10.1186/s12885-018-4206-z
Collapse
Affiliation(s)
- Ajla Mujcic
- Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, Netherlands.,Trimbos Institute, Utrecht, Netherlands
| | - Matthijs Blankers
- Trimbos Institute, Utrecht, Netherlands.,Department of Psychiatry, Amsterdam University Medical Center, Location Amsterdam Medical Center, University of Amsterdam, Amsterdam, Netherlands.,Department of Research, Arkin Mental Health Care, Amsterdam, Netherlands
| | - Brigitte Boon
- Academy het Dorp, Arnhem, Netherlands.,Siza, Arnhem, Netherlands.,Tranzo, Tilburg University, Tilburg, Netherlands
| | - Anne H Berman
- Department of Psychology, Uppsala University, Uppsala, Sweden.,Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.,Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden
| | - Heleen Riper
- Section Clinical Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Department of Psychiatry, Medical University, University of Turku, Turku, Finland.,Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Amsterdam, Netherlands
| | | | - Rutger Engels
- Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, Netherlands
| |
Collapse
|
7
|
Goyal N, Day A, Epstein J, Goodman J, Graboyes E, Jalisi S, Kiess AP, Ku JA, Miller MC, Panwar A, Patel VA, Sacco A, Sandulache V, Williams AM, Deschler D, Farwell DG, Nathan C, Fakhry C, Agrawal N. Head and neck cancer survivorship consensus statement from the American Head and Neck Society. Laryngoscope Investig Otolaryngol 2022; 7:70-92. [PMID: 35155786 PMCID: PMC8823162 DOI: 10.1002/lio2.702] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 10/15/2021] [Accepted: 11/10/2021] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVES To provide a consensus statement describing best practices and evidence regarding head and neck cancer survivorship. METHODS Key topics regarding head and neck cancer survivorship were identified by the multidisciplinary membership of the American Head and Neck Society Survivorship, Supportive Care & Rehabilitation Service. Guidelines were generated by combining expert opinion and a review of the literature and categorized by level of evidence. RESULTS Several areas regarding survivorship including dysphonia, dysphagia, fatigue, chronic pain, intimacy, the ability to return to work, financial toxicity, lymphedema, psycho-oncology, physical activity, and substance abuse were identified and discussed. Additionally, the group identified and described the role of key clinicians in survivorship including surgical, medical and radiation oncologists; dentists; primary care physicians; psychotherapists; as well as physical, occupational, speech, and respiratory therapists. CONCLUSION Head and neck cancer survivorship is complex and requires a multidisciplinary approach centered around patients and their caregivers. As survival related to head and neck cancer treatment improves, addressing post-treatment concerns appropriately is critically important to our patient's quality of life. There continues to be a need to define effective and efficient programs that can coordinate this multidisciplinary effort toward survivorship.
Collapse
Affiliation(s)
- Neerav Goyal
- Department of Otolaryngology—Head and Neck SurgeryThe Pennsylvania State University, College of MedicineHersheyPennsylvaniaUSA
| | - Andrew Day
- Department of Otolaryngology—Head and Neck SurgeryUniversity of Texas Southwestern Medical CenterDallasTexasUSA
| | - Joel Epstein
- Department of SurgeryCedars SinaiLos AngelesCaliforniaUSA
- City of HopeCaliforniaDuarteUSA
| | - Joseph Goodman
- Ear, Nose and Throat CenterGeorge Washington UniversityWashingtonDistrict of ColumbiaUSA
| | - Evan Graboyes
- Department of Otolaryngology—Head and Neck SurgeryMedical University of South CarolinaCharlestonSouth CarolinaUSA
| | - Scharukh Jalisi
- Department of OtolaryngologyBeth Israel DeaconessBostonMassachusettsUSA
| | - Ana P. Kiess
- Department of Radiation Oncology and Molecular Radiation SciencesJohns Hopkins MedicineBaltimoreMarylandUSA
| | - Jamie A. Ku
- Head and Neck InstituteCleveland ClinicClevelandOhioUSA
| | - Matthew C. Miller
- Department of OtolaryngologyUniversity of Rochester Medical CenterRochesterNew YorkUSA
| | - Aru Panwar
- Department of Head and Neck Surgical Oncology, Methodist Estabrook Cancer CenterNebraska Methodist HospitalOmahaNebraskaUSA
| | - Vijay A. Patel
- Department of OtolaryngologyUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Assuntina Sacco
- Department of Medical OncologyUniversity of California San DiegoLa JollaCaliforniaUSA
| | - Vlad Sandulache
- Department of Otolaryngology—Head and Neck SurgeryBaylor College of MedicineHoustonTexasUSA
| | - Amy M. Williams
- Department of Otolaryngology—Head and Neck SurgeryHenry Ford Health SystemDetroitMichiganUSA
| | - Daniel Deschler
- Department of Otolaryngology–Head and Neck SurgeryMassachusetts Eye and EarBostonMassachusettsUSA
| | - D. Gregory Farwell
- Department of Otolaryngology—Head and Neck SurgeryUniversity of California DavisDavisCaliforniaUSA
| | - Cherie‐Ann Nathan
- Department of Otolaryngology—Head and Neck SurgeryLouisiana State UniversityShreveportLouisianaUSA
| | - Carole Fakhry
