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Al-Sayegh H, Al-Zadjali S, Al-Moundhri M. Analyzing Cancer Incidence Trends in Oman From 1996 to 2019: A Comprehensive Study of the National Cancer Annual Reports. JCO Glob Oncol 2024; 10:e2300337. [PMID: 38271648 PMCID: PMC10830084 DOI: 10.1200/go.23.00337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 10/19/2023] [Accepted: 11/17/2023] [Indexed: 01/27/2024] Open
Abstract
PURPOSE Previous studies have reported that cancer incidence trends in Oman varied by tumor site and sex. No comprehensive analysis of all cancer sites had been reported. The objective of this study is to analyze cancer incidence trends in Oman and calculate the annual percent change (APC) in age-standardized rates (ASRs) for all-cancer and 61 individual cancer sites in Omani men and women from 1996 to 2019. METHODS We gathered incidence data from The Omani National Cancer Registry for all cancers combined and individual tumor sites. We estimated the APC using Poisson regression. RESULTS The cancer ASR in the Omani population increased by 23% (from 95/100,000 in 1996 to 117.2/100,000 in 2019), with the increase being more pronounced in females (48% v 7% in males). Among the male population, there was significant increase in the ASRs of colon, rectum, thyroid, and prostate cancers, with APCs of 6.92%, 4.24%, 4.19%, and 2.03%, respectively. Among females, all-cancer incidence showed significant increase (APC = 1.39%), and increasing trends were observed in uterine, colon, rectum, thyroid, and breast cancers (APCs = 7.57%, 7.08%, 5.19%, 5.16%, and 4.19%, respectively). CONCLUSION The ASR of all-cancer increased significantly in Omani women but not in men. Uterine cancer had the highest APC. Colorectal cancer and thyroid ASR increased in both males and females. Breast and prostate cancers showed increasing trends. Further research is needed to explore factors contributing to increasing cancer incidences.
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Affiliation(s)
- Hasan Al-Sayegh
- Sultan Qaboos Comprehensive Cancer Care and Research Center (SQCCCRC), Muscat, Oman
| | - Shoaib Al-Zadjali
- Sultan Qaboos Comprehensive Cancer Care and Research Center (SQCCCRC), Muscat, Oman
| | - Mansour Al-Moundhri
- Sultan Qaboos Comprehensive Cancer Care and Research Center (SQCCCRC), Muscat, Oman
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Smith L, Von Wagner C, Kaushal A, Rafiq M, Lyratzopoulos G, Renzi C. The Role of Type 2 Diabetes in Patient Symptom Attribution, Help-Seeking, and Attitudes to Investigations for Colorectal Cancer Symptoms: An Online Vignette Study. Cancers (Basel) 2023; 15:1668. [PMID: 36980553 PMCID: PMC10045970 DOI: 10.3390/cancers15061668] [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: 01/30/2023] [Revised: 03/05/2023] [Accepted: 03/06/2023] [Indexed: 03/12/2023] Open
Abstract
OBJECTIVES Type 2 diabetes is associated with a higher risk of colorectal cancer (CRC) and advanced-stage cancer diagnosis. To help diagnose cancer earlier, this study aimed at examining whether diabetes might influence patient symptom attribution, help-seeking, and willingness to undergo investigations for possible CRC symptoms. METHODS A total of 1307 adults (340 with and 967 without diabetes) completed an online vignette survey. Participants were presented with vignettes describing new-onset red-flag CRC symptoms (rectal bleeding or a change in bowel habits), with or without additional symptoms of diabetic neuropathy. Following the vignettes, participants were asked questions on symptom attribution, intended help-seeking, and attitudes to investigations. RESULTS Diabetes was associated with greater than two-fold higher odds of attributing changes in bowel habits to medications (OR = 2.48; 95% Cl 1.32-4.66) and of prioritising diabetes-related symptoms over the change in bowel habits during medical encounters. Cancer was rarely mentioned as a possible explanation for the change in bowel habits, especially among diabetic participants (10% among diabetics versus 16% in nondiabetics; OR = 0.55; 95% CI 0.36-0.85). Among patients with diabetes, those not attending annual check-ups were less likely to seek help for red-flag cancer symptoms (OR = 0.23; 95% Cl 0.10-0.50). CONCLUSIONS Awareness of possible cancer symptoms was low overall. Patients with diabetes could benefit from targeted awareness campaigns emphasising the importance of discussing new symptoms such as changes in bowel habits with their doctor. Specific attention is warranted for individuals not regularly attending healthcare despite their chronic morbidity.
