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Aynalem ZB, Adal AB, Ayele TF, Bayeh GM, Yeshiwas AG, Dessie TM, Tsega TD. Mortality rate and predictors of colorectal cancer patients in Ethiopia: a systematic review and meta-analysis. BMC Cancer 2024; 24:821. [PMID: 38987683 PMCID: PMC11234545 DOI: 10.1186/s12885-024-12597-9] [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: 02/10/2024] [Accepted: 07/03/2024] [Indexed: 07/12/2024] Open
Abstract
INTRODUCTION The incidence of colorectal cancer (CRC) has been increasing in Sub-Saharan countries, including Ethiopia. However, the real mortality rate for CRC patients in Ethiopia has not been established. Therefore, this systematic review and meta-analysis aimed to determine the overall mortality rate and identify predictors among CRC patients in Ethiopia. METHODS PubMed, EMBASE, Web of Science, Scopus, Science Direct, and Google Scholar were searched to identify relevant articles. The preferred reporting items for systematic reviews and meta-analyses (PRISMA) were followed. The quality of the included studies was assessed using the Newcastle-Ottawa Scale Critical Appraisal checklist. A random effect model was used to estimate the pooled mortality rate and adjusted hazard ratio (AHR). Publication bias was assessed using funnel plots and Egger's regression test, while heterogeneity was evaluated through the Cochran Q test and I2 statistics. RESULTS After reviewing 74 articles, only 7 studies met the criteria and were included in the analysis. The analysis revealed that the overall mortality rate among CRC patients in Ethiopia was 40.5% (95% confidence interval [CI]: 32.05, 48.87) while the survival rates at 1 year, 3 years, and 5 years were 82.3% (95% CI: 73.33, 91.31), 48.8% (95% CI: 43.35, 54.32), and 26.6% (95% CI: 21.26, 31.91) respectively. Subgroup analysis indicated that studies conducted after 2017 had higher mortality rates compared to those studied earlier (43.0% vs. 38.2%). Older age (AHR: 1.89, 95% CI: 1.27, 2.82); being married (AHR: 2.53, 95% CI: 1.79, 3.57); having comorbidities (AHR: 1.84, 95% CI: 1.45, 2.35); having high CEA levels (AHR: 2.06, CI: 1.35, 3.13); being in stage II (AHR: 4.13, 95% CI: 1.85, 9.22), III (AHR: 8.62, 95% CI: 3.88, 19.15), and IV (AHR: 8.06, CI: 2.89, 22.49) were the most important predictors. CONCLUSION In Ethiopia, the mortality rate among individuals diagnosed with CRC is high, with two out of five patients dying from this disease. Age, marital status, CEA level, comorbidities, and cancer stage were identified as predictors of mortality in CRC patients. Therefore, early detection and screening should be prioritized, particularly for older patients, those who are married, have comorbidities, elevated CEA levels, and advanced cancer stages.
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Affiliation(s)
- Zewdu Bishaw Aynalem
- Department of Nursing, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia.
| | - Abebaw Bires Adal
- Department of Nursing, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Temesgien Fentahun Ayele
- Department of Nursing, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Gashaw Melkie Bayeh
- Department of Environmental Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Almaw Genet Yeshiwas
- Department of Environmental Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Tadesse Miretie Dessie
- Department of Public Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Tilahun Degu Tsega
- Department of Public Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
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Iheanacho CO, Odili VU, Enakirerhi GE, Isiwele EM, Essiet A. Pattern, Clinical Characteristics, and Impact of Family History on Prostate-Specific Antigen in Prostate Cancer: A Multicenter Study. Am J Mens Health 2024; 18:15579883241264949. [PMID: 39054776 PMCID: PMC11282506 DOI: 10.1177/15579883241264949] [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: 04/14/2024] [Revised: 06/06/2024] [Accepted: 06/10/2024] [Indexed: 07/27/2024] Open
Abstract
Prostate cancer (PCa) is a major cause of illness and death in men of Sub-Sahara African origin. The study assessed the pattern of PCa, the effect of family history on PSA at diagnosis, and clinical characteristics of PCa in Nigeria. A cross-sectional survey of 200 participants was performed within a 12-month period in Nigeria. Data were collected through patients' interview and hospital records and analyzed using SPSS version 25. Descriptive and inferential statistics were performed. P values <.05 were significant. Mean age of 68.5 years was observed among the 200 study participants. Only 64 (32.0%) had a positive immediate family history of PCa, and 61 (30.5%) were not aware of their family cancer history. Most patients 140 (70.0%) had lower urinary tract symptom (LUTS)/lower back pain/leg pain, and the average Gleason score was 7.55 (±0.876). Symptoms of LUTS/lower back pain mostly occurred in patients between 58 and 79 years, while LUTS/leg pain was more common in persons between 60 and 84. Average PSA differed among participants; persons with no family cancer history (M = 143.989; 95% confidence interval [CI] = 114.849-173.129), family history of PCa (M = 165.463; 95% CI = 131.435), family history of cervical cancer (M = 133.456; 95% CI = 49.335-217.576), and persons with no knowledge of their family cancer history (M = 121.546; 95% CI = 89.234-153.857). Univariate one-way (F-Tests) showed that family history of cancer had no significant impact on patients' PSA (R2 = 0.017; adjusted R2 = 0.002; df = 3; F = 1.154; p = .329) at diagnosis. PCa mostly occurred in men within 60 to 70 years of age, and family history of cancer did not predict PSA at diagnosis. Patients presented to health facilities at advanced or metastatic stages. These findings highlight the need for policies and strategies that encourage early PCa screening.
