1
|
Edwards PJ, Roberts I, Clarke MJ, DiGuiseppi C, Woolf B, Perkins C. Methods to increase response to postal and electronic questionnaires. Cochrane Database Syst Rev 2023; 11:MR000008. [PMID: 38032037 PMCID: PMC10687884 DOI: 10.1002/14651858.mr000008.pub5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
BACKGROUND Self-administered questionnaires are widely used to collect data in epidemiological research, but non-response reduces the effective sample size and can introduce bias. Finding ways to increase response to postal and electronic questionnaires would improve the quality of epidemiological research. OBJECTIVES To identify effective strategies to increase response to postal and electronic questionnaires. SEARCH METHODS We searched 14 electronic databases up to December 2021 and manually searched the reference lists of relevant trials and reviews. We contacted the authors of all trials or reviews to ask about unpublished trials; where necessary, we also contacted authors to confirm the methods of allocation used and to clarify results presented. SELECTION CRITERIA Randomised trials of methods to increase response to postal or electronic questionnaires. We assessed the eligibility of each trial using pre-defined criteria. DATA COLLECTION AND ANALYSIS We extracted data on the trial participants, the intervention, the number randomised to intervention and comparison groups and allocation concealment. For each strategy, we estimated pooled odds ratios (OR) and 95% confidence intervals (CI) in a random-effects model. We assessed evidence for selection bias using Egger's weighted regression method and Begg's rank correlation test and funnel plot. We assessed heterogeneity amongst trial odds ratios using a Chi2 test and quantified the degree of inconsistency between trial results using the I2 statistic. MAIN RESULTS Postal We found 670 eligible trials that evaluated over 100 different strategies of increasing response to postal questionnaires. We found substantial heterogeneity amongst trial results in half of the strategies. The odds of response almost doubled when: using monetary incentives (odds ratio (OR) 1.86; 95% confidence interval (CI) 1.73 to 1.99; heterogeneity I2 = 85%); using a telephone reminder (OR 1.96; 95% CI 1.03 to 3.74); and when clinical outcome questions were placed last (OR 2.05; 95% CI 1.00 to 4.24). The odds of response increased by about half when: using a shorter questionnaire (OR 1.58; 95% CI 1.40 to 1.78); contacting participants before sending questionnaires (OR 1.36; 95% CI 1.23 to 1.51; I2 = 87%); incentives were given with questionnaires (i.e. unconditional) rather than when given only after participants had returned their questionnaire (i.e. conditional on response) (OR 1.53; 95% CI 1.35 to 1.74); using personalised SMS reminders (OR 1.53; 95% CI 0.97 to 2.42); using a special (recorded) delivery service (OR 1.68; 95% CI 1.36 to 2.08; I2 = 87%); using electronic reminders (OR 1.60; 95% CI 1.10 to 2.33); using intensive follow-up (OR 1.69; 95% CI 0.93 to 3.06); using a more interesting/salient questionnaire (OR 1.73; 95% CI 1.12 to 2.66); and when mentioning an obligation to respond (OR 1.61; 95% CI 1.16 to 2.22). The odds of response also increased with: non-monetary incentives (OR 1.16; 95% CI 1.11 to 1.21; I2 = 80%); a larger monetary incentive (OR 1.24; 95% CI 1.15 to 1.33); a larger non-monetary incentive (OR 1.15; 95% CI 1.00 to 1.33); when a pen was included (OR 1.44; 95% CI 1.38 to 1.50); using personalised materials (OR 1.15; 95% CI 1.09 to 1.21; I2 = 57%); using a single-sided rather than a double-sided questionnaire (OR 1.13; 95% CI 1.02 to 1.25); using stamped return envelopes rather than franked return envelopes (OR 1.23; 95% CI 1.13 to 1.33; I2 = 69%), assuring confidentiality (OR 1.33; 95% CI 1.24 to 1.42); using first-class outward mailing (OR 1.11; 95% CI 1.02 to 1.21); and when questionnaires originated from a university (OR 1.32; 95% CI 1.13 to 1.54). The odds of response were reduced when the questionnaire included questions of a sensitive nature (OR 0.94; 95% CI 0.88 to 1.00). Electronic We found 88 eligible trials that evaluated over 30 different ways of increasing response to electronic questionnaires. We found substantial heterogeneity amongst trial results in half of the strategies. The odds of response tripled when: using a brief letter rather than a detailed letter (OR 3.26; 95% CI 1.79 to 5.94); and when a picture was included in an email (OR 3.05; 95% CI 1.84 to 5.06; I2 = 19%). The odds of response almost doubled when: using monetary incentives (OR 1.88; 95% CI 1.31 to 2.71; I2 = 79%); and using a more interesting topic (OR 1.85; 95% CI 1.52 to 2.26). The odds of response increased by half when: using non-monetary incentives (OR 1.60; 95% CI 1.25 to 2.05); using shorter e-questionnaires (OR 1.51; 95% CI 1.06 to 2.16; I2 = 94%); and using a more interesting e-questionnaire (OR 1.85; 95% CI 1.52 to 2.26). The odds of response increased by a third when: offering survey results as an incentive (OR 1.36; 95% CI 1.16 to 1.59); using a white background (OR 1.31; 95% CI 1.10 to 1.56); and when stressing the benefits to society of response (OR 1.38; 95% CI 1.07 to 1.78; I2 = 41%). The odds of response also increased with: personalised e-questionnaires (OR 1.24; 95% CI 1.17 to 1.32; I2 = 41%); using a simple header (OR 1.23; 95% CI 1.03 to 1.48); giving a deadline (OR 1.18; 95% CI 1.03 to 1.34); and by giving a longer time estimate for completion (OR 1.25; 95% CI 0.96 to 1.64). The odds of response were reduced when: "Survey" was mentioned in the e-mail subject (OR 0.81; 95% CI 0.67 to 0.97); when the email or the e-questionnaire was from a male investigator, or it included a male signature (OR 0.55; 95% CI 0.38 to 0.80); and by using university sponsorship (OR 0.84; 95%CI 0.69 to 1.01). The odds of response using a postal questionnaire were over twice those using an e-questionnaire (OR 2.33; 95% CI 2.25 to 2.42; I2 = 98%). Response also increased when: providing a choice of response mode (electronic or postal) rather than electronic only (OR 1.76 95% CI 1.67 to 1.85; I2 = 97%); and when administering the e-questionnaire by computer rather than by smartphone (OR 1.62 95% CI 1.36 to 1.94). AUTHORS' CONCLUSIONS Researchers using postal and electronic questionnaires can increase response using the strategies shown to be effective in this Cochrane review.
Collapse
Affiliation(s)
- Philip James Edwards
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Ian Roberts
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Mike J Clarke
- Centre for Public Health, Queens University Belfast, Belfast, UK
| | - Carolyn DiGuiseppi
- Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Benjamin Woolf
- School of Psychological Science, University of Bristol, Bristol, UK
| | | |
Collapse
|
2
|
Adesoye T, Liao K, Peterson S, Li L, Zorzi D, Holmes HM, Chavez‐MacGregor M, Giordano SH. Patient-reported outcomes in older breast cancer survivors with and without prior chemotherapy treatment. Cancer Med 2023; 12:17740-17752. [PMID: 37551136 PMCID: PMC10524015 DOI: 10.1002/cam4.6394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 07/11/2023] [Accepted: 07/18/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Little is known about long-term treatment-related symptoms in older breast cancer survivors. We characterized long-term patient-reported symptoms and examined factors associated with the presence and severity of symptoms, and symptom interference with daily activities. METHODS Texas Cancer Registry (TCR) Medicare linkage data was used to identify breast cancer patients age 65 and older with local/regional stage disease diagnosed between 2012-2013. Symptom burden was assessed using breast-specific items from the Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE™). Demographic and clinical data also were collected. Logistic regression models were used to assess the association between symptom burden and respondent sociodemographic and clinical characteristics. RESULTS Of 4448 eligible patients, 1594 (response-rate 35.8%) completed questionnaires. Of these, 1245 eligible respondents were included in the analysis based on self-reported data. Median time from diagnosis to survey completion was 68 months (IQR: 62-73). Most frequently reported symptoms were fatigue/lack of energy (76.8%), aching muscles (72.1%) and aching joints (72.5%). Receipt of chemotherapy was associated with higher symptom burden. Patients treated with adjuvant chemotherapy had higher risk of numbness/tingling (OR: 3.16; 95% CI: 2.36-4.24), hair loss (OR: 2.72; 95% CI: 2.05-3.60), and fatigue/lack of energy (OR: 1.80; 95% CI: 1.29-2.52). Similarly, patients who received chemotherapy were more likely to report the majority of symptoms as moderate to severe and as interfering with daily activities. CONCLUSION Receipt of chemotherapy is associated with significant symptom burden more than 5 years after breast cancer treatment. Long-term chemotherapy impact should be discussed with patients in a shared-decision making process and approaches to symptom management during survivorship care are needed.
Collapse
Affiliation(s)
- Taiwo Adesoye
- Department of Breast Surgical OncologyThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Kai‐Ping Liao
- Department of Health Services ResearchThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Susan Peterson
- Department of Behavioral Science, Division of Cancer Prevention and Population SciencesThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Liang Li
- Department of BiostatisticsThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Daria Zorzi
- Department of Health Services ResearchThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Holly M. Holmes
- Division of Geriatric and Palliative Medicine, Department of Internal MedicineUniversity of Texas Houston McGovern Medical SchoolHoustonTexasUSA
| | - Mariana Chavez‐MacGregor
- Department of Health Services ResearchThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
- Department of Breast Medical OncologyThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| | - Sharon H. Giordano
- Department of Health Services ResearchThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
- Department of Breast Medical OncologyThe University of Texas MD Anderson Cancer CenterHoustonTexasUSA
| |
Collapse
|
3
|
Tran NH, Almodallal Y, Batheja M, Martin NA, Le-Rademacher J, Ridgeway JL, Sia IG, Jatoi A. Social determinants of health: a need for better data capture in Asian American patients with hepatocellular cancer. Support Care Cancer 2023; 31:543. [PMID: 37646853 DOI: 10.1007/s00520-023-08016-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 08/23/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Social determinants of health lead to better cancer care. This multi-site, single-institution study sought to capture data on social determinants of health data in Asian Americans with hepatocellular carcinoma; this group constitutes 60% of patients with this malignancy and are often undertreated or not treated at all. METHODS This study took advantage of an institutional initiative designed to capture and integrate social determinants of health data into the electronic medical record for all patients. Medical records of Asian Americans with hepatocellular cancer were reviewed to acquire data on housing instability, lack of transportation, financial concerns, and social isolation; a score of 1 indicated poor social determinants of health. RESULTS Of 112 adult Asian American patients with hepatocellular cancer, 22 (20%) were Southeast Asian, and 74 (67%) described English proficiency/preference. Total noncompletion per domain (no question answered within that domain) was observed in 90 patients (80%) for housing instability; 90 (80%) for lack of transportation; 92 (82%) for financial hardship; and 90 (80%) for social isolation. A score of 1 (highest risk) was observed in 1 patient (0.9%) for housing instability; 1 (0.9%) lack of transportation; no patient for financial hardship; and 1 (0.9%) for social isolation. Of note, institution-wide benchmark total noncompletion rates were 0.3%, 0.3%, 47%, and 39% for these respective domains. CONCLUSION High total noncompletion rates make social determinants of health data challenging to interpret and underscore the need for evidence-based guidelines on how best to capture such data in underserved patients.
Collapse
Affiliation(s)
- Nguyen H Tran
- Department of Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
| | - Yahya Almodallal
- Department of Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Mashal Batheja
- Division of Gastroenterology, Mayo Clinic, Phoenix, AZ, USA
| | - Nichole A Martin
- Department of Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | | | | | - Irene G Sia
- Division of Infectious Diseases, Mayo Clinic, Rochester, MN, USA
| | - Aminah Jatoi
- Department of Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| |
Collapse
|
4
|
Ghazal LV, Abrahamse P, Ward KC, Morris AM, Hawley ST, Veenstra CM. Financial Toxicity and Its Association With Health-Related Quality of Life Among Partners of Colorectal Cancer Survivors. JAMA Netw Open 2023; 6:e235897. [PMID: 37022684 PMCID: PMC10080378 DOI: 10.1001/jamanetworkopen.2023.5897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 01/31/2023] [Indexed: 04/07/2023] Open
Abstract
Importance Partners of colorectal cancer (CRC) survivors play a critical role in diagnosis, treatment, and survivorship. While financial toxicity (FT) is well documented among patients with CRC, little is known about long-term FT and its association with health-related quality of life (HRQoL) among their partners. Objective To understand long-term FT and its association with HRQoL among partners of CRC survivors. Design, Setting, and Participants This survey study incorporating a mixed-methods design consisted of a mailed dyadic survey with closed- and open-ended responses. In 2019 and 2020, we surveyed survivors who were 1 to 5 years from a stage III CRC diagnosis and included a separate survey for their partners. Patients were recruited from a rural community oncology practice in Montana, an academic cancer center in Michigan, and the Georgia Cancer Registry. Data analysis was performed from February 2022 to January 2023. Exposures Three components of FT, including financial burden, debt, and financial worry. Main Outcomes and Measures Financial burden was assessed with the Personal Financial Burden scale, whereas debt and financial worry were each assessed with a single survey item. We measured HRQoL using the PROMIS-29+2 Profile, version 2.1. We used multivariable regression analysis to assess associations of FT with individual domains of HRQoL. We used thematic analysis to explore partner perspectives on FT, and we merged quantitative and qualitative findings to explain the association between FT and HRQoL. Results Of the 986 patients eligible for this study, 501 (50.8%) returned surveys. A total of 428 patients (85.4%) reported having a partner, and 311 partners (72.6%) returned surveys. Four partner surveys were returned without a corresponding patient survey, resulting in a total of 307 patient-partner dyads for this analysis. Among the 307 partners, 166 (56.1%) were aged younger than 65 years (mean [SD] age, 63.7 [11.1] years), 189 (62.6%) were women, and 263 (85.7%) were White. Most partners (209 [68.1%]) reported adverse financial outcomes. High financial burden was associated with worse HRQoL in the pain interference domain (mean [SE] score, -0.08 [0.04]; P = .03). Debt was associated with worse HRQoL in the sleep disturbance domain (-0.32 [0.15]; P = .03). High financial worry was associated with worse HRQoL in the social functioning (mean [SE] score, -0.37 [0.13]; P = .005), fatigue (-0.33 [0.15]; P = .03), and pain interference (-0.33 [0.14]; P = .02) domains. Qualitative findings revealed that in addition to systems-level factors, individual-level behavioral factors were associated with partner financial outcomes and HRQoL. Conclusions and Relevance This survey study found that partners of CRC survivors experienced long-term FT that was associated with worse HRQoL. Multilevel interventions for both patients and partners are needed to address factors at individual and systemic levels and incorporate behavioral approaches.
Collapse
Affiliation(s)
- Lauren V. Ghazal
- Department of Systems, Populations, and Leadership, School of Nursing, University of Michigan, Ann Arbor
| | - Paul Abrahamse
- Department of Biostatistics, University of Michigan, Ann Arbor
| | - Kevin C. Ward
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Arden M. Morris
- Department of Surgery, Stanford University, Stanford, California
| | - Sarah T. Hawley
- Division of General Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor
| | - Christine M. Veenstra
- Division of Hematology/Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor
| |
Collapse
|
5
|
Jose T, Schroeder DR, Warner DO. Changes in Cigarette Smoking Behavior in Cancer Survivors During Diagnosis and Treatment. Nicotine Tob Res 2022; 24:1581-1588. [PMID: 35311999 PMCID: PMC9575979 DOI: 10.1093/ntr/ntac072] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 02/25/2022] [Accepted: 03/18/2022] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Continued cigarette smoking is a critical determinant of outcome in oncology patients, but how the separate events of cancer diagnosis, cancer treatment, and completion of treatment affect smoking behavior in cancer survivors is unknown. This study described such changes, hypothesizing that they would be more pronounced for smoking-related cancers. METHODS The Cancer Patient Tobacco Use Questionnaire (CTUQ) was sent to every cancer patient ≥ 18 y old scheduled for outpatient visits at the Mayo Clinic Cancer Center with a current or former history of tobacco use. RESULTS From September 2019 to September 2020, 33,831 patients received the CTUQ, and 20,818 (62%) responded. Of the 3007 current smokers analyzed, 34% quit at diagnosis; those with smoking-related cancers were more likely to quit (40% vs. 29%, respectively, p < .001). Among those who did not quit at diagnosis, 31% quit after starting cancer treatment, and those with smoking-related cancers were more likely to quit (35% and 28%, respectively, p = .002) Among those who had quit before the completion of treatment, 13% resumed smoking after treatment ended. In multivariable analysis, patients with smoking-related cancers were more likely to report 30-d point prevalence abstinence from pre-diagnosis to the completion of treatment (adjusted OR 1.98 [95% CI 1.65, 2.36], p < .001). CONCLUSIONS Both cancer diagnosis and treatment prompt smoking abstinence, with most maintaining abstinence after treatment is completed. Those with smoking-related cancers are more likely to quit. These results emphasize the need to provide access to tobacco treatment services that can further support cancer patients who smoke. IMPLICATIONS Approximately one-third of cancer patients who smoke quit smoking at the time of diagnosis, an additional one-third of patients who had not yet quit did so at the initiation of treatment, and most sustained this abstinence after treatment completion. Patients with smoking-related cancers are more likely to quit. Thus, there are multiple opportunities within the cancer care continuum to intervene and support quit attempts or continued abstinence.
