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Mori Y, Seguchi M, Iio Y, Aoyama Y, Tanaka M, Kozai H, Ito M. Factors Influencing Willingness to Undergo Lung Cancer Screening in the Future: A Cross-Sectional Study of Japanese University Students. Healthcare (Basel) 2024; 12:849. [PMID: 38667611 PMCID: PMC11050173 DOI: 10.3390/healthcare12080849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 04/12/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024] Open
Abstract
Lung cancer (LC) is currently the leading cause of cancer deaths in Japan. Early detection through lung cancer screening (LCS) is important for reducing mortality. Therefore, exploring the factors affecting willingness to undergo LCS, particularly among young people, is important. This study aimed to elucidate the inclination toward LCS and its determining factors among Japanese university students. This cross-sectional study, involving 10,969 Japanese university students, was conducted in April 2023. A Pearson's chi-square test and a binomial logistic regression analysis were used to analyze factors related to the dependent variable, willingness to undergo LCS in the future. Out of the 6779 participants (61.8%) involved in this study, 6504 (95.9%) provided valid responses, and 4609 (70.9%) expressed a willingness to undergo LCS in the future. Analysis revealed current smoking as a barrier to future willingness to undergo LCS. Other barriers included postponing the age of screening, anxiety about the screening content, and concerns about the possibility of having cancer after screening. Addressing barriers, such as current smoking and anxiety about screening, that prevent young people from undergoing LCS in the future is crucial. Therefore, universities should provide opportunities to educate students about LCS and explore various educational methods.
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Affiliation(s)
- Yukihiro Mori
- Department of Nursing, College of Life and Health Science, Chubu University, 1200 Matsumoto-cho, Kasugai 487-8501, Aichi, Japan;
| | - Manato Seguchi
- Graduate School of Life and Health Sciences, Chubu University, 1200 Matsumoto-cho, Kasugai 487-8501, Aichi, Japan; (M.S.); (Y.I.); (Y.A.)
| | - Yoko Iio
- Graduate School of Life and Health Sciences, Chubu University, 1200 Matsumoto-cho, Kasugai 487-8501, Aichi, Japan; (M.S.); (Y.I.); (Y.A.)
- Department of Lifelong Sports and Health Sciences, College of Life and Health Sciences, Chubu University, 1200 Matsumoto-cho, Kasugai 487-8501, Aichi, Japan
| | - Yuka Aoyama
- Graduate School of Life and Health Sciences, Chubu University, 1200 Matsumoto-cho, Kasugai 487-8501, Aichi, Japan; (M.S.); (Y.I.); (Y.A.)
- Department of Clinical Engineering, College of Life and Health Sciences, Chubu University, 1200 Matsumoto-cho, Kasugai 487-8501, Aichi, Japan
| | - Mamoru Tanaka
- Department of Food and Nutritional Sciences, College of Bioscience and Biotechnology, Chubu University, 1200 Matsumoto-cho, Kasugai 487-8501, Aichi, Japan; (M.T.); (H.K.)
| | - Hana Kozai
- Department of Food and Nutritional Sciences, College of Bioscience and Biotechnology, Chubu University, 1200 Matsumoto-cho, Kasugai 487-8501, Aichi, Japan; (M.T.); (H.K.)
| | - Morihiro Ito
- Graduate School of Life and Health Sciences, Chubu University, 1200 Matsumoto-cho, Kasugai 487-8501, Aichi, Japan; (M.S.); (Y.I.); (Y.A.)
- Department of Lifelong Sports and Health Sciences, College of Life and Health Sciences, Chubu University, 1200 Matsumoto-cho, Kasugai 487-8501, Aichi, Japan
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Ehman KM, Jenkins GD, Grimm JA, Cammack TL, Samuelson BJ, Stoll RJ, Maxson JA, MacLaughlin KL. Primary Human Papillomavirus Test Uptake and Cervical Cancer Screening Trends in the Midwest, United States. J Prim Care Community Health 2024; 15:21501319241251934. [PMID: 38726652 PMCID: PMC11085000 DOI: 10.1177/21501319241251934] [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: 02/05/2024] [Revised: 03/21/2024] [Accepted: 04/15/2024] [Indexed: 05/12/2024] Open
Abstract
INTRODUCTION/OBJECTIVES Despite U.S. Preventive Services Task Force and American Cancer Society endorsement of primary HPV screening, limited published data shows low uptake. PRIMARY AIM Assess cervical cancer screening rates over time, particularly primary HPV test uptake, among patients in a midwestern practice. SECONDARY AIM Evaluate associations between sociodemographics and screening adherence. METHODS Cross-sectional study. Qualifying subjects and type of screening test used were identified by applying ICD-9, ICD-10, lab test, and CPT codes to the Unified Data Platform. Sociodemographics were found through the electronic health record. RESULTS Primary HPV uptake represented <1% of annual screening from 1/2017 to 1/2022. On 1/1/2022, only 55% of 21 to 29 year old and 63% of 30 to 65 year old were up to date with screening among the studied population. For 21 to 29 year old, compared with White women, Black women were 28% less likely to be screened [RR = 0.72 (0.66-0.79)]. Compared with never-smokers, current smokers were 9% less likely to be screened [RR = 0.91 (0.87-0.96)], past smokers were 14% more likely [RR = 1.14 (1.09-1.2)]. Among 30 to 65 year old, compared with White women, Black women were 14% less likely to be screened [RR = 0.86 (0.81-0.9)]. Compared with never-smokers, current smokers were 21% less likely to be screened [RR = 0.79 (0.77-0.81)], past smokers were 6% less likely [RR = 0.94 (0.92-0.95)]. Jointly considering race, ethnicity, smoking status, Charlson score, and rurality, findings were similar for 21 to 29 year old; Black women were screened less than White women [RR = 0.73 (0.67-0.79)]; current smokers [RR = 0.9 (0.85-0.94)] and past smokers [RR = 1.12 (1.06-1.17)] were screened less than never smokers. For 30 to 65 year old, Black women were screened less than White women [RR = 0.83 (0.79-0.88)]; current smokers [RR = 0.8 (0.78-0.81)] and past smokers [RR = 0.95 (0.93-0.96)] were screened less than never smokers. CONCLUSIONS Screening rates remained below the Healthy People 2030 goal of 79.2% over time, particularly for younger Black women and current smokers, with minimal use of primary HPV screening.
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Affiliation(s)
- Katie M. Ehman
- Department of Family Medicine, Mayo Clinic, Rochester, MN, USA
| | - Gregory D. Jenkins
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Jessica A. Grimm
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | | | | | | | - Julie A. Maxson
- Department of Family Medicine, Mayo Clinic, Rochester, MN, USA
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Mkuu R, Salloum RG, Shenkman E, Schaefer N, Le T, Jorratt A, Meduri Y, Goede D, Lee JH, Staras SA. Screening for cervical cancer among women with behavioral health conditions-A systematic review. Prev Med Rep 2023; 34:102238. [PMID: 37273521 PMCID: PMC10236291 DOI: 10.1016/j.pmedr.2023.102238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 05/08/2023] [Accepted: 05/09/2023] [Indexed: 06/06/2023] Open
Abstract
Cervical cancer screening is credited with dramatically reducing cervical cancer mortality in the United States. There is a lack of consensus on whether women with behavioral health conditions (mental health or substance use) receive cervical cancer screening at rates similar to women without the conditions. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, we searched for articles and abstracts of conference proceedings in PubMed, EMBASE, Web of Science and the EBSCO databases: CINAHL, PsycINFO, Psychosocial and Behavioral Science Collection, Academic Search Premier Databases, and the ProQuest database Applied Social Sciences Index and Abstracts from January 1, 2000 to July 31, 2020. Eligibility criteria included studies conducted in the United States, published in English, and comparing cervical cancer screening rates of women with and without behavioral health conditions. Of 1,242 unique articles screened, 52 were included in the full text review. And after title/abstract/and full-text review, 14 articles met the eligibility criteria. Six studies examined both mental health and substance use conditions, two studies only examined substance use disorders, and six studies examined only mental health conditions. Substance use disorders were associated with a decreased likelihood of receiving screening. This study yeilded inconclusive findings on the relationship between mental health conditions and cervical cancer screening. More research is needed to better understand the relationship between behavioral health conditions and cervical cancer screening.
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Affiliation(s)
- Rahma Mkuu
- Department of Health Outcomes & Biomedical Informatics, University of Florida, 2004 Mowry Rd, Gainesville, FL 32610, United States
- Department of Health Science, University of Alabama, United States
| | - Ramzi G. Salloum
- Department of Health Outcomes & Biomedical Informatics, University of Florida, 2004 Mowry Rd, Gainesville, FL 32610, United States
| | - Elizabeth Shenkman
- Department of Health Outcomes & Biomedical Informatics, University of Florida, 2004 Mowry Rd, Gainesville, FL 32610, United States
| | - Nancy Schaefer
- Health Science Center Libraries, University of Florida Communicore Building, SW Archer Rd, Gainesville, FL 32610, United States
| | - Tran Le
- Department of Health Outcomes & Biomedical Informatics, University of Florida, 2004 Mowry Rd, Gainesville, FL 32610, United States
| | - Andrea Jorratt
- Department of Health Outcomes & Biomedical Informatics, University of Florida, 2004 Mowry Rd, Gainesville, FL 32610, United States
| | - Yashaswini Meduri
- Department of Health Outcomes & Biomedical Informatics, University of Florida, 2004 Mowry Rd, Gainesville, FL 32610, United States
| | - Dianne Goede
- Internal Medicine, College of Medicine, University of Florida, 1549 Gale Lemerand Drive, 4th Floor, Suite 4592, Gainesville, FL 32610-3008, United States
| | - Ji-Hyun Lee
- Division of Quantitative Sciences at the University of Florida Health Cancer Center, 2033 Mowry Rd, Gainesville, FL 32610, United States
| | - Stephanie A.S. Staras
- Department of Health Outcomes & Biomedical Informatics, University of Florida, 2004 Mowry Rd, Gainesville, FL 32610, United States
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Al-Fayez S, El-Metwally A. Cigarette smoking and prostate cancer: A systematic review and meta-analysis of prospective cohort studies. Tob Induc Dis 2023; 21:19. [PMID: 36762260 PMCID: PMC9900478 DOI: 10.18332/tid/157231] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 12/07/2022] [Accepted: 12/10/2022] [Indexed: 02/08/2023] Open
Abstract
INTRODUCTION Cigarette smoking is a well-known cancer-causing behavior and a leading cause of death from cancer. However, according to previously published research and meta-analyses, cigarette smoking has a significant inverse association with prostate cancer incidence. Therefore, this study aims to investigate this association based on updated evidence by conducting a systematic review and meta-analysis. METHODS A search for relevant articles was performed in PubMed and Scopus databases to obtain the pooled relative risk (RR) and the corresponding 95% confidence intervals (CIs) for the risk of prostate cancer incidence among smokers compared to non-smokers. Our search was limited to prospective cohort studies. RESULTS A total of 17 cohort studies were included in the systematic review. Fifteen studies were included in the meta-analysis and showed that cigarette smoking has an inverse association with prostate cancer incidence with a relative risk of 0.84 (95% CI: 0.78-0.91). From all cohorts included in this systematic review, five studies examined the association between current smokers and the risk of death from prostate cancer. Therefore, a meta-analysis of these cohort studies was performed and showed that current smokers had a 42% higher risk of death from prostate cancer when compared to non-smokers with a relative risk of 1.42 (95% CI: 1.20-1.68). CONCLUSIONS Data from observational studies suggest that cigarette smoking has an inverse association with prostate cancer incidence. However, smokers have an increased risk of death from prostate cancer. Important to realize that this lower risk for smokers might be attributed to low prostate cancer screening uptake among smokers, misclassification bias, or selection bias from the included original studies. In summary, our results indicate that the incidence of prostate cancer is lower among smokers. Nevertheless, smokers who develop the disease have a significantly worse prognosis.
