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Lope V, Guerrero-Zotano Á, Fernández de Larrea-Baz N, Antolín S, Benavent Viñuales M, Bermejo B, Ruiz-Moreno E, Baena-Cañada JM, París L, Antón A, Chacón JI, Muñoz M, García-Sáenz JA, Olier C, Sánchez Rovira P, Arcusa Lanza A, González S, Brunet J, Oltra A, Bezares S, Rosell L, Pérez-Gómez B, Pastor-Barriuso R, Martín M, Pollán M. Cross-sectional and longitudinal associations of adherence to WCRF/AICR cancer prevention recommendations with health-related quality of life in breast cancer survivors. Health-EpiGEICAM study. J Nutr Health Aging 2024; 28:100312. [PMID: 38970849 DOI: 10.1016/j.jnha.2024.100312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 06/26/2024] [Accepted: 06/27/2024] [Indexed: 07/08/2024]
Abstract
OBJECTIVES Adherence to healthy lifestyle recommendations has been reported to improve health-related quality of life (HRQL) in breast cancer (BC) patients, but the influence of long-term behavioral changes remains unknown. We evaluated the association between adherence to the 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) cancer prevention recommendations and HRQL both, at BC diagnosis and the change 7-12 years later. DESIGN Prospective cohort study. SETTINGS AND PARTICIPANTS A total of 406 breast cancer survivors, from the EpiGEICAM study, were recruited in 16 Spanish hospitals. MEASUREMENTS Epidemiological, clinical, dietary, physical activity and HRQL information was collected both at recruitment and 7-12 years later. A 7-item score to measure compliance with recommendations was assessed according to the 2018 WCRF/AICR scoring criteria. HRQL was evaluated using SF-36 questionnaire. Linear mixed models for longitudinal data were used to assess the cross-sectional and longitudinal association between adherence score and the physical and mental component summary scores. RESULTS At diagnosis, for each unit increase in WCRF/AICR score adherence, the HRQL physical domain increased 0.78 points (95%CI: -0.04 to 1.60; P trend:0.06). The mean change in physical HRQL from diagnosis to follow-up per unit increase in within-subject adherence score was 0.73 points (95%CI: -0.18 to 1.65; P trend: 0.12). For the mental domain, no association was observed with compliance with the recommendations at diagnosis, nor with changes in adherence over time. CONCLUSIONS Our results suggest that Increased adherence to WCRF/AICR cancer prevention recommendations over time could contribute to slightly improved long-term physical HRQoL in BC survivors.
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Affiliation(s)
- Virginia Lope
- Unidad de Epidemiología del Cáncer y Ambiental, Departamento de Epidemiología de Enfermedades Crónicas, Centro Nacional de Epidemiología (CNE), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III (CIBERESP, ISCIII), Madrid, Spain; GEICAM Spanish Breast Cancer Research Group, Madrid, Spain.
| | - Ángel Guerrero-Zotano
- GEICAM Spanish Breast Cancer Research Group, Madrid, Spain; Instituto Valenciano de Oncología, Valencia, Spain
| | - Nerea Fernández de Larrea-Baz
- Unidad de Epidemiología del Cáncer y Ambiental, Departamento de Epidemiología de Enfermedades Crónicas, Centro Nacional de Epidemiología (CNE), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III (CIBERESP, ISCIII), Madrid, Spain; GEICAM Spanish Breast Cancer Research Group, Madrid, Spain
| | - Silvia Antolín
- GEICAM Spanish Breast Cancer Research Group, Madrid, Spain; Complejo Hospitalario de La Coruña (CHUAC), La Coruña, Spain
| | - Marta Benavent Viñuales
- GEICAM Spanish Breast Cancer Research Group, Madrid, Spain; Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla, Sevilla, Spain
| | - Begoña Bermejo
- GEICAM Spanish Breast Cancer Research Group, Madrid, Spain; Hospital Universitario Clínico de Valencia, Biomedical Research Institut INCLIVA, Medicine Department, Universidad de Valencia, Valencia, Spain; Centro de Investigación Biomédica en Red de Oncología (CIBERONC-ISCIII), Madrid, Spain
| | - Emma Ruiz-Moreno
- Unidad de Epidemiología del Cáncer y Ambiental, Departamento de Epidemiología de Enfermedades Crónicas, Centro Nacional de Epidemiología (CNE), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III (CIBERESP, ISCIII), Madrid, Spain
| | - José Manuel Baena-Cañada
- GEICAM Spanish Breast Cancer Research Group, Madrid, Spain; Hospital Universitario Puerta del Mar, Instituto de Investigación e Innovación Biomédica de Cádiz (INIBICA), Cádiz, Spain
| | | | - Antonio Antón
- GEICAM Spanish Breast Cancer Research Group, Madrid, Spain; Hospital Universitario Miguel Servet, Instituto Investigación Sanitaria Aragon, Departamento Medicina Universidad de Zaragoza, Zaragoza, Spain
| | - José Ignacio Chacón
- GEICAM Spanish Breast Cancer Research Group, Madrid, Spain; Hospital Universitario de Toledo, Toledo, Spain
| | - Montserrat Muñoz
- GEICAM Spanish Breast Cancer Research Group, Madrid, Spain; Hospital Clinic i Provincial de Barcelona, FRCB-Translational Genomics and Targeted Therapies in Solid Tumors, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Department of Medicine, University of Barcelona, Barcelona, Spain
| | - José Angel García-Sáenz
- GEICAM Spanish Breast Cancer Research Group, Madrid, Spain; Hospital Clínico San Carlos, IdISSC, Madrid, Spain
| | - Clara Olier
- GEICAM Spanish Breast Cancer Research Group, Madrid, Spain; Hospital de Alcorcón, Madrid, Spain
| | - Pedro Sánchez Rovira
- GEICAM Spanish Breast Cancer Research Group, Madrid, Spain; Hospital Universitario de Jaén, Jaén, Spain
| | - Angels Arcusa Lanza
- GEICAM Spanish Breast Cancer Research Group, Madrid, Spain; Consorci Sanitari de Terrassa, Barcelona, Spain
| | - Sonia González
- GEICAM Spanish Breast Cancer Research Group, Madrid, Spain; Hospital Mutua Terrassa, Barcelona, Spain
| | - Joan Brunet
- GEICAM Spanish Breast Cancer Research Group, Madrid, Spain; Institut Català d'Oncologia, Hospital Josep Trueta, Oncogir, IDIBGI, Girona, Spain
| | - Amparo Oltra
- GEICAM Spanish Breast Cancer Research Group, Madrid, Spain; Hospital Virgen de los Lirios, Alicante, Spain
| | - Susana Bezares
- GEICAM Spanish Breast Cancer Research Group, Madrid, Spain
| | | | - Beatriz Pérez-Gómez
- Unidad de Epidemiología del Cáncer y Ambiental, Departamento de Epidemiología de Enfermedades Crónicas, Centro Nacional de Epidemiología (CNE), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III (CIBERESP, ISCIII), Madrid, Spain; GEICAM Spanish Breast Cancer Research Group, Madrid, Spain
| | - Roberto Pastor-Barriuso
- Unidad de Epidemiología del Cáncer y Ambiental, Departamento de Epidemiología de Enfermedades Crónicas, Centro Nacional de Epidemiología (CNE), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III (CIBERESP, ISCIII), Madrid, Spain
| | - Miguel Martín
- GEICAM Spanish Breast Cancer Research Group, Madrid, Spain; Centro de Investigación Biomédica en Red de Oncología (CIBERONC-ISCIII), Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain
| | - Marina Pollán
- Unidad de Epidemiología del Cáncer y Ambiental, Departamento de Epidemiología de Enfermedades Crónicas, Centro Nacional de Epidemiología (CNE), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III (CIBERESP, ISCIII), Madrid, Spain; GEICAM Spanish Breast Cancer Research Group, Madrid, Spain
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2
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Hartman YAW, Kenkhuis MF, Stelten S, Brouwer CG, van Lonkhuijzen LRCW, Kenter GG, van Driel WJ, Winkels RM, Bekkers RLM, Ottevanger NPB, Hoedjes M, Buffart LM. Demographic, clinical, and sociocognitive determinants related to physical activity and dietary intake in patients with ovarian cancer: A cross-sectional study. Gynecol Oncol 2024; 183:39-46. [PMID: 38503140 DOI: 10.1016/j.ygyno.2024.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 01/26/2024] [Accepted: 03/07/2024] [Indexed: 03/21/2024]
Abstract
OBJECTIVE To study physical activity and dietary intake among patients with ovarian cancer and to examine which demographic, clinical, and sociocognitive determinants are associated with these behaviours. METHODS This cross-sectional study included 139 patients with ovarian cancer scheduled for (neo)adjuvant chemotherapy. Physical activity was measured with the Physical Activity Scale for the Elderly questionnaire (PASE). Dietary intake was measured with a questionnaire assessing energy and protein intake and a questionnaire assessing adherence to the World Cancer Research Fund (WCRF) lifestyle recommendations. Demographic, clinical, and sociocognitive (e.g., self-efficacy) determinants of physical activity and dietary intake were examined using backward linear regression analyses. RESULTS Patients reported a median PASE score of 50 (IQR 24-94), a mean ± SD dietary intake of 1831 ± 604 kcal/day and 76 ± 27 g protein/day. Patients adhered to 3 out of 5 WCRF lifestyle recommendations. The absence of comorbidities, lower physical outcome expectations, and higher cancer specific outcome expectations were independently associated with higher physical activity levels. Higher age, lower cancer specific outcome expectations, and higher diet-related self-efficacy were significantly associated with adhering to more WCRF lifestyle recommendations, whilst no variables associated with total caloric or protein intake were identified. CONCLUSIONS Patients with ovarian cancer have low physical activity levels and a suboptimal diet, particularly low fruit and vegetable consumption and dietary fibre intake. Interventions aiming to improve physical activity and dietary intake could focus on increasing self-efficacy and outcome expectations, and should consider age and comorbidity as factors that may impact behaviour. TRIAL REGISTRATION Netherlands Trial Registry NTR6300.
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Affiliation(s)
- Yvonne A W Hartman
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Marlou-Floor Kenkhuis
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Stephanie Stelten
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Calvin G Brouwer
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | | | - Gemma G Kenter
- Obstetrics and Gynaecology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Obstetrics and Gynaecology, Cancer Center Amsterdam, Center for Gynaecologic Oncology Amsterdam (CGOA), Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Gynaecology, Center for Gynaecologic Oncology Amsterdam (CGOA), The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands
| | - Willemien J van Driel
- Gynaecology, Center for Gynaecologic Oncology Amsterdam (CGOA), The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands
| | - Renate M Winkels
- Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - Ruud L M Bekkers
- Department of Obstetrics and Gynaecology, Grow School for Oncology and Reproduction, Maastricht University, Maastricht, the Netherlands; Department of Gynecology, Catharina Hospital, Eindhoven, the Netherlands; Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Nelleke P B Ottevanger
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Meeke Hoedjes
- CoRPS - Center of Research on Psychological and Somatic disorders, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands
| | - Laurien M Buffart
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, the Netherlands.
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3
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Gavioli C, Vlooswijk C, Janssen SHM, Kaal SEJ, Kerst JM, Tromp JM, Bos MEMM, van der Hulle T, van der Graaf WTA, Lalisang RI, Nuver J, Bijlsma RM, Kouwenhoven MCM, Husson O, Beijer S. Adherence to the World Cancer Research Fund/American Institute for Cancer Research recommendations for cancer prevention in adolescent and young adult (AYA) cancer survivors: results from the SURVAYA study. J Cancer Surviv 2024:10.1007/s11764-023-01529-4. [PMID: 38224397 DOI: 10.1007/s11764-023-01529-4] [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: 05/31/2023] [Accepted: 12/27/2023] [Indexed: 01/16/2024]
Abstract
PURPOSE For adolescent and young adult (AYA) cancer survivors with a good prognosis, having a healthy lifestyle prevents morbidity and mortality after treatment. The aim of this study was to investigate the prevalence of (un)healthy lifestyle behaviors and related determinants in AYA cancer survivors. METHODS A population-based, cross-sectional study was performed among long-term (5-20 years) AYA cancer survivors (18-39 years old at diagnosis) registered within the Netherlands Cancer Registry. Self-reported questionnaires data about health behaviors were used to calculate the 2018 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) adherence score. Associations between the score and clinical/sociodemographic determinants of (un)healthy behaviors were investigated using logistic regression models. RESULTS The mean WCRF/AICR score was low to moderate, 3.8 ± 1.2 (0.5-7.0) (n = 3668). Sixty-one percent adhered to "limit the consumption of sugar sweetened drinks," 28% to "be a healthy weight," 25% to "fruit and vegetable consumption," and 31% to "limit alcohol consumption." Moderate and high adherence were associated with being a woman (ORmoderate = 1.46, 95% CI = 1.14-1.85, and ORhigh = 1.87, 95% CI = 1.46-2.4) and highly educated (ORmoderate = 1.54, 95% CI = 1.30-1.83, and ORhigh = 1.87, 95% CI = 1.46-2.4). Low adherence was associated with smoking (ORmoderate = 0.68, 95% CI = 0.50-0.92, and ORhigh = 0.30, 95% CI = 0.21-0.44) and diagnosis of germ cell tumor (ORmoderate = 0.58, 95% CI = 0.39-0.86, and ORhigh = 0.45, 95% CI = 0.30-0.69). CONCLUSIONS Adherence to the 2018 WCRF/AICR lifestyle recommendations was low to moderate, especially regarding body weight, fruit, vegetables, and alcohol consumption. Men, current smokers, lower-educated participants, and/or those diagnosed with germ cell tumors were less likely to have a healthy lifestyle. IMPLICATIONS FOR CANCER SURVIVORS Health-promotion programs (e.g., age-specific tools) are needed, focusing on high-risk groups.
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Affiliation(s)
- Costanza Gavioli
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, 3511 DT, Utrecht, The Netherlands
| | - Carla Vlooswijk
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, 3511 DT, Utrecht, The Netherlands
| | - Silvie H M Janssen
- Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, 1066 CX, Amsterdam, The Netherlands
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni Van Leeuwenhoek, 1066 CX, Amsterdam, The Netherlands
| | - Suzanne E J Kaal
- Department of Medical Oncology, Radboud University Medical Center, 6525 GA, Nijmegen, The Netherlands
| | - J Martijn Kerst
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni Van Leeuwenhoek, 1066 CX, Amsterdam, The Netherlands
| | - Jacqueline M Tromp
- Department of Medical Oncology, Amsterdam University Medical Center, 1105 AZ, Amsterdam, The Netherlands
| | - Monique E M M Bos
- Department of Medical Oncology, Erasmus MC Cancer Institute, 3015 GD, Rotterdam, The Netherlands
| | - Tom van der Hulle
- Department of Medical Oncology, Leiden University Medical Center, 2333 ZA, Leiden, The Netherlands
| | - Winette T A van der Graaf
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni Van Leeuwenhoek, 1066 CX, Amsterdam, The Netherlands
- Department of Medical Oncology, Erasmus MC Cancer Institute, 3015 GD, Rotterdam, The Netherlands
| | - Roy I Lalisang
- Department of Internal Medicine, GROW-School of Oncology and Reproduction, Maastricht UMC+ Comprehensive Cancer Center, 6229 HX, Maastricht, The Netherlands
| | - Janine Nuver
- Department of Medical Oncology, University Medical Center Groningen, 9713 GZ, Groningen, The Netherlands
| | - Rhodé M Bijlsma
- Department of Medical Oncology, University Medical Center Utrecht, 3584 CX, Utrecht, The Netherlands
| | - Mathilde C M Kouwenhoven
- Department of Neurology, Amsterdam UMC, Amsterdam University Medical Centers, Location VUmc, 1081 HV, Amsterdam, The Netherlands
| | - Olga Husson
- Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, 1066 CX, Amsterdam, The Netherlands.
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni Van Leeuwenhoek, 1066 CX, Amsterdam, The Netherlands.
