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Sexual Function and Satisfaction in Young Women with Breast Cancer: A Five-Year Prospective Study. 年轻女性乳腺癌患者的性功能和满意度:一项为期五年的前瞻性研究
IF 3.4 Q2 ONCOLOGY Pub Date : 2024-11-06 DOI: 10.1093/jncics/pkae111
Ana Ferrigno Guajardo, Bryan F Vaca-Cartagena, Fernanda Mesa-Chavez, Alejandra Platas, Alan Fonseca, Marlid Cruz-Ramos, Melina Miaja Avila, Ana Laura Rodriguez, Paula Cabrera-Galeana, Alejandro Mohar, Cynthia Villarreal-Garza

Background: Young women with breast cancer (YWBC) face unique challenges that can impact their sexual health. This study aimed to identify factors associated with sexual activity, function, and satisfaction in YWBC up to five years post-diagnosis.

Methods: We conducted a prospective cohort study of 474 women aged ≤40 years diagnosed with non-metastatic breast cancer in Mexico. Sexual function and satisfaction were assessed using the Female Sexual Function Index and the Sexual Satisfaction Inventory, respectively. Factors associated with sexual health outcomes were examined using mixed-effects models.

Results: The prevalence of sexual dysfunction increased from 33.6% at baseline to 52.9% at 4-5 years post-diagnosis. Factors associated with worse sexual function included older age (mean predicted FSFI score -1.35, p = .037), treatment-induced amenorrhea (-2.86, p < .001), depression (-4.11, p < .001), and anxiety (-2.13, p < .001). Lower sexual satisfaction was associated with lower educational attainment (mean predicted SSI score -5.61, p = .002), being single (-6.41, p < .001), treatment induced amenorrhea (-3.76, p = .004), bilateral oophorectomy (-8.21, p = .017), depression (-11.29, p < .001), and anxiety (-7.50, p < .001). Quality of life, body image, and systemic therapy side effects significantly impacted both outcomes. Three distinct trajectories of sexual function were identified: high (62.2%), intermediate (24.3%), and markedly declining (13.5%). Four trajectories of sexual satisfaction were found, ranging from intermediate-to-high (57.3%) to progressively worsening (27.5%).

Conclusion: Sexual dysfunction is prevalent and persistent among YWBC. Multiple biological, psychological, and social factors influence sexual health outcomes in this population. These findings highlight the importance of routine screening and tailored interventions to address the sexual health of YWBC throughout survivorship.

背景:年轻女性乳腺癌患者(YWBC)面临着可能影响其性健康的独特挑战。本研究旨在确定与 YWBC 诊断后五年内的性活动、性功能和性满足相关的因素:我们对墨西哥 474 名年龄小于 40 岁、确诊为非转移性乳腺癌的女性进行了前瞻性队列研究。性功能和满意度分别通过女性性功能指数和性满意度量表进行评估。采用混合效应模型研究了与性健康结果相关的因素:结果:性功能障碍的发生率从基线时的 33.6% 增加到诊断后 4-5 年的 52.9%。与性功能较差相关的因素包括年龄较大(预测的 FSFI 平均得分-1.35,p = .037)、治疗引起的闭经(-2.86,p 结论:性功能障碍在女性同性恋者中普遍存在:性功能障碍在青年妇女和儿童中普遍存在且持续存在。多种生物、心理和社会因素影响着这一人群的性健康结果。这些研究结果强调了常规筛查和有针对性的干预措施对解决女青年在整个生存期的性健康问题的重要性。
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引用次数: 0
County-level racial disparities in prostate cancer specific mortality from 2005 to 2020. 2005 年至 2020 年前列腺癌特定死亡率的县级种族差异。
IF 3.4 Q2 ONCOLOGY Pub Date : 2024-11-04 DOI: 10.1093/jncics/pkae109
Samuel L Washington, Mary Fakunle, Lufan Wang, Avery E Braun, Michael Leapman, Janet E Cowan, Matthew R Cooperberg

Background: Local conditions where people live continue to influence prostate cancer outcomes. By examining local characteristics associated with trends in Black-White differences in prostate cancer specific mortality (PCSM) over time, we aim to identify factors driving county-level PCSM disparities over a 15-year period.

Methods: We linked county-level data (Area Health Resource File) with clinicodemographic data of men with prostate cancer (Surveillance, Epidemiology, and End Results registry) from 2005 to 2020. Generalized linear mixed models evaluated associations between race and county-level age-standardized PCSM, adjusting for age, year of death, rurality, and county-level education, income, uninsured rates, and densities of urologists, radiologists, primary care providers, and hospital beds.