- Department of Otolaryngology—Head and Neck SurgeryJohns Hopkins School of MedicineBaltimoreMarylandUSA
| | - Nishant Agrawal
- Department of Surgery, Section of Otolaryngology—Head and Neck SurgeryUniversity of Chicago Pritzker School of MedicineChicagoIllinoisUSA
| |
Collapse
|
8
|
Kerr AR, Lodi G. Management of Oral Potentially Malignant Disorders. Oral Dis 2021; 27:2008-2025. [PMID: 34324758 DOI: 10.1111/odi.13980] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 07/07/2021] [Accepted: 07/22/2021] [Indexed: 11/29/2022]
Abstract
Patients with oral potentially malignant disorders (OPMDs), including oral leukoplakia and erythroplakia, proliferative verrucous leukoplakia, oral submucous fibrosis, and oral lichen planus/lichenoid lesions can be challenging to manage. A small proportion will undergo cancer development and determining a patient's cancer risk is key to making management decisions. Yet, our understanding of the natural history of OPMDs has not been fully elucidated, and a precision approach based on the integration of numerous predictive markers has not been validated by prospective studies. Evidence-based health promotion by clinicians and healthcare systems is not embraced universally. Medical and surgical interventions evaluated by rigorous research measuring important endpoints, such as cancer development, mortality, or survival are difficult and expensive to run. Most of these studies employ non-ideal surrogate endpoints and have deep methodologic flaws. Diagnostic criteria for enrolling research subjects are not uniform, and patients with the highest risk for cancer development comprise small proportions of those enrolled. Few studies explore quality of life and patient preferences. It is time to rethink how we approach the management of these patients, across each OPMD, and considering the healthcare infrastructure and cost effectiveness. Global networks with well-characterized patient populations with OPMDs and well-designed interventional trials using validated outcome measures are needed.
Collapse
Affiliation(s)
- A Ross Kerr
- Department of Oral & Maxillofacial Pathology, Radiology & Medicine.,New York University College of Dentistry, New York, NY, USA
| | - Giovanni Lodi
- Dipartimento di Scienze Biomediche, Chirurgiche e Odontoiatriche, Università degli Studi di Milano, Milano, Italia
| |
Collapse
|
9
|
Khodadadi AB, Carroll W, Lee EL, Hansen B, Scarinci IC. It Takes Two to Tango: Patients' and Providers' Perspectives in Tobacco Cessation and Head/Neck Cancer. Oncologist 2021; 26:761-770. [PMID: 34105215 DOI: 10.1002/onco.13856] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 05/26/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Tobacco cessation among patients with head/neck cancer continues to be challenging despite evidence that cessation improves treatment outcomes. The purpose of this study was to understand barriers/facilitators to tobacco cessation among patients with head/neck cancer and health care providers and to obtain perspectives toward the development of a patient-centered tobacco cessation intervention. MATERIALS AND METHODS In-depth qualitative interviews with 10 health care providers and 21 patients with head/neck cancer (12 inpatients and 9 outpatients) who were current or former smokers. RESULTS Health was a common motivator to quit among patients. Although most patients indicated that their health care provider asked and advised them to quit, they were unaware of cessation resources. Suggestions for a tobacco cessation program included involvement of former smokers, health care provider involvement/counseling, supporting written materials, and incorporating follow-up and family support. Health care providers identified patients' anger/frustration associated with the disease, social/demographic issues, and poor quality of life as the three most frequent challenges in treating patients. Although all providers reported asking about tobacco use, 70% emphasized a lack of formal training in tobacco cessation and lack of time. Their suggestions for a cessation program included having a "quarterback" responsible for this component with support from the entire health care team and continuity between outpatient and inpatient services to promote cessation, prevent relapse, and highlight the importance of follow-up and social support. CONCLUSION There is great interest and need, both from patients and providers, for tobacco cessation services in the oncology setting tailored for patients with head/neck cancer in the context of cancer care. IMPLICATIONS FOR PRACTICE Although the combination of pharmacotherapy and cognitive-behavioral intervention is the standard evidence-based treatment for tobacco dependence, it must be adapted to meet the needs and wants of patients and providers to be effective. This study provides an in-depth examination of such needs among patients with head and neck cancer and providers in the context of cancer care. Providers and patients emphasized the need of having a trained health care provider dedicated to providing tobacco cessation through seamless integration between outpatient and inpatient services as well as follow-up with an emphasis on family involvement throughout the process.