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Affiliation(s)
- Lauren Smith
- Research Department of Behavioural Science and Health, University College London, London WC1E 6BT, UK; (L.S.)
| | - Christian Von Wagner
- Research Department of Behavioural Science and Health, University College London, London WC1E 6BT, UK; (L.S.)
| | - Aradhna Kaushal
- Research Department of Behavioural Science and Health, University College London, London WC1E 6BT, UK; (L.S.)
| | - Meena Rafiq
- Research Department of Behavioural Science and Health, University College London, London WC1E 6BT, UK; (L.S.)
- Centre for Cancer Research and Department of General Practice, University of Melbourne, Melbourne 3052, Australia
| | - Georgios Lyratzopoulos
- Research Department of Behavioural Science and Health, University College London, London WC1E 6BT, UK; (L.S.)
| | - Cristina Renzi
- Research Department of Behavioural Science and Health, University College London, London WC1E 6BT, UK; (L.S.)
- Faculty of Medicine, University Vita-Salute San Raffaele, 20132 Milan, Italy
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Aliri J, Prego-Jimenez S, Goñi-Balentziaga O, Pereda-Pereda E, Perez-Tejada J, Labaka Etxeberria A. Gender awareness is also nurses' business: Measuring sensitivity and role ideology towards patients. J Nurs Manag 2022; 30:4409-4418. [PMID: 36217683 PMCID: PMC10092084 DOI: 10.1111/jonm.13866] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 09/02/2022] [Accepted: 09/28/2022] [Indexed: 12/30/2022]
Abstract
AIM This study aims to validate the Nijmegen Gender Awareness in Medicine Scale, which assesses gender sensitivity and gender-role ideology towards patients in the Spanish language for use among physicians and nurses. BACKGROUND Women are more likely to suffer pain, delays and health consequences related to low therapeutic effort. Health professionals' gender awareness may minimize such bias; however, the only instrument to assess such awareness is limited to physicians and lacks a Spanish version. METHODS After using the back-translation method, a sample of 167 Spanish nurses and nursing students completed the instrument. In order to obtain additional validity evidence, 98 health professionals filled in gender sensitivity and gender-role ideology towards patients' subscales and the short versions of the Ambivalent Sexism Inventory. RESULTS Gender-role ideology towards patients correlated strongly with sexist attitudes, demonstrating convergent validity, and Cronbach's alpha coefficients showed an adequate internal consistency. CONCLUSIONS Nijmegen Gender Awareness in Medicine Scale perfectly applies to nurse population, and this adaptation also broadens its use for Spanish professionals. IMPLICATIONS FOR NURSING MANAGEMENT Nurse managers and educators can use this applicable tool to treat low gender awareness levels as a modifiable risk factor and promote a gender-sensitive caring culture.
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Affiliation(s)
- Jone Aliri
- Clinical and Health Psychology and Research Methodology Department, University of the Basque Country (UPV/EHU), San Sebastian, Basque Country, Spain
| | - Sara Prego-Jimenez
- Clinical and Health Psychology and Research Methodology Department, University of the Basque Country (UPV/EHU), San Sebastian, Basque Country, Spain.,University Hospital Donostia, San Sebastian, Spain
| | - Olatz Goñi-Balentziaga
- Clinical and Health Psychology and Research Methodology Department, University of the Basque Country (UPV/EHU), San Sebastian, Basque Country, Spain
| | - Eva Pereda-Pereda
- Osakidetza-Basque National Health Service, Vitoria-Gasteiz, Basque Country, Spain.,Group of Mental Health and Psychiatric Care, Biodonostia Health Research Institute, San Sebastian, Basque Country, Spain
| | | | - Ainitze Labaka Etxeberria
- Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), San Sebastian, Basque Country, Spain
