1
|
Chiu AS, Hoxha I, Jensen CB, Saucke MC, Pitt SC. Medical Maximizing Preferences and Beliefs About Cancer Among US Adults. JAMA Netw Open 2024; 7:e2417098. [PMID: 38874925 PMCID: PMC11179133 DOI: 10.1001/jamanetworkopen.2024.17098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 04/16/2024] [Indexed: 06/15/2024] Open
Abstract
Importance Medical overutilization contributes to significant health care expenditures and exposes patients to questionably beneficial surgery and unnecessary risk. Objectives To understand public attitudes toward medical utilization and the association of these attitudes with beliefs about cancer. Design, Setting, and Participants In this cross-sectional survey study conducted from August 26 to October 28, 2020, US-based, English-speaking adults were recruited from the general public using Prolific Academic, a research participant platform. Quota-filling was used to obtain a sample demographically representative of the US population. Adults with a personal history of cancer other than nonmelanoma skin cancer were excluded. Statistical analysis was completed in July 2022. Main Outcome and Measures Medical utilization preferences were characterized with the validated, single-item Maximizer-Minimizer Elicitation Question. Participants preferring to take action in medically ambiguous situations (hereafter referred to as "maximizers") were compared with those who leaned toward waiting and seeing (hereafter referred to as "nonmaximizers"). Beliefs and emotions about cancer incidence, survivability, and preventability were assessed using validated measures. Logistic regression modeled factors associated with preferring to maximize medical utilization. Results Of 1131 participants (mean [SD] age, 45 [16] years; 568 women [50.2%]), 287 (25.4%) were classified as maximizers, and 844 (74.6%) were classified as nonmaximizers. Logistic regression revealed that self-reporting very good or excellent health status (compared with good, fair, or poor; odds ratio [OR], 2.01 [95% CI, 1.52-2.65]), Black race (compared with White race; OR, 1.88 [95% CI, 1.22-2.89]), high levels of cancer worry (compared with low levels; OR, 1.62 [95% CI, 1.09-2.42]), and overestimating cancer incidence (compared with accurate estimation or underestimating; OR, 1.58 [95% CI, 1.09-2.28]) were significantly associated with maximizing preferences. Those who believed that they personally had a higher-than-average risk of developing cancer were more likely to be maximizers (23.6% [59 of 250] vs 17.4% [131 of 751]; P = .03); this factor was not significant in regression analyses. Conclusions and Relevance In this survey study of US adults, those with medical maximizing tendencies more often overestimated the incidence of cancer and had higher levels of cancer-related worry. Targeted and personalized education about cancer and its risk factors may help reduce overutilization of oncologic care.
Collapse
Affiliation(s)
- Alexander S Chiu
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison
| | - Ines Hoxha
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison
| | - Catherine B Jensen
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison
- Department of Surgery, University of Michigan, Ann Arbor
| | - Megan C Saucke
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison
| | - Susan C Pitt
- Department of Surgery, University of Michigan, Ann Arbor
| |
Collapse
|
2
|
Kangkhetkron T, Juntarawijit C. Pesticide exposure and lung cancer risk: A case-control study in Nakhon Sawan, Thailand. F1000Res 2024; 9:492. [PMID: 38435081 PMCID: PMC10904940 DOI: 10.12688/f1000research.24114.4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/03/2024] [Indexed: 03/05/2024] Open
Abstract
Background Pesticide exposure might increase risk of lung cancer. The purpose of this study was to investigate the association between the historical use of pesticides and lung cancer using a case-control design. Methods This case-control study compared a lifetime pesticide exposure of 233 lung cancer cases, and 447 healthy neighbours matched for gender, and age (±5 years). Data on demographic, pesticide exposure and other related factors were collected using a face-to-face interview questionnaire. Associations between lung cancer and types of pesticides as well as individual pesticides were analysed using logistic regression adjusted for gender, age, cigarette smoking, occupation, cooking fumes exposure, and exposure to air pollution. Results It was found that lung cancer was positively associated with the lifetime use of herbicides and insecticides. Compared to people in the non-exposed groups, those in Q3-Q4 days of using herbicides and insecticides had an elevated risk of lung cancer, with odds ratio (OR) between 2.20 (95% confidence interval (CI) 1.24-3.89), and 3.99 (95% CI 1.62-7.11) (p < 0.001). For individual pesticides, those presenting a significant association with lung cancer were dieldrin (OR = 2.56; 95% CI 1.36-4.81), chlorpyrifos (OR = 3.29; 95 % CI 1.93-5.61), and carbofuran (OR = 2.10; 95% CI 1.28-3.42). It was also found, for the first time, carbofuran, glyphosate, and paraquat to be significantly associated with lung cancer. Conclusions The study confirmed dieldrin, and chlorpyrifos as risk factors and suggested carbofuran, glyphosate, and paraquat as potential risk factors for the disease. The paper stands as a noteworthy contribution to literature, particularly because the majority of publications on the topic originate from developed Western countries. However, further studies are imperative to validate the results and pinpoint additional individual pesticides that may be associated with lung cancer.