Collapse
Affiliation(s)
| | - William Carroll
- University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
| | - Erica L Lee
- University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
| | - Barbara Hansen
- University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
| | - Isabel C Scarinci
- University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
| |
Collapse
|
10
|
Cox SR, Daniel CL. Racial and Ethnic Disparities in Laryngeal Cancer Care. J Racial Ethn Health Disparities 2021; 9:800-811. [PMID: 33733426 DOI: 10.1007/s40615-021-01018-3] [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: 11/04/2020] [Revised: 03/02/2021] [Accepted: 03/02/2021] [Indexed: 11/26/2022]
Abstract
There is a long history of racial and ethnic disparities in healthcare and they continue to persist in contemporary society. These disparities have the potential to negatively affect morbidity and mortality in racial and ethnic minorities diagnosed with laryngeal cancer. Diagnosis, medical treatment, and rehabilitation for laryngeal cancer have improved considerably, leading to improvements in overall survival rates and physical, social, and psychological functioning. Yet members of minority and underrepresented groups are at an increased risk for experiencing reduced access to quality care and delays between diagnosis and treatment, and as a result have lower survival rates. Increasing health providers' awareness of racial and ethnic disparities in laryngeal cancer is necessary to facilitate changes in patient and provider education, clinical practice, and health policies. The purpose of this review is to summarize current literature on disparities in laryngeal cancer diagnosis, treatment, and rehabilitation among Black and Hispanic patients. We present recent data from the Surveillance, Epidemiology, and End Results database to examine trends in laryngeal cancer and patient, provider, and health systems factors that may perpetuate these disparities. In addition, we offer interventions to address racism and other racial and ethnic biases in laryngeal cancer care and describe research and legislative actions that are needed to reduce disparities in this area.
Collapse
Affiliation(s)
- Steven R Cox
- Department of Communication Sciences and Disorders, Adelphi University, Garden City, NY, 11530, USA.
| | - Carolann L Daniel
- School of Social Work, Adelphi University, Garden City, NY, 11530, USA
| |
Collapse
|
11
|
Day AT, Dahlstrom KR, Lee R, Karam-Hage M, Sturgis EM. Impact of a tobacco treatment program on abstinence and survival rates among current smokers with head and neck squamous cell carcinoma. Head Neck 2020; 42:2440-2452. [PMID: 32476217 PMCID: PMC8691203 DOI: 10.1002/hed.26268] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 03/14/2020] [Accepted: 05/05/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Approximately one quarter of head and neck cancer (HNC) patients smoke cigarettes at the time of diagnosis. Despite HNC guideline recommendations to treat tobacco dependence, the effectiveness of treatment in this population is poorly described. METHODS This retrospective cohort review evaluated 117 current smokers with p16-negative mucosal head and neck squamous cell carcinoma prospectively enrolled in a tobacco treatment program. Seven-day point prevalence tobacco abstinence rates at 9 months and survival outcomes were compared among abstinent and nonabstinent groups. RESULTS Median follow-up among survivors was 62.4 months. Forty percent of patients were abstinent at 9 months according to intention-to-treat analysis. After adjustment for age, comorbidity and site, abstinent stage I to II patients had a decreased risk of death compared to smoking stage I to II patients (HR 0.15, 95% CI 0.03-0.82). CONCLUSIONS High cohort abstinence rates and favorable survival among abstinent patients with early-stage HNC confirm the importance of tobacco dependence treatment in this population.
