Bruno Murad, Pedro C A Reis, Alice Deberaldini Marinho, Ana Carolina Marin Comini, Débora Pinheiro Xavier, Beatriz Mella Soares Pessoa, Farah Raheem, Brenda Ernst, Lida A Mina, Felipe Batalini
Background: Cyclin-dependent kinases (CDK) 4/6 inhibitors have significantly improved outcomes for patients with ER+/HER2- breast cancer. Nevertheless, they differ from each other in terms of chemical, biological, and pharmacological features, as well as toxicity profiles. We aim to determine whether QTc prolongation is caused by CDK4/6i in general or if it is associated with ribociclib only.
Methods: We systematically searched PubMed, Embase, and Cochrane Library for randomized controlled trials (RCTs) comparing the prevalence of QTc prolongation as an adverse event in HR+ breast cancer patients treated with CDK4/6i vs those without CDK4/6i. We pooled relative risk (RR) and mean difference (MD) with 95% confidence interval (CI) for the binary endpoint of QT prolongation.
Results: We included 14 RCTs comprising 16 196 patients, of whom 8576 underwent therapy with CDK4/6i. An increased risk of QTc prolongation was associated with the use of CDK4/6i (RR = 2.35, 95% CI = 1.67 to 3.29, P < .001; I2 = 44%). Subgroup analyses revealed a significant increase in the QTc interval for the ribociclib and palbociclib cohorts. The ribociclib subgroup showed a relative risk of 3.12 (95% CI = 2.09 to 4.65, P < .001; I2 = 12%), whereas the palbociclib subgroup had a relative risk of 1.51 (95% CI = 1.05 to 2.15, P = .025; I2 = 0%).
Conclusion: Palbociclib was associated with QTc prolongation; however, the relative risk for any grade QTc was quantitively twice with ribociclib. Furthermore, grade 3 QTc prolongations were observed exclusively with ribociclib. These results are important for guiding clinical decision-making and provide reassurance regarding the overall safety profile of this drug class.
{"title":"QTc prolongation across CDK4/6 inhibitors: a systematic review and meta-analysis of randomized controlled trials.","authors":"Bruno Murad, Pedro C A Reis, Alice Deberaldini Marinho, Ana Carolina Marin Comini, Débora Pinheiro Xavier, Beatriz Mella Soares Pessoa, Farah Raheem, Brenda Ernst, Lida A Mina, Felipe Batalini","doi":"10.1093/jncics/pkae078","DOIUrl":"10.1093/jncics/pkae078","url":null,"abstract":"<p><strong>Background: </strong>Cyclin-dependent kinases (CDK) 4/6 inhibitors have significantly improved outcomes for patients with ER+/HER2- breast cancer. Nevertheless, they differ from each other in terms of chemical, biological, and pharmacological features, as well as toxicity profiles. We aim to determine whether QTc prolongation is caused by CDK4/6i in general or if it is associated with ribociclib only.</p><p><strong>Methods: </strong>We systematically searched PubMed, Embase, and Cochrane Library for randomized controlled trials (RCTs) comparing the prevalence of QTc prolongation as an adverse event in HR+ breast cancer patients treated with CDK4/6i vs those without CDK4/6i. We pooled relative risk (RR) and mean difference (MD) with 95% confidence interval (CI) for the binary endpoint of QT prolongation.</p><p><strong>Results: </strong>We included 14 RCTs comprising 16 196 patients, of whom 8576 underwent therapy with CDK4/6i. An increased risk of QTc prolongation was associated with the use of CDK4/6i (RR = 2.35, 95% CI = 1.67 to 3.29, P < .001; I2 = 44%). Subgroup analyses revealed a significant increase in the QTc interval for the ribociclib and palbociclib cohorts. The ribociclib subgroup showed a relative risk of 3.12 (95% CI = 2.09 to 4.65, P < .001; I2 = 12%), whereas the palbociclib subgroup had a relative risk of 1.51 (95% CI = 1.05 to 2.15, P = .025; I2 = 0%).</p><p><strong>Conclusion: </strong>Palbociclib was associated with QTc prolongation; however, the relative risk for any grade QTc was quantitively twice with ribociclib. Furthermore, grade 3 QTc prolongations were observed exclusively with ribociclib. These results are important for guiding clinical decision-making and provide reassurance regarding the overall safety profile of this drug class.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11460542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287468","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}
Susan K Parsons, Rachel Murphy-Banks, Angie Mae Rodday, Michael E Roth, Kimberly Miller, Nadine Linendoll, Randall Chan, Howland E Crosswell, Qingyan Xiang, David R Freyer
Background: The long-term financial impact of cancer care has not been adequately addressed in young adults. As part of a remote intervention study, we describe medical financial distress and hardship among young adult survivors of blood cancer at study entry.
