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Goodman LP, Walsh DW, Kunin-Batson A, Sherwood NE, Arlinghaus KR. Adolescent sources of stress, stress levels, and associations between stress and changes in weight outcomes at the time of COVID-19 related school closure in March 2020. Prev Med Rep 2023; 36:102447. [PMID: 37840589 PMCID: PMC10568412 DOI: 10.1016/j.pmedr.2023.102447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 09/25/2023] [Accepted: 09/27/2023] [Indexed: 10/17/2023] Open
Abstract
Objective Stress is associated with weight changes, yet how level and sources of stress relate to this association is poorly understood. This mixed methods study examined associations between adolescent stress at the COVID-19 pandemic onset and standardized BMI (BMIz) over a three-month period. Methods: Participants (N = 197, mean age 13.66 ± 1.43 years, 85% Hispanic, 56% female) were recruited from a charter school in Texas to participate in a healthy lifestyle intervention during physical education class. We calculated BMIz using height and weight measurements taken December 2019 and the week of COVID-19 school closures in March 2020. We measured stress in March 2020 with the 4-item Perceived Stress Scale. We ran a multiple linear regression model controlling for baseline BMIz (December 2019), age, sex, intervention condition, and assessed the interaction between baseline BMIz and PSS-4 score on BMIz change. Results Overall, our sample had an average PSS-4 score of seven and mean BMIz decrease of 0.04 over the three-month period. We observed a significant interaction between PSS-4 score and baseline BMIz. At lower baseline BMIz scores, higher PSS-4 scores were associated with decreases in BMIz over time. There was no significant association at higher baseline BMIz scores. COVID-19 pandemic-related concerns and school performance were the two primary stressors reported. Conclusions The relation between stress and weight changes differed based on starting weight status. Future interventions should consider the influence of external stressors on intervention adherence and outcomes.
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Affiliation(s)
- Lenora P. Goodman
- University of Minnesota School of Public Health, Division of Epidemiology and Community Health, Minneapolis, MN, USA
| | - David W. Walsh
- University of Houston, Department of Health and Human Performance, TX, USA
| | - Alicia Kunin-Batson
- University of Minnesota Medical School, Department of Pediatrics, Minneapolis, MN, USA
| | - Nancy E. Sherwood
- University of Minnesota School of Public Health, Division of Epidemiology and Community Health, Minneapolis, MN, USA
| | - Katherine R. Arlinghaus
- University of Minnesota School of Public Health, Division of Epidemiology and Community Health, Minneapolis, MN, USA
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2
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Dasari SS, Archer M, Mohamed NE, Tewari AK, Figueiro MG, Kyprianou N. Circadian Rhythm Disruption as a Contributor to Racial Disparities in Prostate Cancer. Cancers (Basel) 2022; 14:cancers14205116. [PMID: 36291899 PMCID: PMC9600368 DOI: 10.3390/cancers14205116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 10/08/2022] [Accepted: 10/15/2022] [Indexed: 01/27/2023] Open
Abstract
In the United States, African American (AA) men have a 2.4 times higher mortality rate due to prostate cancer than White men. The multifactorial causes of the racial disparities in prostate cancer involve various social determinants of health, socioeconomic status, and access to healthcare. However, emerging evidence also suggests that circadian rhythm disruption (CRD) contributes to prostate cancer, and AA men may be more susceptible to developing CRDs. Circadian rhythms play a significant role in metabolism, hormone secretion, and sleep/wake cycles. Disruption in these circadian rhythms can be caused by airplane travel/jetlag, night shift work, exposure to light, and neighborhood noise levels, which can contribute to sleep disorders and chronic conditions such as obesity, diabetes, cardiovascular disease, and depression. The drivers of the racial disparities in CRD include night shift work, racial discrimination, elevated stress, and residing in poor neighborhoods characterized by high noise pollution. Given the increased vulnerability of AA men to CRDs, and the role that CRDs play in prostate cancer, elucidating the clock-related prostate cancer pathways and their behavior and environmental covariates may be critical to better understanding and reducing the racial disparities in prostate cancer.
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Affiliation(s)
- Sonali S. Dasari
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Maddison Archer
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Nihal E. Mohamed
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Tisch Cancer Institute, Mount Sinai Health, New York, NY 10029, USA
| | - Ashutosh K. Tewari
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Tisch Cancer Institute, Mount Sinai Health, New York, NY 10029, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Mariana G. Figueiro
- Tisch Cancer Institute, Mount Sinai Health, New York, NY 10029, USA
- Light and Health Research Center, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Correspondence: (M.G.F.); (N.K.)
| | - Natasha Kyprianou
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Tisch Cancer Institute, Mount Sinai Health, New York, NY 10029, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Correspondence: (M.G.F.); (N.K.)
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3
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Guan Y, Wang X, Guan K, Wang D, Bi X, Xiao Z, Xiao Z, Shan X, Hu L, Ma J, Li C, Zhang Y, Shou J, Wang B, Qian Z, Xing N. Copy number variation of urine exfoliated cells by low-coverage whole genome sequencing for diagnosis of prostate adenocarcinoma: a prospective cohort study. BMC Med Genomics 2022; 15:104. [PMID: 35513884 PMCID: PMC9069213 DOI: 10.1186/s12920-022-01253-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 04/26/2022] [Indexed: 12/31/2022] Open
Abstract
Background Non-invasive, especially the urine-based diagnosis of prostate cancer (PCa) remains challenging. Although prostate cancer antigen (PSA) is widely used in prostate cancer screening, the false positives may result in unnecessary invasive procedures. PSA elevated patients are triaged to further evaluation of free/total PSA ratio (f/t PSA), to find out potential clinically significant PCa before undergoing invasive procedures. Genomic instability, especially chromosomal copy number variations (CNVs) were proved much more tumor specific. Here we performed a prospective study to evaluate the diagnostic value of CNV via urine-exfoliated cell DNA analysis in PCa. Methods We enrolled 28 PSA elevated patients (≥ 4 ng/ml), including 16 PCa, 9 benign prostate hypertrophy (BPH) and 3 prostatic intraepithelial neoplasia (PIN). Fresh initial portion urine was collected after hospital admission. Urine exfoliated cell DNA was analyzed by low coverage Whole Genome Sequencing, followed by CNV genotyping by the prostate cancer chromosomal aneuploidy detector (ProCAD). CNVs were quantified in absolute z-score (|Z|). Serum free/total PSA ratio (f/t PSA) was reported altogether. Results In patients with PCa, the most frequent CNV events were chr3q gain (n = 2), chr8q gain (n = 2), chr2q loss (n = 4), and chr18q loss (n = 3). CNVs were found in 81.2% (95% Confidence Interval (CI) 53.7–95.0%) PCa. No CNV was identified in BPH patients. A diagnosis model was established by incorporating all CNVs. At the optimal cutoff of |Z|≥ 2.50, the model reached an AUC of 0.91 (95% CI 0.83–0.99), a sensitivity of 81.2% and a specificity of 100%. The CNV approach significantly outperformed f/t PSA (AUC = 0.62, P = 0.012). Further analyses showed that the CNV positive rate was significantly correlated with tumor grade. CNVs were found in 90.9% (95% CI 57.1–99.5%) high grade tumors and 60.0% (95% CI 17.0–92.7%) low grade tumors. No statistical significance was found for patient age, BMI, disease history and family history. Conclusions Urine exfoliated cells harbor enriched CNV features in PCa patients. Urine detection of CNV might be a biomarker for PCa diagnosis, especially in terms of the clinically significant high-grade tumors. Supplementary Information The online version contains supplementary material available at 10.1186/s12920-022-01253-5.