Results: 185,390 patients in 1085 counties were identified, of which 15.8% were non-Hispanic Black. Racial disparities in PCSM narrowed from 2005 to 2020 (25.4 per 100,000 to 19.2 per 100,000 overall; 57.9 per 100,000 to 38 per 100,000 for Non-Hispanic Black patients and 23.4 per 100,000 to 18.3 per 100,000 for Non-Hispanic White patients). For both Non-Hispanic Black and Non-Hispanic White patients, county PCSM changes varied greatly (-65% to + 77% and -61% to + 112%, respectively). From 2016 to 2020, Non-Hispanic Black harbored greater PCSM risk (RR 2.09, 95% CI 2.01-2.18); higher radiation oncologist density was significantly associated with lower mortality risk (RR 0.93, 95% CI 0.89-0.98) while other provider densities were not.

Conclusion: Although overall rates improved, specific counties experienced worsening race-based disparities over time. Identifying locations of highest (and lowest) mortality disparities remains critical to development of location-specific solutions to racial disparities in prostate cancer outcomes.

背景:人们生活的当地条件继续影响着前列腺癌的治疗效果。通过研究与黑人-白人前列腺癌特异性死亡率(PCSM)随时间变化的趋势相关的地方特征,我们旨在确定在 15 年间造成县级 PCSM 差异的因素:我们将 2005 年至 2020 年的县级数据(地区卫生资源档案)与前列腺癌男性患者的门诊人口学数据(监测、流行病学和最终结果登记)联系起来。广义线性混合模型评估了种族与县级年龄标准化 PCSM 之间的关系,并调整了年龄、死亡年份、乡村、县级教育、收入、无保险率以及泌尿科医生、放射科医生、初级保健提供者和医院床位的密度:结果:确定了 1085 个县的 185,390 名患者,其中 15.8% 为非西班牙裔黑人。从 2005 年到 2020 年,PCSM 的种族差异有所缩小(总体从每 10 万人 25.4 例降至每 10 万人 19.2 例;非西班牙裔黑人患者从每 10 万人 57.9 例降至每 10 万人 38 例;非西班牙裔白人患者从每 10 万人 23.4 例降至每 10 万人 18.3 例)。对于非西班牙裔黑人和非西班牙裔白人患者而言,县级 PCSM 变化差异很大(分别为 -65% 至 + 77% 和 -61% 至 + 112%)。从2016年到2020年,非西班牙裔黑人的PCSM风险更高(RR 2.09,95% CI 2.01-2.18);放射肿瘤学家密度越高,死亡率风险越低(RR 0.93,95% CI 0.89-0.98),而其他医疗机构密度则不然:结论:尽管总体死亡率有所提高,但随着时间的推移,特定县域的种族差异在不断恶化。确定死亡率差异最高(和最低)的地区对于制定针对特定地区的前列腺癌种族差异解决方案至关重要。
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引用次数: 0
Impact of chemotherapy on patients with mismatch repair deficient advanced endometrial carcinomas-a meta-analysis. 化疗对错配修复缺陷晚期子宫内膜癌患者的影响--一项荟萃分析。
IF 3.4 Q2 ONCOLOGY Pub Date : 2024-11-01 DOI: 10.1093/jncics/pkae101
Angelina Tjokrowidjaja, Peey-Sei Kok, Yoland C Antill, Clare L Scott, Linda R Mileshkin, Michael L Friedlander, Chee K Lee

Background: Chemo-immunotherapy is standard of care for women with recurrent or advanced mismatch repair deficient endometrial carcinoma. However, it is uncertain whether patients with mismatch repair deficient advanced or recurrent endometrial carcinoma derive less benefit from chemotherapy than those with mismatch repair proficient endometrial carcinoma.

Methods: We performed a meta-analysis of randomized controlled trials (RCTs) in advanced or recurrent endometrial carcinoma to determine the difference in the benefit of chemotherapy in mismatch repair deficient vs mismatch repair proficient endometrial carcinoma. Data on chemotherapy outcomes including objective response rate, progression-free survival (PFS), and overall survival were retrieved. We pooled these data using the inverse variance method and examined subgroup difference by mismatch repair status. We also compared differences in PFS and overall survival outcomes by creating individual patient data from the Kaplan-Meier curves of trial publications for sensitivity analyses.

Results: A total of 5 RCTs with 1137 participants (mismatch repair deficient, 26%; mismatch repair proficient, 74%) were included. All participants were treated with carboplatin-based chemotherapy. There was no difference between the mismatch repair deficient and mismatch repair proficient subgroups for objective response rate (66.5% vs 64.0%; P = .20 for subgroup difference), PFS (hazard ratio [HR] = 0.93, 95% confidence interval [CI] = 0.77 to 1.12; P = .44; median PFS = 7.6 vs 9.5 months) or overall survival (HR = 1.03, 95% CI = 0.73 to 1.44; P = .88; median overall survival = not reached vs 28.6 months).