Collapse
Affiliation(s)
- Teera Kangkhetkron
- Department of Natural Resources and Environment, Faculty of Agriculture, Natural Resources and Environment, Naresuan University, Phitsanulok, 65000, Thailand
- Nakhon Sawan Provincial Public Health Office, Minstry of Public Health, Muang District, Nakhon Sawan, 60000, Thailand
| | - Chudchawal Juntarawijit
- Department of Natural Resources and Environment, Faculty of Agriculture, Natural Resources and Environment, Naresuan University, Muang District, Phitsanulok, 65000, Thailand
| |
Collapse
|
3
|
Risk perception and disease knowledge in attendees of a community-based lung cancer screening programme. Lung Cancer 2022; 168:1-9. [DOI: 10.1016/j.lungcan.2022.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 02/06/2022] [Accepted: 04/04/2022] [Indexed: 12/24/2022]
|
4
|
Implementing lung cancer screening in Europe: taking a systems approach. JTO Clin Res Rep 2022; 3:100329. [PMID: 35601926 PMCID: PMC9121320 DOI: 10.1016/j.jtocrr.2022.100329] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 03/30/2022] [Accepted: 04/14/2022] [Indexed: 12/05/2022] Open
Abstract
Lung cancer is the leading cause of cancer death in Europe. Screening by means of low-dose computed tomography (LDCT) can shift detection to an earlier stage and reduce lung cancer mortality in high-risk individuals. However, to date, Poland, Croatia, Italy, and Romania are the only European countries to commit to large-scale implementation of targeted LDCT screening. Using a health systems approach, this article evaluates key factors needed to enable the successful implementation of screening programs across Europe. Recent literature on LDCT screening was reviewed for 10 countries (Belgium, Croatia, France, Germany, Italy, the Netherlands, Poland, Spain, Sweden, and United Kingdom) and complemented by 17 semistructured interviews with local experts. Research findings were mapped against a health systems framework adapted for lung cancer screening. The European policy landscape is highly variable, but potential barriers to implementation are similar across countries and consistent with those reported for other cancer screening programs. While consistent quality and safety of screening must be ensured across all screening centers, system factors are also important. These include appropriate data infrastructure, targeted recruitment methods that ensure equity in participation, sufficient capacity and workforce training, full integration of screening with multidisciplinary care pathways, and smoking cessation programs. Stigma and underlying perceptions of lung cancer as a self-inflicted condition are also important considerations. Building on decades of implementation research, governments now have a unique opportunity to establish effective, efficient, and equitable lung cancer screening programs adapted to their health systems, curbing the impact of lung cancer on their populations.
Collapse
|
5
|
Martini K, Chassagnon G, Frauenfelder T, Revel MP. Ongoing challenges in implementation of lung cancer screening. Transl Lung Cancer Res 2021; 10:2347-2355. [PMID: 34164282 PMCID: PMC8182720 DOI: 10.21037/tlcr-2021-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Lung cancer is the leading cause of cancer deaths in Europe and around the world. Although available therapies have undergone considerable development in the past decades, the five-year survival rate for lung cancer remains low. This sobering outlook results mainly from the advanced stages of cancer most patients are diagnosed with. As the population at risk is relatively well defined and early stage disease is potentially curable, lung cancer outcomes may be improved by screening. Several studies already show that lung cancer screening (LCS) with low-dose computed tomography (LDCT) reduces lung cancer mortality. However, for a successful implementation of LCS programmes, several challenges have to be overcome: selection of high-risk individuals, standardization of nodule classification and measurement, specific training of radiologists, optimization of screening intervals and screening duration, handling of ancillary findings are some of the major points which should be addressed. Last but not least, the psychological impact of screening on screened individuals and the impact of potential false positive findings should not be neglected. The aim of this review is to discuss the different challenges of implementing LCS programmes and to give some hints on how to overcome them. Finally, we will also discuss the psychological impact of screening on quality of life and the importance of smoking cessation.
Collapse
Affiliation(s)
- Katharina Martini
- Radiology Department, Hôpital Cochin, APHP.Centre-Université de Paris, Paris, France.,Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
| | - Guillaume Chassagnon
- Radiology Department, Hôpital Cochin, APHP.Centre-Université de Paris, Paris, France
| | - Thomas Frauenfelder
- Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
| | - Marie-Pierre Revel
- Radiology Department, Hôpital Cochin, APHP.Centre-Université de Paris, Paris, France
| |
Collapse
|
6
|
El-Turk N, Chou MSH, Ting NCH, Girgis A, Vinod SK, Bray V, Dobler CC. Treatment burden experienced by patients with lung cancer. PLoS One 2021; 16:e0245492. [PMID: 33481895 PMCID: PMC7822249 DOI: 10.1371/journal.pone.0245492] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 01/04/2021] [Indexed: 01/20/2023] Open
Abstract
INTRODUCTION Patients' burden from lung cancer treatment is not well researched, but this understanding can facilitate a patient-centred treatment approach. Current models of treatment burden suggest it is influenced by a patient's perception of their disease and treatment and their capacity to do the work required to treat their disease. METHODS Sixteen patients and 1 carer who were undergoing or had completed conventional or stereotactic ablative radiotherapy, chemotherapy or immunotherapy for lung cancer in the last 6 months participated in a semi-structured interview. A treatment burden framework was used with three main themes: a) treatment work, b) consequences of treatment and c) psychosocial factors affecting treatment burden. RESULTS The majority of patients did not feel unduly burdened by treatment tasks, despite having a large treatment-associated workload. Many saw treatment as a priority, causing them to restructure their life to accommodate for it. Patients wished that they would have been better informed about the lifestyle changes that they would have to make before treatment for lung cancer commenced and that the health service would provide services to assist them with this task. DISCUSSION While there was a large burden associated with lung cancer treatment, patients felt motivated and equipped to manage the workload because the disease was considered severe and life-threatening, and the treatment was seen as beneficial. Before initiating treatment for lung cancer, patients should be informed about lifestyle changes they likely have to make and should be offered assistance.