Collapse
Affiliation(s)
- Thulasee Jose
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA
| | | | - David O Warner
- Corresponding Author: David O. Warner, MD, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA. Telephone: 507-255-4288; E-mail:
| |
Collapse
|
6
|
McIntosh M, Opozda MJ, O'Callaghan M, Vincent AD, Galvão DA, Short CE. Impact of different unconditional monetary incentives on survey response rates in men with prostate cancer: a 2-arm randomised trial. BMC Med Res Methodol 2022; 22:252. [PMID: 36175831 PMCID: PMC9520096 DOI: 10.1186/s12874-022-01729-z] [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: 03/25/2022] [Accepted: 09/07/2022] [Indexed: 12/24/2022] Open
Abstract
Background Men are often viewed as a difficult group to recruit for psychological research, including in psycho-oncology. Whilst research has demonstrated the effectiveness of small monetary incentives for encouraging research participation, little research has examined different large unconditional incentive amounts. Larger unconditional incentives may result in increased participation of men in psychological research. This randomised study within a case–control trial of men diagnosed with early-stage prostate cancer aimed to investigate whether (a) response rates to a 30-min questionnaire completed via mail, online, or phone would vary with different unconditional incentive amounts, and (b) demographics would vary in those who responded within the different incentive groups. Methods We conducted this randomised study within a case–control cross-sectional study aiming to identify the social-ecological factors influencing treatment discontinuation in prostate cancer patients. A total of 238 participants from the cross-sectional study were randomised to receive one of two unconditional incentives (n = 121 received AUD$10, n = 117 received AUD$20) with the study materials (consent form and survey). Results Overall, 113 (47%) responded; n = 61/121 (50.4%) in the AUD$10 group, and n = 52/117 (44.4%) in the AUD$20 group. No evidence of a difference was found in response rates by incentive group (odds ratio 1.27, 95% CI = 0.76–2.12, p = 0.36). Additionally, there were no evident differences in the demographics of the responders vs. non-responders within each incentive group (all p > 0.05). Conclusions Unlike previous research, we were unable to show that higher monetary incentives were more effective for increasing response rates. An AUD$20 unconditional incentive may be no more effective than a lesser amount for encouraging prostate cancer survivors to participate in research involving long questionnaires. Future research should consider the cost-benefits of providing large unconditional incentives, as non-responses will result in lost resources perhaps better utilised in other engagement strategies.
Collapse
Affiliation(s)
- Megan McIntosh
- University of Adelaide, Adelaide Medical School, Adelaide, South Australia, Australia.,Freemasons Centre for Male Health and Wellbeing, South Australian Health and Medical Research Institute and The University of Adelaide, Adelaide, South Australia, Australia
| | - Melissa J Opozda
- University of Adelaide, Adelaide Medical School, Adelaide, South Australia, Australia.,Freemasons Centre for Male Health and Wellbeing, South Australian Health and Medical Research Institute and The University of Adelaide, Adelaide, South Australia, Australia
| | - Michael O'Callaghan
- Flinders Medical Centre, South Australian Prostate Cancer Clinical Outcomes Collaborative, Adelaide, South Australia, Australia
| | - Andrew D Vincent
- Freemasons Centre for Male Health and Wellbeing, South Australian Health and Medical Research Institute and The University of Adelaide, Adelaide, South Australia, Australia
| | - Daniel A Galvão
- Edith Cowan University, Exercise Medicine Research Institute, Perth, WA, Australia
| | - Camille E Short
- University of Melbourne, Melbourne School of Psychological Sciences and Melbourne School of Health Sciences, Parkville, VIC, Australia.
| |
Collapse
|
7
|
Paltrinieri S, Vicentini M, Mancuso P, Mazzini E, Fugazzaro S, Rossi PG, Costi S. Return to work of Italian cancer survivors: A focus on prognostic work-related factors. Work 2022; 71:681-691. [DOI: 10.3233/wor-210008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND: Return to work (RTW) enhances the general well-being and social participation of cancer survivors (CSs). OBJECTIVE: To describe the predictive value of work-related factors on the RTW process of CSs. The work accommodations, the perceived workload, and the barriers and facilitations of RTW are also reported. METHODS: This population-based cross-sectional survey was conducted in the Province of Reggio Emilia from July 2016 to July 2017. CSs who were 20–59 years old, first diagnosed with cancer, and employed at diagnosis were recruited. RESULTS: The majority of CSs (140/266, 53%) returned to work without difficulties, 42% reported difficulties, and 5% did not RTW. CSs who were shift workers (sex and age-adjusted Relative Risk [adj-RR] 1.30; 95% CI 0.94 –1.78) and who worked at night (adj-RR 1.36 95% CI 0.99 –1.86), in the evening (adj-RR 1.23; 95% CI 0.95 –1.57) and on Sundays (adj-RR 1.15; 95% CI 0.81 –1.63) perceived more difficulties. Physically demanding work and a long commute seemed to negatively impact RTW. Accommodations in work tasks (37%) or schedule (26%) were implemented. Workload was not acceptable for 18% of CSs. The main barriers concerned energy and drive functions, whereas remunerative employment was the foremost facilitation. CONCLUSIONS: Healthcare professionals should address work-related factors that might influence RTW with personalized interventions of vocational rehabilitation.
Collapse
Affiliation(s)
- Sara Paltrinieri
- Physical Medicine and Rehabilitation Unit, AziendaUnità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Massimo Vicentini
- Epidemiology Unit, Azienda Unità SanitariaLocale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Pamela Mancuso
- Epidemiology Unit, Azienda Unità SanitariaLocale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Elisa Mazzini
- Medical Directorate, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Stefania Fugazzaro
- Physical Medicine and Rehabilitation Unit, AziendaUnità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Paolo Giorgi Rossi
- Epidemiology Unit, Azienda Unità SanitariaLocale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Stefania Costi
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, Università di Modena eReggio Emilia, Reggio Emilia, Italy
- Scientific Directorate, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| |
Collapse
|
8
|
Survey response in colorectal surgery.A systematic review. SURGERY IN PRACTICE AND SCIENCE 2022. [DOI: 10.1016/j.sipas.2022.100068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
|
9
|
Health behaviors and well-being among those "living" with metastatic cancer in Alabama. Support Care Cancer 2021; 30:1689-1701. [PMID: 34562170 DOI: 10.1007/s00520-021-06583-1] [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: 02/10/2021] [Accepted: 09/16/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Approximately 5 million Americans are living with metastatic cancer. Metastatic cancer survivors (MCS) are at risk for poor health behaviors, which may negatively influence well-being. METHODS Using a modified Dillman protocol, 542 MCS were mailed a survey querying physical and mental health (PROMIS® measures), health behaviors, and supportive care interest. Returned surveys were double-key entered into REDCap®. Data were analyzed using SPSS. RESULTS Two hundred seventy-seven surveys were returned (51% response). Respondents (51% female; 88% Caucasian; 12% African-American; Mage = 65 years; Msurvivorship = 38 months; 23% female cancers, 23% melanoma, 21% gastrointestinal, 15% genitourinary, 12% pulmonary, and 6% other) reported low daily fruit and vegetable (F&V) intake (M = 4.1) and weekly minutes of moderate-to-vigorous physical activity (PA) (M = 41.9), with 66% of respondents having overweight or obesity. While mean scores for physical (M = 43.6) and mental (M = 47.7) health were considered "good," scores in the "fair" to "poor" ranges were observed (40% physical; 23% mental). MCS meeting PA (≥ 150 min per week) and dietary (≥ 5 daily servings of F&V) guidelines reported better physical (p = .003; p = .056) and mental (p = .033, p = .549) health, respectively, compared to MCS who were not. While current supportive care use was low (12%), future interest was high (57%), with greatest interest for nutrition (46%), MCS support group (38%), and gardening (31%). CONCLUSIONS Our findings suggest that engaging in regular PA and consuming more F&Vs may enhance physical and mental health among MCS. Future research may explore supportive care approaches with high interest, such as gardening, to aid MCS in improving key health behaviors.
Collapse
|
10
|
Ossowski S, Kammerer A, Stram D, Piazza-DeLap L, Basch E, Katzel JA. Patient-Reported Outcomes Integrated Within an Electronic Medical Record in Patients With Head and Neck Cancer. JCO Clin Cancer Inform 2021; 5:842-848. [PMID: 34406801 DOI: 10.1200/cci.21.00058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Patient-reported outcome (PRO) tools lead to clinical benefits, including improved overall survival for patients with cancer. However, routine implementation of PROs in clinical practice within the electronic medical record (EMR) by integrated health care delivery systems remains limited. We studied the use of a PRO tool for patients with head and neck cancer (HNC) integrated in an EMR at Kaiser Permanente in Northern California. METHODS Between August 2017 and December 2019, patients with newly diagnosed HNC were surveyed at baseline, then every 3 months using the Functional Assessment of Cancer Therapy-General 7 and Functional Assessment of Cancer Therapy-Head and Neck (version 4). A medical assistant performed a baseline survey on diagnosis and then notified patients electronically per surveillance protocol. Patients who did not respond to online PRO surveys could complete them via telephone or in-person appointments with medical assistants. Abnormal findings on PRO surveys were referred to appropriate members of the care team or the treating Otolaryngology-Head and Neck Surgery physicians. RESULTS Two hundred ninety patients received baseline surveys. Patients received up to a maximum of eight subsequent surveys. Of a total of 597 electronic surveys, 585 (97.9%) were completed. The percentage of patients completing each interval survey ranged from 92% to 100%. Multivariate Poisson regression analysis showed patients with English as their primary language and an online secure account were the most likely to complete surveys compared with those patients with non-English as a primary language and without an online account. CONCLUSION PRO tools can be effectively used within the EMR for patients with HNC with a high response rate provided there is strong engagement from a dedicated member of the care team. This has important implications for designing clinical trials and symptom monitoring in clinical practices that incorporate EMRs.
Collapse
Affiliation(s)
| | | | - Douglas Stram
- Division of Research, Kaiser Permanente, Oakland, CA
| | | | - Ethan Basch
- University of North Carolina, Chapel Hill, NC
| | | |
Collapse
|
11
|
Meyer VM, Meuzelaar RR, Schoenaker Y, de Groot JW, de Boer E, Reerink O, de Vos tot Nederveen Cappel W, Beets GL, van Westreenen HL. Delayed Surgery after Neoadjuvant Treatment for Rectal Cancer Does Not Lead to Impaired Quality of Life, Worry for Cancer, or Regret. Cancers (Basel) 2021; 13:cancers13040742. [PMID: 33670120 PMCID: PMC7916848 DOI: 10.3390/cancers13040742] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 02/05/2021] [Accepted: 02/07/2021] [Indexed: 12/24/2022] Open
Abstract
Simple Summary Rectal cancer patients with an initial (near) complete clinical response to neoadjuvant chemoradiotherapy can be repeatedly assessed to see if a complete response endures. Up to 75% of these patients are able to avoid surgery and its related complications. However, the remaining 25% who ‘fail’ will eventually have to undergo surgery. Although recent studies have shown that patients undergoing delayed surgery have promising surgical and oncological outcomes, it is not known how these patients fare in terms of quality of life. The aim of this study was to compare quality of life between these immediate and delayed surgery groups through validated questionnaires. Our study including 51 patients shows no difference in quality of life, worry for cancer, or decision regret. Therefore, from a quality of life perspective, this study supports a repeated response assessment strategy after chemoradiotherapy for rectal carcinoma to identify all complete responders. Abstract Non operative management of complete clinical responders after neoadjuvant treatment for rectal cancer enjoys an increasing popularity because of the increased functional outcome results. Even a near complete response can evolve in a cCR, and therefore further delaying response assessment is accepted. However, up to 40% of patients will develop a regrowth and will eventually require delayed surgery. It is presently unknown if and to what extent quality of life of these patients is affected, compared to patients who undergo immediate surgery. Between January 2015-May 2020, 200 patients were treated with neoadjuvant therapy of whom 94 received TME surgery. Fifty-one (59%) of 87 alive patients returned the questionnaires: 33 patients who underwent immediate and 18 patients who underwent delayed surgery. Quality of life was measured through the QLQ-C30, QLQ-CR29, and Cancer Worry Scale questionnaires. Regret to participate in repeated response assessment protocol was assessed through the Decision Regret Scale. Exploratory factor analysis (EFA) and a ‘known groups comparison’ was performed to assess QLQ questionnaires validity in this sample. Higher mean physical function scores (89.2 vs. 77.6, p = 0.03) were observed in the immediate surgery group, which lost significance after correction for operation type (p = 0.25). Arousal for men was higher in the delayed surgery group (20.0 vs. 57.1, p = 0.02). There were no differences between surgical groups for the other questionnaire items. Worry for cancer was lower in the delayed surgery group (10.8 vs. 14.0, p = 0.21). Regret was very low (12–16%). EFA reproduced most QLQ C-30 and CR29 subscales with good internal consistency. Quality of life is not impaired in patients undergoing delayed TME surgery after neoadjuvant treatment for rectal cancer. Moreover, there is very low regret and no increase in worry for cancer. Therefore, from a quality of life perspective, this study supports a repeated response assessment strategy after CRTx for rectal carcinoma to identify all complete responders.
Collapse
Affiliation(s)
- Vincent Maurice Meyer
- Department of Surgery, Isala Hospitals, P.O. Box 10400, 8000 GK Zwolle, The Netherlands; (R.R.M.); (Y.S.); (H.L.v.W.)
- Correspondence:
| | - Richtje R Meuzelaar
- Department of Surgery, Isala Hospitals, P.O. Box 10400, 8000 GK Zwolle, The Netherlands; (R.R.M.); (Y.S.); (H.L.v.W.)
| | - Yvonne Schoenaker
- Department of Surgery, Isala Hospitals, P.O. Box 10400, 8000 GK Zwolle, The Netherlands; (R.R.M.); (Y.S.); (H.L.v.W.)
| | - Jan-Willem de Groot
- Department of Oncology, Isala Hospitals, P.O. Box 10400, 8000 GK Zwolle, The Netherlands;
| | - Edwin de Boer
- Department of Radiology, Isala Hospitals, 8025 AB Zwolle, The Netherlands;
| | - Onno Reerink
- Department of Radiotherapy, Isala Hospitals, 8025 AB Zwolle, The Netherlands;
| | | | - Geerard L Beets
- Department of Surgery, Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands;
| | - Henderik L van Westreenen
- Department of Surgery, Isala Hospitals, P.O. Box 10400, 8000 GK Zwolle, The Netherlands; (R.R.M.); (Y.S.); (H.L.v.W.)
| |
Collapse
|
12
|
Millar MM, Elena JW, Gallicchio L, Edwards SL, Carter ME, Herget KA, Sweeney C. The feasibility of web surveys for obtaining patient-reported outcomes from cancer survivors: a randomized experiment comparing survey modes and brochure enclosures. BMC Med Res Methodol 2019; 19:208. [PMID: 31730474 PMCID: PMC6858678 DOI: 10.1186/s12874-019-0859-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 10/23/2019] [Indexed: 11/30/2022] Open
Abstract
Background Central cancer registries are often used to survey population-based samples of cancer survivors. These surveys are typically administered via paper or telephone. In most populations, web surveys obtain much lower response rates than paper surveys. This study assessed the feasibility of web surveys for collecting patient-reported outcomes via a central cancer registry. Methods Potential participants were sampled from Utah Cancer Registry records. Sample members were randomly assigned to receive a web or paper survey, and then randomized to either receive or not receive an informative brochure describing the cancer registry. We calculated adjusted risk ratios with 95% confidence intervals to compare response likelihood and the demographic profile of respondents across study arms. Results The web survey response rate (43.2%) was lower than the paper survey (50.4%), but this difference was not statistically significant (adjusted risk ratio = 0.88, 95% confidence interval = 0.72, 1.07). The brochure also did not significantly influence the proportion responding (adjusted risk ratio = 1.03, 95% confidence interval = 0.85, 1.25). There were few differences in the demographic profiles of respondents across the survey modes. Older age increased likelihood of response to a paper questionnaire but not a web questionnaire. Conclusions Web surveys of cancer survivors are feasible without significantly influencing response rates, but providing a paper response option may be advisable particularly when surveying older individuals. Further examination of the varying effects of brochure enclosures across different survey modes is warranted.