Methods: Young adults were recruited from 6 US hospitals. Using a Research Electronic Data Capture link, young adults confirmed their eligibility-namely, currently 18 to 39 years of age, blood cancer diagnosis 3 or more years ago, off active treatment, and not on parent's insurance. Following consent, the baseline assessment was sent. The primary outcome measure, the Personal Financial Wellness Scale, measured financial distress (scored as severe, 1-2; high, 3-4; average, 5-6; and low to no, 7-10). Medical financial hardship encompassed material hardship, psychological impact, and coping behaviors. Descriptive summary statistics and linear regression were used.
Results: Among the 126 participants, 54.5% came from minority racial or ethnic groups. Median time since diagnosis was 10 years (interquartile range = 6-16 years), with 56% having received a diagnosis when they were between 18 and 39 years of age. The overall mean (standard deviation) Personal Financial Wellness Scale score was 5.1 (2.4), but 49% reported severe or high distress. In multivariable analysis, female sex, Hispanic ethnicity, and lower income were strongly associated with worse Personal Financial Wellness Scale scores. Among participants with severe financial distress (n = 26), 72% reported 2 or more household material hardships, had worse scores across all psychological domains, and altered survivorship care because of cost (68%).
Conclusions: Nearly half of long-term young adult cancer survivors reported severe or high levels of financial distress. Individuals with severe or high distress also reported more medical financial hardship than other participants. This finding highlights the need for ongoing financial intervention in this vulnerable population.
{"title":"Financial distress and medical financial hardship among young adult survivors of blood cancer.","authors":"Susan K Parsons, Rachel Murphy-Banks, Angie Mae Rodday, Michael E Roth, Kimberly Miller, Nadine Linendoll, Randall Chan, Howland E Crosswell, Qingyan Xiang, David R Freyer","doi":"10.1093/jncics/pkae071","DOIUrl":"10.1093/jncics/pkae071","url":null,"abstract":"<p><strong>Background: </strong>The long-term financial impact of cancer care has not been adequately addressed in young adults. As part of a remote intervention study, we describe medical financial distress and hardship among young adult survivors of blood cancer at study entry.</p><p><strong>Methods: </strong>Young adults were recruited from 6 US hospitals. Using a Research Electronic Data Capture link, young adults confirmed their eligibility-namely, currently 18 to 39 years of age, blood cancer diagnosis 3 or more years ago, off active treatment, and not on parent's insurance. Following consent, the baseline assessment was sent. The primary outcome measure, the Personal Financial Wellness Scale, measured financial distress (scored as severe, 1-2; high, 3-4; average, 5-6; and low to no, 7-10). Medical financial hardship encompassed material hardship, psychological impact, and coping behaviors. Descriptive summary statistics and linear regression were used.</p><p><strong>Results: </strong>Among the 126 participants, 54.5% came from minority racial or ethnic groups. Median time since diagnosis was 10 years (interquartile range = 6-16 years), with 56% having received a diagnosis when they were between 18 and 39 years of age. The overall mean (standard deviation) Personal Financial Wellness Scale score was 5.1 (2.4), but 49% reported severe or high distress. In multivariable analysis, female sex, Hispanic ethnicity, and lower income were strongly associated with worse Personal Financial Wellness Scale scores. Among participants with severe financial distress (n = 26), 72% reported 2 or more household material hardships, had worse scores across all psychological domains, and altered survivorship care because of cost (68%).</p><p><strong>Conclusions: </strong>Nearly half of long-term young adult cancer survivors reported severe or high levels of financial distress. Individuals with severe or high distress also reported more medical financial hardship than other participants. This finding highlights the need for ongoing financial intervention in this vulnerable population.</p><p><strong>Clinicaltrials.gov: </strong>NCT05620979.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11401610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141995749","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}
Casey Crump, Pär Stattin, James D Brooks, Jan Sundquist, Kristina Sundquist, Weiva Sieh
Background: Men with prostate cancer (PC) may experience significant psychosocial distress from physical symptoms, treatment side effects, or fear of recurrence. However, little is known about the long-term risk of anxiety disorders in men with PC.
