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Rising CJ, Huelsnitz CO, Shepherd RF, Klein WMP, Sleight AG, Wilsnack C, Boyd P, Feldman AE, Khincha PP, Werner-Lin A. Diet and physical activity behaviors: how are they related to illness perceptions, coping, and health-related quality of life in young people with hereditary cancer syndromes? J Behav Med 2024; 47:707-720. [PMID: 38642305 PMCID: PMC11291531 DOI: 10.1007/s10865-024-00489-z] [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: 11/12/2023] [Accepted: 04/05/2024] [Indexed: 04/22/2024]
Abstract
Individuals with inherited cancer syndromes, such as Li-Fraumeni syndrome (LFS), may be motivated to adopt health-protective behaviors, such as eating more fruits and vegetables and increasing physical activity. Examining these health behaviors among young people with high lifetime genetic cancer risk may provide important insights to guide future behavioral interventions that aim to improve health-related quality of life (HRQOL). We used a self-regulatory framework to investigate relationships among diet and physical activity behaviors and psychosocial constructs (e.g., illness perceptions, coping, HRQOL) in adolescents and young adults (AYAs; aged 15-39 years) with LFS. This longitudinal mixed-methods study included 57 AYAs aged 16-39 years at enrollment), 32 (56%) of whom had a history of one or more cancers. Participants completed one or two telephone interviews and/or an online survey. We thematically analyzed interview data and conducted regression analyses to evaluate relationships among variables. AYAs described adopting healthy diet and physical activity behaviors to assert some control over health and to protect HRQOL. More frequent use of active coping strategies was associated with greater reported daily fruit and vegetable intake. Greater reported physical activity was associated with better quality of psychological health. Healthy diet and physical activity behaviors may function as LFS coping strategies that confer mental health benefits. Clinicians might emphasize these potential benefits and support AYAs in adopting health behaviors that protect multiple domains of health. Future research could use these findings to develop behavioral interventions tailored to AYAs with high genetic cancer risk.
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Affiliation(s)
- Camella J Rising
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA.
| | - Chloe O Huelsnitz
- Behavioral Research Program, Office of the Associate Director, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - Rowan Forbes Shepherd
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA
| | - William M P Klein
- Behavioral Research Program, Office of the Associate Director, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - Alix G Sleight
- Department of Physical Medicine & Rehabilitation, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Catherine Wilsnack
- Steve Hicks School of Social Work, University of Texas at Austin, Austin, TX, USA
| | - Patrick Boyd
- Behavioral Research Program, Office of the Associate Director, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - Alexandra E Feldman
- Department of Physical Medicine & Rehabilitation, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- USC Chan Division of Occupational Science and Occupational Therapy, Los Angeles, CA, USA
| | - Payal P Khincha
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA
| | - Allison Werner-Lin
- School of Social Policy and Practice, University of Pennsylvania, Philadelphia, PA, USA
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Lara-Morales A, Soto-Ruiz N, Agudelo-Suárez AA, García-Vivar C. Social determinants of health in post-treatment cancer survivors: Scoping review. Eur J Oncol Nurs 2024; 70:102614. [PMID: 38795448 DOI: 10.1016/j.ejon.2024.102614] [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: 11/29/2023] [Revised: 05/10/2024] [Accepted: 05/18/2024] [Indexed: 05/28/2024]
Abstract
PURPOSE To identify, analyze and describe the available scientific evidence about the influence of social determinants of health on cancer survivors. METHODS A scoping review was outlined according to the steps described by the Joanna Brigs Institute Reviewer's Manual: selection of studies, data mapping, and results grouping, synthesis and report, was conducted. PubMed, CINAHL, Scopus and LILACS databases were searched from 2011 to 2023. RESULTS Out of a total of 1783 papers initially screened, only 19 studies met the inclusion criteria for the scoping review, focusing on the primary social determinants impacting the health of cancer survivors. These studies were categorized into six main themes: a) employment (challenges in work reintegration and work-place difficulties); b) variations among different ethnic groups; c) disparities based on sex; d) barriers and facilitators in accessing health and social security services; e) the role of support networks and social environments; and f) socioeconomic lever (influence of income and socioeconomic status). CONCLUSIONS Understanding the impact of social determinants on the post-treatment quality of life for cancer survivors is crucial. Comprehensive survivorship care should address not just medical needs but also holistic aspects like social support, education, overall well-being, and improvements in physical and social environments. This multifaceted approach ensures the well-rounded support needed for optimal survivorship outcomes.
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Affiliation(s)
- Alfredo Lara-Morales
- Department of Nursing and Obstetrics, Guanajuato University, C. Pedro Lascurain de Retana, Calzada de Guadalupe, 36700, Guanajuato, Gto, Mexico.
| | - Nelia Soto-Ruiz
- Department of Health Sciences, Public University of Navarre (UPNA), Avda. Barañain S/n, 31008, Pamplona, Navarra, Spain; IdiSNA, Navarra Institute for Health Research, Irunlarrea, 3, 31008, Pamplona, Navarra, Spain.
| | - Andrés A Agudelo-Suárez
- Faculty of Dentistry, University of Antioquia, Calle 64 Nº 52-59, 050010, Medellin, Antioquia, Colombia.
| | - Cristina García-Vivar
- Department of Health Sciences, Public University of Navarre (UPNA), Avda. Barañain S/n, 31008, Pamplona, Navarra, Spain; IdiSNA, Navarra Institute for Health Research, Irunlarrea, 3, 31008, Pamplona, Navarra, Spain.
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Antunes P, Joaquim A, Sampaio F, Nunes C, Ascensão A, Vilela E, Teixeira M, Oliveira J, Capela A, Amarelo A, Leão I, Marques C, Viamonte S, Alves A, Esteves D. Exercise Training Benefits Health-Related Quality of Life and Functional Capacity during Breast Cancer Chemotherapy: A Randomized Controlled Trial. Med Sci Sports Exerc 2024; 56:600-611. [PMID: 38051110 DOI: 10.1249/mss.0000000000003341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
PURPOSE To examine the effectiveness of a supervised exercise training program (SETP) on health-related quality of life (HRQoL) and functional capacity in women with breast cancer (BC) undergoing chemotherapy. METHODS Ninety-three women with early-stage BC were randomly allocated to a SETP plus usual care (exercise, n = 47) or usual care alone (UC, n = 46). The SETP included three sessions per week, combining aerobic and resistance training, conducted concurrently over the chemotherapy. The EORTC Cancer Quality-of-Life-Questionnaire-Core-30 (QLQ-C30) and the BC-specific module (QLQ-BR23) were used to assess HRQoL. Functional capacity was analyzed by maximum voluntary handgrip strength (MVHS) and by the 30-s chair sit-to-stand test (30-s CST). These endpoints were assessed at baseline (t0); middle (t1; after 8 or 12 wk of t0); and at the end of chemotherapy (t2; after 20 wk of t0). Mean changes from baseline were assessed by an intention-to-treat approach. RESULTS Mixed linear model analyses showed that Exercise group experienced less deterioration in several domains of QLQ-C30 at t2, including in global health status/QoL (Δ = 9.39 units; P = 0.034), QLQ-C30 summary score (Δ = 8.08 units; P < 0.001), physical (Δ = 15.14 units; P < 0.001), role ( Δ = 21.81 units; P < 0.001), cognitive (Δ = 9.16 units; P = 0.032) and social functioning (Δ = 11.67 units; P = 0.038), compared with the UC group. Similarly, Exercise group exhibited significant lower levels of fatigue (Δ = -20.19 units; P < 0.001) and appetite loss (Δ = -13.69 units; P = 0.034), compared with the UC group. Significant between-group differences were observed on MVHS of the tumor/surgery upper limb side (Δ = 2.64 kg; P < 0.001) and contralateral limb (Δ = 2.22 kg; P < 0.001), and on the 30-s CST score (Δ = 3.56repetitions; P < 0.001), favoring the Exercise group. No differences were observed on QLQ-BR23 domains. CONCLUSIONS Exercise training was an effective complementary therapy to prevent the deterioration of HRQoL and functional capacity during chemotherapy in women with early-stage BC.
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Affiliation(s)
| | | | | | - Célia Nunes
- Department of Mathematics and Center of Mathematics and Applications, University of Beira Interior, Covilhã, PORTUGAL
| | - António Ascensão
- Laboratory of Metabolism and Exercise (LaMetEx), Research Centre in Physical Activity, Health and Leisure (CIAFEL), Laboratory for Integrative and Translational Research in Population Health (ITR), Faculty of Sports, University of Porto, Porto, PORTUGAL
| | - Eduardo Vilela
- Department of Cardiology, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, PORTUGAL
| | - Madalena Teixeira
- Department of Cardiology, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, PORTUGAL
| | - Jorge Oliveira
- Department of Cardiology, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, PORTUGAL
| | | | | | | | - Cristiana Marques
- Department of Medical Oncology, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, PORTUGAL
| | | | | | - Dulce Esteves
- Research Center in Sport Sciences, Health and Human Development (CIDESD), Sport Sciences Department, University of Beira Interior, PORTUGAL
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Feng Y, Su M, Liu Y, Peng J, Sun X. Health-related quality of life among cancer survivors: pre-existing chronic conditions are to be given priority. Support Care Cancer 2024; 32:124. [PMID: 38252273 DOI: 10.1007/s00520-024-08315-7] [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: 09/03/2023] [Accepted: 01/09/2024] [Indexed: 01/23/2024]
Abstract
PURPOSE This study aimed to describe the health-related quality of life (HRQoL) of cancer survivors in China by the five-level EuroQol-5-dimension (EQ-5D-5L) questionnaire and to explore the impact of the comorbidity of pre-existing chronic conditions on HRQoL in cancer survivors. METHODS Data on cancer survivors were obtained from two cross-sectional surveys conducted in Shandong Province, China. The data of the Chinese general population, the Chinese diabetes population, the Chinese hypertension population, and the Chinese urban population from the published studies were used as the controls. The χ2 test was conducted to compare the incidence of five-dimensional problems between the study and control populations. The non-parametric Mann-Whitney U test and Kruskal-Wallis test were performed to examine the differences in EQ-5D-5L utility scores. Besides, the Tobit regression model was used to examine the variables influencing the EQ-5D-5L utility score. RESULTS One thousand fifty-one adult cancer survivors were included. Cancer survivors had significantly lower EQ-5D-5L utility scores (Z = - 15.939, P < 0.001) and EQ-VAS scores (Z = - 11.156, P < 0.001) than the general adult population. The average EQ-5D-5L utility score of hypertensive cancer survivors was lower than that of the hypertensive population (Z = - 1.610, P = 0.107), but the difference was not statistically significant. CONCLUSION Compared to the general population, the HRQoL of cancer survivors was extremely poor in all dimensions of the EQ-5D-5L. Pre-existing chronic conditions had significant antecedent effects on the HRQoL of cancer survivors. Therefore, more attention should be paid to chronic diseases, and effective interventions should be adopted based on this.
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Affiliation(s)
- Yujia Feng
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Wenhuaxi Road 44#, Jinan, China
- National Health Commission Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Mingzhu Su
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Wenhuaxi Road 44#, Jinan, China
- National Health Commission Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Yanxiu Liu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Wenhuaxi Road 44#, Jinan, China
- National Health Commission Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Jiaqi Peng
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Wenhuaxi Road 44#, Jinan, China
- National Health Commission Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Xiaojie Sun
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Wenhuaxi Road 44#, Jinan, China.
- National Health Commission Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China.
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Zheng Z, Shi KS, Kamal A, Howard DH, Horný M, Richards TB, Ekwueme DU, Yabroff KR. Health-related quality of life among prostate cancer survivors with metastatic disease and non-metastatic disease and men without a cancer history in the USA. J Cancer Surviv 2023:10.1007/s11764-023-01509-8. [PMID: 38102521 PMCID: PMC11180215 DOI: 10.1007/s11764-023-01509-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 11/29/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND Few studies have comprehensively compared health-related quality of life (HRQoL) between metastatic prostate cancer survivors, survivors with non-metastatic disease, and men without a cancer history. METHODS We used the Surveillance, Epidemiology, and End Results-Medicare Health Outcomes Survey (SEER-MHOS) data linkage to identify men aged ≥ 65 years enrolled in Medicare Advantage (MA) plans. Prostate cancer survivors were diagnosed between 1988 and 2017 and completed MHOS surveys between 1998 and 2019. We analyzed data from 752 metastatic prostate cancer survivors (1040 survey records), 19,583 localized or regional prostate cancer survivors (non-metastatic; 30,121 survey records), and 784,305 men aged ≥ 65 years without a cancer history in the same SEER regions (1.15 million survey records). We used clustered linear regressions to compare HRQoL measures at the person-level using the Veterans RAND 12 Item Health Survey (VR-12) T-scores for general health and physical and mental component summaries. RESULTS Compared to men without a cancer history, prostate cancer survivors were older, more likely to be married, and had higher socioeconomic status. Compared to men without a cancer history, metastatic prostate cancer survivors reported lower general health (T-score differences [95% confidence interval]: - 6.26, [- 7.14, - 5.38], p < .001), physical health (- 4.33, [- 5.18, - 3.48], p < .001), and mental health (- 2.64, [- 3.40, - 1.88], p < .001) component summaries. Results were similar for other VR-12 T-scores. In contrast, non-metastatic prostate cancer survivors reported similar VR-12 T-scores as men without a cancer history. Further analyses comparing metastatic and non-metastatic prostate cancer survivors support these findings. CONCLUSION Interventions to improve health-related quality of life for men diagnosed with metastatic prostate cancer merit additional investigation. IMPLICATIONS FOR CANCER SURVIVORS Interventions to improve health-related quality of life for metastatic prostate cancer survivors merit additional investigation.
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Affiliation(s)
| | | | - Arif Kamal
- American Cancer Society, Atlanta, GA, USA
| | - David H Howard
- Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Michal Horný
- Emory University Rollins School of Public Health, Atlanta, GA, USA
- Emory University School of Medicine, Atlanta, GA, USA
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Boehmer U, Chang S, Sanchez NF, Jesdale BM, Schabath MB. Cancer survivors' health behaviors and outcomes: a population-based study of sexual and gender minorities. J Natl Cancer Inst 2023; 115:1164-1170. [PMID: 37421397 PMCID: PMC10560602 DOI: 10.1093/jnci/djad131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 06/15/2023] [Accepted: 06/29/2023] [Indexed: 07/10/2023] Open
Abstract
BACKGROUND Most case-control studies compare cancer survivors with general population controls without considering sexual orientation or gender identity. This case-control analysis compared health risk behaviors and health outcomes among sexual and gender minority cancer survivors to those of matched sexual and gender minority participants without cancer (controls). METHODS Using data from the 2014-2021 Behavioral Risk Factor Surveillance System, a population-based sample of 4507 cancer survivors who self-identified as transgender, gay men, bisexual men, lesbian women, or bisexual women were 1:1 propensity score matched, using age at survey, race and ethnicity, marital status, education, access to health care, and US census region. Within each sexual and gender minority group, behaviors and outcomes were compared between survivors and participants without cancer, and survivors' odds ratios and 95% confidence intervals calculated. RESULTS Gay male survivors had higher odds of depression, poor mental health, limited usual activities, difficulty concentrating, and fair or poor health. Few differences were observed between bisexual male survivors and participants without cancer. Compared with controls, lesbian female survivors had greater odds of overweight-obese status, depression, poor physical health, and fair or poor health. Bisexual female survivors had the highest rates of current smoking, depression, poor mental health, and difficulty concentrating across all sexual and gender minority groups. Statistically significantly different from transgender controls, transgender survivors had greater odds of heavy alcohol use, physical inactivity, and fair or poor health. CONCLUSIONS This analysis revealed an urgent need to address the high prevalence of engaging in multiple health risk behaviors and not following guidelines to avoid second cancers, additional adverse outcomes, and cancer recurrences among sexual and gender minority cancer survivors.