Collapse
Affiliation(s)
- Andrew T. Day
- Department of Otolaryngology—Head and Neck Surgery, UT Southwestern Medical Center, Dallas, Texas
- Population Science & Cancer Control, UT Southwestern Simmons Comprehensive Cancer Center, Dallas, Texas
| | - Kristina R. Dahlstrom
- Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Rebecca Lee
- Department of Otolaryngology—Head and Neck Surgery, UT Southwestern Medical Center, Dallas, Texas
| | - Maher Karam-Hage
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Erich M. Sturgis
- Population Science & Cancer Control, UT Southwestern Simmons Comprehensive Cancer Center, Dallas, Texas
- Department of Epidemiology, University of Texas MD Anderson Cancer Center, Houston, Texas
| |
Collapse
|
12
|
Crombet Ramos T, Mestre Fernández B, Mazorra Herrera Z, Iznaga Escobar NE. Nimotuzumab for Patients With Inoperable Cancer of the Head and Neck. Front Oncol 2020; 10:817. [PMID: 32537431 PMCID: PMC7266975 DOI: 10.3389/fonc.2020.00817] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 04/27/2020] [Indexed: 12/18/2022] Open
Abstract
EGFR activation induces cell proliferation, neoformation of blood vessels, survival, and metastasis of the cancer cells. Nimotuzumab is an engineered, intermediate affinity anti-EGFR antibody, that apart from other drugs in its class, is very safe and does not cause hypomagnesemia or grade 3–4 cutaneous rash. The antibody inhibits cell proliferation and angiogenesis, activates natural killer cells, stimulates dendritic cell maturation, and induces cytotoxic T cells. Nimotuzumab restores MHC-I expression on tumor cells, hindering one of the EGFR immune-escape ways. The antibody has been extensively studied in 7 clinical trials, concurrently with irradiation or irradiation plus chemotherapy in subjects with inoperable head and neck tumors. Nimotuzumab was safe and efficacious in unfit patients receiving irradiation alone and in subjects treated with cisplatin and radiotherapy. In patients with locally advanced squamous cell carcinomas of the head and neck, nimotuzumab in combination with low dose cisplatin and radiotherapy was superior to cisplatin and radiotherapy in progression free survival, disease free survival, and locoregional tumor control.
Collapse
|
13
|
Singh LK, Arora RD, Tikka SK, Shukla A, Singh S, Mahant S, Verma S. Brief Intervention for Tobacco when Diagnosed with Oral Cancer (BITDOC): Study protocol of a randomized clinical trial studying efficacy of brief tobacco cessation intervention, Chhattisgarh, India. Tob Prev Cessat 2020; 6:4. [PMID: 32548341 PMCID: PMC7291894 DOI: 10.18332/tpc/115028] [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: 09/29/2019] [Revised: 11/29/2019] [Accepted: 12/03/2019] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Tobacco use is a major causative factor for cancer. Cessation programs along with diagnosis of cancer as a motivating factor may improve quitting rates in patients. This is a protocol of a study that aims to assess the efficacy of brief tobacco cessation intervention (compared to treatment as usual, TAU) on pattern and attitudes towards tobacco chewing in newly diagnosed head and neck cancer patients and their relatives. METHODS The proposed study will be conducted in two phases. Phase 1 will include 105 dyads of patients and relatives and shall assess patterns (amount, frequency, duration of use and dependence etc.) and knowledge and attitudes (quitting, continued use, health-behavioural modifications, long-term effects on treatment etc.) towards tobacco chewing in newly diagnosed head and neck cancer patients using smokeless tobacco and their relatives. Sample will be recruited from outpatients attending the ear, nose, throat and head and neck surgery department of a tertiary health care institute. Phase 2 will be a randomized trial that will compare the efficacy of the ‘Brief Intervention for Tobacco when Diagnosed with Oral Cancer’ (BITDOC) and TAU, and will include 27 dyads in each of the two groups. Intervention will be delivered in three sessions, based on the principles of motivational interviewing and the 3As model. CONCLUSIONS This study will help in the evaluation of the attitude towards smokeless tobacco (SLT) in a population that has faced the adverse consequences from its use and changes brought by a diagnosis of HNC. It will also help in developing a cost-effective model for promotion of smoking cessation.