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Affiliation(s)
- Chinonyerem O. Iheanacho
- Department of Clinical Pharmacy and Public Health, Faculty of Pharmacy, University of Calabar, Calabar, Nigeria
| | - Valentine U. Odili
- Department of Pharmacy and Pharmacy Practice, Faculty of Pharmacy, University of Benin, Benin City, Nigeria
| | - Glen E. Enakirerhi
- Department of Urology, University of Calabar Teaching Hospital, Calabar, Nigeria
| | - Edoise M. Isiwele
- Department of Urology, University of Calabar Teaching Hospital, Calabar, Nigeria
| | - Akanimo Essiet
- Department of Urology, University of Calabar Teaching Hospital, Calabar, Nigeria
- Urology Department, Faculty of Clinical Sciences, College of Medical Sciences, University of Calabar, Calabar, Nigeria
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Siech C, Morra S, Scheipner L, Baudo A, Jannello LMI, de Angelis M, Goyal JA, Tian Z, Saad F, Shariat SF, Longo N, Carmignani L, de Cobelli O, Ahyai S, Briganti A, Mandel P, Kluth LA, Chun FKH, Karakiewicz PI. Married Status Affects Rates of Treatment and Mortality in Male and Female Renal Cell Carcinoma Patients Across all Stages. Clin Genitourin Cancer 2024; 22:593-598. [PMID: 38369387 DOI: 10.1016/j.clgc.2024.01.016] [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: 01/08/2024] [Revised: 01/22/2024] [Accepted: 01/25/2024] [Indexed: 02/20/2024]
Abstract
INTRODUCTION The association between treatment rates and cancer specific mortality (CSM) according to married status in male and female clear cell renal cell carcinoma (ccRCC) patients across all stages is unknown. PATIENT AND METHODS Using the Surveillance, Epidemiology, and End Results database (2004-2020), ccRCC patients were stratified according to married status (married vs. unmarried). Logistic regression models addressed treatment rates; Cox regression models addressed CSM rates. RESULTS Of 98,142 patients, 43,999 (72%) males and 20,287 (55%) females were married. In stage-specific analyses, married status independently predicted higher nephrectomy rates in males and females (all P ≤ .03). In stage IV, married status predicted higher systemic therapy rate in males (P < .001), but not in females. In survival analyses, married males exhibited lower CSM rates relative to unmarried males (all P ≤ .02). Conversely, married females exhibited lower CSM rates only in stages I and III (all P ≤ .02), but not in stages II and IV. In subgroup analyses of T1aN0M0 patients, married status was associated with higher partial nephrectomy rates in both males and females (all P ≤ .005). CONCLUSION In ccRCC, married status invariably predicts higher rates of guideline recommended surgical management (nephrectomy and partial nephrectomy). Moreover, even after adjustment for treatment type, married status independently predicted lower CSM rates in males across all stages. However, the effect of married status in females is only operational in stages I and III. Lack of association between married status in stages II and IV may potentially be explained by stronger association with treatment assignment which reduces the residual effect on survival.
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Affiliation(s)
- Carolin Siech
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Goethe University Frankfurt, University Hospital, Department of Urology, Frankfurt am Main, Germany.
| | - Simone Morra
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Lukas Scheipner
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Department of Urology, Medical University of Graz, Graz, Austria
| | - Andrea Baudo
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Department of Urology, IRCCS Policlinico San Donato, Milan, Italy
| | - Letizia M I Jannello
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Department of Urology, IEO European Institute of Oncology, IRCCS, Milan, Italy; Università degli Studi di Milano, Milan, Italy
| | - Mario de Angelis
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Division of Experimental Oncology/Unit of Urology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Jordan A Goyal
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada
| | - Zhe Tian
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada
| | - Fred Saad
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada
| | - Shahrokh F Shariat
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, Weill Cornell Medical College, New York, NY; Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX; Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman, Jordan
| | - Nicola Longo
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Luca Carmignani
- Department of Urology, IRCCS Policlinico San Donato, Milan, Italy; Department of Urology, IRCCS Ospedale Galeazzi - Sant'Ambrogio, Milan, Italy
| | - Ottavio de Cobelli
- Department of Urology, IEO European Institute of Oncology, IRCCS, Milan, Italy; Università degli Studi di Milano, Milan, Italy; Department of Oncology and Haemato-Oncology, Università degli Studi di Milano, Milan, Italy
| | - Sascha Ahyai
- Department of Urology, Medical University of Graz, Graz, Austria
| | - Alberto Briganti
- Division of Experimental Oncology/Unit of Urology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Philipp Mandel
- Goethe University Frankfurt, University Hospital, Department of Urology, Frankfurt am Main, Germany
| | - Luis A Kluth
- Goethe University Frankfurt, University Hospital, Department of Urology, Frankfurt am Main, Germany
| | - Felix K H Chun
- Goethe University Frankfurt, University Hospital, Department of Urology, Frankfurt am Main, Germany
| | - Pierre I Karakiewicz
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada
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Khan S, Fuzzell L, Langston M, Han Y, Moore JX, Gilbert K, Sutcliffe S, Bensen JT, Mohler JL, Fontham ETH, Song L, Lewis-Thames MW. The impact of marital status on tumor aggressiveness, treatment, and screening among black and white men diagnosed with prostate cancer. Cancer Causes Control 2024; 35:531-539. [PMID: 37919455 PMCID: PMC11323108 DOI: 10.1007/s10552-023-01821-9] [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: 08/02/2022] [Accepted: 10/27/2023] [Indexed: 11/04/2023]
Abstract
PURPOSE To examine the association of marital status with prostate cancer outcomes in a racially-diverse cohort. METHODS The study population consisted of men (1010 Black; 1070 White) with incident prostate cancer from the baseline North Carolina-Louisiana Prostate Cancer (PCaP) cohort. Marital status at time of diagnosis and screening history were determined by self-report. The binary measure of marital status was defined as married (including living as married) vs. not married (never married, divorced/separated, or widowed). High-aggressive tumors were defined using a composite measure of PSA, Gleason Score, and stage. Definitive treatment was defined as receipt of radical prostatectomy or radiation. Multivariable logistic regression was used to examine the association of marital status with (1) high-aggressive tumors, (2) receipt of definitive treatment, and (3) screening history among Black and White men with prostate cancer. RESULTS Black men were less likely to be married than White men (68.1% vs. 83.6%). Not being married (vs. married) was associated with increased odds of high-aggressive tumors in the overall study population (adjusted Odds Ratio (aOR): 1.56; 95% Confidence Interval (CI): 1.20-2.02) and both Black and White men in race-stratified analyses. Unmarried men were less likely to receive definitive treatment in the overall study population (aOR: 0.68; 95% CI: 0.54-0.85). In race-stratified analyses, unmarried Black men were less likely to receive definitive treatment. Both unmarried Black and White men were less likely to have a history of prostate cancer screening than married men. CONCLUSION Lower rates of marriage among Black men might signal decreased support for treatment decision-making, symptom management, and caregiver support which could potentially contribute to prostate cancer disparities.
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Affiliation(s)
- Saira Khan
- Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis School of Medicine, 660 South Euclid Avenue, St. Louis, MO, 8100-0094-02300, 63110, USA.
