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Analyzing Factors Enabling Prostate Cancer Screening Behaviors Among African American Males in the South Region Using the Andersen's Behavioral Model of Healthcare Services Utilization. JOURNAL OF PREVENTION (2022) 2023; 44:253-266. [PMID: 36653553 DOI: 10.1007/s10935-023-00722-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/03/2023] [Indexed: 01/20/2023]
Abstract
Prostate cancer is the second leading cause of cancer death among men in the United States, and African American men especially represent a high risk population for prostate cancer. Although the overall prostate cancer incidence rates have been declining since 1992, the average annual prostate cancer incidence rates among African American men were still higher than any other racial groups, and the mortality rates were 2.1 times higher than that of Caucasian men. This study examined what factors including cultural mistrust were related with the prostate cancer screening behaviors among African American males in the South East region. Out of 496 prostate educational seminar attendees, 304 volunteers completed the survey about the behaviors of prostate cancer, cultural mistrust for health providers and general health beliefs and health behaviors. Using Anderson's Behavioral Model of Health Services Use, hierarchical multivariate logistic regression analysis was conducted to identify which predisposing, enabling, and need factors could predict prostate cancer screening behaviors and whether there was any interaction effects among these predictors. Findings revealed that annual household income and annual health check-up were significantly related with the prostate cancer screening behaviors while the effect of health insurance was diminished among older African American males. Overall, results highlight the importance of financial resources as a determinant of prostate cancer screening behaviors among African American males implying the need of substantial support to overcome the obstacles from financial adversity.
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Taghizadeh N, Tremblay A, Cressman S, Peacock S, McWilliams AM, MacEachern P, Johnston MR, Goffin J, Goss G, Nicholas G, Martel S, Laberge F, Bhatia R, Liu G, Schmidt H, Atkar-Khattra S, Tsao MS, Tammemagi MC, Lam SC. Health-related quality of life and anxiety in the PAN-CAN lung cancer screening cohort. BMJ Open 2019; 9:e024719. [PMID: 30659040 PMCID: PMC6340441 DOI: 10.1136/bmjopen-2018-024719] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES The impact of lung cancer screening with low-dose chest CT (LDCT) on participants' anxiety levels and health-related quality of life (HRQoL) is an important consideration in the implementation of such programmes. We aimed to describe changes in anxiety and HRQoL in a high-risk Canadian cohort undergoing LDCT lung cancer screening. METHODS 2537 subjects who had 2% or greater lung cancer risk over 6 years using a risk prediction tool were recruited from eight centres across Canada in the Pan-Canadian Early Detection of Lung Cancer Study (2008-2010). We compared HRQoL and anxiety levels before and after screening of 1237 participants with LDCT (excluding a subset of 1300 participants who also underwent autofluorescence bronchoscopy screening), as well as after investigations performed because of a positive screening examination. The 12-item short-form Physical and Mental Component Scales (SF-12), EQ-5D-3L scores and State Trait Anxiety Inventory-State anxiety were used at each assessment. RESULTS Overall, there were no clinically significant differences in HRQoL outcomes between baseline and each of the survey time points following initial screening. No mean change in anxiety in the overall cohort was noted following baseline LDCT, but more participants had clinically significant increase in anxiety versus decrease after baseline screening (increase >minimal clinically important difference (MCID) (n=180) vs decrease >MCID (n=50), p<0.001). This finding persisted but to a lesser degree at the 12 month time point (increase >MCID (n=146) vs decrease >MCID (n=87), p<0.001). CONCLUSIONS CT screening for lung cancer has no major overall impact on HRQoL among participants, although a minority of participants (number-needed-to-harm=7 after baseline screening and 18 at 1 year) demonstrated clinically significant increased anxiety levels. TRIALREGISTRATION NUMBER NCT00751660; Results.