Collapse
|
14
|
Mujcic A, Blankers M, Bommelé J, Boon B, Berman AH, Verdonck‐de Leeuw IM, van Laar M, Engels R. The effectiveness of distance‐based interventions for smoking cessation and alcohol moderation among cancer survivors: A meta‐analysis. Psychooncology 2020; 29:49-60. [PMID: 31663182 PMCID: PMC8246955 DOI: 10.1002/pon.5261] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 10/13/2019] [Accepted: 10/15/2019] [Indexed: 12/25/2022]
Abstract
OBJECTIVE The objective of this study is to evaluate current evidence for the effectiveness of distance-based interventions to support smoking cessation (SC) or alcohol moderation (AM) among cancer survivors. Secondary, differences in effectiveness are explored regarding multibehaviour interventions versus single-behaviour interventions targeting SC or AM only. METHODS A systematic search of PubMed, PsycINFO, Web of Science, EMBASE, CINAHL, and Cochrane Central Register of Controlled Trials was conducted. Intervention studies with and without control groups and randomized controlled trials were included. Random effects meta-analyses were conducted for the main outcomes: SC and AM rates at the follow-up closest to 6 months. Using subgroup analyses and meta-regression, effectiveness of single-behaviour versus multibehaviour interventions was evaluated. RESULTS A total of 17 studies with 3796 participants; nine studies on SC only, eight studies on multibehaviour interventions including an SC or AM module, and no studies on AM only were included. All studies had at least some concerns regarding bias. Distance-based SC interventions led to higher cessation rates than control conditions (10 studies, odds ratio [OR] = 1.56; 95% CI, 1.13-2.15, P = .007). Single-behaviour SC interventions reduced smoking rates compared with baseline (risk difference [RD] = 0.29; 95% CI, 0.19-0.39, P < .0001), but multibehaviour interventions did not (RD = 0.13; 95% CI, -0.05 to 0.31, P = 0.15). There was insufficient evidence that distance-based multibehaviour interventions reduced alcohol use compared with controls (three studies, standardized mean difference [SMD] = 0.12; 95% CI, -0.08 to 0.31, P = .24). CONCLUSIONS Distance-based SC interventions are effective in supporting SC among cancer survivors. Single-behaviour SC interventions appear more effective than multibehaviour interventions. No evidence was found for the effectiveness of distance-based AM interventions for cancer survivors.
Collapse
Affiliation(s)
- Ajla Mujcic
- Trimbos InstituteNetherlands Institute of Mental Health and AddictionUtrechtThe Netherlands
- Erasmus School of Social and Behavioural SciencesErasmus University RotterdamRotterdamThe Netherlands
| | - Matthijs Blankers
- Trimbos InstituteNetherlands Institute of Mental Health and AddictionUtrechtThe Netherlands
- Department of Research, Arkin Mental Health CareAmsterdamThe Netherlands
- Amsterdam UMC, Location AMC, Department of PsychiatryUniversity of AmsterdamAmsterdamThe Netherlands
| | - Jeroen Bommelé
- Trimbos InstituteNetherlands Institute of Mental Health and AddictionUtrechtThe Netherlands
| | - Brigitte Boon
- Academy Het Dorp Department Scientific Research, Siza Arnhem, The NetherlandsArnhemThe Netherlands
- Department Scientific ResearchSizaArnhemThe Netherlands
| | - Anne H. Berman
- Centre for Psychiatry Research, Department of Clinical NeuroscienceKarolinska InstituteStockholmSweden
- Stockholm Center for Dependency DisordersStockholm Health Care Services, Stockholm RegionStockholmSweden
- Department of Public Health SciencesStockholm UniversityStockholmSweden
| | - Irma M. Verdonck‐de Leeuw
- Department of Otolaryngology—Head and Neck Surgery, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center AmsterdamAmsterdamThe Netherlands
- Department of Clinical, Neuro and Developmental Psychology, Section Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam Public HealthAmsterdamThe Netherlands
| | - Margriet van Laar
- Trimbos InstituteNetherlands Institute of Mental Health and AddictionUtrechtThe Netherlands
| | - Rutger Engels
- Erasmus School of Social and Behavioural SciencesErasmus University RotterdamRotterdamThe Netherlands
| |
Collapse
|
15
|