Methods: A national cohort study was conducted of 180 189 men diagnosed with PC during 1998-2017 and 1 801 890 age-matched population-based control men in Sweden. Anxiety disorders were ascertained from nationwide outpatient and inpatient records through 2018. Cox regression was used to estimate hazard ratios (HRs) while adjusting for sociodemographic factors and prior psychiatric disorders. Subanalyses explored differences by PC treatment during 2005-2017.
Results: In 7.8 million person-years of follow-up, 94 387 (5%) men were diagnosed with anxiety disorders. Men with high-risk PC had a nearly 2-fold higher risk of anxiety disorders than control men without PC (adjusted HR = 1.96, 95% CI = 1.87 to 2.05). This risk was highest in the first 3 months after PC diagnosis (adjusted HR = 2.99, 95% CI = 2.49 to 3.59) but remained significantly elevated 10 or more years later (adjusted HR = 1.53, 95% CI = 1.35 to 1.74). Those treated only with androgen deprivation therapy (ADT) had the highest risk of anxiety disorders (adjusted HR = 2.08, 95% CI = 1.93 to 2.25). Men with low- or intermediate-risk PC had a modestly increased risk (adjusted HR = 1.39, 95% CI = 1.34 to 1.44).
Conclusions: In this large national cohort, men with PC had substantially increased risk of anxiety disorders, especially those with high-risk PC and treated only with ADT. Men with PC need close monitoring for timely detection and treatment of anxiety symptoms, particularly shortly after PC diagnosis.
背景:患有前列腺癌(PC)的男性可能会因身体症状、治疗副作用或对复发的恐惧而遭受严重的心理社会困扰。然而,人们对患有前列腺癌的男性患焦虑症的长期风险知之甚少:瑞典对 1998-2017 年间确诊为 PC 患者的 180,189 名男性和 1,801,890 名年龄匹配的对照组男性进行了全国性队列研究。焦虑症是从截至 2018 年的全国门诊和住院病人记录中确定的。在调整社会人口因素和既往精神障碍的同时,采用 Cox 回归估算危险比 (HR)。子分析探讨了 2005-2017 年间 PC 治疗的差异:在 780 万人年的随访中,有 94,387 名男性(5%)被诊断患有焦虑症。患高风险 PC 的男性罹患焦虑症的风险比未患 PC 的对照男性高出近 2 倍(调整后 HR 为 1.96;95% CI 为 1.87-2.05)。这种风险在确诊 PC 后的头 3 个月最高(调整后 HR,2.99;95% CI,2.49-3.59),但≥10 年后仍然显著升高(调整后 HR,1.53;95% CI,1.35-1.74)。仅接受雄激素剥夺疗法(ADT)治疗的男性患焦虑症的风险最高(调整后HR为2.08;95% CI为1.93-2.25)。患有低危或中危PC的男性患焦虑症的风险略有增加(调整后HR为1.39;95% CI为1.34-1.44):在这一大型全国性队列中,患有 PC 的男性患焦虑症的风险大幅增加,尤其是那些患有高风险 PC 且仅接受 ADT 治疗的男性。男性 PC 患者需要密切监测,及时发现并治疗焦虑症状,尤其是在确诊 PC 后不久。
{"title":"Risk of anxiety disorders in men with prostate cancer: a national cohort study.","authors":"Casey Crump, Pär Stattin, James D Brooks, Jan Sundquist, Kristina Sundquist, Weiva Sieh","doi":"10.1093/jncics/pkae087","DOIUrl":"10.1093/jncics/pkae087","url":null,"abstract":"<p><strong>Background: </strong>Men with prostate cancer (PC) may experience significant psychosocial distress from physical symptoms, treatment side effects, or fear of recurrence. However, little is known about the long-term risk of anxiety disorders in men with PC.</p><p><strong>Methods: </strong>A national cohort study was conducted of 180 189 men diagnosed with PC during 1998-2017 and 1 801 890 age-matched population-based control men in Sweden. Anxiety disorders were ascertained from nationwide outpatient and inpatient records through 2018. Cox regression was used to estimate hazard ratios (HRs) while adjusting for sociodemographic factors and prior psychiatric disorders. Subanalyses explored differences by PC treatment during 2005-2017.</p><p><strong>Results: </strong>In 7.8 million person-years of follow-up, 94 387 (5%) men were diagnosed with anxiety disorders. Men with high-risk PC had a nearly 2-fold higher risk of anxiety disorders than control men without PC (adjusted HR = 1.96, 95% CI = 1.87 to 2.05). This risk was highest in the first 3 months after PC diagnosis (adjusted HR = 2.99, 95% CI = 2.49 to 3.59) but remained significantly elevated 10 or more years later (adjusted HR = 1.53, 95% CI = 1.35 to 1.74). Those treated only with androgen deprivation therapy (ADT) had the highest risk of anxiety disorders (adjusted HR = 2.08, 95% CI = 1.93 to 2.25). Men with low- or intermediate-risk PC had a modestly increased risk (adjusted HR = 1.39, 95% CI = 1.34 to 1.44).