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Affiliation(s)
| | - Alain Tremblay
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Sonya Cressman
- Department of Integrative Oncology, The British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Stuart Peacock
- Department of Integrative Oncology, The British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Annette M McWilliams
- Department of Respiratory Medicine, Fionna Stanley Hospital and University of Western Australia, Perth, Australia
| | - Paul MacEachern
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Michael R Johnston
- Department of Surgery, Beatrice Hunter Cancer Research Institute and Dalhousie University, Halifax, Canada
| | - John Goffin
- Department of Oncology, The Juravinski Cancer Centre and McMaster University, Hamilton, Ontario, Canada
| | - Glen Goss
- Department of Medicine, The Ottawa Hospital Cancer Center, Ottawa, Ontario, Canada
| | - Garth Nicholas
- Department of Medicine, The Ottawa Hospital Cancer Center, Ottawa, Ontario, Canada
| | - Simon Martel
- Department de Pneumologie, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec, Canada
| | - Francis Laberge
- Department de Pneumologie, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec, Canada
| | - Rick Bhatia
- Department of Medicine, Memorial University, St John’s, Newfoundland and Labrador, Canada
| | - Geoffrey Liu
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Heidi Schmidt
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Sukhinder Atkar-Khattra
- Department of Integrative Oncology, The British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Ming-Sound Tsao
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Martin C Tammemagi
- Department of Health Sciences, Brock University, St. Catharines, Ontario, Canada
| | - Stephen C Lam
- Department of Integrative Oncology, The British Columbia Cancer Agency, Vancouver, British Columbia, Canada
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Wang H, Zhang S, Wan L, Sun H, Tan J, Su Q. Screening and staging for non-small cell lung cancer by serum laser Raman spectroscopy. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2018; 201:34-38. [PMID: 29729529 DOI: 10.1016/j.saa.2018.04.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Revised: 03/26/2018] [Accepted: 04/04/2018] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Lung cancer is the leading cause of cancer-related death worldwide. Current clinical screening methods to detect lung cancer are expensive and associated with many complications. Raman spectroscopy is a spectroscopic technique that offers a convenient method to gain molecular information about biological samples. In this study, we measured the serum Raman spectral intensity of healthy volunteers and patients with different stages of non-small cell lung cancer. The purpose of this study was to evaluate the application of serum laser Raman spectroscopy as a low cost alternative method in the screening and staging of non-small cell lung cancer (NSCLC). METHODS The Raman spectra of the sera of peripheral venous blood were measured with a LabRAM HR 800 confocal Micro Raman spectrometer for individuals from five groups including 14 healthy volunteers (control group), 23 patients with stage I NSCLC (stage I group), 24 patients with stage II NSCLC (stage II group), 19 patients with stage III NSCLC (stage III group), 11 patients with stage IV NSCLC (stage IV group). Each serum sample was measured 3 times at different spots and the average spectra represented the signal of Raman spectra in each case. The Raman spectrum signal data of the five groups were statistically analyzed by analysis of variance (ANOVA), principal component analysis (PCA), linear discriminant analysis (LDA), and cross-validation. RESULTS Raman spectral intensity was sequentially reduced in serum samples from control group, stage I group, stage II group and stage III/IV group. The strongest peak intensity was observed in the control group, and the weakest one was found in the stage III/IV group at bands of 848 cm-1, 999 cm-1, 1152 cm-1, 1446 cm-1 and 1658 cm-1 (P < 0.05). Linear discriminant analysis showed that the sensitivity to identify healthy people, stage I, stage II, and stage III/IV NSCLC was 86%, 65%, 75%, and 87%, respectively; the specificity was 95%, 94%, 88%, and 93%, respectively; and the overall accuracy rate was 92% (71/77). CONCLUSION The laser Raman spectroscopy can effectively identify patients with stage I, stage II or stage III/IV Non-Small Cell Lung cancer using patient serum samples.
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Affiliation(s)
- Hong Wang
- The First Affiliated Hospital of Guangdong Pharmaceutical University, No.19 Nonglinxia Road, Yuexiou District, Guangzhou City, Guangdong Province 510080, PR China.
| | - Shaohong Zhang
- Guangzhou Institute of Energy Conversion, CAS, No.2 Nengyuan Road, Tianhe District, Guangzhou City, Guangdong Province 510640, PR China
| | - Limei Wan
- The First Affiliated Hospital of Guangdong Pharmaceutical University, No.19 Nonglinxia Road, Yuexiou District, Guangzhou City, Guangdong Province 510080, PR China
| | - Hong Sun
- The First Affiliated Hospital of Guangdong Pharmaceutical University, No.19 Nonglinxia Road, Yuexiou District, Guangzhou City, Guangdong Province 510080, PR China
| | - Jie Tan
- The First Affiliated Hospital of Guangdong Pharmaceutical University, No.19 Nonglinxia Road, Yuexiou District, Guangzhou City, Guangdong Province 510080, PR China
| | - Qiucheng Su
- Guangzhou Institute of Energy Conversion, CAS, No.2 Nengyuan Road, Tianhe District, Guangzhou City, Guangdong Province 510640, PR China
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Rao A, Carter J. Ultrasound and ovarian cancer screening: is there a future? J Minim Invasive Gynecol 2011; 18:24-30. [PMID: 21195955 DOI: 10.1016/j.jmig.2010.09.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2010] [Revised: 09/09/2010] [Accepted: 09/16/2010] [Indexed: 12/20/2022]
Abstract
Ovarian cancer is a leading cause of death due to gynecologic malignant disease. Advances in ultrasound have improved the ability to identify the more subtle characteristics of adnexal masses, resulting in an increasing volume of research addressing its use to accurately predict whether masses are benign or malignant, and the inclusion of ultrasound in large-scale studies addressing screening for ovarian cancer. Herein, we explore some of the factors that make screening for ovarian cancer challenging, review the major trials addressing the effect of ovarian cancer screening, and examine data relating to more recent advances in ultrasound technology.