Conclusions: Objective response rate, PFS, and overall survival were similar among those with mismatch repair deficient vs mismatch repair proficient endometrial cancer treated with front-line, platinum-doublet chemotherapy in RCTs. These findings reinforce the importance of combining chemotherapy together with immune checkpoint inhibitors until the results of trials comparing immune checkpoint therapy alone with combination therapy are available.

简介:化疗免疫疗法是治疗复发或晚期错配修复缺陷(dMMR)子宫内膜癌(EC)妇女的标准疗法。然而,目前还不确定dMMR晚期或复发性子宫内膜癌患者从化疗中获得的益处是否少于错配修复熟练型(pMMR)子宫内膜癌患者:我们对晚期/复发性EC的随机对照试验(RCT)进行了荟萃分析,以确定dMMR与pMMR EC化疗获益的差异。我们检索了化疗结果数据,包括客观反应率(ORR)、无进展生存期(PFS)和总生存期(OS)。我们使用逆方差法汇总了这些数据,并根据 MMR 状态研究了亚组差异。我们还通过从试验出版物的 Kaplan-Meier 曲线中创建单个患者数据来比较 PFS 和 OS 结果的差异,以进行敏感性分析:共纳入了 5 项 RCT,1137 名参与者(dMMR,26%;pMMR,74%)。所有参与者均接受了以卡铂为基础的化疗。dMMR亚组和pMMR亚组在ORR(66.5% vs 64.0%,亚组差异P = .20)、PFS(HR 0.93,95% CI 0.77-1.12,P = .44;中位PFS 7.6 vs 9.5个月)或OS(HR 1.03,95% CI 0.73-1.44,P = .88;未达到中位OS vs 28.6个月)方面没有差异:结论:在随机临床试验中,dMMR与pMMR子宫内膜癌患者接受一线铂双药化疗的ORR、PFS和OS相似。这些发现加强了化疗与免疫检查点抑制剂联合治疗的重要性,直到将免疫检查点疗法单独与联合疗法进行比较的试验结果出来为止。
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引用次数: 0
Lung cancer-a one-way ticket. 肺癌--一张单程票
IF 3.4 Q2 ONCOLOGY Pub Date : 2024-11-01 DOI: 10.1093/jncics/pkae098
Drew Moghanaki, Michelle Ann Eala, Jill Feldman, Terri Ann DiJulio, Peter Gorayski
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引用次数: 0
Low CD86 expression is a predictive biomarker for clinical response to the therapeutic human papillomavirus vaccine IGMKK16E7: results of a post hoc analysis. 低 CD86 表达是治疗性 HPV 疫苗 IGMKK16E7 临床反应的预测性生物标志物:事后分析的结果。
IF 3.4 Q2 ONCOLOGY Pub Date : 2024-11-01 DOI: 10.1093/jncics/pkae091
Hanano Ando, Yuki Katoh, Osamu Kobayashi, Yuji Ikeda, Hideaki Yahata, Takashi Iwata, Toyomi Satoh, Azusa Akiyama, Daichi Maeda, Yumiko Hori-Hirose, Yukari Uemura, Kaori Nakayama-Hosoya, Kanoko Katoh, Takahiro Nakajima, Ayumi Taguchi, Atsushi Komatsu, Saki Kamata, Naoko Tomita, Kiyoko Kato, Daisuke Aoki, Shizunobu Igimi, Ai Kawana-Tachikawa, Danny J Schust, Kei Kawana

Background: Although therapeutic human papillomavirus vaccines could offer a noninvasive treatment for patients with cervical intraepithelial neoplasia, none has been clinically implemented. Oral administration of the therapeutic human papillomavirus vaccine IGMKK16E7 results in the histological regression of human papillomavirus 16-positive cervical intraepithelial neoplasia 2/3 to normal (complete response). We investigated biomarkers that could predict complete response after oral administration of IGMKK16E7.

Methods: Forty-two patients administered high-dose oral IGMKK16E7 in a phase I/II trial were included. Cervix-exfoliated cells were collected before vaccine administration. Gene expression of CD4, CD8, FOXP3, programmed cell death 1 protein, CTLA4, CD103, CD28, CD80, CD86, and programmed cell death 1 ligand 1 in the cells was measured by quantitative reverse transcriptase-polymerase chain reaction. Receiver operating characteristic curve analysis and Mann-Whitney tests were used to explore potential biomarkers. Pearson correlation coefficient analysis was used to correlate gene expression profiles with clinical outcome.