- Department of Surgical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, 3015 GD, Rotterdam, The Netherlands.
| | - Sandra Beijer
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, 3511 DT, Utrecht, The Netherlands
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van Cappellen-van Maldegem SJM, Mols F, Seidell JC, de Kruif A, van de Poll-Franse LV, Hoedjes M. Using the Behavior Change Wheel to Identify and Understand Key Facilitators and Barriers for Lifestyle Care for Postmenopausal Breast Cancer Survivors: A Delphi-Study. Ann Behav Med 2024; 58:22-36. [PMID: 37672352 PMCID: PMC10729788 DOI: 10.1093/abm/kaad049] [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] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND Optimal approaches to promote sustained adherence to lifestyle and bodyweight recommendations in postmenopausal breast cancer (PMBC) survivors are lacking. PURPOSE This Delphi-study aims to identify and understand expert-opinion on potential barriers and facilitators for promoting adherence to these lifestyle and bodyweight recommendations in (clinical) care for PMBC survivors, and to determine potential effective intervention strategies. METHODS The expert panel consisted of oncology Health Care Professionals (HCPs) (N = 57), patient advocates (N = 5), and PMBC survivors (N = 38). They completed three questionnaires: Q1-idea generation; Q2-validation and prioritization; Q3-ranking. The Behavior Change Wheel was used as theoretical framework for analysis. Thematic analysis was applied to identify key overarching themes based on the top-ranked facilitators and barriers. Potential Behavior Change Techniques (BCTs) and intervention strategies were identified using the Behavior Change Technique Taxonomy version 1 and the Behavior Change Wheel. RESULTS Eleven core categories of key barriers/facilitators for the promotion of adherence to recommendations for lifestyle and bodyweight among PMBC survivors were identified. For each core category, relevant BCTs and practical potential intervention strategies were selected based on suggestions from the expert panel. These included: increasing knowledge about the link between lifestyle and cancer; enabling self-monitoring of lifestyle behaviors followed by evaluation; offering group lifestyle counseling for PMBC survivors, enhancing social support for favorable lifestyle behaviors; and stimulating multidisciplinary collaboration among HCPs. CONCLUSIONS Findings provide valuable insight for the development of interventions changing behavior of PMBC survivors and HCPs toward increased healthy lifestyle (support) behavior.
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Affiliation(s)
- Sandra J M van Cappellen-van Maldegem
- Center of Research on Psychological Disorders and Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Floortje Mols
- Center of Research on Psychological Disorders and Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
- Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Jacob C Seidell
- Department of Health Sciences, VU University Amsterdam, and Amsterdam Public Health (APH), Amsterdam, The Netherlands
| | - Anja de Kruif
- Department of Epidemiology and Biostatistics, Amsterdam Public Health (APH), VUmc, Amsterdam, The Netherlands
- Department of Nutrition, Dietetics and Lifestyle, School of Allied Health, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Lonneke V van de Poll-Franse
- Center of Research on Psychological Disorders and Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
- Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Meeke Hoedjes
- Center of Research on Psychological Disorders and Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
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Ahmed Shaker Hegian Z, Moh'd Abu Tahoun L, Ramli RM, Noor Azman NZ. The relationship between mean glandular dose and compressed breast thickness specified for Jordan. RADIATION PROTECTION DOSIMETRY 2023; 200:25-31. [PMID: 37738470 DOI: 10.1093/rpd/ncad259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 08/16/2023] [Accepted: 08/28/2023] [Indexed: 09/24/2023]
Abstract
The mean glandular dose (MGD) is a measurement used in mammography to assess the amount of radiation absorbed. By considering specific exposure radiation dose criteria, MGD ensures minimal radiation while maintaining image quality for detecting abnormalities. The relationship between MGD and compressed breast thickness (CBT) is commonly utilized in mammographic dose surveys. This study aims to estimate the MGD-CBT relationship based on patient age in Jordan through retrospective analysis. The analysis involved 3465 screening mammography images of women aged 40-80, divided into three age groups: 40-49, 50-64 and 65-80 years. Each group had a specific CBT range (16.5-156 mm). The results indicate that MGD ranges from 1.6 to 1.7 mGy across all three age groups, independent of CBT. Thus, a significant and positive correlation exists between MGD and CBT in all age groups.
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Affiliation(s)
- Zeinab Ahmed Shaker Hegian
- School of Physics, Universiti Sains Malaysia, Penang 11800 Minden, Malaysia
- Breast Imaging Unit, King Hussein Cancer Center (KHCC), 11831 Amman, Jordan
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Kennedy F, Lally P, Miller NE, Conway RE, Roberts A, Croker H, Fisher A, Beeken RJ. Fatigue, quality of life and associations with adherence to the World Cancer Research Fund guidelines for health behaviours in 5835 adults living with and beyond breast, prostate and colorectal cancer in England: A cross-sectional study. Cancer Med 2023; 12:12705-12716. [PMID: 37021752 PMCID: PMC10278485 DOI: 10.1002/cam4.5899] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 03/06/2023] [Accepted: 03/23/2023] [Indexed: 04/07/2023] Open
Abstract
BACKGROUND Many individuals living with and beyond cancer (LWBC) have ongoing quality of life (QoL) issues, including fatigue. The World Cancer Research Fund (WCRF) provides health behaviour recommendations for people LWBC, and there is some evidence linking adherence to these with improved QoL. METHODS Adults LWBC (specifically breast, colorectal or prostate cancer) completed a survey covering health behaviours (diet, physical activity, alcohol consumption and smoking), fatigue (FACIT-Fatigue Scale, version 4) and a broad measure of QoL (EQ-5D-5L descriptive scale). Participants were categorised as meeting/not meeting WCRF recommendations, using the following cut-offs classified as meeting the guidelines: ≥150 min physical activity/week, fruit and vegetables (≥5 portions/day), fibre (≥30 g fibre per day), free sugar (<5% of total calories from free sugar), fat (<33% total energy), red meat (<500 g/week), processed meat (none), alcohol consumption (<14 units/week) and not a current smoker. Logistic regression analyses explored associations between WCRF adherence and fatigue and QoL issues, controlling for demographic and clinical variables. RESULTS Among 5835 individuals LWBC (mean age: 67 years, 56% female, 90% white, breast 48%, prostate 32% and colorectal 21%), 22% had severe fatigue and 72% had 1+ issue/s on the EQ-5D-5L. Adhering to physical activity recommendations (odds ratio [OR] = 0.88, confidence interval [CI] = 0.77-0.99), meeting various dietary recommendations (fruit and vegetables OR = 0.79; CI = 0.68-0.91, free sugar OR = 0.85; CI = 0.76-0.96, fat OR = 0.71; CI = 0.62-0.82, red meat OR = 0.65; CI = 0.50-0.85) and not smoking (OR = 0.53, CI = 0.41-0.67) were associated with decreased odds of experiencing severe fatigue. Adhering to physical activity guidelines (OR = 0.71, CI = 0.62-0.82) was also associated with decreased odds of having 1+ QoL issue/s. CONCLUSIONS Adherence to various WCRF recommendations, particularly the recommendation for physical activity, was associated with less fatigue and better QoL in a large UK cohort of people living with and beyond breast, colorectal or prostate cancer. Multi-component interventions designed to support people LWBC to improve health behaviours, in line with the levels recommended by the WCRF, may also improve QoL.
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Affiliation(s)
- Fiona Kennedy
- Leeds Institute of Health Sciences, University of LeedsClarendon WayLeedsLS2 9NLUK
| | - Phillippa Lally
- Department of PsychologyUniversity of SurreyGuildfordSurreyGU2 7XHUK
| | - Natalie Ella Miller
- Behavioural Science and HealthUniversity College LondonGower StreetLondonWC1E 6BTUK
| | - Rana E. Conway
- Behavioural Science and HealthUniversity College LondonGower StreetLondonWC1E 6BTUK
| | - Anna Roberts
- Behavioural Science and HealthUniversity College LondonGower StreetLondonWC1E 6BTUK
| | - Helen Croker
- World Cancer Research Fund International140 Pentonville RoadLondonN1 9FWUK
| | - Abigail Fisher
- Behavioural Science and HealthUniversity College LondonGower StreetLondonWC1E 6BTUK
| | - Rebecca J. Beeken
- Leeds Institute of Health Sciences, University of LeedsClarendon WayLeedsLS2 9NLUK
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Vegunta S, Kuhle CL, Vencill JA, Lucas PH, Mussallem DM. Sexual Health after a Breast Cancer Diagnosis: Addressing a Forgotten Aspect of Survivorship. J Clin Med 2022; 11:6723. [PMID: 36431200 PMCID: PMC9698007 DOI: 10.3390/jcm11226723] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 10/12/2022] [Accepted: 11/02/2022] [Indexed: 11/16/2022] Open
Abstract
Breast cancer is the most common cancer in women. The life expectancy after a breast cancer diagnosis is improving steadily, leaving many more persons with the long-term consequences of treatment. Sexual problems are a common concern for breast cancer survivors yet remain overlooked in both the clinical setting and the research literature. Factors that contribute to sexual health concerns in breast cancer survivors are biopsychosocial, as are the barriers to addressing and treating these health concerns. Sexual health needs and treatment may vary by anatomy and gender. Multidisciplinary management may comprise lifestyle modifications, medications, sexual health aids such as vibrators, counseling, and referrals to pelvic health physical therapy and specialty care. In this article, we review the contributing factors, screening, and management of sexual difficulties in cisgender female breast cancer survivors. More information is needed to better address the sexual health of breast cancer survivors whose sexual/gender identity differs from that of cisgender women.
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Affiliation(s)
- Suneela Vegunta
- Division of Women’s Health Internal Medicine, Mayo Clinic, 13400 Shea Blvd, Scottsdale, AZ 85259, USA
| | - Carol L. Kuhle
- Menopause and Women’s Sexaul Health Clinic, Mayo Clinic, Rochester, MN 55905, USA
| | - Jennifer A. Vencill
- Menopause and Women’s Sexaul Health Clinic, Mayo Clinic, Rochester, MN 55905, USA
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA
| | - Pauline H. Lucas
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Scottsdale, AZ 85259, USA
| | - Dawn M. Mussallem
- Jacoby Center for Breast Health, Mayo Clinic, Jacksonville, FL 32224, USA
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8
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Combined lifestyle, mental health, and mortality in US cancer survivors: a national cohort study. J Transl Med 2022; 20:376. [PMID: 35986290 PMCID: PMC9389483 DOI: 10.1186/s12967-022-03584-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 08/10/2022] [Indexed: 12/02/2022] Open
Abstract
Background Adopting healthy lifestyles and staying mentally health are two cost-effective modifiable strategies that cancer survivors can implement in self-management. We aimed to evaluate the independent, mediation, interaction, and joint associations of combined lifestyle and mental health with mortality in cancer survivors. Methods We performed a cohort study including 3145 cancer survivors from National Health and Nutrition Examination Survey (2005–2018). A healthy lifestyle score was constructed based on post-diagnosis body mass index, physical activity, diet, smoking, and drinking. Post-diagnosis mental health was assessed by Patient Health Questionnaire (PHQ-9). Hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause, cancer, and non-cancer mortality were computed using Cox proportional hazards regression models. Results After 20,900 person-years of follow-up (median, 6.3 years), cancer survivors with higher lifestyle score had decreased mortality, independent of mental health. Compared to participants with lower lifestyle score (0–1), HRs (95% CIs) for all-cause and non-cancer mortality among those with higher lifestyle score (3–5) were 0.68 (0.52–0.89) and 0.69 (0.56–0.85), respectively. 6.2–10.3% of the associations were mediated by mental health. Similar trends were observed among participants categorized by mental health, those with better mental health had lower mortality, independent of lifestyle. Participants with better mental health benefited more from adopting healthy lifestyles, and vice versa. Combinations of higher healthy lifestyle score and better mental health were associated with significant decreased mortality, the lowest mortality was seen in participants with highest healthy lifestyle score and concurrently with best mental health. Conclusions For the first time, in this cohort study with a nationally representative sample of US cancer survivors, we comprehensively explored the complex associations of lifestyle, mental health, and mortality. Evidence derived from this study may give much confidence to cancer survivors and healthcare providers that, changing one’s lifestyle and/or staying mentally healthy after cancer diagnosis can improve survival. Supplementary Information The online version contains supplementary material available at 10.1186/s12967-022-03584-4.
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Psychosocial Determinants of Lifestyle Change after a Cancer Diagnosis: A Systematic Review of the Literature. Cancers (Basel) 2022; 14:cancers14082026. [PMID: 35454932 PMCID: PMC9032592 DOI: 10.3390/cancers14082026] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 03/28/2022] [Accepted: 04/07/2022] [Indexed: 11/25/2022] Open
Abstract
Simple Summary Although cancer survivors may experience health benefits from favorable lifestyle changes, many cancer survivors do not adhere to lifestyle recommendations or make favorable lifestyle changes after cancer diagnosis. This systematic review of the literature aimed to provide an overview of the scientific literature on sociodemographic, psychological and social determinants that may facilitate or hamper lifestyle change after the diagnosis cancer. It provides a structured overview of the large variety of determinants of changes in different lifestyle behaviors (physical activity, diet, smoking, alcohol, sun protection, and multiple lifestyle behaviors) derived from the 123 included papers (71 quantitative and 52 qualitative). Findings demonstrate the important role of oncology healthcare professionals in promoting healthy lifestyle changes in cancer survivors and inform researchers and healthcare professionals about the methods and strategies they can use to promote healthy lifestyle changes in cancer survivors. Abstract The aim of this study is to provide a systematic overview of the scientific literature on sociodemographic, psychological and social determinants that may facilitate or hamper lifestyle change after the diagnosis cancer. Four databases (PubMed, PsychINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science) were searched for relevant papers up to October 2021. Of the 9586 references yielded by the literature search, 123 papers were included: 71 quantitative and 52 qualitative papers. Findings showed a large variety of determinants influencing lifestyle change after cancer diagnosis, with differences between lifestyle behaviors (physical activity, diet, smoking, alcohol, sun protection, and multiple lifestyle behaviors) and findings from quantitative vs. qualitative studies. Findings demonstrate the important role of oncology healthcare professionals in promoting healthy lifestyle changes in cancer survivors. In addition, findings inform researchers involved in the development of health promotion programs about the methods and strategies they can use to promote healthy lifestyle changes in cancer survivors. Favorable lifestyle changes are expected to have beneficial effects on cancer risk and overall health in cancer survivors.
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10
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Danko A, Naughton M, Spees C, Bittoni AM, Krok-Schoen JL. Diet Quality and the Number of Comorbidities Are Associated with General Health Among Older Female Cancer Survivors. J Aging Health 2021; 33:908-918. [PMID: 34814773 DOI: 10.1177/08982643211018923] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Objective: We aimed to investigate the associations between diet quality, general health, and comorbidities among older female cancer survivors. Methods: Participants (n = 171) completed one-time surveys to assess health-related quality of life (RAND-36), diet quality (Healthy Eating Index (HEI-2015)), and number of comorbidities. Additional demographic and clinical variables were collected. Descriptive statistics, analysis of covariance, correlations, and linear regressions were utilized. Results: A positive correlation was found between HEI-2015 and general health subscale scores (r = .26, p = .002). A negative correlation was found between the number of comorbidities and general health (r = -.21, p = .02). Being white (β = -.24, p = .02) and having fewer comorbidities (β = -.22, p = .04) were significantly associated with higher general health. Being unmarried (β = .24, p = .02) and having higher education (β = .32, p = .002) were significantly associated with higher HEI-2015 scores. Discussion: Healthcare providers should seek guidance from registered dietitian nutritionists for nutritional education to promote optimal nutritional status, thus contributing to improved general health among this growing population.