- Epidemiology Program, College of Health Sciences, University of Delaware, 100 Discovery Blvd., 7th floor, Newark, DE, 19713, USA.
| | - Lindsay Fuzzell
- Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Dr. MRC-COEE, Tampa, FL, 33612, USA
| | - Marvin Langston
- Department of Epidemiology and Population Health, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA, 94305, USA
| | - Yunan Han
- Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis School of Medicine, 660 South Euclid Avenue, St. Louis, MO, 8100-0094-02300, 63110, USA
| | - Justin X Moore
- Center for Health Equity Transformation, Department of Behavioral Science, Department of Internal Medicine, Markey Cancer Center, University of Kentucky College of Medicine, 760 Press Avenue, Lexington, KY, 40536, USA
| | - Keon Gilbert
- Department of Behavioral Science and Health Education, College for Public Health and Social Justice, St. Louis, University, 3545 Lafayette Ave., Room 316, St. Louis, MO, 63103, USA
| | - Siobhan Sutcliffe
- Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis School of Medicine, 660 South Euclid Avenue, St. Louis, MO, 8100-0094-02300, 63110, USA
- Alvin J. Siteman Cancer Center, Washington University in St. Louis School of Medicine, 4921 Parkview Place, St. Louis, MO, 63110, USA
| | - Jeannette T Bensen
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina - Chapel Hill, 3130 Bioinformatics Building, CB# 7295, Chapel Hill, NC, 27599, USA
| | - James L Mohler
- Roswell Park Comprehensive Cancer Center, Elm and Carlton St, Buffalo, NY, 14263, USA
| | - Elizabeth T H Fontham
- Department of Epidemiology, School of Public Health, Louisiana State University, 2020 Gravier Street, 3rd Floor, New Orleans, LA, 70112, USA
| | - Lixin Song
- School of Nursing, University of North Carolina - Chapel Hill, Carrington Hall, CB #7460, Chapel Hill, NC, 27599, USA
| | - Marquita W Lewis-Thames
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 750 N. Lake Shore Dr, Chicago, IL, 60611, USA
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Chen N, McGrath CB, Ericsson CI, Vaselkiv JB, Rencsok EM, Stopsack KH, Guard HE, Autio KA, Rathkopf DE, Enting D, Bitting RL, Mateo J, Githiaka CW, Chi KN, Cheng HH, Davis ID, Anderson SG, Badal SAM, Bjartell A, Russnes KM, Heath EI, Pomerantz MM, Henegan JC, Hyslop T, Esteban E, Omlin A, McDermott R, Fay AP, Popoola AA, Ragin C, Nowak J, Gerke T, Kantoff PW, George DJ, Penney KL, Mucci LA. Marital Status, Living Arrangement, and Survival among Individuals with Advanced Prostate Cancer in the International Registry for Men with Advanced Prostate Cancer. Cancer Epidemiol Biomarkers Prev 2024; 33:419-425. [PMID: 38189661 PMCID: PMC10922505 DOI: 10.1158/1055-9965.epi-23-1207] [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: 10/06/2023] [Revised: 11/15/2023] [Accepted: 01/03/2024] [Indexed: 01/09/2024] Open
Abstract
BACKGROUND Studies have shown improved survival among individuals with cancer with higher levels of social support. Few studies have investigated social support and overall survival (OS) in individuals with advanced prostate cancer in an international cohort. We investigated the associations of marital status and living arrangements with OS among individuals with advanced prostate cancer in the International Registry for Men with Advanced Prostate Cancer (IRONMAN). METHODS IRONMAN is enrolling participants diagnosed with advanced prostate cancer (metastatic hormone-sensitive prostate cancer, mHSPC; castration-resistant prostate cancer, CRPC) from 16 countries. Participants in this analysis were recruited between July 2017 and January 2023. Adjusting for demographics and tumor characteristics, the associations were estimated using Cox regression and stratified by disease state (mHSPC, CRPC), age (<70, ≥70 years), and continent of enrollment (North America, Europe, Other). RESULTS We included 2,119 participants with advanced prostate cancer, of whom 427 died during up to 5 years of follow-up (median 6 months). Two-thirds had mHSPC. Most were married/in a civil partnership (79%) and 6% were widowed. Very few married participants were living alone (1%), while most unmarried participants were living alone (70%). Married participants had better OS than unmarried participants [adjusted HR: 1.44; 95% confidence interval (CI): 1.02-2.02]. Widowed participants had the worst survival compared with married individuals (adjusted HR: 1.89; 95% CI: 1.22-2.94). CONCLUSIONS Among those with advanced prostate cancer, unmarried and widowed participants had worse OS compared with married participants. IMPACT This research highlighted the importance of social support in OS within this vulnerable population.
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Affiliation(s)
- Naiyu Chen
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Colleen B. McGrath
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Caroline I. Ericsson
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Jane B. Vaselkiv
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Emily M. Rencsok
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Harvard-MIT Division of Health Sciences and Technology, Harvard Medical School, Boston, MA, USA
| | - Konrad H. Stopsack
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Hannah E. Guard
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Karen A. Autio
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Dana E. Rathkopf
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | | | - Joaquin Mateo
- Vall d’Hebron Institute of Oncology (VHIO), Vall d’Hebron University Hospital Campus, Barcelona, Spain
| | | | - Kim N. Chi
- BC Cancer, Vancouver, British Columbia, Canada
| | - Heather H. Cheng
- University of Washington and Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Ian D. Davis
- Monash University Faculty of Medicine, Melbourne, Australia
- Eastern Health, Melbourne, Australia
| | - Simon G. Anderson
- The Glasgow-Caribbean Centre for Development Research and the Caribbean Institute of Health Research, The University of the West Indies, Bridgetown, Barbados
- African–Caribbean Cancer Consortium, Philadelphia, PA, USA
| | - Simone Ann Marie Badal
- African–Caribbean Cancer Consortium, Philadelphia, PA, USA
- The University of the West Indies Mona, Kingston, Jamaica
| | - Anders Bjartell
- Department of Urology, Skåne University Hospital, Malmö, Sweden
| | | | - Elisabeth I. Heath
- Barbara Ann Karmanos Cancer Institute, Wayne State University, Detroit, MI, USA
| | - Mark M. Pomerantz
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - John C. Henegan
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Terry Hyslop
- Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | - Emilio Esteban
- Department of Medical Oncology, Hospital Universitario Central of Asturias, ISPA, Oviedo, Spain
| | | | - Ray McDermott
- St Vincent’s University Hospital & Cancer Trials Ireland, Dublin, Ireland
| | - Andre P. Fay
- PUCRS School of Medicine, Hospital Nora Teixeira, Porto Alegre, Brazil
| | | | - Camille Ragin
- African–Caribbean Cancer Consortium, Philadelphia, PA, USA
- Fox Chase Cancer Center, Philadelphia, PA
| | | | - Travis Gerke
- Prostate Cancer Clinical Trials Consortium, New York, NY, USA
| | - Philip W. Kantoff
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Kathryn L. Penney
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Lorelei A. Mucci
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
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Zhou D, Yang YJ, Niu CC, Yu YJ, Diao JD. Marital status is an independent prognostic factor for cervical adenocarcinoma: A population-based study. Medicine (Baltimore) 2023; 102:e33597. [PMID: 37083782 PMCID: PMC10118355 DOI: 10.1097/md.0000000000033597] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 03/31/2023] [Indexed: 04/22/2023] Open
Abstract
Marriage has been reported as a beneficial factor associated with improved survival among cancer patients, but conflicting results have been observed in cervical adenocarcinoma (AC). Thus, this study is aimed to examine the relationship between the prognosis of cervical AC and marital status. Eligible patients were selected from 2004 to 2015 using the surveillance, epidemiology and end results (SEER) database. Cancer-specific survival (CSS) and overall survival (OS) were compared between married and unmarried groups. A total of 3096 patients had been identified, with married ones accounting for 51.29% (n = 1588). Compared to unmarried groups, more patients in the married group were relatively younger (aged ≤ 45) and belonged to white race, with grade I/II, Federation of International of Gynecologists and Obstetricians (FIGO) stage I/II and tumor size ≤4 cm. Apart from that, more patients received surgery, whereas fewer patients received chemotherapy and radiotherapy (all P < 0.05). The 5-year CSS and OS rates were 80.16% and 78.26% in married patients, 68.58% and 64.62% in the unmarried group (P < .0001). Multivariate analysis showed that marital status was an independent prognostic factor, and the married group performed better CSS (hazard ratio [HR]: 0.770; 95% confidence interval [CI]: 0.663-0.895; P = .001) as well as OS (HR: 0.751; 95%CI: 0.653-0.863; P < .001). As demonstrated by the results of subgroup analysis, married patients had better CSS and OS survival than unmarried ones in nearly all the subgroups. Marital status was identified as an independent prognostic factor for improved survival in patients with cervical AC.