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Affiliation(s)
- Sarah Al-Fayez
- College of Public Health and Health Informatics, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Ashraf El-Metwally
- College of Public Health and Health Informatics, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
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Eysenbach G, Ren F, Xie Y, Li K, Tong Z. The Global, Regional, and National Burdens of Cervical Cancer Attributable to Smoking From 1990 to 2019: Population-Based Study. JMIR Public Health Surveill 2022; 8:e40657. [PMID: 36563035 PMCID: PMC9823574 DOI: 10.2196/40657] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 10/31/2022] [Accepted: 11/30/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Cervical cancer is the fourth most common cause of cancer death in women worldwide. Smoking is one of the risk factors for cervical cancer. Understanding the global distribution of the disease burden of cervical cancer attributable to smoking and related changes is of clear significance for the prevention and control of cervical cancer in key populations and for tobacco control. As far as we know, research on the burden of cervical cancer attributable to smoking is lacking. OBJECTIVE We estimated the disease burden and mortality of cervical cancer attributable to smoking and related trends over time at the global, regional, and national levels. METHODS Data were obtained from the Global Burden of Disease study website. Age-standardized rates were used to facilitate comparisons of mortality and disability-adjusted life years (DALYs) at different levels. The estimated annual percentage change (EAPC) was used to assess trends in the age-standardized mortality rate (ASMR) and the age-standardized DALY rate (ASDR). A Pearson correlation analysis was used to evaluate correlations between the sociodemographic index and the age-standardized rates. RESULTS In 2019, there were 30,136.65 (95% uncertainty interval [UI]: 14,945.09-49,639.87) cervical cancer-related deaths and 893,735.25 (95% UI 469,201.51-1,440,050.85) cervical cancer-related DALYs attributable to smoking. From 1990 to 2019, the global burden of cervical cancer attributable to smoking showed a decreasing trend around the world; the EAPCs for ASMR and ASDR were -2.11 (95% CI -2.16 to -2.06) and -2.22 (95% CI -2.26 to -2.18), respectively. In terms of age characteristics, in 2019, an upward trend was observed for age in the mortality of cervical cancer attributable to smoking. Analysis of the trend in DALYs with age revealed an initially increasing and then decreasing trend. From 1990 to 2019, the burden of disease in different age groups showed a downward trend. Among 204 countries, 180 countries showed downward trends, 10 countries showed upward trends, and the burden was stable in 14 countries. The Pearson correlation analysis revealed a significant negative correlation between sociodemographic index and the age-standardized rates of cervical cancer attributable to smoking (ρ=-0.228, P<.001 for ASMR and ρ=-0.223, P<.001 for ASDR). CONCLUSIONS An increase over time in the absolute number of cervical cancer deaths and DALYs attributable to smoking and a decrease over time in the ASMR and ASDR for cervical cancer attributable to smoking were observed in the overall population, and differences in these variables were also observed between countries and regions. More attention should be paid to cervical cancer prevention and screening in women who smoke, especially in low- and middle-income countries.
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Affiliation(s)
| | - Fang Ren
- Department of Gynecology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yingying Xie
- Department of Scientific Research, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Kaixiang Li
- Clinical Big Data Center, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Henan Academy of Medical Big Data, Zhengzhou, China
| | - Zhuang Tong
- Clinical Big Data Center, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Henan Academy of Medical Big Data, Zhengzhou, China
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Palamenghi L, Giudici F, Graffigna G, Generali D. Patients' Engagement in Early Detection of COVID-19 Symptoms: An Observational Study in the Very Early Peak of the Pandemic in Italy in 2020. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3058. [PMID: 35270748 PMCID: PMC8910395 DOI: 10.3390/ijerph19053058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 02/28/2022] [Accepted: 03/03/2022] [Indexed: 02/05/2023]
Abstract
COVID-19 exerted a strong impact on the Italian healthcare systems, which in turn resulted in a reduction in the citizens’ trust towards healthcare authorities. Moreover, the focused attention on the typical COVID-19 symptoms (fever, cough) has also impacted the social representation of health priorities, potentially reducing the perceived importance and severity of other symptoms. This study aimed to determine the association of general-practitioner (GP) contact with various symptoms during the COVID-19 pandemic in Cremona, an Italian city at the very epicentre of the pandemic. Between April and June 2020, an anonymous survey was completed by 2161 respondents. Logistic-regression analyses were used to examine the associations of GP contact with sociodemographic characteristics and the presence of symptoms. Of the 2161 respondents (43.5% female, 75.0% aged less than 55 years), 959 (44.4%) reported experiencing various symptoms and 33.3% contacted a GP. GP contact was significantly associated with poor appetite (OR, 2.42; 95% CI 1.63 to 3.62; p < 0.001), taste dysfunctions (OR 1.67; 95% CI 1.20 to 2.34; p < 0.001) and sleepiness during the day (OR 4.15; 95% CI 2.13 to 8.09; p = 0.002). None of the gastrointestinal symptoms resulted in significantly increasing the likelihood of contacting a GP. This study offers a unique observation of citizens’ attitudes and behaviours in early symptom communication/detection during the initial peak of the Italian COVID-19 pandemic.
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Affiliation(s)
- Lorenzo Palamenghi
- Engageminds HUB-Consumer, Food and Health Engagement Research Center, Università Cattolica del Sacro Cuore, 20123 Milano, Italy;
- Department of Psychology, Università Cattolica del Sacro Cuore, 20123 Milano, Italy
- Faculty of Agriculture, Food and Nutritional Sciences, Università Cattolica del Sacro Cuore, 26100 Cremona, Italy
| | - Fabiola Giudici
- Biostatistics Unit, Department of Medical Sciences, University of Trieste, 34127 Trieste, Italy;
| | - Guendalina Graffigna
- Engageminds HUB-Consumer, Food and Health Engagement Research Center, Università Cattolica del Sacro Cuore, 20123 Milano, Italy;
- Faculty of Agriculture, Food and Nutritional Sciences, Università Cattolica del Sacro Cuore, 26100 Cremona, Italy
| | - Daniele Generali
- Breast Cancer Unit, ASST of Cremona, Viale Concordia 1, 26100 Cremona, Italy;
- Department of Medical Surgery and Health Sciences, University of Trieste, 34127 Trieste, Italy
- Department of Animal Science, Food and Nutrition–DIANA, Università Cattolica del Sacro Cuore, 29122 Piacenza, Italy
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Fernández-Aparicio Á, Schmidt-RioValle J, García PA, González-Jiménez E. Short Breastfeeding Duration is Associated With Premature Onset of Female Breast Cancer. Clin Nurs Res 2022; 31:901-908. [PMID: 35075913 DOI: 10.1177/10547738211069725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Currently, there is controversy concerning potential factors that contribute to the development of breast cancer. Our study analyzed the possible association between weight status, cigarette consumption, lactation period, serum estrogen levels, family history of breast cancer, and age at breast cancer diagnosis. We conducted a retrospective study at a University Hospital in Granada (Spain) by consulting the medical records of 524 women aged 19 to 91 years, all of them diagnosed and treated for breast cancer from 2011 to 2019. Our findings indicated that in non-morbidly obese females who were also non-smokers, a maternal lactation period of more than 3 months (p = .013) and the absence of family antecedents of cancer (p = .025) were statistically significant factors that led to a more advanced age at breast cancer diagnosis. Thus, maternal lactation seems to have a potential protective effect on breast cancer.
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Zoorob RJ, Mejia MC, Matas J, Wang H, Salemi JL, Levine R. Smoking history and adherence to cancer-related recommendations in a primary care setting. Transl Behav Med 2021; 12:362-367. [PMID: 34918162 DOI: 10.1093/tbm/ibab156] [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: 11/13/2022] Open
Abstract
Public health prevention efforts have led to overall reductions in mortality from screening-preventable cancers. We explored cancer screening behaviors of smokers, former smokers, and nonsmokers among patients of large primary care practices to discover the relationship between smoking status and previous adherence to the United States Preventive Services Task Force breast, cervical, and colorectal cancer screening recommendations. Our descriptive study of electronic medical record data included 6,029 established primary care patients. Multi-predictor log-binomial regression models yielded prevalence ratios (PRs) and 95% confidence intervals (CIs) to determine associations between smoking status and the likelihood of nonadherence. All models were adjusted for race/ethnicity, age, insurance, primary care specialty, number of comorbidities, and sex. Smoking history was obtained from all participants in January 2020. Current smokers accounted for 4.8%, while 22.7% were former smokers, and 72.5% were never smokers. Current smokers (compared to never smokers) were 63% more likely to be mammogram nonadherent (PR: 1.63, 95% CI: 1.31 to 2.02), 26% more likely to be Pap smear nonadherent (PR: 1.26, 95% CI: 1.04 to 1.53), and 39% more likely to be colonoscopy nonadherent (PR: 1.39, 95% CI: 1.16 to 1.66). Current smokers and former Powered by Editorial Manager and ProduXion Manager from Aries Systems Corporation smokers had on average 2.9 comorbidities while never smokers had on average 2.1 comorbidities. Our findings showed that current smokers experienced significantly lower rates of cancer screening compared to never smokers. Further research is needed to investigate and identify best practices for increasing cancer screening uptake in this population.
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Affiliation(s)
- Roger J Zoorob
- Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Maria C Mejia
- Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Jennifer Matas
- Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Haijun Wang
- Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Jason L Salemi
- Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX, USA.,College of Public Health, University of South Florida, Tampa, FL, USA
| | - Robert Levine
- Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX, USA
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Miller EA, Pinsky PF. Healthcare Access, Utilization, and Preventive Health Behaviors by Eligibility for Lung Cancer Screening. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:330-337. [PMID: 31656025 DOI: 10.1007/s13187-019-01634-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
In 2013, the US Preventive Services Task Force recommended low-dose computed tomography screening for smokers at high risk of lung cancer; however, use remains low. Efforts to promote lung cancer screening need to consider how receptive this population is to preventive healthcare and cancer screening. In addition, because of demonstrated heterogeneity in behaviors by smoking status, interventions may need to differ among eligible high-risk subgroups. To assess the engagement of high-risk smokers in other preventive healthcare behaviors, we examined healthcare use, including non-lung cancer screening, and healthcare provider discussions regarding screening by eligibility for lung cancer screening. We used the 2015 National Health Interview Survey to assess smoking history, healthcare use, cancer screening, vaccinations, and healthcare provider discussions regarding non-lung cancer screening. We calculated weighted prevalence estimates and prevalence ratios comparing eligible and ineligible current and former smokers to never smokers. Eligible current and former smokers had significantly different healthcare utilization and screening concordance compared to never smokers and to each other. Compared to never smokers, eligible current smokers were significantly less likely to be concordant with breast, colorectal, and cervical cancer screening while eligible former smokers were only less likely to be concordant with breast cancer screening. Eligible current smokers were less likely to report physician discussions about non-lung screening tests. Provider discussions about screening and engagement in preventive healthcare differed among current and former smokers eligible for lung cancer screening. Intervention efforts to increase lung cancer screening levels will likely need to differ as well.