Results: The only predictive biomarker of vaccine response for which receiver operating characteristic curve analysis showed significant diagnostic performance with histological complete response was CD86 (area under the curve = 0.71, 95% confidence interval = 0.53 to 0.88, P = .020). Patients with complete response had significantly lower CD86 expression (CD86-low) than patients with no complete response (P = .035). The complete response rates for CD86-low and CD86-high patients were 50% and 19%, respectively, and CD86-low patients had a significantly higher complete response rate (P = .047). Compared with all patients, the CD86-low group had a 1.5-fold increase in the complete response rate. Gene expression of CD86 and CTLA4 showed the strongest positive correlation with clinical outcomes in the incomplete response group (P < .001).

Conclusion: Low expression of CD86 in exfoliated cervical cells can be used as a pretreatment biomarker to predict histological complete response after IGMKK16E7 administration.

背景:尽管治疗性HPV疫苗可为宫颈上皮内瘤变(CIN)患者提供一种非侵入性治疗方法,但目前尚未在临床上应用。口服治疗性 HPV 疫苗 IGMKK16E7 可使 HPV16 阳性 CIN2/3 在组织学上恢复正常(完全应答:CR)。在此,我们研究了可预测口服 IGMKK16E7 后 CR 的生物标志物:在一项 I/II 期试验中,42 例患者接受了大剂量口服 IGMKK16E7。用药前收集宫颈脱落细胞。通过定量 RT-PCR 检测细胞中 CD4、CD8、Foxp3、PD-1、CTLA-4、CD103、CD28、CD80、CD86 和 PD-L1 的基因表达。采用 ROC 曲线分析和 Mann-Whitney 检验来探索潜在的生物标记物。采用皮尔逊相关系数分析将基因表达谱与临床结果相关联:结果:ROC曲线分析显示,唯一能预测疫苗反应的生物标记物是CD86(AUC 0.71,95%XI 0.53-0.88,p = .020),它与组织学CR具有显著的诊断性能。CR 患者的 CD86 表达(CD86-低)明显低于非 CR 患者(p = .035)。CD86-低和CD86-高病例的CR率分别为50%和19%,CD86-低病例的CR率明显更高(p = .047)。与所有患者相比,CD86低组的CR率增加了1.5倍。CD86和CTLA-4的基因表达与非CR组的临床结果呈最强的正相关(p 结论:CD86和CTLA-4的基因表达与非CR组的临床结果呈最强的正相关:脱落宫颈细胞中 CD86 的低表达可作为治疗前的生物标志物,预测使用 IGMKK16E7 后的组织学 CR。
{"title":"Low CD86 expression is a predictive biomarker for clinical response to the therapeutic human papillomavirus vaccine IGMKK16E7: results of a post hoc analysis.","authors":"Hanano Ando, Yuki Katoh, Osamu Kobayashi, Yuji Ikeda, Hideaki Yahata, Takashi Iwata, Toyomi Satoh, Azusa Akiyama, Daichi Maeda, Yumiko Hori-Hirose, Yukari Uemura, Kaori Nakayama-Hosoya, Kanoko Katoh, Takahiro Nakajima, Ayumi Taguchi, Atsushi Komatsu, Saki Kamata, Naoko Tomita, Kiyoko Kato, Daisuke Aoki, Shizunobu Igimi, Ai Kawana-Tachikawa, Danny J Schust, Kei Kawana","doi":"10.1093/jncics/pkae091","DOIUrl":"10.1093/jncics/pkae091","url":null,"abstract":"<p><strong>Background: </strong>Although therapeutic human papillomavirus vaccines could offer a noninvasive treatment for patients with cervical intraepithelial neoplasia, none has been clinically implemented. Oral administration of the therapeutic human papillomavirus vaccine IGMKK16E7 results in the histological regression of human papillomavirus 16-positive cervical intraepithelial neoplasia 2/3 to normal (complete response). We investigated biomarkers that could predict complete response after oral administration of IGMKK16E7.</p><p><strong>Methods: </strong>Forty-two patients administered high-dose oral IGMKK16E7 in a phase I/II trial were included. Cervix-exfoliated cells were collected before vaccine administration. Gene expression of CD4, CD8, FOXP3, programmed cell death 1 protein, CTLA4, CD103, CD28, CD80, CD86, and programmed cell death 1 ligand 1 in the cells was measured by quantitative reverse transcriptase-polymerase chain reaction. Receiver operating characteristic curve analysis and Mann-Whitney tests were used to explore potential biomarkers. Pearson correlation coefficient analysis was used to correlate gene expression profiles with clinical outcome.</p><p><strong>Results: </strong>The only predictive biomarker of vaccine response for which receiver operating characteristic curve analysis showed significant diagnostic performance with histological complete response was CD86 (area under the curve = 0.71, 95% confidence interval = 0.53 to 0.88, P = .020). Patients with complete response had significantly lower CD86 expression (CD86-low) than patients with no complete response (P = .035). The complete response rates for CD86-low and CD86-high patients were 50% and 19%, respectively, and CD86-low patients had a significantly higher complete response rate (P = .047). Compared with all patients, the CD86-low group had a 1.5-fold increase in the complete response rate. Gene expression of CD86 and CTLA4 showed the strongest positive correlation with clinical outcomes in the incomplete response group (P < .001).</p><p><strong>Conclusion: </strong>Low expression of CD86 in exfoliated cervical cells can be used as a pretreatment biomarker to predict histological complete response after IGMKK16E7 administration.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11528511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Neighborhood vulnerability and associations with poor health-related quality of life among adult survivors of childhood cancer. 儿童癌症成年幸存者的邻里脆弱性及与健康相关的生活质量低下的关联。
IF 3.4 Q2 ONCOLOGY Pub Date : 2024-11-01 DOI: 10.1093/jncics/pkae088
Jaesung Choi, Madeline R Horan, Tara M Brinkman, D Kumar Srivastava, Kirsten K Ness, Gregory T Armstrong, Melissa M Hudson, I-Chan Huang