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Affiliation(s)
- Youyan Guan
- Department of Urology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Xiaobing Wang
- State Key Laboratory of Molecular Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Kaopeng Guan
- Department of Urology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Dong Wang
- Department of Urology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Xingang Bi
- Department of Urology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Zhendong Xiao
- Department of Urology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Zejun Xiao
- Department of Urology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Xingli Shan
- Cancer Hospital of Huanxing, ChaoYang District, Beijing, 100122, China
| | - Linjun Hu
- Cancer Hospital of Huanxing, ChaoYang District, Beijing, 100122, China
| | - Jianhui Ma
- Department of Urology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Changling Li
- Department of Urology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Yong Zhang
- Department of Urology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Jianzhong Shou
- Department of Urology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | | | | | - Nianzeng Xing
- Department of Urology, 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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4
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Prostate-Specific Antigen Screening According to Health Professional Counseling and Age in the United States. Prostate Cancer 2022; 2022:8646314. [PMID: 35036010 PMCID: PMC8758274 DOI: 10.1155/2022/8646314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 12/11/2021] [Indexed: 11/25/2022] Open
Abstract
Background In 2018, the US Preventive Services Task Force recommended that PSA screening for prostate cancer involve men aged 55–69, based on a personal decision following consultation with a health professional. PSA screening in men aged 70 or older should only occur if symptoms exist. This study identifies the association between having a PSA test in the past two years and whether or not there was consultation with a health professional about the benefits and/or harms of PSA screening. Methods Analyses were based on data involving men aged 40 years or older, who responded to PSA related questions in the 2018 BRFSS survey. Results Approximately 32.0% (14.6% for ages 40–54, 41.7% for ages 55–69, and 49.8% for ages 70 years and older) of respondents had a PSA test in the past two years. Approximately 81.7% of these men had talked with a health professional about the benefits and/or harms of PSA screening, with 42.4% having discussed the benefits and harms, 54.6% having discussed the benefits only, and 3.0% having discussed the harms only. The odds of a PSA test in the past two years in men having talked with a health professional about the benefits and harms of the test versus no talk are 10.1 (95% CI 9.3–10.8), in men who talked with a health professional about the benefits only versus no talk are 10.8 (95% CI 10.0–11.6), and in men who talked with a health professional about the harms only versus no talk are 3.9 (95% CI 2.9–5.1). Conclusion PSA screening is most common in men aged 70 or older, which is counter to the US Preventive Task Force recommendation. Most men having a PSA test have talked with a health professional about the test, but the talks tended to focus on just the benefits of screening and not both potential benefits and harms.
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5
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Chau EM, Russell B, Santaolalla A, Van Hemelrijck M, McCracken S, Page T, Liyanage SH, Aning J, Gnanapragasam VJ, Acher P. MRI-based nomogram for the prediction of prostate cancer diagnosis: A multi-centre validated patient–physician decision tool. JOURNAL OF CLINICAL UROLOGY 2022. [DOI: 10.1177/20514158211065949] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Objective: To update and externally validate a magnetic resonance imaging (MRI)-based nomogram for predicting prostate biopsy outcomes with a multi-centre cohort. Materials and methods: Prospective data from five UK-based centres were analysed. All men were biopsy naïve. Those with missing data, no MRI, or prostate-specific antigen (PSA) > 30 ng/mL were excluded. Logistic regression analysis was used to confirm predictors of prostate cancer outcomes including MRI-PIRADS (Prostate Imaging Reporting and Data System) score, PSA density, and age. Clinically significant disease was defined as International Society of Urological Pathology (ISUP) Grade Group ⩾ 2 (Gleason grade ⩾ 7). Biopsy strategy included transrectal and transperineal approaches. Nomograms were produced using logistic regression analysis results. Results: A total of 506 men were included in the analysis with median age 66 (interquartile range (IQR) = 60–69). Median PSA was 6.6 ng/mL (IQR = 4.72–9.26). PIRADS ⩾ 3 was reported in 387 (76.4%). Grade Group ⩾ 2 detection was 227 (44.9%) and 318 (62.8%) for any cancer. Performance of the MRI-based nomogram was an area under curve (AUC) of 0.84 (95% confidence interval (CI) = 0.81–0.88) for Grade Group ⩾ 2% and 0.85 (95% CI = 0.82–0.88) for any prostate cancer. Conclusion: We present external validation of a novel MRI-based nomogram in a multi-centre UK-based cohort, showing good discrimination in identifying men at high risk of having clinically significant disease. These findings support this risk calculator use in the prostate biopsy decision-making process. Level of evidence: 2c
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Affiliation(s)
- Edwin M Chau
- Department of Urology, Southend University Hospital, UK
| | - Beth Russell
- Translational Oncology and Urology Research, King’s College London, UK
| | - Aida Santaolalla
- Translational Oncology and Urology Research, King’s College London, UK
| | | | - Stuart McCracken
- Department of Urology, South Tyneside and Sunderland NHS Trust, UK
| | - Toby Page
- Department of Urology, Newcastle Hospitals NHS Trust, UK
| | | | | | - Vincent J Gnanapragasam
- Department of Urology, Cambridge University Hospitals Trust, UK
- Division of Urology, Department of Surgery, University of Cambridge, UK
| | - Peter Acher
- Department of Urology, Southend University Hospital, UK
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6
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Nakajima M, Haji A, Sero A, Taha S, Habte H, Jama S, Hodges J, Mohamud S, Ahmed O, Hassan O, al'Absi M. Psychosocial Correlates of Experience and Intention to Receive Colorectal Cancer Screening: A Cross-Sectional Study Among East African Men in the U.S. J Prim Prev 2021; 42:603-623. [PMID: 34654996 DOI: 10.1007/s10935-021-00648-x] [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] [Accepted: 09/21/2021] [Indexed: 12/16/2022]
Abstract
Cancer screening is an important approach to reducing disease burden. The rate of colorectal cancer (CRC) screening among immigrants in the U.S. is very low. Our study's aim was to examine correlates of experience with, and intention to, receive CRC screening among East African men who were up-to-date (UTD) with CRC screening (n = 64, mean age 65) and those who had never been screened or were overdue for one (NOD; n = 47, mean age 60), compared on demographic characteristics, attitudes toward cancer, psychosocial stress, and health behaviors. UTD men had significantly less emotional concerns about cancer screening and experienced significantly greater distress and lower resiliency than NOD men. However, these results were attenuated after controlling for demographic confounders. Perceived risk, trust in the medical system, and PTSD symptoms were significantly associated with an intention to undertake CRC screening in the next 12 months. These results should be used to guide efforts toward increasing CRC screening rates among immigrant communities.