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Affiliation(s)
- Di Zhou
- Department of Oncology and Hematology, China-Japan Union Hospital of Jilin University, Changchun Jilin, China
| | - Yong-Jing Yang
- Department of Radiation Oncology, Jilin Cancer Hospital, Changchun, Jilin, China
| | - Chun-Cao Niu
- Department of Oncology and Hematology, China-Japan Union Hospital of Jilin University, Changchun Jilin, China
| | - Yong-Jiang Yu
- Department of Endocrinology, Affiliated Hospital of Changchun University of Traditional Chinese Medicine, Changchun, Jilin, China
| | - Jian-Dong Diao
- Department of Oncology and Hematology, China-Japan Union Hospital of Jilin University, Changchun Jilin, China
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Walsh EA, Boland CL, Popok PJ, Pedreira PB, Fox RS, Moreno PI, Yanez B, Penedo FJ. Marital status and perceived stress in men with advanced prostate cancer: A randomized-controlled trial of cognitive behavioral stress management. J Psychosom Res 2023; 167:111198. [PMID: 36812663 PMCID: PMC10023351 DOI: 10.1016/j.jpsychores.2023.111198] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 02/09/2023] [Accepted: 02/13/2023] [Indexed: 02/17/2023]
Abstract
OBJECTIVE Relationship status predicts numerous outcomes among medical populations. Few interventions evaluate the role of marital status on response to psychosocial treatment, and no such studies exist within advanced prostate cancer (APC). This study examined whether marital status modified the effect of a cognitive behavioral stress management (CBSM) intervention on perceived stress. METHODS Men with APC (N = 190) were randomized to 10-week CBSM or a health promotion (HP) intervention (#NCT03149185). The Perceived Stress Scale assessed perceived stress at baseline and 12-month follow-up. Medical status and sociodemographics were captured at enrollment. RESULTS Participants were mostly White (59.5%), non-Hispanic (97.4%), heterosexual (97.4%) men, 66.8% of whom were partnered. Neither condition nor marital status predicted perceived stress change at follow-up. However, a significant interaction was found between condition and marital status (p = 0.014; Cohen's f = 0.07), such that partnered men who received CBSM and unpartnered men who received HP reported greater reductions in perceived stress. CONCLUSION This is the first study to assess the impact of marital status on psychosocial intervention effects among men with APC. Partnered men derived greater benefit from a cognitive-behavioral intervention and unpartnered men equally benefitted from a HP intervention. Further research is necessary to understand the mechanisms underlying these relationships.
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Affiliation(s)
- Emily A Walsh
- Department of Psychology, University of Miami, Coral Gables, FL, United States of America.
| | - Cody L Boland
- Department of Psychology, University of Miami, Coral Gables, FL, United States of America
| | - Paula J Popok
- Department of Psychology, University of Miami, Coral Gables, FL, United States of America
| | - Patricia B Pedreira
- Department of Psychology, University of Miami, Coral Gables, FL, United States of America
| | - Rina S Fox
- University of Arizona, College of Nursing, Tucson, AZ, United States of America
| | - Patricia I Moreno
- University of Miami, Sylvester Comprehensive Cancer Center, Miami, FL, United States of America; Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, United States of America
| | - Betina Yanez
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America
| | - Frank J Penedo
- Department of Psychology, University of Miami, Coral Gables, FL, United States of America; University of Miami, Sylvester Comprehensive Cancer Center, Miami, FL, United States of America
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8
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Prospective Predictors of Blood Pressure Among African American Men Living with HIV. J Racial Ethn Health Disparities 2023; 10:168-175. [PMID: 35048309 DOI: 10.1007/s40615-021-01207-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 12/03/2021] [Accepted: 12/06/2021] [Indexed: 02/03/2023]
Abstract
Little is known about the predictors of blood pressure (BP) among African American men living with HIV. We examined whether age and body mass index (BMI) are associated with higher blood pressure (BP) and whether being married and muscular endurance are associated with lower BP among African American men living with HIV. Second, we examined whether being married moderated the effects of the other predictors on BP. Finally, we examined whether BMI mediated the relationship between muscular endurance and BP. This article is a prospective secondary analysis of data from a randomized controlled trial of a health-promotion intervention for African American men living with HIV. We measured the participants' BP pre-intervention and three, six, and 12 months post-intervention. Generalized estimating equations linear regression analyses examined whether marital status, age, BMI, and muscular endurance predicted BP post-intervention, adjusting for pre-intervention BP and the intervention. Older age, higher BMI, and lower muscular endurance predicted higher BP post-intervention, adjusting for the intervention and baseline BP. Although marital status did not predict post-intervention BP, it moderated the negative effect of higher BMI. The positive relation of BMI to BP was weaker among married men than unmarried men. Muscular endurance had an indirect impact on BP mediated through BMI. Public health efforts targeting older African American men with HIV should focus on increasing muscular endurance in this population to lower BMI as a strategy to reduce cardiovascular disease risk in this population.