Background: Few studies have investigated the relationship between neighborhood vulnerability and health-related quality of life (HRQOL) in the childhood cancer population. This study evaluated the impact of neighborhood vulnerability on HRQOL among adult survivors of childhood cancer.

Methods: This cross-sectional study included 4393 adult survivors of childhood cancer from the St Jude Lifetime Cohort Study. At the baseline (2007-2020), HRQOL was assessed using the SF36v2's physical and mental components summaries (PCS and MCS). Neighborhood vulnerability was assessed using the overall, domain, and indicator-specific scores of the Social Vulnerability Index (SVI) and Minority Health SVI (MHSVI). Multivariable logistic regression was used to evaluate associations of neighborhood vulnerability (quartiles: Q1-Q4) with impaired HRQOL (1SD below the norm), adjusting for diagnosis, demographics, personal socioeconomic status (SES), lifestyle, and chronic health condition burden. Interactions of SVI and MHSVI with personal SES on impaired HRQOL were analyzed.

Results: Among survivors, 51.9% were male, averaging 30.3 years of age at evaluation and 21.5 years since diagnosis. Comparing neighborhoods with higher vs lower vulnerability (Q4 vs Q1), overall (odds ratio [OR] = 1.60, 95% confidence interval [CI] = 1.19 to 2.16) and domain-specific vulnerability (socioeconomic: OR = 1.59, 95% CI = 1.18 to 2.15; household composition: OR = 1.54, 95% CI = 1.16 to 2.06; housing and transportation: OR = 1.33, 95% CI = 1.00 to 1.76; medical vulnerability: OR = 1.60, 95% CI = 1.22 to 2.09) were significantly associated with impaired PCS, but not MCS. Residing in neighborhoods lacking urgent care clinics was significantly associated with impaired PCS (OR = 1.39, 95% CI = 1.08 to 1.78). Having lower vs higher personal education and living in higher vulnerability neighborhoods were associated with more impaired PCS (Pinteraction = .021).

Conclusions: Specific aspects of neighborhood vulnerability increase the risk for impaired physical HRQOL. Addressing these neighborhood factors is essential to enhance the HRQOL of survivors.