Collapse
Affiliation(s)
- Morgan M Millar
- Department of Internal Medicine, 295 Chipeta Way University of Utah, Salt Lake City, UT, 84132, USA. .,Utah Cancer Registry, University of Utah, 250 E 200 S, Suite 1375, Salt Lake City, UT, 84111, USA.
| | - Joanne W Elena
- Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Rockville, MD, 20852, USA
| | - Lisa Gallicchio
- Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Rockville, MD, 20852, USA
| | - Sandra L Edwards
- Utah Cancer Registry, University of Utah, 250 E 200 S, Suite 1375, Salt Lake City, UT, 84111, USA
| | - Marjorie E Carter
- Utah Cancer Registry, University of Utah, 250 E 200 S, Suite 1375, Salt Lake City, UT, 84111, USA
| | - Kimberly A Herget
- Utah Cancer Registry, University of Utah, 250 E 200 S, Suite 1375, Salt Lake City, UT, 84111, USA
| | - Carol Sweeney
- Department of Internal Medicine, 295 Chipeta Way University of Utah, Salt Lake City, UT, 84132, USA.,Utah Cancer Registry, University of Utah, 250 E 200 S, Suite 1375, Salt Lake City, UT, 84111, USA.,Huntsman Cancer Institute, University of Utah, 2000 Cir of Hope Dr. Salt, Lake City, UT, 84112, USA
| |
Collapse
|
13
|
Millar MM, Elena JW, Gallicchio L, Edwards SL, Carter ME, Herget KA, Sweeney C. The feasibility of web surveys for obtaining patient-reported outcomes from cancer survivors: a randomized experiment comparing survey modes and brochure enclosures. BMC Med Res Methodol 2019. [PMID: 31730474 DOI: 10.1186/s12874-019-0859-9:10.1186/s12874-019-0859-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023] Open
Abstract
BACKGROUND Central cancer registries are often used to survey population-based samples of cancer survivors. These surveys are typically administered via paper or telephone. In most populations, web surveys obtain much lower response rates than paper surveys. This study assessed the feasibility of web surveys for collecting patient-reported outcomes via a central cancer registry. METHODS Potential participants were sampled from Utah Cancer Registry records. Sample members were randomly assigned to receive a web or paper survey, and then randomized to either receive or not receive an informative brochure describing the cancer registry. We calculated adjusted risk ratios with 95% confidence intervals to compare response likelihood and the demographic profile of respondents across study arms. RESULTS The web survey response rate (43.2%) was lower than the paper survey (50.4%), but this difference was not statistically significant (adjusted risk ratio = 0.88, 95% confidence interval = 0.72, 1.07). The brochure also did not significantly influence the proportion responding (adjusted risk ratio = 1.03, 95% confidence interval = 0.85, 1.25). There were few differences in the demographic profiles of respondents across the survey modes. Older age increased likelihood of response to a paper questionnaire but not a web questionnaire. CONCLUSIONS Web surveys of cancer survivors are feasible without significantly influencing response rates, but providing a paper response option may be advisable particularly when surveying older individuals. Further examination of the varying effects of brochure enclosures across different survey modes is warranted.
Collapse
Affiliation(s)
- Morgan M Millar
- Department of Internal Medicine, 295 Chipeta Way University of Utah, Salt Lake City, UT, 84132, USA. .,Utah Cancer Registry, University of Utah, 250 E 200 S, Suite 1375, Salt Lake City, UT, 84111, USA.
| | - Joanne W Elena
- Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Rockville, MD, 20852, USA
| | - Lisa Gallicchio
- Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Rockville, MD, 20852, USA
| | - Sandra L Edwards
- Utah Cancer Registry, University of Utah, 250 E 200 S, Suite 1375, Salt Lake City, UT, 84111, USA
| | - Marjorie E Carter
- Utah Cancer Registry, University of Utah, 250 E 200 S, Suite 1375, Salt Lake City, UT, 84111, USA
| | - Kimberly A Herget
- Utah Cancer Registry, University of Utah, 250 E 200 S, Suite 1375, Salt Lake City, UT, 84111, USA
| | - Carol Sweeney
- Department of Internal Medicine, 295 Chipeta Way University of Utah, Salt Lake City, UT, 84132, USA.,Utah Cancer Registry, University of Utah, 250 E 200 S, Suite 1375, Salt Lake City, UT, 84111, USA.,Huntsman Cancer Institute, University of Utah, 2000 Cir of Hope Dr. Salt, Lake City, UT, 84112, USA
| |
Collapse
|
14
|
Paltrinieri S, Vicentini M, Mazzini E, Ricchi E, Fugazzaro S, Mancuso P, Giorgi Rossi P, Costi S. Factors influencing return to work of cancer survivors: a population-based study in Italy. Support Care Cancer 2019; 28:701-712. [PMID: 31129762 DOI: 10.1007/s00520-019-04868-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 05/09/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE Little is known about return to work (RTW) of cancer survivors (CSs) in Central and Southern Europe. This study investigates the RTW rate of Italian CSs, describes their sick leave (SL) pattern, and explores factors affecting their RTW process. METHODS A population-based cross-sectional survey involving CSs registered at the Cancer Registry of Reggio Emilia Province (Italy) was launched in July 2016. Eligibility was restricted to individuals with first diagnosis of cancer in 2012 (stages I-III), aged 20-59, and employed at the time of diagnosis. RESULTS Of the 266 individuals interviewed, 140 (52.6%) were reintegrated without difficulty, 113 (42.5%) returned to work with some difficulty, and 13 did not RTW (4.9%). The majority of CSs (56%) took SL for some periods during treatment. Age > 50 years and higher income seemed to facilitate RTW (RR = 0.65, 95% CI 0.49-0.88 and RR = 0.72, 95% CI 0.54-0.97, respectively), while being divorced acted as a barrier compared to being married (RR = 1.45, 95% CI 1.04-2.01). Individuals uncertain about the type of company they were working for reported greater difficulty in RTW (RR = 1.68, 95% CI 1.03-2.72). Individuals who had undergone chemotherapy and those perceiving physical limitations had a higher risk of difficulty in the RTW process (RR = 1.79, 95% CI 1.42-2.24 and RR = 1.59, 95% CI 1.25-2.02, respectively). CONCLUSIONS Most CSs did RTW, with 2/3 combining work and treatment. However, almost half reported difficulty in RTW process. Factors affecting this process should be addressed throughout context-specific social and healthcare pathways aimed at preventing difficulties and potential job loss in this population.
Collapse
Affiliation(s)
- Sara Paltrinieri
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Viale Risorgimento 80, 42123, Reggio Emilia, Italy
| | - Massimo Vicentini
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, 42122, Reggio Emilia, Italy
| | - Elisa Mazzini
- Medical Directorate, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Viale Umberto I 50, 42123, Reggio Emilia, Italy
| | - Elena Ricchi
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Viale Risorgimento 80, 42123, Reggio Emilia, Italy
| | - Stefania Fugazzaro
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Viale Risorgimento 80, 42123, Reggio Emilia, Italy
| | - Pamela Mancuso
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, 42122, Reggio Emilia, Italy
| | - Paolo Giorgi Rossi
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, 42122, Reggio Emilia, Italy
| | - Stefania Costi
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Viale Risorgimento 80, 42123, Reggio Emilia, Italy. .,Department of Surgery, Medicine, Dentistry and Morphological Sciences, Università di Modena e Reggio Emilia, Viale Umberto I 50, 42123, Reggio Emilia, Italy.
| |
Collapse
|
15
|
Millar MM, Kinney AY, Camp NJ, Cannon-Albright LA, Hashibe M, Penson DF, Kirchhoff AC, Neklason DW, Gilsenan AW, Dieck GS, Stroup AM, Edwards SL, Bateman C, Carter ME, Sweeney C. Predictors of Response Outcomes for Research Recruitment Through a Central Cancer Registry: Evidence From 17 Recruitment Efforts for Population-Based Studies. Am J Epidemiol 2019. [PMID: 30689685 DOI: 10.1093/aje/kwz011:10.1093/aje/kwz011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023] Open
Abstract
When recruiting research participants through central cancer registries, high response fractions help ensure population-based representation. We conducted multivariable mixed-effects logistic regression to identify case and study characteristics associated with making contact with and obtaining cooperation of Utah cancer cases using data from 17 unique recruitment efforts undertaken by the Utah Cancer Registry (2007-2016) on behalf of the following studies: A Population-Based Childhood Cancer Survivors Cohort Study in Utah, Comparative Effectiveness Analysis of Surgery and Radiation for Prostate Cancer (CEASAR Study), Costs and Benefits of Follow-up Care for Adolescent and Young Adult Cancers, Study of Exome Sequencing for Head and Neck Cancer Susceptibility Genes, Genetic Epidemiology of Chronic Lymphocytic Leukemia, Impact of Remote Familial Colorectal Cancer Risk Assessment and Counseling (Family CARE Project), Massively Parallel Sequencing for Familial Colon Cancer Genes, Medullary Thyroid Carcinoma (MTC) Surveillance Study, Osteosarcoma Surveillance Study, Prostate Cancer Outcomes Study, Risk Education and Assessment for Cancer Heredity Project (REACH Project), Study of Shared Genomic Segment Analysis and Tumor Subtyping in High-Risk Breast-Cancer Gene Pedigrees, Study of Shared Genomic Segment Analysis for Localizing Multiple Myeloma Genes. Characteristics associated with lower odds of contact included Hispanic ethnicity (odds ratio (OR) = 0.34, 95% confidence interval (CI): 0.27, 0.41), nonwhite race (OR = 0.46, 95% CI: 0.35, 0.60), and younger age at contact. Years since diagnosis was inversely associated with making contact. Nonwhite race and age ≥60 years had lower odds of cooperation. Study features with lower odds of cooperation included longitudinal design (OR = 0.50, 95% CI: 0.41, 0.61) and study brochures (OR = 0.70, 95% CI: 0.54, 0.90). Increased odds of cooperation were associated with including a questionnaire (OR = 3.19, 95% CI: 1.54, 6.59), postage stamps (OR = 1.60, 95% CI: 1.21, 2.12), and incentives (OR = 1.62, 95% CI: 1.02, 2.57). Among cases not responding after the first contact, odds of eventual response were lower when >10 days elapsed before subsequent contact (OR = 0.71, 95% CI: 0.59, 0.85). Obtaining high response is challenging, but study features identified in this analysis support better results when recruiting through central cancer registries.
Collapse
Affiliation(s)
- Morgan M Millar
- Division of Epidemiology, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, Utah.,Utah Cancer Registry, University of Utah Health, University of Utah, Salt Lake City, Utah
| | - Anita Y Kinney
- Department of Biostatistics and Epidemiology, School of Public Health, Rutgers University, New Brunswick, New Jersey.,Rutgers Cancer Institute of New Jersey, Rutgers Health, Rutgers University, New Brunswick, New Jersey
| | - Nicola J Camp
- Division of Hematology and Hematological Malignancies, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, Utah.,Cancer Control and Population Sciences Program, Huntsman Cancer Institute, University of Utah Health, University of Utah, Salt Lake City, Utah
| | - Lisa A Cannon-Albright
- Division of Epidemiology, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, Utah.,Cancer Control and Population Sciences Program, Huntsman Cancer Institute, University of Utah Health, University of Utah, Salt Lake City, Utah
| | - Mia Hashibe
- Utah Cancer Registry, University of Utah Health, University of Utah, Salt Lake City, Utah.,Cancer Control and Population Sciences Program, Huntsman Cancer Institute, University of Utah Health, University of Utah, Salt Lake City, Utah.,Division of Public Health, Department of Family and Preventive Medicine, School of Medicine, University of Utah, Salt Lake City, Utah
| | - David F Penson
- Urologic Surgery, Department of Urology, Vanderbilt University Medical Center, Vanderbilt University, Nashville, Tennessee.,Center for Surgical Quality and Outcomes Research, Vanderbilt Institute for Medicine and Public Health, Vanderbilt University Medical Center, Vanderbilt University, Nashville, Tennessee
| | - Anne C Kirchhoff
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, University of Utah Health, University of Utah, Salt Lake City, Utah.,Division of Pediatric Hematology and Oncology, Department of Pediatrics, School of Medicine, University of Utah, Salt Lake City, Utah
| | - Deborah W Neklason
- Division of Epidemiology, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, Utah.,Cancer Control and Population Sciences Program, Huntsman Cancer Institute, University of Utah Health, University of Utah, Salt Lake City, Utah
| | - Alicia W Gilsenan
- Department of Epidemiology, RTI Health Solutions, RTI International, Research Triangle Park, North Carolina
| | - Gretchen S Dieck
- Safety, Epidemiology, and Risk Management, United BioSource Corporation, Blue Bell, Pennsylvania
| | - Antoinette M Stroup
- Rutgers Cancer Institute of New Jersey, Rutgers Health, Rutgers University, New Brunswick, New Jersey.,Division of Cancer Epidemiology, Rutgers School of Public Health, Rutgers University, New Brunswick, New Jersey.,New Jersey State Cancer Registry, New Jersey Department of Health, Trenton, New Jersey
| | - Sandra L Edwards
- Utah Cancer Registry, University of Utah Health, University of Utah, Salt Lake City, Utah
| | - Carrie Bateman
- Utah Cancer Registry, University of Utah Health, University of Utah, Salt Lake City, Utah
| | - Marjorie E Carter
- Utah Cancer Registry, University of Utah Health, University of Utah, Salt Lake City, Utah
| | - Carol Sweeney
- Division of Epidemiology, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, Utah.,Utah Cancer Registry, University of Utah Health, University of Utah, Salt Lake City, Utah.,Cancer Control and Population Sciences Program, Huntsman Cancer Institute, University of Utah Health, University of Utah, Salt Lake City, Utah
| |
Collapse
|
16
|
Millar MM, Kinney AY, Camp NJ, Cannon-Albright LA, Hashibe M, Penson DF, Kirchhoff AC, Neklason DW, Gilsenan AW, Dieck GS, Stroup AM, Edwards SL, Bateman C, Carter ME, Sweeney C. Predictors of Response Outcomes for Research Recruitment Through a Central Cancer Registry: Evidence From 17 Recruitment Efforts for Population-Based Studies. Am J Epidemiol 2019; 188:928-939. [PMID: 30689685 DOI: 10.1093/aje/kwz011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 01/09/2019] [Accepted: 01/10/2019] [Indexed: 12/24/2022] Open
Abstract
When recruiting research participants through central cancer registries, high response fractions help ensure population-based representation. We conducted multivariable mixed-effects logistic regression to identify case and study characteristics associated with making contact with and obtaining cooperation of Utah cancer cases using data from 17 unique recruitment efforts undertaken by the Utah Cancer Registry (2007-2016) on behalf of the following studies: A Population-Based Childhood Cancer Survivors Cohort Study in Utah, Comparative Effectiveness Analysis of Surgery and Radiation for Prostate Cancer (CEASAR Study), Costs and Benefits of Follow-up Care for Adolescent and Young Adult Cancers, Study of Exome Sequencing for Head and Neck Cancer Susceptibility Genes, Genetic Epidemiology of Chronic Lymphocytic Leukemia, Impact of Remote Familial Colorectal Cancer Risk Assessment and Counseling (Family CARE Project), Massively Parallel Sequencing for Familial Colon Cancer Genes, Medullary Thyroid Carcinoma (MTC) Surveillance Study, Osteosarcoma Surveillance Study, Prostate Cancer Outcomes Study, Risk Education and Assessment for Cancer Heredity Project (REACH Project), Study of Shared Genomic Segment Analysis and Tumor Subtyping in High-Risk Breast-Cancer Gene Pedigrees, Study of Shared Genomic Segment Analysis for Localizing Multiple Myeloma Genes. Characteristics associated with lower odds of contact included Hispanic ethnicity (odds ratio (OR) = 0.34, 95% confidence interval (CI): 0.27, 0.41), nonwhite race (OR = 0.46, 95% CI: 0.35, 0.60), and younger age at contact. Years since diagnosis was inversely associated with making contact. Nonwhite race and age ≥60 years had lower odds of cooperation. Study features with lower odds of cooperation included longitudinal design (OR = 0.50, 95% CI: 0.41, 0.61) and study brochures (OR = 0.70, 95% CI: 0.54, 0.90). Increased odds of cooperation were associated with including a questionnaire (OR = 3.19, 95% CI: 1.54, 6.59), postage stamps (OR = 1.60, 95% CI: 1.21, 2.12), and incentives (OR = 1.62, 95% CI: 1.02, 2.57). Among cases not responding after the first contact, odds of eventual response were lower when >10 days elapsed before subsequent contact (OR = 0.71, 95% CI: 0.59, 0.85). Obtaining high response is challenging, but study features identified in this analysis support better results when recruiting through central cancer registries.