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Affiliation(s)
- Eric A Miller
- Division of Cancer Prevention, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA.
| | - Paul F Pinsky
- Division of Cancer Prevention, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA
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Racial and ethnic differences in risk of second primary cancers among prostate cancer survivors. Cancer Causes Control 2020; 31:1011-1019. [PMID: 32839916 DOI: 10.1007/s10552-020-01336-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 08/06/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Previous studies have shown an overall decreased risk of second cancers among prostate cancer survivors, but this has not been comprehensively examined by race/ethnicity. We conducted a retrospective cohort study of 716,319 one-year survivors of prostate cancer diagnosed at ages 35-84 during 2000-2015 as reported to 17 US Surveillance, Epidemiology and End Results (SEER) registries. METHODS We estimated standardized incidence ratios (SIRs) for second primary non-prostate malignancies by race/ethnicity (non-Latino white, Black, Asian/Pacific Islander [API] and Latino), by Gleason, and by time since prostate cancer diagnosis. Poisson regression models were used to test heterogeneity between groups with the expected number as the offset. RESULTS 60,707 second primary malignancies were observed. SIRs for all second cancers combined varied significantly by race/ethnicity: SIRwhite: 0.88 (95% confidence interval: 0.87-0.89), SIRLatino: 0.92 (0.89-0.95), SIRBlack: 0.97 (0.95-0.99), and SIRAPI: 1.05 (1.01-1.09) (p-heterogeneity < 0.001). SIRs for all cancers combined were higher among survivors of higher vs. lower Gleason prostate cancers irrespective of race/ethnicity. We observed significant heterogeneity by race/ethnicity in SIRs for 9 of 14 second cancer types investigated including lung, bladder, kidney, and liver. CONCLUSIONS Our results confirm that most prostate cancer survivors have lower risks of second cancers than expected, but the magnitude varied by race/ethnicity. Exceptionally, API men had small but significantly increased risk. Further research to understand drivers of the observed race/ethnicity heterogeneity is warranted.
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Quaife SL, Ruparel M, Dickson JL, Beeken RJ, McEwen A, Baldwin DR, Bhowmik A, Navani N, Sennett K, Duffy SW, Wardle J, Waller J, Janes SM. Lung Screen Uptake Trial (LSUT): Randomized Controlled Clinical Trial Testing Targeted Invitation Materials. Am J Respir Crit Care Med 2020; 201:965-975. [PMID: 31825647 PMCID: PMC7159423 DOI: 10.1164/rccm.201905-0946oc] [Citation(s) in RCA: 75] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 12/10/2019] [Indexed: 12/25/2022] Open
Abstract
Rationale: Low uptake of low-dose computed tomography (LDCT) lung cancer screening, particularly by current smokers of a low socioeconomic position, compromises effectiveness and equity.Objectives: To compare the effect of a targeted, low-burden, and stepped invitation strategy versus control on uptake of hospital-based Lung Health Check appointments offering LDCT screening.Methods: In a two-arm, blinded, between-subjects, randomized controlled trial, 2,012 participants were selected from 16 primary care practices using these criteria: 1) aged 60 to 75 years, 2) recorded as a current smoker within the last 7 years, and 3) no prespecified exclusion criteria contraindicating LDCT screening. Both groups received a stepped sequence of preinvitation, invitation, and reminder letters from their primary care practitioner offering prescheduled appointments. The key manipulation was the accompanying leaflet. The intervention group's leaflet targeted psychological barriers and provided low-burden information, mimicking the concept of the U.K. Ministry of Transport's annual vehicle test ("M.O.T. For Your Lungs").Measurements and Main Results: Uptake was 52.6%, with no difference between intervention (52.3%) and control (52.9%) groups in unadjusted (odds ratio [OR], 0.98; 95% confidence interval [CI], 0.82-1.16) or adjusted (OR, 0.98; 95% CI, 0.82-1.17) analyses. Current smokers were less likely to attend (adjusted OR, 0.70; 95% CI, 0.56-0.86) than former smokers. Socioeconomic deprivation was significantly associated with lower uptake for the control group only (P < 0.01).Conclusions: The intervention did not improve uptake. Regardless of trial arm, uptake was considerably higher than previous clinical and real-world studies, particularly given that the samples were predominantly lower socioeconomic position smokers. Strategies common to both groups, including a Lung Health Check approach, could represent a minimum standard.Clinical trial registered with www.clinicaltrials.gov (NCT02558101) and registered prospectively with the International Standard Registered Clinical/Social Study (N21774741).
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Affiliation(s)
| | - Mamta Ruparel
- Lungs for Living Research Centre, UCL Respiratory, Division of Medicine, University College London, London, United Kingdom
| | - Jennifer L. Dickson
- Lungs for Living Research Centre, UCL Respiratory, Division of Medicine, University College London, London, United Kingdom
| | - Rebecca J. Beeken
- Research Department of Behavioural Science and Health and
- Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom
| | - Andy McEwen
- National Centre for Smoking Cessation and Training, Dorchester, United Kingdom
| | - David R. Baldwin
- Respiratory Medicine Unit, David Evans Research Centre, Nottingham University Hospitals, Nottingham, United Kingdom
| | - Angshu Bhowmik
- Department of Thoracic Medicine, Homerton University Hospital, London, United Kingdom
| | - Neal Navani
- Department of Thoracic Medicine, University College London Hospital, London, United Kingdom
| | - Karen Sennett
- Killick Street Health Centre, London, United Kingdom
| | - Stephen W. Duffy
- Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom; and
| | - Jane Wardle
- Research Department of Behavioural Science and Health and
| | - Jo Waller
- Research Department of Behavioural Science and Health and
- School of Cancer and Pharmaceutical Sciences, King’s College London, London, United Kingdom
| | - Samuel M. Janes
- Lungs for Living Research Centre, UCL Respiratory, Division of Medicine, University College London, London, United Kingdom
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12
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Kensler KH, Rebbeck TR. Cancer Progress and Priorities: Prostate Cancer. Cancer Epidemiol Biomarkers Prev 2020; 29:267-277. [PMID: 32024765 PMCID: PMC7006991 DOI: 10.1158/1055-9965.epi-19-0412] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 06/10/2019] [Accepted: 12/03/2019] [Indexed: 02/06/2023] Open
Affiliation(s)
- Kevin H Kensler
- Division of Population Sciences, Dana-Farber Cancer Institute and Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Timothy R Rebbeck
- Division of Population Sciences, Dana-Farber Cancer Institute and Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
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13
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Snowsill T, Yang H, Griffin E, Long L, Varley-Campbell J, Coelho H, Robinson S, Hyde C. Low-dose computed tomography for lung cancer screening in high-risk populations: a systematic review and economic evaluation. Health Technol Assess 2019; 22:1-276. [PMID: 30518460 DOI: 10.3310/hta22690] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Diagnosis of lung cancer frequently occurs in its later stages. Low-dose computed tomography (LDCT) could detect lung cancer early. OBJECTIVES To estimate the clinical effectiveness and cost-effectiveness of LDCT lung cancer screening in high-risk populations. DATA SOURCES Bibliographic sources included MEDLINE, EMBASE, Web of Science and The Cochrane Library. METHODS Clinical effectiveness - a systematic review of randomised controlled trials (RCTs) comparing LDCT screening programmes with usual care (no screening) or other imaging screening programmes [such as chest X-ray (CXR)] was conducted. Bibliographic sources included MEDLINE, EMBASE, Web of Science and The Cochrane Library. Meta-analyses, including network meta-analyses, were performed. Cost-effectiveness - an independent economic model employing discrete event simulation and using a natural history model calibrated to results from a large RCT was developed. There were 12 different population eligibility criteria and four intervention frequencies [(1) single screen, (2) triple screen, (3) annual screening and (4) biennial screening] and a no-screening control arm. RESULTS Clinical effectiveness - 12 RCTs were included, four of which currently contribute evidence on mortality. Meta-analysis of these demonstrated that LDCT, with ≤ 9.80 years of follow-up, was associated with a non-statistically significant decrease in lung cancer mortality (pooled relative risk 0.94, 95% confidence interval 0.74 to 1.19). The findings also showed that LDCT screening demonstrated a non-statistically significant increase in all-cause mortality. Given the considerable heterogeneity detected between studies for both outcomes, the results should be treated with caution. Network meta-analysis, including six RCTs, was performed to assess the relative clinical effectiveness of LDCT, CXR and usual care. The results showed that LDCT was ranked as the best screening strategy in terms of lung cancer mortality reduction. CXR had a 99.7% probability of being the worst intervention and usual care was ranked second. Cost-effectiveness - screening programmes are predicted to be more effective than no screening, reduce lung cancer mortality and result in more lung cancer diagnoses. Screening programmes also increase costs. Screening for lung cancer is unlikely to be cost-effective at a threshold of £20,000/quality-adjusted life-year (QALY), but may be cost-effective at a threshold of £30,000/QALY. The incremental cost-effectiveness ratio for a single screen in smokers aged 60-75 years with at least a 3% risk of lung cancer is £28,169 per QALY. Sensitivity and scenario analyses were conducted. Screening was only cost-effective at a threshold of £20,000/QALY in only a minority of analyses. LIMITATIONS Clinical effectiveness - the largest of the included RCTs compared LDCT with CXR screening rather than no screening. Cost-effectiveness - a representative cost to the NHS of lung cancer has not been recently estimated according to key variables such as stage at diagnosis. Certain costs associated with running a screening programme have not been included. CONCLUSIONS LDCT screening may be clinically effective in reducing lung cancer mortality, but there is considerable uncertainty. There is evidence that a single round of screening could be considered cost-effective at conventional thresholds, but there is significant uncertainty about the effect on costs and the magnitude of benefits. FUTURE WORK Clinical effectiveness and cost-effectiveness estimates should be updated with the anticipated results from several ongoing RCTs [particularly the NEderlands Leuvens Longkanker Screenings ONderzoek (NELSON) screening trial]. STUDY REGISTRATION This study is registered as PROSPERO CRD42016048530. FUNDING The National Institute for Health Research Health Technology Assessment programme.
