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Diez de los Rios de la Serna C, Fernández-Ortega P, Lluch-Canut T. Lifestyle Behavior Interventions for Preventing Cancer in Adults with Inherited Cancer Syndromes: Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14098. [PMID: 36360977 PMCID: PMC9655661 DOI: 10.3390/ijerph192114098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 10/24/2022] [Accepted: 10/25/2022] [Indexed: 06/16/2023]
Abstract
(1) Background: The link between lifestyle behaviors and cancer risk is well established, which is important for people with personal/family history or genetic susceptibility. Genetic testing is not sufficient motivation to prompt healthier lifestyle behaviors. This systematic review aims to describe and assess interventions for promoting healthy behaviors in people at high risk of cancer. (2) Methods: The review was performed according to PRISMA guidelines using search terms related to hereditary cancer and health education to identify studies indexed in: CINAHL, MEDLINE, PubMed, Cochrane Library, Scopus, and Joanna Briggs, and published from January 2010 to July 2022. (3) Results: The search yielded 1558 initial records; four randomized controlled trials were eligible. Three included patients with and without a personal history of cancer who were at increased risk of cancer due to inherited cancer syndromes, and one included people undergoing genetic testing due to family history. Interventions targeted diet, physical activity, and alcohol. (4) Conclusions: There is a paucity of research on interventions for promoting healthy lifestyle behaviors in people with a high risk of cancer. Interventions produced positive short-term results, but there was no evidence that behavioral modifications were sustained over time. All healthcare professionals can actively promote healthy behaviors that may prevent cancer.
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Affiliation(s)
| | - Paz Fernández-Ortega
- School of Nursing, Faculty of Medicine and Health Sciences, Bellvitge Campus, University of Barcelona (UB), 08907 Barcelona, Spain
- Institut Català d’Oncologia (ICO) Barcelona, Bellvitge, 08908 Barcelona, Spain
| | - Teresa Lluch-Canut
- School of Nursing, Faculty of Medicine and Health Sciences, Bellvitge Campus, University of Barcelona (UB), 08907 Barcelona, Spain
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Tlusty K, Jackson M, Riley B, Blase T. Effects of diet education on empowerment for individuals who have an increased risk of developing breast or colon cancer: A pilot study. J Genet Couns 2022; 31:1138-1147. [PMID: 35502599 PMCID: PMC9790378 DOI: 10.1002/jgc4.1584] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 04/10/2022] [Accepted: 04/12/2022] [Indexed: 12/30/2022]
Abstract
Strong evidence indicates following a healthy diet reduces cancer risk; however, the impact of diet education on empowerment on individuals with an increased cancer risk has not been evaluated. Study participants included patients who had met with a cancer genetic counselor without a history of cancer. Participants received pre- and post-diet education surveys including questions to measure empowerment and feedback for diet education in relation to cancer risk. Empowerment was measured using a ten-question survey adapted from the Genetic Counseling Outcome Scale. The diet education intervention consisted of viewing an infographic created for this study based on recommendations for diets that reduce cancer risk by the World Cancer Research Fund and American Institute for Cancer Research. Twenty-eight participants completed both surveys and reviewed the diet education intervention. There was no change in empowerment between pre- and post- diet education (mean change = -0.5; p = 0.49). Participants previously learned about the relationship between a healthy diet and cancer risk reduction from several sources including family and friends (25.0%), online (25.0%), and primary care providers (25.0%). Most participants preferred diet education to be delivered online (42.9%), followed by on paper (39.3%), and in-person delivery (17.9%). This pilot study promotes further investigation on the impact of diet or lifestyle education on individuals who have a predisposition to developing cancer. While the results demonstrated no change in empowerment because of diet education, the results established a desire for learning about a healthy diet related to cancer risk and preferences for the modes of delivering education.