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Affiliation(s)
- Ulrike Boehmer
- Boston University School of Public Health, Boston, MA, USA
| | - Shine Chang
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Bill M Jesdale
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Matthew B Schabath
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
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Han CJ, Tounkara F, Kalady M, Noonan AM, Burse NR, Paskett ED, Von Ah D. Risk Factors of Health-Related Quality of Life among Gastrointestinal Cancer Survivors in the U.S.: With a Focus on Social and Behavioral Determinants of Health (SBDH). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6676. [PMID: 37681816 PMCID: PMC10487530 DOI: 10.3390/ijerph20176676] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/24/2023] [Accepted: 08/26/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND Increasing numbers of long-term gastrointestinal (GI) cancer survivors highlight the importance of understanding the factors contributing to their health-related quality of life (HRQoL). We investigated the risk factors of HRQoL, including demographics, clinical characteristics, and social and behavioral determinants of health (SBDH). METHODS Data on adult GI cancer survivors (n = 3201) from the Behavioral Risk Factors Surveillance System (BRFSS) surveys from 2014-2021 (except for 2015) were analyzed. Unadjusted/adjusted logistic regression was used. RESULTS The majority were women (54%) and white (78%), with a median age of 67. Survivors who were 65 years or older, diagnosed with colorectal cancer, or who had fewer comorbidities were more likely to report significantly better HRQoL. Significant social factors of poor HRQoL included unmarried, racial and ethnic minorities, poor socioeconomic status, and poor healthcare access. Significant behavioral factors of poor HRQoL were lack of physical activity, heavy alcohol consumption, and current smoking, with lack of physical activity being the most significant factor. CONCLUSIONS The SBDH has a critical role in HRQoL. Future studies are warranted to develop a tailored survivorship intervention, such as physical rehabilitation, and to explore machine learning/artificial intelligence-based predictive models to identify cancer survivors at a high risk of developing poor HRQoL.
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Affiliation(s)
- Claire J. Han
- Center for Healthy Aging, Self-Management and Complex Care, College of Nursing, Ohio State University, Columbus, OH 43210, USA;
- Cancer Treatment and Research Center, Ohio State University-James, Columbus, OH 43210, USA; (F.T.); (M.K.); (A.M.N.); (E.D.P.)
| | - Fode Tounkara
- Cancer Treatment and Research Center, Ohio State University-James, Columbus, OH 43210, USA; (F.T.); (M.K.); (A.M.N.); (E.D.P.)
- Department of Biomedical Informatics, College of Medicine Ohio State University, Columbus, OH 43210, USA
| | - Matthew Kalady
- Cancer Treatment and Research Center, Ohio State University-James, Columbus, OH 43210, USA; (F.T.); (M.K.); (A.M.N.); (E.D.P.)
- Division of Colon and Rectal Surgery, Ohio State University-James, Columbus, OH 43210, USA
| | - Anne M. Noonan
- Cancer Treatment and Research Center, Ohio State University-James, Columbus, OH 43210, USA; (F.T.); (M.K.); (A.M.N.); (E.D.P.)
- GI Medical Oncology Selection, Ohio State University-James, Columbus, OH 43210, USA
| | - Natasha R. Burse
- School of Nursing, University of North Carolina, Chapel Hill, NC 27514, USA;
| | - Electra D. Paskett
- Cancer Treatment and Research Center, Ohio State University-James, Columbus, OH 43210, USA; (F.T.); (M.K.); (A.M.N.); (E.D.P.)
- Division of Epidemiology, College of Public Health, Ohio State University, Columbus, OH 43210, USA
| | - Diane Von Ah
- Center for Healthy Aging, Self-Management and Complex Care, College of Nursing, Ohio State University, Columbus, OH 43210, USA;
- Cancer Treatment and Research Center, Ohio State University-James, Columbus, OH 43210, USA; (F.T.); (M.K.); (A.M.N.); (E.D.P.)
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Tsai MH, Wu YH, Bevel MS. The relationship of chronic disease conditions to mental and physical health among cancer survivors. Support Care Cancer 2023; 31:364. [PMID: 37249650 DOI: 10.1007/s00520-023-07841-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 05/24/2023] [Indexed: 05/31/2023]
Abstract
PURPOSE This study examined the relationship between the presence of chronic disease conditions and mental and physical health among cancer survivors in the United States. METHODS We conducted a cross-sectional analysis utilizing survey data from the 2016-2017 Behavioral Risk Factor Surveillance System (BRFSS) on 65,673 eligible cancer survivors. The primary outcomes of interest were self-rated metal/physical health in the past 30 days. Descriptive statistics and multivariate logistic regression were used to examine the mentioned association. RESULTS 15.3% and 24.8% of survivors reported having several days of poor mental and physical health (14-30 days compared to 0-13 days), and 42.4% of survivors reported having one to two chronic diseases. In multivariate analysis, survivors with one to two chronic diseases were more likely to report several days of poor mental (OR, 2.74; 95% CI, 2.22-3.38) and physical (OR, 1.95; 95% CI, 1.72-2.22) health. Survivors with 3+ chronic diseases had markedly higher odds of having several days of poor mental (OR, 6.41; 95% CI, 5.19-7.91) and physical health (OR, 4.71; 95% CI, 4.16-5.34). Among survivors with at least one chronic disease, older age, insured, and more perceived social/emotional support were negatively associated with mental health (p value <0.05). Similarly, older age was related to fewer days of poor physical health (p value <0.05) regardless of chronic disease conditions. CONCLUSION Having chronic diseases was associated with more days of poor mental and physical health among cancer survivors. Integrated, extensive care should include mental/physical health components and chronic disease management in cancer survivorship care.
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Affiliation(s)
- Meng-Han Tsai
- Cancer Prevention, Control, & Population Health Program, Georgia Cancer Center, Department of Medicine, Medical College of Georgia, Augusta University, 1410 Laney Walker Boulevard CN-2116, Augusta, GA, 30912, USA.
- Georgia Prevention Institute, Augusta University, 1457 Walton Way, Augusta, GA, 30901, USA.
| | - Yun-Hsuan Wu
- Department of Public Health, China Medical University, Taichung, Taiwan
| | - Malcolm S Bevel
- Cancer Prevention, Control, & Population Health Program, Georgia Cancer Center, Department of Medicine, Medical College of Georgia, Augusta University, 1410 Laney Walker Boulevard CN-2116, Augusta, GA, 30912, USA
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Choi E, Becker H, Jung H. Health-related quality of life in adolescents and young adults with and without cancer, using propensity score matching. J Cancer Surviv 2023; 17:279-289. [PMID: 34850323 DOI: 10.1007/s11764-021-01150-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 11/22/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE To assess health-related quality of life (HRQOL) among adolescents and young adults (AYAs) with and without cancer, using Andersen's behavioral model of health services use. METHODS We used a cross-sectional, matched case-control design; data were from the Texas Behavioral Risk Factor Surveillance System for 2015-2019. AYAs aged between 18 and 39 years and with cancer were matched to controls using propensity score matching to control for predisposing and enabling factors. Chi-square tests were used to compare differences in need for care, health practices, and health services utilization between AYAs with cancer and controls without cancer. Multiple logistic regression models were used to compare HRQOL outcomes. RESULTS The final study sample consisted of 276 AYAs diagnosed with cancer and 828 controls after propensity score matching. The AYAs with cancer were more likely to have chronic comorbidities, smoke, and avoid health services utilization because of cost in comparison with the matched controls. Multiple logistic regressions showed significant differences in HRQOL between AYAs with cancer and controls: AYAs with cancer were more likely to have worse general health (OR = 2.488; 95% CI, 1.305-4.741) and worse perceived cognitive function (OR = 2.070; 95% CI, 1.076-3.919). CONCLUSION AYAs with cancer experience more chronic comorbidities, smoking, financial barriers to health service, and worse HRQOL than do AYAs without cancer. IMPLICATIONS FOR CANCER SURVIVORS Age-appropriate tailored surveillance and survivorship supports/resources are needed for AYAs with cancer.
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Affiliation(s)
- Eunju Choi
- Department of Nursing, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA.
| | - Heather Becker
- School of Nursing, University of Texas at Austin, 1710 Red River St, Austin, TX, 78712, USA
| | - Hyekyung Jung
- Department of Human Resource and Development, Korea University of Technology and Education, 1600 Chungjeol-ro, Byengcheon-myeon, Dongnam-gu, Cheonan-si, 31253, South Korea
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Choi E, Becker H, Lu Q, Roth M. Sex differences in comorbid conditions, health behaviors, health care utilization, and health-related quality of life among young adult cancer survivors. Support Care Cancer 2023; 31:181. [PMID: 36820926 DOI: 10.1007/s00520-023-07650-5] [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: 07/12/2022] [Accepted: 02/19/2023] [Indexed: 02/24/2023]
Abstract
PURPOSE Although cancer experiences and health-related quality of life (HRQOL) differ by sex, little is known about how sex affects comorbid conditions, health behaviors, health service utilization, and HRQOL in young adult (YA) cancer survivors. We sought to determine the relationship of sex to these factors in this population. METHODS This matched case-control, cross-sectional study used data from the Texas Behavioral Risk Factor Surveillance System for 2015-2019. YA survivors aged 18-39 years, were matched to controls. Chi-square and multiple logistic regressions were used to assess the relationship between sex and the measured factors. RESULTS The analysis included 276 YA survivors and 828 controls. Male survivors were more likely than male controls to have a depressive disorder (OR = 3.06, p = 0.007), smoke (OR = 3.87, p < 0.001), and forgo health care because of cost (OR = 5.60, p < 0.001). Female survivors were more likely than female controls to have at least one comorbidity (OR = 3.52, p < 0.001), forgo health care because of cost (OR = 3.03, p < 0.001), and report poorer HRQOL (aORs = 1.52-2.22, p < 0.05). Female survivors were more likely to have at least one comorbid condition (aOR = 1.70, p = 0.02) than male survivors. CONCLUSION YA cancer survivors differed in their health outcomes from both the general population and by sex. Tailored, sex-based interventions are needed to decrease long-term morbidity and improve HROQL in this population.
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Affiliation(s)
- Eunju Choi
- Department of Nursing, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX, 77030, USA. .,Department of Health Disparities Research, Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX, 77030, USA.
| | - Heather Becker
- School of Nursing, The University of Texas at Austin, 1710 Red River St., Austin, TX, 78712, USA
| | - Qian Lu
- Department of Health Disparities Research, Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX, 77030, USA
| | - Michael Roth
- Department of Pediatric Patient Care, Division of Pediatrics, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX, 77030, USA
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11
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Wang L, Langlais C, Kenfield SA, Van Loon K, Laffan A, Atreya CE, Chan JM, Zhang L, Allen IE, Miaskowski C, Fukuoka Y, Meyerhardt JA, Venook AP, Van Blarigan EL. Quality of life among colorectal cancer survivors participating in a pilot randomized controlled trial of a web-based dietary intervention with text messages. Support Care Cancer 2023; 31:155. [PMID: 36763183 PMCID: PMC9918568 DOI: 10.1007/s00520-023-07620-x] [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] [Accepted: 01/29/2023] [Indexed: 02/11/2023]
Abstract
PURPOSE We aimed to estimate the effect of a 12-week web-based dietary intervention with text messages on quality of life (QoL) among colorectal cancer (CRC) survivors. METHODS Between 2017 and 2018, 50 CRC survivors were randomized (1:1) to receive a 12-week web-based dietary intervention with daily text messages or wait-list control. Health-related QoL was assessed using the European Organization for the Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30 (QLQ-C30) and colorectal quality of life module (QLQ-CR29) at baseline, 12, and 24 weeks. Within- and between-group mean changes in health-related QoL with 95% confidence intervals (CI) were calculated for both arms. RESULTS Compared to the controls, participants receiving the intervention had an improvement in emotional functioning (mean change: 14.3; 95% CI: 3.0, 25.6) at 12 weeks and social functioning (mean change: 13.8; 95% CI: 2.1, 25.5) at 24 weeks. A decrease of fatigue from baseline was also observed in the intervention arm (mean change: - 9.1; 95% CI: - 17.1, - 1.1) at 24 weeks. No other changes in QoL scores were associated with the intervention. CONCLUSION CRC survivors randomized to receive a web-based dietary intervention with text messages experienced higher emotional and social functioning. Further study with a larger population may be warranted. TRIAL REGISTRATION clinicaltrials.gov, NCT02965521. Registered 16 November 2016, https://clinicaltrials.gov/ct2/keydates/NCT02965521.
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Affiliation(s)
- Lufan Wang
- Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA USA
| | - Crystal Langlais
- Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA USA
- Present Address: IQVIA, Durham, NC USA
| | - Stacey A. Kenfield
- Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA USA
- Department of Urology, University of California, San Francisco, UCSF, San Francisco, CA USA
| | - Katherine Van Loon
- UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA USA
- Department of Medicine, University of California, San Francisco, San Francisco, CA USA
| | - Angela Laffan
- UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA USA
| | - Chloe E. Atreya
- UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA USA
- Department of Medicine, University of California, San Francisco, San Francisco, CA USA
| | - June M. Chan
- Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA USA
- Department of Urology, University of California, San Francisco, UCSF, San Francisco, CA USA
| | - Li Zhang
- Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA USA
- Department of Medicine, University of California, San Francisco, San Francisco, CA USA
| | - Isabel E. Allen
- Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA USA
| | - Christine Miaskowski
- Department of Physiologic Nursing, University of California, San Francisco, San Francisco, CA USA
| | - Yoshimi Fukuoka
- Department of Physiologic Nursing, University of California, San Francisco, San Francisco, CA USA
| | | | - Alan P. Venook
- UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA USA
- Department of Medicine, University of California, San Francisco, San Francisco, CA USA
| | - Erin L. Van Blarigan
- Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA USA
- Department of Urology, University of California, San Francisco, UCSF, San Francisco, CA USA
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12
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Burse NR, Weng X, Wang L, Cuffee YL, Veldheer S. Influence of social and behavioral determinants on health-related quality of life among cancer survivors in the USA. Support Care Cancer 2022; 31:67. [PMID: 36538142 PMCID: PMC9901575 DOI: 10.1007/s00520-022-07534-0] [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: 08/03/2022] [Accepted: 12/07/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE Cancer survivors experience a worse health-related quality of life (HRQoL) than non-cancer survivors. However, it is not fully understood whether social determinants of health (SDOH) and health behaviors are significantly associated with HRQoL among cancer survivors. The purpose of this study was to investigate the influence of SDOH and health behaviors on HRQoL among cancer survivors. METHODS We identified adult (18 years or older) cancer survivors (n = 5784) in the 2017 and 2019 Behavioral Risk Factor Surveillance System. The primary outcome (HRQoL) was defined as whether cancer survivors reported having poor mental or physical health (e.g., 14 or more mentally or physically unhealthy days). Unadjusted and adjusted logistic regression was used to compute the odds ratios and 95% CIs of factors associated with poor HRQoL among the cancer survivors. RESULTS More than half of the cancer survivors were non-Hispanic White, female, and 65 years or older. In the adjusted multivariable logistic regression models, cancer survivors who were physically active and who did not avoid care because of costs had a lower risk of poor mental and physical health. Current smokers were more likely to report poor physical health. Homeowners were less likely to report poor mental health. Daily fruit and vegetable consumption and healthcare coverage were not associated with poor HRQoL. CONCLUSIONS Some SDOH (healthcare access, economic stability, and the neighborhood and built environment) and health behavior (physical activity) are associated with lower likelihood of experiencing poor mental and/or physical health in the cancer survivors. The study findings can be used to target survivors who experience suboptimal HRQoL and to inform research, public health policies, and/or programs.
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Affiliation(s)
- Natasha Renee Burse
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, PA, USA.
| | - Xingran Weng
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Li Wang
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, PA, USA
| | | | - Susan Veldheer
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, PA, USA
- Department of Family and Community Medicine, The Pennsylvania State University College of Medicine, Hershey, PA, USA
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13
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Wang X, Liu Y, Xu J. Influence of Exercise Intervention on the Quality of Life for Colon
Cancer: A Meta-Analysis of Randomized Controlled Studies. PHYSIKALISCHE MEDIZIN, REHABILITATIONSMEDIZIN, KURORTMEDIZIN 2022. [DOI: 10.1055/a-1623-4968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Abstract
Introduction The influence of exercise intervention for colon cancer
remains controversial. We conduct a systematic review and meta-analysis to
explore the effect of exercise intervention on the quality of life in patients
with colon cancer.
Methods We have searched PubMed, EMbase, Web of science, EBSCO, and
Cochrane library databases through September 2020 for randomized controlled
trials (RCTs) assessing the effect of exercise intervention for colon cancer.