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Affiliation(s)
- Tristan Snowsill
- Peninsula Technology Assessment Group (PenTAG), University of Exeter Medical School, Exeter, UK
| | - Huiqin Yang
- Peninsula Technology Assessment Group (PenTAG), University of Exeter Medical School, Exeter, UK
| | - Ed Griffin
- Peninsula Technology Assessment Group (PenTAG), University of Exeter Medical School, Exeter, UK
| | - Linda Long
- Peninsula Technology Assessment Group (PenTAG), University of Exeter Medical School, Exeter, UK
| | - Jo Varley-Campbell
- Peninsula Technology Assessment Group (PenTAG), University of Exeter Medical School, Exeter, UK
| | - Helen Coelho
- Peninsula Technology Assessment Group (PenTAG), University of Exeter Medical School, Exeter, UK
| | - Sophie Robinson
- Peninsula Technology Assessment Group (PenTAG), University of Exeter Medical School, Exeter, UK
| | - Chris Hyde
- Peninsula Technology Assessment Group (PenTAG), University of Exeter Medical School, Exeter, UK.,Exeter Test Group, University of Exeter Medical School, Exeter, UK
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14
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Sanford NN, Sher DJ, Butler S, Xu X, Ahn C, D’Amico AV, Rebbeck T, Aizer AA, Mahal BA. Cancer Screening Patterns Among Current, Former, and Never Smokers in the United States, 2010-2015. JAMA Netw Open 2019; 2:e193759. [PMID: 31099863 PMCID: PMC6537823 DOI: 10.1001/jamanetworkopen.2019.3759] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
IMPORTANCE National guidelines recommend screening for several cancer types, yet screening rates remain below target. To date, cancer screening patterns by smoking status, a major cancer risk factor, are unknown. OBJECTIVE To assess cancer screening patterns among individuals who never smoked (never smokers), formerly smoked (former smokers), and currently smoke (current smokers) in the United States. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study assessed data from the National Health Interview Survey years 2010, 2013, and 2015. Adult participants (aged ≥18 years) who had never reported a cancer diagnosis were included in the analysis. Data were analyzed from August 1, 2018, through February 1, 2019. EXPOSURES Receipt of cancer screening, including colonoscopy, mammography, prostate-specific antigen testing, and Papanicolaou test per the US Preventive Services Task Force guidelines. MAIN OUTCOMES AND MEASURES Multivariable logistic regression defined adjusted odds ratios (AORs) and 95% CIs for undergoing cancer screening by smoking status. Among participants who received a specific screening test, AORs and 95% CIs of receiving the test within guideline-recommended intervals were also assessed. RESULTS Among 83 176 participants (45 851 [55.1%] women; mean [SD] age, 47 [18] years), 51 014 (61.3%) were never smokers; 17 235 (20.7%), former smokers; and 14 927 (17.9%), current smokers. Compared with never smokers, current smokers were less likely to ever have received a colonoscopy (43.8% vs 57.7%; AOR, 0.74; 95% CI, 0.68-0.82; P < .001), mammogram (88.8% vs 93.3%; AOR, 0.70; 95% CI, 0.57-0.87; P = .001), or prostate-specific antigen test (46.1% vs 60.8%; AOR, 0.76; 95% CI, 0.64-0.90; P = .001). Among those who had ever received a specific screening test, current smokers were less likely to have undergone colonoscopy (92.1% vs 95.1%; AOR, 0.75; 95% CI, 0.59-0.96; P = .02), mammography (62.4% vs 79.4%; AOR, 0.52; 95% CI, 0.45-0.60; P < .001), or Papanicolaou test (80.9% vs 90.8%; AOR, 0.61; 95% CI, 0.56-0.67; P < .001) within the recommended time frame compared with never smokers. Former smokers were more likely than never smokers to undergo any of the screening studies evaluated, with the exception of prostate-specific antigen screening (colonoscopy, 65.2% vs 57.7%; AOR, 1.20; 95% CI, 1.12-1.30; P < .001; mammography, 95.7% vs 93.3%; AOR, 1.35; 95% CI, 1.07-1.70; P = .01; Papanicolaou test, 97.6% vs 91.4%; AOR, 2.51; 95% CI, 1.93-3.26; P < .001). CONCLUSIONS AND RELEVANCE This study found that current smokers appeared to be less likely to receive guideline-concordant screening studies for breast, prostate, and colorectal cancer compared with never smokers. Further research is needed to identify barriers to screening among current smokers with the goal of increasing acceptance and uptake of cancer screening among this population at high risk of cancer.
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Affiliation(s)
- Nina N. Sanford
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas
| | - David J. Sher
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas
| | - Santino Butler
- Dana-Farber Cancer Institute/Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Xiaohan Xu
- Division of Biostatistics, Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas
- Department of Statistical Science, Southern Methodist University, Dallas, Texas
| | - Chul Ahn
- Harold Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas
| | - Anthony V. D’Amico
- Department of Radiation Oncology, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Timothy Rebbeck
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Ayal A. Aizer
- Department of Radiation Oncology, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Brandon A. Mahal
- McGraw/Patterson Center for Population Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts
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15
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Lee J, Lim J, Kim Y, Kim HY, Goo JM, Lee CT, Jang SH, Lee WC, Lee CW, An JY, Ko KD, Lee MK, Choi KS, Park B, Lee DH. Development of Protocol for Korean Lung Cancer Screening Project (K-LUCAS) to Evaluate Effectiveness and Feasibility to Implement National Cancer Screening Program. Cancer Res Treat 2019; 51:1285-1294. [PMID: 30776882 PMCID: PMC6790831 DOI: 10.4143/crt.2018.464] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 01/19/2019] [Indexed: 12/17/2022] Open
Abstract
Purpose To reduce lung cancer mortality, lung cancer screening was recommended using low-dose computed tomography (LDCT) to high-risk population. A protocol for multicenter lung cancer screening pilot project was developed to evaluate the effectiveness and feasibility of lung cancer screening to implement National Cancer Screening Program in Korea. Materials and Methods Multidisciplinary expert committee was comprised to develop a standardized protocol for Korean Lung Cancer Screening Project (K-LUCAS). K-LUCAS is a population-based single arm trial that targets high-risk population aged 55-74 years with at least 30 pack-year smoking history. LDCT results are reported by Lung-RADS suggested by American Radiology Society. Network-based system using computer-aided detection program is prepared to assist reducing diagnostic errors. Smoking cessation counselling is provided to all currently smoking participants. A small pilot test was conducted to check the feasibility and compliance of the protocols for K-LUCAS. Results In pilot test, 256 were participated. The average age of participants was 63.2 years and only three participants (1.2%) were female. The participants had a smoking history of 40.5 pack-year on average and 53.9% were current smokers. Among them, 86.3% had willing to participate in lung cancer screening again. The average willingness to quit smoking among current smokers was 12.7% higher than before screening. In Lung-RADS reports, 10 (3.9%) were grade 3 and nine (3.5%) were grade 4. One participant was diagnosed as lung cancer. Conclusion The protocol developed by this study is assessed to be feasible to perform K-LUCAS in multicenter nationwide scale.
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Affiliation(s)
- Jaeho Lee
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Juntae Lim
- National Cancer Control Institute, National Cancer Center, Goyang, Korea.,Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Yeol Kim
- National Cancer Control Institute, National Cancer Center, Goyang, Korea.,Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Hyae Young Kim
- Department of Diagnostic Radiology, National Cancer Center, Goyang, Korea
| | - Jin Mo Goo
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
| | - Choon-Taek Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Seung Hun Jang
- Department of Pulmonary, Allergy and Critical Care Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Won-Chul Lee
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Chan Wha Lee
- Department of Diagnostic Radiology, National Cancer Center, Goyang, Korea
| | - Jin Young An
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Ki Dong Ko
- Department of Family Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Min Ki Lee
- Department of Internal Medicine, Pusan National University, Busan, Korea
| | - Kui Son Choi
- National Cancer Control Institute, National Cancer Center, Goyang, Korea.,Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Boyoung Park
- National Cancer Control Institute, National Cancer Center, Goyang, Korea.,Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Duk Hyoung Lee
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
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16
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MacLaughlin KL, Jacobson RM, Radecki Breitkopf C, Wilson PM, Jacobson DJ, Fan C, St Sauver JL, Rutten LJF. Trends Over Time in Pap and Pap-HPV Cotesting for Cervical Cancer Screening. J Womens Health (Larchmt) 2019; 28:244-249. [PMID: 30614380 DOI: 10.1089/jwh.2018.7380] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND In 2012, updated cervical cancer screening recommendations were released with consensus on Papanicolaou (Pap) testing every 3 years for women age 21-65 years or Pap-human papillomavirus (HPV) cotesting at 5-year intervals for women age 30-65 years. Primary study aims: Assess current use of Pap-HPV cotesting and describe local population trends over time in Pap and Pap-HPV cotesting. Secondary aim: Assess sociodemographic factors correlating with screening. METHODS We assessed Rochester Epidemiology Project data for Pap and Pap-HPV cotesting among women age 16 years and older living in Olmsted County, Minnesota, yearly from 2005 (study population n = 47,203) through 2016 (study population n = 49,510). We calculated 3-year (Pap) and 5-year (Pap-HPV) moving prevalence rates of screening as proportion of eligible population. Multivariable logistic regression was used to assess factors potentially associated with screening. RESULTS In 2016, 64.6% of 27,418 eligible 30- to 65-year-old women were up to date with cervical cancer screening; 60.8% had received Pap-HPV cotest screening. Significant declines in Pap completion rates over time were observed in all age groups, including an unexpected decline in 21- to 29-year-old women. Coincident with decreasing Pap screening rates, Pap-HPV cotesting significantly increased among women age 30-65 years, from 10.0% in 2007 to 60.8% in 2016. CONCLUSIONS This suggests increasing adoption of 2012 screening recommendations in the 30- to 65-year-old population. However, decline in Pap screening among 21- to 29-year-old women is concerning. Disparities by race, ethnicity, smoking status, and comorbidity level were observed. Results suggest need for multilevel patient and clinician interventions to increase cervical cancer screening adherence.
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Affiliation(s)
| | - Robert M Jacobson
- 2 Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota.,3 Division of Community Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota.,4 Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | | | - Patrick M Wilson
- 4 Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Debra J Jacobson
- 4 Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Chun Fan
- 4 Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Jennifer L St Sauver
- 2 Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota.,4 Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Lila J Finney Rutten
- 2 Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota.,4 Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
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17
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Jia S, Li H, Zeng H, Zheng R, Li J, Shi J, Yang Z, Cao M, Chen W. Association of cancer prevention awareness with esophageal cancer screening participation rates: Results from a population-based cancer screening program in rural China. Chin J Cancer Res 2019; 31:601-608. [PMID: 31564803 PMCID: PMC6736664 DOI: 10.21147/j.issn.1000-9604.2019.04.04] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Objective China have implemented population-based esophageal cancer (EC) screening programs, however, the participant rates were relatively low. This study was conducted to examine the association between cancer prevention knowledge and EC screening participation rates (PRs). Methods Data in the analyses were obtained from a population-based cancer screening program in four provinces in China since 2007. In the course of 2007−2016, participants who were evaluated as high risk for EC and subsequently recommended for endoscopy examination were included in the final analysis. One-way analysis of variance test, Chi-square test and logistic regression analysis were applied. Results A total of 28,543 individuals assessed as high-risk population for EC were included in this study, with 13,036 males (45.67%) and 15,507 females (54.33%). The prevalence rates of current smoking and alcohol drinking were higher in males (58.25% and 44.22%, respectively) than in females (5.35% and 4.05%, respectively). Participants of females, and those who had older age, lower income, as well as higher education level and cancer prevention knowledge level were more likely to undergo endoscopy. Multivariable analysis showed that higher cancer prevention knowledge was associated with higher PR for endoscopic screening [adjusted odd ratio (aORQ4/Q1) =1.511, 95% confidence interval (95% CI): 1.398−1.632] among our study subjects. This association between cancer prevention knowledge and compliance with endoscopic screening also tends to be strong within subgroups of males, females, aged below 60 years, aged 60 years and above, and lower level of education (illiterate individuals and those with junior high education or less).