</p><p><strong>Conclusions: </strong>In this large national cohort, men with PC had substantially increased risk of anxiety disorders, especially those with high-risk PC and treated only with ADT. Men with PC need close monitoring for timely detection and treatment of anxiety symptoms, particularly shortly after PC diagnosis.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11512143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287469","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}
Giulia Maneri, Camilla Nero, Luciano Giacò, Giovanni Scambia, Angelo Minucci
The majority of tumor comprehensive genomic profiling (CGP) currently does not include a matched normal control. The use of a tumor-only CGP approach needs the development of a strategy to refine germline pathogenic/likely pathogenic variants (gP/LPVs) calls, so as to limit the performance of unnecessary germline reflex tests and instead successfully identify patients who are carriers of likely gP/LPVs. Guidelines have been developed for the identification of gP/LPVs in BRCA1/2 genes on the basis of tumor-only CGP results and for the evaluation of the appropriateness of performing germline reflex BRCA1/2 testing. In this study, an algorithm to assist decision-making for germline reflex testing of BRCA1/2 variants following tumor-only CGP is proposed.
{"title":"Germline reflex BRCA1/2 testing following tumor-only comprehensive genomic profiling: why, when, and how.","authors":"Giulia Maneri, Camilla Nero, Luciano Giacò, Giovanni Scambia, Angelo Minucci","doi":"10.1093/jncics/pkae096","DOIUrl":"10.1093/jncics/pkae096","url":null,"abstract":"<p><p>The majority of tumor comprehensive genomic profiling (CGP) currently does not include a matched normal control. The use of a tumor-only CGP approach needs the development of a strategy to refine germline pathogenic/likely pathogenic variants (gP/LPVs) calls, so as to limit the performance of unnecessary germline reflex tests and instead successfully identify patients who are carriers of likely gP/LPVs. Guidelines have been developed for the identification of gP/LPVs in BRCA1/2 genes on the basis of tumor-only CGP results and for the evaluation of the appropriateness of performing germline reflex BRCA1/2 testing. In this study, an algorithm to assist decision-making for germline reflex testing of BRCA1/2 variants following tumor-only CGP is proposed.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11512647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371868","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}
Abhijit Pal, Rayan Saleh Moussa, Ben Smith, Bernadette Brady, Deme Karikios, Frances Boyle, Wei Chua
{"title":"Structural racism and inequity in cancer clinical trial participation: time for solutions.","authors":"Abhijit Pal, Rayan Saleh Moussa, Ben Smith, Bernadette Brady, Deme Karikios, Frances Boyle, Wei Chua","doi":"10.1093/jncics/pkae089","DOIUrl":"https://doi.org/10.1093/jncics/pkae089","url":null,"abstract":"","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500640","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}
Shuai Shao, Dan Tian, Mingyang Li, Shanshan Wu, Dong Zhang
Background: Sigmoid colon cancer is a common type of colorectal cancer, frequently leading to liver metastasis. Predicting cause-specific survival and overall survival in patients with sigmoid colon cancer metastasis to liver is challenging because of the lack of suitable models.