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Affiliation(s)
- Kaitlyn Tlusty
- Division of Genetic Counseling EducationCollege of Allied Health ProfessionsUniversity of Nebraska Medical CenterOmahaNebraskaUSA
| | - Mariah Jackson
- Division of Medical Nutrition EducationCollege of Allied Health ProfessionsUniversity of Nebraska Medical CenterOmahaNebraskaUSA
| | | | - Terri Blase
- Munroe‐Meyer Institute for Genetics and RehabilitationUniversity of Nebraska Medical CenterOmahaNebraskaUSA
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Hibler EA, Fought AJ, Kershaw KN, Molsberry R, Nowakowski V, Lindner D. Novel Interactive Tool for Breast and Ovarian Cancer Risk Assessment (Bright Pink Assess Your Risk): Development and Usability Study. J Med Internet Res 2022; 24:e29124. [PMID: 35200148 PMCID: PMC8914739 DOI: 10.2196/29124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 07/23/2021] [Accepted: 12/02/2021] [Indexed: 12/04/2022] Open
Abstract
Background The lifetime risk of breast and ovarian cancer is significantly higher among women with genetic susceptibility or a strong family history. However, current risk assessment tools and clinical practices may identify only 10% of asymptomatic carriers of susceptibility genes. Bright Pink developed the Assess Your Risk (AYR) tool to estimate breast and ovarian cancer risk through a user-friendly, informative web-based quiz for risk assessment at the population level. Objective This study aims to present the AYR tool, describe AYR users, and present evidence that AYR works as expected by comparing classification using the AYR tool with gold standard genetic testing guidelines. Methods The AYR is a recently developed population-level risk assessment tool that includes 26 questions based on the National Comprehensive Cancer Network (NCCN) guidelines and factors from other commonly used risk assessment tools. We included all women who completed the AYR between November 2018 and January 2019, with the exception of self-reported cancer or no knowledge of family history. We compared AYR classifications with those that were independently created using NCCN criteria using measures of validity and the McNemar test. Results There were 143,657 AYR completions, and most participants were either at increased or average risk for breast cancer or ovarian cancer (137,315/143,657, 95.59%). Using our estimates of increased and average risk as the gold standard, based on the NCCN guidelines, we estimated the sensitivity and specificity for the AYR algorithm–generated risk categories as 100% and 89.9%, respectively (P<.001). The specificity improved when we considered the additional questions asked by the AYR to define increased risk, which were not examined by the NCCN criteria. By race, ethnicity, and age group; we found that the lowest observed specificity was for the Asian race (85.9%) and the 30 to 39 years age group (87.6%) for the AYR-generated categories compared with the NCCN criteria. Conclusions These results demonstrate that Bright Pink’s AYR is an accurate tool for use by the general population to identify women at increased risk of breast and ovarian cancer. We plan to validate the tool longitudinally in future studies, including the impact of race, ethnicity, and age on breast and ovarian cancer risk assessment.
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Affiliation(s)
- Elizabeth A Hibler
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Angela J Fought
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Kiarri N Kershaw
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Rebecca Molsberry
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Virginia Nowakowski
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
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Masala G, Palli D, Ermini I, Occhini D, Facchini L, Sequi L, Castaldo M, Caini S, Bendinelli B, Saieva C, Assedi M, Zanna I. The DAMA25 Study: Feasibility of a Lifestyle Intervention Programme for Cancer Risk Reduction in Young Italian Women with Breast Cancer Family History. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312287. [PMID: 34886036 PMCID: PMC8656952 DOI: 10.3390/ijerph182312287] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 11/19/2021] [Accepted: 11/20/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Diet and physical activity (PA) can modulate sporadic and possibly familial breast cancer (BC) risk. The DAMA25 study is a single-arm 12-month intervention aimed to modify dietary and PA habits in healthy young Italian women with a positive BC family history, categorized as having intermediate or high genetic risk according to NICE (National Institute for Health and Cancer Excellence) guidelines. METHODS Participants, aged 25-49 years, were asked to adopt a diet mainly based on plant-based foods and to increase moderate daily activities combined with 1 h/week of more intense activity. Cooking lessons, collective walks, educational sessions, brochures, booklets and online materials were implemented. Dietary, PA habits and anthropometry were collected at baseline and at the end of the intervention. Changes on dietary, lifestyle habits and anthropometry were evaluated by GLM adjusted for weight reduction counselling aimed to participant with a BMI ≥ 25, age and baseline values of each variable. RESULTS Out of 237 eligible women 107 (45.2%) agreed to participate and among them 98 (91.6%) completed the intervention. The adherence rate of the intervention was 77.8%. We observed a reduction in red and processed meat (p < 0.0001) and cakes consumption (p < 0.0001). Consumption of whole grain bread (p < 0.001), leafy vegetables (p = 0.01) and olive oil (p = 0.04) increased. We observed an increase in moderate (p < 0.0001) and more intense (p < 0.0001) recreational activities, an average 1.4 kg weight loss (p = 0.005), a reduction of waist circumference (p < 0.001) and fat mass (p = 0.015). CONCLUSIONS The DAMA25 study shows that it is feasible an intervention to improve in the short-term dietary and PA habits and anthropometry in women with high BC familial risk.