Conclusions Our results displayed a positive relationship between cancer prevention knowledge and PRs for endoscopic screening, implying cancer prevention awareness being an independent influence factor for compliance with EC screening. Promoting public campaigns about comprehensive knowledge of cancer prevention seemed to be a reasonable and effective strategy to improve population PRs for EC screening.
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Affiliation(s)
- Shangchun Jia
- Anhui Provincial Center for Disease Control and Prevention, Hefei 230601, China
| | - He Li
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Hongmei Zeng
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Rongshou Zheng
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Jiang Li
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Jufang Shi
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Zhixun Yang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Maomao Cao
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Wanqing Chen
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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18
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Abstract
Prostate cancer is a major cause of disease and mortality among men, and each year 1.6 million men are diagnosed with and 366,000 men die of prostate cancer. In this review, we discuss the state of evidence for specific genetic, lifestyle, and dietary factors associated with prostate cancer risk. Given the biological heterogeneity of this cancer, we focus on risk factors for advanced or fatal prostate cancer. First, we provide descriptive epidemiology statistics and patterns for prostate cancer incidence and mortality around the world. This includes discussion of the impact of prostate-specific antigen screening on prostate cancer epidemiology. Next, we summarize evidence for selected risk factors for which there is strong or probable evidence of an association: genetics, obesity and weight change, physical activity, smoking, lycopene and tomatoes, fish, vitamin D and calcium, and statins. Finally, we highlight future directions for prostate cancer epidemiology research.
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Affiliation(s)
- Claire H Pernar
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115
| | - Ericka M Ebot
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115
| | - Kathryn M Wilson
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115
| | - Lorelei A Mucci
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115
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19
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Hall MB, Vos P. Comparison of Cancer Fatalism Among Rural Smokers and Nonsmokers. J Community Health 2018; 44:215-221. [DOI: 10.1007/s10900-018-0576-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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20
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Kushalnagar P, Engelman A, Sadler G. Deaf patient-provider communication and lung cancer screening: Health Information National Trends survey in American Sign Language (HINTS-ASL). PATIENT EDUCATION AND COUNSELING 2018; 101:1232-1239. [PMID: 29548598 PMCID: PMC5985205 DOI: 10.1016/j.pec.2018.03.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2017] [Revised: 02/26/2018] [Accepted: 03/01/2018] [Indexed: 05/26/2023]
Abstract
OBJECTIVE To assess whether mode of communication and patient centered communication (PCC) with physicians were associated with the likelihood of deaf smokers inquiring about lung cancer screening. METHODS An accessible health survey including questions about PCC, modes of communication, smoking status and lung cancer screening was administered in American Sign Language (HINTS-ASL) to a nationwide sample of deaf adults from February to August 2017. Of 703 deaf adults who answered the lung screening question, 188 were 55-80 years old. RESULTS The odds ratio of asking about a lung cancer screening test was higher for people with lung disease or used ASL (directly or through an interpreter) to communicate with their physicians. PCC was not associated with asking about a lung cancer screening test. CONCLUSION Current or former smokers who are deaf and use ASL are at greater risk for poorer health outcomes if they do not have accessible communication with their physicians. PRACTICE IMPLICATIONS Optimal language access through interpreters or directly in ASL is critical when discussing smoking cessation or lung cancer screening tests. Counseling and shared decision-making will help improve high-risk deaf patients' understanding and decision-making about lung cancer screening.
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Affiliation(s)
- P Kushalnagar
- Department of Psychology, Gallaudet University, Washington, D.C, United States.
| | - Alina Engelman
- Department of Nursing and Health Sciences, California State University, East Bay, United States
| | - G Sadler
- Moore Cancer Center, University of California, San Diego, United States
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21
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Tang B, Han CT, Gan HL, Zhang GM, Zhang CZ, Yang WY, Shen Y, Zhu Y, Ye DW. Smoking increased the risk of prostate cancer with grade group ≥ 4 and intraductal carcinoma in a prospective biopsy cohort. Prostate 2017; 77:984-989. [PMID: 28422303 DOI: 10.1002/pros.23354] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 03/17/2017] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To investigate the association between smoking and different prostate cancer (PCa) pathological subtypes incidence in Chinese men. PATIENTS AND METHODS We prospectively included 1795 patients who underwent prostate biopsies in one tertiary center between March 2013 and April 2016. Clinical data and biopsy outcomes were collected. Logistic regression was used to evaluate the association between cigarette smoking and PCa incidence. RESULTS A total of 737 men, 480 men and 58 men were diagnosed with PCa, high-grade PCa (HGPCa, grade group ≥ 4 as accepted by the 2014 ISUP) and intraductal carcinoma of the prostate (IDC-P), respectively. Current smokers had a significantly higher risk of HGPCa than never smokers (OR = 1.89, 95%CI: 1.44-2.48). No such association was observed for low-grade disease and cigarette smoking (OR = 0.84, 95%CI: 0.61-1.16). In a sub-analysis, men who had smoked longer than 30 years had a higher risk of HGPCa, compared with men who had smoked fewer than 30 years (OR = 1.50, 95%CI: 1.09-2.06). Current smokers were more likely to develop IDC-P than never smokers (OR = 2.29, 95%CI: 1.14-4.59). CONCLUSION Among men in this Chinese biopsy cohort, current smoking was associated with highly malignant PCa incidence, such as HGPCa and IDC-P. The duration of smoking may be associated with HGPCa.
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Affiliation(s)
- Bo Tang
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical Colleague, Fudan University, Shanghai, China
| | - Cheng-Tao Han
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical Colleague, Fudan University, Shanghai, China
| | - Hua-Lei Gan
- Department of Oncology, Shanghai Medical Colleague, Fudan University, Shanghai, China
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Gui-Ming Zhang
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical Colleague, Fudan University, Shanghai, China
| | - Cui-Zhu Zhang
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical Colleague, Fudan University, Shanghai, China
| | - Wei-Yi Yang
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical Colleague, Fudan University, Shanghai, China
| | - Ying Shen
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical Colleague, Fudan University, Shanghai, China
| | - Yao Zhu
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical Colleague, Fudan University, Shanghai, China
| | - Ding-Wei Ye
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical Colleague, Fudan University, Shanghai, China
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Hayek S, Enav T, Shohat T, Keinan-Boker L. Factors Associated with Breast Cancer Screening in a Country with National Health Insurance: Did We Succeed in Reducing Healthcare Disparities? J Womens Health (Larchmt) 2017; 26:159-168. [DOI: 10.1089/jwh.2016.5835] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Affiliation(s)
- Samah Hayek
- Israel Centre for Disease Control, Israel Ministry of Health, Ramat-Gan, Israel
| | - Teena Enav
- Israel Centre for Disease Control, Israel Ministry of Health, Ramat-Gan, Israel
| | - Tamy Shohat
- Israel Centre for Disease Control, Israel Ministry of Health, Ramat-Gan, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Lital Keinan-Boker
- Israel Centre for Disease Control, Israel Ministry of Health, Ramat-Gan, Israel
- School of Public Health, University of Haifa, Haifa, Israel
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Daniel M, Cătană A, Popp RA, Dumitraș DE, Stamatian F, Buzoianu AD, Rotar IC. Genetic polymorphisms of glutathione S transferase and cervical intraepithelial neoplasia. REV ROMANA MED LAB 2016. [DOI: 10.1515/rrlm-2016-0036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
Aim: The present study aim to analyze the relationship between GST M/T genotypes of glutathione S-transferases and cervical intraepithelial neoplasia.
Materials and Methods: A prospective case-control study has been designed including 69 cases with different degrees of cervical dysplasia and 107 controls. All patients had been examined colposcopically. For every patient both cervical and blood specimen have been obtained. The peripheral blood was used for GST M/T genotyping. The statistical analysis was performed using OR and chi-square at a level of significance inferior to 0.05.
Results: No statistically significant differences had been found between cases and controls for GST T-/M- geno-type (T-/M-, χ2=0.03, p= 0.8610) and T+/M+ χ2=0.65, p = 0.4197. Patients with in situ carcinoma had significant GST genotype association for T-/M+ genotype (OR=4.66, CI 95% [0.6528,24.9725], χ2=4.6, p=0.0314) and for T+/M- genotype (OR=0.12, CI 95% [0.0027,0.9465], χ2=0.05, p=0.0219).
Conclusion: The combination of GST genotypes can be included in a predictive score for patients with cervical carcinoma.
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Affiliation(s)
- Mureșan Daniel
- Department of Mother and the Baby, University of Medicine and Pharmacy “Iuliu Hatieganu”, Cluj Napoca, Romania
| | - Andreea Cătană
- Department of Molecular Sciences, University of Medicine and Pharmacy “Iuliu Hatieganu”, Cluj Napoca, Romania
| | - Radu Anghel Popp
- Department of Molecular Sciences, University of Medicine and Pharmacy “Iuliu Hatieganu”, Cluj Napoca, Romania
| | - Diana Elena Dumitraș
- Department of Economic Sciences, University of Agricultural Sciences and Veterinary Medicine, Cluj-Napoca, Romania
| | - Florin Stamatian
- 1 st Clinic of Obstetrics and Gynecology, University of Medicine and Pharmacy “Iuliu Hatieganu”, Cluj Napoca, Romania
| | - Anca Dana Buzoianu
- Department of Pharmacology, Toxicology and Clinical Pharmacology, University of Medicine and Pharmacy “Iuliu Hatieganu”, Cluj-Napoca, Romania
| | - Ioana Cristina Rotar
- 1 st Clinic of Obstetrics and Gynecology, University of Medicine and Pharmacy “Iuliu Hatieganu”, Cluj Napoca, Romania
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Quaife SL, Ruparel M, Beeken RJ, McEwen A, Isitt J, Nolan G, Sennett K, Baldwin DR, Duffy SW, Janes SM, Wardle J. The Lung Screen Uptake Trial (LSUT): protocol for a randomised controlled demonstration lung cancer screening pilot testing a targeted invitation strategy for high risk and 'hard-to-reach' patients. BMC Cancer 2016; 16:281. [PMID: 27098676 PMCID: PMC4839109 DOI: 10.1186/s12885-016-2316-z] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 04/14/2016] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Participation in low-dose CT (LDCT) lung cancer screening offered in the trial context has been poor, especially among smokers from socioeconomically deprived backgrounds; a group for whom the risk-benefit ratio is improved due to their high risk of lung cancer. Attracting high risk participants is essential to the success and equity of any future screening programme. This study will investigate whether the observed low and biased uptake of screening can be improved using a targeted invitation strategy. METHODS/DESIGN A randomised controlled trial design will be used to test whether targeted invitation materials are effective at improving engagement with an offer of lung cancer screening for high risk candidates. Two thousand patients aged 60-75 and recorded as a smoker within the last five years by their GP, will be identified from primary care records and individually randomised to receive either intervention invitation materials (which take a targeted, stepped and low burden approach to information provision prior to the appointment) or control invitation materials. The primary outcome is uptake of a nurse-led 'lung health check' hospital appointment, during which patients will be offered a spirometry test, an exhaled carbon monoxide (CO) reading, and an LDCT if eligible. Initial data on demographics (i.e. age, sex, ethnicity, deprivation score) and smoking status will be collected in primary care and analysed to explore differences between attenders and non-attenders with respect to invitation group. Those who attend the lung health check will have further data on smoking collected during their appointment (including pack-year history, nicotine dependence and confidence to quit). Secondary outcomes will include willingness to be screened, uptake of LDCT and measures of informed decision-making to ensure the latter is not compromised by either invitation strategy. DISCUSSION If effective at improving informed uptake of screening and reducing bias in participation, this invitation strategy could be adopted by local screening pilots or a national programme. TRIAL REGISTRATION This study was registered with the ISRCTN (International Standard Registered Clinical/soCial sTudy Number: ISRCTN21774741) on the 23rd September 2015 and the NIH ClinicalTrials.gov database (NCT0255810) on the 22nd September 2015.