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Affiliation(s)
- Allison Danko
- Division of Medical Dietetics and Health Sciences, School of Health and Rehabilitation Sciences, 51121Ohio State University, Columbus, OH, USA
| | - Michelle Naughton
- 549472The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA.,Department of Internal Medicine, College of Medicine, 24600Ohio State University, Columbus, OH, USA
| | - Colleen Spees
- Division of Medical Dietetics and Health Sciences, School of Health and Rehabilitation Sciences, 51121Ohio State University, Columbus, OH, USA.,549472The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Anna Maria Bittoni
- 549472The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Jessica L Krok-Schoen
- Division of Medical Dietetics and Health Sciences, School of Health and Rehabilitation Sciences, 51121Ohio State University, Columbus, OH, USA.,549472The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
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11
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Kiew SJ, Majid HA, Mohd Taib NA. A qualitative exploration: Dietary behaviour of Malaysian breast cancer survivors. Eur J Cancer Care (Engl) 2021; 31:e13530. [PMID: 34693588 DOI: 10.1111/ecc.13530] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 09/22/2021] [Accepted: 10/04/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVE This study aimed to explore the dietary practices and factors affecting Malaysian breast cancer survivors' dietary behaviours. METHODS We conducted an in-depth qualitative interview on 20 participants from a cohort study. An ecological framework was used to construct the semi-structured topic guide. The interviews were audio-recorded and transcribed verbatim. Thematic analysis with theoretical saturation was used in data analysis. RESULTS The participants were found to have variable dietary practices that either followed or did not follow dietary recommendations. The social environment was critical as most women relied on family and friends for food choices; additionally, individuals in charge of food preparation had to prepare food based on their family member preferences. Furthermore, individuals had difficulty sustaining healthy dietary changes during the acute survivorship phase due to a lack of health consciousness and difficulty in healthy food access. Notably, there was a lack of dietary guidance from health care professionals, especially dietitians, in long-term survivorship care. CONCLUSION This study highlights the lack of breast cancer survivors' healthy diet and lifestyle knowledge. A holistic multidisciplinary approach involving individual, social, physical, and macro-level environmental elements are crucial to influencing healthy eating behaviours.
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Affiliation(s)
- Siew Juan Kiew
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Hazreen Abdul Majid
- Centre for Population Health and Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Department of Nutrition, Faculty of Public Health, University of Airlangga, Surabaya, Indonesia
| | - Nur Aishah Mohd Taib
- UM Cancer Research Institute and Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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12
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Sanft T, Harrigan M, Cartmel B, Ferrucci LM, Li FY, McGowan C, Zupa M, Nguyen TH, Ligibel J, Neuhouser ML, Hershman DL, Basen-Engquist K, Jones B, Knobf T, Chagpar A, Silber A, Irwin ML. Effect of healthy diet and exercise on chemotherapy completion rate in women with breast cancer: The Lifestyle, Exercise and Nutrition Early after Diagnosis (LEANer) study: Study protocol for a randomized clinical trial. Contemp Clin Trials 2021; 109:106508. [PMID: 34274495 PMCID: PMC10424280 DOI: 10.1016/j.cct.2021.106508] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 07/02/2021] [Accepted: 07/12/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND The World Cancer Research Fund and the American Cancer Society provide nutrition and physical activity guidelines for cancer survivors. Many women with breast cancer do not follow these guidelines and delay efforts toward following them until active treatment is complete. However, adoption of these recommended lifestyle behaviors soon after diagnosis may prevent adverse treatment-related side effects and may improve adherence to treatment, resulting in improved breast cancer prognosis. The Lifestyle, Exercise, and Nutrition Early after Diagnosis (LEANer) study is testing the effect of a nutrition and physical activity intervention on chemotherapy completion rates. METHODS 172 women with stage I-III breast cancer undergoing chemotherapy will be randomized 1:1 to a yearlong, 16 session, nutrition and exercise intervention or usual care control group. The intervention is delivered by registered dietitians specializing in oncology nutrition and exercise training. The intervention includes goal setting to meet nutrition and physical activity guidelines for cancer survivors. After each chemotherapy session, date and dose of each drug administered, and reason for dose-adjustments and/or dose-delays are abstracted from the electronic medical record or obtained from the treating oncologist. Chemotherapy completion rate is assessed as the average relative dose-intensity (RDI) for the originally planned regimen based on standard formulas. Secondary endpoints of endocrine therapy adherence, treatment-related side effects, and changes in inflammatory and metabolic biomarkers, body composition, and patient reported outcomes are assessed at four timepoints. DISCUSSION If successful, this study has the potential to make healthy lifestyle interventions a standard component of breast cancer treatment.
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Affiliation(s)
- Tara Sanft
- Yale University School of Medicine, New Haven, CT, United States of America; Yale Cancer Center, New Haven, CT, United States of America.
| | - Maura Harrigan
- Yale University School of Public Health, New Haven, CT, United States of America.
| | - Brenda Cartmel
- Yale University School of Public Health, New Haven, CT, United States of America; Yale Cancer Center, New Haven, CT, United States of America.
| | - Leah M Ferrucci
- Yale University School of Public Health, New Haven, CT, United States of America; Yale Cancer Center, New Haven, CT, United States of America.
| | - Fang-Yong Li
- Yale University School of Public Health, New Haven, CT, United States of America.
| | - Courtney McGowan
- Yale University School of Public Health, New Haven, CT, United States of America.
| | - Michelle Zupa
- Yale University School of Public Health, New Haven, CT, United States of America.
| | - Thai Hien Nguyen
- Yale University School of Public Health, New Haven, CT, United States of America.
| | - Jennifer Ligibel
- Dana-Farber Cancer Institute, Boston, MA, United States of America.
| | - Marian L Neuhouser
- Fred Hutchinson Cancer Research Center, Seattle, WA, United States of America.
| | - Dawn L Hershman
- Columbia University Medical Center, New York, NY, United States of America.
| | - Karen Basen-Engquist
- The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America.
| | - Beth Jones
- Yale University School of Public Health, New Haven, CT, United States of America; Yale Cancer Center, New Haven, CT, United States of America.
| | - Tish Knobf
- Yale Cancer Center, New Haven, CT, United States of America; Yale School of Nursing, New Haven, CT, United States of America.
| | - Anees Chagpar
- Yale University School of Medicine, New Haven, CT, United States of America; Yale Cancer Center, New Haven, CT, United States of America.
| | - Andrea Silber
- Yale University School of Medicine, New Haven, CT, United States of America; Yale Cancer Center, New Haven, CT, United States of America.
| | - Melinda L Irwin
- Yale University School of Public Health, New Haven, CT, United States of America; Yale Cancer Center, New Haven, CT, United States of America.
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13
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van Cappellen-van Maldegem SJM, Mols F, Horevoorts N, de Kruif A, Buffart LM, Schoormans D, Trompetter H, Beijer S, Ezendam NPM, de Boer M, Winkels R, Kampman E, Schuit J, van de Poll-Franse L, Seidell JC, Hoedjes M. Towards OPtimal TIming and Method for promoting sUstained adherence to lifestyle and body weight recommendations in postMenopausal breast cancer survivors (the OPTIMUM-study): protocol for a longitudinal mixed-method study. BMC WOMENS HEALTH 2021; 21:268. [PMID: 34229690 PMCID: PMC8258491 DOI: 10.1186/s12905-021-01406-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 06/30/2021] [Indexed: 11/10/2022]
Abstract
Background The majority of postmenopausal breast cancer (PMBC) survivors do not adhere to lifestyle recommendations and have excess body weight. In this group, this is associated with poorer health-related quality of life and an increased risk of type II diabetes mellitus, cardiovascular disease, second primary cancers, cancer recurrences, and mortality. Gaining and maintaining a healthy lifestyle and body composition is therefore important. It is unknown when and how sustained adherence to these recommendations can be promoted optimally in PMBC survivors. Therefore, the OPTIMUM study aims to identify the optimal timing and method for promoting sustained adherence to lifestyle and body weight recommendations in PMBC survivors.
Methods The OPTIMUM-study has a mixed-methods design. To assess optimal timing, a longitudinal observational study will be conducted among approximately 1000 PMBC survivors. The primary outcomes are adherence to lifestyle and body weight recommendations, readiness for change, and need for support. Questionnaires will be administered at 4–6 months after cancer diagnosis (wave 1: during treatment and retrospectively before diagnosis), 1 year after diagnosis (wave 2: after completion of initial treatment), and 1.5 years after diagnosis (wave 3: during follow-up). Wave 2 and 3 include blood sampling, and either wearing an accelerometer for 7 days or completing a 3-day online food diary (randomly assigned at hospital level). To assess the optimal method, behavioural determinants of the primary outcomes will be matched with Behavior Change Techniques using the Behaviour Change Technique Taxonomy. Qualitative research methods will be used to explore perceptions, needs and preferences of PMBC survivors (semi-structured interviews, focus groups) and health care providers (Delphi study). Topics include perceptions on optimal timing to promote adherence; facilitators and motivators of, and barriers towards (sustained) adherence to recommendations; and acceptability of the selected methods. Discussion The OPTIMUM study aims to gain scientific knowledge on when and how to promote sustained adherence to lifestyle and body weight recommendations among PBMC survivors. This knowledge can be incorporated into guidelines for tailored promotion in clinical practice to improve health outcomes.
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Affiliation(s)
- Sandra J M van Cappellen-van Maldegem
- CoRPS - Center of Research On Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, 5000 LE, Tilburg, the Netherlands
| | - Floortje Mols
- CoRPS - Center of Research On Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, 5000 LE, Tilburg, the Netherlands.,Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands
| | - Nicole Horevoorts
- CoRPS - Center of Research On Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, 5000 LE, Tilburg, the Netherlands.,Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands
| | - Anja de Kruif
- Department of Epidemiology and Biostatistics, Amsterdam Public Health (APH), VUmc, Amsterdam, the Netherlands.,Department of Nutrition, Dietetics and Lifestyle, School of Allied Health, HAN University of Applied Sciences, Nijmegen, the Netherlands
| | - Laurien M Buffart
- Radboudumc, Department of Physiology, Radboud Institute for Health Sciences, Nijmegen, the Netherlands
| | - Dounya Schoormans
- CoRPS - Center of Research On Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, 5000 LE, Tilburg, the Netherlands
| | - Hester Trompetter
- CoRPS - Center of Research On Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, 5000 LE, Tilburg, the Netherlands
| | - Sandra Beijer
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands
| | - Nicole P M Ezendam
- CoRPS - Center of Research On Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, 5000 LE, Tilburg, the Netherlands.,Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands
| | - Michiel de Boer
- Department of Health Sciences and the Amsterdam Public Health Research Institute, VU University Amsterdam, Amsterdam, the Netherlands.,Department of General Practice and Elderly Care Medicine, UMCG, Groningen, the Netherlands
| | - Renate Winkels
- Division of Human Nutrition and Health, Wageningen University, Wageningen, the Netherlands
| | - Ellen Kampman
- Division of Human Nutrition and Health, Wageningen University, Wageningen, the Netherlands
| | - Jantine Schuit
- CoRPS - Center of Research On Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, 5000 LE, Tilburg, the Netherlands
| | - Lonneke van de Poll-Franse
- CoRPS - Center of Research On Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, 5000 LE, Tilburg, the Netherlands.,Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands.,Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Jacob C Seidell
- Department of Health Sciences and the Amsterdam Public Health Research Institute, VU University Amsterdam, Amsterdam, the Netherlands
| | - Meeke Hoedjes
- CoRPS - Center of Research On Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, 5000 LE, Tilburg, the Netherlands.
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Flora PK, Lopez P, Mina DS, Jones JM, Brawley LR, Sabiston CM, Ferguson SE, Obadia MM, Auger LE. Feasibility and acceptability of a group-mediated exercise intervention for gynecological cancer survivors. J Psychosoc Oncol 2021; 40:770-789. [PMID: 34185628 DOI: 10.1080/07347332.2021.1939474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE Examine feasibility and acceptability of a group-mediated cognitive-behavioral (GMCB) intervention targeting planned, self-managed physical activity (PA). DESIGN Sequential mixed methods, single arm pre-/post-test design with a 4-week follow-up. PARTICIPANTS Post-treatment gynecologic cancer survivors. METHODS Participants attended 8 weekly facilitator-led group sessions and completed assessments at baseline, post-intervention and follow-up. Feasibility was assessed by recruitment rate, retention rate, capture of outcomes, intervention usability and intervention fidelity. Acceptability was examined via qualitative interviews. Preliminary estimates of intervention effectiveness (PA, PA social cognitions and sleep) were collected. FINDINGS 355 participants were approached and 38 consented. Twenty took part in the study and 17 (85%) completed the intervention. Thematic content analysis revealed positive group experiences. Cognitive-behavioral strategies were beneficial. Goal-setting and shared cancer recovery experience facilitated connection among group members. IMPLICATIONS Program acceptability was high among a diverse sample of gynecologic cancer survivors and delivery of the program is feasible to this group of gynecologic cancer survivors. Recruitment challenges were present but study retention was high.
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Affiliation(s)
- Parminder K Flora
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Paty Lopez
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.,Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
| | - Daniel Santa Mina
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
| | - Jennifer M Jones
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | | | - Catherine M Sabiston
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
| | - Sarah E Ferguson
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.,Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Toronto, Toronto, Canada
| | - Maya M Obadia
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.,Kinesiology, University of Guelph-Humber, Toronto, Canada
| | - Leslie E Auger
- Kinesiology, University of Guelph-Humber, Toronto, Canada
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15
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Barlow KH, van der Pols JC, Ekberg S, Johnston EA. Cancer survivors' perspectives of dietary information provision after cancer treatment: A scoping review of the Australian context. Health Promot J Austr 2021; 33:232-244. [PMID: 33890348 DOI: 10.1002/hpja.496] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 04/16/2021] [Indexed: 01/25/2023] Open
Abstract
ISSUE ADDRESSED To support survivor-centred care in Australia, this review maps current knowledge regarding adult cancer survivors' perspectives of dietary information provision post-treatment. METHODS A scoping review of research conducted in Australia within the past decade reported using PRISMA-ScR guidelines. Seven databases were searched (01/01/2009-05/06/2020) and records were independently screened by two researchers using eligibility criteria. Papers in the peer-reviewed literature with dietary information post-treatment as a primary and secondary outcome were eligible for inclusion. Data charting included participant characteristics, study methodology and cancer survivors' reports of dietary information provision post-treatment. RESULTS Of 531 records identified, 12 met eligibility criteria. Most studies included breast (58%) and colorectal (42%) cancer survivors within 5 years post-diagnosis (84%). Three studies were conducted amongst specific ethnic groups (Indigenous Australians, Chinese-Australians, Greek-Australians). Participants in the included studies commonly reported limited or ineffective dietary information from healthcare providers post-treatment. Cancer survivors identified a need for individualised information regarding dietary strategies to manage ongoing symptoms, professional support for weight management, and practical skills for healthy eating. Amongst ethnic groups, there was a need for dietary information that considers traditional foods and cultural beliefs, and is available in their native language. Cancer survivors valued ongoing dietary follow-up and support post-treatment, and suggested a variety of face-to-face and online delivery modes. Those residing in rural and remote areas reported barriers to accessing dietary information post-treatment including time, cost, and availability of local services. CONCLUSIONS There is scope to improve dietary information provision after cancer treatment in Australia. SO WHAT?: Dietary guidance post-treatment should consider individual needs, cultural background, and opportunity for ongoing follow-up and support.
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Affiliation(s)
- Katherine H Barlow
- Faculty of Health, School of Exercise and Nutrition Sciences, Queensland University of Technology (QUT), Brisbane, Australia
| | - Jolieke C van der Pols
- Faculty of Health, School of Exercise and Nutrition Sciences, Queensland University of Technology (QUT), Brisbane, Australia
| | - Stuart Ekberg
- Faculty of Health, School of Psychology and Counselling, Queensland University of Technology (QUT), Brisbane, Australia
| | - Elizabeth A Johnston
- Faculty of Health, School of Exercise and Nutrition Sciences, Queensland University of Technology (QUT), Brisbane, Australia
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Taborelli M, Dal Maso L, Zucchetto A, Lamaj E, De Paoli P, Carbone A, Serraino D. Prevalence and determinants of quitting smoking after cancer diagnosis: a prospective cohort study. TUMORI JOURNAL 2021; 108:213-222. [PMID: 33876985 DOI: 10.1177/03008916211009301] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To describe smoking behaviours of patients with incident cancer attending an Italian cancer centre and to examine changes in their smoking habits within 12 months from cancer diagnosis, evaluating determinants of smoking cessation. METHODS A hospital-based prospective cohort included patients hospitalized in an Italian cancer centre (2016-2018). Patients were mostly female (74%) and included a limited proportion of aerodigestive cancers (7%). Face-to-face interviews were performed during hospital stay to gather information on patient characteristics and smoking history. Changes in smoking habits were assessed through telephone interviews at 3, at 6, and at 12 months after cancer diagnosis. RESULTS Among 1011 enrolled patients, 222 (22%) were current smokers at cancer diagnosis. Smoking prevalence was high in male patients (30%), in patients <50 years old (28%), in those with aerodigestive cancers (50%), and in those diagnosed at advanced stages (26%). Among current smokers at cancer diagnosis, 38% quit smoking after 12 months, 26% reduced intensity, and 36% did not modify smoking habits. Smoking cessation was associated with chemotherapy and, although not statistically significant, with female sex, older age, and advanced cancer stage. Patients with gastrointestinal, breast, or genitourinary cancer and those treated with surgery were less likely to quit smoking. CONCLUSIONS Our results highlighted that 62% of smoking patients with cancer did not quit the habit. Smoking cessation programs targeted to patients with cancer need intensification, particularly for those who may underestimate smoking effects after diagnosis.