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Affiliation(s)
- Motohiro Nakajima
- Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, USA.
| | | | - Abdul Sero
- University of Minnesota Medical School, Duluth, USA
| | - Sartu Taha
- University of Minnesota Medical School, Duluth, USA
| | | | - Shamso Jama
- University of Minnesota Medical School, Duluth, USA
| | - James Hodges
- School of Public Health, Division of Biostatistics, University of Minnesota, Minneapolis, USA
| | | | | | - Obsa Hassan
- Mercy Hospital, Allina Health, Coon Rapids, USA
| | - Mustafa al'Absi
- Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, USA
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7
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Abstract
Objectives: This study examines the relationship between sexual obligation and perceived stress among older adults in the United States.Methods: Using longitudinal data from three waves of the National Social Life, Health, and Aging Project (NSHAP), our sample included 1,477 partnered, sexually-active respondents aged 57 to 85 at the baseline survey. We estimated mixed-effects models to test how feelings of sexual obligation are related to changes in perceived stress score.Results: Sexual obligation was positively associated with perceived stress score. The positive relationship between sexual obligation and perceived stress score became stronger over the study period among older men, although it remained relatively stable among older women. Relationship quality only partially explains this relationship.Conclusions: Feeling more obligated to have sex had a significantly greater effect on older men's perceived level of stress over time than older women's. This association became marginally significant after relationship quality was controlled for, suggesting that relationship quality was a key explanatory factor for the gendered patterns in sexual obligation's linkage to stress. These results highlight the importance of understanding gendered sexuality among aging older adults within the context of their relationship.Clinical Implications: Older adults' feelings of sexual obligation can manifest in their daily stress experience. Clinicians seeking to lower older adults', in particular older men's, stress levels should address the context of their sexual life and if they feel obligated to have sex, along with the positive and negative aspects of their relationship, as these could elevate their stress levels over time.
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Affiliation(s)
- Shannon Shen
- Department of Sociology, Texas A&M University-San Antonio, San Antonio, Texas, USA
| | - Hui Liu
- Department of Sociology, Michigan State University, East Lansing, Michigan, USA
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8
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Beckmann K, Kinsella N, Olsson H, Wallerstedt Lantz A, Nordstrom T, Aly M, Adolfsson J, Eklund M, Van Hemelrijck M. Is there any association between prostate-specific antigen screening frequency and uptake of active surveillance in men with low or very low risk prostate cancer? BMC Urol 2019; 19:73. [PMID: 31383015 PMCID: PMC6683376 DOI: 10.1186/s12894-019-0502-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 07/18/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Patient-related factors such as concern about cancer are believed to influence both men's decisions to undergo prostate specific antigen (PSA) testing and to have definitive treatment if diagnosed with low risk prostate cancer (PCa). The potential link between screening frequency and choice of active surveillance (AS) for low risk disease has not been studied previously. Our aim was to investigate whether there is any association between PCa screening frequency or previous negative prostate biopsy and uptake of AS among men with low risk PCa. METHODS This register-based study included all men ≤75 years from Stockholm who were diagnosed with low risk PCa from 2008 to 2014 (n = 4336). Pre-diagnostic PSA testing and biopsy histories were obtained from the Stockholm PSA and Biopsy Register, a population-based register for the Stockholm country. The association between previous screening/biopsy history and AS uptake (based on primary treatment recorded in the National Prostate Cancer Register) was examined using multivariable logistic regression. RESULTS Forty seven percent of men with low risk PCa underwent AS. Uptake was associated with older age, very low risk disease, more recent diagnosis and absence of family history. None of the screening/biopsy measures (testing frequency, mean interval, PSA velocity, highest pre-diagnostic PSA or prior negative biopsy) were associated with uptake of AS among men with low risk PCa. Generalisability to settings with different policies and practices may be limited. CONCLUSION We found no evidence that screening frequency and negative biopsy influence uptake of AS among Swedish men with low risk PCa. Further research is required to determine factors that still present barriers for men taking up AS.
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Affiliation(s)
- Kerri Beckmann
- Translational Oncology & Urology Research, Comprehensive Cancer Centre, King's College London, 3rd Floor, Bermondsey Wing, Guy's Hospital, London, SE1 9RT, UK. .,University of South Australia, Centre for population Health Research Adelaide Australia, Adelaide, Australia.
| | - Netty Kinsella
- Translational Oncology & Urology Research, Comprehensive Cancer Centre, King's College London, 3rd Floor, Bermondsey Wing, Guy's Hospital, London, SE1 9RT, UK.,Department of Urology, The Royal Marsden Hospital, London, UK
| | - Henrik Olsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Anna Wallerstedt Lantz
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Tobias Nordstrom
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Markus Aly
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Jan Adolfsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,CLINTEC-Department, Karolinska Institutet, Stockholm, Sweden
| | - Martin Eklund
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Mieke Van Hemelrijck
- Translational Oncology & Urology Research, Comprehensive Cancer Centre, King's College London, 3rd Floor, Bermondsey Wing, Guy's Hospital, London, SE1 9RT, UK.,Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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9
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Beckmann K, Russell B, Josephs D, Garmo H, Haggstrom C, Holmberg L, Stattin P, Van Hemelrijck M, Adolfsson J. Chronic inflammatory diseases, anti-inflammatory medications and risk of prostate cancer: a population-based case-control study. BMC Cancer 2019; 19:612. [PMID: 31226970 PMCID: PMC6588859 DOI: 10.1186/s12885-019-5846-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 06/17/2019] [Indexed: 12/20/2022] Open
Abstract
Background Whether chronic inflammation increases prostate cancer risk remains unclear. This study investigated whether chronic inflammatory diseases (CID) or anti-inflammatory medication use (AIM) were associated with prostate cancer risk. Methods Fifty-five thousand nine hundred thirty-seven cases (all prostate cancer, 2007–2012) and 279,618 age-matched controls were selected from the Prostate Cancer Database Sweden. CIDs and AIMs was determined from national patient and drug registers. Associations were investigated using conditional logistic regression, including for disease/drug subtypes and exposure length/dose. Results Men with a history of any CID had slightly increased risk of any prostate cancer diagnosis (OR: 1.08; 95%CI: 1.04–1.12) but not ‘unfavourable’ (high-risk or advanced) prostate cancer. Generally, risk of prostate cancer was highest for shorter exposure times. However, a positive association was observed for asthma > 5 years before prostate cancer diagnosis (OR: 1.21; 95%CI: 1.05–1.40). Risk of prostate cancer was increased with prior use of any AIMs (OR: 1.26; 95%CI: 1.24–1.29). A positive trend with increasing cumulative dose was only observed for inhaled glucocorticoids (p < 0.011). Conclusion Detection bias most likely explains the elevated risk of prostate cancer with prior history of CIDs or use of AIMs, given the higher risk immediately after first CID event and lack of dose response. However, findings for length of time with asthma and dose of inhaled glucocorticoids suggest that asthma may increase risk of prostate cancer through other pathways. Electronic supplementary material The online version of this article (10.1186/s12885-019-5846-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kerri Beckmann
- UniSA Cancer Research Institute, University of South Australia, Adelaide, Australia. .,School of Cancer and Pharmaceutical Studies, Translational Oncology & Urology Research (TOUR), King's College London, London, UK.