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Affiliation(s)
- Samantha L Quaife
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, Gower Street, London, WC1E 6BT, UK.
| | - Mamta Ruparel
- Lungs for Living Research Centre, UCL Respiratory, Division of Medicine, Rayne Building, University College London, 5 University Street, London, WC1E 6JF, UK
| | - Rebecca J Beeken
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, Gower Street, London, WC1E 6BT, UK
| | - Andy McEwen
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, Gower Street, London, WC1E 6BT, UK
| | - John Isitt
- Resonant Media, 55 Old Compton Street, London, W1D 6HW, UK
| | - Gary Nolan
- Resonant Media, 55 Old Compton Street, London, W1D 6HW, UK
| | - Karen Sennett
- Killick Street Health Centre, 75 Killick Street, London, N1 9RH, UK
| | - David R Baldwin
- Respiratory Medicine Unit, David Evans Research Centre, Nottingham University Hospitals, City Campus, Nottingham, NG5 1 PB, UK
| | - Stephen W Duffy
- Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, UK
| | - Samuel M Janes
- Lungs for Living Research Centre, UCL Respiratory, Division of Medicine, Rayne Building, University College London, 5 University Street, London, WC1E 6JF, UK
| | - Jane Wardle
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, Gower Street, London, WC1E 6BT, UK
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Ruparel M, Quaife SL, Navani N, Wardle J, Janes SM, Baldwin DR. Pulmonary nodules and CT screening: the past, present and future. Thorax 2016; 71:367-75. [PMID: 26921304 PMCID: PMC4819623 DOI: 10.1136/thoraxjnl-2015-208107] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2015] [Revised: 01/10/2016] [Accepted: 01/12/2016] [Indexed: 12/17/2022]
Abstract
Lung cancer screening has come a long way since the early studies with chest X-ray. Advancing technology and progress in the processing of images have enabled low dose CT to be tried and tested, and evidence suggests its use can result in a significant mortality benefit. There are several issues that need refining in order to successfully implement screening in the UK and elsewhere. Some countries have started patchy implementation of screening and there is increased recognition that the appropriate management of pulmonary nodules is crucial to optimise benefits of early detection, while reducing harm caused by inappropriate medical intervention. This review summarises and differentiates the many recent guidelines on pulmonary nodule management, discusses screening activity in other countries and exposes the present barriers to implementation in the UK.
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Affiliation(s)
- M Ruparel
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
| | - S L Quaife
- Health Behaviour Research Centre, University College London, London, UK
| | - N Navani
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
- Department of Thoracic Medicine, University College London Hospital, London, UK
| | - J Wardle
- Health Behaviour Research Centre, University College London, London, UK
| | - S M Janes
- Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK
| | - D R Baldwin
- Respiratory Medicine Unit, David Evans Research Centre, Nottingham University Hospitals, Nottingham, UK
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26
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Richard A, Rohrmann S, Schmid SM, Tirri BF, Huang DJ, Güth U, Eichholzer M. Lifestyle and health-related predictors of cervical cancer screening attendance in a Swiss population-based study. Cancer Epidemiol 2015; 39:870-6. [DOI: 10.1016/j.canep.2015.09.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 09/15/2015] [Accepted: 09/16/2015] [Indexed: 10/22/2022]
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Petrova D, Garcia-Retamero R, Catena A. Lonely hearts don't get checked: On the role of social support in screening for cardiovascular risk. Prev Med 2015; 81:202-8. [PMID: 26361754 DOI: 10.1016/j.ypmed.2015.09.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 08/31/2015] [Accepted: 09/01/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Regular cardiovascular risk screening can prevent cardiovascular disease through timely implementation of lifestyle changes or medication. However, few studies have investigated what factors promote regular screening for risk factors like hypertension and high blood cholesterol. The aim of this study was to investigate the relationship between social support and adherence to cardiovascular risk screening. METHODS We analyzed data from the Spanish National Health Survey-a cross-sectional representative survey conducted by the Spanish Ministry of Health in 2012 (N=21,007). Participants reported whether they had their blood pressure and cholesterol levels measured by a health professional in the previous 12 months. Social support (i.e., the perception that emotional and practical support was available when needed) was measured with a validated scale. Multiple logistic regressions were conducted adjusted for demographic and health-related factors. RESULTS Compared to individuals who reported a lack of social support, individuals who perceived sufficient social support were on average twice more likely to report participation in blood pressure screening, OR=2.06, 95% CI [1.60, 2.66] and cholesterol screening, OR=2.85, 95% CI [1.99, 4.09]. These effects were uniform across different demographics and were replicated in a previous wave of the survey. Factors associated with worse screening adherence were low social class, being single or widowed, smoking, alcohol consumption, and no history of cardiovascular risk. DISCUSSION Perceptions of social support are positively related to cardiovascular risk screening adherence. Future research should investigate what type of social support most effectively increases screening participation among high risk populations.
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Affiliation(s)
- Dafina Petrova
- Mind, Brain, and Behavior Research Center, University of Granada, Spain.
| | - Rocio Garcia-Retamero
- Mind, Brain, and Behavior Research Center, University of Granada, Spain; Max Planck Institute for Human Development, Germany
| | - Andrés Catena
- Mind, Brain, and Behavior Research Center, University of Granada, Spain
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28
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Sauer AG, Jemal A, Simard EP, Fedewa SA. Differential uptake of recent Papanicolaou testing by HPV vaccination status among young women in the United States, 2008-2013. Cancer Epidemiol 2015; 39:650-5. [PMID: 26055147 DOI: 10.1016/j.canep.2015.05.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 04/30/2015] [Accepted: 05/10/2015] [Indexed: 11/18/2022]
Abstract
BACKGROUND A positive association between recent Papanicolaou (Pap) test uptake and initiation of HPV vaccination among U.S. women has been reported. However, it is unknown whether recent Pap testing by HPV vaccination status varies by race/ethnicity. Discerning racial/ethnic variations is important given the higher prevalence of HPV types other than 16 and 18 in some racial/ethnic groups. We assessed whether uptake of recent Pap testing differed among women aged 21-30 years who had not initiated the HPV vaccination series versus those who had and whether this pattern differed by sociodemographic factors. METHODS 2008, 2010, and 2013 National Health Interview Survey data were used to generate weighted prevalence estimates and 95% confidence intervals (CIs) (n=7095). Adjusted predicted marginal models were used to generate adjusted prevalence ratios (aPRs) to assess the relationship between recent Pap test uptake and HPV vaccination series initiation by race/ethnicity. RESULTS The uptake of recent Pap testing among those who had not initiated the HPV vaccination series was significantly lower (81.0%) compared to those who had initiated vaccination (90.5%) (aPR=0.93, 95% CI: 0.90-0.96). This finding was consistent across most sociodemographic factors, though not statistically significant for Blacks, Hispanics, those with lower levels of education, or those with higher levels of income. CONCLUSION Young women who had not initiated HPV vaccination were less likely to have had a recent Pap test compared to women who had initiated vaccination. Concerted efforts are needed to increase uptake of recommended cervical cancer screening and HPV vaccination among young women.
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Affiliation(s)
- Ann Goding Sauer
- Surveillance and Health Services Research Program, Intramural Research Department, American Cancer Society, 250 Williams Street, Atlanta, GA 30303-1002, United States.
| | - Ahmedin Jemal
- Surveillance and Health Services Research Program, Intramural Research Department, American Cancer Society, 250 Williams Street, Atlanta, GA 30303-1002, United States
| | - Edgar P Simard
- Epidemiology Department, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, United States
| | - Stacey A Fedewa
- Surveillance and Health Services Research Program, Intramural Research Department, American Cancer Society, 250 Williams Street, Atlanta, GA 30303-1002, United States; Epidemiology Department, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, United States
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Quaife SL, McEwen A, Janes SM, Wardle J. Smoking is associated with pessimistic and avoidant beliefs about cancer: results from the International Cancer Benchmarking Partnership. Br J Cancer 2015; 112:1799-804. [PMID: 25950385 PMCID: PMC4647255 DOI: 10.1038/bjc.2015.148] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Revised: 03/30/2015] [Accepted: 04/07/2015] [Indexed: 11/09/2022] Open
Abstract
Background: Smoking cessation is the key cancer prevention behaviour for smokers; nonetheless, smokers can
still benefit from earlier diagnosis of cancer. However, fewer smokers participate in screening
despite their increased risk, which may reflect different beliefs about cancer. Methods: A UK population-representative sample of ⩾50 year-olds (n=6965) was surveyed
using the Awareness and Beliefs about Cancer measure. These analyses examine six items on cancer
beliefs (e.g., ‘cancer can often be cured'), and four on help-seeking barriers (e.g.,
‘I would be too embarrassed'). Results: Smokers were more likely to hold pessimistic cancer beliefs than never-smokers or former-smokers
on four of six items. For example, 34% agreed ‘a cancer diagnosis is a death
sentence', compared with 24% of non/former-smokers (P<0.001). More
smokers (18%) than non/former-smokers (11%) would not want to know if they had
cancer (P<0.01). The only barrier to symptomatic help-seeking differing by smoking
status was ‘worry about what the doctor might find' (36% vs 28%,
P<0.01). Associations were independent of demographics, self-rated health and cancer
experience. Conclusions: Smokers held more pessimistic and avoidant beliefs about cancer, which could deter
early-detection behaviour. A better understanding of these beliefs is needed to increase engagement
in early diagnosis by this high-risk group.