This meta-analysis is performed using the random-effect model.
Results Five RCTs are included in the meta-analysis. In patients with
colon cancer, exercise intervention is associated with improved health-related
quality of life (SMD=2.79; 95% CI=1.66 to 3.92;
P<0.00001) and reduced fatigue score (SMD=−2.21;
95% CI=−3.22 to −1.20; P<0.0001), but
revealed no obvious impact on emotional functioning (SMD=0.51;
95% CI=−0.57 to 1.58; P=0.35), anxiety score
(SMD=−0.93; 95% CI=−2.50 to 0.64;
P=0.25) or weight (SMD=0.28; 95%
CI=−0.19 to 0.75; P=0.24).
Conclusions Exercise intervention is effective to improve the quality of
life in patients with colon cancer.
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Affiliation(s)
- Xuefen Wang
- Kaizhou People Hospital, General Surgery, Chongqing,
China
| | - Yunfeng Liu
- Kaizhou People Hospital, General Surgery, Chongqing,
China
| | - Jifan Xu
- Kaizhou People Hospital, General Surgery, Chongqing,
China
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14
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Robbins R, Cole R, Ejikeme C, Orstad SL, Porten S, Salter CA, Sanchez Nolasco T, Vieira D, Loeb S. Systematic review of sleep and sleep disorders among prostate cancer patients and caregivers: a call to action for using validated sleep assessments during prostate cancer care. Sleep Med 2022; 94:38-53. [PMID: 35489117 PMCID: PMC9277625 DOI: 10.1016/j.sleep.2022.03.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/20/2022] [Accepted: 03/24/2022] [Indexed: 12/27/2022]
Abstract
OBJECTIVE/BACKGROUND To examine the impact of prostate cancer (PCa) on sleep health for patients and caregivers. We hypothesized that sleep disturbances and poor sleep quality would be prevalent among patients with PCa and their caregivers. PATIENTS/METHODS A systematic literature search was conducted according to the Preferred Reporting Items for a Systematic Review and Meta-analysis guidelines. To be eligible for this systematic review, studies had to include: (1) patients diagnosed with PCa and/or their caregivers; and (2) objective or subjective data on sleep. 2431 articles were identified from the search. After duplicates were removed, 1577 abstracts were screened for eligibility, and 315 underwent full-text review. RESULTS AND CONCLUSIONS Overall, 83 articles met inclusion criteria and were included in the qualitative synthesis. The majority of papers included patients with PCa (98%), who varied widely in their treatment stage. Only 3 studies reported on sleep among caregivers of patients with PCa. Most studies were designed to address a different issue and examined sleep as a secondary endpoint. Commonly used instruments included the Insomnia Severity Index and European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaires (EORTC-QLQ). Overall, patients with PCa reported a variety of sleep issues, including insomnia and general sleep difficulties. Both physical and psychological barriers to sleep are reported in this population. There was common use of hypnotic medications, yet few studies of behavioral interventions to improve sleep for patients with PCa or their caregivers. Many different sleep issues are reported by patients with PCa and caregivers with diverse sleep measurement methods and surveys. Future research may develop consensus on validated sleep assessment tools for use in PCa clinical care and research to promote facilitate comparison of sleep across PCa treatment stages. Also, future research is needed on behavioral interventions to improve sleep among this population.
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Affiliation(s)
- Rebecca Robbins
- Harvard Medical School, Boston, MA, USA; Brigham & Women's Hospital, Boston, MA, USA.
| | - Renee Cole
- Department of Urology, University of Michigan, Ann Arbor, MI, USA
| | | | - Stephanie L Orstad
- Division of General Internal Medicine and Clinical Innovation, Department of Medicine, NYU Grossman School of Medicine, New York, NY, USA
| | - Sima Porten
- Department of Urology, University of California, San Francisco, USA
| | | | | | - Dorice Vieira
- NYU Grossman School of Medicine, New York, NY, USA; Department of Population Health, NYU School of Medicine, New York, NY, USA
| | - Stacy Loeb
- Departments of Urology and Population Health, NYU School of Medicine and Manhattan Veterans Affairs, New York, NY, USA
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15
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Mahumud RA, Sultana M, Gow J, Rahman MA, Uddin KF, Kamal M, Alam K, Dawson A, Law CK. Association of dietary risks, behavioural and lifestyle factors, and the magnitude of disability burden among Australian cancer patients: An observational epidemiology study. Cancer Epidemiol 2022; 78:102161. [PMID: 35447539 DOI: 10.1016/j.canep.2022.102161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 03/18/2022] [Accepted: 04/10/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Cancer patients are confronted with a variety of other health-related issues, including physical disability, poor quality of life, and psychological challenges. This study aims to quantify the association of dietary, behavioural and lifestyle risk factors and comorbidities on the magnitude and distribution of disability burden among cancer patients in Australia. METHODS This study comprised a sample of 2283 cancer patients drawn from the latest nationwide Australian National Health Survey conducted in 2017-18. Negative binomial regression models were used to estimate the incidence rate ratio (IRR) of the number of disabilities and its associations. RESULTS Forty-five percent of cancer patients experienced at least one disability. The magnitude of disability was significantly associated with sugar-sweetened drink consumption ≥ 3 days per week (IRR= 1.12, 95% CI: 1.02-1.26), a lack of physical activity (IRR = 1.69, 1.38-2.07), frequent or regular alcohol consumption (IRR = 1.95, 1.84-2.08), poor health status (IRR = 1.99, 1.78-2.24) and the presence of five or more chronic comorbid conditions (IRR = 3.59, 2.90-4.46). Cancer patients who consumed vegetables at least two or more times per day had a 10% lower risk of disability burden (IRR = 0.90, 0.82-0.99). CONCLUSIONS This study shows the association of diet, behavioural, and lifestyle risk factors on the degree of disability burden among cancer patients, highlighting the need for bold and effective policies. The findings will inform the implementation of evidence-based lifestyle interventions and offer a foundation for evaluating their influence on cancer survivors' health.
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Affiliation(s)
- Rashidul Alam Mahumud
- NHMRC Clinical Trials Centre, Faculty of Medicine and Health, The University of Sydney, Camperdown, Sydney, New South Wales 2050, Australia; Centre for Health Research, University of Southern Queensland, Toowoomba, Queensland, Australia.
| | - Marufa Sultana
- Deakin Health Economics, School of Health and Social Development, Deakin University, Geelong, Victoria, Australia
| | - Jeff Gow
- Centre for Health Research, University of Southern Queensland, Toowoomba, Queensland, Australia
| | - Md Ashfikur Rahman
- Development Studies Discipline, Khulna University, Khulna 9208, Bangladesh
| | - Khandakar Farid Uddin
- School of Social Sciences, Western Sydney University, Penrith Campus, New South Wales, Australia
| | - Mostafa Kamal
- Deakin Health Economics, School of Health and Social Development, Deakin University, Geelong, Victoria, Australia
| | - Khorshed Alam
- Centre for Health Research, University of Southern Queensland, Toowoomba, Queensland, Australia
| | - Angela Dawson
- The Australian Centre for Public and Population Health Research, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales 2007, Australia
| | - Chi Kin Law
- NHMRC Clinical Trials Centre, Faculty of Medicine and Health, The University of Sydney, Camperdown, Sydney, New South Wales 2050, Australia
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16
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Short- and long-term effect of high versus low-to-moderate intensity exercise to optimise health-related quality of life after oncological treatment-results from the Phys-Can project. Support Care Cancer 2022; 30:5949-5963. [PMID: 35391574 PMCID: PMC9135802 DOI: 10.1007/s00520-022-07016-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 03/25/2022] [Indexed: 11/13/2022]
Abstract
Purpose This study aimed to evaluate the effect of high intensity (HI) vs low-to-moderate intensity (LMI) exercise on health-related quality of life (HRQoL) up to 18 months after commencement of oncological treatment in patients with breast, colorectal or prostate cancer. In addition, we conducted a comparison with usual care (UC). Methods Patients scheduled for (neo)adjuvant oncological treatment (n = 577) were randomly assigned to 6 months of combined resistance and endurance training of HI or LMI. A longitudinal descriptive study (UC) included participants (n = 89) immediately before the RCT started. HRQoL was assessed by EORTC QLQ-C30 at baseline, 3, 6 and 18 months (1 year after completed exercise intervention) follow-up. Linear mixed models were used to study the groups over time. Results Directly after the intervention, HI scored significant (P = 0.02), but not clinically relevant, higher pain compared with LMI. No other significant difference in HRQoL was found between the exercise intensities over time. Clinically meaningful improvements in HRQoL over time were detected within both exercise intensities. We found favourable significant differences in HRQoL in both exercise intensities compared with UC over time. Conclusion This study adds to the strong evidence of positive effect of exercise and shows that exercise, regardless of intensity, can have beneficial effects on HRQoL during oncological treatment and also for a substantial time after completion of an exercise intervention. In this study, for one year after. Implications for cancer survivors Patients can be advised to exercise at either intensity level according to their personal preferences, and still benefit from both short-term and long-term improvements in HRQoL. Supplementary Information The online version contains supplementary material available at 10.1007/s00520-022-07016-3.
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17
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Legg M, Meertens RM, van Roekel E, Breukink SO, Janssen ML, Keulen ETP, Steindorf K, Weijenberg MP, Bours M. The Association between Sleep Quality and Fatigue in Colorectal Cancer Survivors up until Two Years after Treatment: A Cross-Sectional and Longitudinal Analysis. Cancers (Basel) 2022; 14:cancers14061527. [PMID: 35326678 PMCID: PMC8945971 DOI: 10.3390/cancers14061527] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/02/2022] [Accepted: 03/11/2022] [Indexed: 02/01/2023] Open
Abstract
Simple Summary Fatigue is a distressing complaint with high detriment to quality of life that persists in one third of colorectal cancer survivors after cancer treatment. Surprisingly, the contribution of poor sleep quality to fatigue in colorectal cancer survivors is underinvestigated. We aimed to investigate the association between sleep quality and fatigue in colorectal cancer survivors up until two years post-treatment. Results showed worse sleep quality in colorectal cancer patients was associated with higher levels of fatigue during the first two years post-treatment. The results of this study suggest that more attention for sleep quality in colorectal cancer survivors and offering sleep health interventions may lead to less fatigue and better quality of life in this group. Abstract Fatigue is a distressing complaint with high detriment to quality of life that persists in one-third of colorectal cancer survivors after cancer treatment. Previous studies in mixed groups of cancer patients have suggested sleep quality is associated with fatigue. We aimed to investigate this association in colorectal cancer survivors up until two years post-treatment. Data on n = 388 stage I–III colorectal cancer patients were utilized from the EnCoRe study. Sleep quality and fatigue were measured at 6 weeks and 6, 12, and 24 months post-treatment. Sleep quality was measured using the Pittsburgh Sleep Quality Index (cross-sectional analysis only) and the single-item insomnia scale from the EORTC QLQ-C30. Fatigue was measured by the Checklist Individual Strength. Linear and mixed-model regression analyses analysed associations between sleep quality and fatigue cross-sectionally and longitudinally. Longitudinal analysis revealed worsening sleep quality over time was significantly associated with increased levels of fatigue over time (β per 0.5 SD increase in the EORTC-insomnia score = 2.56, 95% Cl: 1.91, 3.22). Significant cross-sectional associations were observed between worse sleep quality and higher levels of fatigue at all time points. Worse sleep quality in colorectal cancer patients was associated with higher levels of fatigue during the first two years post-treatment.
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Affiliation(s)
- Meera Legg
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, 6200 MD Maastricht, The Netherlands;
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, 6200 MD Maastricht, The Netherlands; (E.v.R.); (M.P.W.); (M.B.)
| | - Ree M. Meertens
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, 6200 MD Maastricht, The Netherlands;
- Correspondence:
| | - Eline van Roekel
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, 6200 MD Maastricht, The Netherlands; (E.v.R.); (M.P.W.); (M.B.)
| | - Stéphanie O. Breukink
- Department of Surgery, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center+, 6202 AZ Maastricht, The Netherlands;
| | - Maryska L. Janssen
- Department of Clinical Epidemiology, VieCuri Medical Centre, Tegelseweg 210, 5912 BL Venlo, The Netherlands;
| | - Eric T. P. Keulen
- Department of Internal Medicine and Gastroenterology, Zuyderland Medical Centre, Dr. H. van der Hoffplein 1, 6162 BG Sittard-Geleen, The Netherlands;
| | - Karen Steindorf
- Division of Physical Activity, Prevention and Cancer, National Center for Tumor Diseases (NCT) and German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany;
| | - Matty P. Weijenberg
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, 6200 MD Maastricht, The Netherlands; (E.v.R.); (M.P.W.); (M.B.)
| | - Martijn Bours
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, 6200 MD Maastricht, The Netherlands; (E.v.R.); (M.P.W.); (M.B.)
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18
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Ngan TT, Mai VQ, Van Minh H, Donnelly M, O'Neill C. Health-related quality of life among breast cancer patients compared to cancer survivors and age-matched women in the general population in Vietnam. Qual Life Res 2022; 31:777-787. [PMID: 34541610 PMCID: PMC8921138 DOI: 10.1007/s11136-021-02997-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE This study compared the health-related quality of life (HRQoL) of breast cancer (BC) patients, survivors, and age-matched women from the general population in Vietnam to address the paucity of HRQoL research and contribute to the robust assessment of BC screening and care in Vietnam. METHODS The standardised EQ-5D-5L instrument was incorporated in an online survey and a hospital-based face-to-face survey, and together with data from the Vietnam EQ-5D-5L norms study. χ2 tests assessed EQ-5D health profile associations and a Tobit regression model investigated the association between overall health status (EQ-VAS/utility scores) and sociodemographic and clinical characteristics. RESULTS A total of 309 participants (107 patients undergoing treatment and 202 survivors who had completed treatment) provided usable responses. The dimensions that affected mostly the HRQoL of women with BC were pain/discomfort and anxiety/depression. Current patients and survivors differed significantly regarding HRQoL dimensions of mobility, self-care, usual activities, and anxiety/depression. Their health utilities were 0.74 and 0.84, respectively, compared with 0.91 for age-matched Vietnamese women in the general population (p < 0.001). Treatment status (survivor vs patient), younger age, higher monthly household income, and higher education levels were associated with higher health utility. CONCLUSIONS The results point to unmet needs in mental health support and well-being and for attention to be given to the development of a biopsychosocial system of cancer diagnosis, treatment, and care. The results will also inform future assessments of the comparative value for money of interventions intended to impact on breast cancer in Vietnam.
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Affiliation(s)
- Tran Thu Ngan
- Centre for Public Health, Queen's University Belfast, Belfast, UK.
- Centre for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam.
| | - Vu Quynh Mai
- Centre for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam
- Department of Epidemiology and Global Health, Umea University, Umea, Sweden
| | - Hoang Van Minh
- Centre for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam
| | - Michael Donnelly
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Ciaran O'Neill
- Centre for Public Health, Queen's University Belfast, Belfast, UK
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Zhu C, Lian Z, Chen Y, Wang J. Physical Activity and Cancer Status Among Middle-Aged and Older Chinese: A Population-Based, Cross-Sectional Study. Front Physiol 2022; 12:812290. [PMID: 35153818 PMCID: PMC8830231 DOI: 10.3389/fphys.2021.812290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 12/22/2021] [Indexed: 11/15/2022] Open
Abstract
Background The relative contributions of demographic and lifestyle behaviors to the association between physical activity (PA) and cancer are poorly understood. This study assesses the relationship between PA level and cancer status considering the full activity spectrum within a large and representative Chinese population. Methods Data were derived from the Chinese Health and Retirement Longitudinal Study (using four-stage stratified probability-proportional-to-size sampling), including 416 cancer survivors and 14,574 individuals without cancer from 28 provinces in China. Cancer status and sites were self-reported, and PA, other health behaviors (e.g., smoking, drinking) and comorbidities (e.g., hypertension, diabetes) were assessed by a questionnaire. The total PA score was calculated using metabolic equivalent (MET) multipliers. Multivariable logistic regression was used to estimate differences in PA levels between cancer survivors and those without a cancer diagnosis, adjusting for age, sex, and other potential confounding factors. Results Cancer survivors (416, 2.8%) were more likely to be women than men (65.4 vs. 34.6%). They were older (age ≥65 years, 43.8 vs. 38.9%) and more likely to be overweight (18.3 vs. 13.3%), be depressed (49.5 vs. 37.6%), have quit smoking (17.8 vs. 14.4%), drink less (17.5 vs. 26.6%), sleep less (65.9 vs. 56.8%) and have more chronic comorbidities (≥2 comorbidities, 26.0 vs. 19.2%) than those without cancer. There was a significant associations between cancer status and participation in vigorous-intensity activity for at least 10 min every week, when compared with the inactivity [odds ratio (OR) = 0.56, 95% CI = 0.39–0.80], while no differences were observed in the moderate and light activity groups. Individuals who spent more than half an hour performing moderate or vigorous intensity activity every day were significantly less likely to report a cancer diagnosis than inactive individuals (moderate OR = 0.64, 95% CI = 0.48–0.86; vigorous OR = 0.50, 95% CI = 0.37–0.68). Participants who spent more than 2 h performing light, moderate or vigorous intensity activity reported fewer cancer cases than their inactive counterparts. In addition, there was an inverse dose-response relationship between the total PA score and cancer status (P–trend < 0.001). Conclusion Associations between PA and cancer status were independent of demographics, lifestyle confounders, and comorbidities. Cancer survivors are less physically active than those without cancer.