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Affiliation(s)
- Archana Rao
- Sydney Gynaecological Oncology Group, Sydney Cancer Centre, Royal Prince Alfred Hospital, Sydney, Australia.
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Malmi H, Ruutu M, Määttänen L, Stenman UH, Juusela H, Tammela TL, Auvinen A. Why do men opt out of prostate-cancer screening? Attitudes and perception among participants and non-participants of a screening trial. BJU Int 2010; 106:472-7. [DOI: 10.1111/j.1464-410x.2010.09165.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Weinrich SP, Seger R, Miller BL, Davis C, Kim S, Wheeler C, Weinrich M. Knowledge of the Limitations Associated With Prostate Cancer Screening Among Low-income Men. Cancer Nurs 2004; 27:442-53. [PMID: 15632783 DOI: 10.1097/00002820-200411000-00003] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This correlational pilot study measured limitations of prostate cancer screening, using a revised Knowledge of Prostate Cancer Questionnaire. Knowledge in 81 low-income men is reported. The Knowledge About Prostate Cancer Screening Questionnaire consists of 12 questions, with scores ranging from 0 to 12. Concepts measured include limitations, symptoms, risk factors, and screening age guidelines. The Total Knowledge Score had a mean of 6.60, with a standard deviation of 3.00, indicating that knowledge was low. Half of the men knew that "some treatments for prostate cancer can make it harder for men to control their urine." More than half of the men knew that, "some treatments for prostate cancer can cause problems with a man's ability to have sex." Married men, low-income men, and Caucasian men had significantly lower Total Knowledge Scores than unmarried, higher income, and African American men. Implications for practice and research are discussed.
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Affiliation(s)
- Sally P Weinrich
- University of Louisville School of Nursing, Louisville, KY 40202, USA.
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Abstract
PURPOSE OF REVIEW The aim of this review is to discuss advances in the field of screening and early detection of prostate cancer from papers published in 2003. RECENT FINDINGS The fall in distant prostate cancer mortality accounted for the overall decline in cause-specific mortality rates in the USA. In the European prostate cancer screening trial (European Randomized Study of Screening for Prostate Cancer), there is considerable stage migration towards organ-confined disease, which becomes more pronounced in the second screening round. The high sensitivity of the screening protocol (approximately 90%), low interval cancer rate (13-19%) and lead time estimates of 10 years and longer support a 4-year screening interval, current procedure in the European Randomized Study of Screening for Prostate Cancer trial. Advances achieved in research on the discriminative power of the free prostate-specific antigen forms, particularly pro-prostate-specific antigen, have progressed and may be introduced in cancer detection at low prostate-specific antigen levels rather than a further reduction of the current prostate-specific antigen threshold. SUMMARY Definitive evidence on the effectiveness of prostate cancer screening with prostate-specific antigen should come from the ongoing European Randomized Study of Screening for Prostate Cancer and Prostate, Lung, Colorectal and Ovary cancer trials, and should further elucidate the debate about the appropriate prostate-specific antigen threshold. Free prostate-specific antigen sub-forms offer prospects for prostate cancer detection at low prostate-specific antigen levels.