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Affiliation(s)
- S L Quaife
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, Gower Street, London WC1E 6BT, UK
| | - A McEwen
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, Gower Street, London WC1E 6BT, UK
| | - S M Janes
- Lungs for Living Research Centre, UCL Respiratory, Division of Medicine, Rayne Building, University College London, 5 University Street, London WC1E 6JF, UK
| | - J Wardle
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, Gower Street, London WC1E 6BT, UK
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Association between colorectal cancer screening rate and motivation to quit smoking: the Fourth Korean National Health and Nutrition Examination Survey. Public Health 2014; 128:1039-42. [PMID: 25443129 DOI: 10.1016/j.puhe.2014.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2013] [Revised: 05/07/2014] [Accepted: 09/04/2014] [Indexed: 11/21/2022]
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Ho T, Howard LE, Vidal AC, Gerber L, Moreira D, McKeever M, Andriole G, Castro-Santamaria R, Freedland SJ. Smoking and risk of low- and high-grade prostate cancer: results from the REDUCE study. Clin Cancer Res 2014; 20:5331-8. [PMID: 25139338 DOI: 10.1158/1078-0432.ccr-13-2394] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Although the relationship between smoking and prostate cancer risk is inconsistent, some studies show that smoking is associated with prostate cancer mortality. Whether this reflects delayed diagnosis or direct smoking-related effects is unknown. REDUCE, which followed biopsy-negative men with protocol-dictated prostate-specific antigen (PSA)-independent biopsies at 2 and 4 years, provides an opportunity to evaluate smoking and prostate cancer diagnosis with minimal confounding from screening biases. EXPERIMENTAL DESIGN Logistic regression was conducted to test the association between smoking and cancer on the first on-study biopsy (no cancer, low-grade Gleason 4-6, high-grade Gleason 7-10) in REDUCE. RESULTS Of 6,240 men with complete data and ≥1 on-study biopsy, 2,937 (45.8%) never smoked, 929 (14.5%) were current smokers, and 2,554 (39.8%) were former smokers. Among men with negative first on-study biopsies, smokers were 36% less likely to receive a second on-study biopsy (P < 0.001). At first on-study biopsy, 941 (14.7%) men had cancer. Both current and former smoking were not significantly associated with either total or low-grade prostate cancer (all P > 0.36). Current (OR = 1.44, P = 0.028) but not former smokers (OR = 1.21, P = 0.12) were at increased risk of high-grade disease. On secondary analysis, there was an interaction between smoking and body mass index (BMI; Pinteraction = 0.017): current smokers with BMI ≤ 25 kg/m(2) had an increased risk of low-grade (OR = 1.54, P = 0.043) and high-grade disease (OR = 2.45, P = 0.002), with null associations for BMI ≥ 25 kg/m(2). CONCLUSION Among men with elevated PSA and negative pre-study biopsy in REDUCE, in which biopsies were largely PSA independent, smoking was unrelated to overall prostate cancer diagnosis but was associated with increased risk of high-grade prostate cancer.
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Affiliation(s)
- Tammy Ho
- Duke University School of Medicine, Durham, North Carolina. Urology Section, Durham Veterans Affairs Medical Center, Durham, North Carolina
| | - Lauren E Howard
- Urology Section, Durham Veterans Affairs Medical Center, Durham, North Carolina. Division of Urology, Department of Surgery, Duke Prostate Center, Duke University School of Medicine, Durham, North Carolina
| | - Adriana C Vidal
- Urology Section, Durham Veterans Affairs Medical Center, Durham, North Carolina. Division of Urology, Department of Surgery, Duke Prostate Center, Duke University School of Medicine, Durham, North Carolina
| | - Leah Gerber
- Urology Section, Durham Veterans Affairs Medical Center, Durham, North Carolina. Division of Urology, Department of Surgery, Duke Prostate Center, Duke University School of Medicine, Durham, North Carolina
| | - Daniel Moreira
- Arthur Smith Institute for Urology, North Shore-Long Island Jewish Health System, New Hyde Park, New York
| | - Madeleine McKeever
- Urology Section, Durham Veterans Affairs Medical Center, Durham, North Carolina
| | - Gerald Andriole
- Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri. Prostate Study Center, Barnes-Jewish Hospital, St. Louis, Missouri
| | | | - Stephen J Freedland
- Urology Section, Durham Veterans Affairs Medical Center, Durham, North Carolina. Division of Urology, Department of Surgery, Duke Prostate Center, Duke University School of Medicine, Durham, North Carolina. Department of Pathology, Duke University Medical Center, Durham, North Carolina.
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Bryan L, Westmaas L, Alcaraz K, Jemal A. Cigarette smoking and cancer screening underutilization by state: BRFSS 2010. Nicotine Tob Res 2014; 16:1183-9. [PMID: 24696511 DOI: 10.1093/ntr/ntu047] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
INTRODUCTION To quantify the impact of current smokers' underutilization of colorectal cancer (CRC) and breast cancer screenings on overall cancer screening prevalence at the state level. METHODS Behavioral Risk Factor Surveillance System 2010 data were used to calculate states' prevalence of screening for breast cancer and CRC overall and by current smoking status. To quantify the effect of underutilization of screening by current smokers on the overall breast cancer and CRC screening prevalence in each state, we derived a cancer screening underutilization (CSU) measure. RESULTS CRC screening rates among adults aged 50 years and older ranged from 38.3% in Oklahoma to 59.5% in Rhode Island for current smokers and from 58.0% in Idaho to 75.9% in New Hampshire for nonsmokers. Mammography rates among women aged 40 years and older ranged from 26.8% in Utah to 63.6% in the District of Columbia for current smokers and from 50.8% in Utah to 73.0% in Massachusetts for nonsmokers. As a result, CSU values ranged from 2.1% to 6.7% for CRC screening and from 0.3% to 7.9% for mammography. Most states with the largest CSU values were located in the South or Midwest, whereas those with the smallest CSU values were located in the Northeast or West. CONCLUSIONS Lower levels of CRC and mammography screening among current smokers substantially contribute to many states' lower overall screening prevalence, particularly in Southern and Midwestern states where smoking prevalence is highest. These findings underscore the potential for more concentrated efforts to promote cessation and screening among smokers as a means to achieving cancer screening goals.
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Affiliation(s)
- Leah Bryan
- Intramural Research Department, American Cancer Society, Atlanta, GA
| | - Lee Westmaas
- Intramural Research Department, American Cancer Society, Atlanta, GA
| | - Kassandra Alcaraz
- Intramural Research Department, American Cancer Society, Atlanta, GA
| | - Ahmedin Jemal
- Intramural Research Department, American Cancer Society, Atlanta, GA
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Wiener RS, Slatore CG. Framing discussions about CT scan screening for lung cancer so that patients see the whole picture. Chest 2014; 144:1749-1750. [PMID: 24297116 DOI: 10.1378/chest.13-1521] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Affiliation(s)
- Renda Soylemez Wiener
- Pulmonary Center, Boston University School of Medicine, Bedford, MA; Center for Healthcare Organization & Implementation Research, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA; The Dartmouth Institute for Health Policy & Clinical Practice, Hanover, NH.
| | - Christopher G Slatore
- Health Services Research & Development, Portland VA Medical Center, Portland, OR; Section of Pulmonary & Critical Care Medicine, Portland VA Medical Center, Portland, OR; Division of Pulmonary & Critical Care Medicine, Department of Medicine, Oregon Health & Science University, Portland, OR
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Fletcher FE, Vidrine DJ, Tami-Maury I, Danysh HE, King RM, Buchberg M, Arduino RC, Gritz ER. Cervical cancer screening adherence among HIV-positive female smokers from a comprehensive HIV clinic. AIDS Behav 2014; 18:544-54. [PMID: 23605155 DOI: 10.1007/s10461-013-0480-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
HIV-positive women are at elevated risk for developing cervical cancer. While emerging research suggests that gynecologic health care is underutilized by HIV-positive women, factors associated with adherence to Pap testing, especially among HIV-positive female smokers are not well known. We utilized baseline data from a smoking cessation trial and electronic medical records to assess Pap smear screening prevalence and the associated characteristics among the HIV-positive female participants (n = 138). 46 % of the women had at least 1 Pap test in the year following study enrollment. Multiple logistic regression analysis indicated that younger age, African American race, hazardous drinking, increased number of cigarettes smoked per day, and smoking risk perception were associated with non-adherence to Pap smear screening. Cervical cancer screening was severely underutilized by women in this study. Findings underscore the importance of identifying predictors of non-adherence and addressing multiple risk factors and behavioral patterns among HIV-positive women who smoke.
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Affiliation(s)
- Faith E Fletcher
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, PO Box 301439, Unit 1330, Houston, TX, 77030-1439, USA,
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Tastan S, Andsoy II, Iyigun E. Evaluation of the Knowledge, Behavior and Health Beliefs of Individuals over 50 Regarding Colorectal Cancer Screening. Asian Pac J Cancer Prev 2013; 14:5157-63. [DOI: 10.7314/apjcp.2013.14.9.5157] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Inequalities in uptake of breast cancer screening in Spain: analysis of a cross-sectional national survey. Public Health 2013; 127:822-7. [DOI: 10.1016/j.puhe.2013.03.006] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2012] [Revised: 11/30/2012] [Accepted: 03/23/2013] [Indexed: 01/31/2023]
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Dugué PA, Rebolj M, Garred P, Lynge E. Immunosuppression and risk of cervical cancer. Expert Rev Anticancer Ther 2013; 13:29-42. [PMID: 23259425 DOI: 10.1586/era.12.159] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
A markedly increased risk of cervical cancer is known in women immunosuppressed due to AIDS or therapy following organ transplantation. The aim of this review is to determine the association between other conditions affecting the immune system and the risk of cervical cancer. Patients with end-stage renal disease seem to be at an increased risk of cervical cancer. A higher risk of cervical precancerous lesions was found in patients with some autoimmune diseases; particularly if treated with immunosuppressants. Among behavioral factors weakening the immune system, smoking appeared to strongly increase the risk of cervical cancer, while poor diet only moderately increased the risk. It is difficult to determine whether sexually transmitted infections other than human papillomavirus infection are independent risk factors. Identifying those groups of women likely to fail in clearing persistent human papillomavirus infections would help individualize screening guidelines and target immune-associated factors in the cervical cancer etiology.
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Affiliation(s)
- Pierre-Antoine Dugué
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, DK 1014 København K, Denmark.
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Anderson JC. Smoking-associated colorectal cancer risk: do micronutrients help or hurt? Clin Gastroenterol Hepatol 2013; 11:416-8. [PMID: 23333702 DOI: 10.1016/j.cgh.2012.12.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Revised: 12/16/2012] [Accepted: 12/17/2012] [Indexed: 02/07/2023]
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Erickson BK, Alvarez RD, Huh WK. Human papillomavirus: what every provider should know. Am J Obstet Gynecol 2013; 208:169-75. [PMID: 23021131 DOI: 10.1016/j.ajog.2012.09.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2012] [Revised: 08/28/2012] [Accepted: 09/05/2012] [Indexed: 10/27/2022]
Abstract
Persistence of human papillomavirus (HPV) infection is necessary for the development of cervical cancer. Additionally, infection with HPV is implicated in the majority of cases of other genital tract malignancies including vulvar, penile, and vaginal cancer. HPV testing and vaccination are a routine part of obstetrical/gynecological clinical practice. With an enhanced public awareness of HPV infections, many patients turn to their obstetricians/gynecologists with questions about transmission, testing, and prevention. In this review, we will discuss the biology of HPV, epidemiology of disease, methods and indications for testing, and vaccination strategies.