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Vyas N, Brunckhorst O, Fox L, Van Hemelrijck M, Muir G, Stewart R, Dasgupta P, Ahmed K. Undergoing radical treatment for prostate cancer and its impact on wellbeing: A qualitative study exploring men's experiences. PLoS One 2022; 17:e0279250. [PMID: 36525457 PMCID: PMC9757548 DOI: 10.1371/journal.pone.0279250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 12/03/2022] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Quality of life in prostate cancer survivorship is becoming increasingly important, with mental and social wellbeing recognised as key components. However, limited global evaluation of psychosocial challenges experienced after treatment exists. Therefore, we aimed to explore the lived experiences of men who underwent radical treatment, and its psychosocial impact. MATERIAL AND METHODS This qualitative study was conducted using 19 men who had undergone radical treatment (prostatectomy or radiotherapy) for their cancer. Semi-structured interviews were conducted exploring lived experiences of men after treatment. A Structured thematic analysis of collected data was undertaken, with an inductive co-construction of themes through the lens of the biopsychosocial model. Themes generated were considered within a psychological, social, and physical wellbeing framework. RESULTS An initial knowledge gap meant mental wellbeing was strongly impacted initially leading to a 'Diagnostic Blow and the Search for Clarity'. Doubt over individuals' future resulted in 'An Uncertain Future' in many men. Once treatment was completed a 'Reflective journey' began, with men considering their outcomes and decisions made. Social wellbeing was also impacted with many identifying the 'Emotional Repercussions' on their relationships and the impact their diagnosis had on their partner and family. Many subsequently sought to increase their support through 'The Social Network and Advocacy', while physical changes led to an increased need for 'Social Planning'. Finally, physical wellbeing was highlighted by a continual acknowledgement of the 'Natural process of ageing' leading to a reluctancy to seek help, whilst simultaneously attempting to improve existing health via 'The Health Kick'. CONCLUSIONS Radical treatments have a considerable impact on mental and social wellbeing of individuals. Anxiety after diagnosis and significant uncertainty over individual futures exist, with physical complications of treatment leading to social repercussions. Future research should aim to identify forms of support to improve quality of life of these men.
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Affiliation(s)
- Neel Vyas
- MRC Centre for Transplantation, Guy’s Hospital Campus, King’s College London, King’s Health Partners, London, United Kingdom
| | - Oliver Brunckhorst
- MRC Centre for Transplantation, Guy’s Hospital Campus, King’s College London, King’s Health Partners, London, United Kingdom
| | - Louis Fox
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London, United Kingdom
| | - Mieke Van Hemelrijck
- Translational Oncology and Urology Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London, London, United Kingdom
| | - Gordon Muir
- Department of Urology, King’s College Hospital, London, United Kingdom
| | - Robert Stewart
- King’s College London Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Prokar Dasgupta
- MRC Centre for Transplantation, Guy’s Hospital Campus, King’s College London, King’s Health Partners, London, United Kingdom
- Urology Centre, Guy’s and St. Thomas’ NHS Foundation Trust, King’s Health Partners, London, United Kingdom
| | - Kamran Ahmed
- MRC Centre for Transplantation, Guy’s Hospital Campus, King’s College London, King’s Health Partners, London, United Kingdom
- Department of Urology, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
- Khalifa University, Abu Dhabi, United Arab Emirates
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10
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Pan S, Yan N, Zhao Y, Li Z. Marital status as an independent prognostic factor for patients of malignant pleural mesothelioma. Front Med (Lausanne) 2022; 9:955619. [PMID: 36341233 PMCID: PMC9633843 DOI: 10.3389/fmed.2022.955619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 09/30/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives The prognostic impact of marital status on malignant pleural mesothelioma (MPM) is not investigated. This paper probes into the relationship between the prognosis of MPM and marital status. Materials and methods The Surveillance, Epidemiology, and End Results (SEER) database of American had been applied to choose eligible patients over the 2004–2015 periods. Moreover, cancer-specific survival (CSS) and overall survival (OS) of unmarried and married groups were compared. Results A total of 3,997 patients in total had been identified, including 2,735 (68.43%) married patients. In comparison to unmarried patients, married ones tended to be younger, male, white, and received active treatment (surgery, chemotherapy, or radiotherapy). In addition, the 1, 3, and 5-year CSS rates were 44.40, 12.09, and 6.88% in married patients, while 35.75, 12.12, and 6.37% in unmarried group (p = 0.0014). At the same time, the 1, 3, and 5-year OS rates were 41.84, 10.56, and 5.91% in married patients, while 33.67, 10.44, and 4.93%, respectively, in the unmarried group (p < 0.0001). As revealed by the multivariate analysis results, the marital status was an independent favorable prognostic factor, in which the married groups showed better CSS [hazard ratio (HR): 0.870; 95% confidence interval (CI): 0.808–0.938; p < 0.001] as well as OS (HR: 0.871; 95% CI: 0.810–0.936; p < 0.001). According to the results of subgroup analysis, the CSS and OS survival of married groups were better than the unmarried groups in almost all the subgroups. Conclusion Marital status is an independent favorable prognostic indicator of MPM. Poor prognosis in unmarried patients is likely to be related to insufficient treatments and socioeconomic and psychosocial factors.
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11
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Nyame YA, Cooperberg MR, Cumberbatch MG, Eggener SE, Etzioni R, Gomez SL, Haiman C, Huang F, Lee CT, Litwin MS, Lyratzopoulos G, Mohler JL, Murphy AB, Pettaway C, Powell IJ, Sasieni P, Schaeffer EM, Shariat SF, Gore JL. Deconstructing, Addressing, and Eliminating Racial and Ethnic Inequities in Prostate Cancer Care. Eur Urol 2022; 82:341-351. [PMID: 35367082 DOI: 10.1016/j.eururo.2022.03.007] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 02/24/2022] [Accepted: 03/10/2022] [Indexed: 12/24/2022]
Abstract
CONTEXT Men of African ancestry have demonstrated markedly higher rates of prostate cancer mortality than men of other races and ethnicities around the world. In fact, the highest rates of prostate cancer mortality worldwide are found in the Caribbean and Sub-Saharan West Africa, and among men of African descent in the USA. Addressing this inequity in prostate cancer care and outcomes requires a focused research approach that creates durable solutions to address the structural, social, environmental, and health factors that create racial disparities in care and outcomes. OBJECTIVE To introduce a conceptual model for evaluating racial inequities in prostate cancer care to facilitate the development of translational research studies and interventions. EVIDENCE ACQUISITION A collaborative review of literature relevant to racial inequities in prostate cancer care and outcomes was performed. Existing literature was used to highlight various components of the conceptual model to inform future research and interventions toward equitable care and outcomes. EVIDENCE SYNTHESIS Racial inequities in prostate cancer outcomes are driven by a series of structural and social determinants of health that impact exposures, mediators, and outcomes. Social determinants of equity, such as laws/policies, economic systems, and structural racism, affect the inequitable access to environmental and neighborhood exposures, in addition to health care access. Although the incidence disparity remains problematic, various studies have demonstrated parity in outcomes when social and health factors, such as access to equitable care, are normalized. Few studies have tested interventions to reduce inequities in prostate cancer among Black men. CONCLUSIONS Worldwide, men of African ancestry demonstrate worse outcomes in prostate cancer, a phenomenon driven largely by social factors that inform biologic, environmental, and health care risks. A conceptual model was presented that organizes the many factors that influence prostate cancer incidence and mortality. Within that framework, we must understand the current state of inequities in clinical prostate cancer practice, the optimal state of what equitable practice would be, and how achieving equity in prostate cancer care balances costs, benefits, and harms. More robust characterization of the sources of prostate cancer inequities should inform testing of ambitious and innovative interventions as we work toward equity in care and outcomes. PATIENT SUMMARY Men of African ancestry demonstrate the highest rates of prostate cancer mortality, which may be reduced through social interventions. We present a framework for formalizing the identification of the drivers of prostate cancer inequities to facilitate the development of interventions and trials to eradicate them.