Collapse
Affiliation(s)
- Nicole El-Turk
- Department of Respiratory and Sleep Medicine, Liverpool Hospital, Sydney, NSW, Australia
- South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - Michael S. H. Chou
- Department of Respiratory and Sleep Medicine, Liverpool Hospital, Sydney, NSW, Australia
- South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - Natasha C. H. Ting
- Department of Respiratory and Sleep Medicine, Liverpool Hospital, Sydney, NSW, Australia
- South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - Afaf Girgis
- South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia
- Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, Sydney, NSW, Australia
| | - Shalini K. Vinod
- South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia
- Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, Sydney, NSW, Australia
- Cancer Therapy Centre, Liverpool Hospital, Sydney, NSW, Australia
| | - Victoria Bray
- Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, Sydney, NSW, Australia
- Cancer Therapy Centre, Liverpool Hospital, Sydney, NSW, Australia
| | - Claudia C. Dobler
- Department of Respiratory and Sleep Medicine, Liverpool Hospital, Sydney, NSW, Australia
- South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia
- Institute for Evidence-Based Healthcare, Bond University and Gold Coast University Hospital, Gold Coast, QLD, Australia
| |
Collapse
|
7
|
Bani M, Rossi E, Cortinovis D, Russo S, Gallina F, Hillen MA, Canova S, Cicchiello F, Longarini R, Cazzaniga ME, Bidoli P, Valsecchi MG, Strepparava MG. Validation of the Italian version of the full and abbreviated Trust in Oncologist Scale. Eur J Cancer Care (Engl) 2020; 30:e13334. [PMID: 33015898 DOI: 10.1111/ecc.13334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 05/29/2020] [Accepted: 08/07/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The Trust in Oncologist Scale (TiOS) is an 18-item questionnaire aimed to assess the cancer patients' trust in their oncologist and has been validated in Dutch and English language. This study aims to validate the Italian version of the TiOS (IT-TiOS) and the TiOS-Short Form (IT-TiOS-SF). METHODS The IT-TiOS was administered to 194 patients recruited in an Italian oncology department from April to December 2018. Data collected included socio-demographic data, health and clinical information, satisfaction with the most recent oncology visit and trust in the regional healthcare system. Internal consistency, test-retest reliability, convergent and the structural validity of both the full and short form were tested. RESULTS Factor analyses indicated that neither four-factor nor one-factor models of the full scale were acceptable. However, confirmatory factor analysis supported the one-dimensionality of the IT-TiOS-SF, and internal consistency assessed with Cronbach's alpha was 0.88. Mean scores on the IT-TiOS-SF correlated with satisfaction with the oncologist (rs = 0.64) and willingness to recommend the oncologist to others (rs = 0.67), confirming good construct validity. CONCLUSION The IT-TiOS-SF demonstrates good psychometric properties and can be used to assess trust for both clinical and research purposes.