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Abstract
PURPOSE Health services research often utilizes secondary data sources such as the Behavioral Risk Factor Surveillance System (BRFSS). Since 2006, the released BRFSS data do not include respondents who live in counties with 10,000 or fewer residents, and the CDC no longer offers the opportunity to access the unrestricted data set. As a result, rural residents can be underrepresented in BRFSS data after 2005. The purpose of this analysis is to examine the potential for bias introduced by rural underestimation. METHODS We utilized 6 BRFSS data sets; the 2005 full data and the 2005-2009 restricted data. We estimated population sizes for each survey year, and we compared these estimates to comparable data from the US Census intercensal estimates. We also compared estimates of preventive service utilization (mammography, Pap tests, colorectal cancer screening, and influenza vaccinations) between the two 2005 data versions. RESULTS Rural populations were underrepresented, particularly with the smaller counties excluded. Remote rural residents were the most consistently underrepresented. Preventive service delivery estimates differed between the full and restricted 2005 data versions. Mammography and Pap test estimates tended to be higher in the restricted data, while colorectal cancer screening and influenza vaccinations were similar or inconsistent. These results indicate that restricting by county size introduced bias in these estimates. CONCLUSIONS Having quality, nationally representative data is important to study disparities in service delivery. The potential bias introduced by the BRFSS county restriction may result in rural research being less effective for policy recommendations and interventions.
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Affiliation(s)
- Kevin J Bennett
- Department of Family and Preventive Medicine, University of South Carolina School of Medicine, Columbia, South Carolina, USA.
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Deng SX, An W, Gao J, Yin J, Cai QC, Yang M, Hong SY, Fu XX, Yu ED, Xu XD, Zhu W, Li ZS. Factors influencing diagnosis of colorectal cancer: a hospital-based survey in China. J Dig Dis 2012; 13:517-24. [PMID: 22988925 DOI: 10.1111/j.1751-2980.2012.00626.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To investigate the diagnostic status of colorectal cancer (CRC) and the influence of early diagnosis and cancer stage in a tertiary care hospital in China. METHODS Face-to-face interviews were conducted in 364 consecutive CRC patients who had never participated in CRC screening. Initial symptoms, diagnosis and treatment delay were determined using a questionnaire. Factors influencing diagnostic status were analyzed using univariate analysis and logistic regression model. RESULTS A total of 307 patients were enrolled, in which 128 were with colon cancer and 179 with rectal cancer. The duration of diagnosis delay was significant longer than that of treatment delay. Unlike rectal cancer, colon cancer was likely to be treated at an advanced stage with a short interval between symptom onset and treatment. Colon cancer patients with a history of biliary tract or gallbladder stones, aged ≥ 50 years and with abdominal mass or intestinal obstruction as the initial symptom were diagnosed and treated much earlier. In rectal cancer, women and non-smokers were diagnosed and treated quickly. Factors correlated with early cancer stage were found in colon cancer, including bloody stool as the initial symptom (OR = 2.63, 95% CI 1.08-6.25, P = 0.034) and a history of appendectomy (OR = 4.00, 95% CI 1.15-14.29, P = 0.029). CONCLUSIONS The factors contributing to early cancer detection were identified but their clinical value is limited. Diagnosis by symptoms suggesting CRC needs to be improved and CRC screening should be vigorously promoted.
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Affiliation(s)
- Shang Xin Deng
- Department of Gastroenterology, Lanzhou General Hospital of Chinese People's Liberation Army, Lanzhou, Gansu Province, China
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Wilson KM, Giovannucci EL, Mucci LA. Lifestyle and dietary factors in the prevention of lethal prostate cancer. Asian J Androl 2012; 14:365-74. [PMID: 22504869 DOI: 10.1038/aja.2011.142] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The prevention of lethal prostate cancer is a critical public health challenge that would improve health and reduce suffering from this disease. In this review, we discuss the evidence surrounding specific lifestyle and dietary factors in the prevention of lethal prostate cancer. We present a summary of evidence for the following selected behavioral risk factors: obesity and weight change, physical activity, smoking, antioxidant intake, vitamin D and calcium, and coffee intake.
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Affiliation(s)
- Kathryn M Wilson
- Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA
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Vander Weg MW, Howren MB, Cai X. Use of Routine Clinical Preventive Services Among Daily Smokers, Non-daily Smokers, Former Smokers, and Never-smokers. Nicotine Tob Res 2011; 14:123-30. [DOI: 10.1093/ntr/ntr141] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Fonseca-Moutinho JA. Smoking and cervical cancer. ISRN OBSTETRICS AND GYNECOLOGY 2011; 2011:847684. [PMID: 21785734 PMCID: PMC3140050 DOI: 10.5402/2011/847684] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/24/2011] [Accepted: 05/25/2011] [Indexed: 01/26/2023]
Abstract
Cervical cancer (CC) is the third most common cancer in women worldwide; however, CC is a preventable disease, and much effort should be done to prevent it. Persistence of high-risk HPV infection is the strongest epidemiologic risk factor for CC, however it is not sufficient for development of the disease it cofactors should be present. In 2004; IARC listed cervical cancer among those causally related to smoking. Smoking interferes with incidence and prevalence of HPV infection and is associated with cervical intraepithelial neoplasia and invasive CC. Multiple factors seem to intervene on cervical carcinogenesis related with tobacco, especially by direct local carcinogenic effect and local immunosuppression. Smoking addition is also closely related with other confounding factors, like unfavorable psychosocial events, systemic immunity, contraception, and nutrition, which got difficult epidemiologic evaluation of smoking role on cervical carcinogenesis. Smoking habits should be taken in account in clinical practice and in research concerning CC.
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Affiliation(s)
- José Alberto Fonseca-Moutinho
- Faculdade de Ciências da Saúde, Universidade da Beira Interior, Avenida Infante D. Henrique, 6200-506 Covilhã, Portugal
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Abstract
CONTEXT Studies of smoking in relation to prostate cancer mortality or recurrence in prostate cancer patients are limited, with few prostate cancer-specific outcomes. OBJECTIVE To assess the relation of cigarette smoking and smoking cessation with overall, prostate cancer-specific, and cardiovascular disease (CVD) mortality and biochemical recurrence among men with prostate cancer. DESIGN, SETTING, AND PARTICIPANTS Prospective observational study of 5366 men diagnosed with prostate cancer between 1986 and 2006 in the Health Professionals Follow-Up Study. MAIN OUTCOME MEASURES Hazard ratios (HRs) for overall, prostate cancer-specific, and CVD mortality, and biochemical recurrence, defined by an increase in prostate-specific antigen (PSA) levels. RESULTS There were 1630 deaths, 524 (32%) due to prostate cancer and 416 (26%) to CVD, and 878 biochemical recurrences. Absolute crude rates for prostate cancer-specific death for never vs current smokers were 9.6 vs 15.3 per 1000 person-years; for all-cause mortality, the corresponding rates were 27.3 and 53.0 per 1000 person-years. In multivariable analysis, current vs never smokers had an increased risk of prostate cancer mortality (HR, 1.61; 95% confidence interval [CI], 1.11-2.32), as did current smokers with clinical stage T1 through T3 (HR, 1.80; 95% CI, 1.04-3.12). Current smokers also had increased risk of biochemical recurrence (HR, 1.61; 95% CI, 1.16-2.22), total mortality (HR, 2.28; 95% CI, 1.87-2.80), and CVD mortality (HR, 2.13; 95% CI, 1.39-3.26). After adjusting for clinical stage and grade (likely intermediates of the relation of smoking with prostate cancer recurrence and survival), current smokers had increased risk of prostate cancer mortality (HR, 1.38; 95% CI, 0.94-2.03), as did current smokers with clinical stage T1 through T3 (HR, 1.41; 95% CI, 0.80-2.49); they also had an increased risk of biochemical recurrence (HR, 1.47; 95% CI, 1.06-2.04). Greater number of pack-years was associated with significantly increased risk of prostate cancer mortality but not biochemical recurrence. Current smokers of 40 or more pack-years vs never smokers had increased prostate cancer mortality (HR, 1.82; 95% CI, 1.03-3.20) and biochemical recurrence (HR, 1.48; 95% CI, 0.88-2.48). Compared with current smokers, those who had quit smoking for 10 or more years (HR, 0.60; 95% CI, 0.42-0.87) or who have quit for less than 10 years but smoked less than 20 pack-years (HR, 0.64; 95% CI, 0.28-1.45) had prostate cancer mortality risks similar to never smokers (HR, 0.61; 95% CI, 0.42-0.88). CONCLUSIONS Smoking at the time of prostate cancer diagnosis is associated with increased overall and CVD mortality and prostate cancer-specific mortality and recurrence. Men who have quit for at least 10 years have prostate cancer-specific mortality risks similar to those who have never smoked.
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Affiliation(s)
- Stacey A Kenfield
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA.
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Vilensky D, Lawrentschuk N, Hersey K, Fleshner NE. A smoking cessation program as a resource for bladder cancer patients. Can Urol Assoc J 2011; 6:E167-73. [PMID: 21539769 DOI: 10.5489/cuaj.10070] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Continued tobacco use following a bladder cancer (CaB) diagnosis puts patients at risk for other tobacco-associated diseases and has also been associated with heightened risks of treatment-related complications, tumour recurrence, morbidity and mortality. Our aim was to determine if patients with CaB who continue to smoke warrant a smoking cessation program as a resource for improving their prognosis and long-term health. METHODS A cross-sectional quantitative questionnaire-based study was performed between January and April 2009. We surveyed patients with a pathologically confirmed diagnosis of CaB during their cystoscopy appointments at a single cancer centre. RESULTS One hundred patients completed the survey with 72% of them admitting to smoking in their lifetime. A third of respondents smoked at the time of their diagnosis; 76% of patients who had been active smokers at the time of their diagnosis (n = 33) reported smoking at some point thereafter and 58% continued to smoke. Among continued smokers, they were classified in the following categories: 26% were in "precontemplation," 5% in "contemplation," 16% in "preparation," and 53% in "action;" 37% of patients who continued to smoke were interested in a hospital-based smoking cessation program. Overall, 70% reported smoking as a risk factor for a poor CaB prognosis. The two most common barriers to quitting were "trouble managing stress and mood" and "fear of gaining weight." CONCLUSION Based on the data from our centre, patients with CaB who continue to smoke after their diagnosis warrant a smoking cessation program as a resource for improving prognosis and long-term health. Further research should focus on establishing an efficacious and cost-effective program that provides these patients with the resources they need to quit smoking.
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Affiliation(s)
- Daniel Vilensky
- Department of Urology and Surgical Oncology, University Health Network, Princess Margaret Hospital and Toronto General Hospital, Toronto, University of Toronto, ON
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