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Affiliation(s)
- Martina Taborelli
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Luigino Dal Maso
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Antonella Zucchetto
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Elda Lamaj
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | | | - Antonino Carbone
- Scientific Directorate, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Diego Serraino
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
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Johnston EA, Ibiebele TI, van der Pols JC, Webb PM. Dietitian encounters after treatment for ovarian cancer. J Hum Nutr Diet 2021; 34:1053-1063. [PMID: 33749900 DOI: 10.1111/jhn.12898] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 03/11/2021] [Accepted: 03/17/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND After ovarian cancer treatment, women report health issues that may be amenable to change with dietary support. The present study investigated how many women encounter a dietitian post-treatment and the factors associated with dietitian service use. METHODS We used data from a cohort of women with invasive epithelial ovarian cancer to identify socio-economic, clinical and personal factors associated with dietitian encounter after treatment completion. Data were collected at regular intervals using validated questionnaires up to 4 years post-treatment completion. Logistic regression (LR) and generalised linear mixed models (GLMM) were used to calculate adjusted odds ratios (OR) and 95% confidence intervals (CI) to assess factors associated with dietitian encounter at any time-point post-treatment (LR), as well as in the 3 months prior to a follow-up questionnaire (GLMM) to assess time-varying factors. RESULTS Of 819 women, 97 (12%) reported seeing a dietitian post-treatment. Factors associated with dietitian encounter were being overweight (ORLR = 1.7, CI = 1.1-2.8), having poorer self-rated health (ORLR = 2.5, CI = 1.2-5.2; ORGLMM = 2.3, CI = 1.2-4.4) or poorer diet quality (ORLR = 0.5, CI = 0.2-1.0) pre-diagnosis, treatment within the public health system (ORGLMM = 1.8, CI = 1.2-2.7), previous support from dietetic (ORLR = 3.1, CI = 1.8-5.4; ORGLMM = 2.8, CI = 1.8-4.2) or other allied health services (ORLR = 2.0, CI = 1.2-3.2; ORGLMM = 3.7, CI = 2.4-5.5), and having progressive disease at follow-up (ORGLMM = 2.2, CI = 1.4-3.3). Most women (86%) with ≥ 3 moderate-to-severe nutrition impact symptoms did not report a dietitian encounter post-treatment. CONCLUSIONS Few women encounter a dietitian post-treatment for ovarian cancer, including those with multiple nutrition impact symptoms. Further work is needed to engage those likely to benefit from dietitian support but less likely to seek or receive it.
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Affiliation(s)
- Elizabeth A Johnston
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.,Faculty of Health, School of Exercise and Nutrition Sciences, Queensland University of Technology (QUT), Brisbane, QLD, Australia
| | - Torukiri I Ibiebele
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Jolieke C van der Pols
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.,Faculty of Health, School of Exercise and Nutrition Sciences, Queensland University of Technology (QUT), Brisbane, QLD, Australia
| | - Penelope M Webb
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
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Quality of Life in Women Diagnosed with Breast Cancer after a 12-Month Treatment of Lifestyle Modifications. Nutrients 2020; 13:nu13010136. [PMID: 33396551 PMCID: PMC7824271 DOI: 10.3390/nu13010136] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 12/28/2020] [Accepted: 12/30/2020] [Indexed: 12/11/2022] Open
Abstract
Healthy lifestyles are associated with better health-related quality of life (HRQoL), favorable prognosis and lower mortality in breast cancer (BC) survivors. We investigated changes in HRQoL after a 12-month lifestyle modification program in 227 BC survivors participating in DEDiCa trial (Mediterranean diet, exercise, vitamin D). HRQoL was evaluated through validated questionnaires: EQ-5D-3L, EORTC-QLQ-C30 and EORTC QLQ-BR23. Baseline changes were tested using analysis of variance. Multiple regression analyses were performed to assess treatment effects on HRQoL. Increases were observed in global health status (p < 0.001), physical (p = 0.003), role (p = 0.002) and social functioning (p < 0.001), body image (p < 0.001), future perspective (p < 0.001), well-being (p = 0.001), and reductions in fatigue (p < 0.001), nausea and vomiting (p = 0.015), dyspnea (p = 0.001), constipation (p = 0.049), financial problems (p = 0.012), sexual functioning (p = 0.025), systematic therapy side effects (p < 0.001) and breast symptoms (p = 0.004). Multiple regression analyses found inverse associations between changes in BMI and global health status (p = 0.048) and between serum 25(OH)D levels and breast symptoms (p = 0.002). A healthy lifestyle treatment of traditional Mediterranean diet and exercise may impact positively on HRQoL in BC survivors possibly through reductions in body weight while vitamin D sufficiency may improve BC-related symptoms. These findings are relevant to BC survivors whose lower HRQoL negatively affects treatment compliance and disease outcomes.
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19
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Johnston EA, van der Pols JC, Ekberg S. Needs, preferences, and experiences of adult cancer survivors in accessing dietary information post-treatment: A scoping review. Eur J Cancer Care (Engl) 2020; 30:e13381. [PMID: 33377564 DOI: 10.1111/ecc.13381] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 10/13/2020] [Accepted: 11/18/2020] [Indexed: 01/08/2023]
Abstract
INTRODUCTION To support provision of healthy lifestyle information tailored to patients' needs and preferences, this review maps adult cancer survivors' self-reported needs, preferences, and experiences accessing dietary information post-treatment. METHODS A scoping review of research published within the past decade conducted using PRISMA-ScR guidelines. Seven databases were searched in June 2020. RESULTS Of 15,973 articles identified, 57 met eligibility criteria. Studies most frequently included survivors of breast cancer (49%), persons aged 40+ years (95%), ≤5 years post-diagnosis (54%), and residing in North America (44%). Cancer survivors commonly identified needing information regarding healthy eating, particularly practical skills, and support in changing dietary behaviours. Preferences included specific recommendations, direct communication with healthcare professionals, and peer support from other cancer survivors. In practice, survivors frequently reported receiving generic advice from healthcare professionals, limited dietary follow-up, and lack of referral to support. Unmet needs in healthcare settings led to dietary information-seeking elsewhere; however, survivors indicated difficulty identifying credible sources. Personal beliefs and desire for involvement in care motivated dietary information-seeking post-treatment. CONCLUSION Cancer survivors' experiences accessing dietary information post-treatment do not align with needs and preferences. Less is known about survivors who are young adults, >5 years post-diagnosis, and living in rural areas.
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Affiliation(s)
- Elizabeth A Johnston
- School of Exercise and Nutrition Sciences, Queensland University of Technology (QUT), Kelvin Grove, QLD, Australia
| | - Jolieke C van der Pols
- School of Exercise and Nutrition Sciences, Queensland University of Technology (QUT), Kelvin Grove, QLD, Australia
| | - Stuart Ekberg
- School of Psychology and Counselling, Queensland University of Technology (QUT), Kelvin Grove, QLD, Australia
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20
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Lei YY, Ho SC, Kwok C, Cheng A, Cheung KL, Lee R, Yeo W. Longitudinal changes in sports activity from pre-diagnosis to first five years post-diagnosis: a prospective Chinese breast cancer cohort study. BMC Cancer 2020; 20:1013. [PMID: 33076863 PMCID: PMC7574482 DOI: 10.1186/s12885-020-07517-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 10/09/2020] [Indexed: 02/08/2023] Open
Abstract
Background To compare change in level of physical activity between pre-and post- diagnosis of breast cancer in Chinese women. Methods Based on an on-going prospective study consisting of a sample of Chinese women with breast cancer, a validated modified Chinese Baecke questionnaire was used to measure physical activity at baseline (12 months before cancer diagnosis), 18-, 36- and 60-months after diagnosis (over the previous 12 months before each interview). Results In our cohort of 1462 Chinese women with a mean age of 52 years, the mean level of physical activity at post-diagnosis was 9.6 metabolic equivalent of task (MET)-hours/week, which was significantly higher than that at pre-diagnosis with mean level of 5.9 MET-hours/week (P < 0.001). The mean levels of physical activity at 18-, 36- and 60-months follow-up were 9.9, 9.8 and 9.3 MET-hours/week, respectively. There was no significant difference between any two of the three follow-ups at post-diagnosis. The proportions of participant who met World Cancer Research Fund/ American Institute for Cancer Research (WCRF/AICR) recommendation before and after cancer diagnosis were both low, being 20.7 and 35.1%, respectively. Compared to pre-diagnosis, most of the patients improved or had no change on level of physical activity at post-diagnosis, with the respective proportion being 48.2 and 43.8%. Conclusions Adherence to current lifestyle recommendation for cancer survivors, Chinese women with breast cancer significantly increased level of physical activity level after cancer diagnosis, and such improvement was sustained to 5 years post-diagnosis. The proportion of patients who met the exercise recommendation for cancer survivors was still low. Encouraging patients on the importance of durable high level of physical activity in breast cancer survivorship is warranted.
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Affiliation(s)
- Yuan-Yuan Lei
- Department of Clinical Oncology, Prince of Wales Hospital, the Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
| | - Suzanne C Ho
- Division of Epidemiology, the Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, New Territories, Hong Kong SAR, China
| | - Carol Kwok
- Department of Clinical Oncology, Princess Margaret Hospital, Hong Kong SAR, China
| | - Ashley Cheng
- Department of Clinical Oncology, Princess Margaret Hospital, Hong Kong SAR, China
| | - Ka Li Cheung
- Department of Clinical Oncology, Prince of Wales Hospital, the Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
| | - Roselle Lee
- Department of Clinical Oncology, Prince of Wales Hospital, the Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
| | - Winnie Yeo
- Department of Clinical Oncology, Prince of Wales Hospital, the Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China. .,Hong Kong Cancer Institute, State Key Laboratory in Oncology in South China, Faculty of Medicine, the Chinese University of Hong Kong, New Territories, Hong Kong SAR, China.
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21
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Krok-Schoen JL, Pisegna J, Arthur E, Ridgway E, Stephens C, Rosko AE. Prevalence of lifestyle behaviors and associations with health-related quality of life among older female cancer survivors. Support Care Cancer 2020; 29:3049-3059. [PMID: 33040283 DOI: 10.1007/s00520-020-05812-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 10/02/2020] [Indexed: 12/01/2022]
Abstract
PURPOSE Healthy lifestyles including maintaining a normal weight, consuming a healthy diet, and being physically active can improve prognosis and health-related quality of life (HRQoL) among cancer survivors. The largest proportion of cancer survivors are older adults (≥ 65 years), yet their lifestyle behaviors are understudied. This study sought to examine the lifestyle behaviors (maintaining healthy weight, diet quality, physical activity) of older female cancer survivors and identify associations with HRQoL. METHODS Older female cancer survivors (n = 171) completed surveys to assess HRQoL (RAND-36), unintentional weight loss, body mass index (BMI), diet quality (HEI-2015), and physical activity. Demographic information and medical record data were also collected. Descriptive analyses, correlations, and stepwise linear regressions were utilized. RESULTS Physical and mental HRQoL of the sample (mean age = 74.50 years) were low: 41.94 ± 10.50 and 48.47 ± 7.18, respectively, out of 100. Physical activity was low: 75.3%, 54.2%, and 68.1% reported no strenuous, moderate, and mild physical activity, respectively. Mean BMI was 27.71 ± 6.24 (overweight) with 64% of the participants being overweight or obese. Mean HEI-2015 scores were 66.54 ± 10.0. Engagement in moderate physical activity was associated with higher physical HRQoL (β = 0.42, p = 0.004). Being white (β = 0.53, p < 0.001), older (β = 0.27, p = 0.025), and having higher HEI scores (β = 0.30, p = 0.011) were associated with higher mental HRQoL. CONCLUSIONS Older cancer survivors report poor diet quality, high rates of being overweight or obese, and low levels of physical activity that impact their HRQoL. Results indicate the need for tailored health coaching for older cancer survivors regarding their lifestyle behaviors to improve prognosis and HRQoL.
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Affiliation(s)
- Jessica L Krok-Schoen
- Division of Medical Dietetics and Health Sciences, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, 453 W. 10th Ave, 306N Atwell Hall, Columbus, OH, 43210, USA. .,Comprehensive Cancer Center, The Ohio State University, 460 W. 10th Ave, Columbus, OH, USA.
| | - Janell Pisegna
- Division of Medical Dietetics and Health Sciences, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, 453 W. 10th Ave, 306N Atwell Hall, Columbus, OH, 43210, USA
| | - Elizabeth Arthur
- Comprehensive Cancer Center, The Ohio State University, 460 W. 10th Ave, Columbus, OH, USA.,College of Nursing, The Ohio State University, 1585 Neil Ave., Columbus, OH, USA
| | - Emily Ridgway
- Comprehensive Cancer Center, The Ohio State University, 460 W. 10th Ave, Columbus, OH, USA
| | - Christian Stephens
- Division of Medical Dietetics and Health Sciences, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, 453 W. 10th Ave, 306N Atwell Hall, Columbus, OH, 43210, USA
| | - Ashley E Rosko
- College of Nursing, The Ohio State University, 1585 Neil Ave., Columbus, OH, USA.,Division of Hematology, College of Medicine, The Ohio State University, 370 W. 9th Ave., Columbus, OH, USA
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22
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Porciello G, Montagnese C, Crispo A, Grimaldi M, Libra M, Vitale S, Palumbo E, Pica R, Calabrese I, Cubisino S, Falzone L, Poletto L, Martinuzzo V, Prete M, Esindi N, Thomas G, Cianniello D, Pinto M, Laurentiis MD, Pacilio C, Rinaldo M, D’Aiuto M, Serraino D, Massarut S, Evangelista C, Steffan A, Catalano F, Banna GL, Scandurra G, Ferraù F, Rossello R, Antonelli G, Guerra G, Farina A, Messina F, Riccardi G, Gatti D, Jenkins DJA, Minopoli A, Grilli B, Cavalcanti E, Celentano E, Botti G, Montella M, Augustin LSA. Mediterranean diet and quality of life in women treated for breast cancer: A baseline analysis of DEDiCa multicentre trial. PLoS One 2020; 15:e0239803. [PMID: 33031478 PMCID: PMC7544033 DOI: 10.1371/journal.pone.0239803] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 09/15/2020] [Indexed: 02/08/2023] Open
Abstract
Evidence suggests a beneficial role of the Mediterranean Diet (MedDiet) on health-related quality of life (HRQoL) in healthy subjects. HRQoL is relevant in cancer therapy and disease outcomes, therefore we investigated the association between adherence to the MedDiet and HRQoL in breast cancer survivors participating in the multicentre trial DEDiCa. Diet and HRQoL were assessed at baseline in a subgroup of 309 women enrolled within 12 months of breast cancer diagnosis without metastasis (stages I-III, mean age 52±1 yrs, BMI 27±7 kg/m2). The 14-item PREDIMED questionnaire was used to analyse adherence to the MedDiet. HRQoL was assessed with three validated questionnaires measuring physical, mental, emotional and social factors: EQ-5D-3L, EORTC QLQ-C30 and EORTC QLQ-BR23. Analysis of variance (ANOVA) and multivariate analyses were performed to assess the possible role of the MedDiet on HRQoL. Patients with higher adherence to MedDiet (PREDIMED score >7) showed significantly higher scores for physical functioning (p = 0.02) and lower scores on the symptomatic pain scale (p = 0.04) assessed by the EORTC QLQ-C30 questionnaire compared to patients with a lower adherence to MedDiet (PREDIMED score ≤7). Higher scores from the EQ-5D-3L indicating higher well-being were observed mainly in participants with higher MedDiet adherence (p = 0.05). In adjusted multivariate analyses significant positive associations were found between MedDiet, physical functioning (p = 0.001) and EQ 5D-3L score (p = 0.003) while inverse associations were found with pain and insomnia symptoms (p = 0.005 and p = 0.029, respectively). These results suggest that higher adherence to the MedDiet in breast cancer survivors is associated with better aspects of quality of life, specifically higher physical functioning, better sleep, lower pain and generally higher well-being confirming findings in healthy subjects.