Collapse
Affiliation(s)
- Morgan M Millar
- Division of Epidemiology, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, Utah
- Utah Cancer Registry, University of Utah Health, University of Utah, Salt Lake City, Utah
| | - Anita Y Kinney
- Department of Biostatistics and Epidemiology, School of Public Health, Rutgers University, New Brunswick, New Jersey
- Rutgers Cancer Institute of New Jersey, Rutgers Health, Rutgers University, New Brunswick, New Jersey
| | - Nicola J Camp
- Division of Hematology and Hematological Malignancies, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, Utah
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, University of Utah Health, University of Utah, Salt Lake City, Utah
| | - Lisa A Cannon-Albright
- Division of Epidemiology, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, Utah
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, University of Utah Health, University of Utah, Salt Lake City, Utah
| | - Mia Hashibe
- Utah Cancer Registry, University of Utah Health, University of Utah, Salt Lake City, Utah
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, University of Utah Health, University of Utah, Salt Lake City, Utah
- Division of Public Health, Department of Family and Preventive Medicine, School of Medicine, University of Utah, Salt Lake City, Utah
| | - David F Penson
- Urologic Surgery, Department of Urology, Vanderbilt University Medical Center, Vanderbilt University, Nashville, Tennessee
- Center for Surgical Quality and Outcomes Research, Vanderbilt Institute for Medicine and Public Health, Vanderbilt University Medical Center, Vanderbilt University, Nashville, Tennessee
| | - Anne C Kirchhoff
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, University of Utah Health, University of Utah, Salt Lake City, Utah
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, School of Medicine, University of Utah, Salt Lake City, Utah
| | - Deborah W Neklason
- Division of Epidemiology, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, Utah
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, University of Utah Health, University of Utah, Salt Lake City, Utah
| | - Alicia W Gilsenan
- Department of Epidemiology, RTI Health Solutions, RTI International, Research Triangle Park, North Carolina
| | - Gretchen S Dieck
- Safety, Epidemiology, and Risk Management, United BioSource Corporation, Blue Bell, Pennsylvania
| | - Antoinette M Stroup
- Rutgers Cancer Institute of New Jersey, Rutgers Health, Rutgers University, New Brunswick, New Jersey
- Division of Cancer Epidemiology, Rutgers School of Public Health, Rutgers University, New Brunswick, New Jersey
- New Jersey State Cancer Registry, New Jersey Department of Health, Trenton, New Jersey
| | - Sandra L Edwards
- Utah Cancer Registry, University of Utah Health, University of Utah, Salt Lake City, Utah
| | - Carrie Bateman
- Utah Cancer Registry, University of Utah Health, University of Utah, Salt Lake City, Utah
| | - Marjorie E Carter
- Utah Cancer Registry, University of Utah Health, University of Utah, Salt Lake City, Utah
| | - Carol Sweeney
- Division of Epidemiology, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, Utah
- Utah Cancer Registry, University of Utah Health, University of Utah, Salt Lake City, Utah
- Cancer Control and Population Sciences Program, Huntsman Cancer Institute, University of Utah Health, University of Utah, Salt Lake City, Utah
| |
Collapse
|
17
|
Downing A, Glaser AW, Finan PJ, Wright P, Thomas JD, Gilbert A, Corner J, Richards M, Morris EJA, Sebag-Montefiore D. Functional Outcomes and Health-Related Quality of Life After Curative Treatment for Rectal Cancer: A Population-Level Study in England. Int J Radiat Oncol Biol Phys 2018; 103:1132-1142. [PMID: 30553942 DOI: 10.1016/j.ijrobp.2018.12.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 10/18/2018] [Accepted: 12/04/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE There is a growing population of cancer survivors at risk of treatment-related morbidity. This study investigated how potentially curative rectal cancer treatment influences subsequent function and health-related quality of life using data from a large-scale survey of patient-reported outcomes. METHODS AND MATERIALS All individuals 12 to 36 months after receiving a diagnosis of colorectal cancer in England were sent a survey in January 2013. The survey responses were linked with cancer registration, hospital admissions, and radiation therapy data through the National Cancer Registration and Analysis Service. Outcome measures were cancer specific (Functional Assessment of Cancer Therapy and Social Difficulties Inventory items related to fecal incontinence, urinary incontinence, and sexual difficulties) and generic (EuroQol EQ-5D). RESULTS Surveys were returned by 6713 (64.2%) of 10,452 patients with rectal cancer. Of these, 3998 patients were in remission after a major resection and formed the final analysis sample. Compared with those who had surgery alone, patients who received preoperative radiation therapy had higher odds of reporting poor bowel control (43.6% vs 33.0%; odds ratio [OR] = 1.55; 95% confidence interval [CI], 1.26-1.91), severe urinary leakage (7.2% vs 3.5%; OR = 1.69; 95% CI, 1.18-2.43), and severe sexual difficulties (34.4% vs 18.3%; OR = 1.73; 95% CI, 1.43-2.11). Patients who received long-course chemoradiotherapy reported significantly better bowel control than those who had short-course radiation therapy, with no difference for other outcomes. Respondents with a stoma present reported significantly higher levels of severe sexual difficulties and worse health-related quality of life than those who had never had a stoma or had undergone stoma reversal. CONCLUSIONS This study demonstrated the feasibility of a large-scale assessment of patient-reported outcomes and provided "real-world" data regarding the effect of rectal cancer treatment. The results show that patients who receive preoperative radiation therapy reported poorer outcomes, particularly for bowel and sexual function, and highlighted the negative impact of a stoma. We hope that our experience will encourage researchers to perform similar studies in other healthcare systems.
Collapse
Affiliation(s)
- Amy Downing
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK; Leeds Institute of Data Analytics, University of Leeds, Leeds, UK.
| | - Adam W Glaser
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK; Leeds Institute of Data Analytics, University of Leeds, Leeds, UK
| | - Paul J Finan
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK; Leeds Institute of Data Analytics, University of Leeds, Leeds, UK
| | - Penny Wright
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
| | | | - Alexandra Gilbert
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
| | - Jessica Corner
- Faculty of Executive Office, University of Nottingham, Nottingham, UK
| | | | - Eva J A Morris
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK; Leeds Institute of Data Analytics, University of Leeds, Leeds, UK
| | | |
Collapse
|
18
|
The musculoskeletal consequences of latissmus dorsi breast reconstruction in women following mastectomy for breast cancer. PLoS One 2018; 13:e0202859. [PMID: 30153282 PMCID: PMC6112655 DOI: 10.1371/journal.pone.0202859] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 08/12/2018] [Indexed: 12/03/2022] Open
Abstract
Introduction Current evidence suggests that patients who have latissimus dorsi (LD) breast reconstruction following mastectomy for breast cancer can experience long-term shoulder dysfunction. However, as there is no standardised assessment or follow-up period within the literature, findings are conflicting. This research aimed to investigate the impact on daily living of immediate and delayed LD breast reconstruction in women following mastectomy for breast cancer. Methods Both qualitative and quantitative methods of enquiry were used. A focus group study explored the musculoskeletal consequences of surgery as perceived by the women (n = 15) and their healthcare professionals (n = 11). A questionnaire survey was administered (n = 159), including a range of outcome measures to quantify both the physical and psychosocial impact of LD breast reconstruction. Dyad interviews were also conducted in order to determine the impact of surgery on function and activities of daily living (ADL) from the woman’s perspective and that of her significant other (n = 8). Results The qualitative studies highlighted a lack of preparedness and unrealistic expectations regarding functional recovery among women and their significant others’. Post-surgery it was apparent that women weighed up reduced shoulder function against survival, demonstrating resilience in their approach to coping with this adaptive way of living. The survey identified low to moderate effect on the outcomes assessed (n = 159), however, node removal significantly impacted certain aspects of quality of life (p<0.05) and disability (p = 0.04). Conclusions Breast reconstruction using the LD had an impact on shoulder function and some ADL, which impacted not only on the women but also family and significant others. Despite the functional implications associated with surgery, findings would suggest that shoulder dysfunction is not their main concern. This work identified that women and their significant other require further information to clarify expectation regarding recovery, highlighting the changing priorities of women throughout their journey from diagnosis into long-term recovery.
Collapse
|
19
|
Sturgeon KM, Hackley R, Fornash A, Dean LT, Laudermilk M, Brown JC, Sarwer DB, DeMichele AM, Troxel AB, Schmitz KH. Strategic recruitment of an ethnically diverse cohort of overweight survivors of breast cancer with lymphedema. Cancer 2017; 124:95-104. [PMID: 28881471 DOI: 10.1002/cncr.30935] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 06/16/2017] [Accepted: 07/09/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND Black women are more likely to experience adverse effects from cancer treatment such as lymphedema. Thus, black women may particularly benefit from research regarding interventions to improve lymphedema. Herein, the authors report the challenges and strategies related to the recruitment of minority survivors of breast cancer and to the recruitment of survivors of breast cancer with lymphedema into the Women In Steady Exercise Research (WISER) Survivor Clinical Trial. METHODS Subjects for this community-based trial were recruited from the Philadelphia area through active (mailings) and passive (printed materials and Web site) recruitment strategies. In addition, education sessions coordinated through partner hospitals in communities with a predominantly minority population were conducted to increase awareness of lymphedema in survivors of breast cancer. Women who were interested in the study were screened for lymphedema via telephone questionnaire and invited to see a study-related certified lymphedema therapist to confirm the presence of lymphedema. RESULTS Screening was conducted among 2295 women: 628 were eligible, 450 consented, and 351 were randomized. Minority women comprised 38% of the study population. Letters to women on state and hospital registries resulted in a 0.4% randomization rate; education sessions yielded a 10% randomization rate. The authors observed that approximately 23.6% of the study sample had no previous diagnosis of lymphedema. CONCLUSIONS The WISER Survivor Clinical Trial faced multiple recruitment challenges and used unique strategies to successfully enroll minority survivors of breast cancer into a lifestyle intervention. Cancer 2018;124:95-104. © 2017 American Cancer Society.
Collapse
Affiliation(s)
- Kathleen M Sturgeon
- Department of Public Health Sciences, Pennsylvania State University, Hershey, Pennsylvania
| | - Renata Hackley
- Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Anna Fornash
- Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Lorraine T Dean
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | - Justin C Brown
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - David B Sarwer
- College of Public Health, Temple University, Philadelphia, Pennsylvania
| | - Angela M DeMichele
- Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Andrea B Troxel
- Department of Population Health, New York University, New York City, New York
| | - Kathryn H Schmitz
- Department of Public Health Sciences, Pennsylvania State University, Hershey, Pennsylvania
| |
Collapse
|
20
|
Hagan TL, Belcher SM, Donovan HS. Mind the Mode: Differences in Paper vs. Web-Based Survey Modes Among Women With Cancer. J Pain Symptom Manage 2017; 54:368-375. [PMID: 28711752 PMCID: PMC5610085 DOI: 10.1016/j.jpainsymman.2017.07.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 06/06/2017] [Accepted: 07/07/2017] [Indexed: 11/18/2022]
Abstract
CONTEXT Researchers administering surveys seek to balance data quality, sources of error, and practical concerns when selecting an administration mode. Rarely are decisions about survey administration based on the background of study participants, although socio-demographic characteristics like age, education, and race may contribute to participants' (non)responses. OBJECTIVES In this study, we describe differences in paper- and web-based surveys administered in a national cancer survivor study of women with a history of cancer to compare the ability of each survey administrative mode to provide quality, generalizable data. METHODS We compared paper- and web-based survey data by socio-demographic characteristics of respondents, missing data rates, scores on primary outcome measure, and administrative costs and time using descriptive statistics, tests of mean group differences, and linear regression. RESULTS Our findings indicate that more potentially vulnerable patients preferred paper questionnaires and that data quality, responses, and costs significantly varied by mode and participants' demographic information. We provide targeted suggestions for researchers conducting survey research to reduce survey error and increase generalizability of study results to the patient population of interest. CONCLUSION Researchers must carefully weigh the pros and cons of survey administration modes to ensure a representative sample and high-quality data.
Collapse
Affiliation(s)
- Teresa L Hagan
- Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.
| | - Sarah M Belcher
- University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania, USA
| | - Heidi S Donovan
- University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania, USA
| |
Collapse
|
21
|
Machicado JD, Gougol A, Stello K, Tang G, Park Y, Slivka A, Whitcomb DC, Yadav D, Papachristou GI. Acute Pancreatitis Has a Long-term Deleterious Effect on Physical Health Related Quality of Life. Clin Gastroenterol Hepatol 2017; 15:1435-1443.e2. [PMID: 28579182 DOI: 10.1016/j.cgh.2017.05.037] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Revised: 04/24/2017] [Accepted: 05/08/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS It is not clear how acute pancreatitis (AP) affects health related quality of life (HRQOL). We aimed to determine the long-term independent effect of AP on physical and mental HRQOL. METHODS We analyzed data from 91 patients (mean 52 years of age, 54% women) admitted with AP to the University of Pittsburgh Medical Center from 2011 to 2015 who responded to telephone surveys at a median of 14 months after hospital discharge (interquartile range, 12-16 months). Individuals who did not answer the telephone survey were sent a questionnaire by regular mail. Patients answered questions from the 12-Item Short-Form Survey, and answers were used to calculate mental component summary (MCS) and physical component summary (PCS) scores with norm-based scoring (normal ≥50). HRQOL for these subjects was compared with that of age- and sex-matched individuals without pancreatitis (1:2) identified from the North American Pancreatitis Study. We controlled for other covariates using multivariable regression analysis. RESULTS At follow-up, individuals with AP had a significantly lower PCS score (46.2 ± 11.8) than did control subjects (51.1 ± 9.5; P < .01), but a similar MCS score. A 4-point reduction of the PCS was attributed to AP after controlling for sociodemographic factors and medical comorbidities. The only pancreatitis-related factor associated with low PCS score was multisystem organ failure. Presence of abdominal pain, analgesic use, disability, and current smoking at the time of follow-up were also associated with lower PCS scores. Etiology of AP, disease severity (by Revised Atlanta classification), use of nutritional support, and performance of pancreatic interventions did not affect HRQOL at follow-up. CONCLUSIONS In a 14-month follow-up of patients hospitalized with AP, we found a meaningful, independent, and deleterious effect of AP in the physical HRQOL of these patients, compared to individuals without AP. Further research is needed to determine the duration of this impairment and to evaluate the effects of modifying risk factors.
Collapse
Affiliation(s)
- Jorge D Machicado
- Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Amir Gougol
- Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Kimberly Stello
- Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Gong Tang
- Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Yongseok Park
- Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Adam Slivka
- Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - David C Whitcomb
- Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Dhiraj Yadav
- Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Georgios I Papachristou
- Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; Division of Gastroenterology, Veterans Affairs Pittsburgh Health System, Pittsburgh, Pennsylvania.
| |
Collapse
|
22
|
Johnston A, Sugrue M. Targeting breast cancer outcomes-what about the primary relatives? Mol Genet Genomic Med 2017; 5:317-322. [PMID: 28717658 PMCID: PMC5511799 DOI: 10.1002/mgg3.286] [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: 12/29/2016] [Revised: 03/01/2017] [Accepted: 03/02/2017] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Up to 65% of newly diagnosed breast cancer patients had not been screened correctly before diagnosis resulting in increased stage of cancer at presentation. This study assessed whether their primary relatives are, in turn, assessed appropriately. METHODS An ethically approved prospective study involving 274 primary relatives of women diagnosed with breast cancer, between 2009-2012, at a symptomatic breast unit in Ireland. Telephone interview established: demographics, menstrual history, family history verification, breast screening history. Personal risk level was calculated and whether current screening met screening guidelines. Participants were enrolled into appropriate screening programs if currently not in one and results analyzed. RESULTS Two hundred and fifteen of the 280 (76.8%) newly diagnosed patients responded giving details of their 274 primary relatives; this made up the study cohort. Mean age 50 ± 10 (35-75). Thirty two percent were low risk, 64% moderate and 4% high. 190/274 (69%) were being screened appropriately. Seventy five relatives were then assessed with: mammography in 55, Mg and US in 16. Four underwent a biopsy and to date none had cancer. Surveillance was: annual screening in 48%; national screening program and General Practitioner (GP) in 33%; GP only in over 65s in 13%; 6% await further assessment at specialist genetics clinics where their surveillance will be decided. CONCLUSIONS This study has identified an opportunity to improve the delivery of appropriate screening to higher risk primary relatives of patients with breast cancer. This necessitates an integrated national approach involving providers of primary care, patients and screening breast programs.
Collapse
Affiliation(s)
- Alison Johnston
- Breast Centre North WestLetterkenny University HospitalLetterkennyIreland.,Donegal Clinical Research AcademyDonegalIreland
| | - Michael Sugrue
- Breast Centre North WestLetterkenny University HospitalLetterkennyIreland.,Donegal Clinical Research AcademyDonegalIreland
| |
Collapse
|
23
|
Gallagher S, Deal A, Ballard D, Mayer D. Oropharyngeal Cancer and HPV: Measuring Knowledge and Impact Among Survivors of Head and Neck Cancer. Clin J Oncol Nurs 2017. [DOI: 10.1188/17.cjon.321-330] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
24
|
Segal S, John G, Sammel M, Andy UU, Chu C, Arya LA, Brown J, Schmitz K. Urinary incontinence and other pelvic floor disorders after radiation therapy in endometrial cancer survivors. Maturitas 2017; 105:83-88. [PMID: 28396018 DOI: 10.1016/j.maturitas.2017.03.313] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 03/10/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To investigate radiation therapy as a risk factor for urinary or fecal incontinence, pelvic organ prolapse, and sexual dysfunction in endometrial cancer survivors. STUDY DESIGN We performed a retrospective cohort study of endometrial cancer survivors. Data were collected using a mailed survey and the medical record. Validated questionnaires were used to generate rates of urinary incontinence and other pelvic floor disorders. The incidence rates of pelvic floor disorders were compared across groups with different exposures to radiation. RESULTS Of the 149 endometrial cancer survivors, 41% received radiation therapy. Fifty-one percent of women reported urine leakage. The rates of urinary incontinence in women exposed and not exposed to vaginal brachytherapy (VBT) or whole-pelvis radiation were 48% and 58%, respectively (p=0.47). The incidence of fecal incontinence did not differ between groups, but the score for overall sexual function was significantly higher in women who did not undergo radiation therapy. On multivariable analysis, significant risk factors for urinary incontinence were age (AOR 1.06 95% CI 1.02, 1.10) and BMI (AOR 1.07 95% CI 1.02, 1.11), but treatment with radiation was not significantly associated with urinary incontinence, or fecal incontinence (p>0.05). Age, BMI, and radiation exposure were independent predictors of decreased sexual function score (p<0.01). CONCLUSION Local or regional radiation is not associated with urinary or fecal incontinence, but may contribute to sexual dysfunction in endometrial cancer survivors.