| | - Beth Russell
- School of Cancer and Pharmaceutical Studies, Translational Oncology & Urology Research (TOUR), King's College London, London, UK
| | - Debra Josephs
- School of Cancer and Pharmaceutical Studies, Translational Oncology & Urology Research (TOUR), King's College London, London, UK
| | - Hans Garmo
- School of Cancer and Pharmaceutical Studies, Translational Oncology & Urology Research (TOUR), King's College London, London, UK.,Regional Cancer Centre Uppsala, Uppsala University Hospital, Uppsala, Sweden
| | - Christel Haggstrom
- Department of Biobank Research, Umea University, Umea, Sweden.,Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden
| | - Lars Holmberg
- School of Cancer and Pharmaceutical Studies, Translational Oncology & Urology Research (TOUR), King's College London, London, UK.,Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden
| | - Pär Stattin
- Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden
| | - Mieke Van Hemelrijck
- School of Cancer and Pharmaceutical Studies, Translational Oncology & Urology Research (TOUR), King's College London, London, UK.,Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Jan Adolfsson
- CLINTEC-department, Karolinska Institutet, Stockholm, Sweden
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10
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Landier W, Skinner R, Wallace WH, Hjorth L, Mulder RL, Wong FL, Yasui Y, Bhakta N, Constine LS, Bhatia S, Kremer LC, Hudson MM. Surveillance for Late Effects in Childhood Cancer Survivors. J Clin Oncol 2018; 36:2216-2222. [PMID: 29874139 PMCID: PMC6804892 DOI: 10.1200/jco.2017.77.0180] [Citation(s) in RCA: 116] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Many childhood cancer survivors carry a significant risk for late morbidity and mortality, a consequence of the numerous therapeutic exposures that contribute to their cure. Focused surveillance for late therapy-related complications provides opportunities for early detection and implementation of health-preserving interventions. The substantial body of research that links therapeutic exposures used during treatment of childhood cancer to adverse outcomes among survivors enables the characterization of groups at the highest risk for developing complications related to specific therapies; however, methods available to optimize screening strategies to detect these therapy-related complications are limited. Moreover, the feasibility of conducting clinical trials to test screening recommendations for childhood cancer survivors is limited by requirements for large sample sizes, lengthy study periods, prohibitive costs, and ethical concerns. In addition, the harms of screening should be considered, including overdiagnosis and psychological distress. Experts in several countries have developed guideline recommendations for late effects surveillance and have collaborated to harmonize these recommendations internationally to enhance long-term follow-up care and quality of life for childhood cancer survivors. Methods used in these international efforts include systematic literature searches, development of evidence-based summaries, rigorous evaluation of the evidence, and formulation of consensus-based surveillance recommendations for each late complication. Alternate methods to refine recommendations, such as cumulative burden assessment and risk prediction and cost-effectiveness modeling, may provide novel approaches to guide survivorship care in this vulnerable population and, thus, represents a worthy objective for future international survivorship collaborations.
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Affiliation(s)
- Wendy Landier
- Wendy Landier and Smita Bhatia, University of Alabama at Birmingham, Birmingham, AL; Roderick Skinner, University of Newcastle upon Tyne, Newcastle upon Tyne; W. Hamish Wallace, Royal Hospital for Sick Children, Edinburgh, United Kingdom; Lars Hjorth, Skåne University Hospital, Lund, Sweden; Renée L. Mulder and Leontien C. Kremer, Emma Children’s Hospital, Amsterdam; Leontien C. Kremer, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; F. Lennie Wong, City of Hope, Duarte, CA; Yutaka Yasui, Nickhill Bhakta, and Melissa M. Hudson, St Jude Children’s Research Hospital, Memphis, TN; and Louis S. Constine, University of Rochester Medical Center, Rochester, NY
| | - Roderick Skinner
- Wendy Landier and Smita Bhatia, University of Alabama at Birmingham, Birmingham, AL; Roderick Skinner, University of Newcastle upon Tyne, Newcastle upon Tyne; W. Hamish Wallace, Royal Hospital for Sick Children, Edinburgh, United Kingdom; Lars Hjorth, Skåne University Hospital, Lund, Sweden; Renée L. Mulder and Leontien C. Kremer, Emma Children’s Hospital, Amsterdam; Leontien C. Kremer, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; F. Lennie Wong, City of Hope, Duarte, CA; Yutaka Yasui, Nickhill Bhakta, and Melissa M. Hudson, St Jude Children’s Research Hospital, Memphis, TN; and Louis S. Constine, University of Rochester Medical Center, Rochester, NY
| | - W. Hamish Wallace
- Wendy Landier and Smita Bhatia, University of Alabama at Birmingham, Birmingham, AL; Roderick Skinner, University of Newcastle upon Tyne, Newcastle upon Tyne; W. Hamish Wallace, Royal Hospital for Sick Children, Edinburgh, United Kingdom; Lars Hjorth, Skåne University Hospital, Lund, Sweden; Renée L. Mulder and Leontien C. Kremer, Emma Children’s Hospital, Amsterdam; Leontien C. Kremer, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; F. Lennie Wong, City of Hope, Duarte, CA; Yutaka Yasui, Nickhill Bhakta, and Melissa M. Hudson, St Jude Children’s Research Hospital, Memphis, TN; and Louis S. Constine, University of Rochester Medical Center, Rochester, NY
| | - Lars Hjorth
- Wendy Landier and Smita Bhatia, University of Alabama at Birmingham, Birmingham, AL; Roderick Skinner, University of Newcastle upon Tyne, Newcastle upon Tyne; W. Hamish Wallace, Royal Hospital for Sick Children, Edinburgh, United Kingdom; Lars Hjorth, Skåne University Hospital, Lund, Sweden; Renée L. Mulder and Leontien C. Kremer, Emma Children’s Hospital, Amsterdam; Leontien C. Kremer, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; F. Lennie Wong, City of Hope, Duarte, CA; Yutaka Yasui, Nickhill Bhakta, and Melissa M. Hudson, St Jude Children’s Research Hospital, Memphis, TN; and Louis S. Constine, University of Rochester Medical Center, Rochester, NY
| | - Renée L. Mulder
- Wendy Landier and Smita Bhatia, University of Alabama at Birmingham, Birmingham, AL; Roderick Skinner, University of Newcastle upon Tyne, Newcastle upon Tyne; W. Hamish Wallace, Royal Hospital for Sick Children, Edinburgh, United Kingdom; Lars Hjorth, Skåne University Hospital, Lund, Sweden; Renée L. Mulder and Leontien C. Kremer, Emma Children’s Hospital, Amsterdam; Leontien C. Kremer, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; F. Lennie Wong, City of Hope, Duarte, CA; Yutaka Yasui, Nickhill Bhakta, and Melissa M. Hudson, St Jude Children’s Research Hospital, Memphis, TN; and Louis S. Constine, University of Rochester Medical Center, Rochester, NY