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Affiliation(s)
- Giuseppe Porciello
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori—IRCCS "Fondazione G. Pascale", Napoli, Italy
| | - Concetta Montagnese
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori—IRCCS "Fondazione G. Pascale", Napoli, Italy
- * E-mail:
| | - Anna Crispo
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori—IRCCS "Fondazione G. Pascale", Napoli, Italy
| | - Maria Grimaldi
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori—IRCCS "Fondazione G. Pascale", Napoli, Italy
| | - Massimo Libra
- Department of Biomedical and Biotechnological Sciences Oncologic, Clinical and General Pathology Section, University of Catania, Catania, Italy
| | - Sara Vitale
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori—IRCCS "Fondazione G. Pascale", Napoli, Italy
| | - Elvira Palumbo
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori—IRCCS "Fondazione G. Pascale", Napoli, Italy
| | - Rosa Pica
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori—IRCCS "Fondazione G. Pascale", Napoli, Italy
| | - Ilaria Calabrese
- Department of Clinical Medicine and Surgery, Federico II University, Napoli, Italy
| | - Serena Cubisino
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori—IRCCS "Fondazione G. Pascale", Napoli, Italy
| | - Luca Falzone
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori—IRCCS "Fondazione G. Pascale", Napoli, Italy
| | - Luigina Poletto
- Cancer Epidemiology Unit, National Cancer Institute Centro di Riferimento Oncologico, IRCCS, Aviano, Italy
| | - Valentina Martinuzzo
- Cancer Epidemiology Unit, National Cancer Institute Centro di Riferimento Oncologico, IRCCS, Aviano, Italy
| | - Melania Prete
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori—IRCCS "Fondazione G. Pascale", Napoli, Italy
| | - Nadia Esindi
- School of Life and Environmental Sciences and Charles Perkins Centre, University of Sydney, Sydney, Australia
| | | | - Daniela Cianniello
- Division of Breast Oncology, Istituto Nazionale Tumori—IRCCS "Fondazione G. Pascale", Napoli, Italy
| | - Monica Pinto
- Rehabilitation Medicine Unit, Istituto Nazionale Tumori—IRCCS "Fondazione G. Pascale", Napoli, Italy
| | - Michelino De Laurentiis
- Division of Breast Oncology, Istituto Nazionale Tumori—IRCCS "Fondazione G. Pascale", Napoli, Italy
| | - Carmen Pacilio
- Division of Breast Oncology, Istituto Nazionale Tumori—IRCCS "Fondazione G. Pascale", Napoli, Italy
| | - Massimo Rinaldo
- Division of Breast Oncology, Istituto Nazionale Tumori—IRCCS "Fondazione G. Pascale", Napoli, Italy
| | | | - Diego Serraino
- Cancer Epidemiology Unit, National Cancer Institute Centro di Riferimento Oncologico, IRCCS, Aviano, Italy
| | - Samuele Massarut
- Division of Breast Cancer Surgery, Centro di Riferimento Oncologico, IRCCS, Aviano, Italy
| | - Chiara Evangelista
- Cancer Epidemiology Unit, National Cancer Institute Centro di Riferimento Oncologico, IRCCS, Aviano, Italy
| | - Agostino Steffan
- Immunopathology and Cancer Biomarkers Unit, National Cancer Institute Centro di Riferimento Oncologico IRCCS, Aviano, Italy
| | | | | | | | | | | | | | | | | | | | - Gabriele Riccardi
- Department of Clinical Medicine and Surgery, Federico II University, Napoli, Italy
| | - Davide Gatti
- Rheumatology Unit, University of Verona, Verona, Italy
| | - David J. A. Jenkins
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, ON, Canada
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, ON, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, ON, Canada
| | - Anita Minopoli
- Laboratory Medicine Unit, Istituto Nazionale Tumori—IRCCS "Fondazione G. Pascale", Napoli, Italy
| | - Bruna Grilli
- Laboratory Medicine Unit, Istituto Nazionale Tumori—IRCCS "Fondazione G. Pascale", Napoli, Italy
| | - Ernesta Cavalcanti
- Laboratory Medicine Unit, Istituto Nazionale Tumori—IRCCS "Fondazione G. Pascale", Napoli, Italy
| | - Egidio Celentano
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori—IRCCS "Fondazione G. Pascale", Napoli, Italy
| | - Gerardo Botti
- Scientific Directorate, Istituto Nazionale Tumori—IRCCS "Fondazione G. Pascale", Napoli, Italy
| | - Maurizio Montella
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori—IRCCS "Fondazione G. Pascale", Napoli, Italy
| | - Livia S. A. Augustin
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori—IRCCS "Fondazione G. Pascale", Napoli, Italy
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Modifiable health behaviors among low-income, uninsured men with prostate cancer. Urol Oncol 2020; 38:735.e1-735.e8. [PMID: 32624421 DOI: 10.1016/j.urolonc.2020.06.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 05/15/2020] [Accepted: 06/03/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND As life expectancy of men with prostate cancer (CaP)improves, the risks of chronic diseases and comorbid conditions become more relevant. Improving modifiable health behaviors now serves as a focus of guidelines to reduce all-cause morbidity and mortality from chronic disease among CaP survivors. Few studies have reported on these health behaviors in low-income, uninsured men with CaP METHODS: In addition to baseline demographic data, we collected four health behaviors in low-income men with CaP via telephone survey: physical activity, dietary intake of fruits and vegetables, weight management, and alcohol consumption. These behaviors were assessed for adherence to the American Cancer Society Prostate Cancer Survivorship Care Guidelines for health promotion. RESULTS Of 236 participants, most self-identified as racial/ethnic minority (61% Hispanic, 16% Black). Most men demonstrated low (21%) or moderate (66%) adherence to guidelines, almost all of whom had poor adherence with recommendations for physical activity and fruit and vegetable intake. Multivariate analysis showed that non-white men were more likely to demonstrate low or moderate adherence. CONCLUSIONS Most men in this cohort of low-income, uninsured CaP survivors did not engage the healthy behaviors promulgated by the American Cancer Society. Future interventions in this population should focus on encouraging and facilitating healthier lifestyle choices in physical activity, diet, and weight management.
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24
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Onyeaghala G, Lintelmann AK, Joshu CE, Lutsey PL, Folsom AR, Robien K, Platz EA, Prizment AE. Adherence to the World Cancer Research Fund/American Institute for Cancer Research cancer prevention guidelines and colorectal cancer incidence among African Americans and whites: The Atherosclerosis Risk in Communities study. Cancer 2020; 126:1041-1050. [PMID: 31873947 PMCID: PMC7021569 DOI: 10.1002/cncr.32616] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 09/27/2019] [Accepted: 10/01/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Adherence to the World Cancer Research Fund (WCRF)/American Institute for Cancer Research (AICR) cancer prevention recommendations is associated with colorectal cancer (CRC) risk in whites, but only 1 previous study has reported on this link in African Americans. This study assessed the association between the 2018 WCRF/AICR guidelines and CRC incidence in African Americans (26.5%) and whites (73.5%) in the Atherosclerosis Risk in Communities prospective cohort (n = 13,822). METHODS A total of 368 incident CRC cases (268 among whites and 100 among African Americans) were identified between the baseline (1987) and 2012. A baseline adherence score was created for 7 WCRF/AICR guidelines (each contributing 0, 0.5, or 1 point to the score, with higher scores corresponding to greater adherence). Adherence scores were also categorized as tertiles (0.0-3.0, 3.5-4.0, and 4.5-7.0). Cox proportional hazards regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for the total cohort and with stratification by race. RESULTS After adjustments for age, sex, race, center, smoking, education, intake of aspirin, calcium, total calories, diabetes status, and, in women, hormone replacement therapy, greater adherence was associated with decreased CRC risk. The HRs per 1-unit increment in score were 0.88 (95% CI, 0.80-0.97) for the whole cohort, 0.89 (95% CI, 0.73-1.09) for African Americans, and 0.88 (95% CI, 0.77-0.99) for whites. Similar associations between higher adherence scores and decreased cancer risk were observed for men and women and for colon cancer but not for rectal cancer. CONCLUSIONS Greater adherence to the cancer prevention recommendations appears to be associated with decreased CRC risk for both African Americans and whites.
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Affiliation(s)
- Guillaume Onyeaghala
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Anna K Lintelmann
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Corrine E Joshu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland
| | - Pamela L Lutsey
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Aaron R Folsom
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Kimberly Robien
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University, Washington, DC
| | - Elizabeth A Platz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland
| | - Anna E Prizment
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
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25
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Solans M, Chan DSM, Mitrou P, Norat T, Romaguera D. A systematic review and meta-analysis of the 2007 WCRF/AICR score in relation to cancer-related health outcomes. Ann Oncol 2020; 31:352-368. [PMID: 32067678 DOI: 10.1016/j.annonc.2020.01.001] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 12/20/2019] [Accepted: 01/03/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND We conducted a systematic literature review and meta-analysis of observational studies investigating adherence to the 2007 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) lifestyle recommendations for cancer prevention and health outcomes. PATIENTS AND METHODS We searched PubMed and the in-house database of the WCRF Continuous Update Project for publications up to June 2019. Cross-sectional studies were only narratively reviewed given their heterogeneity while findings of cohort/case-control studies were synthesized in umbrella reviews and meta-analyses. Summary relative risks (RRs) and 95% confidence intervals (CI) were estimated using a random-effects model when at least two studies reported results on a specific outcome. RESULTS Thirty-eight articles (17 prospective, 8 case-control, and 13 cross-sectional studies) were included. The summary RR per each point increment in the 2007 WCRF/AICR score was 0.90 (95% CI: 0.87-0.93, n = 11) for breast cancer, regardless of hormone receptor and menopausal status, 0.86 (95% CI: 0.82-0.89, n = 10) for colorectal cancer, and 0.93 (95% CI: 0.89-0.96, n = 2) for lung cancer risk. No statistically significant associations were reported for prostate (n = 6) and pancreatic cancers (n = 2). Adherence to the recommendations was associated with lower overall mortality (RR = 0.90, 95% CI 0.84-0.96, n = 3) and cancer-specific mortality (RR = 0.91, 95% CI 0.89-0.92; n = 3) in healthy populations, as well as with higher survival in cancer patients (n = 2). In cross-sectional studies, a healthier plasma marker profile and lower cancer risk factors in the general population and a better health status and quality of life in cancer patients/survivors were reported. CONCLUSIONS Adhering to the 2007 WCRF/AICR recommendations is associated with lower risks of cancer incidence, namely breast and colorectal cancers, and mortality. Primary prevention of cancer should emphasize modification of multiple lifestyle factors. Upcoming studies examining the recently updated 2018 guidelines will further clarify such associations.
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Affiliation(s)
- M Solans
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain; Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain
| | - D S M Chan
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - P Mitrou
- World Cancer Research Fund International, London, UK
| | - T Norat
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - D Romaguera
- Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases, Palma de Mallorca, Spain; Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Madrid, Spain.
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26
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Hoang T, Lee J, Kim J, Park B. Food Intake Behavior in Cancer Survivors in Comparison With Healthy General Population; From the Health Examination Center-based Cohort. J Cancer Prev 2019; 24:208-216. [PMID: 31950020 PMCID: PMC6951320 DOI: 10.15430/jcp.2019.24.4.208] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 12/18/2019] [Accepted: 12/20/2019] [Indexed: 01/04/2023] Open
Abstract
Background This study aimed to investigate the food intake behavior of cancer survivors based on main sources of energy intake from different food groups in comparison with healthy individuals. Methods Baseline survey data from the Health Examinee cohort, which recruited participants from 2014 to 2013 were applied. A total of 5,269 cancer survivors and 5,219 healthy subjects without comorbidities who were matched by age, sex, and enrollment center were included in the analysis. The proportion of energy intake for 17 food groups was devided into lower median and median or upper. OR and 95% CIs were determined to measure the difference of energy intake proportion in cancer survivors, five major types of cancer survivors versus healthy individuals. Results Generally, the proportion of calories intake from sugars and sweets, meat and poultry, oils and fats, and beverage was lower in cancer survivors than in healthy individuals (OR = 0.83 [95% CI = 0.79–0.88], 0.75 [95% CI = 0.71–0.80], 0.84 [95% CI = 0.80–0.89], and 0.93 [95% CI = 0.88–0.99], respectively) with more prominently shown in breast, colon, and thyroid cancer individuals. In contrast, cancer survivors tended to intake calories from potatoes and starches, legume, seeds and nuts, vegetables, mushrooms, fruits, and seasonings more than healthy individuals (OR = 1.09 [95% CI = 1.03–1.16], 1.13 [95% CI = 1.06–1.19], 1.15 [95% CI = 1.09–1.22], 1.07 [95% CI = 1.01–1.13], 1.07 [95% CI = 1.02–1.14], 1.15 [95% CI = 1.08–1.21], and 1.17 [95% CI = 1.10–1.23], respectively) which were more prominent in gastric and breast cancer survivors. Conclusions The dietary behavior measured by main sources of energy intake in cancer survivors was different from healthy individuals in terms of several food groups. Although there are nutrition guidelines for cancer survivors, because of the differences between Western population and Asian people in terms of food culture, the guidelines for balanced nutritious behavior should be established among Asian cancer survivors.
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Affiliation(s)
- Tung Hoang
- National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea
| | - Jeonghee Lee
- National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea
| | - Jeongseon Kim
- National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea
| | - Boyoung Park
- Department of Medicine, Hanyang University College of Medicine, Seoul, Korea
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Adherence to the American Cancer Society Guidelines for Cancer Survivors and Health-Related Quality of Life among Breast Cancer Survivors. Nutrients 2019; 11:nu11122924. [PMID: 31816813 PMCID: PMC6950022 DOI: 10.3390/nu11122924] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Revised: 11/22/2019] [Accepted: 11/23/2019] [Indexed: 12/24/2022] Open
Abstract
The development and validation of guidelines for breast cancer survivors are of importance due to the increased survival rate for breast cancer. In this cross-sectional study, we aimed to examine the association between adherence to the American Cancer Society (ACS) guidelines for cancer survivors and health-related quality of life (HRQoL). A total of 618 breast cancer survivors aged 30 to 81 years who had been diagnosed with stage I to III primary breast cancer and had surgery at least a year before enrollment were included. The participants completed the 36 Item Short-Form Health Survey (SF-36) to evaluate HRQoL, and adherence scores were calculated based on the Nutrition and Physical Activity Guidelines for Cancer Survivors, which were released by the ACS. Increasing adherence scores were associated with increasing scores on the physical component summary (PCS) and the physical functioning (PF), bodily pain (BP), and vitality (VT) domains (p for trend <0.001 for PCS and PF, 0.01 for BP, and 0.02 for VT); these scores were mainly driven by the associations among survivors with stage II–III cancer. Further prospective studies are needed to evaluate whether adherence to these guidelines improves HRQoL scores among breast cancer survivors.
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Winkels RM, Artrip R, Tupinio M, Veldheer S, Dandekar SC, George DR. Opportunities for Growth: Evaluating the Feasibility of a Community Gardening Intervention Pairing Adolescent and Young Adult Cancer Survivors with Experienced Gardeners. J Adolesc Young Adult Oncol 2019; 9:115-119. [PMID: 31580754 DOI: 10.1089/jayao.2019.0035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
We evaluated the feasibility of a mentored gardening intervention for adolescent and young adult (AYA) cancer survivors in a hospital-based community garden as a way to improve diet and physical activity, using qualitative data to assess the challenges, facilitators, and areas for future programmatic improvement and replication. Over the course of growing season 2018, AYA cancer survivors tended a garden plot in a community garden under the mentorship of an experienced (master) gardener. AYA cancer survivors were successful in planting and harvesting vegetables from the garden in partnership with their mentors. Qualitative results and future directions for the project are discussed.