Collapse
Affiliation(s)
- Saya Segal
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, and Division of Urology, Department of Surgery, Rutgers - Robert Wood Johnson Medical School, New Brunswick, NJ, United States.
| | - Gabriella John
- Memorial Sloan-Kettering Cancer Center, New York, NY, United States
| | - Mary Sammel
- Center for Clinical Epidemiology and Biostatistics, and Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Uduak Umoh Andy
- Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Pennsylvania; Philadelphia, PA, United States
| | - Christina Chu
- Division of Gynecologic Oncology, Fox Chase Cancer Center, Philadelphia, PA, United States
| | - Lily A Arya
- Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Pennsylvania; Philadelphia, PA, United States
| | - Justin Brown
- Center for Clinical Epidemiology and Biostatistics, and Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Kathryn Schmitz
- Center for Clinical Epidemiology and Biostatistics, and Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| |
Collapse
|
25
|
Cerin E, Nathan A, van Cauwenberg J, Barnett DW, Barnett A. The neighbourhood physical environment and active travel in older adults: a systematic review and meta-analysis. Int J Behav Nutr Phys Act 2017; 14:15. [PMID: 28166790 PMCID: PMC5294838 DOI: 10.1186/s12966-017-0471-5] [Citation(s) in RCA: 249] [Impact Index Per Article: 35.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Accepted: 01/31/2017] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Perceived and objectively-assessed aspects of the neighbourhood physical environment have been postulated to be key contributors to regular engagement in active travel (AT) in older adults. We systematically reviewed the literature on neighbourhood physical environmental correlates of AT in older adults and applied a novel meta-analytic approach to statistically quantify the strength of evidence for environment-AT associations. METHODS Forty two quantitative studies that estimated associations of aspects of the neighbourhood built environment with AT in older adults (aged ≥ 65 years) and met selection criteria were reviewed and meta-analysed. Findings were analysed according to five AT outcomes (total walking for transport, within-neighbourhood walking for transport, combined walking and cycling for transport, cycling for transport, and all AT outcomes combined) and seven categories of the neighbourhood physical environment (residential density/urbanisation, walkability, street connectivity, access to/availability of services/destinations, pedestrian and cycling infrastructure, aesthetics and cleanliness/order, and safety and traffic). RESULTS Most studies examined correlates of total walking for transport. A sufficient amount of evidence of positive associations with total walking for transport was found for residential density/urbanisation, walkability, street connectivity, overall access to destinations/services, land use mix, pedestrian-friendly features and access to several types of destinations. Littering/vandalism/decay was negatively related to total walking for transport. Limited evidence was available on correlates of cycling and combined walking and cycling for transport, while sufficient evidence emerged for a positive association of within-neighbourhood walking with pedestrian-friendly features and availability of benches/sitting facilities. Correlates of all AT combined mirrored those of walking for transport. Positive associations were also observed with food outlets, business/institutional/industrial destinations, availability of street lights, easy access to building entrance and human and motorised traffic volume. Several but inconsistent individual- and environmental-level moderators of associations were identified. CONCLUSIONS Results support strong links between the neighbourhood physical environment and older adults' AT. Future research should focus on the identification of types and mixes of destinations that support AT in older adults and how these interact with individual characteristics and other environmental factors. Future research should also aim to clarify dose-response relationships through multi-country investigations and data-pooling from diverse geographical regions.
Collapse
Affiliation(s)
- Ester Cerin
- Institute for Health and Ageing, Australian Catholic University, Level 6, 215 Spring Street, Melbourne, VIC 3000 Australia
- School of Public Health, The University of Hong Kong, Hong Kong, China
- Baker IDI Heart and Diabetes Institute, Melbourne, Australia
| | - Andrea Nathan
- Institute for Health and Ageing, Australian Catholic University, Level 6, 215 Spring Street, Melbourne, VIC 3000 Australia
| | | | - David W. Barnett
- Institute for Health and Ageing, Australian Catholic University, Level 6, 215 Spring Street, Melbourne, VIC 3000 Australia
| | - Anthony Barnett
- Institute for Health and Ageing, Australian Catholic University, Level 6, 215 Spring Street, Melbourne, VIC 3000 Australia
| | - on behalf of the Council on Environment and Physical Activity (CEPA) – Older Adults working group
- Institute for Health and Ageing, Australian Catholic University, Level 6, 215 Spring Street, Melbourne, VIC 3000 Australia
- School of Public Health, The University of Hong Kong, Hong Kong, China
- Baker IDI Heart and Diabetes Institute, Melbourne, Australia
- Department of Public Health, Ghent University, Ghent, Belgium
| |
Collapse
|
26
|
Cerin E, Nathan A, van Cauwenberg J, Barnett DW, Barnett A. The neighbourhood physical environment and active travel in older adults: a systematic review and meta-analysis. Int J Behav Nutr Phys Act 2017. [PMID: 28166790 DOI: 10.1186/sl2966-017-0471-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND Perceived and objectively-assessed aspects of the neighbourhood physical environment have been postulated to be key contributors to regular engagement in active travel (AT) in older adults. We systematically reviewed the literature on neighbourhood physical environmental correlates of AT in older adults and applied a novel meta-analytic approach to statistically quantify the strength of evidence for environment-AT associations. METHODS Forty two quantitative studies that estimated associations of aspects of the neighbourhood built environment with AT in older adults (aged ≥ 65 years) and met selection criteria were reviewed and meta-analysed. Findings were analysed according to five AT outcomes (total walking for transport, within-neighbourhood walking for transport, combined walking and cycling for transport, cycling for transport, and all AT outcomes combined) and seven categories of the neighbourhood physical environment (residential density/urbanisation, walkability, street connectivity, access to/availability of services/destinations, pedestrian and cycling infrastructure, aesthetics and cleanliness/order, and safety and traffic). RESULTS Most studies examined correlates of total walking for transport. A sufficient amount of evidence of positive associations with total walking for transport was found for residential density/urbanisation, walkability, street connectivity, overall access to destinations/services, land use mix, pedestrian-friendly features and access to several types of destinations. Littering/vandalism/decay was negatively related to total walking for transport. Limited evidence was available on correlates of cycling and combined walking and cycling for transport, while sufficient evidence emerged for a positive association of within-neighbourhood walking with pedestrian-friendly features and availability of benches/sitting facilities. Correlates of all AT combined mirrored those of walking for transport. Positive associations were also observed with food outlets, business/institutional/industrial destinations, availability of street lights, easy access to building entrance and human and motorised traffic volume. Several but inconsistent individual- and environmental-level moderators of associations were identified. CONCLUSIONS Results support strong links between the neighbourhood physical environment and older adults' AT. Future research should focus on the identification of types and mixes of destinations that support AT in older adults and how these interact with individual characteristics and other environmental factors. Future research should also aim to clarify dose-response relationships through multi-country investigations and data-pooling from diverse geographical regions.
Collapse
Affiliation(s)
- Ester Cerin
- Institute for Health and Ageing, Australian Catholic University, Level 6, 215 Spring Street, Melbourne, VIC, 3000, Australia.
- School of Public Health, The University of Hong Kong, Hong Kong, China.
- Baker IDI Heart and Diabetes Institute, Melbourne, Australia.
| | - Andrea Nathan
- Institute for Health and Ageing, Australian Catholic University, Level 6, 215 Spring Street, Melbourne, VIC, 3000, Australia
| | | | - David W Barnett
- Institute for Health and Ageing, Australian Catholic University, Level 6, 215 Spring Street, Melbourne, VIC, 3000, Australia
| | - Anthony Barnett
- Institute for Health and Ageing, Australian Catholic University, Level 6, 215 Spring Street, Melbourne, VIC, 3000, Australia
| |
Collapse
|
27
|
Feigelson HS, McMullen CK, Madrid S, Sterrett AT, Powers JD, Blum-Barnett E, Pawloski PA, Ziegenfuss JY, Quinn VP, Arterburn DE, Corley DA. Optimizing patient-reported outcome and risk factor reporting from cancer survivors: a randomized trial of four different survey methods among colorectal cancer survivors. J Cancer Surviv 2017; 11:393-400. [PMID: 28084606 DOI: 10.1007/s11764-017-0596-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 01/04/2017] [Indexed: 10/20/2022]
Abstract
PURPOSE The goal of this study was to determine response rates and associated costs of different survey methods among colorectal cancer (CRC) survivors. METHODS We assembled a cohort of 16,212 individuals diagnosed with CRC (2010-2014) from six health plans, and randomly selected 4000 survivors to test survey response rates across four mixed-mode survey administration protocols (in English and Spanish): arm 1, mailed survey with phone follow-up; arm 2, interactive voice response (IVR) followed by mail; arm 3; email linked to web-based survey with mail follow-up; and arm 4, email linked to web-based survey followed by IVR. RESULTS Our overall response rate was 50.2%. Arm 1 had the highest response rate (59.9%), followed by arm 3 (51.9%), arm 2 (51.2%), and arm 4 (37.9%). Response rates were higher among non-Hispanic whites in all arms than other racial/ethnic groups (p < 0.001), among English (51.5%) than Spanish speakers (36.4%) (p < 0.001), and among higher (53.7%) than lower (41.4%) socioeconomic status (p < 0.001). Survey arms were roughly comparable in cost, with a difference of only 8% of total costs between the most (arm 2) and least (arm 3) expensive arms. CONCLUSIONS Mailed surveys followed by phone calls achieved the highest response rate; email invitations and online surveys cost less per response. Electronic methods, even among those with email availability, may miss important populations including Hispanics, non-English speakers, and those of lower socioeconomic status. IMPLICATIONS FOR CANCER SURVIVORS Our results demonstrate effective methods for capturing patient-reported outcomes, inform the relative benefits/disadvantages of the different methods, and identify future research directions.
Collapse
Affiliation(s)
- Heather Spencer Feigelson
- Institute for Health Research, Kaiser Permanente Colorado, 10065 E. Harvard Avenue, Suite 300, Denver, CO, 80231, USA.
| | - Carmit K McMullen
- Center for Health Research, Kaiser Permanente Northwest, Portland, OR, USA
| | - Sarah Madrid
- Institute for Health Research, Kaiser Permanente Colorado, 10065 E. Harvard Avenue, Suite 300, Denver, CO, 80231, USA
| | - Andrew T Sterrett
- Institute for Health Research, Kaiser Permanente Colorado, 10065 E. Harvard Avenue, Suite 300, Denver, CO, 80231, USA
| | - J David Powers
- Institute for Health Research, Kaiser Permanente Colorado, 10065 E. Harvard Avenue, Suite 300, Denver, CO, 80231, USA
| | - Erica Blum-Barnett
- Institute for Health Research, Kaiser Permanente Colorado, 10065 E. Harvard Avenue, Suite 300, Denver, CO, 80231, USA
| | | | | | - Virginia P Quinn
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | | | - Douglas A Corley
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| |
Collapse
|
28
|
Hammer SM, Brown JC, Segal S, Chu CS, Schmitz KH. Cancer-related impairments influence physical activity in uterine cancer survivors. Med Sci Sports Exerc 2015; 46:2195-201. [PMID: 24781886 DOI: 10.1249/mss.0000000000000360] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION The extent to which physical activity (PA) participation among uterine cancer survivors may be limited by physical and functional impairments (PFI) related to cancer treatment is unknown. We sought to describe PA participation, characterize the prevalence of PFI, and examine the association between PFI status and PA participation within this population. METHODS We conducted a study using a mailed survey among uterine cancer survivors who received treatment at a university hospital. We asked about PA and PFI using validated self-report questionnaires. PA was calculated using MET-hours per week (MET·h·wk). PFI was defined as having one or more of the following symptoms: lower limb lymphedema, general pain, fatigue, or severe bladder, bowel, or pelvic issues. Ordinal logistic regression was used to quantify the odds ratio (OR) between PA and PFI. RESULTS The response rate to our survey was 43%. Among the 213 study participants, 40%, 13%, 13%, 12%, and 23% reported participating in <3.0, 3.0-8.9, 9.0-17.9, 18.0-26.9, and ≥27.0 MET·h·wk of PA, respectively. Walking is the preferred mode of exercise for physically active uterine cancer survivors. Of the survivors, 53% experience at least one PFI. The most common PFI is lower limb lymphedema (36.2%), followed by general pain (22.5%). The OR of PFI decreased as MET-hours per week of PA increased (OR, 0.51; 95% confidence interval, 0.31-0.84; P = 0.009). CONCLUSIONS The majority of uterine cancer survivors experience PFI that significantly reduce the likelihood of PA participation. PA recommendations for uterine cancer survivors should take into account treatment-related impairments that can affect PA participation.
Collapse
Affiliation(s)
- Sean M Hammer
- 1Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA; 2Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology; Department of Surgery (Urology), University of Medicine and Dentistry of New Jersey, New Brunswick, NJ; and 3Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA
| | | | | | | | | |
Collapse
|
29
|
Markowitz FE. Involvement in mental health self-help groups and recovery. HEALTH SOCIOLOGY REVIEW : THE JOURNAL OF THE HEALTH SECTION OF THE AUSTRALIAN SOCIOLOGICAL ASSOCIATION 2015; 24:199-212. [PMID: 27570477 PMCID: PMC5000855 DOI: 10.1080/14461242.2015.1015149] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- Fred E. Markowitz
- Department of Sociology, Northern Illinois University, DeKalb, IL, USA
| |
Collapse
|
30
|
Quality of life, body mass index, and physical activity among uterine cancer patients. Int J Gynecol Cancer 2015; 24:1027-32. [PMID: 24927246 DOI: 10.1097/igc.0000000000000166] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE The purpose of this study was to assess the independent and joint effects of body mass index (BMI) and physical activity (PA) on overall quality of life (QoL) in survivors of uterine cancer. METHODS We conducted a survey among uterine cancer patients who received curative therapy at the University of Pennsylvania between 2006 and 2010. Surveys assessed the weight, height, PA (college alumnus survey), and QoL (Functional Assessment of Cancer Therapy-Gynecologic Oncology Group). RESULTS The response rate to the survey was 43%. Among 213 patients, the mean (SD) BMI was 31.1 (8.9) kg/m, and 48% reported greater than or equal to 150 min·wk of PA. Higher BMI was independently associated with poorer overall QoL (P = 0.050), including physical (P = 0.002) and functional well-being (P = 0.008). Higher min·wk of PA was not independently associated with any QoL outcome. However, among patients who engaged in greater than or equal to 150 min·wk of PA, the negative association between BMI and overall QoL was attenuated (P = 0.558), whereas among patients who engaged in less than 150 min·wk of PA, the negative association between BMI and overall QoL persisted (P = 0.025). Among patients who engaged in greater than or equal to 150 min·wk of PA, the negative association between BMI and physical and functional well-being was attenuated (P = 0.765 and P = 0.284), whereas among patients who engaged in less than 150 min·wk of PA, the negative association between BMI and physical and functional well-being persisted (P < 0.001 and P = 0.010), respectively. CONCLUSIONS Body mass index is associated with poorer QoL among uterine cancer patients. The findings from this cross-sectional study are consistent with the hypothesis that endometrial cancer survivors who are able to perform 150 min/wk of PA may be protected from the negative effects of BMI on QoL.
Collapse
|
31
|
Drummond FJ, O'Leary E, Sharp L. Lottery ticket was more effective than a prize draw in increasing questionnaire response among cancer survivors. J Clin Epidemiol 2015; 68:769-75. [PMID: 25704725 DOI: 10.1016/j.jclinepi.2015.01.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Revised: 01/14/2015] [Accepted: 01/21/2015] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Compare the effect of financial incentives on response to a cancer survivors' postal questionnaire. STUDY DESIGN AND SETTING Prostate cancer survivors in Ireland, 1.5-18 years after diagnosis, were randomized to the (1) "lottery" arm [a € 1 lottery scratch card sent with the questionnaire (n = 2,413)] or (2) "prize" arm [entry into a draw on return of a completed questionnaire (n = 2,407)]. Impact of interventions on response overall and by survival period ("short term": < 5 years after diagnosis; "long term": ≥ 5 years after diagnosis) was compared as was cost-effectiveness. RESULTS Adjusted response rate was 54.4%. Response was higher among younger men (P < 0.001) and those with earlier stage disease (P = 0.002). A modest 2.6% higher response rate was observed in the lottery compared with the prize arm [multivariate relative risk (RR) = 1.06; 95% confidence interval (CI): 1.00, 1.11]. When stratified by survival period, higher response in the lottery arm was only observed among long-term survivors (multivariate RR = 1.10; 95% CI: 1.02, 1.19; short-term survivors: RR = 1.01; 95% CI: 0.94, 1.09). Costs per completed questionnaire were € 4.54 and € 3.57 for the lottery and prize arms, respectively. Compared with the prize arm, cost per additional questionnaire returned in the lottery arm was € 25.65. CONCLUSION Although more expensive, to optimize response to postal questionnaires among cancer survivors, researchers might consider inclusion of a lottery scratch card.