背景:很少有研究调查儿童癌症人群中邻里脆弱性与健康相关生活质量(HRQOL)之间的关系。本研究评估了邻里脆弱性对儿童癌症成年幸存者 HRQOL 的影响:这项横断面研究纳入了圣裘德终身队列研究(St Jude Lifetime Cohort Study)中的 4393 名儿童癌症成年幸存者。在基线期(2007-2020 年),HRQOL 采用 SF36v2 的身体/精神成分汇总表(PCS/MCS)进行评估。邻里脆弱性采用社会脆弱性指数(SVI)和少数民族健康 SVI(MHSVI)的总分、领域分和特定指标分进行评估。多变量逻辑回归用于评估邻里脆弱性(四分位数:Q1-Q4)与受损的 HRQOL(低于标准值 1SD)之间的关系,并对诊断、人口统计学、个人社会经济地位 (SES)、生活方式和慢性疾病负担进行调整。分析了SVI/MHSVI与个人社会经济地位对受损的HRQOL的交互作用:在幸存者中,51.9%为男性,评估时平均年龄为30.3岁,确诊后平均年龄为21.5岁。比较易感性较高与较低的社区(Q4 与 Q1),总体易感性(OR = 1.60,95%CI = 1.19-2.16)和特定领域的易感性(社会经济,OR = 1.59,95%CI = 1.19-2.16)均有所下降:OR = 1.59,95%CI = 1.18-2.15;家庭组成:OR=1.54,95%CI=1.16-2.06;住房/交通:OR=1.33,95%CI=1.00-1.76;医疗脆弱性:OR=1.60,95%CI=1.22-2.09)与 PCS 下降显著相关,但与 MCS 无关。居住在缺乏紧急护理诊所的社区与 PCS 受损有显著相关性(OR = 1.39,95%CI = 1.08-1.78)。个人教育程度较低与较高以及居住在较脆弱的社区都与PCS受损有关(P交互作用=0.021):结论:邻里脆弱性的某些方面会增加身体健康与生活质量受损的风险。解决这些邻里因素对于提高幸存者的 HRQOL 至关重要。
{"title":"Neighborhood vulnerability and associations with poor health-related quality of life among adult survivors of childhood cancer.","authors":"Jaesung Choi, Madeline R Horan, Tara M Brinkman, D Kumar Srivastava, Kirsten K Ness, Gregory T Armstrong, Melissa M Hudson, I-Chan Huang","doi":"10.1093/jncics/pkae088","DOIUrl":"10.1093/jncics/pkae088","url":null,"abstract":"<p><strong>Background: </strong>Few studies have investigated the relationship between neighborhood vulnerability and health-related quality of life (HRQOL) in the childhood cancer population. This study evaluated the impact of neighborhood vulnerability on HRQOL among adult survivors of childhood cancer.</p><p><strong>Methods: </strong>This cross-sectional study included 4393 adult survivors of childhood cancer from the St Jude Lifetime Cohort Study. At the baseline (2007-2020), HRQOL was assessed using the SF36v2's physical and mental components summaries (PCS and MCS). Neighborhood vulnerability was assessed using the overall, domain, and indicator-specific scores of the Social Vulnerability Index (SVI) and Minority Health SVI (MHSVI). Multivariable logistic regression was used to evaluate associations of neighborhood vulnerability (quartiles: Q1-Q4) with impaired HRQOL (1SD below the norm), adjusting for diagnosis, demographics, personal socioeconomic status (SES), lifestyle, and chronic health condition burden. Interactions of SVI and MHSVI with personal SES on impaired HRQOL were analyzed.</p><p><strong>Results: </strong>Among survivors, 51.9% were male, averaging 30.3 years of age at evaluation and 21.5 years since diagnosis. Comparing neighborhoods with higher vs lower vulnerability (Q4 vs Q1), overall (odds ratio [OR] = 1.60, 95% confidence interval [CI] = 1.19 to 2.16) and domain-specific vulnerability (socioeconomic: OR = 1.59, 95% CI = 1.18 to 2.15; household composition: OR = 1.54, 95% CI = 1.16 to 2.06; housing and transportation: OR = 1.33, 95% CI = 1.00 to 1.76; medical vulnerability: OR = 1.60, 95% CI = 1.22 to 2.09) were significantly associated with impaired PCS, but not MCS. Residing in neighborhoods lacking urgent care clinics was significantly associated with impaired PCS (OR = 1.39, 95% CI = 1.08 to 1.78). Having lower vs higher personal education and living in higher vulnerability neighborhoods were associated with more impaired PCS (Pinteraction = .021).</p><p><strong>Conclusions: </strong>Specific aspects of neighborhood vulnerability increase the risk for impaired physical HRQOL. Addressing these neighborhood factors is essential to enhance the HRQOL of survivors.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11549958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The feasibility and acceptability of home phlebotomy for patients with cancer. 癌症患者居家抽血的可行性和可接受性。
IF 3.4 Q2 ONCOLOGY Pub Date : 2024-11-01 DOI: 10.1093/jncics/pkae104
Erin M Bange, Camila Bernal, Kemi Bolutayo Gaffney, Jill Ackerman, David Kwong, Jithin Thomas, Bobby Daly

Time toxicity is a considerable burden for oncology patients. This study evaluated the feasibility and acceptability of integrating mobile phlebotomy into standard of care procedures. From September 26, 2022, through December 31, 2023, a total of 345 patients had 1464 home laboratory test collection visits completed. These mobile phlebotomy laboratory collection visits occurred in New York (68.6% of visits), New Jersey (29.9%), Connecticut (1.1%), and Pennsylvania (0.5%). Specimen quality for home laboratory test collection surpassed the Memorial Sloan Kettering Department of Pathology and Laboratory Medicine benchmarks. Acceptability was high, 173 patients were approached, and 149 responded (86% response rate); most respondents (147 of 149, 99%) would use the service again or recommend it to others. This study assessed the integration of mobile phlebotomy into standard of care management for the collection of routine cancer laboratory tests. Mobile phlebotomy results in high patient satisfaction with superior specimen quality, offering a valuable solution to oncology patients for improved efficiency and convenience.