Collapse
Affiliation(s)
- Marco Bani
- School of Medicine and Surgery, University of Milano - Bicocca, Milano, Italy
| | - Emanuela Rossi
- School of Medicine and Surgery, University of Milano - Bicocca, Milano, Italy
| | - Diego Cortinovis
- School of Medicine and Surgery, University of Milano - Bicocca, Milano, Italy.,Department of Medical Oncology, ASST Monza, Monza, Italy
| | - Selena Russo
- School of Medicine and Surgery, University of Milano - Bicocca, Milano, Italy
| | | | - Marij A Hillen
- Department of Medical Psychology, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | | | | | | | - Marina Elena Cazzaniga
- School of Medicine and Surgery, University of Milano - Bicocca, Milano, Italy.,Department of Medical Oncology, ASST Monza, Monza, Italy.,Department of Mental Health, ASST Monza, Monza, Italy
| | - Paolo Bidoli
- School of Medicine and Surgery, University of Milano - Bicocca, Milano, Italy.,Department of Medical Oncology, ASST Monza, Monza, Italy
| | | | - Maria Grazia Strepparava
- School of Medicine and Surgery, University of Milano - Bicocca, Milano, Italy.,Phase 1 Research Unit, ASST Monza, Monza, Italy
| |
Collapse
|
8
|
Fresán A, Yoldi-Negrete M, Robles-García R, Tovilla-Zárate CA, Suárez-Mendoza A. Professional Adversities and Protective Factors Associated with Suicidal Ideation in Mexican Psychiatrists. Arch Med Res 2020; 50:484-489. [PMID: 32018070 DOI: 10.1016/j.arcmed.2019.11.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 11/13/2019] [Accepted: 11/20/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Psychiatrists may be at an increased risk of suicide, since they encounter stressful factors in their everyday activities in addition to the sociodemographic factors for suicidal ideation reported for Mexican population. AIM OF THE STUDY To determine whether experiences inherent to the profession were related to the self-report of suicidal ideation among Mexican psychiatrists or could be attributed to factors previously reported in the general population (age, marital status, presence of a mental disorder and not having received specialized treatment). METHODS This was a cross-sectional retrospective study with 288 psychiatrists from Mexico who participated through an online survey where current working activities, self-reported mental health conditions (major depression, anxiety, burnout and suicidal ideation) and professional adversities (assaults, lawsuits, patients with suicidal ideation or who had committed suicide, perceived discrimination and social support) throughout the professional lifespan were evaluated. RESULTS Twenty-two psychiatrists (7.6%) reported having had suicidal ideation at some point in their training in psychiatry or their professional lives as psychiatrists. Depression and burnout were the most important predictors for suicidal ideation while greater satisfaction with social support was the most important protector, followed by being married/living together and having other physicians in the family. CONCLUSIONS Psychiatrist represent a risk population for suicidal ideation. As such, detection and attention are essential. Psychiatrists need to be encouraged to pursue healthy, lasting interpersonal relationships and seek professional help when required.
Collapse
Affiliation(s)
- Ana Fresán
- Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñíz, Ciudad de México, Mexico.
| | - María Yoldi-Negrete
- Consejo Nacional de Ciencia y Tecnología, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñíz, Ciudad de México, Mexico
| | - Rebeca Robles-García
- Centro de Investigación en Salud Mental Global. Instituto Nacional de Psiquiatría Ramón de la Fuente Muñíz, Ciudad de México, Mexico
| | - Carlos-Alfonso Tovilla-Zárate
- División Académica Multidisciplinaria de Comalcalco, Universidad Juárez Autónoma de Tabasco, Ranchería Sur, Cuarta Sección, Comalcalco, Tabasco, Mexico
| | | |
Collapse
|
9
|
Santoro A, Tomino C, Prinzi G, Lamonaca P, Cardaci V, Fini M, Russo P. Tobacco Smoking: Risk to Develop Addiction, Chronic Obstructive Pulmonary Disease, and Lung Cancer. Recent Pat Anticancer Drug Discov 2019; 14:39-52. [PMID: 30605063 DOI: 10.2174/1574892814666190102122848] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 12/11/2018] [Accepted: 12/27/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND The morbidity and mortality associated with tobacco smoking is well established. Nicotine is the addictive component of tobacco. Nicotine, through the non-neuronal α7nicotinic receptor, induces cell proliferation, neo-angiogenesis, epithelial to mesenchymal transition, and inhibits drug-induced apoptosis. OBJECTIVE To understand the genetic, molecular and cellular biology of addiction, chronic obstructive pulmonary disease and lung cancer. METHODS The search for papers to be included in the review was performed during the months of July- September 2018 in the following databases: PubMed (http://www.ncbi.nlm.nih.gov), Scopus (http://www.scopus.com), EMBASE (http://www.elsevier.com/online-tools/embase), and ISI Web of Knowledge (http://apps.webofknowledge.com/). The following searching terms: "nicotine", "nicotinic receptor", and "addiction" or "COPD" or "lung cancer" were used. Patents were retrieved in clinicaltrials.gov (https://clinicaltrials.gov/). All papers written in English were evaluated. The reference list of retrieved articles was also reviewed to identify other eligible studies that were not indexed by the above-mentioned databases. New experimental data on the ability of nicotine to promote transformation of human bronchial epithelial cells, exposed for one hour to Benzo[a]pyrene-7,8-diol-9-10-epoxide, are reported. RESULTS Nicotinic receptors variants and nicotinic receptors upregulation are involved in addiction, chronic obstructive pulmonary disease and/or lung cancer. Nicotine through α7nicotinic receptor upregulation induces complete bronchial epithelial cells transformation. CONCLUSION Genetic studies highlight the involvement of nicotinic receptors variants in addiction, chronic obstructive pulmonary disease and/or lung cancer. A future important step will be to translate these genetic findings to clinical practice. Interventions able to help smoking cessation in nicotine dependence subjects, under patent, are reported.