Collapse
Affiliation(s)
- Frances J Drummond
- National Cancer Registry Ireland, Building 6800, Airport Business Park, Airport Rd, Cork, Ireland.
| | - Eamonn O'Leary
- National Cancer Registry Ireland, Building 6800, Airport Business Park, Airport Rd, Cork, Ireland
| | - Linda Sharp
- National Cancer Registry Ireland, Building 6800, Airport Business Park, Airport Rd, Cork, Ireland
| |
Collapse
|
32
|
Downing A, Morris EJA, Richards M, Corner J, Wright P, Sebag-Montefiore D, Finan P, Kind P, Wood C, Lawton S, Feltbower R, Wagland R, Vernon S, Thomas J, Glaser AW. Health-related quality of life after colorectal cancer in England: a patient-reported outcomes study of individuals 12 to 36 months after diagnosis. J Clin Oncol 2015; 33:616-24. [PMID: 25559806 DOI: 10.1200/jco.2014.56.6539] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE This population-level study was conducted to define the health-related quality of life (HRQL) of individuals living with and beyond colorectal cancer (CRC) and to identify factors associated with poor health outcomes. PATIENTS AND METHODS All individuals diagnosed with CRC in England in 2010 and 2011 who were alive 12 to 36 months after diagnosis were sent a questionnaire. This included questions related to treatment, disease status, other long-term conditions (LTCs), generic HRQL (EuroQol-5D), and cancer-specific outcomes (Functional Assessment of Cancer Therapy and Social Difficulties Inventory items). RESULTS The response rate was 63.3% (21,802 of 34,467 patients). One or more generic health problems were reported by 65% of respondents, with 10% of patients reporting problems in all five domains. The reporting of problems was higher than in the general population and was most marked in those age less than 55 years. Certain subgroups reported a higher number of problems, notably those with one or more other LTCs, those with active or recurrent disease, those with a stoma, and those at the extremes of the age range (< 55 and > 85 years). Of respondents without a stoma, 16.3% reported no bowel control. Reversal of a stoma resulted in fewer severe bowel problems but more moderate problems than those who had never had a stoma. A quarter of rectal cancer respondents (25.1%) reported difficulties with sexual matters (compared with 11.2% of colon cancer respondents). CONCLUSION This study demonstrates the success of a national patient-reported outcomes survey. The results have the potential to support system-wide improvement in health outcomes through the identification of particular challenges faced by individuals after treatment for CRC.
Collapse
Affiliation(s)
- Amy Downing
- Amy Downing, Eva J.A. Morris, Penny Wright, David Sebag-Montefiore, Paul Finan, and Adam W. Glaser, Leeds Institute of Cancer and Pathology, University of Leeds, St James's University Hospital; David Sebag-Montefiore, Paul Finan, and Adam W. Glaser, Leeds Teaching Hospitals NHS Trust, St James's University Hospital; Paul Kind, Leeds Institute of Health Sciences, University of Leeds; Richard Feltbower, Leeds Institute of Genetics, Health, and Therapeutics, University of Leeds; James Thomas, National Cancer Registration Service (Northern and Yorkshire), Public Health England, St James's University Hospital, Leeds; Mike Richards, Care Quality Commission; Paul Finan, National Cancer Intelligence Network, London; Jessica Corner and Richard Wagland, University of Southampton, Highfield, Southampton; Charlotte Wood and Sarah Lawton, Knowledge and Intelligence Team (Northern and Yorkshire), Public Health England, York; and Sally Vernon, National Cancer Registration Service (Eastern), Public Health England, Cambridge, United Kingdom
| | - Eva J A Morris
- Amy Downing, Eva J.A. Morris, Penny Wright, David Sebag-Montefiore, Paul Finan, and Adam W. Glaser, Leeds Institute of Cancer and Pathology, University of Leeds, St James's University Hospital; David Sebag-Montefiore, Paul Finan, and Adam W. Glaser, Leeds Teaching Hospitals NHS Trust, St James's University Hospital; Paul Kind, Leeds Institute of Health Sciences, University of Leeds; Richard Feltbower, Leeds Institute of Genetics, Health, and Therapeutics, University of Leeds; James Thomas, National Cancer Registration Service (Northern and Yorkshire), Public Health England, St James's University Hospital, Leeds; Mike Richards, Care Quality Commission; Paul Finan, National Cancer Intelligence Network, London; Jessica Corner and Richard Wagland, University of Southampton, Highfield, Southampton; Charlotte Wood and Sarah Lawton, Knowledge and Intelligence Team (Northern and Yorkshire), Public Health England, York; and Sally Vernon, National Cancer Registration Service (Eastern), Public Health England, Cambridge, United Kingdom
| | - Mike Richards
- Amy Downing, Eva J.A. Morris, Penny Wright, David Sebag-Montefiore, Paul Finan, and Adam W. Glaser, Leeds Institute of Cancer and Pathology, University of Leeds, St James's University Hospital; David Sebag-Montefiore, Paul Finan, and Adam W. Glaser, Leeds Teaching Hospitals NHS Trust, St James's University Hospital; Paul Kind, Leeds Institute of Health Sciences, University of Leeds; Richard Feltbower, Leeds Institute of Genetics, Health, and Therapeutics, University of Leeds; James Thomas, National Cancer Registration Service (Northern and Yorkshire), Public Health England, St James's University Hospital, Leeds; Mike Richards, Care Quality Commission; Paul Finan, National Cancer Intelligence Network, London; Jessica Corner and Richard Wagland, University of Southampton, Highfield, Southampton; Charlotte Wood and Sarah Lawton, Knowledge and Intelligence Team (Northern and Yorkshire), Public Health England, York; and Sally Vernon, National Cancer Registration Service (Eastern), Public Health England, Cambridge, United Kingdom
| | - Jessica Corner
- Amy Downing, Eva J.A. Morris, Penny Wright, David Sebag-Montefiore, Paul Finan, and Adam W. Glaser, Leeds Institute of Cancer and Pathology, University of Leeds, St James's University Hospital; David Sebag-Montefiore, Paul Finan, and Adam W. Glaser, Leeds Teaching Hospitals NHS Trust, St James's University Hospital; Paul Kind, Leeds Institute of Health Sciences, University of Leeds; Richard Feltbower, Leeds Institute of Genetics, Health, and Therapeutics, University of Leeds; James Thomas, National Cancer Registration Service (Northern and Yorkshire), Public Health England, St James's University Hospital, Leeds; Mike Richards, Care Quality Commission; Paul Finan, National Cancer Intelligence Network, London; Jessica Corner and Richard Wagland, University of Southampton, Highfield, Southampton; Charlotte Wood and Sarah Lawton, Knowledge and Intelligence Team (Northern and Yorkshire), Public Health England, York; and Sally Vernon, National Cancer Registration Service (Eastern), Public Health England, Cambridge, United Kingdom
| | - Penny Wright
- Amy Downing, Eva J.A. Morris, Penny Wright, David Sebag-Montefiore, Paul Finan, and Adam W. Glaser, Leeds Institute of Cancer and Pathology, University of Leeds, St James's University Hospital; David Sebag-Montefiore, Paul Finan, and Adam W. Glaser, Leeds Teaching Hospitals NHS Trust, St James's University Hospital; Paul Kind, Leeds Institute of Health Sciences, University of Leeds; Richard Feltbower, Leeds Institute of Genetics, Health, and Therapeutics, University of Leeds; James Thomas, National Cancer Registration Service (Northern and Yorkshire), Public Health England, St James's University Hospital, Leeds; Mike Richards, Care Quality Commission; Paul Finan, National Cancer Intelligence Network, London; Jessica Corner and Richard Wagland, University of Southampton, Highfield, Southampton; Charlotte Wood and Sarah Lawton, Knowledge and Intelligence Team (Northern and Yorkshire), Public Health England, York; and Sally Vernon, National Cancer Registration Service (Eastern), Public Health England, Cambridge, United Kingdom
| | - David Sebag-Montefiore
- Amy Downing, Eva J.A. Morris, Penny Wright, David Sebag-Montefiore, Paul Finan, and Adam W. Glaser, Leeds Institute of Cancer and Pathology, University of Leeds, St James's University Hospital; David Sebag-Montefiore, Paul Finan, and Adam W. Glaser, Leeds Teaching Hospitals NHS Trust, St James's University Hospital; Paul Kind, Leeds Institute of Health Sciences, University of Leeds; Richard Feltbower, Leeds Institute of Genetics, Health, and Therapeutics, University of Leeds; James Thomas, National Cancer Registration Service (Northern and Yorkshire), Public Health England, St James's University Hospital, Leeds; Mike Richards, Care Quality Commission; Paul Finan, National Cancer Intelligence Network, London; Jessica Corner and Richard Wagland, University of Southampton, Highfield, Southampton; Charlotte Wood and Sarah Lawton, Knowledge and Intelligence Team (Northern and Yorkshire), Public Health England, York; and Sally Vernon, National Cancer Registration Service (Eastern), Public Health England, Cambridge, United Kingdom
| | - Paul Finan
- Amy Downing, Eva J.A. Morris, Penny Wright, David Sebag-Montefiore, Paul Finan, and Adam W. Glaser, Leeds Institute of Cancer and Pathology, University of Leeds, St James's University Hospital; David Sebag-Montefiore, Paul Finan, and Adam W. Glaser, Leeds Teaching Hospitals NHS Trust, St James's University Hospital; Paul Kind, Leeds Institute of Health Sciences, University of Leeds; Richard Feltbower, Leeds Institute of Genetics, Health, and Therapeutics, University of Leeds; James Thomas, National Cancer Registration Service (Northern and Yorkshire), Public Health England, St James's University Hospital, Leeds; Mike Richards, Care Quality Commission; Paul Finan, National Cancer Intelligence Network, London; Jessica Corner and Richard Wagland, University of Southampton, Highfield, Southampton; Charlotte Wood and Sarah Lawton, Knowledge and Intelligence Team (Northern and Yorkshire), Public Health England, York; and Sally Vernon, National Cancer Registration Service (Eastern), Public Health England, Cambridge, United Kingdom
| | - Paul Kind
- Amy Downing, Eva J.A. Morris, Penny Wright, David Sebag-Montefiore, Paul Finan, and Adam W. Glaser, Leeds Institute of Cancer and Pathology, University of Leeds, St James's University Hospital; David Sebag-Montefiore, Paul Finan, and Adam W. Glaser, Leeds Teaching Hospitals NHS Trust, St James's University Hospital; Paul Kind, Leeds Institute of Health Sciences, University of Leeds; Richard Feltbower, Leeds Institute of Genetics, Health, and Therapeutics, University of Leeds; James Thomas, National Cancer Registration Service (Northern and Yorkshire), Public Health England, St James's University Hospital, Leeds; Mike Richards, Care Quality Commission; Paul Finan, National Cancer Intelligence Network, London; Jessica Corner and Richard Wagland, University of Southampton, Highfield, Southampton; Charlotte Wood and Sarah Lawton, Knowledge and Intelligence Team (Northern and Yorkshire), Public Health England, York; and Sally Vernon, National Cancer Registration Service (Eastern), Public Health England, Cambridge, United Kingdom
| | - Charlotte Wood
- Amy Downing, Eva J.A. Morris, Penny Wright, David Sebag-Montefiore, Paul Finan, and Adam W. Glaser, Leeds Institute of Cancer and Pathology, University of Leeds, St James's University Hospital; David Sebag-Montefiore, Paul Finan, and Adam W. Glaser, Leeds Teaching Hospitals NHS Trust, St James's University Hospital; Paul Kind, Leeds Institute of Health Sciences, University of Leeds; Richard Feltbower, Leeds Institute of Genetics, Health, and Therapeutics, University of Leeds; James Thomas, National Cancer Registration Service (Northern and Yorkshire), Public Health England, St James's University Hospital, Leeds; Mike Richards, Care Quality Commission; Paul Finan, National Cancer Intelligence Network, London; Jessica Corner and Richard Wagland, University of Southampton, Highfield, Southampton; Charlotte Wood and Sarah Lawton, Knowledge and Intelligence Team (Northern and Yorkshire), Public Health England, York; and Sally Vernon, National Cancer Registration Service (Eastern), Public Health England, Cambridge, United Kingdom
| | - Sarah Lawton
- Amy Downing, Eva J.A. Morris, Penny Wright, David Sebag-Montefiore, Paul Finan, and Adam W. Glaser, Leeds Institute of Cancer and Pathology, University of Leeds, St James's University Hospital; David Sebag-Montefiore, Paul Finan, and Adam W. Glaser, Leeds Teaching Hospitals NHS Trust, St James's University Hospital; Paul Kind, Leeds Institute of Health Sciences, University of Leeds; Richard Feltbower, Leeds Institute of Genetics, Health, and Therapeutics, University of Leeds; James Thomas, National Cancer Registration Service (Northern and Yorkshire), Public Health England, St James's University Hospital, Leeds; Mike Richards, Care Quality Commission; Paul Finan, National Cancer Intelligence Network, London; Jessica Corner and Richard Wagland, University of Southampton, Highfield, Southampton; Charlotte Wood and Sarah Lawton, Knowledge and Intelligence Team (Northern and Yorkshire), Public Health England, York; and Sally Vernon, National Cancer Registration Service (Eastern), Public Health England, Cambridge, United Kingdom
| | - Richard Feltbower
- Amy Downing, Eva J.A. Morris, Penny Wright, David Sebag-Montefiore, Paul Finan, and Adam W. Glaser, Leeds Institute of Cancer and Pathology, University of Leeds, St James's University Hospital; David Sebag-Montefiore, Paul Finan, and Adam W. Glaser, Leeds Teaching Hospitals NHS Trust, St James's University Hospital; Paul Kind, Leeds Institute of Health Sciences, University of Leeds; Richard Feltbower, Leeds Institute of Genetics, Health, and Therapeutics, University of Leeds; James Thomas, National Cancer Registration Service (Northern and Yorkshire), Public Health England, St James's University Hospital, Leeds; Mike Richards, Care Quality Commission; Paul Finan, National Cancer Intelligence Network, London; Jessica Corner and Richard Wagland, University of Southampton, Highfield, Southampton; Charlotte Wood and Sarah Lawton, Knowledge and Intelligence Team (Northern and Yorkshire), Public Health England, York; and Sally Vernon, National Cancer Registration Service (Eastern), Public Health England, Cambridge, United Kingdom
| | - Richard Wagland
- Amy Downing, Eva J.A. Morris, Penny Wright, David Sebag-Montefiore, Paul Finan, and Adam W. Glaser, Leeds Institute of Cancer and Pathology, University of Leeds, St James's University Hospital; David Sebag-Montefiore, Paul Finan, and Adam W. Glaser, Leeds Teaching Hospitals NHS Trust, St James's University Hospital; Paul Kind, Leeds Institute of Health Sciences, University of Leeds; Richard Feltbower, Leeds Institute of Genetics, Health, and Therapeutics, University of Leeds; James Thomas, National Cancer Registration Service (Northern and Yorkshire), Public Health England, St James's University Hospital, Leeds; Mike Richards, Care Quality Commission; Paul Finan, National Cancer Intelligence Network, London; Jessica Corner and Richard Wagland, University of Southampton, Highfield, Southampton; Charlotte Wood and Sarah Lawton, Knowledge and Intelligence Team (Northern and Yorkshire), Public Health England, York; and Sally Vernon, National Cancer Registration Service (Eastern), Public Health England, Cambridge, United Kingdom
| | - Sally Vernon
- Amy Downing, Eva J.A. Morris, Penny Wright, David Sebag-Montefiore, Paul Finan, and Adam W. Glaser, Leeds Institute of Cancer and Pathology, University of Leeds, St James's University Hospital; David Sebag-Montefiore, Paul Finan, and Adam W. Glaser, Leeds Teaching Hospitals NHS Trust, St James's University Hospital; Paul Kind, Leeds Institute of Health Sciences, University of Leeds; Richard Feltbower, Leeds Institute of Genetics, Health, and Therapeutics, University of Leeds; James Thomas, National Cancer Registration Service (Northern and Yorkshire), Public Health England, St James's University Hospital, Leeds; Mike Richards, Care Quality Commission; Paul Finan, National Cancer Intelligence Network, London; Jessica Corner and Richard Wagland, University of Southampton, Highfield, Southampton; Charlotte Wood and Sarah Lawton, Knowledge and Intelligence Team (Northern and Yorkshire), Public Health England, York; and Sally Vernon, National Cancer Registration Service (Eastern), Public Health England, Cambridge, United Kingdom
| | - James Thomas
- Amy Downing, Eva J.A. Morris, Penny Wright, David Sebag-Montefiore, Paul Finan, and Adam W. Glaser, Leeds Institute of Cancer and Pathology, University of Leeds, St James's University Hospital; David Sebag-Montefiore, Paul Finan, and Adam W. Glaser, Leeds Teaching Hospitals NHS Trust, St James's University Hospital; Paul Kind, Leeds Institute of Health Sciences, University of Leeds; Richard Feltbower, Leeds Institute of Genetics, Health, and Therapeutics, University of Leeds; James Thomas, National Cancer Registration Service (Northern and Yorkshire), Public Health England, St James's University Hospital, Leeds; Mike Richards, Care Quality Commission; Paul Finan, National Cancer Intelligence Network, London; Jessica Corner and Richard Wagland, University of Southampton, Highfield, Southampton; Charlotte Wood and Sarah Lawton, Knowledge and Intelligence Team (Northern and Yorkshire), Public Health England, York; and Sally Vernon, National Cancer Registration Service (Eastern), Public Health England, Cambridge, United Kingdom
| | - Adam W Glaser
- Amy Downing, Eva J.A. Morris, Penny Wright, David Sebag-Montefiore, Paul Finan, and Adam W. Glaser, Leeds Institute of Cancer and Pathology, University of Leeds, St James's University Hospital; David Sebag-Montefiore, Paul Finan, and Adam W. Glaser, Leeds Teaching Hospitals NHS Trust, St James's University Hospital; Paul Kind, Leeds Institute of Health Sciences, University of Leeds; Richard Feltbower, Leeds Institute of Genetics, Health, and Therapeutics, University of Leeds; James Thomas, National Cancer Registration Service (Northern and Yorkshire), Public Health England, St James's University Hospital, Leeds; Mike Richards, Care Quality Commission; Paul Finan, National Cancer Intelligence Network, London; Jessica Corner and Richard Wagland, University of Southampton, Highfield, Southampton; Charlotte Wood and Sarah Lawton, Knowledge and Intelligence Team (Northern and Yorkshire), Public Health England, York; and Sally Vernon, National Cancer Registration Service (Eastern), Public Health England, Cambridge, United Kingdom.