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Gudina AT, Cheruvu VK, Gilmore NJ, Kleckner AS, Arana-Chicas E, Kehoe LA, Belcher EK, Cupertino AP. Health related quality of life in adult cancer survivors: Importance of social and emotional support. Cancer Epidemiol 2021; 74:101996. [PMID: 34333220 PMCID: PMC10079325 DOI: 10.1016/j.canep.2021.101996] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 07/13/2021] [Accepted: 07/17/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Adult cancer survivors (ACS) are at increased risk for developing various comorbid conditions and having poor health-related quality of life (HRQOL) when compared to adults with no history of cancer. The effect of social and emotional support on HRQOL among ACS is not fully elucidated. The purpose of this study was to understand the role of social and emotional support on HRQOL in ACS and to examine if the association between social and emotional support and HRQOL is modified by gender, time since cancer diagnosis, or marital status. METHODS Data for this study were obtained from the 2009 Behavioral Risk Factor Surveillance System. Statistical analysis was based on ACS with complete data (n = 23,939) on all variables considered. Multivariable logistic regression models were used to model the association between social and emotional support and indicators of HRQOL (i.e., general health, physical health, mental health, and activity limitation). To examine if gender, marital status, or the number of years since cancer diagnosis modify the association, separate stratified analyses were conducted. RESULTS When compared to ACS who reported that they Rarely/Never received social and emotional support, those who reported that they Always received were 32 % less likely to report Fair/Poor General health, 23 % less likely to report frequent unhealthy days of Physical health, 73 % less likely to report frequent unhealthy days of Mental health and 38 % less likely to report frequent unhealthy days of Activity limitation. Social and emotional support was positively associated with all four domains of HRQOL among ACS who were female, unmarried, or greater than 5 years since cancer diagnosis, while this positive association was evident only with one or two domains of HRQOL among their corresponding counterparts (i.e., male, married, less than 5 years since diagnosis). CONCLUSIONS Social and emotional support is an important factor directly related to a better HRQOL, but it is modified by gender, marital status, and time since diagnosis. Findings from this study should inform health care providers about the importance of a support system for ACS in improving their overall quality of life.
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Affiliation(s)
- Abdi T Gudina
- Division of Cancer Control and Survivorship, University of Rochester Medical Center, Rochester, NY, USA; University of Rochester Cancer Center NCI Community Oncology Research Program (NCORP), USA
| | - Vinay K Cheruvu
- Dvision of Biostatistics, Environmental Health Sciences, and Epidemiology, College of Public Health, Kent State University, Kent, OH, USA.
| | - Nikesha J Gilmore
- Division of Cancer Control and Survivorship, University of Rochester Medical Center, Rochester, NY, USA; University of Rochester Cancer Center NCI Community Oncology Research Program (NCORP), USA
| | - Amber S Kleckner
- Division of Cancer Control and Survivorship, University of Rochester Medical Center, Rochester, NY, USA; University of Rochester Cancer Center NCI Community Oncology Research Program (NCORP), USA
| | - Evelyn Arana-Chicas
- Division of Cancer Control and Survivorship, University of Rochester Medical Center, Rochester, NY, USA; University of Rochester Cancer Center NCI Community Oncology Research Program (NCORP), USA
| | - Lee A Kehoe
- Division of Cancer Control and Survivorship, University of Rochester Medical Center, Rochester, NY, USA; University of Rochester Cancer Center NCI Community Oncology Research Program (NCORP), USA
| | - Elizabeth K Belcher
- Division of Cancer Control and Survivorship, University of Rochester Medical Center, Rochester, NY, USA; University of Rochester Cancer Center NCI Community Oncology Research Program (NCORP), USA
| | - Ana Paula Cupertino
- Division of Cancer Control and Survivorship, University of Rochester Medical Center, Rochester, NY, USA; University of Rochester Cancer Center NCI Community Oncology Research Program (NCORP), USA
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21
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Trends in health-related quality of life of female breast cancer survivors using the Medical Expenditure Panel Survey (MEPS), 2008-2016. Qual Life Res 2021; 30:3547-3558. [PMID: 34052940 DOI: 10.1007/s11136-021-02895-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE In recent years, breast cancer detection and treatment have advanced. As a result, increased attention to breast cancer survivorship should have improved their health-related quality of life (HRQoL). Our aim was to examine the trends in the HRQoL of female breast cancer survivors between 2008 and 2016, to determine whether or not the increased focus on survivorship has translated into improved HRQoL. Furthermore, stratified analyses were conducted by race/ethnicity and age group and these were compared to a similar group of women without a breast cancer history. METHODS Repeated cross-sectional analyses using the Medical Expenditure Panel Survey between 2008 and 2016 were conducted. Pooled ordinary least squares (OLS) regression was used to examine the trends in physical component scores (PCS-12) and mental component scores (MCS-12) among breast cancer survivors and a similar population of women without a breast cancer history. Analyses stratified by race/ethnicity and age group were also conducted. RESULTS Among breast cancer survivors, after adjusting for confounders, there was no change in PCS-12 scores over time, but the MCS-12 scores increased by 0.27 points (95% CI 0.09-0.45). Those without a history of breast cancer had mean PCS-12 scores that were 0.13 points greater each year (95% CI 0.02-0.24) while their mean MCS-12 scores were 0.10 (95% CI 0.00-0.21) points greater each year. After stratifying by race/ethnicity, Hispanic breast cancer survivors had a small increase in PCS-12 (β: 0.65; 95% CI 0.01-1.29), and MCS-12 scores (β: 0.70; 95% CI 0.06-1.33) over time. Similar small effects were found when stratified by age group, both among breast cancer survivors and those without a history of breast cancer. The younger age group (< 50 years) reported poorer MCS-12 than the older population (age 50 years and above). CONCLUSION Our study generated findings showing the trends in the HRQoL of breast cancer survivors and compared these to a similar population of women without a history of breast cancer. This paper highlights the importance of focusing on the mental health of young breast cancer survivors to improve their prospects at a good quality of life post-breast cancer diagnosis and treatment.
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22
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Rivera Rivera JN, Burris JL. A Systematic Literature Review and Head-to-Head Comparison of Social Support and Social Constraint in Relation to the Psychological Functioning of Cancer Survivors. Ann Behav Med 2021; 54:176-192. [PMID: 31581293 DOI: 10.1093/abm/kaz037] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Quality of life is a multidimensional concept that includes perceptions of one's physical, psychological, social, and spiritual functioning, all of which are theorized to be interdependent. The focus of this study is social functioning, which itself is a multidimensional concept that includes social support and social constraint among other things. In cancer survivors, social support receives most of the research attention, but social constraint may have a stronger influence on quality of life. PURPOSE This systematic literature review evaluates which aspect of social functioning-social support or social constraint-has a stronger relationship with the psychological functioning of cancer survivors. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed in the identification and review of 32 independent records. Multiple measures of social support and social constraint were used across studies, with most having adequate psychometric properties. Psychological outcomes were divided into (a) general distress, (b) cancer-specific distress, (c) general well-being, and (d) cancer-specific well-being. RESULTS For general and cancer-specific distress, social constraint exhibited a larger association with distress than social support. Similarly, for general well-being, most studies reported a stronger association with social constraint than social support. For cancer-specific well-being, the opposite was true such that associations were stronger for social support than social constraint. CONCLUSIONS Results highlight the importance of considering social constraint when examining quality-of-life outcomes like psychological distress and well-being. Findings support social constraint as a target in interventions to reduce cancer survivors' distress, while social support could be considered in attempts to promote cancer-specific well-being.
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Affiliation(s)
| | - Jessica L Burris
- Department of Psychology, University of Kentucky, Lexington, KY, USA.,Markey Cancer Center, University of Kentucky, Lexington, KY, USA
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23
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Scherer S, Jansen L, Boakye D, Hoffmeister M, Brenner H. Changes in health-related outcomes among colorectal cancer patients undergoing inpatient rehabilitation therapy: a systematic review of observational and interventional studies. Acta Oncol 2021; 60:124-134. [PMID: 33073647 DOI: 10.1080/0284186x.2020.1828620] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Colorectal cancer (CRC) and its treatment can lead to several physical and psychosocial impairments. Cancer rehabilitation aims to reduce morbidity and improve quality of life. The objective of this review was to summarize and evaluate evidence on changes in health-related outcomes among CRC patients undergoing inpatient rehabilitation therapy and on the effectiveness of such treatment. MATERIAL AND METHODS We conducted a systematic literature search including the electronic databases Pubmed and Web of Science to find observational and interventional studies, which investigated changes in health-related outcomes among CRC patients undergoing multidisciplinary inpatient rehabilitation programs or treatment effects. Study findings were synthesized narratively. RESULTS Eleven studies were eligible and included in this review. Eight patient cohort studies addressed outcomes such as physical and functional status, fecal incontinence, anxiety and depression, and quality of life. Positive changes during rehabilitation therapy were observed for physical health (functional and physical status, fecal incontinence), and several dimensions of quality of life. Study findings concerning anxiety and depression were not conclusive. Studies that additionally conducted long-term follow-ups indicated that the improved health status after rehabilitative treatment waned over time. One RCT reported no effect of inpatient rehabilitation on distress and two randomized trials reported effects of exercise intensity on oxidative stress and immune response. Sample sizes were low (<100 included CRC patients) in eight studies and only the RCT included a comparison group (non-rehabilitants). CONCLUSION The scientific evidence level was very limited. Due to the lack of a comparison group in most studies, we were only able to evaluate changes during/after inpatient rehabilitation therapy but not the effectiveness of treatment. However, study findings suggest that physical health and functional independence improve during inpatient rehabilitation, but improvements wane over time. Further large representative studies, in particular RCTs with long-term follow-up, are essential to evaluate the effectiveness of inpatient rehabilitation and identify determinants of treatment success.
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Affiliation(s)
- Sophie Scherer
- Division of Preventive Oncology, German Cancer Research Center (DKFZ)-National Center for Tumor Diseases (NCT), Heidelberg, Germany
- Medical Faculty Heidelberg, University of Heidelberg, Heidelberg, Germany
| | - Lina Jansen
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Daniel Boakye
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Michael Hoffmeister
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Hermann Brenner
- Division of Preventive Oncology, German Cancer Research Center (DKFZ)-National Center for Tumor Diseases (NCT), Heidelberg, Germany
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
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Joshy G, Thandrayen J, Koczwara B, Butow P, Laidsaar-Powell R, Rankin N, Canfell K, Stubbs J, Grogan P, Bailey L, Yazidjoglou A, Banks E. Disability, psychological distress and quality of life in relation to cancer diagnosis and cancer type: population-based Australian study of 22,505 cancer survivors and 244,000 people without cancer. BMC Med 2020; 18:372. [PMID: 33256726 PMCID: PMC7708114 DOI: 10.1186/s12916-020-01830-4] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 10/27/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Improved survival means that cancer is increasingly becoming a chronic disease. Understanding and improving functional outcomes are critical to optimising survivorship. We quantified physical and mental health-related outcomes in people with versus without cancer, according to cancer type. METHODS Questionnaire data from an Australian population-based cohort study (45 and Up Study (n = 267,153)) were linked to cancer registration data to ascertain cancer diagnoses up to enrolment. Modified Poisson regression estimated age- and sex-adjusted prevalence ratios (PRs) for adverse person-centred outcomes-severe physical functional limitations (disability), moderate/high psychological distress and fair/poor quality of life (QoL)-in participants with versus without cancer, for 13 cancer types. RESULTS Compared to participants without cancer (n = 244,000), cancer survivors (n = 22,505) had greater disability (20.6% versus 12.6%, respectively, PR = 1.28, 95%CI = (1.25-1.32)), psychological (22.2% versus 23.5%, 1.05 (1.02-1.08)) and poor/fair QoL (15.2% versus 10.2%; 1.28 (1.24-1.32)). The outcomes varied by cancer type, being worse for multiple myeloma (PRs versus participants without cancer for disability 3.10, 2.56-3.77; distress 1.53, 1.20-1.96; poor/fair QoL 2.40, 1.87-3.07), lung cancer (disability 2.81, 2.50-3.15; distress 1.67, 1.46-1.92; poor/fair QoL 2.53, 2.21-2.91) and non-Hodgkin's lymphoma (disability 1.56, 1.37-1.78; distress 1.20, 1.05-1.36; poor/fair QoL 1.66, 1.44-1.92) and closer to those in people without cancer for breast cancer (disability 1.23, 1.16-1.32; distress 0.95, 0.90-1.01; poor/fair QoL 1.15, 1.05-1.25), prostate cancer (disability 1.11, 1.04-1.19; distress 1.09, 1.02-1.15; poor/fair QoL 1.15, 1.08-1.23) and melanoma (disability 1.02, 0.94-1.10; distress 0.96, 0.89-1.03; poor/fair QoL 0.92, 0.83-1.01). Outcomes were worse with recent diagnosis and treatment and advanced stage. Physical disability in cancer survivors was greater in all population subgroups examined and was a major contributor to adverse distress and QoL outcomes. CONCLUSIONS Physical disability, distress and reduced QoL are common after cancer and vary according to cancer type suggesting priority areas for research, and care and support.
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Affiliation(s)
- Grace Joshy
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Mills Road, Acton, Canberra, ACT, 2601, Australia.
| | - Joanne Thandrayen
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Mills Road, Acton, Canberra, ACT, 2601, Australia
| | - Bogda Koczwara
- Flinders University and Flinders Medical Centre, Adelaide, SA, Australia
| | - Phyllis Butow
- Centre for Medical Psychology and Evidence-based Medicine, School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
| | - Rebekah Laidsaar-Powell
- Centre for Medical Psychology and Evidence-based Medicine, School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
| | - Nicole Rankin
- Centre for Medical Psychology and Evidence-based Medicine, School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
| | - Karen Canfell
- Centre for Medical Psychology and Evidence-based Medicine, School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia.,Cancer Research Division, Cancer Council New South Wales, Kings Cross, NSW, Australia.,Prince of Wales Clinical School, University of New South Wales, Sydney, NSW, Australia
| | | | - Paul Grogan
- Cancer Research Division, Cancer Council New South Wales, Kings Cross, NSW, Australia
| | - Louise Bailey
- Primary Care Collaborative Cancer Clinical Trials Group Community Advisory Group, Melbourne, VIC, Australia.,Psycho-oncology Cooperative Research Group Community Advisory Group, Camperdown, NSW, Australia
| | - Amelia Yazidjoglou
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Mills Road, Acton, Canberra, ACT, 2601, Australia
| | - Emily Banks
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Mills Road, Acton, Canberra, ACT, 2601, Australia.,Sax Institute, Haymarket, NSW, Australia
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25
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Almatkyzy G, Mojica CM, Stroup AM, Llanos AAM, O'Malley D, Xu B, Tsui J. Predictors of health-related quality of life among Hispanic and non-Hispanic White breast cancer survivors in New Jersey. J Psychosoc Oncol 2020; 39:595-612. [PMID: 33198603 DOI: 10.1080/07347332.2020.1844844] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE To examine predictors of health-related quality of life (HRQoL) in Hispanic and non-Hispanic White (NHW) breast cancer (BC) survivors. DESIGN Cross-sectional study using survey data. PARTICIPANTS Women diagnosed with BC at ages 21-79 years, between 2012-2014, recruited from the New Jersey State Cancer Registry. METHODS HRQoL was assessed using the Functional Assessment Cancer Therapy (FACT-G) instrument. Descriptive statistics compared Hispanics and NHWs, and multivariate regression analyses identified predictors of HRQoL. RESULTS HRQoL was significantly higher scores among NHW (85.7 ± 18.5) than Hispanics (79.4 ± 20.1) (p < 0.05). In multivariate analyses, comorbidities (β: -13.3, 95%CI: -20.6, -5.92), late-stage diagnosis (β: -5.67, 95%CI: -10.7, -0.62), lower income (β: -13.9, 95%CI: -19.8, -7.97) and younger age at diagnosis were associated with lower HRQoL. CONCLUSION Socio-demographic and clinic characteristics were significant predictors of HRQoL among diverse BC survivors. IMPLICATIONS FOR PSYCHOSOCIAL ONCOLOGY Supportive psychosocial care interventions tailored to the needs of young, low-income BC survivors with comorbidities are needed.