Collapse
Affiliation(s)
- Alessia Santoro
- Clinical and Molecular Epidemiology, IRCSS San Raffaele Pisana, Via di Valcannuta 247, I-00166 Rome, Italy
| | - Carlo Tomino
- Scientific Direction, IRCSS San Raffaele Pisana, Via di Valcannuta 247, I-00166 Rome, Italy
| | - Giulia Prinzi
- Clinical and Molecular Epidemiology, IRCSS San Raffaele Pisana, Via di Valcannuta 247, I-00166 Rome, Italy
| | - Palma Lamonaca
- Clinical and Molecular Epidemiology, IRCSS San Raffaele Pisana, Via di Valcannuta 247, I-00166 Rome, Italy
| | - Vittorio Cardaci
- Pulmonary Rehabilitation, IRCCS San Raffaele Pisana, Via della Pisana, 235, I-00163 Rome, Italy
| | - Massimo Fini
- Scientific Direction, IRCSS San Raffaele Pisana, Via di Valcannuta 247, I-00166 Rome, Italy
| | - Patrizia Russo
- Clinical and Molecular Epidemiology, IRCSS San Raffaele Pisana, Via di Valcannuta 247, I-00166 Rome, Italy
| |
Collapse
|
10
|
Kedia SK, Collins A, Dillon PJ, Akkus C, Ward KD, Jackson BM. Psychosocial interventions for informal caregivers of lung cancer patients: A systematic review. Psychooncology 2019; 29:251-262. [DOI: 10.1002/pon.5271] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 10/19/2019] [Accepted: 10/20/2019] [Indexed: 01/08/2023]
Affiliation(s)
- Satish K. Kedia
- Division of Social and Behavioral Sciences, School of Public Health University of Memphis Memphis Tennessee
| | - Andy Collins
- Division of Social and Behavioral Sciences, School of Public Health University of Memphis Memphis Tennessee
| | - Patrick J. Dillon
- School of Communication Studies Kent State University at Stark North Canton Ohio
| | - Cem Akkus
- Division of Social and Behavioral Sciences, School of Public Health University of Memphis Memphis Tennessee
| | - Kenneth D. Ward
- Division of Social and Behavioral Sciences, School of Public Health University of Memphis Memphis Tennessee
| | - Bianca M. Jackson
- Multidisciplinary Thoracic Oncology Program, Baptist Cancer Center, Memphis Tennessee
| |
Collapse
|
11
|
Liu X, Zhang Y, Liu Z, Xie X. Anti-tumor effect of chitin oligosaccharide plus cisplatin in vitro and in vivo. Onco Targets Ther 2019; 12:7581-7590. [PMID: 31571909 PMCID: PMC6754620 DOI: 10.2147/ott.s220619] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 08/30/2019] [Indexed: 11/23/2022] Open
Abstract
Background Lung cancer is one of the most common malignant tumors in human beings, and cisplatin is a widely used chemotherapy drug, but its clinical application is limited because of its dose-dependent toxicity and drug resistance. Chitin is known to have various biological activities including anti-tumor, but the insoluble feature in common solvents greatly restricts its application. Chitin oligosaccharide is a small water-soluble molecule degraded from chitin without any toxic effect. Methods Chitin oligosaccharide was adopted to investigate the effects on lung adenocarcinoma A549 cells and tumor xenografts of nude mice. The experiments were divided into control group, chitin oligosaccharide group, cisplatin group and combination group. MTS assay, cell scratch test and migration assay were used to observe the proliferation and migration of A549 cells, and Western blot was used to detect the expression levels of caspase8, caspase3 and BAK. Ki67 and P53 expressions of tumor xenografts were detected to explore the effects of drugs on tumor prognosis. Results The results in vitro showed that chitin oligosaccharides could inhibit the proliferation and migration of A549 cells, and the effect was superior to chitin oligosaccharide or cisplatin when combined with cisplatin. Chitin oligosaccharide plus cisplatin up-regulated the expression level of caspase8 and caspase3, while had minor influence on the expression level of BAK. In vivo experiments showed that chitin oligosaccharide plus cisplatin could down-regulate the expression level of Ki67, while had minor influence on the expression level of P53. Conclusion The study demonstrated that chitin oligosaccharide plus cisplatin had positive synergistic effects, and it is possible to improve the prognosis of lung adenocarcinoma patients by up-regulating the expression level of caspase8, caspase3 and down-regulating the expression level of Ki67.