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Affiliation(s)
- Yaw A Nyame
- Department of Urology, University of Washington Medical Center, Seattle, WA, USA; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
| | - Matthew R Cooperberg
- Department of Urology, University of California at San Francisco, San Francisco, CA, USA
| | | | - Scott E Eggener
- Department of Urology, University of Chicago, Chicago, IL, USA
| | - Ruth Etzioni
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Scarlett L Gomez
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Christopher Haiman
- Department of Preventive Medicine, Center for Genetic Epidemiology, University of Southern California, Los Angeles, CA, USA
| | - Franklin Huang
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Cheryl T Lee
- Department of Urology, The Ohio State University, Columbus, OH, USA
| | - Mark S Litwin
- Department of Urology, University of California Los Angeles, Los Angeles, CA, USA
| | - Georgios Lyratzopoulos
- Epidemiology of Cancer Healthcare & Outcomes, Institute of Epidemiology & Health Care, University College London, London, UK
| | - James L Mohler
- Department of Urology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Adam B Murphy
- Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Curtis Pettaway
- Department of Urology, M.D. Anderson Cancer Center, The University of Texas, Houston, TX, USA
| | - Isaac J Powell
- Department of Urology, Wayne State University, Detroit, MI, USA
| | - Peter Sasieni
- Cancer Research UK & King's College London Cancer Prevention Trials Unit, King's College London, London, UK
| | - Edward M Schaeffer
- Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Shahrokh F Shariat
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan; Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia; Department of Urology, Weill Cornell Medical College, New York, NY, USA; Department of Urology, University of Texas Southwestern, Dallas, TX, USA
| | - John L Gore
- Department of Urology, University of Washington Medical Center, Seattle, WA, USA; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
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12
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Husaini DC, Harris-Thurton L, Brown NT, Enriquez LS, Novelo JC, Pot SV, Humes A. Prostate cancer awareness, knowledge, and perception of screening among men aged 40–70 in the Belize district. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-021-01527-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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13
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Zhang L, Zhou B, Luo P, Xu A, Han W, Wei Z. A model established using marital status and other factors from the Surveillance, Epidemiology, and End Results database for early stage gastric cancer. J Investig Med 2022; 70:1373-1380. [PMID: 35790416 PMCID: PMC9380518 DOI: 10.1136/jim-2021-002285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2022] [Indexed: 01/19/2023]
Abstract
Currently, the postoperative prognosis of early stage gastric cancer (GC) is difficult to accurately predict. In particular, social factors are not frequently used in the prognostic assessment of early stage GC. Therefore, this study aimed to combine the clinical indicators and social factors to establish a predictive model for early stage GC based on a new scoring system. A total of 3647 patients with early stage GC from the Surveillance, Epidemiology, and End Results database were included in this study. A Kaplan-Meier survival analysis was used to compare differences in prognosis between different marital status, as an innovative prognostic indicator. Univariate and multivariate analyses were used to screen available prediction factors and then build a nomogram using the Cox proportional hazard regression model. The univariate analysis and multivariate analysis revealed that age at diagnosis, sex, histology, stage_T, surgery, tumor size, and marital status were independent prognostic factors of overall survival. Both the C-index and calibration curves confirmed that the nomogram had a great predictive effect on patient prognosis in training and testing sets. This nomogram based on clinical indicators and marital status can effectively help patients with early stage GC in the future.
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Affiliation(s)
- Lixiang Zhang
- General Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Baichuan Zhou
- General Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Panquan Luo
- General Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Aman Xu
- General Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Wenxiu Han
- General Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Zhijian Wei
- General Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
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14
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Krajc K, Miroševič Š, Sajovic J, Klemenc Ketiš Z, Spiegel D, Drevenšek G, Drevenšek M. Marital status and survival in cancer patients: A systematic review and meta-analysis. Cancer Med 2022; 12:1685-1708. [PMID: 35789072 PMCID: PMC9883406 DOI: 10.1002/cam4.5003] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 06/13/2022] [Accepted: 06/13/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND In recent years, authors have repeatedly reported on the significance of social support in cancer survival. Although overall the studies appear to be convincing, little is known about which types of social support promote better survival rates, and which subgroups of cancer patients are more susceptible to the benefits of it. The aim of this study was to identify, organize, and examine studies reporting on the significance of social support in cancer survival. METHODS The PubMed, CINAHL and EBSCO databases were searched using the keywords social support/marital status, cancer, and survival/mortality. Where possible we used a meta-analytical approach, specifically a random effect model, in order to combine the results of the hazard ratios in studies from which this information could be obtained. When interpreting clinical relevance, we used the number needed to treat (NNT). RESULTS Better survival was observed in married patients when compared to unmarried (single, never-married, divorced/separated, and widowed) in overall and cancer-specific survival. Gender group differences showed that the association was statistically significant only in cancer-specific survival when comparing divorced/separated male and female cancer patients (p < 0.001), thus confirming results from the previous meta-analysis. CONCLUSIONS Being unmarried is associated with significantly worse overall and cancer-specific survival. The most vulnerable group found in our study were divorced/separated men. The results of this review can motivate physicians, oncologists, and other healthcare professionals to be aware of the importance of patients' social support, especially in the identified sub-group.
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Affiliation(s)
- Kaja Krajc
- Faculty of Mathematics, Natural Sciences and Information TechnologiesUniversity of PrimorskaKoperSlovenia
| | - Špela Miroševič
- Department of Family Medicine, Faculty of MedicineUniversity of LjubljanaLjubljanaSlovenia
| | - Jakob Sajovic
- Department of StomatologyUniversity Medical Centre LjubljanaLjubljanaSlovenia
| | - Zalika Klemenc Ketiš
- Department of Family Medicine, Faculty of MedicineUniversity of LjubljanaLjubljanaSlovenia,Department of Family Medicine, Faculty of MedicineUniversity of MariborMariborSlovenia,Community Health Centre LjubljanaLjubljanaSlovenia
| | - David Spiegel
- Department of Psychiatry and Behavioural SciencesStanford University School of MedicineStanfordCaliforniaUSA
| | - Gorazd Drevenšek
- Institute of Pharmacology and Experimental Toxicology, Faculty of Medicine LjubljanaUniversity of LjubljanaLjubljanaSlovenia
| | - Martina Drevenšek
- Department of StomatologyUniversity Medical Centre LjubljanaLjubljanaSlovenia
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15
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McGillivray HMK, Piccolo EEL, Wassersug RJ. "Partner", "Caregiver", or "Co-Survivor"-Might the Label We Give the Partners of Cancer Patients Affect the Health Outcome of the Patients and Their Partners? Curr Oncol 2021; 29:122-129. [PMID: 35049684 PMCID: PMC8774593 DOI: 10.3390/curroncol29010010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/17/2021] [Accepted: 12/24/2021] [Indexed: 11/17/2022] Open
Abstract
Having a life partner significantly extends survival for most cancer patients. The label given to the partners of cancer patients may, however, influence the health of not just the patients but their partners. "Caregiver" is an increasingly common label for the partners of patients, but it carries an implicit burden. Referring to partners as "caregivers" may be detrimental to the partnerships, as it implies that the individuals are no longer able to be co-supportive. Recognizing this, there has been some effort to relabel cancer dyads as "co-survivors". However, many cancer patients are not comfortable being called a "survivor", and the same may apply to their partners. Cancer survivorship, we argue, could be enhanced by helping keep the bond between patients and their partners strong. This includes educating patients and partners about diverse coping strategies that individuals use when facing challenges to their health and wellbeing. We suggest that preemptive couples' counselling in cancer centers may benefit both patients and their partners.