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Affiliation(s)
- Gulaiim Almatkyzy
- School of Social and Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, USA
| | - Cynthia M Mojica
- School of Social and Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, USA
| | - Antoinette M Stroup
- Division of Cancer Epidemiology, Rutgers School of Public Health, Cancer Prevention and Cancer Control, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Adana A M Llanos
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, New Jersey, USA
| | - Denalee O'Malley
- Department of Family Medicine and Community Health, Rutgers State University of New Jersey, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
| | - Baichen Xu
- Division of Population Science, Rutgers Cancer Institute of New, New Brunswick, New Jersey, USA
| | - Jennifer Tsui
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
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Zhang Y, Joshy G, Glass K, Banks E. Physical functional limitations and psychological distress in people with and without colorectal cancer: findings from a large Australian study. J Cancer Surviv 2020; 14:894-905. [PMID: 32613443 DOI: 10.1007/s11764-020-00901-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 05/30/2020] [Indexed: 12/20/2022]
Abstract
PURPOSE To quantify physical disability and psychological distress in people with and without colorectal cancer (CRC). METHODS Questionnaire data (2006-2009) from 267,153 Australian general population members aged ≥ 45 years participating in the 45 and Up Study (n = 213,231 following exclusions) were linked to cancer registry and hospital admission data, to ascertain CRC status. Modified Poisson regression estimated adjusted prevalence ratios (PRs) for physical disability and psychological distress in participants with CRC versus those without. RESULTS Compared with participants without CRC (n = 210,836), CRC survivors (n = 2395) had significantly higher physical disability prevalence (11.9% versus 19.5%, respectively), PR = 1.11 (95% CI = 1.03-1.20); and a similar prevalence of distress (23.1% versus 20.2%), PR = 1.03 (0.94-1.20). Adverse outcomes were associated with certain clinical characteristics. Compared with participants without CRC, CRC survivors diagnosed 5-< 10 and ≥ 10 years, with regional spread, and without recent cancer treatment had broadly similar outcomes; survivors with metastatic CRC and recent treatment had 30-60% higher prevalence of disability and distress. Compared with participants with neither CRC nor disability, PRs for distress were 4.71 (4.22-5.26) for those with disability and CRC; and 4.22 (4.13-4.31) for those with disability without CRC. CONCLUSIONS Physical disability is elevated in CRC survivors. Psychological distress is elevated 4- to 5-fold with disability, regardless of CRC diagnosis, with lesser increases around diagnosis and treatment. IMPLICATIONS FOR CANCER SURVIVORS CRC survivors with less advanced disease and who have not been recently diagnosed or treated have physical disability and psychological distress comparable to the general population. Survivors with disability are at particularly high risk of psychological distress.
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Affiliation(s)
- Yuehan Zhang
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, ACT, Australia
| | - Grace Joshy
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, ACT, Australia.
| | - Kathryn Glass
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, ACT, Australia
| | - Emily Banks
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, ACT, Australia
- The Sax Institute, Sydney, Australia
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Babcock ZR, Kogut SJ, Vyas A. Association between polypharmacy and health-related quality of life among cancer survivors in the United States. J Cancer Surviv 2019; 14:89-99. [PMID: 31792811 DOI: 10.1007/s11764-019-00837-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 11/14/2019] [Indexed: 01/18/2023]
Abstract
PURPOSE Polypharmacy (PP) is present in many cancer survivors and may lead to lower health-related quality of life (HRQoL). The study's objective was to evaluate the association between PP and HRQoL among cancer survivors in the US. METHODS A cross-sectional analysis of the Medical Expenditure Panel Survey (MEPS) was conducted. Our analytic sample included all adult patients with cancer, during even years 2008-2014. PP was defined as reported use of five or more unique therapeutic classes of prescription medications. The MEPS measured HRQoL using the Short Form 12-Item Health Survey Version 2 (SF-12v2) physical component summary (PCS) and mental component summary (MCS) scores. Ordinary least squares regressions were used to assess associations between PP and HRQoL controlling for demographic, socioeconomic, and clinical factors. RESULTS PP was prevalent among 44.4% of 10.1 million cancer survivors per calendar year (on average) for years 2008, 2010, 2012, and 2014. The mean adjusted PCS score for cancer survivors with PP was 35.8 points, which was significantly lower compared with cancer survivors without PP (39.5) by 3.7 points (p value < .0001). Conversely, the mean adjusted MCS scores were not significantly lower in cancer survivors with PP compared with cancer survivors without PP (44.9 versus 45.4, p value = 0.3145). CONCLUSIONS PP was prevalent in 44.4% of cancer survivors and was associated with significantly poorer physical HRQoL than reported in their counterparts without PP. IMPLICATIONS FOR CANCER SURVIVORS PP should be examined closely among cancer survivors because of increased association with poorer physical HRQoL.
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Affiliation(s)
- Zachary R Babcock
- Health Outcomes, Department of Pharmacy Practice, College of Pharmacy, University of Rhode Island, 7 Greenhouse Rd, Kingston, RI, 02881, USA.
| | - Stephen J Kogut
- Health Outcomes, Department of Pharmacy Practice, College of Pharmacy, University of Rhode Island, 7 Greenhouse Rd, Kingston, RI, 02881, USA
| | - Ami Vyas
- Health Outcomes, Department of Pharmacy Practice, College of Pharmacy, University of Rhode Island, 7 Greenhouse Rd, Kingston, RI, 02881, USA
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Yu EY, Nekeman D, Billingham LJ, James ND, Cheng KK, Bryan RT, Wesselius A, Zeegers MP. Health-related quality of life around the time of diagnosis in patients with bladder cancer. BJU Int 2019; 124:984-991. [PMID: 31077532 PMCID: PMC6907410 DOI: 10.1111/bju.14804] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To quantify the health-related quality of life (HRQoL) of patients with bladder cancer around the time of diagnosis and to test the hypotheses of a two-factor model for the HRQoL questionnaire QLQ-C30. METHODS From participants in the Bladder Cancer Prognoses Programme, a multicentre cohort study, sociodemographic data were collected using semi-structured face-to-face interviews. Answers to the QLQ-C30 were transformed into a scale from 0 to 100. HRQoL data were analysed in multivariate analyses. The hypothesized two-factor (Physical and Mental Health) domain structure of the QLQ-C30 was also tested with confirmatory factor analyses (CFA). RESULTS A total of 1160 participants (78%) completed the questionnaire after initial visual diagnosis and before pathological confirmation. Despite non-muscle-invasive bladder cancer (NMIBC) being associated with a higher HRQoL than carcinoma invading bladder muscle, only the domain Role Functioning was clinically significantly better in patients with NMIBC. Age, gender, bladder cancer stage and comorbidity all had a significant influence on QLQ-C30 scores. The CFA showed an overall good fit of the hypothesized two-factor model. CONCLUSION This study identified a baseline reference value for HRQoL for patients with bladder cancer, which allows better evaluation of any changes in HRQoL as disease progresses or after treatment. In addition, a two-factor (Physical and Mental Health) model was developed for the QLQ-C30.
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Affiliation(s)
- Evan Yi‐Wen Yu
- NUTRIM School for Nutrition and Translational Research in MetabolismUniversity of MaastrichtMaastrichtthe Netherlands
- CAPHRI School for Public Health and Primary CareUniversity of MaastrichtMaastrichtthe Netherlands
| | - Duncan Nekeman
- Department of Public Health, Epidemiology and BiostatisticsSchool of Health and Population SciencesUniversity of BirminghamBirminghamUK
| | - Lucinda J. Billingham
- MRC Midland Hub for Trials Methodology Research and Cancer Research UK Clinical Trials UnitUniversity of BirminghamBirminghamUK
| | | | - KK Cheng
- Department of Public Health, Epidemiology and BiostatisticsSchool of Health and Population SciencesUniversity of BirminghamBirminghamUK
| | | | - Anke Wesselius
- NUTRIM School for Nutrition and Translational Research in MetabolismUniversity of MaastrichtMaastrichtthe Netherlands
| | - Maurice P. Zeegers
- CAPHRI School for Public Health and Primary CareUniversity of MaastrichtMaastrichtthe Netherlands
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Fisher PL, Byrne A, Fairburn L, Ullmer H, Abbey G, Salmon P. Brief Metacognitive Therapy for Emotional Distress in Adult Cancer Survivors. Front Psychol 2019; 10:162. [PMID: 30766505 PMCID: PMC6365419 DOI: 10.3389/fpsyg.2019.00162] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Accepted: 01/17/2019] [Indexed: 01/07/2023] Open
Abstract
Background: Adult cancer survivors often experience substantial psychological morbidity following the completion of acute cancer treatment. Unfortunately, current psychological interventions are of limited efficacy. This study explored if metacognitive therapy (MCT); a brief transdiagnostic psychological intervention was potentially efficacious and could be delivered effectively to adult cancer survivors with psychological morbidity. Methods: An open trial with 3- and 6-month follow-up evaluated the treatment effects of MCT in 27 consecutively referred individuals to a clinical psychology health service specializing in psycho-oncology. Each participant received a maximum of six 1-hour sessions of MCT. Levels of anxiety, depression, fear of cancer recurrence, post-traumatic stress symptoms, health related quality of life, and metacognitive beliefs and processes were assessed using self-report questionnaires. Results: MCT was associated with statistically significant reductions across all outcome measures which were maintained through to 6-month follow-up. In the ITT sample on the primary treatment outcome measure, the Hospital Anxiety and Depression Scale-Total, 59% of participants met recovery criteria at post-treatment and 52% at 6-month follow-up, respectively. No participants significantly deteriorated. In the completer sample (N = 20), 80% recovered at post-treatment and 70% at 6-month follow-up. MCT was acceptable to patients with approximately 75% of patients completing all treatment sessions. Conclusion: MCT, a brief transdiagnostic psychological intervention can be delivered effectively to a heterogenous group of cancer survivors with promising treatment effects. Examining the efficacy of brief MCT against the current gold standard psychological intervention would be a valuable advance toward improving the quality of life of cancer survivors.
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Affiliation(s)
- Peter L Fisher
- Department of Psychological Sciences, University of Liverpool, Liverpool, United Kingdom.,Liverpool Clinical Health, Royal Liverpool and Broadgreen University Hospital NHS Trust, Liverpool, United Kingdom.,Psychology Service, Royal Liverpool and Broadgreen University Hospital NHS Trust, Liverpool, United Kingdom
| | - Angela Byrne
- Department of Psychological Sciences, University of Liverpool, Liverpool, United Kingdom.,Liverpool Clinical Health, Royal Liverpool and Broadgreen University Hospital NHS Trust, Liverpool, United Kingdom.,Psychology Service, Royal Liverpool and Broadgreen University Hospital NHS Trust, Liverpool, United Kingdom
| | - Louise Fairburn
- Department of Psychological Sciences, University of Liverpool, Liverpool, United Kingdom.,Liverpool Clinical Health, Royal Liverpool and Broadgreen University Hospital NHS Trust, Liverpool, United Kingdom.,Psychology Service, Royal Liverpool and Broadgreen University Hospital NHS Trust, Liverpool, United Kingdom
| | - Helen Ullmer
- Department of Psychological Sciences, University of Liverpool, Liverpool, United Kingdom.,Liverpool Clinical Health, Royal Liverpool and Broadgreen University Hospital NHS Trust, Liverpool, United Kingdom.,Psychology Service, Royal Liverpool and Broadgreen University Hospital NHS Trust, Liverpool, United Kingdom
| | - Gareth Abbey
- Department of Psychological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Peter Salmon
- Department of Psychological Sciences, University of Liverpool, Liverpool, United Kingdom.,Liverpool Clinical Health, Royal Liverpool and Broadgreen University Hospital NHS Trust, Liverpool, United Kingdom.,Psychology Service, Royal Liverpool and Broadgreen University Hospital NHS Trust, Liverpool, United Kingdom
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30
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Comorbid conditions and health-related quality of life in long-term cancer survivors-associations with demographic and medical characteristics. J Cancer Surviv 2018; 12:712-720. [PMID: 30097854 DOI: 10.1007/s11764-018-0708-6] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 07/28/2018] [Indexed: 01/17/2023]
Abstract
PURPOSE Our study provides a detailed overview of comorbid conditions and health-related quality of life of long-term cancer survivors and analyses the impact of demographic, disease- and treatment-related characteristics. METHODS We present data obtained from 1000 survivors across mixed tumour entities 5 and 10 years after cancer diagnosis in a cross-sectional study. We analyse the prevalence of physical symptoms and health conditions via self-report and health-related quality of life using the EORTC QLQ-C30 in comparison to gender- and age-matched reference values of the general population. RESULTS Cancer survivors reported on average 5 comorbidities; 23% had 7 or more comorbid conditions. Cancer survivors reported higher physical symptom burden than the population-especially fatigue, insomnia and pain. Type and prevalence of long-term and late effects differ with disease-related factors (e.g. cancer type, treatment) and characteristics of the patient. Cancer survivors also reported lower quality of life than the population, especially in everyday activities, social life, psychological well-being and financial difficulties. There was a positive association between high quality of life and a low level of morbidity. CONCLUSIONS The specific knowledge about physical long-term consequences for the individual types of cancer could raise awareness in health care professionals for high-risk patients and help to develop adequate prevention and survivorship-programs. IMPLICATIONS FOR CANCER SURVIVORS Limitations in the mental health area underlines the importance of psycho-oncological survivorship-care-plans, which go beyond the time of rehabilitation. Special attention should be given to the financial situation of patients in long-term follow-up care.
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31
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Capistrant BD, Lesher L, Kohli N, Merengwa EN, Konety B, Mitteldorf D, West WG, Rosser BRS. Social Support and Health-Related Quality of Life Among Gay and Bisexual Men With Prostate Cancer. Oncol Nurs Forum 2018; 45:439-455. [PMID: 29947351 PMCID: PMC7201404 DOI: 10.1188/18.onf.439-455] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVES To describe social support patterns of gay and bisexual men with prostate cancer (GBMPCa) and how social support is associated with prostate cancer outcomes. SAMPLE & SETTING A cross-sectional online survey with 186 GBMPCa recruited from a national cancer support group network. METHODS & VARIABLES Descriptive statistics of social support and linear regression of social support on general and prostate cancer-specific quality of life (QOL). Social support and health-related QOL were assessed generally and specific to prostate cancer. RESULTS Participants primarily relied on partners or husbands, gay and bisexual friends, chosen family, and men from support groups for support. The most common types of support received were informational and emotional social support. Low general social support was significantly associated with worse prostate cancer symptom bother and general mental QOL. Wanting more social support was significantly associated with worse prostate cancer-specific and general QOL. IMPLICATIONS FOR NURSING Clinicians should be aware of the different social support networks and needs of GBMPCa and refer them to relevant support groups to improve QOL.