| |
Collapse
|
33
|
Shand LK, Cowlishaw S, Brooker JE, Burney S, Ricciardelli LA. Correlates of post-traumatic stress symptoms and growth in cancer patients: a systematic review and meta-analysis. Psychooncology 2014; 24:624-34. [PMID: 25393527 DOI: 10.1002/pon.3719] [Citation(s) in RCA: 162] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Revised: 10/06/2014] [Accepted: 10/08/2014] [Indexed: 01/10/2023]
Abstract
OBJECTIVE The aim of this study is to examine the relationships among demographic, medical, and psychosocial factors and post-traumatic stress symptoms (PTSS) and post-traumatic growth (PTG) in oncology populations. METHOD A systematic search identified k = 116 relevant studies published between 1990 and 2012. Meta-analyses synthesized results from studies that reported data on correlates of PTSS (k = 26) or PTG (k = 48). A meta-analysis was performed for k = 5 studies reporting the correlation between PTSS and PTG. RESULTS Post-traumatic stress symptoms were associated with depression (r = 0.56), anxiety (r = 0.65), distress (r = 0.62), social support (r = -0.33), and physical quality of life (r = -0.44). PTG was associated with age (r = -0.08), gender (r = -0.15), distress (r = -0.16), depression (r = -0.06), social support (r = 0.30), optimism (r = 0.27), positive reappraisal (r = 0.46), spirituality (r = 0.33), and religious coping (r = 0.36). There was a small positive relationship between PTSS and PTG (r = 0.13). CONCLUSIONS Post-traumatic stress symptoms and PTG appear to be independent constructs, rather than opposite ends of a single dimension. This is reflected in a small relationship between these variables and different psychosocial correlates. PTSS were strongly associated with variables reflecting a general state of negative affect. Optimism, spirituality, and positive coping styles were associated with PTG. It remains unclear how they are associated with PTSS, given the lack of relevant studies. Longitudinal research is required to examine how psychosocial factors influence the relationship between PTSS and PTG.
Collapse
Affiliation(s)
- Lyndel K Shand
- School of Psychology, Deakin University, Burwood, Victoria, 3125, Australia
| | - Sean Cowlishaw
- School of Social and Community Medicine, University of Bristol, Bristol, BS8 2PS, UK
| | - Joanne E Brooker
- Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Victoria, 3800, Australia.,Cabrini-Monash Psycho-oncology, Cabrini Health, Malvern, Victoria, 3144, Australia
| | - Sue Burney
- School of Psychological Sciences, Monash University, Clayton, Victoria, 3800, Australia.,Cabrini-Monash Psycho-oncology, Cabrini Health, Malvern, Victoria, 3144, Australia
| | | |
Collapse
|
34
|
Packel LB, Prehn AW, Anderson CL, Fisher PL. Factors influencing physical activity behaviors in colorectal cancer survivors. Am J Health Promot 2014; 30:85-92. [PMID: 25372238 DOI: 10.4278/ajhp.140103-quan-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE To elucidate factors that impact intention (INT) to be active as well as actual physical activity (PA) behavior in colorectal cancer survivors (CRC-S) using the theory of planned behavior (TpB). Planning for PA was explored as a mediator of the INT-behavior relationship. Chemotherapy-induced neuropathy and fatigue were also explored. DESIGN A cross-sectional quantitative mailed survey was used. SETTING The study was conducted among community-dwelling adults living in Pennsylvania when diagnosed with colorectal cancer (CRC). SUBJECTS Subjects comprised 843 CRC-S diagnosed with CRC in Pennsylvania in 2009. MEASURES The survey included questions about planning for PA, TpB constructs, medical and social variables, and PA as measured by a modified Godin Leisure Time Questionnaire. ANALYSIS Descriptive statistics were used to characterize the sample. A mediation analysis was used to determine if planning mediated the relationship between INT and actual PA behavior. A stepwise regression was used to determine predictors of INT and PA. RESULTS Ninety-six CRC-S responded, with 25% meeting PA recommendations for health promotion, suggesting that CRC-S are insufficiently active. Perceived behavioral control (PBC) and social norm (SN) accounted for 43% of the variance in INT, whereas 30% of the variance in PA was explained by PBC and age. Neuropathy negatively impacted PA behavior (p = .008). Both action and coping planning partially mediated the INT-behavior relationship (β = 20.08, p = .007; β = 22.85, p = .001, respectively). CONCLUSION Survivors at risk for inactivity are those with low PBC, low SN, and neuropathy, and those who are older.
Collapse
|
35
|
Tan ASL. A Study of the Frequency and Social Determinants of Exposure to Cancer-Related Direct-to-Consumer Advertising Among Breast, Prostate, and Colorectal Cancer Patients. HEALTH COMMUNICATION 2014; 30:1102-11. [PMID: 25357119 PMCID: PMC4416102 DOI: 10.1080/10410236.2014.921752] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Cancer-related direct-to-consumer advertising (DTCA) is controversial because cancer treatment is complex and entails more risks and costs than typical treatments that are advertised for other conditions. Drawing from the Structural Influence Model of Communication, this study explores communication inequalities in DTCA exposure across social determinants among a population-based sample of 2013 patients diagnosed with breast, prostate, or colorectal cancers. Three survey items assessed patients' frequency of encountering ads concerning treatment alternatives for cancer, dealing with side effects of treatment, and doctors or hospitals offering services for cancer following their diagnosis. The analysis showed that overall exposure to DTCA in this study population was modest (median was once per week). Breast cancer patients reported significantly higher exposure to all three ad categories and overall DTCA exposure than prostate and colorectal cancer patients. Older patients consistently reported lower overall exposure to DTCA across the three cancer types. Other significant correlates included ethnicity (higher exposures among African American prostate cancer patients vs. White; lower exposures in Hispanic colorectal cancer patients vs. White) and cancer stage (higher exposures in Stage IV prostate cancer patients vs. Stages 0-II). Education level did not predict patients' DTCA exposure. The implications of these observed inequalities in DTCA exposure on cancer outcomes are discussed.
Collapse
Affiliation(s)
- Andy SL Tan
- Center of Excellence in Cancer Communication Research, Annenberg School for Communication, University of Pennsylvania, 3620 Walnut Street, Philadelphia, PA 19104
| |
Collapse
|
36
|
Smoking, alcohol, diabetes, obesity, socioeconomic status, and the risk of colorectal cancer in a population-based case-control study. Cancer Causes Control 2014; 25:1659-68. [PMID: 25301194 DOI: 10.1007/s10552-014-0470-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Accepted: 09/25/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE Although previous research has identified factors that may determine willingness to participate in research, relatively few studies have attempted to quantify the impact non-participation may have on exposure-disease associations. The aims of this study were to (a) investigate the associations between smoking, alcohol, diabetes, obesity, and socioeconomic status and the risk of colorectal cancer in a case-control study (59.7 and 47.2 % response fractions among cases and controls, respectively); and (b) perform sensitivity analyses to examine the possible influence of non-participation. METHODS Logistic regression was used to estimate the exposure-disease associations. We then investigated the associations between various demographic and health factors and the likelihood that an individual would participate in the case-control study and then performed two sensitivity analyses (sampling weights and multiple imputation) to examine whether non-participation bias may have influenced the exposure-disease associations. RESULTS The exposures alcohol, smoking, and diabetes were associated with an increased risk of colorectal cancer. We found some differences between cases and controls when examining the factors associated with the participation in the study, and in the sensitivity analyses, the exposure-disease associations were slightly attenuated when compared with those from the original analysis. CONCLUSION Non-participation may have biased the risk estimates away from the null, but generally not enough to change the conclusions of the study.
Collapse
|
37
|
Higgerson RA, Olsho LEW, Christie LM, Rehder K, Doksum T, Gedeit R, Giuliano JS, Brennan B, Wendlandt R, Randolph AG. Variability in IRBs regarding parental acceptance of passive consent. Pediatrics 2014; 134:e496-503. [PMID: 25002659 DOI: 10.1542/peds.2013-4190] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Passive, opt-out recruitment strategies have the potential to improve efficiency and enlarge the participant pool for clinical studies. We report on the feasibility of using a passive consent strategy for a multicenter pediatric study. METHODS We assessed the response to passive and active control recruitment strategies used in a multicenter pediatric cohort study and describe the variability in acceptance among institutional review boards (IRBs) and parents of pediatric patients. RESULTS Twenty-six pediatric centers submitted IRB applications; 24 centers participated. Sixteen IRBs approved the proposed passive recruitment strategy, and 6 IRBs required active consent strategies; 2 centers used a modified participation mode using control subjects from neighboring centers. In all, 4529 potential participants were identified across 22 centers. In the pre-enrollment phase, opt-out rates were significantly lower in the passive consent group compared with the active recruitment centers (1.6% vs. 11.8%; P < .001). During the enrollment phase, however, refusal rates in the passive consent group were significantly higher (38.1% vs. 12.2%; P = .004). The overall refusal rate across both groups was 33.3%. CONCLUSIONS IRB variability in interpretation and application of regulations affects consistency of study procedure across sites and may reduce validity of study findings. Opt-out consent allowed us to create a large representative pool of control subjects. Parents were more likely to refuse to be approached for a study in the pre-enrollment phase when active consent was used, but were more likely to decline actual study enrollment when passive consent was used in the pre-enrollment period.
Collapse
Affiliation(s)
| | | | | | - Kyle Rehder
- Duke Children's Hospital and Health Center, Durham, North Carolina
| | | | - Rainer Gedeit
- Children's Hospital of Wisconsin, Milwaukee, Wisconsin
| | | | | | | | | | | |
Collapse
|
38
|
Paul C, Courtney R, Sanson-Fisher R, Carey M, Hill D, Simmons J, Rose S. A randomized controlled trial of the effectiveness of a pre-recruitment primer letter to increase participation in a study of colorectal screening and surveillance. BMC Med Res Methodol 2014. [PMID: 24690533 DOI: 10.1186/1471-2288-14-44:10.1186/1471-2288-14-44] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023] Open
Abstract
BACKGROUND Recruiting cancer patients is a barrier often encountered in research trials. However, very few randomized trials explore strategies to improve participation rates. The purpose of this study was to evaluate the effectiveness of a pre-recruitment primer letter to recruit persons diagnosed with colorectal cancer for a research trial. METHODS Potentially eligible participants were identified by the Victorian Cancer Registry. A total of 1,062 participants were randomized to receive either a mailed explanatory primer letter designed to encourage research participation, or no primer letter. Two weeks after the intervention, the Victorian Cancer Registry sought permission from patients to release their contact details to researchers. Those who agreed were contacted and invited to the study. RESULTS Pre-recruitment encouragement was not effective at increasing recruitment, with no significant differences demonstrated between experimental groups. Overall, 40% (n = 425) consented to participate, 25% (n = 243) refused and 35% (n = 394) did not respond. CONCLUSIONS While this study demonstrated disappointing outcomes, pre-recruitment letters should not be ruled out as an approach altogether. Rather, future research should explore whether other factors to increase motivation, such as intensity and timing, are feasible and acceptable for contacting cancer patients. TRIAL REGISTRATION Australian and New Zealand Clinical Trials Registry, ACTRN12609000628246.
Collapse
Affiliation(s)
- Christine Paul
- Priority Research Centre for Health Behaviour (PRCHB), University of Newcastle, Callaghan, NSW, Australia.
| | | | | | | | | | | | | |
Collapse
|
39
|
Remick RA, Araki Y, Bruce R, Gorman C, Allen J, Remick AK, Lear SA. The mood disorders association of british columbia psychiatric urgent care program: a preliminary evaluation of a suggested alternative model of outpatient psychiatric care. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2014; 59:220-7. [PMID: 25007115 PMCID: PMC4079133 DOI: 10.1177/070674371405900407] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Accepted: 11/01/2013] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To describe an alternative model of psychiatric outpatient care for patients with mood and anxiety disorders (the Mood Disorders Association of British Columbia Psychiatric Urgent Care Program or the MDA Program) using group medical visits (GMV) and (or) email communications in lieu of individual follow-up appointments. METHOD Annual costs of the MDA Program were compared with average costs of private psychiatrists offering outpatient care and patients being treated in a mental health centre. In addition, questionnaires as to patient satisfaction with the MDA Program intake, GMV experience, and family physician satisfaction with the MDA Program were administered. RESULTS The MDA Program model of care is significantly more cost effective than individual psychiatric outpatient care or health authority mental health centre care for patients with moderate or severe illness. Patients and family physicians were very satisfied with the model of care and GMVs offered. CONCLUSIONS The MDA Program model of care appears to be efficient and cost-effective, and patients and referring physicians appear satisfied with the care offered in this program.
Collapse
Affiliation(s)
- Ronald A Remick
- Medical Director, Mood Disorders Association of British Columbia Psychiatric Urgent Care Program, Vancouver, British Columbia
| | - Yuriko Araki
- Director of Research and Development, Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia
| | - Robin Bruce
- Research Assistant, Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia
| | - Chris Gorman
- Cofounder, Mood Disorders Association of British Columbia Psychiatric Urgent Care Program; Vancouver, British Columbia; Director, Psychiatric Outpatient Services, Department of Psychiatry, St Paul's Hospital, Vancouver, British Columbia
| | - Judy Allen
- Consultant Psychiatrist, Mood Disorders Association of British Columbia Psychiatric Urgent Care Program, Vancouver, British Columbia
| | - Abigail K Remick
- Research Associate, Mood Disorders Association of British Columbia Psychiatric Urgent Care Program, Vancouver, British Columbia
| | - Scott A Lear
- Professor, Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia; Member, Division of Cardiology, Providence Health Care, Vancouver, British Columbia
| |
Collapse
|
40
|
Paul C, Courtney R, Sanson-Fisher R, Carey M, Hill D, Simmons J, Rose S. A randomized controlled trial of the effectiveness of a pre-recruitment primer letter to increase participation in a study of colorectal screening and surveillance. BMC Med Res Methodol 2014; 14:44. [PMID: 24690533 PMCID: PMC3975453 DOI: 10.1186/1471-2288-14-44] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Accepted: 03/27/2014] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Recruiting cancer patients is a barrier often encountered in research trials. However, very few randomized trials explore strategies to improve participation rates. The purpose of this study was to evaluate the effectiveness of a pre-recruitment primer letter to recruit persons diagnosed with colorectal cancer for a research trial. METHODS Potentially eligible participants were identified by the Victorian Cancer Registry. A total of 1,062 participants were randomized to receive either a mailed explanatory primer letter designed to encourage research participation, or no primer letter. Two weeks after the intervention, the Victorian Cancer Registry sought permission from patients to release their contact details to researchers. Those who agreed were contacted and invited to the study. RESULTS Pre-recruitment encouragement was not effective at increasing recruitment, with no significant differences demonstrated between experimental groups. Overall, 40% (n = 425) consented to participate, 25% (n = 243) refused and 35% (n = 394) did not respond. CONCLUSIONS While this study demonstrated disappointing outcomes, pre-recruitment letters should not be ruled out as an approach altogether. Rather, future research should explore whether other factors to increase motivation, such as intensity and timing, are feasible and acceptable for contacting cancer patients. TRIAL REGISTRATION Australian and New Zealand Clinical Trials Registry, ACTRN12609000628246.