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Affiliation(s)
| | - Rick Artrip
- Department of Penn State College of Medicine, Hershey, Pennsylvania
| | - Maegan Tupinio
- Department of Penn State College of Medicine, Hershey, Pennsylvania
| | - Susan Veldheer
- Department of Family and Community Medicine, Hershey, Pennsylvania
| | - Smita C Dandekar
- Pediatric Hematology/Oncology, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania
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Findlay SG, Gill JH, Plummer R, DeSantis C, Plummer C. Chronic cardiovascular toxicity in the older oncology patient population. J Geriatr Oncol 2019; 10:685-689. [DOI: 10.1016/j.jgo.2019.01.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 01/21/2019] [Accepted: 01/24/2019] [Indexed: 12/28/2022]
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Onyeaghala G, Lutsey PL, Demerath EW, Folsom AR, Joshu CE, Platz EA, Prizment AE. Association between greater leg length and increased incidence of colorectal cancer: the atherosclerosis risk in communities (ARIC) study. Cancer Causes Control 2019; 30:791-797. [PMID: 31165420 PMCID: PMC6681820 DOI: 10.1007/s10552-019-01192-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 05/29/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE Previous studies have reported that taller people have an increased risk of colorectal cancer (CRC). We examined the association of two height components-leg length and sitting height-with CRC risk in 14,532 individuals aged 45-64 years in the Atherosclerosis Risk in Communities study. METHODS Anthropometrics were measured at baseline (1987-1989). Incident CRC cases (n = 382) were ascertained from 1987 to 2012. Cox proportional hazards regression was used to estimate multivariable-adjusted hazard ratios for CRC and colon cancer across quintiles of sex-specific leg length and sitting height. RESULTS The highest (versus the lowest) quintile of leg length was associated with a 36% greater CRC risk (p-trend = 0.04), and 51% greater colon cancer risk (p-trend = 0.01). For the top four quintiles combined, risk was increased by 34% for CRC and by 45% for colon cancer versus the lowest quintile. Total height and sitting height were not significantly associated with CRC or colon cancer risk. A small number of cases (n = 57) limited our ability to conduct subgroup analyses for rectal cancer. CONCLUSIONS A positive association of leg length with CRC and colon cancer risk suggests that biological mechanisms leading to greater leg length during puberty may explain the association between taller height and CRC.
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Affiliation(s)
- Guillaume Onyeaghala
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Pamela L Lutsey
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Ellen W Demerath
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Aaron R Folsom
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Corinne E Joshu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA
| | - Elizabeth A Platz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA
| | - Anna E Prizment
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA.
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA.
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S 2nd St, Suite 300, Minneapolis, MN, 55454, USA.
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van Veen MR, Mols F, Smeets L, Kampman E, Beijer S. Colorectal cancer survivors' beliefs on nutrition and cancer; correlates with nutritional information provision. Support Care Cancer 2019; 28:1255-1263. [PMID: 31227989 PMCID: PMC6989414 DOI: 10.1007/s00520-019-04934-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 06/07/2019] [Indexed: 12/11/2022]
Abstract
Purpose To investigate CRC survivors’ beliefs on nutrition and cancer and the association with nutritional information provision by (kind and number) of health professionals and to inquire about foods that CRC survivors believed either had a positive or negative influence on their cancer. Methods A total of 326 CRC survivors of an ongoing prospective cohort study filled out questionnaires 1 month after surgery on whether they had received nutritional information from health professionals. Also, their beliefs that nutrition influences (1) feelings of well-being, (2) complaints after treatment, (3) recovery and (4) cancer recurrence were investigated. Prevalence ratios were calculated (using Cox proportional hazard regression analysis) to study associations between information provision and the four beliefs adjusted for age, gender and cancer stage. Results Sixty-two percent of respondents received information about nutrition from one or more health professionals. Most respondents who received information strongly believe nutrition influences feelings of well-being (59%) and recovery after cancer (62%). Compared with those who did not receive information, respondents who received information from three professionals showed the strongest beliefs on the influence of nutrition on complaints after treatment (PR 3.4; 95% CI 1.6–7.4), recovery after treatment (PR 2.0; 95% CI 1.2–3.3) and recurrence (PR 2.8; 95% CI 1.3–6.2). Conclusion Nutritional information provision by health professionals positively influences the beliefs of CRC survivors on the influence of nutrition on cancer outcomes: stronger beliefs occur when respondents received information from three health professionals.
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Affiliation(s)
- Merel R van Veen
- Division of Human Nutrition and Health, Wageningen University, P.O. Box 17, 6700 AA, Wageningen, The Netherlands. .,Department of Research & Development Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.
| | - Floortje Mols
- CoRPS-Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Lian Smeets
- Division of Human Nutrition and Health, Wageningen University, P.O. Box 17, 6700 AA, Wageningen, The Netherlands
| | - Ellen Kampman
- Division of Human Nutrition and Health, Wageningen University, P.O. Box 17, 6700 AA, Wageningen, The Netherlands
| | - Sandra Beijer
- Department of Research & Development Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
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Jung AY, Miljkovic I, Rubin S, Kritchevsky SB, Klepin HD, Newman AB, Cauley J, Ayonayon H, Harris TB, Murphy RA. Adherence to Cancer Prevention Guidelines among Older White and Black Adults in the Health ABC Study. Nutrients 2019; 11:nu11051008. [PMID: 31058834 PMCID: PMC6566295 DOI: 10.3390/nu11051008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 04/28/2019] [Accepted: 04/30/2019] [Indexed: 12/25/2022] Open
Abstract
One-third of cancers can be prevented through healthy lifestyles. This study investigates the prevalence of and factors associated with engagement in cancer prevention guidelines in a population-based cohort of 2124 older white and black men and women. We used Health ABC data to construct a score from 0 (lowest adherence) to 7 (greatest adherence) based on the sum of seven recommendations for cancer prevention from the World Cancer Research Fund/American Institute for Cancer Research; body fatness (maintenance of healthy body weight), physical activity (at least moderately physically active), diet (fruit, vegetables, fiber, and red and processed meat), and alcohol. Mean (SD) scores in men and women were 3.24 (1.09) and 3.17 (1.10). Lower scores were associated with younger age (women only), black race, current smoking, and prevalent cardiovascular disease. Less than 1% of men and women adhered to all recommendations. Of the individual guidelines, adherence was lowest for fiber (9% of men; 6% of women) followed by physical activity (26% of men; 18% of women), and body weight (21% of men; 26% of women). These results suggest a critical public health need, especially given the growing older population. Black older adults, smokers, and those with prevalent disease may be at higher risk and thus warrant additional focus.
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Affiliation(s)
- Audrey Y Jung
- School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada.
| | - Iva Miljkovic
- Center for Aging and Population Health, Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA 15261, USA.
| | - Susan Rubin
- Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CA 94158, USA.
| | - Stephen B Kritchevsky
- Sticht Center for Healthy Aging and Alzheimer's Prevention, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.
| | - Heidi D Klepin
- Comprehensive Cancer Center, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.
| | - Anne B Newman
- Center for Aging and Population Health, Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA 15261, USA.
| | - Jane Cauley
- Center for Aging and Population Health, Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA 15261, USA.
| | - Hilsa Ayonayon
- Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CA 94158, USA.
| | - Tamara B Harris
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD 20814, USA.
| | - Rachel A Murphy
- School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada.
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Compliance with Multiple Health Behaviour Recommendations: A Cross-Sectional Comparison between Female Cancer Survivors and Those with no Cancer History. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16081345. [PMID: 30991645 PMCID: PMC6517956 DOI: 10.3390/ijerph16081345] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Revised: 04/02/2019] [Accepted: 04/03/2019] [Indexed: 01/26/2023]
Abstract
Lifestyle behaviours have an important role in preventing cancer, reducing treatment side effects, and improving survival and quality of life for cancer survivors. This study investigated adherence to multiple lifestyle behaviours among women with and without a cancer history. From the Australian Longitudinal Study on Women’s Health (ALSWH) surveys, 2407 cancer survivors and 3896 controls (cancer free population) were identified. Based on the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) recommendations, adherence to six health behaviours (smoking, physical activity, fruit and vegetable intake, alcohol consumption, sugary drink intake, and Body Mass Index [BMI]) were assessed. Overall adherence was low, and there were no differences between survivors and controls on adherence to any of the six individual health behaviours. However, both recent and long-term cancer survivors were more likely than controls to adhere to multiple health behaviours (p < 0.05). When participants with melanoma or non-melanoma skin cancer were excluded, adherence was less likely (but not significant) in the cancer group than controls. Higher education (p < 0.01), being married (p < 0.01), and lower comorbidity of chronic illnesses (p < 0.01) were significantly associated with adherence to multiple lifestyle behaviours. Overall, the findings suggest that a cancer diagnosis may result in increased compliance with multiple health behaviour guidelines.
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Springfield S, Odoms-Young A, Tussing-Humphreys L, Freels S, Stolley M. Adherence to American Cancer Society and American Institute of Cancer Research dietary guidelines in overweight African American breast cancer survivors. J Cancer Surviv 2019; 13:257-268. [PMID: 30982113 PMCID: PMC6612676 DOI: 10.1007/s11764-019-00748-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 02/27/2019] [Indexed: 12/12/2022]
Abstract
PURPOSE The American Cancer Society (ACS) and the American Institute for Cancer Research (AICR) each created dietary and physical activity guidelines to improve cancer survivorship. Despite African American breast cancer survivors (AABCS) having the lowest survival rates of any racial or ethnic group, limited information exists on their adherence to cancer-specific lifestyle recommendations. The study's purpose was to measure adherence to ACS/AICR dietary recommendations in AABCS. METHODS Two hundred ten AABCS enrolled in the Moving Forward intervention trial, a randomized, community-based, 6-month weight loss study, were assessed for socio-demographics, dietary intake (via food frequency questionnaire), and related health factors at baseline. We operationalized the dietary recommendations put forth by ACS/AICR and created component and total adherence index scores. Descriptive statistics were used to calculate the proportion of women who met recommendations. Student's t test and χ2 tests were used to compare participant characteristics by median adherence scores. RESULTS The mean total ACS/AICR score was 12.7 ± 2.5 out of 21 points (median, 13; range, 5 to 21). Over 90% were moderately or completely adherent to limiting alcohol and red & processed meat consumption, but the majority failed to meet the other recommendations to eat whole grains, legumes, fruits, vegetables, and avoid added sugars. Women with total scores below the median were younger, with higher BMI, had fewer years of education, and lower income levels. IMPLICATIONS FOR CANCER SURVIVORS The present study extends the literature on AABCS adherence to cancer survivor-specific dietary guidelines. Findings will inform future dietary lifestyle interventions in this population.
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Affiliation(s)
- Sparkle Springfield
- Stanford Prevention Research Center, School of Medicine, Stanford University, 3300 Hillview Ave, Palo Alto, CA, 94304, USA.
| | - Angela Odoms-Young
- Department of Kinesiology and Nutrition, 646 Applied Health Sciences Building, University of Illinois at Chicago, 1919 West Taylor Street MC 517, Chicago, IL, 60612, USA
- Division of Academic and Internal Medicine, College of Medicine, University of Illinois, Chicago, IL, USA
- University of Illinois Cancer Center, Chicago, IL, USA
| | - Lisa Tussing-Humphreys
- Division of Academic and Internal Medicine, College of Medicine, University of Illinois, Chicago, IL, USA
- University of Illinois Cancer Center, Chicago, IL, USA
- Institute for Health Research and Policy, 416 Westside Research Office Bldg., 1747 West Roosevelt Road, Chicago, IL, 60608, USA
| | - Sally Freels
- School of Public Health, University of Illinois at Chicago, 1603 W Taylor St, Chicago, IL, 60612, USA
| | - Melinda Stolley
- Department of Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA
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Adherence to the World Cancer Research Fund/American Institute for Cancer Research recommendations for cancer prevention is associated with better health-related quality of life among long-term colorectal cancer survivors: results of the PROFILES registry. Support Care Cancer 2019; 27:4565-4574. [PMID: 30927111 PMCID: PMC6825038 DOI: 10.1007/s00520-019-04735-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 03/05/2019] [Indexed: 12/26/2022]
Abstract
Since colorectal cancer (CRC) survivors often suffer from long-term adverse health effects of the cancer and its treatment, having a negative impact on their health-related quality of life (HRQL), this study focuses on the association between adherence to WCRF/AICR recommendations and HRQL among CRC survivors. In a cross-sectional PROFILES registry study in 1096 CRC survivors (mean time since diagnosis 8.1 years), WCRF/AICR adherence scores (range 0–8, with a higher score for better adherence) were calculated, and HRQL was assessed using the EORTC QLQ-C30. Associations between adherence scores and HRQL scores were investigated using linear regression analyses. Additionally, associations with adherence to guidelines for body mass index (BMI) (normal weight, overweight and obese), physical activity (PA) (score 0/1) and diet (score < 3, 3– < 4 and > 4) were evaluated separately. Mean adherence score was 4.81 ± 1.04. Higher WCRF/AICR scores were associated with better global health status (β 1.64; 95%CI 0.69/2.59), physical functioning (β 2.71; 95%CI 1.73/3.68), role functioning (β 2.87; 95%CI 1.53/4.21), cognitive functioning (β 1.25; 95%CI 0.19/2.32), social functioning (β 2.01; 95%CI 0.85/3.16) and fatigue (β − 2.81; 95%CI − 4.02/− 1.60). Adherence versus non-adherence PA was significantly associated with better physical, role, emotional and social functioning, global health status and less fatigue. Except for the association between being obese and physical functioning (β − 4.15; 95%CI − 47.16/− 1.15), no statistically significant associations with physical functioning were observed comparing adherence to non-adherence to BMI and dietary recommendations. Better adherence to the WCRF/AICR recommendations was positively associated with global health status, most functioning scales and less fatigue among CRC survivors. PA seemed to be the main contributor.
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Tjon-A-Joe S, Pannekoek S, Kampman E, Hoedjes M. Adherence to Diet and Body Weight Recommendations among Cancer Survivors after Completion of Initial Cancer Treatment: A Systematic Review of the Literature. Nutr Cancer 2018; 71:367-374. [PMID: 30477361 DOI: 10.1080/01635581.2018.1540713] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This systematic review of the literature aimed to 1) provide an overview of the extent to which cancer survivors adhere to diet and body weight recommendations after completion of initial treatment and 2) gain insight into characteristics associated with adherence to these recommendations. Four databases were searched for relevant papers. We included observational studies describing adherence to recommendations on body mass index (BMI), waist-to-hip ratio and waist circumference, fruit and vegetable intake, and alcohol consumption of adult (≥18 yr) cancer survivors after the completion of initial treatment (i.e. surgery, chemotherapy, and radiotherapy). Of the 2,830 articles retrieved from the database search, 12 articles were included. Adherence to the recommendation on BMI varied from 34% to 77%; adherence to the fruit and vegetable recommendation varied from 9% to 83%; and adherence to the recommendation on alcohol consumption varied from 62% to 96.8%. Adherence to waist-to-hip ratio (43%) and waist circumference recommendations (11%) was described in one study among overweight breast cancer survivors. The results of these studies generally suggest that adherence to the recommendation on alcohol intake is relatively high and that adherence to the recommendation on body weight and fruit and vegetable intake should particularly be promoted.