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32
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Halpern MT, Urato MP, Lines LM, Cohen JB, Arora NK, Kent EE. Healthcare experience among older cancer survivors: Analysis of the SEER-CAHPS dataset. J Geriatr Oncol 2018; 9:194-203. [PMID: 29249645 PMCID: PMC6002869 DOI: 10.1016/j.jgo.2017.11.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 07/29/2017] [Accepted: 11/09/2017] [Indexed: 01/13/2023]
Abstract
OBJECTIVE Little is known about factors affecting medical care experiences of cancer survivors. This study examined experience of care among cancer survivors and assessed associations of survivors' characteristics with their experience. MATERIALS AND METHODS We used a newly-developed, unique data resource, SEER-CAHPS (NCI's Surveillance Epidemiology and End Results [SEER] data linked to Medicare Consumer Assessment of Healthcare Providers and Systems [CAHPS] survey responses), to examine experiences of care among breast, colorectal, lung, and prostate cancer survivors age >66years who completed CAHPS >1year after cancer diagnosis and survived ≥1year after survey completion. Experience of care was assessed by survivor-provided scores for overall care, health plan, physicians, customer service, doctor communication, and aspects of care. Multivariable logistic regression models assessed associations of survivors' sociodemographic and clinical characteristics with care experience. RESULTS Among 19,455 cancer survivors with SEER-CAHPS data, higher self-reported general-health status was significantly associated with better care experiences for breast, colorectal, and prostate cancer survivors. In contrast, better mental-health status was associated with better care experience for lung cancer survivors. College-educated and Asian survivors were less likely to indicate high scores for care experiences. Few differences in survivors' experiences were observed by sex or years since diagnosis. CONCLUSIONS The SEER-CAHPS data resources allows assessment of factors influencing experience of cancer among U.S. cancer survivors. Higher self-reported health status was associated with better experiences of care; other survivors' characteristics also predicted care experience. Interventions to improve cancer survivors' health status, such as increased access to supportive care services, may improve experience of care.
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Affiliation(s)
- Michael T Halpern
- RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC 27709, USA; Temple University, 1301 Cecil B. Moore Ave., Philadelphia, PA 19122, USA.
| | - Matthew P Urato
- RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC 27709, USA
| | - Lisa M Lines
- RTI International, 307 Waverley Oaks Road, Suite 101,Waltham, MA 02452, USA
| | - Julia B Cohen
- RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC 27709, USA
| | - Neeraj K Arora
- Patient-Centered Outcomes Research Institute (PCORI), 1828 L Street, NW, Suite 900, Washington, DC 20036, USA
| | - Erin E Kent
- National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20850, USA
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33
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Brown JC, Damjanov N, Courneya KS, Troxel AB, Zemel BS, Rickels MR, Ky B, Rhim AD, Rustgi AK, Schmitz KH. A randomized dose-response trial of aerobic exercise and health-related quality of life in colon cancer survivors. Psychooncology 2018; 27:1221-1228. [PMID: 29388275 PMCID: PMC5895514 DOI: 10.1002/pon.4655] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 01/17/2018] [Accepted: 01/18/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To examine the dose-response effects of aerobic exercise on health-related quality of life (HRQoL) among colon cancer survivors. METHODS Thirty-nine stage I to III colon cancer survivors were randomized to 1 of 3 groups: usual-care control, 150 min·wk-1 of aerobic exercise (low-dose) and 300 min·wk-1 of aerobic exercise (high-dose) for 6 months. HRQoL outcomes included the Short Form (SF)-36 physical and mental component summary, Functional Assessment of Cancer Therapy-Colorectal, Pittsburgh Sleep Quality Index, Fear of Cancer Recurrence Inventory, Fatigue Symptom Inventory, and North Central Cancer Treatment Group bowel function questionnaire, assessed at baseline and post intervention. The primary hypothesis was that exercise would improve HRQoL outcomes in a dose-response fashion, such that high-dose aerobic exercise would yield the largest improvements in HRQoL outcomes. RESULTS Over 6 months, the low-dose group completed 141 ± 10 min·wk-1 of aerobic exercise, and the high-dose group completed 247 ± 11 min·wk-1 of aerobic exercise. Over 6 months, exercise improved the physical component summary score of the SF-36 (Ptrend = 0.002), the Functional Assessment of Cancer Therapy-Colorectal (Ptrend = 0.025), the Pittsburgh Sleep Quality Index (Ptrend = 0.049), and the Fatigue Symptom Inventory (Ptrend = 0.045) in a dose-response fashion. Between-group standardized mean difference effects sizes for the above-described findings were small to moderate in magnitude (0.35-0.75). No dose-response effects were observed for the mental component summary score of the SF-36, the Fear of Cancer Recurrence Inventory, or bowel function. CONCLUSION Higher doses of aerobic exercise, up to 300 min·wk-1 , improve multiple HRQoL outcomes among stage I to III colon cancer survivors. These findings provide evidence that aerobic exercise may provide multiple health benefits for colon cancer survivors.
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Affiliation(s)
| | | | | | | | - Babette S. Zemel
- University of Pennsylvania, Philadelphia, PA, USA, 19104
- Childrens Hospital of Philadelphia, Philadelphia, PA, USA, 19104
| | | | - Bonnie Ky
- University of Pennsylvania, Philadelphia, PA, USA, 19104
| | | | - Anil K. Rustgi
- University of Pennsylvania, Philadelphia, PA, USA, 19104
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Coles T, Bennett AV, Tan X, Battaglini CL, Sanoff HK, Basch E, Jensen RE, Reeve BB. Relationship between sleep and exercise as colorectal cancer survivors transition off treatment. Support Care Cancer 2018; 26:2663-2673. [PMID: 29470704 DOI: 10.1007/s00520-018-4110-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 02/11/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE The primary objective of this study was to evaluate the relationship between exercise and sleep disturbance in a sample of individuals diagnosed with stage I, II, and III colorectal cancer (CRC) as patients transitioned off first-line treatment. We also sought to identify heterogeneity in the relationship between sleep disturbance and exercise. METHODS Data were obtained from the MY-Health study, a community-based observational study of adults diagnosed with cancer. Patient-Reported Outcomes Measurement Information System® (PROMIS) measures (e.g., PROMIS Sleep) were administered, and participants self-reported demographics, comorbidities, cancer treatment, and exercise. Regression mixture and multiple regression models were used to evaluate the relationship between sleep disturbance and exercise cross-sectionally at an average of 10 months after diagnosis, and the change in sleep disturbance over a 7-month period, from approximately 10 to 17 months post-diagnosis. RESULTS Patients whose exercise was categorized as likely at or above American College of Sports Medicine's guidelines did not report statistically better sleep quality compared to patients who were classified as not active. However, retirement (B = - 2.4), anxiety (B = 0.21), and fatigue (B = 0.24) had statistically significant relationships with sleep disturbance (p < 0.05). Increase in exercise was not significantly associated with a decrease in sleep disturbance. No statistical heterogeneity was revealed in the relationship between sleep and exercise. CONCLUSIONS Further prospective research using an objective measure of exercise is warranted to confirm or refute the nature of the relationship between exercise and sleep disturbance in individuals diagnosed with CRC transitioning off first-line treatment.
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Affiliation(s)
- Theresa Coles
- RTI-Health Solutions, 200 Park Offices Drive, Research Triangle Park, NC, 27709, USA.
| | - Antonia V Bennett
- University of North Carolina at Chapel Hill Department of Health Policy and Management, Chapel Hill, NC, USA.,University of North Carolina at Chapel Hill, Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
| | - Xianming Tan
- University of North Carolina at Chapel Hill, Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA.,Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Claudio L Battaglini
- University of North Carolina at Chapel Hill, Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA.,Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Hanna K Sanoff
- Division of Hematology/Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ethan Basch
- University of North Carolina at Chapel Hill Department of Health Policy and Management, Chapel Hill, NC, USA.,University of North Carolina at Chapel Hill, Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
| | - Roxanne E Jensen
- Department of Oncology, Georgetown University, Washington, DC, USA
| | - Bryce B Reeve
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
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Fowler B, Ding Q, Pappas L, Wu YP, Linder L, Yancey J, Wright J, Clayton M, Kepka D, Kirchhoff AC. Utah Cancer Survivors: A Comprehensive Comparison of Health-Related Outcomes Between Survivors and Individuals Without a History of Cancer. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2018; 33:214-221. [PMID: 27592022 PMCID: PMC5532077 DOI: 10.1007/s13187-016-1098-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Assessments of cancer survivors' health-related needs are often limited to national estimates. State-specific information is vital to inform state comprehensive cancer control efforts developed to support patients and providers. We investigated demographics, health status/quality of life, health behaviors, and health care characteristics of long-term Utah cancer survivors compared to Utahans without a history of cancer. Utah Behavioral Risk Factor Surveillance System (BRFSS) 2009 and 2010 data were used. Individuals diagnosed with cancer within the past 5 years were excluded. Multivariable survey weighted logistic regressions and computed predictive marginals were used to estimate age-adjusted percentages and 95 % confidence intervals (CI). A total of 11,320 eligible individuals (727 cancer survivors, 10,593 controls) were included. Respondents were primarily non-Hispanic White (95.3 % of survivors, 84.1 % of controls). Survivors were older (85 % of survivors ≥40 years of age vs. 47 % of controls). Survivors reported the majority of their cancer survivorship care was managed by primary care physicians or non-cancer specialists (93.5 %, 95 % CI = 87.9-99.1). Furthermore, 71.1 % (95 % CI = 59.2-82.9) of survivors reported that they did not receive a cancer treatment summary. In multivariable estimates, fair/poor general health was more common among survivors compared to controls (17.8 %, 95 % CI = 12.5-23.1 vs. 14.2 %, 95 % CI = 12.4-16.0). Few survivors in Utah receive follow-up care from a cancer specialist. Provider educational efforts are needed to promote knowledge of cancer survivor issues. Efforts should be made to improve continuity in follow-up care that addresses the known issues of long-term survivors that preclude optimal quality of life, resulting in a patient-centered approach to survivorship.
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Affiliation(s)
- Brynn Fowler
- Huntsman Cancer Institute, 2000 Circle of Hope Drive, Salt Lake City, UT, 84112, USA.
| | - Qian Ding
- Study Design and Biostatistics Center, University of Utah, 295 Chipeta Way, Salt Lake City, UT, 84112, USA
| | - Lisa Pappas
- Huntsman Cancer Institute, 2000 Circle of Hope Drive, Salt Lake City, UT, 84112, USA
- Study Design and Biostatistics Center, University of Utah, 295 Chipeta Way, Salt Lake City, UT, 84112, USA
| | - Yelena P Wu
- Huntsman Cancer Institute, 2000 Circle of Hope Drive, Salt Lake City, UT, 84112, USA
- Department of Family and Preventive Medicine, University of Utah, 375 Chipeta Way, Salt Lake City, UT, 84112, USA
| | - Lauri Linder
- College of Nursing, University of Utah, 10 South 2000 East, Salt Lake City, UT, 84112, USA
- Primary Children's Hospital, 100 Mario Capecchi Dr, Salt Lake City, UT, 84132, USA
| | - Jeff Yancey
- Huntsman Cancer Institute, 2000 Circle of Hope Drive, Salt Lake City, UT, 84112, USA
| | - Jennifer Wright
- Huntsman Cancer Institute, 2000 Circle of Hope Drive, Salt Lake City, UT, 84112, USA
- Primary Children's Hospital, 100 Mario Capecchi Dr, Salt Lake City, UT, 84132, USA
| | - Margaret Clayton
- College of Nursing, University of Utah, 10 South 2000 East, Salt Lake City, UT, 84112, USA
| | - Deanna Kepka
- Huntsman Cancer Institute, 2000 Circle of Hope Drive, Salt Lake City, UT, 84112, USA
- College of Nursing, University of Utah, 10 South 2000 East, Salt Lake City, UT, 84112, USA
| | - Anne C Kirchhoff
- Huntsman Cancer Institute, 2000 Circle of Hope Drive, Salt Lake City, UT, 84112, USA
- Department of Pediatrics, University of Utah, 295 Chipeta Way, Salt Lake City, UT, 84112, USA
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Toohey K, Pumpa K, McKune A, Cooke J, Semple S. High-intensity exercise interventions in cancer survivors: a systematic review exploring the impact on health outcomes. J Cancer Res Clin Oncol 2017; 144:1-12. [PMID: 29210001 DOI: 10.1007/s00432-017-2552-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Accepted: 11/27/2017] [Indexed: 02/07/2023]
Abstract
PURPOSE There is an increasing body of evidence underpinning high-intensity exercise as an effective and time-efficient intervention for improving health in cancer survivors. The aim of this study was to, (1) evaluate the efficacy and (2) the safety of high-intensity exercise interventions in improving selected health outcomes in cancer survivors. METHODS Design Systematic review. Data sources Google Scholar and EBSCO, CINAHL Plus, Computers and Applied Sciences Complete, Health Source-Consumer Edition, Health Source: Nursing/Academic Edition, MEDLINE, Web of Science and SPORTDiscuss from inception up until August 2017. Eligibility criteria Randomized controlled trials of high-intensity exercise interventions in cancer survivors (all cancer types) with health-related outcome measures. The guidelines adopted for this review were the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). RESULTS The search returned 447 articles, of which nine articles (n = 531 participants mean, age 58 ± 9.5 years) met the eligibility criteria. Exercise interventions of between 4 and 18 weeks consisting of high-intensity interval bouts of up to 4-min were compared with a continuous moderate intensity (CMIT) intervention or a control group. High-intensity exercise interventions elicited significant improvements in VO2 max, strength, body mass, body fat and hip and waist circumference compared with CMIT and/or control groups. The studies reviewed showed low risk in participating in supervised high-intensity exercise interventions. Mixed mode high-intensity interventions which included both aerobic and resistance exercises were most effective improving the aerobic fitness levels of cancer survivors by 12.45-21.35%, from baseline to post-intervention. CONCLUSION High-intensity exercise interventions improved physical and physiological health-related outcome measures such as cardiovascular fitness and strength in cancer survivors. Given that high-intensity exercise sessions require a shorter time commitment, it may be a useful modality to improve health outcomes in those who are time poor. The risk of adverse events associated with high-intensity exercise was low.
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Affiliation(s)
- Kellie Toohey
- Discipline of Sport and Exercise Science, Faculty of Health, University of Canberra, University Drive, Bruce, Canberra, ACT, 2617, Australia. .,Research Institute for Sport and Exercise, University of Canberra, Canberra, Australia. .,Health Research Institute, University of Canberra, Canberra, Australia.
| | - Kate Pumpa
- Discipline of Sport and Exercise Science, Faculty of Health, University of Canberra, University Drive, Bruce, Canberra, ACT, 2617, Australia.,Research Institute for Sport and Exercise, University of Canberra, Canberra, Australia
| | - Andrew McKune
- Discipline of Sport and Exercise Science, Faculty of Health, University of Canberra, University Drive, Bruce, Canberra, ACT, 2617, Australia.,Research Institute for Sport and Exercise, University of Canberra, Canberra, Australia.,Discipline of Biokinetics, Exercise and Leisure Sciences, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Julie Cooke
- Discipline of Sport and Exercise Science, Faculty of Health, University of Canberra, University Drive, Bruce, Canberra, ACT, 2617, Australia.,Research Institute for Sport and Exercise, University of Canberra, Canberra, Australia
| | - Stuart Semple
- Discipline of Sport and Exercise Science, Faculty of Health, University of Canberra, University Drive, Bruce, Canberra, ACT, 2617, Australia.,Research Institute for Sport and Exercise, University of Canberra, Canberra, Australia.,Health Research Institute, University of Canberra, Canberra, Australia
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Mollon L, Bhattacharjee S. Health related quality of life among myocardial infarction survivors in the United States: a propensity score matched analysis. Health Qual Life Outcomes 2017; 15:235. [PMID: 29202758 PMCID: PMC5716338 DOI: 10.1186/s12955-017-0809-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 11/23/2017] [Indexed: 12/30/2022] Open
Abstract
Background Little is known regarding the health-related quality of life among myocardial infarction (MI) survivors in the United States. The purpose of this population-based study was to identify differences in health-related quality of life domains between MI survivors and propensity score matched controls. Methods This retrospective, cross-sectional matched case-control study examined differences in health-related quality of life (HRQoL) among MI survivors of myocardial infarction compared to propensity score matched controls using data from the 2015 Behavioral Risk Factor Surveillance System (BRFSS) survey. Propensity scores were generated via logistic regression for MI survivors and controls based on gender, race/ethnicity, age, body mass index (BMI), smoking status, and comorbidities. Chi-square tests were used to compare differences between MI survivors to controls for demographic variables. A multivariate analysis of HRQoL domains estimated odds ratios. Life satisfaction, sleep quality, and activity limitations were estimated using binary logistic regression. Social support, perceived general health, perceived physical health, and perceived mental health were estimated using multinomial logistic regression. Significance was set at p < 0.05. Results The final sample consisted of 16,729 MI survivors matched to 50,187 controls (n = 66,916). Survivors were approximately 2.7 times more likely to report fair/poor general health compared to control (AOR = 2.72, 95% CI: 2.43–3.05) and 1.5 times more likely to report limitations to daily activities (AOR = 1.46, 95% CI: 1.34–1.59). Survivors were more likely to report poor physical health >15 days in the month (AOR = 1.63, 95% CI: 1.46–1.83) and poor mental health >15 days in the month (AOR = 1.25, 95% CI: 1.07–1.46) compared to matched controls. There was no difference in survivors compared to controls in level of emotional support (rarely/never: AOR = 0.75, 95% CI: 0.48–1.18; sometimes: AOR = 0.73, 95% CI: 0.41–1.28), hours of recommended sleep (AOR = 1.14, 95% CI: 0.94–1.38), or life satisfaction (AOR = 1.62, 95% CI: 0.99–2.63). Conclusion MI survivors experienced lower HRQoL on domains of general health, physical health, daily activity, and mental health compared to the general population.