Methods: Patients with sigmoid colon cancer metastasis to liver (2010-2017) in the Surveillance, Epidemiology, and End Results (SEER) Program were recruited. Patients were split into training and validation groups (7:3). Prognostic factors were identified using competing risk and Cox proportional hazards models, and nomograms for cause-specific survival and overall survival were developed. Model performance was evaluated with the concordance index and calibration curves, with a 2-sided P value less than .05 considered statistically significant.
Results: A total of 4981 sigmoid colon cancer with liver metastasis patients were included, with a median follow-up of 20 months (interquartile range [IQR] = 9-33 months). During follow-up, 72.25% of patients died (68.44% from sigmoid colon cancer, 3.81% from other causes). Age, race, grade, T stage, N stage, surgery, chemotherapy, carcinoembryonic antigen, tumor deposits, lung metastasis, and tumor size were prognostic factors for cause-specific survival and overall survival. The models demonstrated good discrimination and calibration performance, with C index values of 0.79 (95% confidence interval [CI] = 0.78 to 0.80) for cause-specific survival and 0.74 (95% CI = 0.73 to 0.75) for overall survival. A web-based application for real-time cause-specific survival predictions was created, accessible at https://shuaishao.shinyapps.io/SCCLM/.
Conclusion: Prognostic factors for sigmoid colon cancer with liver metastasis patients were identified based on the SEER database, and nomograms for cause-specific survival and overall survival showed good performance. A web-based application was developed to predict sigmoid colon cancer with liver metastasis-specific survival, aiding in survival risk stratification.
{"title":"Survival prediction in sigmoid colon cancer patients with liver metastasis: a prospective cohort study.","authors":"Shuai Shao, Dan Tian, Mingyang Li, Shanshan Wu, Dong Zhang","doi":"10.1093/jncics/pkae080","DOIUrl":"10.1093/jncics/pkae080","url":null,"abstract":"<p><strong>Background: </strong>Sigmoid colon cancer is a common type of colorectal cancer, frequently leading to liver metastasis. Predicting cause-specific survival and overall survival in patients with sigmoid colon cancer metastasis to liver is challenging because of the lack of suitable models.</p><p><strong>Methods: </strong>Patients with sigmoid colon cancer metastasis to liver (2010-2017) in the Surveillance, Epidemiology, and End Results (SEER) Program were recruited. Patients were split into training and validation groups (7:3). Prognostic factors were identified using competing risk and Cox proportional hazards models, and nomograms for cause-specific survival and overall survival were developed. Model performance was evaluated with the concordance index and calibration curves, with a 2-sided P value less than .05 considered statistically significant.</p><p><strong>Results: </strong>A total of 4981 sigmoid colon cancer with liver metastasis patients were included, with a median follow-up of 20 months (interquartile range [IQR] = 9-33 months). During follow-up, 72.25% of patients died (68.44% from sigmoid colon cancer, 3.81% from other causes). Age, race, grade, T stage, N stage, surgery, chemotherapy, carcinoembryonic antigen, tumor deposits, lung metastasis, and tumor size were prognostic factors for cause-specific survival and overall survival. The models demonstrated good discrimination and calibration performance, with C index values of 0.79 (95% confidence interval [CI] = 0.78 to 0.80) for cause-specific survival and 0.74 (95% CI = 0.73 to 0.75) for overall survival. A web-based application for real-time cause-specific survival predictions was created, accessible at https://shuaishao.shinyapps.io/SCCLM/.</p><p><strong>Conclusion: </strong>Prognostic factors for sigmoid colon cancer with liver metastasis patients were identified based on the SEER database, and nomograms for cause-specific survival and overall survival showed good performance. A web-based application was developed to predict sigmoid colon cancer with liver metastasis-specific survival, aiding in survival risk stratification.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11476935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287478","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}
{"title":"The silent struggle: anxiety in men with prostate cancer.","authors":"Zhiyu Qian, Stephan M Korn, Quoc-Dien Trinh","doi":"10.1093/jncics/pkae094","DOIUrl":"https://doi.org/10.1093/jncics/pkae094","url":null,"abstract":"","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11512141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500641","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}
Arrianna Marie Planey, Lisa P Spees, Caitlin B Biddell, Austin Waters, Emily P Jones, Hillary K Hecht, Donald Rosenstein, Stephanie B Wheeler
Background: In addition to greater delays in cancer screening and greater financial hardship, rural-dwelling cancer patients experience greater costs associated with accessing cancer care, including higher cumulative travel costs. This study aimed to identify and synthesize peer-reviewed research on the cumulative and overlapping costs associated with care access and utilization.