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Affiliation(s)
| | - Saraï Pannekoek
- b Centrum voor Topsport en Onderwijs Amsterdam , Amsterdam , Netherlands
| | - Ellen Kampman
- c Division of Human Nutrition , Wageningen University , Wageningen , Netherlands
| | - Meeke Hoedjes
- d Department of Medical and Clinical Psychology, Tilburg University , Tilburg , Noord-Brabant , Netherlands
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Rim CH, Ahn SJ, Kim JH, Yoon WS, Chun M, Yang DS, Lee JH, Kim K, Kong M, Kim S, Kim J, Park KR, Shin YJ, Ma SY, Jeong BK, Kim SS, Kim YB, Lee DS, Cha J. Questionnaire study of the dietary habits of breast cancer survivors and their relationship to quality of life (KROG 14-09). Eur J Cancer Care (Engl) 2018; 28:e12961. [PMID: 30421577 DOI: 10.1111/ecc.12961] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 08/29/2018] [Accepted: 10/08/2018] [Indexed: 11/26/2022]
Abstract
We evaluated the dietary habits of breast cancer survivors and investigated the relationship with quality of life (QoL), with 1,156 survivors recruited from 17 institutions. We used the Questionnaire Survey of Dietary Habits of Korean Adults (Q-DH-KOR) comprising 25 questions. The following indices were derived as follows: (1) quality of healthy dietary habits (Q-HD)-eight questions on number of meals, regularity, quantity, duration, skipping breakfast, dinner with companion(s), overeating and late-night snacks; (2) habits of nutritional balance (H-NB)-questions on consuming five food categories (grains, fruits, proteins, vegetables and dairy products); and (3) habits of unhealthy foods (H-UF)-questions on consuming three food categories (fatty, instant and fast foods). The times and regularity of meals, frequency of skipping breakfast, dinner with companion(s) and overeating were better in groups with high symptomatic and functional QoL. Symptomatic QoL positively affected Q-HD and H-NB (p < 0.001 and p = 0.024 respectively) and negatively affected H-UF (p = 0.02). Breast cancer survivors more frequently ate from the fruit, protein and vegetable categories than did the control group, with lower H-UF and higher Q-HD values (p < 0.001 and p < 0.001 respectively). Our findings supported the relationship between QoL and dietary habit and showed healthier dietary habits of breast cancer survivors than controls.
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Affiliation(s)
- Chai Hong Rim
- Radiation Oncology, Ansan Hospital, Korea University, Ansan, Korea
| | - Sung-Ja Ahn
- Radiation Oncology, Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Jin Hee Kim
- Radiation Oncology, Dongsan Medical Center, Keimyung University, Daegu, Korea
| | - Won Sup Yoon
- Radiation Oncology, Ansan Hospital, Korea University, Ansan, Korea
| | - Mison Chun
- Radiation Oncology, Ajou University, Suwon, Korea
| | - Dae Sik Yang
- Radiation Oncology, Guro Hospital, Korea University, Seoul, Korea
| | - Jong-Hoon Lee
- Radiation Oncology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kyubo Kim
- Radiation Oncology, Seoul National University Hospital, Seoul, Korea.,Radiation Oncology, Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea
| | - Moonkyoo Kong
- Radiation Oncology, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul, Korea
| | - Suzy Kim
- Radiation Oncology, Boramae Medical Center, Seoul National University, Seoul, Korea
| | - Juree Kim
- Radiation Oncology, Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea
| | - Kyung Ran Park
- Radiation Oncology, Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea
| | - Young-Joo Shin
- Radiation Oncology, Sanggye Paik Hospital, Inje University, Seoul, Korea
| | - Sun Young Ma
- Radiation Oncology, Kosin University Gospel Hospital, Busan, Korea
| | - Bae-Kwon Jeong
- Radiation Oncology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Korea
| | - Su Ssan Kim
- Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yong Bae Kim
- Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
| | - Dong Soo Lee
- Radiation Oncology, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea
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Derksen JW, Beijer S, Koopman M, Verkooijen HM, van de Poll-Franse LV, May AM. Monitoring potentially modifiable lifestyle factors in cancer survivors: A narrative review on currently available methodologies and innovations for large-scale surveillance. Eur J Cancer 2018; 103:327-340. [DOI: 10.1016/j.ejca.2018.06.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 05/28/2018] [Accepted: 06/05/2018] [Indexed: 12/11/2022]
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Gopalakrishna A, Chang A, Longo TA, Fantony JJ, Harrison MR, Wischmeyer PE, Inman BA. Dietary patterns and health-related quality of life in bladder cancer survivors. Urol Oncol 2018; 36:469.e21-469.e29. [PMID: 30126776 DOI: 10.1016/j.urolonc.2018.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 05/09/2018] [Accepted: 06/05/2018] [Indexed: 11/16/2022]
Abstract
PURPOSE A nutritious diet has been associated with better health-related quality of life (HRQOL) in a variety of cancer survivors. However, little is known about dietary habits and its association with HRQOL in bladder cancer survivors. The objective of this cross-sectional study is to describe dietary intake patterns and its relationship to HRQOL in a large cohort of bladder cancer survivors. METHODS Bladder cancer survivors within our institutional database were mailed surveys to assess dietary intake patterns utilizing the Diet History Questionnaire II and assessing HRQOL utilizing the Functional Assessment of Cancer Therapy-Bladder Cancer. Diet quality was assessed via Healthy Eating Index 2010 scores based on subjects' Diet History Questionnaire II results. Univariate and multivariate analyses of HRQOL based on diet quality were used to evaluate whether diet quality was associated with HRQOL. RESULTS Four hundred and fifty-nine patients (48%) returned questionnaires. Mean age was 74 years, 81% were male and 28% underwent radical cystectomy. Diet quality and quantity in our cohort was similar to the general older U.S. population and did not differ significantly between those managed conservatively or long-term following cystectomy. Our cohort had low intake of whole grains and fat-soluble vitamins, particularly vitamin D. Diet quality was significantly associated with HRQOL in the univariate analysis but lost statistical significance in our multivariate analysis. Elixhauser Comorbidity Index was significantly associated with HRQOL in the multivariate analysis. CONCLUSIONS This study demonstrates a similar diet quality of bladder cancer survivors to the older general U.S. population that, on average, "needs improvement." Dietary intake is particularly lacking in whole grain and vitamin D intake. Future studies are warranted to determine the impact on long-term outcome, but bladder cancer survivors should be counseled on the importance and benefits of adherence to dietary guidelines, including its potential contribution toward better HRQOL.
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Affiliation(s)
| | - Andrew Chang
- Division of Urology, Duke University Medical Center, Durham, NC
| | - Thomas A Longo
- Division of Urology, Duke University Medical Center, Durham, NC
| | | | - Michael R Harrison
- Division of Medical Oncology, Duke University Medical Center, Durham, NC
| | - Paul E Wischmeyer
- Division of Anesthesiology, Duke University Medical Center, Durham, NC
| | - Brant A Inman
- Division of Urology, Duke University Medical Center, Durham, NC.
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Kim NH, Song S, Jung SY, Lee E, Kim Z, Moon HG, Noh DY, Lee JE. Dietary pattern and health-related quality of life among breast cancer survivors. BMC WOMENS HEALTH 2018; 18:65. [PMID: 29747623 PMCID: PMC5946513 DOI: 10.1186/s12905-018-0555-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/16/2017] [Accepted: 04/26/2018] [Indexed: 11/12/2022]
Abstract
Background There is limited evidence for the association between dietary pattern and quality of life among breast cancer survivors. We examined the association between dietary patterns and health-related quality of life (HRQoL) among Korean breast cancer survivors. Methods Our study included a total of 232 women, aged 21 to 79 years, who had been diagnosed with stage I to III breast cancer and who underwent breast cancer surgery at least 6 months prior to our baseline evaluation. We assessed HRQoL using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) and the Quality of Life Questionnaire Breast Cancer Module 23 (QLQ-BR23). We conducted a factor analysis to identify the major dietary patterns and used a generalized linear model to obtain the least squares mean (LS mean) and 95% confidence interval (CI) for HRQoL according to the dietary pattern scores. Results We identified 2 major dietary patterns: the Healthy dietary pattern and the Western dietary pattern. We found that breast cancer survivors who had higher Healthy dietary pattern scores tended to have lower dyspnea scores but higher insomnia scores, compared to breast cancer survivors with lower Healthy dietary pattern scores. For dyspnea, the LS mean (95% CI) was 8.86 (5.05-15.52) in the bottom quartile and 2.87 (1.62-5.08) in the top quartile (p for trend = 0.005). This association was limited to survivors with stage I for dyspnea or survivors with stage II or III for insomnia. Conclusions Healthy dietary patterns were associated with better scores for dyspnea but worse scores for insomnia among breast cancer survivors. Other components of EORTC QLQ did not vary by dietary patterns overall, but they warrant further investigation for subgroups of breast cancer survivors. Electronic supplementary material The online version of this article (10.1186/s12905-018-0555-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Na-Hui Kim
- Department of Food and Nutrition, Sookmyung Women's University, Cheongpa-ro 47-gil 100, Yongsan-gu, Seoul, 04310, Korea
| | - Sihan Song
- Department of Food and Nutrition, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, Korea
| | - So-Youn Jung
- Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10408, Korea
| | - Eunsook Lee
- Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10408, Korea
| | - Zisun Kim
- Department of Surgery, Soonchunhyang University College of Medicine, 1174 Joong-dong, Wonmi-gu, Bucheon, Gyeonggi-do, 14584, Korea
| | - Hyeong-Gon Moon
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, 101 Daehakro, Jongno-gu, Seoul, 03080, Korea.,Breast Care Center, Seoul National University Hospital, 101 Daehakro, Jongno-gu, Seoul, 03080, Korea
| | - Dong-Young Noh
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, 101 Daehakro, Jongno-gu, Seoul, 03080, Korea.,Breast Care Center, Seoul National University Hospital, 101 Daehakro, Jongno-gu, Seoul, 03080, Korea
| | - Jung Eun Lee
- Department of Food and Nutrition, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, Korea.
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Amireault S, Fong AJ, Sabiston CM. Promoting Healthy Eating and Physical Activity Behaviors: A Systematic Review of Multiple Health Behavior Change Interventions Among Cancer Survivors. Am J Lifestyle Med 2018; 12:184-199. [PMID: 30202391 PMCID: PMC6124968 DOI: 10.1177/1559827616661490] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Revised: 06/17/2016] [Accepted: 07/07/2016] [Indexed: 12/31/2022] Open
Abstract
Multiple health behavior change (MHBC) interventions have great potential for enhancing health and well-being following cancer diagnosis and treatment. However, the characteristics and effects of MHBC interventions remain elusive for cancer survivors. The main purpose of this study was to evaluate the effectiveness of MHBC interventions on healthy eating and physical activity behaviors among cancer survivors. A secondary aim was to examine the effect of using a simultaneous and sequential design approach to MHBC (ie, changing both behaviors at the same time or one after the other). Randomized controlled trials reporting the impact of a MHBC intervention on both healthy eating and physical activity behaviors among cancer survivors were retrieved from MEDLINE, Cochrane Library, and PsycINFO. A total of 27 MHBC interventions were identified; most (92.6%) were designed to promote simultaneous change in both behaviors and assessed end-of-treatment effect among breast cancer survivors. MHBC interventions led by nurses or multidisciplinary teams showed the most compelling evidence for small to moderate improvement in both behaviors, with interventions that lasted ≥17 weeks more likely to improve both behaviors. This study identifies research priorities and provides preliminary evidence for clinical decision making and advancements in MHBC intervention design and delivery for clinical oncology.
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Affiliation(s)
- Steve Amireault
- Steve Amireault, PhD, Department of Health and Kinesiology, Purdue University, 800 West Stadium Avenue, Lambert Fieldhouse, Office 311A, West Lafayette, IN 47907; e-mail:
| | - Angela J. Fong
- Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana (SA)
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada (AJF, CMS)
| | - Catherine M. Sabiston
- Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana (SA)
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada (AJF, CMS)
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The Design, Development and Evaluation of the Vegetarian Lifestyle Index on Dietary Patterns among Vegetarians and Non-Vegetarians. Nutrients 2018; 10:nu10050542. [PMID: 29701727 PMCID: PMC5986422 DOI: 10.3390/nu10050542] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 04/24/2018] [Accepted: 04/25/2018] [Indexed: 12/11/2022] Open
Abstract
Traditionally, healthful diets and lifestyles have been examined only in relation to single nutrients, foods, or food groups in terms of dietary exposure. An alternative approach is to conceptualize an index based on vegetarian food pyramid guidelines as a measure of overall diet and lifestyle quality. Our objectives were to: (1) develop the Vegetarian Lifestyle Index (VLI); and (2) evaluate adherence to the Vegetarian Food Guide Pyramid (VFGP) among a low-risk population of Adventists. The index was based on the operationalization of 14 dietary and lifestyle components. All components were equally weighted. Higher score reflected greater adherence to the VFGP. The analytic sample (n = 90,057) comprised 47.7% non-vegetarians, 5.6% semi-, 10.1% pesco-, and 29.0% lacto-ovo-vegetarians, and 7.7% vegans, of which 1.1% were current smokers and 9.9% were alcohol consumers. Population mean VLI score was 7.43 (SD = 1.75) ranging from 1 to 12.5. Non-vegetarians (6.14; 95% confidence interval (CI), 6.06⁻6.21) had a significantly lower mean compared to semi- (7.31; 95% CI, 7.22⁻7.40), pesco- (7.41; 95% CI, 7.32⁻7.49), and lacto-ovo-vegetarians (8.16; 95% CI, 8.08⁻8.24), as well as vegans (8.88; 95% CI, 8.78⁻8.96). Vegetarians scored on average 1.18 to 2.73 more points than their non-vegetarian counterparts. Results demonstrate that the index has strong discriminant ability across distinct dietary patterns. Additionally, the VLI provides a useful measure of diet and lifestyle adherence to further refine vegetarian food pyramid guidelines.
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Colorectal cancers survivors' adherence to lifestyle recommendations and cross-sectional associations with health-related quality of life. Br J Nutr 2018; 120:188-197. [PMID: 29658446 DOI: 10.1017/s0007114518000661] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The lifestyle recommendations of the World Cancer Research Fund (WCRF)/American Institute for Cancer Research (AICR) are primarily intended for cancer prevention. In the absence of specific recommendations for cancer survivors, we investigated adherence of colorectal cancer (CRC) survivors to the WCRF/AICR lifestyle recommendations and associations with health-related quality of life (HRQoL). The cross-sectional part of the Energy for life after ColoRectal cancer (EnCoRe) study was conducted in 155 CRC survivors (stage I-III), 2-10 years post diagnosis. Dietary intake, physical activity and general body fatness were measured by 7-d food diaries, by questionnaires and accelerometers and BMI, respectively. Adherence to each of the ten WCRF/AICR recommendations was scored as 0 (no/low adherence), 0·5 (moderate adherence) or 1 point (complete adherence), and summed into an overall adherence score (range: 0-10). HRQoL, disability and distress were assessed by validated questionnaires. Associations of the overall WCRF/AICR adherence score with HRQoL outcomes were analysed by confounder-adjusted linear regression. The mean adherence score was 5·1 (sd 1·4, range: 1·5-8·5). In confounder-adjusted models, a higher adherence score was significantly associated with the HRQoL dimension better physical functioning (β per 1 point difference in score: 2·6; 95 % CI 0·2, 5·1) and with less fatigue (β: -3·3; 95 % CI -6·4, -0·1). In conclusion, higher adherence of CRC survivors to WCRF/AICR lifestyle recommendations for cancer prevention was associated with better physical functioning and with less fatigue. This study adds to the limited knowledge on adherence to lifestyle behaviours in CRC survivors and relationships with quality of life. Prospective studies are needed to investigate longitudinal associations.
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Jochems SHJ, Van Osch FHM, Bryan RT, Wesselius A, van Schooten FJ, Cheng KK, Zeegers MP. Impact of dietary patterns and the main food groups on mortality and recurrence in cancer survivors: a systematic review of current epidemiological literature. BMJ Open 2018; 8:e014530. [PMID: 29459359 PMCID: PMC5857700 DOI: 10.1136/bmjopen-2016-014530] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE To determine whether there is an association between dietary patterns/indices and foods from the main food groups (highest vs lowest intakes) prior to or after cancer diagnosis and mortality and cancer recurrence in cancer survivors. PARTICIPANTS Survivors of common cancers with a 10-year survival rate of ≥50%: bladder, bowel, breast, cervical, kidney, laryngeal, prostate, testicular, uterine cancer, malignant melanoma and (non-)Hodgkin's lymphoma. OUTCOME MEASURES Mortality (overall, cancer-specific, from other causes) and cancer recurrence. INFORMATION SOURCES PubMed, Embase and the Cochrane Library were searched from inception to April 2017. Additional studies were identified by searching reference lists. Two authors independently screened titles and abstracts, assessed study quality and extracted the data. RESULTS A total of 38 studies were included. The risk of bias was rated low for the included randomised controlled trials (RCTs) and moderate for the cohort studies. The quality of evidence was assessed with the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach and was rated moderate (RCTs), and (very)low (cohort studies). Reducing the amount of fat after diagnosis appears to decrease the risk of breast cancer recurrence. Adherence to a high-quality diet and prudent diet after diagnosis appears to decrease the risk of death from other causes (and overall mortality for high-quality diet) in breast cancer survivors. Adherence to a Western diet, before and after diagnosis, appears to increase the risk of overall mortality and death from other causes among breast cancer survivors. Evidence from studies among other cancer survivors was too limited or could not be identified. CONCLUSION For many cancer survivors, there is little evidence to date to indicate that particular dietary behaviours influence outcomes with regard to recurrence and mortality. Notwithstanding, limited evidence suggests that a low-fat diet, a high-quality diet and a prudent diet are beneficial for breast cancer survivors, while a Western diet is detrimental for breast cancer survivors.