Collapse
Affiliation(s)
- Xing Liu
- Oncology Department, General Hospital of Northern Theater Command, Shenyang, Liaoning Province, People's Republic of China
| | - Yan Zhang
- Medical Examination Center, General Hospital of Northern Theater Command, Shenyang, Liaoning Province, People's Republic of China
| | - Zhaozhe Liu
- Oncology Department, General Hospital of Northern Theater Command, Shenyang, Liaoning Province, People's Republic of China
| | - Xiaodong Xie
- Oncology Department, General Hospital of Northern Theater Command, Shenyang, Liaoning Province, People's Republic of China
| |
Collapse
|
12
|
Chalian H, Khoshpouri P, Assari S. Demographic, Social, and Behavioral Determinants of Lung Cancer Perceived Risk and Worries in a National Sample of American Adults; Does Lung Cancer Risk Matter? MEDICINA (KAUNAS, LITHUANIA) 2018; 54:E97. [PMID: 30513895 PMCID: PMC6306727 DOI: 10.3390/medicina54060097] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 11/20/2018] [Accepted: 11/29/2018] [Indexed: 12/19/2022]
Abstract
Background: Perceived risk and worries of developing cancer are important constructs for cancer prevention. Many studies have investigated the relationship between health behaviors and subjective risk perception. However, factors correlated with lung cancer risk perception and worries in individuals more susceptible to lung cancer have rarely been investigated. Objective: To determine demographic, social, and behavioral determinants of cancer perceived risk and worries and to explore heterogeneities in these associations by the level of lung cancer risk in a nationally representative sample of American adults. Methods: For this cross-sectional study, data came from the Health Information National Trends Survey (HINTS) 2017, which included a 2277 representative sample of American adults. Smoking status, cancer perceived risk, cancer worries, age, gender, race, education, income, and insurance status were measured. We ran structural equation models (SEMs) for data analysis. Results: "Ever smoker" status was associated with higher cancer perceived risk (b = 0.25; 95% CI = 0.05⁻0.44, p = 0.013) and worries (b = 0.34, 95% CI = 0.18⁻0.50, p < 0.001), suggesting that "ever smokers" experience higher levels of cancer perceived risk and worries regarding cancer, compared to "never smokers". Other factors that correlate with cancer perceived risk and worries were race, age, income, and insurance status. Blacks demonstrated less cancer perceived risk and worry (b = -0.98, 95% CI = -1.37⁻0.60, p < 0.001) in both low and high risk lung cancer groups. However, the effects of social determinants (income and insurance status) and age were observed in low but not high risk group. Conclusions: Determinants of cancer perceived risk and worries vary in individuals depending on the level of lung cancer risk. These differences should be considered in clinical practice and policy makings with the goal of improving participation rates in lung cancer screening programs.
Collapse
Affiliation(s)
- Hamid Chalian
- Department of Radiology, Duke University Medical Center, Durham, NC 27705, USA.
| | - Pegah Khoshpouri
- Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21205 USA.
| | - Shervin Assari
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48104, USA.
- Department of Psychology, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA.
| |
Collapse
|
13
|
Reach G, Pellan M, Crine A, Touboul C, Ciocca A, Djoudi Y. Holistic psychosocial determinants of adherence to medication in people with type 2 diabetes. DIABETES & METABOLISM 2018; 44:500-507. [PMID: 30031714 DOI: 10.1016/j.diabet.2018.06.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 06/02/2018] [Accepted: 06/06/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND The aim of this study was to determine whether adherent and non-adherent patients with type 2 diabetes can be differentiated according to psychosocial characteristics. METHODS A total of 1214 patients were included in the analysis. Data were derived from a cross-sectional observational study of adults with diabetes of the Access Santé (Access Health) panel of Kantar Health France. Patients completed a questionnaire on adherence to medication, psychological determinants (trust in physicians, constancy of habits, patience, temporal horizon, health locus of control, obedience, psychological reactivity, prevention vs promotion, optimism vs pessimism) and social deprivation. RESULTS Of these 1214 subjects, 46.2% were considered strictly adherent to antidiabetic medication, as reflected by negative answers to all six questions suggesting a non-adherent behaviours, whereas 48.9% provided 1-2 positive answers and 4.9% provided 3-6 positive answers, and were considered non-adherent. In addition to the effect of younger age (P=0.03), multivariate logistic regression analysis demonstrated the following psychosocial determinants of non-adherence: chance locus of control (P=0.02); lack of trust in physicians (P=0.010); and pessimism (P=0.021). Multiple factor analysis identified adherence and social deprivation as dimensions separating three distinct patient populations: (i) non-adherent; (ii) adherent and socially deprived; and (iii) adherent and non-socially deprived. It also revealed that patience, obedience, cautious behaviour, optimism, trust in physicians and constancy of habits were associated with adherence. CONCLUSION Of the multiple determinants of adherence, trust in physicians and constancy of habits represent modifiable factors, and constitute targets to prevent non-adherence because they can be reinforced through patient education and improved physician - patient relationship. Also, psychosocial determinants of adherence differ widely between socially deprived and non-deprived patients.
Collapse
Affiliation(s)
- G Reach
- Endocrinology, diabetes and metabolic diseases department, Avicenne hospital, EA 3412, Paris 13 University, Paris Sorbonne Cité, AP-HP, 125, route de Stalingrad, 93000 Bobigny, France.