时间毒性是肿瘤患者的一大负担。这项研究评估了将移动抽血术纳入标准护理程序的可行性和可接受性。从 2022 年 9 月 26 日到 2023 年 12 月 31 日,共有 345 名患者完成了 1464 次家庭化验采集。这些移动抽血化验采集就诊发生在纽约州(68.6%)、新泽西州(29.9%)、康涅狄格州(1.1%)和宾夕法尼亚州(0.5%)。家庭化验室检验标本采集的质量超过了病理学和化验医学部的基准。接受度很高,共接触了 173 名患者,其中 149 人做出了回应(回应率为 86%);大多数受访者(147/149,99%)会再次使用该服务或向他人推荐。这项研究评估了将移动抽血纳入常规癌症实验室检测的标准护理管理的情况。移动抽血技术使患者满意度高,标本质量上乘,为肿瘤患者提高效率和便利性提供了有价值的解决方案。
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引用次数: 0
Neighborhood homicide rate and odds of colorectal adenoma among adult patients seeking colonoscopy. 邻里凶杀率与寻求结肠镜检查的成年患者患结直肠腺瘤的几率。
IF 3.4 Q2 ONCOLOGY Pub Date : 2024-10-29 DOI: 10.1093/jncics/pkae110
Alyshia Hamm, Evgenia Karayeva, Manoela Lima Oliveira, Nabil Kahouadji, Paul Grippo, Patricia G Wolf, Ece Mutlu, Lisa Tussing-Humphreys, Sage J Kim

Background: Chronic exposure to ambient stressors, including neighborhood crime, may have a detrimental impact on the body's stress response system with implications for colorectal carcinogenesis.

Methods: We examined associations between the mean neighborhood homicide rates from 2000 and 2018 and diagnosis of colorectal adenoma among patients at the University of Illinois Health and Hospital System in Chicago, Illinois, between 2015 and 2018.

Results: Of the 5,225 patients who underwent colonoscopy and were included in the analytic dataset, 60% had colorectal adenoma. Older age, male sex, and higher body mass index (BMI) were associated with greater odds of colorectal adenoma. The neighborhood homicide rate was associated with identifying as Black and Hispanic and higher BMI. A mediation analysis showed that the neighborhood homicide rate effects on colorectal adenoma were mediated through BMI.

Conclusion: The study concluded that older age, male sex, and higher BMI significantly increase the odds of colorectal adenoma, with neighborhood homicide rate indirectly influencing this risk through its association with BMI, particularly among Black and Hispanic individuals.

背景:长期暴露于环境应激源(包括社区犯罪)可能会对人体的应激反应系统产生不利影响,并对大肠癌的发生产生影响:长期暴露于包括邻里犯罪在内的环境应激源可能会对人体的应激反应系统产生不利影响,从而对结直肠癌的发生产生影响:我们研究了伊利诺伊州芝加哥市伊利诺伊大学健康与医院系统的患者在2015年至2018年期间,2000年至2018年社区凶杀案平均发生率与结直肠腺瘤诊断之间的关联:在接受结肠镜检查并纳入分析数据集的5225名患者中,60%患有结直肠腺瘤。年龄越大、性别为男性、体重指数(BMI)越高,患结直肠腺瘤的几率越大。邻里凶杀率与黑人和西班牙裔以及较高的体重指数有关。中介分析表明,邻里凶杀率对结直肠腺瘤的影响是通过体重指数中介的:研究结论:年龄较大、男性和较高的体重指数会显著增加患结直肠腺瘤的几率,而邻里凶杀率则会通过与体重指数的关联间接影响这一风险,尤其是在黑人和西班牙裔人群中。
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引用次数: 0
Patient-reported outcomes (PROs) programs for monitoring symptoms among patients treated with immunotherapy: A scoping review. 用于监测接受免疫疗法患者症状的患者报告结果 (PROs) 计划:范围综述。
IF 3.4 Q2 ONCOLOGY Pub Date : 2024-10-28 DOI: 10.1093/jncics/pkae102
Sylvie D Lambert, Sara Soldera, Jordana Kazdan, Francesca Frati, Anita Slominska, Melina Boutin, Vanessa Samouelian, Caroline Letendre, Karine Bilodeau, Doris Howell, Karine Le Breton, Michel-Olivier Gratton

Background: Monitoring toxicities among patients receiving immune checkpoint inhibitors (ICIs) using patient-reported outcome (PRO) measures (PROMs) is relatively recent. This scoping review aims to guide decision-making in the development of PROMs ICI programs.

Methods: Four electronic databases were searched from inception to January 2024. Data on PROMs ICI programs (eg, PROMs used, frequency) were extracted. Two authors with established inter-rater reliability screened titles, abstracts, and full texts. A narrative synthesis identified patterns in the data.