| | - F. Lennie Wong
- Wendy Landier and Smita Bhatia, University of Alabama at Birmingham, Birmingham, AL; Roderick Skinner, University of Newcastle upon Tyne, Newcastle upon Tyne; W. Hamish Wallace, Royal Hospital for Sick Children, Edinburgh, United Kingdom; Lars Hjorth, Skåne University Hospital, Lund, Sweden; Renée L. Mulder and Leontien C. Kremer, Emma Children’s Hospital, Amsterdam; Leontien C. Kremer, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; F. Lennie Wong, City of Hope, Duarte, CA; Yutaka Yasui, Nickhill Bhakta, and Melissa M. Hudson, St Jude Children’s Research Hospital, Memphis, TN; and Louis S. Constine, University of Rochester Medical Center, Rochester, NY
| | - Yutaka Yasui
- Wendy Landier and Smita Bhatia, University of Alabama at Birmingham, Birmingham, AL; Roderick Skinner, University of Newcastle upon Tyne, Newcastle upon Tyne; W. Hamish Wallace, Royal Hospital for Sick Children, Edinburgh, United Kingdom; Lars Hjorth, Skåne University Hospital, Lund, Sweden; Renée L. Mulder and Leontien C. Kremer, Emma Children’s Hospital, Amsterdam; Leontien C. Kremer, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; F. Lennie Wong, City of Hope, Duarte, CA; Yutaka Yasui, Nickhill Bhakta, and Melissa M. Hudson, St Jude Children’s Research Hospital, Memphis, TN; and Louis S. Constine, University of Rochester Medical Center, Rochester, NY
| | - Nickhill Bhakta
- Wendy Landier and Smita Bhatia, University of Alabama at Birmingham, Birmingham, AL; Roderick Skinner, University of Newcastle upon Tyne, Newcastle upon Tyne; W. Hamish Wallace, Royal Hospital for Sick Children, Edinburgh, United Kingdom; Lars Hjorth, Skåne University Hospital, Lund, Sweden; Renée L. Mulder and Leontien C. Kremer, Emma Children’s Hospital, Amsterdam; Leontien C. Kremer, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; F. Lennie Wong, City of Hope, Duarte, CA; Yutaka Yasui, Nickhill Bhakta, and Melissa M. Hudson, St Jude Children’s Research Hospital, Memphis, TN; and Louis S. Constine, University of Rochester Medical Center, Rochester, NY
| | - Louis S. Constine
- Wendy Landier and Smita Bhatia, University of Alabama at Birmingham, Birmingham, AL; Roderick Skinner, University of Newcastle upon Tyne, Newcastle upon Tyne; W. Hamish Wallace, Royal Hospital for Sick Children, Edinburgh, United Kingdom; Lars Hjorth, Skåne University Hospital, Lund, Sweden; Renée L. Mulder and Leontien C. Kremer, Emma Children’s Hospital, Amsterdam; Leontien C. Kremer, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; F. Lennie Wong, City of Hope, Duarte, CA; Yutaka Yasui, Nickhill Bhakta, and Melissa M. Hudson, St Jude Children’s Research Hospital, Memphis, TN; and Louis S. Constine, University of Rochester Medical Center, Rochester, NY
| | - Smita Bhatia
- Wendy Landier and Smita Bhatia, University of Alabama at Birmingham, Birmingham, AL; Roderick Skinner, University of Newcastle upon Tyne, Newcastle upon Tyne; W. Hamish Wallace, Royal Hospital for Sick Children, Edinburgh, United Kingdom; Lars Hjorth, Skåne University Hospital, Lund, Sweden; Renée L. Mulder and Leontien C. Kremer, Emma Children’s Hospital, Amsterdam; Leontien C. Kremer, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; F. Lennie Wong, City of Hope, Duarte, CA; Yutaka Yasui, Nickhill Bhakta, and Melissa M. Hudson, St Jude Children’s Research Hospital, Memphis, TN; and Louis S. Constine, University of Rochester Medical Center, Rochester, NY
| | - Leontien C. Kremer
- Wendy Landier and Smita Bhatia, University of Alabama at Birmingham, Birmingham, AL; Roderick Skinner, University of Newcastle upon Tyne, Newcastle upon Tyne; W. Hamish Wallace, Royal Hospital for Sick Children, Edinburgh, United Kingdom; Lars Hjorth, Skåne University Hospital, Lund, Sweden; Renée L. Mulder and Leontien C. Kremer, Emma Children’s Hospital, Amsterdam; Leontien C. Kremer, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; F. Lennie Wong, City of Hope, Duarte, CA; Yutaka Yasui, Nickhill Bhakta, and Melissa M. Hudson, St Jude Children’s Research Hospital, Memphis, TN; and Louis S. Constine, University of Rochester Medical Center, Rochester, NY
| | - Melissa M. Hudson
- Wendy Landier and Smita Bhatia, University of Alabama at Birmingham, Birmingham, AL; Roderick Skinner, University of Newcastle upon Tyne, Newcastle upon Tyne; W. Hamish Wallace, Royal Hospital for Sick Children, Edinburgh, United Kingdom; Lars Hjorth, Skåne University Hospital, Lund, Sweden; Renée L. Mulder and Leontien C. Kremer, Emma Children’s Hospital, Amsterdam; Leontien C. Kremer, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; F. Lennie Wong, City of Hope, Duarte, CA; Yutaka Yasui, Nickhill Bhakta, and Melissa M. Hudson, St Jude Children’s Research Hospital, Memphis, TN; and Louis S. Constine, University of Rochester Medical Center, Rochester, NY
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11
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Nair-Shalliker V, Bang A, Weber M, Goldsbury DE, Caruana M, Emery J, Banks E, Canfell K, O'Connell DL, Smith DP. Factors associated with prostate specific antigen testing in Australians: Analysis of the New South Wales 45 and Up Study. Sci Rep 2018. [PMID: 29523809 PMCID: PMC5844910 DOI: 10.1038/s41598-018-22589-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Australia has one of the highest incidence rates of prostate cancer (PC) worldwide, due in part to widespread prostate specific antigen (PSA) testing. We aimed to identify factors associated with PSA testing in Australian men without a diagnosis of prostate cancer or prior prostate disease. Participants were men joining the 45 and Up Study in 2006–2009, aged ≥45 years at recruitment. Self-completed questionnaires were linked to cancer registrations, hospitalisations, health services data and deaths. Men with a history of PC, radical prostatectomy or a “monitoring” PSA test for prostate disease were excluded. We identified Medicare reimbursed PSA tests during 2012–2014. Multivariable logistic regression was used to estimate adjusted odds ratios (OR) for the association between having PSA tests and factors of interest. Of the 62,765 eligible men, 51.8% had at least one screening PSA test during 2012–2014. Factors strongly associated with having a PSA test included having 27+ general practitioner consultations (versus 3–9 consultations; OR = 2.00; 95%CI = 1.90–2.11), benign prostatic hyperplasia treatment (versus none; OR = 1.59(95%CI = 1.49–1.70), aged 60–69 years (versus 50–59 years; OR = 1.54; 95%CI = 1.48–1.60). These results emphasise the important role of primary care in decision making about PSA testing.