Gray JL, Maghlouth AA, Hussain HA, Sheef MA. Impact of oral and oropharyngeal cancer diagnosis on smoking cessation patients and cohabiting smokers. Tob Induc Dis 2019; 17:75. [PMID: 31768167 PMCID: PMC6843181 DOI: 10.18332/tid/109413] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 03/18/2019] [Accepted: 05/16/2019] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Our aim was to determine the influence of oral and oropharyngeal (OOP) cancer diagnosis on smoking cessation in patients and/or cohabiting smokers. We also aimed to determine whether OOP cancer patients received smoking-cessation advice and evaluated the factors that were influential in aiding them to quit or decrease smoking. METHODS This study was conducted at King Fahad Medical City, Saudi Arabia from March 2015 to May 2017. A pre-validated self-administered questionnaire was administered to OOP cancer patients visiting the Dentistry and Head & Neck Oncology outpatient clinics. Sociodemographics and baseline information were obtained from electronic medical records. Data were collected from 203 patients; 88 were ever-smokers and 115 were never-smokers. RESULTS Among patients who were smoking at the time of the OOP cancer diagnosis, 47.7% continued to smoke after the diagnosis. OOP cancer diagnosis was influential in smoking cessation in ever-smoker patients and their cohabiting smokers. The apparent influence of OOP cancer diagnosis was different between cohabiting smokers of ever-smoker patients (n=21/25; 84%) and those of never-smokers (n=10/21; 47.6%). Former-smokers (n=16/19; 84.2%) were less likely to remember receiving smoking-cessation advice than current-smokers (n=17/39; 43.6%). Pressure from family and friends, adverse impact on cancer prognosis, and adverse impact of cancer treatment were influential factors for smoking cessation. Among treatment modalities, combined chemoradiotherapy had the greatest impact (n=10/21; 47.6%) on smoking cessation among patients who stated that oncology treatment was influential in causing them to quit or decrease smoking. CONCLUSIONS A substantial number of patients continued to smoke after the OOP cancer diagnosis; however, diagnosis facilitated smoking cessation in many cases. Current smoking status should be reviewed throughout the OOP cancer patient’s disease course, and smoking-cessation assistance should be provided where necessary.
Collapse
|
16
|
Bazargan M, Smith JL, Robinson P, Uyanne J, Abdulrahoof R, Chuku C, Assari S. Chronic Respiratory Disease and Health-Related Quality of Life of African American Older Adults in an Economically Disadvantaged Area of Los Angeles. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E1756. [PMID: 31108963 PMCID: PMC6571607 DOI: 10.3390/ijerph16101756] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 05/06/2019] [Accepted: 05/16/2019] [Indexed: 12/14/2022]
Abstract
Background. Most of the attention of policy makers, program planners, clinicians, and researchers in the area of physical health disparities among African American older adults has been traditionally focused on cardiometabolic disease and cancer. Among a long list of chronic medical conditions, chronic respiratory conditions (CRCs), such as asthma, chronic bronchitis, and emphysema, have received less attention. Purpose. This study investigated whether CRCs contribute to physical and mental health-related quality of life (HRQoL) of African American older adults who live in economically disadvantaged urban areas, and whether these effects are due to demographic factors, socioeconomic status (SES), health behaviors, and comorbid medical and mental conditions. Methods. This community-based study recruited 617 African American older adults (age ≥ 65 years) from Service Planning Areas (SPA) 6, an economically disadvantaged area in South Los Angeles. Structured face-to-face interviews were used to collect data on demographic factors (age and gender), SES (educational attainment and financial difficulty), living arrangements, marital status, health behaviors (cigarette smoking and alcohol drinking), health (CRC, number of comorbid medical conditions, depressive symptoms, and pain intensity), and physical and mental HRQoL (Physical and Mental Component Summary Scores; PCS and MCS; SF-12). Linear regressions were used to analyze the data. Results. The presence of CRCs was associated with lower PCS and MCS in bivariate analysis. The association between CRCs and PCS remained significant above and beyond all confounders. However, the association between CRCs and MCS disappeared after controlling for confounders. Conclusion. For African American older adults living in economically disadvantaged urban areas, CRCs contribute to poor physical HRQoL. Evaluation and treatment of CRCs in African American older adults may be a strategy for reduction of disparities in HRQoL in this population. As smoking is the major modifiable risk factor for CRCs, there is a need to increase accessibility of smoking cessation programs in economically disadvantaged urban areas. More research is needed on the types, management, and prognosis of CRCs such as asthma, chronic bronchitis, and emphysema in African American older adults who reside in low-income and resource limited urban areas.