Results: 22 articles described 16 unique multicomponent, electronic PRO programs, mainly developed for remote monitoring of toxicities between appointments. Patients typically completed 18-26 items from the PRO-CTCAE or CTCAE weekly, with high adherence/satisfaction. Commonly monitored symptoms were diarrhea, fatigue, shortness of breath, cough, nausea, decreased appetite, rash, joint pain, pain, and mood. Other features of PROM programs included clinician alerts, with some program only flagging symptoms that had an impact on treatment. Some program also or only sent alerts to patients to contact their clinicians and gave access to symptom management information. In terms of efficacy, the only consistent finding was an increase in QOL.

Discussion: The findings of this scoping review provide some indication as to which components of a PROM program are promising. However, as the evidence-based for PROMs among patients receiving ICIs is growing, many questions remain, including which symptoms to monitor, using which PROM, and at what frequency. More trials are needed to answer these questions and to determine how best to implement PROM ICI programs in clinical practice.

背景:使用患者报告结果(PRO)指标(PROMs)监测接受免疫检查点抑制剂(ICIs)治疗的患者的毒性相对较新。本综述旨在为制定PROMs ICI计划的决策提供指导:方法:检索了从开始到 2024 年 1 月的四个电子数据库。提取了有关 PROMs ICI 项目的数据(如使用的 PROMs、频率)。两位作者对标题、摘要和全文进行了筛选,他们的筛选结果具有良好的互评可靠性。结果:22 篇文章描述了 16 个独特的多组件电子 PRO 程序,主要用于在预约期间远程监测毒性。患者通常每周完成 18-26 个 PRO-CTCAE 或 CTCAE 项目,依从性/满意度较高。常见的监测症状包括腹泻、疲劳、气短、咳嗽、恶心、食欲下降、皮疹、关节痛、疼痛和情绪。PROM 项目的其他特点包括向临床医生发出警报,有些项目只标记对治疗有影响的症状。有些程序也会或仅会向患者发出与临床医生联系的提示,并提供症状管理信息。在疗效方面,唯一一致的发现是患者的 QOL 有所提高:讨论:本范围综述的研究结果为 PROM 计划的哪些组成部分具有前景提供了一些启示。然而,随着在接受 ICIs 治疗的患者中使用 PROM 的证据越来越多,许多问题依然存在,包括监测哪些症状、使用哪种 PROM 以及监测的频率。需要进行更多试验来回答这些问题,并确定如何在临床实践中最好地实施 PROM ICI 计划。
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引用次数: 0
Randomized pilot trial of an unconditional cash transfer intervention to address food insecurity in oncology. 无条件现金转移干预的随机试点试验,以解决肿瘤患者的粮食不安全问题。
IF 3.4 Q2 ONCOLOGY Pub Date : 2024-10-24 DOI: 10.1093/jncics/pkae107
Jean A Mcdougall, Shoshana Adler Jaffe, Kendal Jacobson, Tori L Shaver, Jennifer L F Wilson, Katrina Baca, Tawny Boyce, Bernard Tawfik, Janet Page-Reeves

Screening for food insecurity and other social determinants of health is being integrated into oncology practice. We performed a pilot randomized trial to investigate whether an unconditional cash transfer (UCT) could be used to address food insecurity among female breast and gynecologic cancer survivors. Food insecure cancer survivors completed a baseline survey and were randomized to receive $100/month for three months (UCT) or usual care (UC). Participants (n = 14) completed a follow-up survey after 3-months and we compared changes in health-related quality of life, indicators of food insecurity, diet quality, and whether a participant had to forgo, delay, or make changes to medical care because of cost. The UCT was associated with higher physical health scores, fewer indicators of food insecurity, better diet quality, and a lower likelihood of forgoing medical care than those who received UC. Our results suggest that UCTs can improve outcomes for food insecure cancer survivors.

食品不安全及其他健康社会决定因素的筛查正被纳入肿瘤治疗实践中。我们进行了一项试点随机试验,研究是否可以使用无条件现金转移(UCT)来解决女性乳腺癌和妇科癌症幸存者的食物不安全问题。食物无保障的癌症幸存者完成了一项基线调查,并被随机分配到每月 100 美元、为期 3 个月(UCT)或常规护理(UC)中。参与者(n = 14)在 3 个月后完成了后续调查,我们比较了他们在健康相关生活质量、食物不安全指标、饮食质量以及是否因费用而放弃、推迟或改变医疗护理等方面的变化。与接受 UC 的人相比,接受 UCT 的人身体健康得分更高,食物不安全指标更少,饮食质量更好,放弃医疗的可能性更低。我们的研究结果表明,"统一治疗方案 "可以改善食物无保障癌症幸存者的治疗效果。
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引用次数: 0
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JNCI Cancer Spectrum
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