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Affiliation(s)
- Visalini Nair-Shalliker
- Cancer Research Division, Cancer Council NSW, Sydney, NSW, Australia.,Sydney School of Public Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.,Department of Clinical Medicine, Macquarie University, Sydney, Australia
| | - Albert Bang
- Cancer Research Division, Cancer Council NSW, Sydney, NSW, Australia
| | - Marianne Weber
- Cancer Research Division, Cancer Council NSW, Sydney, NSW, Australia.,Sydney School of Public Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - David E Goldsbury
- Cancer Research Division, Cancer Council NSW, Sydney, NSW, Australia
| | - Michael Caruana
- Cancer Research Division, Cancer Council NSW, Sydney, NSW, Australia.,Sydney School of Public Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Jon Emery
- Department of General Practice, Centre for Cancer Research, University of Melbourne. Victorian Comprehensive Cancer Centre. Melbourne, Victoria, Australia
| | - Emily Banks
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australia
| | - Karen Canfell
- Cancer Research Division, Cancer Council NSW, Sydney, NSW, Australia.,Sydney School of Public Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.,School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Dianne L O'Connell
- Cancer Research Division, Cancer Council NSW, Sydney, NSW, Australia.,Sydney School of Public Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.,School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | - David P Smith
- Cancer Research Division, Cancer Council NSW, Sydney, NSW, Australia. .,Sydney School of Public Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia. .,Menzies Health Institute, Queensland, Griffith University, Gold Coast, Queensland, Australia.
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12
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Drummond FJ, O'Leary E, Gavin A, Kinnear H, Sharp L. Mode of prostate cancer detection is associated with the psychological wellbeing of survivors: results from the PiCTure study. Support Care Cancer 2016; 24:2297-2307. [PMID: 26594035 PMCID: PMC4805717 DOI: 10.1007/s00520-015-3033-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 11/15/2015] [Indexed: 12/14/2022]
Abstract
PURPOSE Many men with prostate cancer are asymptomatic, diagnosed following prostate specific antigen (PSA) testing. We investigate whether mode of detection, i.e. 'PSA detected' or 'clinically detected', was associated with psychological wellbeing among prostate cancer survivors. METHODS A cross-sectional postal questionnaire was administered in 2012 to 6559 prostate cancer (ICD10 C61) survivors up to 18 years post-diagnosis, identified through population-based cancer registries in Ireland. Psychological wellbeing was assessed using the Depression Anxiety Stress Scale-21. Logistic regression was used to investigate associations between mode of detection and depression, anxiety and stress, adjusting for socio-demographic and clinical confounders. RESULTS The response rate was 54 % (3348/6262). Fifty-nine percent of survivors were diagnosed with asymptomatic PSA-tested disease. Prevalence of depression (13.8 vs 20.7 %; p < 0.001), anxiety (13.6 vs 20.9 %; p < 0.001) and stress (8.7 vs 13.8 %; p < 0.001) were significantly lower among survivors diagnosed with PSA-detected, than clinically detected disease. After adjusting for clinical and socio-demographic factors, survivors with clinically detected disease had significantly higher risk of depression (odds ratio (OR) = 1.46 95 % CI 1.18, 1.80; p = 0.001), anxiety (OR = 1.36 95 % CI 1.09, 1.68; p = 0.006) and stress (OR = 1.43 95 % CI 1.11, 1.85; p = 0.006) than survivors with PSA-detected disease. CONCLUSIONS These findings contribute to the ongoing debate on benefits and risks of PSA testing and may be considered by policy makers formulating population-based prostate cancer screening policies. The relatively high prevalence of negative psychological states among survivors means that a 'risk-adapted approach' should be implemented to screen survivors most at risk of psychological morbidity for psychological health, and mode of detection could be considered as a risk stratum.
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Affiliation(s)
- Frances J Drummond
- National Cancer Registry Ireland, Building 6800, Airport Business Park, Kinsale Road, Cork, Ireland.
- School of Nursing and Midwifery, University College Cork, Cork, Ireland.
| | - Eamonn O'Leary
- National Cancer Registry Ireland, Building 6800, Airport Business Park, Kinsale Road, Cork, Ireland
| | - Anna Gavin
- Northern Ireland Cancer Registry, Centre for Public Health, Queen's University Belfast, Mulhouse Building, Grosvenor Road, Belfast, BT12 6BJ, Ireland
| | - Heather Kinnear
- Northern Ireland Cancer Registry, Centre for Public Health, Queen's University Belfast, Mulhouse Building, Grosvenor Road, Belfast, BT12 6BJ, Ireland
| | - Linda Sharp
- National Cancer Registry Ireland, Building 6800, Airport Business Park, Kinsale Road, Cork, Ireland
- University of Newcastle, Tyne and Wear, Newcastle upon Tyne, NE1 7RU, UK
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13
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Venkatachalam S, Makarov DV. Health Policy for Prostate Cancer: PSA Screening as Case Study. Prostate Cancer 2016. [DOI: 10.1016/b978-0-12-800077-9.00064-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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14
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Sun Y, Vedsted P, Fenger-Grøn M, Wu CS, Bech BH, Olsen J, Benros ME, Vestergaard M. Cancer Mortality in People Treated with Antidepressants before Cancer Diagnosis: A Population Based Cohort Study. PLoS One 2015; 10:e0138134. [PMID: 26367120 PMCID: PMC4569483 DOI: 10.1371/journal.pone.0138134] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 08/25/2015] [Indexed: 01/06/2023] Open
Abstract
Background Depression is common after a cancer diagnosis and is associated with an increased mortality, but it is unclear whether depression occurring before the cancer diagnosis affects cancer mortality. We aimed to study cancer mortality of people treated with antidepressants before cancer diagnosis. Methods and Findings We conducted a population based cohort study of all adults diagnosed with cancer between January 2003 and December 2010 in Denmark (N = 201,662). We obtained information on cancer from the Danish Cancer Registry, on the day of death from the Danish Civil Registry, and on redeemed antidepressants from the Danish National Prescription Registry. Current users of antidepressants were defined as those who redeemed the latest prescription of antidepressant 0–4 months before cancer diagnosis (irrespective of earlier prescriptions), and former users as those who redeemed the latest prescription five or more months before cancer diagnosis. We estimated an all-cause one-year mortality rate ratio (MRR) and a conditional five-year MRR for patients who survived the first year after cancer diagnosis and confidence interval (CI) using a Cox proportional hazards regression model. Overall, 33,111 (16.4%) patients redeemed at least one antidepressant prescription in the three years before cancer diagnosis of whom 21,851 (10.8%) were current users at the time of cancer diagnosis. Current antidepressant users had a 32% higher one-year mortality (MRR = 1.32, 95% CI: 1.29–1.35) and a 22% higher conditional five-year mortality (MRR = 1.22, 95% CI: 1.17–1.26) if patients survived the first year after the cancer diagnosis than patients not redeeming antidepressants. The one-year mortality was particularly high for patients who initiated antidepressant treatment within four months before cancer diagnosis (MRR = 1.54, 95% CI: 1.47–1.61). Former users had no increased cancer mortality. Conclusions Initiation of antidepressive treatment prior to cancer diagnosis is common and is associated with an increased mortality.