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Affiliation(s)
| | | | - Richard J. Wassersug
- Department of Cellular and Physiological Sciences, Faculty of Medicine, The University of British Columbia, Vancouver, BC V6T 1Z3, Canada
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16
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Zhou X, Qiu S, Jin K, Yuan Q, Jin D, Zhang Z, Zheng X, Li J, Wei Q, Yang L. Predicting Cancer-Specific Survival Among Patients With Prostate Cancer After Radical Prostatectomy Based on the Competing Risk Model: Population-Based Study. Front Surg 2021; 8:770169. [PMID: 34901145 PMCID: PMC8660757 DOI: 10.3389/fsurg.2021.770169] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 11/08/2021] [Indexed: 02/05/2023] Open
Abstract
Introduction: We aimed to develop an easy-to-use individual survival prognostication tool based on competing risk analyses to predict the risk of 5-year cancer-specific death after radical prostatectomy for patients with prostate cancer (PCa). Methods: We obtained the data from the Surveillance, Epidemiology, and End Results (SEER) database (2004–2016). The main variables obtained included age at diagnosis, marital status, race, pathological extension, regional lymphonode status, prostate specific antigen level, pathological Gleason Score. In order to reveal the independent prognostic factors. The cumulative incidence function was used as the univariable competing risk analyses and The Fine and Gray's proportional subdistribution hazard approach was used as the multivariable competing risk analyses. With these factors, a nomogram and risk stratification based on the nomogram was established. Concordance index (C-index) and calibration curves were used for validation. Results: A total of 95,812 patients were included and divided into training cohort (n = 67,072) and validation cohort (n = 28,740). Seven independent prognostic factors including age, race, marital status, pathological extension, regional lymphonode status, PSA level, and pathological GS were used to construct the nomogram. In the training cohort, the C-index was 0.828 (%95CI, 0.812–0.844), and the C-index was 0.838 (%95CI, 0.813–0.863) in the validation cohort. The results of the cumulative incidence function showed that the discrimination of risk stratification based on nomogram is better than that of the risk stratification system based on D'Amico risk stratification. Conclusions: We successfully developed the first competing risk nomogram to predict the risk of cancer-specific death after surgery for patients with PCa. It has the potential to help clinicians improve post-operative management of patients.
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Affiliation(s)
- Xianghong Zhou
- Department of Urology, National Clinical Research Center for Geriatrics and Center of Biomedical Big Data, Institute of Urology, West China Hospital of Sichuan University, Chengdu, China
| | - Shi Qiu
- Department of Urology, National Clinical Research Center for Geriatrics and Center of Biomedical Big Data, Institute of Urology, West China Hospital of Sichuan University, Chengdu, China
| | - Kun Jin
- Department of Urology, National Clinical Research Center for Geriatrics and Center of Biomedical Big Data, Institute of Urology, West China Hospital of Sichuan University, Chengdu, China
| | - Qiming Yuan
- Department of Urology, National Clinical Research Center for Geriatrics and Center of Biomedical Big Data, Institute of Urology, West China Hospital of Sichuan University, Chengdu, China
| | - Di Jin
- Department of Urology, National Clinical Research Center for Geriatrics and Center of Biomedical Big Data, Institute of Urology, West China Hospital of Sichuan University, Chengdu, China
| | - Zilong Zhang
- Department of Urology, National Clinical Research Center for Geriatrics and Center of Biomedical Big Data, Institute of Urology, West China Hospital of Sichuan University, Chengdu, China
| | - Xiaonan Zheng
- Department of Urology, National Clinical Research Center for Geriatrics and Center of Biomedical Big Data, Institute of Urology, West China Hospital of Sichuan University, Chengdu, China
| | - Jiakun Li
- Department of Urology, National Clinical Research Center for Geriatrics and Center of Biomedical Big Data, Institute of Urology, West China Hospital of Sichuan University, Chengdu, China
| | - Qiang Wei
- Department of Urology, National Clinical Research Center for Geriatrics and Center of Biomedical Big Data, Institute of Urology, West China Hospital of Sichuan University, Chengdu, China
| | - Lu Yang
- Department of Urology, National Clinical Research Center for Geriatrics and Center of Biomedical Big Data, Institute of Urology, West China Hospital of Sichuan University, Chengdu, China
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17
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Efficacy and Prognostic Factors of Androgen Deprivation Therapy Combined with Radiation Therapy for Prostate Cancer. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:2237069. [PMID: 34795779 PMCID: PMC8595001 DOI: 10.1155/2021/2237069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 10/15/2021] [Indexed: 11/29/2022]
Abstract
Objective To analyze the efficacy of androgen deprivation therapy (ADT) combined with radiation therapy (also known as radiotherapy) for prostate cancer. Methods The clinical data of 94 prostate cancer patients treated in the Oncology Department of Xiangzhou People's Hospital from January 2017 to January 2018 were retrospectively analyzed, and the patients were divided into the combined group and the reference group according to their admission order, with 47 cases each. The patients in the reference group only received the radiotherapy, and on this basis, those in the combined group accepted ADT, so as to evaluate the efficacy of different treatment methods by comparing the patients' serum total prostate-specific antigen (T-PSA), vascular endothelial growth factor (VEGF), and other indicators and analyze the relevant factors affecting patients' prognosis by Cox single-factor and multi-factor regression models. Results Compared with the reference group after treatment, the patients in the combined group obtained significantly lower T-PSA and VEGF levels (P < 0.001), significantly higher objective remission rate and disease control rate (P < 0.05), and remarkably longer modified progression-free survival (mPFS) and overall survival (OS) (P < 0.001), and after the multi-factor research, it was found that the Gleason score of 8–10, positive lymphatic metastasis, and single radiotherapy were the factors affecting the clinical prognosis of prostate cancer. Conclusion Combining ADT with radiotherapy ensures a better survival benefit for prostate cancer patients and has a fairly well efficacy. Further study will be conducive to establishing a better solution for such patients.