| | - M Pellan
- Kantar Health France, 75014 Paris, France
| | - A Crine
- Kantar Health France, 75014 Paris, France
| | - C Touboul
- Kantar Health France, 75014 Paris, France
| | - A Ciocca
- Sanofi-Aventis, 94250 Gentilly, France
| | - Y Djoudi
- Sanofi-Aventis, 94250 Gentilly, France
| |
Collapse
|
14
|
Quaife SL, Vrinten C, Ruparel M, Janes SM, Beeken RJ, Waller J, McEwen A. Smokers' interest in a lung cancer screening programme: a national survey in England. BMC Cancer 2018; 18:497. [PMID: 29716550 PMCID: PMC5930691 DOI: 10.1186/s12885-018-4430-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Accepted: 04/24/2018] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Following the recommendation of lung cancer screening in the US, screening committees in several European countries are reviewing the evidence for implementing national programmes. However, inadequate participation from high-risk groups poses a potential barrier to its effectiveness. The present study examined interest in a national lung cancer screening programme and modifiable attitudinal factors that may affect participation by smokers. METHODS A population-based survey of English adults (n = 1464; aged 50-70 years) investigated screening intentions in different invitation scenarios, beliefs about lung cancer, early detection and treatment, worry about lung cancer risk, and stigma. Data on smoking status and perceived chances of quitting were also collected, but eligibility for lung screening in the event of a national programme was unknown. RESULTS Intentions to be screened were high in all three invitation scenarios for both current (≥ 89%) and former (≥ 94%) smokers. However, smokers were less likely to agree that early-stage survival is good (43% vs. 53%; OR: 0.64, 0.46-0.88) or be willing to have surgery for an early stage, screen-detected cancer (84% vs. 94%; OR: 0.38, 0.21-0.68), compared with former smokers. Willingness to have surgery was positively associated with screening intentions; with absolute differences of 25% and 29%. Worry about lung cancer risk was also most common among smokers (48%), and one fifth of respondents thought screening smokers was a waste of NHS money. CONCLUSIONS A national lung cancer screening programme would be well-received in principle. To improve smokers' participation, care should be taken to communicate the survival benefits of early-stage diagnosis, address concerns about surgery, and minimise anxiety and stigma related to lung cancer risk.
Collapse
Affiliation(s)
- Samantha L. Quaife
- Department of Behavioural Science and Health, University College London, Gower Street, London, WC1E 6BT UK
| | - Charlotte Vrinten
- Department of Behavioural Science and 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
| | - 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
| | - Rebecca J. Beeken
- Department of Behavioural Science and Health, University College London, Gower Street, London, WC1E 6BT UK
- Leeds Institute of Health Sciences, University of Leeds, Worsley Building, Clarendon Way, Leeds, LS2 9NL UK
| | - Jo Waller
- Department of Behavioural Science and Health, University College London, Gower Street, London, WC1E 6BT UK
| | - Andy McEwen
- Department of Behavioural Science and Health, University College London, Gower Street, London, WC1E 6BT UK
| |
Collapse
|
15
|
|
16
|
Do Correlates of Pain-Related Stoicism and Cautiousness Differ in Younger and Older People With Advanced Cancer? THE JOURNAL OF PAIN 2017; 19:301-316. [PMID: 29155166 DOI: 10.1016/j.jpain.2017.11.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 10/31/2017] [Accepted: 11/06/2017] [Indexed: 11/20/2022]
Abstract
Age differences are not evident in pain-related stoicism and cautiousness in people with cancer pain. Little is known about the factors associated with these pain-related attitudes or age-related patterns in these associations. The present cross-sectional study investigated the biopsychosocial correlates of the attitudes in younger and older patients with advanced cancer. Pain-related stoicism (fortitude, concealment, superiority) and cautiousness (self-doubt, reluctance) were assessed using the Pain Attitudes Questionnaire-Revised (PAQ-R). Participants, 155 younger (younger than 60 years old) and 114 older (60 years old or older) patients with advanced cancer completed the PAQ-R and measures of sociodemographic and medical characteristics, pain intensity, cognitive-affective pain-related responses, physical functioning, psychological distress and well-being, and psychosocial functioning. Backwards regression analyses identified correlates for each PAQ-R factor separately for younger and older patients. Activity engagement was a frequent correlate, but its relationship with concealment was the only association common to both age groups. Younger and older patients exhibited different avoidance-related constructs suggesting relational challenges in the former group (avoidant attachment) and intrapersonal fear in the latter (cognitive avoidance). Medical correlates also showed age differences: younger patients showed symptom-focused correlates, whereas older patients showed aging-related correlates. Findings support a biopsychosocial framework of cancer-pain adaptation incorporating a lifespan-developmental perspective. PERSPECTIVE To our knowledge, this article is the first to identify biopsychosocial correlates of stoic and cautious attitudes toward cancer pain in younger and older patients with advanced cancer. Findings highlight possible age-related motivations for greater pain-related stoicism or cautiousness and can potentially inform interventions addressing challenges in cancer-pain adaptation in advanced cancer.