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Affiliation(s)
- Lea Mollon
- Department of Pharmacy Practice and Science, College of Pharmacy, The University of Arizona, 1295 North Martin Avenue, Tucson, AZ, 85721, USA
| | - Sandipan Bhattacharjee
- Department of Pharmacy Practice and Science, College of Pharmacy, The University of Arizona, 1295 North Martin Avenue, Tucson, AZ, 85721, USA.
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38
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Haviland J, Sodergren S, Calman L, Corner J, Din A, Fenlon D, Grimmett C, Richardson A, Smith PW, Winter J, Foster C. Social support following diagnosis and treatment for colorectal cancer and associations with health-related quality of life: Results from the UK ColoREctal Wellbeing (CREW) cohort study. Psychooncology 2017; 26:2276-2284. [PMID: 29094430 PMCID: PMC6220760 DOI: 10.1002/pon.4556] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 08/11/2017] [Accepted: 09/09/2017] [Indexed: 01/09/2023]
Abstract
Objective Social support is acknowledged as important in cancer survivorship, but little is known about change in support after cancer diagnosis and factors associated with this, particularly in colorectal cancer. The CREW cohort study investigated social support up to 2 years following curative intent surgery for colorectal cancer. Methods A total of 871 adults recruited pre‐treatment from 29 UK centres 2010 to 2012 consented to follow‐up. Questionnaires at baseline, 3, 9, 15, and 24 months post‐surgery included assessments of social support (Medical Outcomes Study‐Social Support Survey, MOS‐SSS) and health‐related quality of life (HRQoL). Socio‐demographic, clinical and treatment details were collected. Longitudinal analyses assessed social support over follow‐up, associations with participant characteristics, and HRQoL. Results Around 20% were living alone and 30% without a partner. Perceived social support declined in around 29% of participants, with 8% of these reporting very low levels overall from baseline to 2 years (mean MOS‐SSS overall score < 40 on a scale from 0 to 100). Older age, female gender, greater neighbourhood deprivation, presence of co‐morbidities, and rectal cancer site were significantly associated with reductions in perceived support. Poorer HRQoL outcomes (generic health/QoL, reduced wellbeing, anxiety, and depression) were significantly associated with lower levels of social support. Conclusions Levels of social support decline following colorectal cancer diagnosis and treatment in nearly a third of patients and are an important risk factor for recovery of HRQoL. Assessment of support early on and throughout follow‐up would enable targeted interventions to improve recovery, particularly in the more vulnerable patient groups at risk of poorer social support.
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Affiliation(s)
- Joanne Haviland
- Institute of Cancer Research Clinical Trials and Statistics Unit, Division of Clinical Studies, The Institute of Cancer Research, London, UK
| | - Samantha Sodergren
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Lynn Calman
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Jessica Corner
- Executive Office, University of Nottingham, Nottingham, UK
| | - Amy Din
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Deborah Fenlon
- College of Health and Human Sciences, Swansea University, Swansea, Wales, UK
| | - Chloe Grimmett
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Alison Richardson
- Faculty of Health Sciences, University of Southampton, Southampton, UK.,University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Peter W Smith
- Social Statistics and Demography, Social Sciences, University of Southampton, Southampton, UK
| | - Jane Winter
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, UK.,University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | | | - Claire Foster
- Macmillan Survivorship Research Group, Faculty of Health Sciences, University of Southampton, Southampton, UK
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Ahn S, Jung H, Kim S, Shin SJ, Park CG, Chu SH. Quality of life among Korean gastrointestinal cancer survivors. Eur J Oncol Nurs 2017; 30:15-21. [DOI: 10.1016/j.ejon.2017.07.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 06/22/2017] [Accepted: 07/03/2017] [Indexed: 12/30/2022]
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Harvey J, Dittus K, Mench E. eHealth and behavioral weight loss interventions for female cancer survivors: A review. ACTA ACUST UNITED AC 2017; 13:80-88. [PMID: 28905688 PMCID: PMC7789030 DOI: 10.1177/1745505717731012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Cancer survivors are at increased risk of chronic disease and diminished quality
of life. The presence of overweight and obesity can exacerbate these health
risks. Fortunately, even small weight losses have been found to produce
clinically meaningful health outcomes. However, effective obesity treatment is
difficult to access, and recently, efforts have been made to disseminate
interventions using eHealth or distantly delivered technology. This review aims
to focus on the efficacy and limitations of these technologies for female cancer
survivors. Suggestions are also provided to encourage further meaningful work in
this area.
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Affiliation(s)
- Jean Harvey
- 1 Department of Nutrition and Food Sciences, Vermont Center on Behavior and Health, The University of Vermont, Burlington, VT, USA
| | - Kim Dittus
- 2 Department of Internal Medicine, Vermont Center on Behavior and Health, The University of Vermont, Burlington, VT, USA
| | - Elise Mench
- 3 Department of Nutrition and Food Sciences, The University of Vermont, Burlington, VT, USA
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Hoedjes M, van Stralen MM, Joe STA, Rookus M, van Leeuwen F, Michie S, Seidell JC, Kampman E. Toward the optimal strategy for sustained weight loss in overweight cancer survivors: a systematic review of the literature. J Cancer Surviv 2017; 11:360-385. [PMID: 28097452 PMCID: PMC5418328 DOI: 10.1007/s11764-016-0594-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 12/20/2016] [Indexed: 12/05/2022]
Abstract
PURPOSE To gain more insight into the optimal strategy to achieve weight loss and weight loss maintenance in overweight and obese cancer survivors after completion of initial treatment, this systematic review aimed to provide an overview of the literature on intervention effects on weight, to describe intervention components used in effective interventions, to identify and synthesize behaviour change techniques (BCTs) and to assess the frequency with which these BCTs were used in effective interventions. METHODS Six databases were searched for original research articles describing weight changes in adult overweight cancer survivors after participation in a lifestyle intervention initiated after completion of initial treatment. Two researchers independently screened the retrieved papers and extracted BCTs using the BCT Taxonomy version 1. RESULTS Thirty-two papers describing 27 interventions were included. Interventions that were evaluated with a robust study design (n = 8) generally showed <5% weight loss and did not evaluate effects at ≥12 months after intervention completion. Effective interventions promoted both diet and physical activity and used the BCTs 'goal setting (behaviour)', 'action planning', 'social support (unspecified)' and 'instruction on how to perform the behaviour'. CONCLUSIONS The results of this first review on intervention components of effective interventions could be used to inform intervention development and showed a need for future publications to report long-term effects, a detailed intervention description and an extensive process evaluation. IMPLICATIONS FOR CANCER SURVIVORS This study contributed to increasing knowledge on the optimal strategy to achieve weight loss, which is recommended for overweight cancer survivors to improve health outcomes.
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Affiliation(s)
- Meeke Hoedjes
- Department of Health Sciences and the EMGO+ Institute for Health and Care Research, VU University Amsterdam, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands.
| | - Maartje M van Stralen
- Department of Health Sciences and the EMGO+ Institute for Health and Care Research, VU University Amsterdam, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands
| | - Sheena Tjon A Joe
- Department of Dietetics, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Matti Rookus
- Department of Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Flora van Leeuwen
- Department of Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Susan Michie
- Department of Clinical, Educational and Health Psychology, UCL Centre for Behaviour Change, University College London, London, UK
| | - Jacob C Seidell
- Department of Health Sciences and the EMGO+ Institute for Health and Care Research, VU University Amsterdam, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands
| | - Ellen Kampman
- Department of Health Sciences and the EMGO+ Institute for Health and Care Research, VU University Amsterdam, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
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Jensen RE, Potosky AL, Moinpour CM, Lobo T, Cella D, Hahn EA, Thissen D, Smith AW, Ahn J, Luta G, Reeve BB. United States Population-Based Estimates of Patient-Reported Outcomes Measurement Information System Symptom and Functional Status Reference Values for Individuals With Cancer. J Clin Oncol 2017; 35:1913-1920. [PMID: 28426375 DOI: 10.1200/jco.2016.71.4410] [Citation(s) in RCA: 122] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose To estimate cancer population-based reference values in the United States for eight PROMIS (Patient-Reported Outcomes Measurement Information System) domains by age and stage of disease. Patients and Methods For the Measuring Your Health (MY-Health) study, persons newly diagnosed with cancer (prostate, colorectal, non-small-cell lung, non-Hodgkin lymphoma, breast, uterine, or cervical) from 2010 to 2012 (N = 5,284) were recruited through the National Cancer Institute's SEER Program. Participants were mailed surveys 6 to 13 months after diagnosis. Raking by race/ethnicity, age, and stage generated weighted average PROMIS scores for pain interference, fatigue, anxiety, depression, sleep disturbance, physical function, ability to participate in social roles, and cognitive function. PROMIS measures are standardized to a T-score metric, with a score of 50 representing the general US population mean. Clinically meaningful differences were defined as a 3-point difference in scores. Results Several reference values (means) for patients with cancer were worse than the general United States population norms of 50. These include pain interference (52.4), fatigue (52.2), and physical function (44.1). Reference values were highest (ie, showed greatest symptom burden) in lung cancer (pain interference, 55.5; fatigue, 57.3; depression, 51.4) and cervical cancer (anxiety, 53.2; sleep disturbance, 53.4). Reference values for patients age 65 to 84 years reported lower sleep disturbance, anxiety, and depression, and better cognitive function than younger patients. Cancer reference values were poorer among those with advanced disease compared with patients with limited or no evidence of disease, specifically physical function (41.1 v 46.6, respectively), fatigue (55.8 v 50.2, respectively), and pain interference (55.2 v 50.9, respectively). Conclusion In a large, population-based sample of patients with recently diagnosed cancer, we observed symptom severity and functional deficits by age, stage, and cancer type consistent with the expected impact of cancer diagnosis and treatment. These United States cancer reference values can help facilitate interpretation of the PROMIS domain scores in research studies or in clinical applications that measure and evaluate the symptom and functional burden patients with cancer experience after initial treatment.
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Affiliation(s)
- Roxanne E Jensen
- Roxanne E. Jensen, Arnold L. Potosky, Tania Lobo, and George Luta, Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University; Jaeil Ahn and George Luta, Georgetown University, Washington, DC; Carol M. Moinpour, Fred Hutchinson Cancer Research Center, Seattle, WA; David Cella and Elizabeth A. Hahn, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; David Thissen and Bryce B. Reeve, University of North Carolina; Bryce B. Reeve, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC; and Ashley Wilder Smith, National Cancer Institute, Bethesda, MD
| | - Arnold L Potosky
- Roxanne E. Jensen, Arnold L. Potosky, Tania Lobo, and George Luta, Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University; Jaeil Ahn and George Luta, Georgetown University, Washington, DC; Carol M. Moinpour, Fred Hutchinson Cancer Research Center, Seattle, WA; David Cella and Elizabeth A. Hahn, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; David Thissen and Bryce B. Reeve, University of North Carolina; Bryce B. Reeve, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC; and Ashley Wilder Smith, National Cancer Institute, Bethesda, MD
| | - Carol M Moinpour
- Roxanne E. Jensen, Arnold L. Potosky, Tania Lobo, and George Luta, Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University; Jaeil Ahn and George Luta, Georgetown University, Washington, DC; Carol M. Moinpour, Fred Hutchinson Cancer Research Center, Seattle, WA; David Cella and Elizabeth A. Hahn, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; David Thissen and Bryce B. Reeve, University of North Carolina; Bryce B. Reeve, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC; and Ashley Wilder Smith, National Cancer Institute, Bethesda, MD
| | - Tania Lobo
- Roxanne E. Jensen, Arnold L. Potosky, Tania Lobo, and George Luta, Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University; Jaeil Ahn and George Luta, Georgetown University, Washington, DC; Carol M. Moinpour, Fred Hutchinson Cancer Research Center, Seattle, WA; David Cella and Elizabeth A. Hahn, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; David Thissen and Bryce B. Reeve, University of North Carolina; Bryce B. Reeve, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC; and Ashley Wilder Smith, National Cancer Institute, Bethesda, MD
| | - David Cella
- Roxanne E. Jensen, Arnold L. Potosky, Tania Lobo, and George Luta, Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University; Jaeil Ahn and George Luta, Georgetown University, Washington, DC; Carol M. Moinpour, Fred Hutchinson Cancer Research Center, Seattle, WA; David Cella and Elizabeth A. Hahn, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; David Thissen and Bryce B. Reeve, University of North Carolina; Bryce B. Reeve, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC; and Ashley Wilder Smith, National Cancer Institute, Bethesda, MD
| | - Elizabeth A Hahn
- Roxanne E. Jensen, Arnold L. Potosky, Tania Lobo, and George Luta, Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University; Jaeil Ahn and George Luta, Georgetown University, Washington, DC; Carol M. Moinpour, Fred Hutchinson Cancer Research Center, Seattle, WA; David Cella and Elizabeth A. Hahn, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; David Thissen and Bryce B. Reeve, University of North Carolina; Bryce B. Reeve, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC; and Ashley Wilder Smith, National Cancer Institute, Bethesda, MD
| | - David Thissen
- Roxanne E. Jensen, Arnold L. Potosky, Tania Lobo, and George Luta, Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University; Jaeil Ahn and George Luta, Georgetown University, Washington, DC; Carol M. Moinpour, Fred Hutchinson Cancer Research Center, Seattle, WA; David Cella and Elizabeth A. Hahn, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; David Thissen and Bryce B. Reeve, University of North Carolina; Bryce B. Reeve, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC; and Ashley Wilder Smith, National Cancer Institute, Bethesda, MD
| | - Ashley Wilder Smith
- Roxanne E. Jensen, Arnold L. Potosky, Tania Lobo, and George Luta, Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University; Jaeil Ahn and George Luta, Georgetown University, Washington, DC; Carol M. Moinpour, Fred Hutchinson Cancer Research Center, Seattle, WA; David Cella and Elizabeth A. Hahn, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; David Thissen and Bryce B. Reeve, University of North Carolina; Bryce B. Reeve, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC; and Ashley Wilder Smith, National Cancer Institute, Bethesda, MD
| | - Jaeil Ahn
- Roxanne E. Jensen, Arnold L. Potosky, Tania Lobo, and George Luta, Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University; Jaeil Ahn and George Luta, Georgetown University, Washington, DC; Carol M. Moinpour, Fred Hutchinson Cancer Research Center, Seattle, WA; David Cella and Elizabeth A. Hahn, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; David Thissen and Bryce B. Reeve, University of North Carolina; Bryce B. Reeve, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC; and Ashley Wilder Smith, National Cancer Institute, Bethesda, MD
| | - George Luta
- Roxanne E. Jensen, Arnold L. Potosky, Tania Lobo, and George Luta, Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University; Jaeil Ahn and George Luta, Georgetown University, Washington, DC; Carol M. Moinpour, Fred Hutchinson Cancer Research Center, Seattle, WA; David Cella and Elizabeth A. Hahn, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; David Thissen and Bryce B. Reeve, University of North Carolina; Bryce B. Reeve, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC; and Ashley Wilder Smith, National Cancer Institute, Bethesda, MD
| | - Bryce B Reeve
- Roxanne E. Jensen, Arnold L. Potosky, Tania Lobo, and George Luta, Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University; Jaeil Ahn and George Luta, Georgetown University, Washington, DC; Carol M. Moinpour, Fred Hutchinson Cancer Research Center, Seattle, WA; David Cella and Elizabeth A. Hahn, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; David Thissen and Bryce B. Reeve, University of North Carolina; Bryce B. Reeve, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC; and Ashley Wilder Smith, National Cancer Institute, Bethesda, MD
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Schneider A, Kotronoulas G, Papadopoulou C, McCann L, Miller M, McBride J, Polly Z, Bettles S, Whitehouse A, Kearney N, Maguire R. Trajectories and predictors of state and trait anxiety in patients receiving chemotherapy for breast and colorectal cancer: Results from a longitudinal study. Eur J Oncol Nurs 2016; 24:1-7. [DOI: 10.1016/j.ejon.2016.07.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 06/12/2016] [Accepted: 07/02/2016] [Indexed: 01/10/2023]
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Skinner TL, Peeters GG, Croci I, Bell KR, Burton NW, Chambers SK, Bolam KA. Impact of a brief exercise program on the physical and psychosocial health of prostate cancer survivors: A pilot study. Asia Pac J Clin Oncol 2016; 12:225-34. [PMID: 26923217 DOI: 10.1111/ajco.12474] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 11/11/2015] [Accepted: 01/13/2016] [Indexed: 12/31/2022]
Abstract
AIM It is well established that exercise is beneficial for prostate cancer survivors. The challenge for health professionals is to create effective strategies to encourage survivors to exercise in the community. Many community exercise programs are brief in duration (e.g. <5 exercise sessions); whilst evidence for the efficacy of exercise within the literature are derived from exercise programs ≥8 weeks in duration, it is unknown if health benefits can be obtained from a shorter program. This study examined the effect of a four-session individualized and supervised exercise program on the physical and psychosocial health of prostate cancer survivors. METHODS Fifty-one prostate cancer survivors (mean age 69±7 years) were prescribed 1 h, individualized, supervised exercise sessions once weekly for 4 weeks. Participants were encouraged to increase their physical activity levels outside of the exercise sessions. Objective measures of muscular strength, exercise capacity, physical function and flexibility; and self-reported general, disease-specific and psychosocial health were assessed at baseline and following the intervention. RESULTS Improvements were observed in muscle strength (leg press 17.6 percent; P < 0.001), exercise capacity (400-m walk 9.3 percent; P < 0.001), physical function (repeated chair stands 20.1 percent, usual gait speed 19.3 percent, timed up-and-go 15.0 percent; P < 0.001), flexibility (chair sit and reach +2.9 cm; P < 0.001) and positive well-being (P = 0.014) following the exercise program. CONCLUSION A four-session exercise program significantly improved the muscular strength, exercise capacity, physical function and positive well-being of prostate cancer survivors. This short-duration exercise program is safe and feasible for prostate cancer survivors and a randomized controlled trial is now required to determine whether a similar individualized exercise regimen improves physical health and mental well-being over the short, medium and long term.