Methods: A scoping review was conducted to identify relevant studies published after 1995 by searching 5 electronic databases: PubMed, Scopus, Cumulative Index of Nursing and Allied Health Literature (CINAHL), PsycInfo, and Healthcare Administration. Eligibility was determined using the PEO (Population, Exposure, and Outcomes) method, with clearly defined populations (cancer patients), exposures (financial hardship, toxicity, or distress; travel-related burdens), and outcomes (treatment access, treatment outcomes, health-related quality of life, and survival/mortality). Study characteristics, methods, and findings were extracted and summarized.
Results: Database searches yielded 6439 results, of which 3366 were unique citations. Of those, 141 were eligible for full-text review, and 98 studies at the intersection of cancer-related travel burdens and financial hardship were included. Five themes emerged as we extracted from the full texts of the included articles: 1) Cancer treatment choices, 2) Receipt of guideline-concordant care, 3) Cancer treatment outcomes, 4) Health-related quality of life, and 5) Propensity to participate in clinical trials.
Conclusions: This scoping review identifies and summarizes available research at the intersection of cancer care-related travel burdens and financial hardship. This review will inform the development of future interventions aimed at reducing the negative effects of cancer-care related costs on patient outcomes and quality of life.
背景:除了癌症筛查的更多延误和更大的经济困难之外,居住在农村的癌症患者在接受癌症治疗时还需要支付更多的相关费用,包括更高的累积旅行费用。本研究旨在确定和综合经同行评审的、与获得和利用医疗服务相关的累积和重叠成本的研究:通过搜索五个电子数据库,对 1995 年之后发表的相关研究进行了范围界定:PubMed、Scopus、Cumulative Index of Nursing and Allied Health Literature (CINAHL)、PsycInfo 和 Healthcare Administration。采用 PEO(人群、暴露和结果)方法确定研究资格,明确界定人群(癌症患者)、暴露(经济困难、毒性或痛苦;与旅行相关的负担)和结果(治疗机会、治疗结果、与健康相关的生活质量和存活率/死亡率)。对研究特点、方法和结果进行了提取和总结:结果:通过数据库检索获得了 6,439 条结果,其中 3,366 条为唯一引用。其中 141 篇符合全文审阅条件,98 篇与癌症相关的旅行负担和经济困难相关的研究被纳入其中。我们从收录文章的全文中提取出了五 (5) 个主题:(1) 癌症治疗选择;(2) 接受与指南一致的护理;(3) 癌症治疗结果;(4) 与健康相关的生活质量;(5) 参与临床试验的倾向:本范围界定综述确定并总结了与癌症护理相关的旅行负担和经济困难交叉点的现有研究。该综述将为今后制定旨在减少癌症治疗相关费用对患者预后和生活质量的负面影响的干预措施提供参考。
{"title":"The intersection of travel burdens and financial hardship in cancer care: a scoping review.","authors":"Arrianna Marie Planey, Lisa P Spees, Caitlin B Biddell, Austin Waters, Emily P Jones, Hillary K Hecht, Donald Rosenstein, Stephanie B Wheeler","doi":"10.1093/jncics/pkae093","DOIUrl":"10.1093/jncics/pkae093","url":null,"abstract":"<p><strong>Background: </strong>In addition to greater delays in cancer screening and greater financial hardship, rural-dwelling cancer patients experience greater costs associated with accessing cancer care, including higher cumulative travel costs. This study aimed to identify and synthesize peer-reviewed research on the cumulative and overlapping costs associated with care access and utilization.</p><p><strong>Methods: </strong>A scoping review was conducted to identify relevant studies published after 1995 by searching 5 electronic databases: PubMed, Scopus, Cumulative Index of Nursing and Allied Health Literature (CINAHL), PsycInfo, and Healthcare Administration. Eligibility was determined using the PEO (Population, Exposure, and Outcomes) method, with clearly defined populations (cancer patients), exposures (financial hardship, toxicity, or distress; travel-related burdens), and outcomes (treatment access, treatment outcomes, health-related quality of life, and survival/mortality). Study characteristics, methods, and findings were extracted and summarized.</p><p><strong>Results: </strong>Database searches yielded 6439 results, of which 3366 were unique citations. Of those, 141 were eligible for full-text review, and 98 studies at the intersection of cancer-related travel burdens and financial hardship were included. Five themes emerged as we extracted from the full texts of the included articles: 1) Cancer treatment choices, 2) Receipt of guideline-concordant care, 3) Cancer treatment outcomes, 4) Health-related quality of life, and 5) Propensity to participate in clinical trials.