Collapse
|
17
|
Lung Cancer Awareness Month-A Lot of Progress, But More Work Needs to Be Done. J Thorac Oncol 2017; 12:1603-1605. [PMID: 29074205 DOI: 10.1016/j.jtho.2017.09.091] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Indexed: 11/21/2022]
|
18
|
Abbasi A, Siddiqi R, Owais A, Laeeq T, Ali SN, Mushahid Z, Ahsan SM, Jatoi AS, Abbasi A, Butt I, Ali R, Abbasi M, Jaffri SNN, Jabir M, Khanani H, Fatima K. Prevalence and Barriers to Lung Cancer Screening in Karachi, Pakistan: A Cross-Sectional Survey of Smokers and Physicians. Cureus 2017. [PMID: 28630806 PMCID: PMC5472400 DOI: 10.7759/cureus.1248] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background Early detection of lung cancer using low-dose computed tomography (LDCT) can potentially reduce morbidity and mortality. However, LDCT for lung cancer screening, especially in low income countries, has been underutilized. The objective of this study was to evaluate the prevalence and the potential personal, social, and economic barriers of lung cancer screening using LDCT. Methods A total sample of 156 smokers and 200 general physicians was collected during December 2016-February 2017 from community settings in Karachi, Pakistan. Two separate questionnaires were constructed to characterize participants’ knowledge, attitudes, and practices regarding lung cancer screening. Screening-eligible smokers and physicians were asked to identify patient barriers to screening and were asked their opinion regarding most effective approach for increasing awareness of screening guidelines. Results The majority of smokers' (n=91, 58.3%) and physicians' (n=131, 65.7%) beliefs about the US Preventive Services Task Force (USPSTF) eligibility criteria were inconsistent with the actual recommendations. Major barriers to screening included financial cost, lack of patient counseling and health anxiety related to screening. Over two-thirds (n=105, 67.3%) of smokers were receptive to further information about LDCT screening, and half (n=78, 50.0%) favored one-on-one counseling by their physician, compared to other media. Only one-third (n=65, 33.3%) of physicians reported use of LDCT screening, although 54.5% (n=108) felt that screening implementation would be very effective in their practice. Conclusion LDCT screening is currently an uncommon practice in Pakistan. Financial cost, inadequate doctor-patient communication, and lack of awareness of guidelines among both patients and physicians are the major barriers in the utilization of LDCT screening.
Collapse
Affiliation(s)
- Aleeza Abbasi
- Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan
| | - Rabbia Siddiqi
- Department of Internal Medicine, Dow University of Health Sciences (DUHS), Karachi, Pakistan
| | - Aatika Owais
- Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan
| | - Tooba Laeeq
- Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan
| | - Sara N Ali
- Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan
| | - Zonaira Mushahid
- Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan
| | - Syed M Ahsan
- Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan
| | - Aliya S Jatoi
- Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan
| | - Aleena Abbasi
- Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan
| | - Ifrah Butt
- Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan
| | - Ruba Ali
- Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan
| | - Maham Abbasi
- Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan
| | | | - Mariam Jabir
- Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan
| | - Hajra Khanani
- Dow Medical College, Dow University of Health Sciences (DUHS), Karachi, Pakistan
| | - Kaneez Fatima
- Department of Internal Medicine, Dow University of Health Sciences (DUHS), Karachi, Pakistan
| |
Collapse
|
19
|
Evolution of Symptom Burden of Advanced Lung Cancer Over a Decade. Clin Lung Cancer 2017; 18:274-280.e6. [DOI: 10.1016/j.cllc.2016.12.010] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2016] [Revised: 11/29/2016] [Accepted: 12/13/2016] [Indexed: 01/17/2023]
|
20
|
Pujol JL, Mérel JP, Roth C. How Preconceptions About Lung Cancer Treatment Interact With Medical Discourse for Patients Who Accept Chemotherapy? Psychooncology 2016; 26:793-799. [PMID: 27449209 DOI: 10.1002/pon.4231] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 07/11/2016] [Accepted: 07/19/2016] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Chemotherapy is widely prescribed for lung cancer with palliation as primary end point. This study aimed at determining how preconceptions about lung cancer and its treatment interact with medical discourse into acceptance of chemotherapy. METHODS Twenty-three purposively selected patients who recently accepted chemotherapy were invited to participate in this survey consisting of semi-structured in-depth interviews. Grounded theory was applied to investigate participants' perceptions of the context that have surrounded their decision to undergo chemotherapy. RESULTS Major drivers of social representation of illness were linked with stigma. Participants also evoked the disease itself as a stereotype representation of incurable disease. Significant others' experiences were major components of participants' knowledge of chemotherapy. Searching for information regarding lung cancer actively confronted participants with the disease and its prognosis. However, the searching process was self-limited because of the poor prognosis of the disease, insofar as complete information would have precluded from any hope. We therefore identified 3 domains that provide insights into the participant's views and attitude toward chemotherapy: (i) synthesizing preconceptions of disease and chemotherapy with personal medical case; (ii) slowly constructing complex knowledge of cancer and treatment; and (iii) accepting chemotherapy as a surrogate for acknowledging incurable disease. CONCLUSION Patients have preconceptions about chemotherapy that result from complex features involving social perception, stigma, and significant others' experiences. In this context, developing a personal knowledge about lung cancer and its treatment is a slow construction. This process needs time to be explained and reformulated, so that patients might give their informed consent.
Collapse
Affiliation(s)
- Jean-Louis Pujol
- Thoracic Oncology, Montpellier Academic Hospital, Montpellier, France
| | - Jean-Pierre Mérel
- Thoracic Oncology, Montpellier Academic Hospital, Montpellier, France
| | - Caroline Roth
- Thoracic Oncology, Montpellier Academic Hospital, Montpellier, France
| |
Collapse
|
21
|
Guibert N, Noel-Savina E, Mazières J. Perspective of a pulmonologist: what might we expect and what do we need to know? Lung Cancer 2015. [DOI: 10.1183/2312508x.10011014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|