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Affiliation(s)
- Yuelian Sun
- Research Unit for General Practice, Department of Public Health, Aarhus University, Aarhus, Denmark
- Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark
- * E-mail:
| | - Peter Vedsted
- Research Unit for General Practice, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Morten Fenger-Grøn
- Research Unit for General Practice, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Chun Sen Wu
- Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Bodil Hammer Bech
- Research Unit for General Practice, Department of Public Health, Aarhus University, Aarhus, Denmark
- Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Jørn Olsen
- Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark
| | | | - Mogens Vestergaard
- Research Unit for General Practice, Department of Public Health, Aarhus University, Aarhus, Denmark
- Section for General Practice, Department of Public Health, Aarhus University, Aarhus, Denmark
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15
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Parker MS, Groves RC, Fowler AA, Shepherd RW, Cassano AD, Cafaro PL, Chestnut GT. Lung cancer screening with low-dose computed tomography: an analysis of the MEDCAC decision. J Thorac Imaging 2015; 30:15-23. [PMID: 25286290 DOI: 10.1097/rti.0000000000000119] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Lung cancer is the leading cause of cancer death in the United States and worldwide. However, among the top 4 deadliest cancers, lung cancer is the only one not subject to routine screening. Optimism for an effective lung cancer-screening examination soared after the release of the National Lung Screening Trial results in November 2011. Since then, nearly 40 major medical societies and organizations have endorsed low-dose computed tomography (LDCT) screening. In December 2013, the United States Preventive Services Task Force also endorsed LDCT. However, the momentum for LDCT screening slowed in April 2014 when the Medicare Evidence Development and Coverage Advisory Committee (MEDCAC) panel concluded that there was not enough evidence to justify the annual use of LDCT scans for the detection of early lung cancer. This article briefly reviews the epidemiology of lung cancer, the National Lung Screening Trial study results, and the growing national endorsement of LDCT from a variety of key stakeholder organizations. We subsequently analyze and offer our evidence-based counterpoints to the major assumptions underlying the MEDCAC decision.
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Affiliation(s)
- Mark S Parker
- *Department of Diagnostic Radiology, Cardiothoracic Imaging †Department of Internal Medicine, Division of Pulmonary Disease and Critical Care Medicine ‡Department of Surgery, Division of Cardiothoracic Surgery ∥Department of Radiology §Department of Internal Medicine, VCU Medical Center, Richmond, VA
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16
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Tavlarides AM, Ames SC, Thiel DD, Diehl NN, Parker AS. Baseline and follow-up association of the MAX-PC in Men with newly diagnosed prostate cancer. Psychooncology 2015; 24:451-7. [PMID: 24953309 PMCID: PMC4326594 DOI: 10.1002/pon.3605] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 05/20/2014] [Accepted: 05/23/2014] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The objective of this paper is to conduct a prospective, longitudinal study employing the Memorial Anxiety Scale for Prostate Cancer (MAX-PC) to examine the baseline and follow-up association of prostate cancer (PCa)-specific anxiety, health-related quality of life (HRQOL), and PCa aggressiveness in men with newly-diagnosed PCa undergoing prostatectomy at our institution. METHODS From our prospective PCa registry, we identified a total of 350 men with newly-diagnosed PCa who completed the MAX-PC and the Expanded Prostate Cancer Index Composite (EPIC) at baseline and one-year following surgery. Scores on both measures were compared with clinical measure and demographics using the Wilcoxon Rank Sum, Fisher's exact, and Cochran-Armitage Trend tests. Spearman test was used to assess correlation at between the MAX-PC and EPIC at baseline and one-year. RESULTS Baseline overall MAX-PC measures were correlated with measures at one-year (r=0.5479, p<0.001). Those reporting high anxiety at one-year were more likely to have Gleason score>6 (p=0.004), T-Stage ≥ 2C disease (p=0.004), and a postoperative prostate-specific antigen (PSA)>0.1 (p=0.002); however, this did not apply to all anxious patients. Baseline EPIC sexual function scores were predictive of follow-up EPIC sexual function scores as well (r=0.5790, p<0.001). Depression was noted as a problem in 16% of patients at follow-up. CONCLUSIONS Our data suggests that the MAX-PC could be used at baseline as a tool to determine who may benefit from psychological intervention pre-PCa and post-PCa treatment. In terms of individualized medicine, behavioral therapy may be the most beneficial in improving HRQOL for younger patients, those with advanced stage disease, and more specifically those whose anxiety outweighs their actual prognosis.
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Affiliation(s)
| | - Steven C. Ames
- Division of Hematology and Oncology, Mayo Clinic, FL, USA
| | - David D. Thiel
- Department of Urology, Mayo Clinic, Jacksonville, FL, USA
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17
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Mitchell AJ, Pereira IES, Yadegarfar M, Pepereke S, Mugadza V, Stubbs B. Breast cancer screening in women with mental illness: comparative meta-analysis of mammography uptake. Br J Psychiatry 2014; 205:428-35. [PMID: 25452600 DOI: 10.1192/bjp.bp.114.147629] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND There is a higher mortality rate due to cancer in people with mental illness and previous work suggests suboptimal medical care in this population. It remains unclear if this extends to breast cancer population screening. AIMS To conduct a systematic review and meta-analysis to establish if women with a mental health condition are less likely to receive mammography screening compared with those without mental ill health. METHOD Major electronic databases were searched from inception until February 2014. We calculated odds ratios (OR) with a random effects meta-analysis comparing mammography screening rates among women with and without a mental illness. Results were stratified according to primary diagnosis including any mental illness, mood disorders, depression, severe mental illness (SMI), distress and anxiety. RESULTS We identified 24 publications reporting breast cancer screening practices in women with mental illness (n = 715,705). An additional 5 studies investigating screening for those with distress (n = 21,491) but no diagnosis of mental disorder were identified. The pooled meta-analysis showed significantly reduced rates of mammography screening in women with mental illness (OR = 0.71, 95% CI 0.66-0.77), mood disorders (OR = 0.83, 95% CI 0.76-0.90) and particularly SMI (OR = 0.54, 95% CI 0.45-0.65). No disparity was evident among women with distress alone. CONCLUSIONS Rates of mammography screening are lower in women with mental illness, particularly women with SMI, and this is not explained by the presence of emotional distress. Disparities in medical care due to mental illness clearly extend into preventive population screening.