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18
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Alyabsi M, Ramadan M, Algarni M, Alshammari K, Jazieh AR. The effect of marital status on stage at diagnosis and survival in Saudis diagnosed with colorectal cancer: cancer registry analysis. Sci Rep 2021; 11:8603. [PMID: 33883627 PMCID: PMC8060407 DOI: 10.1038/s41598-021-88042-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 04/07/2021] [Indexed: 12/17/2022] Open
Abstract
Colorectal cancer (CRC) is the most common cancer in males and third in females in Saudi Arabia, with the majority (66%) diagnosed at a late stage. We evaluated the effect of marital status on stage at diagnosis and CRC survival. We hypothesized that married patients would be more likely to present at an early stage and have higher survival than unmarried patients. The Ministry of National Guard-Health Affairs (MNG-HA) cancer registry was used to identify patients diagnosed with CRC from 2009 to 2017. A competing risk analysis was performed to assess the 5-year CRC-specific survival, adjusting for potential confounders. The Kaplan-Meier method and the Cox regressions were used to assess survival. Two-thirds (76.50%) of the 936 CRC patients were married, 11.64% were unmarried, and 11.86% had an unknown marital status. With multiple imputation-based analysis, the multivariate analysis indicated that unmarried patients were 52% more likely to present at an advanced stage [adjusted odds ratio (aOR) 1.52; 95% CI 1.33-1.73], and had a 30% higher risk of death due to CRC compared to the married patients (aHR 1.30; CI 1.17, 1.44). Future CRC screening and survivorship programs should assess the needs of the vulnerable unmarried population. Interventions supporting the early detection of CRC in this population may be beneficial in the long term and lead to improved cancer outcomes.
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Affiliation(s)
- Mesnad Alyabsi
- Population Health Research Section, King Abdullah International Medical Research Center, P.O. Box 22490, Riyadh, 11426, Saudi Arabia.
- King Saud Bin Abdulaziz University for Health Sciences, P.O. Box 22490, Riyadh, 11426, Saudi Arabia.
| | - Majed Ramadan
- Population Health Research Section, King Abdullah International Medical Research Center, King Abdul Aziz Medical City, Jeddah, 22384, Saudi Arabia
- King Saud Bin Abdulaziz University for Health Sciences, P.O. Box 22490, Riyadh, 11426, Saudi Arabia
| | - Mohammed Algarni
- Oncology Department, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
- King Saud Bin Abdulaziz University for Health Sciences, P.O. Box 22490, Riyadh, 11426, Saudi Arabia
- King Abdullah International Medical Research Center, P.O. Box 22490, Riyadh, 11426, Saudi Arabia
| | - Kanan Alshammari
- Oncology Department, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
- King Saud Bin Abdulaziz University for Health Sciences, P.O. Box 22490, Riyadh, 11426, Saudi Arabia
- King Abdullah International Medical Research Center, P.O. Box 22490, Riyadh, 11426, Saudi Arabia
| | - Abdul Rahman Jazieh
- Oncology Department, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
- King Saud Bin Abdulaziz University for Health Sciences, P.O. Box 22490, Riyadh, 11426, Saudi Arabia
- King Abdullah International Medical Research Center, P.O. Box 22490, Riyadh, 11426, Saudi Arabia
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19
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Feng L, Yang YJ, Du J, Yu YJ, Diao JD. Marital status and survival of patients with colorectal signet ring cell carcinoma: a population-based study. Sci Rep 2020; 10:17881. [PMID: 33087758 PMCID: PMC7578023 DOI: 10.1038/s41598-020-74720-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 10/05/2020] [Indexed: 12/15/2022] Open
Abstract
The prognostic role of marital status on colorectal signet ring cell carcinoma (SRCC) has not been studied. In this study, the correlation of marital status with prognosis of colorectal SRCC was analyzed. Eligible subjects were extracted from the Surveillance, Epidemiology, and End Results (SEER) dataset from 2004 to 2015, followed by comparison of cancer-specific survival (CSS) and overall survival (OS) between married and unmarried group. 3152 patients were identified including 1777 married patients (56.38%). Married populations tended to be more patients aged < 65, male, receiving chemotherapy, and less black race and large tumor size compared to unmarried group (all P < 0.05).Moreover, 5-year CSS (30.04% vs. 28.19%, P = 0.0013) and OS rates (26.68% vs. 22.94%, P < 0.0001) were superior in married population. Multivariate analysis revealed that marital status was an independent favorable prognostic indicator, and married population had better CSS (HR: 0.898; 95% CI: 0.822–0.980; P = 0.016) and OS (HR: 0.898; 95%CI: 0.827–0.975; P = 0.011).In addition, CSS as well as OS were superior in married populations than unmarried ones in most subgroups. Marital status was an independent prognostic factor for survival in patients with colorectal SRCC. Additionally, married patients obtained better survival advantages.
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Affiliation(s)
- Li Feng
- Department of Radiation Oncology, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
| | - Yong-Jing Yang
- Department of Radiation Oncology, Jilin Cancer Hospital, Changchun, Jilin, China
| | - Juan Du
- Department of Medical Oncology, Jilin Cancer Hospital, Changchun, Jilin, China
| | - Yong-Jiang Yu
- Department of Endocrinology, Affiliated Hospital of Changchun University of Traditional Chinese Medicine, Changchun, Jilin, China
| | - Jian-Dong Diao
- Department of Oncology and Hematology, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China.
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Mathew S, Rapsey CM, Wibowo E. Psychosocial Barriers and Enablers for Prostate Cancer Patients in Starting a Relationship. JOURNAL OF SEX & MARITAL THERAPY 2020; 46:736-746. [PMID: 32835628 DOI: 10.1080/0092623x.2020.1808549] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Single prostate cancer (PCa) patients may face difficulties in starting a new relationship for various reasons. Here, we studied barriers and enablers to starting a relationship for PCa patients and characteristics of patients who were and were not in a relationship. PCa organizations distributed for us a 20-minute online survey, consisting of validated questionnaires (on treatment side effects, loneliness, social provision, and shyness) and questions on factors identified by patients as barriers and enablers to forming a new relationship. Participants were either single [n = 20] or had started a new relationship post-diagnosis [non-single, n = 15]. Three factors-confidence, sexual function, finding the right person-were perceived of as factors that can affect starting a relationship. Fourteen of twenty single patients were confident that they could find a partner and sixteen were comfortable in disclosing their cancer diagnosis to a potential partner. Non-single patients met their partners through various ways, including online dating and social events. They all revealed their cancer status prior to starting the relationship, and most partners reacted well to this disclosure. Single patients were lacking emotional support, more shy, and lonelier than non-single patients. Clinicians need to consider biopsychosocial factors when advising single patients who wish to start a new relationship.
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Affiliation(s)
- Sandra Mathew
- Department of Anatomy, University of Otago, Dunedin, New Zealand
| | - Charlene M Rapsey
- Department of Psychological Medicine, University of Otago, Dunedin, New Zealand
| | - Erik Wibowo
- Department of Anatomy, University of Otago, Dunedin, New Zealand
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