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Affiliation(s)
- Giovanna Masala
- Clinical Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50139 Florence, Italy;
- Correspondence: ; Tel.: +39-055-416942 (ext. 704)
| | - Domenico Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50139 Florence, Italy; (D.P.); (I.E.); (D.O.); (L.F.); (L.S.); (M.C.); (S.C.); (C.S.); (M.A.); (I.Z.)
| | - Ilaria Ermini
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50139 Florence, Italy; (D.P.); (I.E.); (D.O.); (L.F.); (L.S.); (M.C.); (S.C.); (C.S.); (M.A.); (I.Z.)
| | - Daniela Occhini
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50139 Florence, Italy; (D.P.); (I.E.); (D.O.); (L.F.); (L.S.); (M.C.); (S.C.); (C.S.); (M.A.); (I.Z.)
| | - Luigi Facchini
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50139 Florence, Italy; (D.P.); (I.E.); (D.O.); (L.F.); (L.S.); (M.C.); (S.C.); (C.S.); (M.A.); (I.Z.)
| | - Lisa Sequi
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50139 Florence, Italy; (D.P.); (I.E.); (D.O.); (L.F.); (L.S.); (M.C.); (S.C.); (C.S.); (M.A.); (I.Z.)
| | - Maria Castaldo
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50139 Florence, Italy; (D.P.); (I.E.); (D.O.); (L.F.); (L.S.); (M.C.); (S.C.); (C.S.); (M.A.); (I.Z.)
| | - Saverio Caini
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50139 Florence, Italy; (D.P.); (I.E.); (D.O.); (L.F.); (L.S.); (M.C.); (S.C.); (C.S.); (M.A.); (I.Z.)
| | - Benedetta Bendinelli
- Clinical Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50139 Florence, Italy;
| | - Calogero Saieva
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50139 Florence, Italy; (D.P.); (I.E.); (D.O.); (L.F.); (L.S.); (M.C.); (S.C.); (C.S.); (M.A.); (I.Z.)
| | - Melania Assedi
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50139 Florence, Italy; (D.P.); (I.E.); (D.O.); (L.F.); (L.S.); (M.C.); (S.C.); (C.S.); (M.A.); (I.Z.)
| | - Ines Zanna
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50139 Florence, Italy; (D.P.); (I.E.); (D.O.); (L.F.); (L.S.); (M.C.); (S.C.); (C.S.); (M.A.); (I.Z.)