Collapse
Affiliation(s)
- Christine Paul
- Priority Research Centre for Health Behaviour (PRCHB), University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute (HMRI), New Lambton Heights, NSW, Australia
| | - Ryan Courtney
- Priority Research Centre for Health Behaviour (PRCHB), University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute (HMRI), New Lambton Heights, NSW, Australia
| | - Rob Sanson-Fisher
- Priority Research Centre for Health Behaviour (PRCHB), University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute (HMRI), New Lambton Heights, NSW, Australia
| | - Mariko Carey
- Priority Research Centre for Health Behaviour (PRCHB), University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute (HMRI), New Lambton Heights, NSW, Australia
| | - David Hill
- Centre for Behavioural Research in Cancer, The Cancer Council Victoria, Carlton, VIC, Australia
- Professorial Fellow, University of Melbourne, Parkville, VIC, Australia
| | - Jody Simmons
- Cancer Prevention Centre, The Cancer Council Victoria, Carlton, VIC, Australia
| | - Shiho Rose
- Priority Research Centre for Health Behaviour (PRCHB), University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute (HMRI), New Lambton Heights, NSW, Australia
| |
Collapse
|
41
|
Jagsi R, Pottow JAE, Griffith KA, Bradley C, Hamilton AS, Graff J, Katz SJ, Hawley ST. Long-term financial burden of breast cancer: experiences of a diverse cohort of survivors identified through population-based registries. J Clin Oncol 2014; 32:1269-76. [PMID: 24663041 DOI: 10.1200/jco.2013.53.0956] [Citation(s) in RCA: 201] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To evaluate the financial experiences of a racially and ethnically diverse cohort of long-term breast cancer survivors (17% African American, 40% Latina) identified through population-based registries. METHODS Longitudinal study of women diagnosed with nonmetastatic breast cancer in 2005 to 2007 and reported to the SEER registries of metropolitan Los Angeles and Detroit. We surveyed 3,133 women approximately 9 months after diagnosis and 4 years later. Multivariable models evaluated correlates of self-reported decline in financial status attributed to breast cancer and of experiencing at least one type of privation (economically motivated treatment nonadherence and broader hardships related to medical expenses). RESULTS Among 1,502 patients responding to both surveys, median out-of-pocket expenses were ≤ $2,000; 17% of respondents reported spending > $5,000; 12% reported having medical debt 4 years postdiagnosis. Debt varied significantly by race: 9% of whites, 15% of blacks, 17% of English-speaking Latinas, and 10% of Spanish-speaking Latinas reported debt (P = .03). Overall, 25% of women experienced financial decline at least partly attributed to breast cancer; Spanish-speaking Latinas had significantly increased odds of this decline relative to whites (odds ratio [OR], 2.76; P = .006). At least one privation was experienced by 18% of the sample; blacks (OR, 2.6; P < .001) and English-speaking Latinas (OR, 2.2; P = .02) were significantly more likely to have experienced privation than whites. CONCLUSION Racial and ethnic minority patients appear most vulnerable to privations and financial decline attributable to breast cancer, even after adjustment for income, education, and employment. These findings should motivate efforts to control costs and ensure communication between patients and providers regarding financial distress, particularly for vulnerable subgroups.
Collapse
Affiliation(s)
- Reshma Jagsi
- Reshma Jagsi, Kent A. Griffith, Steven J. Katz, and Sarah T. Hawley, University of Michigan, Ann Arbor, MI; John A.E. Pottow, University of Michigan Law School, Ann Arbor, MI; Cathy Bradley, Virginia Commonwealth University, Richmond, VA; Ann S. Hamilton, University of Southern California, Los Angeles, CA; and John Graff, Rutgers, Cancer Institute of New Jersey, Robert Wood Johnson Medical School, New Brunswick, NJ
| | | | | | | | | | | | | | | |
Collapse
|
42
|
Effects of a gift certificate incentive and specialized delivery on prostate cancer survivors' response rate to a mailed survey: a randomized-controlled trial. J Geriatr Oncol 2013; 5:127-32. [PMID: 24495697 DOI: 10.1016/j.jgo.2013.11.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Revised: 09/10/2013] [Accepted: 11/25/2013] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Most men diagnosed with prostate cancer become long-term survivors, but are at risk for medical late-effects that can affect their long-term health. Mailed surveys are well suited to study late-effects in this population, but low response rates can compromise survey validity. This study investigated whether an unconditional $5.00 gift certificate incentive or Priority Mail delivery increased prostate cancer survivors' response to mailed surveys. MATERIALS AND METHODS 976 participants (mean age = 66.8 years), 2-8 years post-diagnosis, were randomized to one of four groups: Incentive; Priority Mail; Incentive & Priority Mail; or Control. After an introductory letter, initial study packets were mailed based on randomization; 46 days later, a second study packet was mailed to all non-responders by First-Class Mail. RESULTS The first mailing yielded a significant variation in response rates across groups (χ(2) = 9.34; p = 0.025). Priority Mail (64.7%; p = 0.008) and Incentive & Priority Mail (63.6%; p = 0.016) groups had significantly higher response rates than Controls (52.9%). After the second mailing, the overall response rate increased significantly from 59.6% to 71.4% (p < 0.001); however, response rates no longer differed across groups (range, 69.3% [Incentive group] to 73.9% [Priority Mail group]). CONCLUSIONS Long-term prostate cancer survivors' response rates to mailed surveys increased with the use of Priority Mail and a repeat survey mailing, but the unconditional gift certificate incentive was not supported in this population. By identifying and applying specialized survey methods, studies targeting survivors of prostate cancer and other geriatric cancers may improve response rates, thus limiting a source of potential bias.
Collapse
|
43
|
Gewandter JS, Walker J, Heckler CE, Morrow GR, Ryan JL. Characterization of skin reactions and pain reported by patients receiving radiation therapy for cancer at different sites. THE JOURNAL OF SUPPORTIVE ONCOLOGY 2013; 11:183-189. [PMID: 24645338 PMCID: PMC4502437 DOI: 10.12788/j.suponc.0009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/15/2023]
Abstract
BACKGROUND Skin reactions and pain are commonly reported side effects of radiation therapy (RT). OBJECTIVE To characterize RT-induced symptoms according to treatment site subgroups and identify skin symptoms that correlate with pain. METHODS A self-report survey-adapted from the MD Anderson Symptom Inventory and the McGill Pain Questionnaire--assessed RT-induced skin problems, pain, and specific skin symptoms. Wilcoxon Sign Ranked tests compared mean severity or pre- and post-RT pain and skin problems within each RT-site subgroup. Multiple linear regression (MLR) investigated associations between skin symptoms and pain. RESULTS Survey respondents (N = 106) were 58% female and on average 64 years old. RT sites included lung, breast, lower abdomen, head/neck/brain, and upper abdomen. Only patients receiving breast RT reported significant increases in treatment site pain and skin problems (P < or = .007). Patients receiving head/neck/brain RT reported increased skin problems (P < .0009). MLR showed that post-RT skin tenderness and tightness were most strongly associated with post-RT pain (P = .066 and P = .122, respectively). LIMITATIONS Small sample size, exploratory analyses, and nonvalidated measure. CONCLUSIONS Only patients receiving breast RT reported significant increases in pain and skin problems at the RT site while patients receiving head/neck/brain RT had increased skin problems but not pain. These findings suggest that the severity of skin problems is not the only factor that contributes to pain and that interventions should be tailored to specifically target pain at the RT site, possibly by targeting tenderness and tightness. These findings should be confirmed in a larger sampling of RT patients.
Collapse
|
44
|
Fischer CM, Burkhardt JK, Sarnthein J, Bernays RL, Bozinov O. Aesthetic outcome in patients after polymethyl-methacrylate (PMMA) cranioplasty — a questionnaire-based single-centre study. Neurol Res 2013; 34:281-5. [DOI: 10.1179/1743132812y.0000000007] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Affiliation(s)
- Claudia M Fischer
- Department of NeurosurgeryUniversity Hospital, University of Zurich, Switzerland
| | - Jan-Karl Burkhardt
- Department of NeurosurgeryUniversity Hospital, University of Zurich, Switzerland
- Department of Neurological SurgeryPresbyterian Hospital, Weill Cornell Medical College, New York, USA
| | - Johannes Sarnthein
- Department of NeurosurgeryUniversity Hospital, University of Zurich, Switzerland
| | - René Ludwig Bernays
- Department of NeurosurgeryUniversity Hospital, University of Zurich, Switzerland
| | - Oliver Bozinov
- Department of NeurosurgeryUniversity Hospital, University of Zurich, Switzerland
| |
Collapse
|
45
|
Brown JC, John GM, Segal S, Chu CS, Schmitz KH. Physical activity and lower limb lymphedema among uterine cancer survivors. Med Sci Sports Exerc 2013; 45:2091-7. [PMID: 23657171 PMCID: PMC4122421 DOI: 10.1249/mss.0b013e318299afd4] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE Physical activity (PA) is known to provide physical and mental health benefits to uterine cancer survivors. However, it is unknown if PA is associated with lower limb lymphedema (LLL), an accumulation of protein-rich fluid in the lower limbs. Therefore, we sought to examine the association between PA and LLL in uterine cancer survivors, with a focus on walking. METHODS We conducted a cross-sectional study using mailed surveys among uterine cancer survivors who received care at a university-based cancer center. We asked about PA, walking, and LLL symptoms using validated self-report questionnaires. PA was calculated using MET-hours per week, and walking was calculated using blocks per day. RESULTS The response rate to our survey was 43%. Among the 213 uterine cancer survivors in our survey, 36% were classified as having LLL. Compared with participants who reported <3 MET · h · wk of PA, participants who reported ≥ 18.0 MET · h · wk of PA had an odds ratio of LLL of 0.32 (95% confidence interval, 0.15-0.69; P trend = 0.003). Stratified analyses suggested the association between PA and LLL existed only among women with body mass index (BMI) <30 kg · m (P trend = 0.007) compared with women with BMI ≥ 30 kg · m (P trend = 0.47). Compared with participants who reported <4.0 blocks per day of walking, participants who reported ≥ 12 blocks per day of walking had an odds ratio of LLL of 0.19 (95% confidence interval, 0.09-0.43; P trend < 0.0001). Stratified analyses suggested the association between walking and LLL was similar among women with BMI <30 kg · m (P trend = 0.007) and women with BMI ≥ 30 kg · m (P trend = 0.03). CONCLUSION Participation in higher levels of PA or walking is associated with reduced proportions of LLL in dose-response fashion. These findings should be interpreted as preliminary and should be investigated in future studies.
Collapse
Affiliation(s)
- Justin C. Brown
- Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, PA
| | | | - Saya Segal
- Division of Female Pelvic Medicine and Reconstructive Surgery; University of Medicine and Dentistry of New Jersey, New Brunswick, NJ
| | - Christina S. Chu
- Divsion of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Pennsylvania, PA
| | - Kathryn H. Schmitz
- Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, PA
| |
Collapse
|
46
|
Abstract
BACKGROUND Rural older adults are not often targeted for surveys, and little is known about survey response rates in this population. Because overall numbers of rural older adults are small, it is important to consider techniques to improve their survey response rates. OBJECTIVES The purpose of this study was to work with community partners to determine whether rural older adults participating in a rural county home-delivered meals program were more likely to respond to an injury risk survey hand-delivered via the postal service or hand-delivered by the home-delivered meals drivers. METHODS All home-delivered meals clients older than 65 years old were randomized to one of two groups. One group (n = 70) received the following via the postal service: a prenotice letter, a survey packet containing a description of the survey, the survey, a stamped and addressed return envelope, and a reminder/thank-you card. Older adults in the other group (n = 69) were personally handed the survey packet by the home-delivered meals driver. RESULTS The overall survey response rate was 43.9%. Older adults who were handed the survey packets by the home-delivered meals drivers were older and significantly more likely to return the survey (57%) compared with those who received survey materials in the mail (31%). Only 27% of respondents agreed to be contacted regarding participation in future face-to-face interviews. When taking into account response rates, postage costs alone were over five times higher for the postal-delivered surveys compared with the hand-delivered surveys. DISCUSSION By working with community partners, we were able to determine that older adults in a rural community were more likely to respond to surveys personally handed to them by someone they knew.
Collapse
|
47
|
The prevalence of lymphedema symptoms among survivors of long-term cancer with or at risk for lower limb lymphedema. Am J Phys Med Rehabil 2013; 92:223-31. [PMID: 23069748 DOI: 10.1097/phm.0b013e31826edd97] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE The aim of this study was to identify commonly reported symptoms in the lower limbs among those with or at risk for developing lower limb lymphedema (LLL). DESIGN The authors surveyed survivors of long-term cancer using the Pennsylvania State Cancer Registry. They inquired about demographics, cancer treatment history, knowledge about LLL, and symptoms experienced since completing cancer treatment. They invited all participants for an in-person clinical assessment to better identify and characterize the symptoms associated with LLL. RESULTS The response rate to the study survey was 57.2%. Among the 107 participants who answered the study survey, 37 (34.5%) reported one or more symptoms associated with LLL. Many reported a combination of symptoms that included difficulty walking (n = 37; 100%), aching (n = 32; 86%), puffiness (n = 28; 76%), and pain (n = 27; 73%) on one side of the body since cancer treatment. The in-person clinical assessment among a subsample of 17 participants revealed 10 participants with no evidence of LLL and 5 and 2 participants with grade 1 and 2 LLL, respectively. The in-person clinical assessment identified three cases of previously undiagnosed LLL. CONCLUSIONS One third of the survivors of cancer surveyed reported experiencing new symptoms in the lower limbs since cancer treatment. Cases of symptomatic, undiagnosed LLL may exist in the population.
Collapse
|
48
|
Carpentier MY, Tiro JA, Savas LS, Bartholomew LK, Melhado TV, Coan SP, Argenbright KE, Vernon SW. Are cancer registries a viable tool for cancer survivor outreach? A feasibility study. J Cancer Surviv 2013. [PMID: 23247719 DOI: 10.1007/s11764-012-0259-1:10.1007/s11764-012-0259-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
PURPOSE Little is known about cancer survivors' receptivity to being contacted through cancer registries for research and health promotion efforts. We sought to (1) determine breast and colorectal cancer (CRC) survivors' responsiveness to a mailed survey using an academic medical center's cancer registry, (2) assess whether responsiveness varied according to sociodemographic characteristics and medical history, and (3) examine the prevalence and correlates of respondents' awareness and willingness to be contacted through the state cancer registry for future research studies. METHODS Stage 0-III breast and CRC survivors diagnosed between January 2004 and December 2009 were identified from an academic medical center cancer registry. Survivors were mailed an invitation letter with an opt-out option, along with a survey assessing sociodemographic characteristics, medical history, and follow-up cancer care access and utilization. RESULTS A total of 452 (31.4 %) breast and 53 (22.2 %) CRC survivors responded. Willingness to be contacted through the state cancer registry was high among both breast (74 %) and CRC (64 %) respondents even though few were aware of the registry and even fewer knew that their information was in the registry. In multivariable analyses, tumor stage I and not having a family history of cancer were associated with willingness among breast and CRC survivors, respectively. CONCLUSIONS Our findings support the use of state cancer registries to contact survivors for participation in research studies. IMPLICATIONS FOR CANCER SURVIVORS Survivors would benefit from partnerships between researchers and cancer registries that are focused on health promotion interventions.
Collapse
|
49
|
Koopman L, Donselaar L(CG, Rademakers JJ, Hendriks M. A prenotification letter increased initial response, whereas sender did not affect response rates. J Clin Epidemiol 2013; 66:340-8. [DOI: 10.1016/j.jclinepi.2012.09.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2011] [Revised: 07/31/2012] [Accepted: 09/10/2012] [Indexed: 10/27/2022]
|
50
|
Carpentier MY, Tiro JA, Savas LS, Bartholomew LK, Melhado TV, Coan SP, Argenbright KE, Vernon SW. Are cancer registries a viable tool for cancer survivor outreach? A feasibility study. J Cancer Surviv 2012; 7:155-63. [PMID: 23247719 DOI: 10.1007/s11764-012-0259-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2012] [Accepted: 11/30/2012] [Indexed: 11/26/2022]
Abstract
PURPOSE Little is known about cancer survivors' receptivity to being contacted through cancer registries for research and health promotion efforts. We sought to (1) determine breast and colorectal cancer (CRC) survivors' responsiveness to a mailed survey using an academic medical center's cancer registry, (2) assess whether responsiveness varied according to sociodemographic characteristics and medical history, and (3) examine the prevalence and correlates of respondents' awareness and willingness to be contacted through the state cancer registry for future research studies. METHODS Stage 0-III breast and CRC survivors diagnosed between January 2004 and December 2009 were identified from an academic medical center cancer registry. Survivors were mailed an invitation letter with an opt-out option, along with a survey assessing sociodemographic characteristics, medical history, and follow-up cancer care access and utilization. RESULTS A total of 452 (31.4 %) breast and 53 (22.2 %) CRC survivors responded. Willingness to be contacted through the state cancer registry was high among both breast (74 %) and CRC (64 %) respondents even though few were aware of the registry and even fewer knew that their information was in the registry. In multivariable analyses, tumor stage I and not having a family history of cancer were associated with willingness among breast and CRC survivors, respectively. CONCLUSIONS Our findings support the use of state cancer registries to contact survivors for participation in research studies. IMPLICATIONS FOR CANCER SURVIVORS Survivors would benefit from partnerships between researchers and cancer registries that are focused on health promotion interventions.
Collapse
|