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Martins T, Abel G, Ukoumunne OC, Mounce LTA, Price S, Lyratzopoulos G, Chinegwundoh F, Hamilton W. Ethnic inequalities in routes to diagnosis of cancer: a population-based UK cohort study. Br J Cancer 2022; 127:863-871. [PMID: 35661833 PMCID: PMC9427836 DOI: 10.1038/s41416-022-01847-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 04/08/2022] [Accepted: 05/06/2022] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND UK Asian and Black ethnic groups have poorer outcomes for some cancers and are less likely to report a positive care experience than their White counterparts. This study investigated ethnic differences in the route to diagnosis (RTD) to identify areas in patients' cancer journeys where inequalities lie, and targeted intervention might have optimum impact. METHODS We analysed data of 243,825 patients with 10 cancers (2006-2016) from the RTD project linked to primary care data. Crude and adjusted proportions of patients diagnosed via six routes (emergency, elective GP referral, two-week wait (2WW), screen-detected, hospital, and Other routes) were calculated by ethnicity. Adjusted odds ratios (including two-way interactions between cancer and age, sex, IMD, and ethnicity) determined cancer-specific differences in RTD by ethnicity. RESULTS Across the 10 cancers studied, most patients were diagnosed via 2WW (36.4%), elective GP referral (23.2%), emergency (18.2%), hospital routes (10.3%), and screening (8.61%). Patients of Other ethnic group had the highest proportion of diagnosis via the emergency route, followed by White patients. Asian and Black group were more likely to be GP-referred, with the Black and Mixed groups also more likely to follow the 2WW route. However, there were notable cancer-specific differences in the RTD by ethnicity. CONCLUSION Our findings suggest that, where inequalities exist, the adverse cancer outcomes among Asian and Black patients are unlikely to be arising solely from a poorer diagnostic process.
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Affiliation(s)
- Tanimola Martins
- College of Medicine and Health, University of Exeter, College House, St Luke's Campus, Magdalen Road, Exeter, EX1 2LU, UK.
| | - Gary Abel
- College of Medicine and Health, University of Exeter, College House, St Luke's Campus, Magdalen Road, Exeter, EX1 2LU, UK
| | - Obioha C Ukoumunne
- National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) South West Peninsula (PenARC), University of Exeter, Exeter, UK
| | - Luke T A Mounce
- College of Medicine and Health, University of Exeter, College House, St Luke's Campus, Magdalen Road, Exeter, EX1 2LU, UK
| | - Sarah Price
- College of Medicine and Health, University of Exeter, College House, St Luke's Campus, Magdalen Road, Exeter, EX1 2LU, UK
| | - Georgios Lyratzopoulos
- Epidemiology of Cancer Healthcare & Outcomes (ECHO) Group, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - Frank Chinegwundoh
- Barts Health NHS Trust & Department of Health Sciences, University of London, London, UK
| | - William Hamilton
- College of Medicine and Health, University of Exeter, College House, St Luke's Campus, Magdalen Road, Exeter, EX1 2LU, UK
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Quiroga M, Shephard EA, Mounce LTA, Carney M, Hamilton WT, Price SJ. Quantifying the impact of pre-existing conditions on the stage of oesophagogastric cancer at diagnosis: a primary care cohort study using electronic medical records. Fam Pract 2021; 38:425-431. [PMID: 33346832 PMCID: PMC8414906 DOI: 10.1093/fampra/cmaa132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Pre-existing conditions interfere with cancer diagnosis by offering diagnostic alternatives, competing for clinical attention or through patient surveillance. OBJECTIVE To investigate associations between oesophagogastric cancer stage and pre-existing conditions. METHODS Retrospective cohort study using Clinical Practice Research Datalink (CPRD) data, with English cancer registry linkage. Participants aged ≥40 years had consulted primary care in the year before their incident diagnosis of oesophagogastric cancer in 01/01/2010-31/12/2015. CPRD records pre-diagnosis were searched for codes denoting clinical features of oesophagogastric cancer and for pre-existing conditions, including those providing plausible diagnostic alternatives for those features. Logistic regression analysed associations between stage and multimorbidity (≥2 conditions; reference category: no multimorbidity) and having 'diagnostic alternative(s)', controlling for age, sex, deprivation and cancer site. RESULTS Of 2444 participants provided, 695 (28%) were excluded for missing stage, leaving 1749 for analysis (1265/1749, 72.3% had advanced-stage disease). Multimorbidity was associated with stage [odds ratio 0.63, 95% confidence interval (CI) 0.47-0.85, P = 0.002], with moderate evidence of an interaction term with sex (1.76, 1.08-2.86, P = 0.024). There was no association between alternative explanations and stage (odds ratio 1.18, 95% CI 0.87-1.60, P = 0.278). CONCLUSIONS In men, multimorbidity is associated with a reduced chance of advanced-stage oesophagogastric cancer, to levels seen collectively for women.