Collapse
Affiliation(s)
- Mohsen Bazargan
- Departments of Family Medicine, College of Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA.
- Departments of Public Health, College of Health and Science, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA.
- Departments of Family Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA.
| | - James L Smith
- Departments of Family Medicine, College of Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA.
| | - Paul Robinson
- Departments of Family Medicine, College of Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA.
- Departments of Family Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA.
| | - John Uyanne
- Division of Internal Medicine & Geriatrics, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA.
| | - Ruqayyah Abdulrahoof
- Departments of Public Health, College of Health and Science, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA.
| | - Chika Chuku
- Departments of Public Health, College of Health and Science, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA.
| | - Shervin Assari
- Departments of Family Medicine, College of Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA.
| |
Collapse
|
17
|
Shingler E, Robles LA, Perry R, Penfold C, Ness AR, Thomas S, Lane JA, Martin RM. Systematic review evaluating randomized controlled trials of smoking and alcohol cessation interventions in people with head and neck cancer and oral dysplasia. Head Neck 2018; 40:1845-1853. [PMID: 29603464 PMCID: PMC6120449 DOI: 10.1002/hed.25138] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 09/08/2017] [Accepted: 02/01/2018] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Smoking and alcohol increase the risk of head and neck cancer and affect treatment outcomes. Interventions modifying these behaviors may improve posttreatment outcomes and survival. We systematically reviewed evidence of the effectiveness of smoking/alcohol interventions in head and neck cancer and oral dysplasia. METHODS The AMED, CINAHL, Embase, MEDLINE, and Web of Science databases were searched for randomized controlled trials (RCTs) of smoking/alcohol interventions in people with head and neck cancer. A qualitative synthesis of the studies was conducted. RESULTS Three RCTs were identified: 2 smoking interventions and 1 smoking and alcohol intervention. One intervention, which was comprised of a smoking intervention based on Cognitive Behavioral Therapy and pharmacologic management compared to usual care, reduced smoking prevalence. CONCLUSION Further research is required into the underlying mechanisms that lead to cessation and interventions that include both pharmacological and behavioral therapy. Future RCTs should include suitable control conditions and sufficient power to assess clinical outcomes.
Collapse
Affiliation(s)
- Ellie Shingler
- National Institute for Health Research (NIHR), Bristol Biomedical Research Centre (BRC) Nutrition ThemeUniversity of BristolBristolUnited Kingdom
| | - Luke A. Robles
- National Institute for Health Research (NIHR), Bristol Biomedical Research Centre (BRC) Nutrition ThemeUniversity of BristolBristolUnited Kingdom
- Bristol Medical School: Population Health SciencesUniversity of BristolBristolUnited Kingdom
| | - Rachel Perry
- National Institute for Health Research (NIHR), Bristol Biomedical Research Centre (BRC) Nutrition ThemeUniversity of BristolBristolUnited Kingdom
| | - Chris Penfold
- National Institute for Health Research (NIHR), Bristol Biomedical Research Centre (BRC) Nutrition ThemeUniversity of BristolBristolUnited Kingdom
| | - Andy R. Ness
- National Institute for Health Research (NIHR), Bristol Biomedical Research Centre (BRC) Nutrition ThemeUniversity of BristolBristolUnited Kingdom
| | - Steve Thomas
- Department of Maxillofacial SurgeryUniversity of BristolBristolUnited Kingdom
| | - J. Athene Lane
- Bristol Medical School: Population Health SciencesUniversity of BristolBristolUnited Kingdom
- Department of Randomised Trials CollaborationUniversity of Bristol, School of Social and Community MedicineBristolUnited Kingdom
| | - Richard M. Martin
- National Institute for Health Research (NIHR), Bristol Biomedical Research Centre (BRC) Nutrition ThemeUniversity of BristolBristolUnited Kingdom