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Underhill-Blazey M, Blonquist T, Lawrence J, Hong F, Yurgelun MB, Syngal S. Health behaviours and beliefs in individuals with familial pancreatic cancer. Fam Cancer 2019; 18:457-464. [PMID: 31522335 PMCID: PMC6784816 DOI: 10.1007/s10689-019-00143-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Individuals at high risk for pancreatic cancer are recommended surveillance and healthy lifestyle behaviours and patient experience with recommendations are understudied. To describe engagement and experience with surveillance, tobacco and alcohol use, health beliefs and motivation (Champion Health Belief Measure) and the relationship with personal, psychosocial (Impact of Event Scale), and familial characteristics. Interest in integrative therapies (complementary therapies) are described. A multi-site cross-sectional survey including individuals at high risk for pancreatic cancer with no diagnosis of pancreatic cancer who have been evaluated at a comprehensive cancer center. Descriptive statistics and Wilcoxon rank sum test and Fisher's exact test were used to assess univariate associations. Of the 132 respondents (72% response rate), 92 (70%) reported undergoing surveillance which was associated with older age (p = 0.001). Of which, 36% and 51% report that magnetic resonance imaging (MRI) or endoscopic ultrasound (EUS), respectively, were uncomfortable; 22% and 30% dread the next MRI or EUS, respectively. Of those who reported alcohol consumption (n = 88); 15% consumed 1 or more drinks daily and no alcohol consumption was associated with higher Impact of Event scale scores (p = 0.024). A total of six participants were currently smoking every day or some days. Participants reported high motivation to engage in heathy behaviours and 92% were interested in integrative therapies. In these select participants, most were engaging in pancreatic cancer surveillance, alcohol intake was moderate, and tobacco intake was minimal. Modifiable factors, such as experience and comfort with surveillance could be addressed. The sample is motivated to engage in behavioural health intervention.
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Affiliation(s)
| | - Traci Blonquist
- Dana-Farber Cancer Institute, 450 Brookline Avenue, LW 522, Boston, MA, 02215, USA
| | - Janette Lawrence
- Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | - Fangxin Hong
- Dana-Farber Cancer Institute, 450 Brookline Avenue, LW 522, Boston, MA, 02215, USA
| | - Matthew B Yurgelun
- Dana-Farber Cancer Institute, 450 Brookline Avenue, LW 522, Boston, MA, 02215, USA
- Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02215, USA
| | - Sapna Syngal
- Dana-Farber Cancer Institute, 450 Brookline Avenue, LW 522, Boston, MA, 02215, USA
- Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02215, USA
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Identification as a Mutation Carrier and Effects on Life According to Experiences of Finnish Male BRCA1/2 Mutation Carriers. J Genet Couns 2018; 27:874-884. [DOI: 10.1007/s10897-017-0209-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Accepted: 12/26/2017] [Indexed: 10/18/2022]
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Kulkarni A, Carley H. Advances in the recognition and management of hereditary cancer. Br Med Bull 2016; 120:123-138. [PMID: 27941041 DOI: 10.1093/bmb/ldw046] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 10/02/2016] [Accepted: 10/12/2016] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Constitutional mutations in genes controlling DNA repair, cell-cycle regulation and cell apoptosis can determine an individual's tendency to develop cancer. Hereditary cancer predisposition syndromes present with multiple cancers at a young age and underlie a significant burden of morbidity and mortality. Recent advances in the recognition and management of hereditary cancer will be illustrated with specific examples of developments in diagnosis and treatment. SOURCES OF DATA Key recent published literature. AREAS OF AGREEMENT The identification of individuals with hereditary cancer offers important opportunities for cancer prevention, early intervention and personalized management. AREAS OF CONTROVERSY Individuals at risk of hereditary cancer remain under-recognized. There is a need to develop evidence-based guidelines for the recognition and management of hereditary cancer predisposition conditions. GROWING POINTS The study of Mendelian cancer susceptibility syndromes has added to our understanding of hereditary and sporadic cancers and facilitated the development of targeted agents directed against cancer-driving mutations. Increasingly, cancer patients with constitutional gene mutations treated with targeted therapies have improved clinical outcomes. AREAS FOR TIMELY RESEARCH Building the infrastructure to enable constitutional gene mutation testing to become integrated into routine cancer care, including the parallel development of robust referral pathways alongside genomic sequencing technologies.
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Affiliation(s)
- Anju Kulkarni
- Guy's Regional Genetics Service, Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, London SE1 9RT, UK
| | - Helena Carley
- Guy's Regional Genetics Service, Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, London SE1 9RT, UK
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