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Affiliation(s)
- Sylvia H J Jochems
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Frits H M Van Osch
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Richard T Bryan
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Anke Wesselius
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Frederik J van Schooten
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Kar Keung Cheng
- Institute of Applied Health Research, Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, UK
| | - Maurice P Zeegers
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
- CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
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Imbalanced Nutrient Intake in Cancer Survivors from the Examination from the Nationwide Health Examination Center-Based Cohort. Nutrients 2018; 10:nu10020212. [PMID: 29443930 PMCID: PMC5852788 DOI: 10.3390/nu10020212] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 02/04/2018] [Accepted: 02/06/2018] [Indexed: 12/18/2022] Open
Abstract
This study was conducted to examine the nutrient intake status of cancer survivors. A total of 5224 cancer survivors, 19,926 non-cancer individuals without comorbidities (non-cancer I), and 20,622 non-cancer individuals with comorbidities, matched by age, gender, and recruitment center location were included in the analysis. Generally, the proportion of total energy from carbohydrates was higher and the proportion from fat was lower in cancer survivors. The odds ratios (ORs) for total energy (OR = 0.92, 95% confidence interval (CI) = 0.86–0.99), proportion of total energy from fat (OR = 0.54, 95% CI = 0.35–0.83), and protein (OR = 0.85, 95% CI = 0.79–0.90) were significantly lower, and the OR for the proportion of total energy from carbohydrates was higher (OR = 1.21, 95% CI = 1.10–1.33) in the cancer survivors than in non-cancer I. Additionally, the cancer survivors’ protein, vitamin B1, vitamin B2, niacin, and phosphorus intakes were lower, whereas their vitamin C intake was higher. When divided by cancer type, the ORs for the carbohydrate percentages were significantly higher in the colon and breast cancer survivors, whereas protein intake was lower in gastric, breast, and cervical cancer survivors. The nutrient intake patterns in Asian cancer survivors are poor, with higher carbohydrate and lower fat and protein intakes.
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Hart V, Trentham-Dietz A, Berkman A, Fujii M, Veal C, Hampton J, Gangnon RE, Newcomb PA, Gilchrist SC, Sprague BL. The association between post-diagnosis health behaviors and long-term quality of life in survivors of ductal carcinoma in situ: a population-based longitudinal cohort study. Qual Life Res 2018; 27:1237-1247. [PMID: 29417425 DOI: 10.1007/s11136-018-1807-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2018] [Indexed: 12/13/2022]
Abstract
PURPOSE Women diagnosed with ductal carcinoma in situ (DCIS) often experience adverse changes in health-related behaviors following diagnosis. The impact of health behaviors on long-term quality of life (QoL) in DCIS survivors has not been investigated. METHODS We examined the association of post-diagnosis body mass index (BMI), physical activity, alcohol, and smoking with QoL among 1448 DCIS survivors aged 20-74 enrolled in the population-based Wisconsin in situ Cohort from 1997 to 2006. Health behaviors and QoL were self-reported during biennial post-diagnosis interviews. Physical and mental QoL were measured using the validated SF-36 questionnaire. Generalized linear regression was used to determine the association between behaviors and QoL with adjustment for confounders. Lagged behavior variables were used to predict QoL during follow-up and avoid reverse causation. RESULTS Women reported 3,536 QoL observations over an average 7.9 years of follow-up. Women maintaining a healthy BMI had on average a significantly higher summary measure score of physical QoL than obese women (normal versus obese: β = 3.02; 2.18, 3.85). Physical QoL scores were also elevated among those who were physically active (5 + h/week vs. none: β = 1.96; 0.72, 3.20), those consuming at least seven drinks/week of alcohol (vs. none; β = 1.40; 0.39, 2.41), and nonsmokers (vs. current smokers: β = 1.80; 0.89, 2.71). Summary measures of mental QoL were significantly higher among women who were moderately physically active (up to 2 h/week vs. none: β = 1.11; 0.30, 1.92) and nonsmokers (vs. current smokers: β = 1.49;0.45, 2.53). CONCLUSIONS Our results demonstrate that maintaining healthy behaviors following DCIS treatment is associated with modest improvements in long-term QoL. These results inform interventions aimed at promoting healthy behaviors and optimizing QoL in DCIS survivors.
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Affiliation(s)
- Vicki Hart
- Vermont Center for Behavior and Health, Office of Health Promotion Research, Department of Surgery, University of Vermont, 1 South Prospect Street, Rm. 4425, Burlington, VT, 05401, USA
| | - Amy Trentham-Dietz
- Department of Population Health Sciences and Carbone Cancer Center, University of Wisconsin, Madison, WI, USA
| | - Amy Berkman
- Office of Health Promotion Research and Department of Surgery, University of Vermont, Burlington, VT, USA
| | - Mayo Fujii
- Office of Health Promotion Research and Department of Surgery, University of Vermont, Burlington, VT, USA
| | - Christopher Veal
- Vermont Center for Behavior and Health, Office of Health Promotion Research, Department of Surgery, University of Vermont, 1 South Prospect Street, Rm. 4425, Burlington, VT, 05401, USA
| | - John Hampton
- Department of Population Health Sciences and Carbone Cancer Center, University of Wisconsin, Madison, WI, USA
| | - Ronald E Gangnon
- Departments of Biostatistics and Medical Informatics and Population Health Sciences, Carbone Cancer Center, University of Wisconsin, Madison, WI, USA
| | - Polly A Newcomb
- Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Susan C Gilchrist
- Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Brian L Sprague
- Vermont Center for Behavior and Health, Office of Health Promotion Research, Department of Surgery, University of Vermont, 1 South Prospect Street, Rm. 4425, Burlington, VT, 05401, USA.
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Does adherence to the World Cancer Research Fund/American Institute of Cancer Research cancer prevention guidelines reduce risk of colorectal cancer in the UK Women's Cohort Study? Br J Nutr 2018; 119:340-348. [PMID: 29352814 DOI: 10.1017/s0007114517003622] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Evidence on adherence to diet-related cancer prevention guidelines and associations with colorectal cancer (CRC) risk is limited and conflicting. The aim of this cohort analysis is to evaluate associations between adherence to the World Cancer Research Fund/American Institute of Cancer Research (WCRF/AICR) 2007 recommendations and incident CRC. The UK Women's Cohort Study comprises over 35 372 women who filled in a FFQ at baseline in 1995. They were followed up for CRC incidence for a median of 17·4 years, an individual score linking adherence to eight of the WCRF/AICR recommendations was constructed. Cox proportional hazards regression provided hazard ratios (HR) and 95 % CI for the estimation of CRC risk, adjusting for confounders. Following exclusions, 444 CRC cases were identified. In the multivariate-adjusted model, women within the second and third (highest) categories of the WRCF/AICR score had HR of 0·79 (95 % CI 0·62, 1·00) and 0·73 (95 % CI 0·48, 1·10), respectively, for CRC compared with those in the lowest, reference category. The overall linear trend across the categories was not significant (P=0·17). No significant associations were observed between the WCRF/AICR score and proximal colon, distal colon and rectal cancers separately. Of the individual score components, a BMI within the normal weight range was borderline significantly protective only for rectal cancer in the fully adjusted model. In view of the likely different causes of CRC subtypes, further research is needed to identify the optimal dietary patterns associated with reducing colon and rectal cancer risk, respectively.
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Armenian SH, Ryan TD, Khouri MG. Cardiac Dysfunction and Heart Failure in Hematopoietic Cell Transplantation Survivors: Emerging Paradigms in Pathophysiology, Screening, and Prevention. Heart Fail Clin 2017; 13:337-345. [PMID: 28279419 DOI: 10.1016/j.hfc.2016.12.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Hematopoietic cell transplantation (HCT) has been used for curative intent in patients with hematologic and nonhematologic malignancies, resulting in an increasing number of HCT survivors. These survivors are at risk for serious and life-threatening complications, including cardiovascular disease (CVD). This article provides an overview of CVD in HCT survivors, describing the pathophysiology of disease, with a special emphasis on therapeutic exposures and comorbidities unique to this population. This article also discusses novel screening and prevention strategies that have shown promise in non-HCT cancer populations, emphasizing opportunities for collaboration between cardiologists and hematologists to improve the cardiovascular health of HCT survivors.
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Affiliation(s)
- Saro H Armenian
- Division of Outcomes Research, Department of Population Sciences, Comprehensive Cancer Center, City of Hope, 1500 East Duarte Road, Duarte, CA 91010-3000, USA.
| | - Thomas D Ryan
- Department of Cardiology, The Heart Institute, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229-3026, USA
| | - Michel G Khouri
- Division of Cardiology, Department of Medicine, Duke University, 2301 Erwin Road, Durham, NC 27710, USA
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Fassier P, Zelek L, Lécuyer L, Bachmann P, Touillaud M, Druesne‐Pecollo N, Galan P, Cohen P, Hoarau H, Latino‐Martel P, Kesse‐Guyot E, Baudry J, Hercberg S, Deschasaux M, Touvier M. Modifications in dietary and alcohol intakes between before and after cancer diagnosis: Results from the prospective population-based NutriNet-Santé cohort. Int J Cancer 2017; 141:457-470. [PMID: 28335085 PMCID: PMC5655904 DOI: 10.1002/ijc.30704] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 02/20/2017] [Accepted: 03/08/2017] [Indexed: 12/19/2022]
Abstract
Postdiagnosis diet and alcohol consumption may be associated with cancer prognosis, recurrence and mortality. Our aim was to investigate food, nutrient and alcohol intake variations between before and after cancer diagnosis and their determinants in a prospective cohort. Subjects (n = 696) were incident cancer cases diagnosed in the NutriNet-Santé cohort between 2009 and 2016. Food, nutrient and alcohol intakes were prospectively collected using repeated nonconsecutive 24-hr dietary records since subjects' inclusion (i.e. an average of 2 y before diagnosis). Mean number of dietary records per subject was 5.9 before and 8.1 after diagnosis. All dietary data before and after diagnosis were compared by mixed models. Factors associated with the main dietary changes observed were also investigated using multivariable logistic regressions. We observed a decrease in intakes of vegetables (mean decrease in intake in patients who decreased their intake=-102.4 ± 79.8 g/d), dairy products (-93.9 ± 82.8 g/d), meat/offal (-35.5 ± 27.8/d), soy products (-85.8 ± 104.1 g/d), sweetened soft drinks (-77.9 ± 95.4 g/d), and alcoholic drinks (-92.9 ± 119.9 g/d), and an increase in broths (42.1 ± 34.9 g/d) and fats/sauces (18.0 ± 13.4 g/d). We observed a decrease in energy intake (-377.2 ± 243.5 kcal/d) and in intakes of alcohol (-7.6 ± 9.4 g/d) proteins (-17.4 ± 12.5 g/d), and several vitamins (p < 0.05) and micronutrients (p < 0.05). Conversely, lipid (19.4 ± 14.6 g/d), SFA (9.3 ± 7.0 g/d), MUFA (8.3 ± 6.3 g/d) and vitamin E (3.9 ± 3.3 mg/d) intakes increased after diagnosis. This large prospective study suggests that cancer diagnosis is a key period for nutritional changes. It highlights some healthy behaviors such as a decrease in alcohol and sweetened drink consumption, but also less favorable trends, such as a decrease in vegetable consumption and in many vitamin and mineral intakes. These results provide insights to identify and target recommendations to put forward for better nutritional care of cancer survivors.
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Affiliation(s)
- Philippine Fassier
- Sorbonne Paris Cité Epidemiology and Statistics Research Center, Nutritional Epidemiology Research Team (EREN): Inserm U1153Inra U1125, Cnam, Paris 5, 7 and 13 UniversitiesBobignyF‐93017France
| | - Laurent Zelek
- Sorbonne Paris Cité Epidemiology and Statistics Research Center, Nutritional Epidemiology Research Team (EREN): Inserm U1153Inra U1125, Cnam, Paris 5, 7 and 13 UniversitiesBobignyF‐93017France
- Oncology DepartmentAvicenne HospitalBobignyF‐93017France
| | - Lucie Lécuyer
- Sorbonne Paris Cité Epidemiology and Statistics Research Center, Nutritional Epidemiology Research Team (EREN): Inserm U1153Inra U1125, Cnam, Paris 5, 7 and 13 UniversitiesBobignyF‐93017France
| | | | - Marina Touillaud
- Léon Bérard Cancer CenterLyonF‐69008France
- Cancer Research Centre of Lyon UMR Inserm 1052 CNRS 5286 CLBLyonF‐69003France
| | - Nathalie Druesne‐Pecollo
- Sorbonne Paris Cité Epidemiology and Statistics Research Center, Nutritional Epidemiology Research Team (EREN): Inserm U1153Inra U1125, Cnam, Paris 5, 7 and 13 UniversitiesBobignyF‐93017France
| | - Pilar Galan
- Sorbonne Paris Cité Epidemiology and Statistics Research Center, Nutritional Epidemiology Research Team (EREN): Inserm U1153Inra U1125, Cnam, Paris 5, 7 and 13 UniversitiesBobignyF‐93017France
| | - Patrice Cohen
- Sociology DepartmentUniversity of Rouen, DySolaEA 4701RouenF‐76821France
| | - Hélène Hoarau
- Sociology DepartmentUniversity of Rouen, DySolaEA 4701RouenF‐76821France
| | - Paule Latino‐Martel
- Sorbonne Paris Cité Epidemiology and Statistics Research Center, Nutritional Epidemiology Research Team (EREN): Inserm U1153Inra U1125, Cnam, Paris 5, 7 and 13 UniversitiesBobignyF‐93017France
| | - Emmanuelle Kesse‐Guyot
- Sorbonne Paris Cité Epidemiology and Statistics Research Center, Nutritional Epidemiology Research Team (EREN): Inserm U1153Inra U1125, Cnam, Paris 5, 7 and 13 UniversitiesBobignyF‐93017France
| | - Julia Baudry
- Sorbonne Paris Cité Epidemiology and Statistics Research Center, Nutritional Epidemiology Research Team (EREN): Inserm U1153Inra U1125, Cnam, Paris 5, 7 and 13 UniversitiesBobignyF‐93017France
| | - Serge Hercberg
- Sorbonne Paris Cité Epidemiology and Statistics Research Center, Nutritional Epidemiology Research Team (EREN): Inserm U1153Inra U1125, Cnam, Paris 5, 7 and 13 UniversitiesBobignyF‐93017France
- Public Health DepartmentAvicenne HospitalBobignyF‐93017France
| | - Mélanie Deschasaux
- Sorbonne Paris Cité Epidemiology and Statistics Research Center, Nutritional Epidemiology Research Team (EREN): Inserm U1153Inra U1125, Cnam, Paris 5, 7 and 13 UniversitiesBobignyF‐93017France
| | - Mathilde Touvier
- Sorbonne Paris Cité Epidemiology and Statistics Research Center, Nutritional Epidemiology Research Team (EREN): Inserm U1153Inra U1125, Cnam, Paris 5, 7 and 13 UniversitiesBobignyF‐93017France
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Frateur L, Blondeel N, Gilquin A, Aujoulat I, Duhoux F. Comment améliorer l’accompagnement diététique des patientes « survivors » d’un cancer du sein en surcharge pondérale ? Analyse des besoins éducatifs de cette population. NUTR CLIN METAB 2017. [DOI: 10.1016/j.nupar.2016.10.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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