- Bristol Medical School: Population Health SciencesUniversity of BristolBristolUnited Kingdom
| |
Collapse
|
18
|
Shimpi N, Jethwani M, Bharatkumar A, Chyou PH, Glurich I, Acharya A. Patient awareness/knowledge towards oral cancer: a cross-sectional survey. BMC Oral Health 2018; 18:86. [PMID: 29764414 PMCID: PMC5952627 DOI: 10.1186/s12903-018-0539-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 04/26/2018] [Indexed: 11/30/2022] Open
Abstract
Background Oral cancer (OC) is associated with multiple risk factors and high mortality rates and substantially contributes to the global cancer burden despite being highly preventable. This cross-sectional study sought to assess current knowledge, awareness, and behaviors of patients in rural communities surrounding OC risk. Methods An anonymous 21-question survey was distributed to patients in waiting rooms of a large integrated medical-dental health system serving north-central Wisconsin. Survey results were summarized via descriptive statistics. Odds ratios surrounding health literacy on OC risk factors were obtained using unconditional univariate logistic regression analysis. Results Of 504 dental and 306 medical patients completing the survey, 62.2% were female, Caucasian/White (92%) with 41% having a ≤ high school diploma/equivalent. Current smoker/smokeless tobacco use was reported by 34%, while 39% reported former tobacco exposure. Alcohol use was reported by 54% of respondents at the following frequencies: < once/week, (35%); 1–2 times/week, (16%); 3–4 times/week, (6%); 5–6 times/week, (2%); and daily, (23%). Knowledge about tobacco and alcohol use and increased OC risk was reported by 94 and 40%, respectively. About 50% reported knowledgeability regarding cancer-associated symptomology. Tobacco cessation was reported by 20% of responders. Receipt of education on OC from healthcare providers and human papilloma virus links to OC causation was reported by 38 and 21%, respectively. Conclusion Patients who smoked > 20+ cigarettes per day were more knowledgeable about tobacco and OC risk compared to non-smokers and those who smoked ≤ 19 cigarettes/day (p = 0.0647). Patients who were alcohol consumers exhibited higher knowledgeability surrounding increased OC risk with alcohol and tobacco exposures compared to alcohol abstainers (p = 0.06). We concluded that patients recognized links between tobacco and OC risk but demonstrated lower knowledge of other causal factors. Strategic patient education by providers could increase awareness of OC risk. Electronic supplementary material The online version of this article (10.1186/s12903-018-0539-x) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Neel Shimpi
- Center for Oral and Systemic Health, Marshfield Clinic Research Institute, 1000 North Oak Avenue, Marshfield, 54449, WI, United States of America
| | - Monica Jethwani
- Center for Oral and Systemic Health, Marshfield Clinic Research Institute, 1000 North Oak Avenue, Marshfield, 54449, WI, United States of America.,Family Health Center of Marshfield Inc., 1307 N St Joseph Ave, Marshfield, 54449, WI, United States of America
| | - Aditi Bharatkumar
- Center for Oral and Systemic Health, Marshfield Clinic Research Institute, 1000 North Oak Avenue, Marshfield, 54449, WI, United States of America.,Family Health Center of Marshfield Inc., 1307 N St Joseph Ave, Marshfield, 54449, WI, United States of America
| | - Po-Huang Chyou
- Office of Research Computing and Analytics, Marshfield Clinic Research Institute, 1000 North Oak Avenue, Marshfield, 54449, WI, United States of America
| | - Ingrid Glurich
- Center for Oral and Systemic Health, Marshfield Clinic Research Institute, 1000 North Oak Avenue, Marshfield, 54449, WI, United States of America
| | - Amit Acharya
- Center for Oral and Systemic Health, Marshfield Clinic Research Institute, 1000 North Oak Avenue, Marshfield, 54449, WI, United States of America. .,Family Health Center of Marshfield Inc., 1307 N St Joseph Ave, Marshfield, 54449, WI, United States of America. .,Office of Research Computing and Analytics, Marshfield Clinic Research Institute, 1000 North Oak Avenue, Marshfield, 54449, WI, United States of America.
| |
Collapse
|