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Affiliation(s)
- Suzie J Otto
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
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Taylor KL, Shelby R, Gelmann E, McGuire C. Quality of life and trial adherence among participants in the prostate, lung, colorectal, and ovarian cancer screening trial. J Natl Cancer Inst 2004; 96:1083-94. [PMID: 15265970 DOI: 10.1093/jnci/djh194] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The National Cancer Institute's Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial was designed to examine whether annual screening tests for these four tumor sites result in reduced disease-related mortality. We assessed the impact of trial participation on both health-related quality of life (HRQL) and trial adherence. METHODS Participants (N = 432; 217 in the control arm and 215 in screening arm) were accrued from the Georgetown University PLCO site from May through December 1998. Screening-arm participants were interviewed by telephone at baseline (prescreening), shortly after notification of screening results (short-term follow-up), and 9 months after notification of screening results (intermediate-term follow up). Control-arm participants completed a baseline and 1-year follow-up assessment. Logistic regression analyses were conducted. RESULTS Participants reported high levels of HRQL and satisfaction with their decision to participate. Screening-arm participants with abnormal screening results had a higher level of intrusive thoughts about cancer than those with all normal results (odds ratio [OR] = 2.9, 95% confidence interval [CI] = 1.3 to 6.3) at the short-term follow-up but not at the intermediate-term follow-up (when abnormal test results were known to be false positive; OR = 1.9, 95% CI = 0.89 to 4.2). Trial adherence was statistically significantly better among participants who had received all normal results in the previous year's screening tests (93.7% versus 78.7%; OR = 3.7, CI = 1.1 to 12.0) than in those who received at least one abnormal result. In the control arm, adherence (defined as returning annual questionnaires) was positively associated with education (OR = 3.4, 95% CI = 1.4 to 8.4) and sex, with women being more likely to return questionnaires than men (OR = 2.1, 95% CI = 1.05 to 4.4). CONCLUSIONS It is feasible to collect HRQL measures as part of a large cancer screening trial. Prior abnormal screening results were related to short-term HRQL but not to intermediate-term HRQL. Trial adherence was poorer among those who had received previous false-positive results. These results suggest several methods for improving adherence in this and other subgroups.
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Affiliation(s)
- Kathryn L Taylor
- Cancer Control Program, Lombardi Comprehensive Cancer Center, Georgetown University, 2233 Wisconsin Ave., NW, Ste. 317, Washington, DC 20007, USA.
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Essink-Bot ML, Korfage IJ, De Koning HJ. Including the quality-of-life effects in the evaluation of prostate cancer screening: expert opinions revisited? BJU Int 2004; 92 Suppl 2:101-5. [PMID: 14983965 DOI: 10.1111/j.1464-410x.2003.04409.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To apply the general empirical framework for estimating utilities in cost-utility analysis (CUA) of population-based prostate cancer screening, including an assessment of empirical health status with a classifying measure (e.g. the EQ-5D) and linking these descriptions to utility estimates using the standard preference-based algorithm, combining them with the appropriate duration into quality-adjusted life years, and sensitivity analysis. MATERIALS AND METHODS Empirical studies to describe and value the health status effects of prostate cancer screening have been ongoing within the Rotterdam centre of the European Randomised Study on Screening for Prostate Cancer since 1995. The results of these studies, including the screening, the primary treatment phase and advanced disease, will be used in estimating utilities for cost-utility analysis. RESULTS Estimation of cost-utility of population-based prostate cancer screening with the results of the three empirical health status studies yielded partly counterintuitive results, underestimating the unfavourable health status effects that are inevitably associated with prostate cancer screening. This may be caused by other than health effects of the screening itself ('process effects') and adaptive changes in perception of their situation in patients after curative primary treatment ('response shift'), among other elements. CONCLUSIONS These results prompted us to reconsider the suitability of the general framework of CUA for screening programmes. Possible directions for solutions are indicated.
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Affiliation(s)
- M L Essink-Bot
- Department of Public Health, Erasmus MC/University Medical Centre Rotterdam, the Netherlands.
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Roobol MJ, Schröder FH. European Randomized Study of Screening for Prostate Cancer: achievements and presentation. BJU Int 2004; 92 Suppl 2:117-22. [PMID: 14983969 DOI: 10.1111/j.1464-410x.2003.4698x.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Schröder FH, Denis LJ, Roobol M, Nelen V, Auvinen A, Tammela T, Villers A, Rebillard X, Ciatto S, Zappa M, Berenguer A, Paez A, Hugosson J, Lodding P, Recker F, Kwiatkowski M, Kirkels WJ. The story of the European Randomized Study of Screening for Prostate Cancer. BJU Int 2003; 92 Suppl 2:1-13. [PMID: 14983946 DOI: 10.1111/j.1464-410x.2003.04389.x] [Citation(s) in RCA: 97] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- F H Schröder
- Department of Urology, Erasmus Medical Centre, Rotterdam, the Netherlands.
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