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Affiliation(s)
- Alex J Mitchell
- Alex J. Mitchell, MD, Department of Psycho-oncology, Cancer and Molecular Medicine, University of Leicester; Isabel Espirito Santo Pereira, Motahare Yadegarfar, Shingai Pepereke, Vongai Mugadza, University of Leicester Medical School, Leicester; Brendon Stubbs, MSc, MCSP, Faculty of Education and Health, University of Greenwich, London, UK
| | - Isabel Espirito Santo Pereira
- Alex J. Mitchell, MD, Department of Psycho-oncology, Cancer and Molecular Medicine, University of Leicester; Isabel Espirito Santo Pereira, Motahare Yadegarfar, Shingai Pepereke, Vongai Mugadza, University of Leicester Medical School, Leicester; Brendon Stubbs, MSc, MCSP, Faculty of Education and Health, University of Greenwich, London, UK
| | - Motahare Yadegarfar
- Alex J. Mitchell, MD, Department of Psycho-oncology, Cancer and Molecular Medicine, University of Leicester; Isabel Espirito Santo Pereira, Motahare Yadegarfar, Shingai Pepereke, Vongai Mugadza, University of Leicester Medical School, Leicester; Brendon Stubbs, MSc, MCSP, Faculty of Education and Health, University of Greenwich, London, UK
| | - Shingai Pepereke
- Alex J. Mitchell, MD, Department of Psycho-oncology, Cancer and Molecular Medicine, University of Leicester; Isabel Espirito Santo Pereira, Motahare Yadegarfar, Shingai Pepereke, Vongai Mugadza, University of Leicester Medical School, Leicester; Brendon Stubbs, MSc, MCSP, Faculty of Education and Health, University of Greenwich, London, UK
| | - Vongai Mugadza
- Alex J. Mitchell, MD, Department of Psycho-oncology, Cancer and Molecular Medicine, University of Leicester; Isabel Espirito Santo Pereira, Motahare Yadegarfar, Shingai Pepereke, Vongai Mugadza, University of Leicester Medical School, Leicester; Brendon Stubbs, MSc, MCSP, Faculty of Education and Health, University of Greenwich, London, UK
| | - Brendon Stubbs
- Alex J. Mitchell, MD, Department of Psycho-oncology, Cancer and Molecular Medicine, University of Leicester; Isabel Espirito Santo Pereira, Motahare Yadegarfar, Shingai Pepereke, Vongai Mugadza, University of Leicester Medical School, Leicester; Brendon Stubbs, MSc, MCSP, Faculty of Education and Health, University of Greenwich, London, UK
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18
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Flahavan EM, Drummond FJ, Bennett K, Barron TI, Sharp L. Prostate specific antigen testing is associated with men's psychological and physical health and their healthcare utilisation in a nationally representative sample: a cross-sectional study. BMC FAMILY PRACTICE 2014; 15:121. [PMID: 24938184 PMCID: PMC4065544 DOI: 10.1186/1471-2296-15-121] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Accepted: 06/04/2014] [Indexed: 11/10/2022]
Abstract
BACKGROUND Prostate cancer incidence has risen considerably in recent years, primarily due to Prostate Specific Antigen (PSA) testing in primary care. The objective of this study was to investigate associations between PSA testing and the psychological and physical health, and healthcare utilisation of men in a population where PSA testing is widespread. METHODS A cross-sectional study was carried out in a population-representative sample of men ≥ 50 years enrolled in The Irish Longitudinal Study on Ageing (TILDA). TILDA participants underwent structured interviews, health assessments and completed standardised questionnaires. Men were classified as ever/never having received a PSA test. Multivariate logistic regression (Odds Ratios (OR) and 95% Confidence Intervals (CI) was used to determine associations between PSA testing, and men's psychological and physical health and healthcare utilisation. RESULTS This analysis included 3,628 men, 68.2% of whom ever had a PSA test. In adjusted analysis, men with sub-threshold depression were significantly less likely to have had a PSA test, (OR=0.79, 95% CI 0.64-0.97). Likelihood of having a PSA test was inversely associated with anxiety, but this was not significant (OR=0.79, 95% CI 0.57-1.09). Frailty (OR=0.61, 95% CI 0.31-1.05) and eligibility for free primary care (OR=0.63, 95% CI 0.52-0.77) were also inversely associated with PSA testing. Positive associations were observed between PSA testing and more chronic illnesses (OR=1.11, 95% CI 1.05-1.19), more primary care visits (OR=1.03, 95% CI 1.01-1.05) and preventative health practices, including cholesterol testing and influenza vaccination (OR=1.35, 95% CI 1.13-1.60). CONCLUSIONS Men's psychological and physical health and their healthcare utilisation are associated with PSA testing in primary care. The association between poorer psychological health, in particular sub-threshold depression, and reduced likelihood of PSA testing in primary care requires further investigation. These findings may have wider implications for other cancer screening.
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Affiliation(s)
- Evelyn M Flahavan
- Department of Pharmacology & Therapeutics, Trinity College, University of Dublin, Dublin, Ireland.
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Jacob R, Arnold LD, Hunleth J, Greiner KA, James AS. Daily hassles' role in health seeking behavior among low-income populations. Am J Health Behav 2014; 38:297-306. [PMID: 24629558 DOI: 10.5993/ajhb.38.2.15] [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: 12/24/2022]
Abstract
OBJECTIVES To adapt a daily hassles measure for a low-income population and assess the relationship between hassles and health seeking behavior. METHODS The mixed methods approach used cognitive interviews (N = 23) to inform an adapted measure of daily hassles. The adapted scale was then tested via surveys (N = 144) in community health centers; multivariate logistic regression models were used to assess relationships among variables. RESULTS Hassle concerning having enough money for emergencies (76.5%) and worrying about personal health (68.8%) were among the most common. Increased health-related hassles were associated with an increased likelihood to delay needed care. CONCLUSIONS Findings suggest daily hassles are unique among low-income populations and should be considered in health behavior interventions.
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Affiliation(s)
- Rebekah Jacob
- Washington University in Saint Louis, School of Medicine, Division of Public Health Sciences, St Louis, MO, USA.
| | - Lauren D Arnold
- Saint Louis University, College of Public Health & Social Justice, Department of Epidemiology, Kansas City, KS, USA
| | - Jean Hunleth
- Washington University in Saint Louis, School of Medicine, Division of Public Health Sciences, St Louis, MO, USA
| | - K Allen Greiner
- University of Kansas Medical Center, Department of Family Medicine, Kansas City, KS, USA
| | - Aimee S James
- Washington University in Saint Louis, School of Medicine, Division of Public Health Sciences, St Louis, MO, USA
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Abstract
This article presents an overview of the challenges that men encounter in making decisions about prostate cancer screening, including complex affective and cognitive factors and controversies in the interpretation of the evidence on prostate cancer screening. Shared decision making involving patient decision aids are discussed as approaches that can be used to improve the quality of prostate cancer screening decisions, including a close alignment between a man's values, goals, and preferences and his choice about screening.
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Affiliation(s)
- Sara J Knight
- Health Services Research and Development Service, Office of Research and Development, Veterans Health Administration, 810 Vermont Avenue, Northwest, Washington, DC 20420, USA; Department of Psychiatry, University of California San Francisco, 401 Parnassus Avenue, San Francisco, CA 94143, USA; Department of Urology, University of California San Francisco, 400 Parnassus Avenue, Suite A610, San Francisco, CA 94123, USA.
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