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Affiliation(s)
- Tina L Skinner
- The University of Queensland, Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, Brisbane, Queensland, Australia
| | - Gmme Geeske Peeters
- The University of Queensland, Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, Brisbane, Queensland, Australia.,The University of Queensland, School of Public Health, Brisbane, Queensland, Australia
| | - Ilaria Croci
- The University of Queensland, Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, Brisbane, Queensland, Australia
| | - Katherine R Bell
- The University of Queensland, Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, Brisbane, Queensland, Australia
| | - Nicola W Burton
- The University of Queensland, Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, Brisbane, Queensland, Australia
| | - Suzanne K Chambers
- The University of Queensland, Centre for Clinical Research, Brisbane, Queensland, Australia.,Griffith University, Griffith Health Institute, Southport, Queensland, Australia.,Cancer Council Queensland, Brisbane, Queensland, Australia.,Prostate Cancer Foundation of Australia, Sydney, New South Wales, Australia.,Edith Cowan University, Edith Cowan University Health and Wellness Institute, Joondalup, Western Australia, Australia
| | - Kate A Bolam
- The University of Queensland, Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, Brisbane, Queensland, Australia.,The Swedish School of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, Stockholm, Sweden
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45
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Heins MJ, Korevaar JC, Hopman PE, Donker GA, Schellevis FG, Rijken MP. Health-related quality of life and health care use in cancer survivors compared with patients with chronic diseases. Cancer 2016; 122:962-70. [DOI: 10.1002/cncr.29853] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 10/23/2015] [Accepted: 11/19/2015] [Indexed: 12/25/2022]
Affiliation(s)
- Marianne J. Heins
- Netherlands Institute for Health Services Research (NIVEL); Utrecht the Netherlands
| | - Joke C. Korevaar
- Netherlands Institute for Health Services Research (NIVEL); Utrecht the Netherlands
| | - Petra E.P.C. Hopman
- Netherlands Institute for Health Services Research (NIVEL); Utrecht the Netherlands
| | - Gé A. Donker
- Netherlands Institute for Health Services Research (NIVEL); Utrecht the Netherlands
| | - François G. Schellevis
- Netherlands Institute for Health Services Research (NIVEL); Utrecht the Netherlands
- Department of General Practice and Elderly Care Medicine, EMGO Institute for Health and Care Research; VU University Medical Centre; Amsterdam the Netherlands
| | - Mieke P.M. Rijken
- Netherlands Institute for Health Services Research (NIVEL); Utrecht the Netherlands
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Hyphantis T, Goulia P, Zerdes I, Solomou S, Andreoulakis E, Carvalho AF, Pavlidis N. Sense of Coherence and Defense Style Predict Sleep Difficulties in Early Non-metastatic Colorectal Cancer. Dig Dis Sci 2016; 61:273-82. [PMID: 26289259 DOI: 10.1007/s10620-015-3843-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 08/02/2015] [Indexed: 12/09/2022]
Abstract
BACKGROUND Sleep disturbances are common in cancer patients, but little is known about the complex interplay between the background psychological profile, coping with health stressors capacities and psychological distress in the formation of sleep difficulties in colorectal cancer. AIMS To study the course and to identify psychological predictors of sleep difficulties in early non-metastatic colorectal cancer patients over a one-year period. METHODS In this 1-year prospective study, we assessed in 84 early non-metastatic colorectal cancer patients the association of psychological distress (SCL-90-R), sense of coherence (SOC-29), and defense styles (Defense Style Questionnaire) with sleep difficulties (SCL-90-R) in multiple regression models. Eighty-two patients with breast cancer and 50 patients with cancer of unknown primary site served as disease controls, and 84 matched for age and sex alleged healthy individuals served as healthy controls. RESULTS Colorectal cancer patients presented more sleep difficulties compared to healthy participants but fewer than patients with breast cancer and cancer of unknown primary site. Colorectal cancer patients' trouble falling asleep (p = 0.033) and wakening up early in the morning (p < 0.001) deteriorated over time. Sleep that was restless or disturbed was independently associated with low SOC (p = 0.046) and maladaptive defenses (p = 0.008). Anxiety symptoms (p < 0.001) predicted deterioration in trouble falling asleep, while depressive symptoms (p = 0.022) and self-sacrificing defense style (p = 0.049) predicted deterioration in wakening up early in the morning. CONCLUSIONS Psychological parameters and coping with health stressors capacities are independently associated with sleep difficulties in colorectal cancer patients, indicating the need for psychological interventions aiming at improving adjustment to the disease.
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Affiliation(s)
- Thomas Hyphantis
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, 45110, Greece.
| | - Panagiota Goulia
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, 45110, Greece
| | - Ioannis Zerdes
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, 45110, Greece
| | - Solomis Solomou
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, 45110, Greece
| | - Elias Andreoulakis
- 3rd Department of Psychiatry, Aristotle University of Thessaloniki, University Campus, Thessaloniki, 54124, Greece
| | - André F Carvalho
- Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Nicholas Pavlidis
- Department of Medical Oncology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, 45110, Greece
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Rohan EA, Townsend JS, Fairley TL, Stewart SL. Health behaviors and quality of life among colorectal cancer survivors. J Natl Compr Canc Netw 2015; 13:297-302. [PMID: 25736006 DOI: 10.6004/jnccn.2015.0041] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To examine, at the population level, health behaviors, comorbidities, and health-related quality of life among colorectal cancer (CRC) survivors compared with other cancer survivors and persons without cancer. METHODS We used data from the 2009 and 2010 Behavioral Risk Factor Surveillance System cancer survivor modules. We calculated descriptive statistics, conducted chi-square tests for comparisons, and used multivariable logistic regression analysis to compare CRC survivors with other cancer survivors and persons without cancer. RESULTS Of the 52,788 cancer survivors included in this analysis, 4001 reported being CRC survivors. When compared with other cancer survivors, CRC survivors reported higher percentages of obesity and lack of physical activity; however, they had lower levels of current smoking. Adjusted results show that CRC survivors were significantly more likely to report lack of physical activity, fair/poor health, and other chronic health conditions compared with persons without a cancer diagnosis. Conversely, CRC survivors reported lower levels of current smoking than persons without cancer. CONCLUSIONS CRC survivors have a higher proportion of heath conditions and behaviors that may significantly increase their risks for recurrence or development of a second cancer. Targeted interventions to address these health issues should be considered.
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Affiliation(s)
- Elizabeth A Rohan
- From the Centers for Disease Control and Prevention, Division of Cancer Prevention and Control, Chamblee, Georgia
| | - Julie S Townsend
- From the Centers for Disease Control and Prevention, Division of Cancer Prevention and Control, Chamblee, Georgia
| | - Temeika L Fairley
- From the Centers for Disease Control and Prevention, Division of Cancer Prevention and Control, Chamblee, Georgia
| | - Sherri L Stewart
- From the Centers for Disease Control and Prevention, Division of Cancer Prevention and Control, Chamblee, Georgia
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Morgenthaler TI, Croft JB, Dort LC, Loeding LD, Mullington JM, Thomas SM. Development of the National Healthy Sleep Awareness Project Sleep Health Surveillance Questions. J Clin Sleep Med 2015; 11:1057-62. [PMID: 26235156 DOI: 10.5664/jcsm.5026] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 07/20/2015] [Indexed: 11/13/2022]
Abstract
OBJECTIVES For the first time ever, as emphasized by inclusion in the Healthy People 2020 goals, sleep health is an emphasis of national health aims. The National Healthy Sleep Awareness Project (NHSAP) was tasked to propose questions for inclusion in the next Behavioral Risk Factor Surveillance System (BRFSS), a survey that includes a number of questions that target behaviors thought to impact health, as a means to measure community sleep health. The total number of questions could not exceed five, and had to include an assessment of the risk for obstructive sleep apnea (OSA). METHODS An appointed workgroup met via teleconference and face-to-face venues to develop an inventory of published survey questions being used to identify sleep health, to develop a framework on which to analyze the strengths and weaknesses of current survey questions concerning sleep, and to develop recommendations for sleep health and disease surveillance questions going forward. RESULTS The recommendation was to focus on certain existing BRFSS questions pertaining to sleep duration, quality, satisfaction, daytime alertness, and to add to these other BRFSS existing questions to make a modified STOP-BANG questionnaire (minus the N for neck circumference) to assess for risk of OSA. CONCLUSIONS Sleep health is an important dimension of health that has previously received less attention in national health surveys. We believe that 5 questions recommended for the upcoming BRFSS question banks will assist as important measures of sleep health, and may help to evaluate the effectiveness of interventions to improve sleep health in our nation.
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Affiliation(s)
| | - Janet B Croft
- Centers for Disease Control and Prevention, Atlanta, GA
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Schoormans D, Czene K, Hall P, Brandberg Y. The impact of co-morbidity on health-related quality of life in breast cancer survivors and controls. Acta Oncol 2015; 54:727-34. [PMID: 25761088 DOI: 10.3109/0284186x.2014.998277] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND The objective of this study was: 1) to compare health-related quality of life (HRQoL) scores of breast cancer survivors to matched controls; and 2) to examine the relative impact (explained variance) of the type and number of co-morbidities on HRQoL. MATERIAL AND METHODS Data from the KARMA project was used in this cross-sectional study. For each woman diagnosed with breast cancer (n = 2552) there were two healthy age- and geographically matched females (n = 5104). Breast cancer survivors were categorized according to time since diagnosis: recently diagnosed (0-1 year), short- (2-5 years), mid- (6-10 years), and long-term survivors (> 10 years). Women completed a questionnaire addressing demographics (age, educational level, and geographical location), lifestyle factors (body mass index (BMI) and smoking), co-morbidities, and HRQoL. The difference in explained variance in six HRQoL-domains between demographics, lifestyle factors, and co-morbidity in women with breast cancer and matched controls was examined by hierarchical regression analyses. RESULTS AND CONCLUSION Women recently diagnosed (n = 63), reported the worst HRQoL followed by short-term survivors (2-5 years, n = 863). Thereafter, HRQoL scores further improved (6-10 years, n = 726), and were comparable to healthy females after 10 years (n = 893). Co-morbidity has a negative impact on HRQoL, which increased with time after diagnosis. Cardiovascular disease and depression were the strongest associates. Breast cancer survivors report clinically significant improvement in HRQoL scores six years after diagnosis. Co-morbidity has a negative impact on HRQoL, which increases with time after diagnosis, even though the number of co-morbidities remains stable. In long-term survivors there should be increasing awareness of co-morbidity and its impact on HRQoL.
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Affiliation(s)
- Dounya Schoormans
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet , Stockholm , Sweden
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LeMasters TJ, Madhavan SS, Sambamoorthi U, Kurian S. Health behaviors among breast, prostate, and colorectal cancer survivors: a US population-based case-control study, with comparisons by cancer type and gender. J Cancer Surviv 2014; 8:336-48. [PMID: 24532045 DOI: 10.1007/s11764-014-0347-5] [Citation(s) in RCA: 90] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Accepted: 01/24/2014] [Indexed: 12/11/2022]
Abstract
PURPOSE The aim of this study is to compare health behaviors between breast, prostate, female, and male colorectal cancer survivors to noncancer controls, stratified by short- and long-term survivors, and between cancer types and genders. METHODS A 3:1 population-based sample of breast (6,259), prostate (3,609), female colorectal (1,082), and male colorectal (816) cancer survivors from the 2009 Behavioral Risk Factor Surveillance System survey were matched to noncancer controls on age, gender, race/ethnicity, income, insurance, and region of the US. The likelihood of flu immunization, physical check-up, cholesterol check, body mass index (BMI), physical activity, diet (5-A-Day), smoking, and alcohol use were compared between groups using binomial logistic regression models. RESULTS Short-term breast cancer survivors were significantly more likely to meet multiple behavioral recommendations, than controls, but the likelihood decreased in the long term. Breast and female colorectal cancer survivors were up to 2.27 (95 % CI 1.90, 2.71) and 1.89 times more likely (95 % CI 1.60, 2.24) to meet the 5-A-Day and BMI recommendations, up to 0.54 times less likely (95 % CI 0.46, 0.64) to drink any alcohol, but were 0.68 times less likely (95 % CI 0.49, 0.95) to meet the physical activity recommendation, compared to prostate and male colorectal cancer survivors. CONCLUSIONS Some cancer survivors may engage in better health behaviors shortly after diagnosis, but the majority of cancer survivors do not have better health behaviors than individuals without a history of cancer. However, a consistent pattern of behavioral differences exist between male and female cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS Gender differences in health behaviors among cancer survivors may be influenced by perceptions of masculinity/femininity and disease risk. Ongoing health behavioral promotion and disease prevention efforts could be improved by addressing these perceptions.
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Affiliation(s)
- Traci J LeMasters
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA,
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