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Affiliation(s)
- Myra Quiroga
- Morsani College of Medicine, University of Southern Florida, Tampa, FL, USA
| | - Elizabeth A Shephard
- Discovery Research Group, College of Medicine and Health, University of Exeter, St Luke's Campus, Exeter, UK
| | - Luke T A Mounce
- Discovery Research Group, College of Medicine and Health, University of Exeter, St Luke's Campus, Exeter, UK
| | - Madeline Carney
- Morsani College of Medicine, University of Southern Florida, Tampa, FL, USA
| | - William T Hamilton
- Discovery Research Group, College of Medicine and Health, University of Exeter, St Luke's Campus, Exeter, UK
| | - Sarah J Price
- Discovery Research Group, College of Medicine and Health, University of Exeter, St Luke's Campus, Exeter, UK
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Koo MM, Swann R, McPhail S, Abel GA, Renzi C, Rubin GP, Lyratzopoulos G. The prevalence of chronic conditions in patients diagnosed with one of 29 common and rarer cancers: A cross-sectional study using primary care data. Cancer Epidemiol 2020; 69:101845. [PMID: 33227628 PMCID: PMC7768190 DOI: 10.1016/j.canep.2020.101845] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 10/09/2020] [Accepted: 10/14/2020] [Indexed: 01/15/2023]
Abstract
BACKGROUND Pre-existing chronic conditions (morbidities) influence the diagnosis and management of cancer. The prevalence of specific morbidities in patients diagnosed with common and rarer cancers is inadequately described. METHODS Using data from the English National Cancer Diagnosis Audit 2014, we studied 11 pre-existing morbidities recorded as yes/no items by participating general practitioners based on information included in primary care records. We examined the number and type of morbidities across socio-demographic and cancer site strata, and subsequently estimated observed and age/sex standardised prevalence of each morbidity by cancer. RESULTS Over three-quarters (77 %; 11,429/14,774) of non-screen-detected patients had at least one chronic condition before diagnosis, while nearly half (47 %) had two or more. Hypertension (39 %) and physical disability (2%) were the most and least common conditions. Male, older and more socio-economically deprived patients were more likely to have at least one morbidity (p < 0.001 for all between variable group comparisons). For most morbidities, the standardised prevalence was similar across different cancers with a few exceptions, including respiratory disease prevalence being greatest among lung cancer patients and diabetes prevalence being greatest among liver, pancreatic, and endometrial cancer patients. CONCLUSIONS Most cancer patients have at least one morbidity, while almost one in two have two or more. The findings highlight the need to take certain morbidity- and cancer-site combinations into account when examining associations between morbidity and cancer outcomes.
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Affiliation(s)
- Minjoung Monica Koo
- University College London, 1-19 Torrington Place, London WC1E 6BT, UK; National Cancer Registration and Analysis Service, Public Health England, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK.
| | - Ruth Swann
- National Cancer Registration and Analysis Service, Public Health England, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK; Cancer Research UK, 2 Redman Place, London, E20 1JQ, UK
| | - Sean McPhail
- University College London, 1-19 Torrington Place, London WC1E 6BT, UK; National Cancer Registration and Analysis Service, Public Health England, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK
| | - Gary A Abel
- University of Exeter Medical School, St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - Cristina Renzi
- University College London, 1-19 Torrington Place, London WC1E 6BT, UK
| | - Greg P Rubin
- Institute of Health and Society, Newcastle University, Sir James Spence Institute, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK
| | - Georgios Lyratzopoulos
- University College London, 1-19 Torrington Place, London WC1E 6BT, UK; National Cancer Registration and Analysis Service, Public Health England, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK
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Renzi C, Lyratzopoulos G. Comorbidity and the diagnosis of symptomatic-but-as-yet-undiagnosed cancer. Br J Gen Pract 2020; 70:e598-e599. [PMID: 32855148 PMCID: PMC7449439 DOI: 10.3399/bjgp20x712193] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Affiliation(s)
- Cristina Renzi
- Epidemiology of Cancer Healthcare and Outcomes (ECHO) Group, University College London, London, UK
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