</p><p><strong>Conclusions: </strong>This scoping review identifies and summarizes available research at the intersection of cancer care-related travel burdens and financial hardship. This review will inform the development of future interventions aimed at reducing the negative effects of cancer-care related costs on patient outcomes and quality of life.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11519048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365247","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}
Priyanshu Nain, Nickolas Stabellini, Omar M Makram, Johnathan Rast, Sandeep Yerraguntla, Gaurav Gopu, Aditya Bhave, Lakshya Seth, Vraj Patel, Stephanie Jiang, Sarah Malik, Ahmed Shetewi, Alberto J Montero, Jennifer Cullen, Neeraj Agarwal, Xiaoling Wang, Bonnie Ky, Lauren A Baldassarre, Neal L Weintraub, Ryan A Harris, Avirup Guha
The role of social determinants of health (SDOH) in controlling hypertension (HTN) in cancer patients is unknown. We hypothesize that high SDOH scores correlate with uncontrolled HTN in hypertensive cancer patients. In our prospective study, patients completed the Protocol for Responding to & Assessing Patients' Assets, Risks & Experiences questionnaire. After integrating home and clinic blood pressure readings, uncontrolled HTN was defined as systolic blood pressure greater than or equal to 140 mm Hg and/or diastolic blood pressure greater than or equal to 90 mm Hg. Using Cox regression, we analyzed the impact of SDOH on HTN control, adjusting for relevant factors. The study involved 318 participants (median age 66.4, median follow-up 166 days, SDOH score 6.5 ± 3.2), with stress, educational insecurity, and social isolation as prevalent adverse SDOH. High SDOH scores led to 77% increased risk of uncontrolled HTN (adjusted hazards ratio = 1.77; 95% confidence interval = 1.10 to 2.83, P = .018). Urban residents with high SDOH scores were at an even greater risk. Identifying SDOH and mitigating underlying factors may help control HTN, the most typical disease process treated in all cardio-oncology clinics.
{"title":"Adverse social determinants of health elevate uncontrolled hypertension risk: a cardio-oncology prospective cohort study.","authors":"Priyanshu Nain, Nickolas Stabellini, Omar M Makram, Johnathan Rast, Sandeep Yerraguntla, Gaurav Gopu, Aditya Bhave, Lakshya Seth, Vraj Patel, Stephanie Jiang, Sarah Malik, Ahmed Shetewi, Alberto J Montero, Jennifer Cullen, Neeraj Agarwal, Xiaoling Wang, Bonnie Ky, Lauren A Baldassarre, Neal L Weintraub, Ryan A Harris, Avirup Guha","doi":"10.1093/jncics/pkae064","DOIUrl":"10.1093/jncics/pkae064","url":null,"abstract":"<p><p>The role of social determinants of health (SDOH) in controlling hypertension (HTN) in cancer patients is unknown. We hypothesize that high SDOH scores correlate with uncontrolled HTN in hypertensive cancer patients. In our prospective study, patients completed the Protocol for Responding to & Assessing Patients' Assets, Risks & Experiences questionnaire. After integrating home and clinic blood pressure readings, uncontrolled HTN was defined as systolic blood pressure greater than or equal to 140 mm Hg and/or diastolic blood pressure greater than or equal to 90 mm Hg. Using Cox regression, we analyzed the impact of SDOH on HTN control, adjusting for relevant factors. The study involved 318 participants (median age 66.4, median follow-up 166 days, SDOH score 6.5 ± 3.2), with stress, educational insecurity, and social isolation as prevalent adverse SDOH. High SDOH scores led to 77% increased risk of uncontrolled HTN (adjusted hazards ratio = 1.77; 95% confidence interval = 1.10 to 2.83, P = .018). Urban residents with high SDOH scores were at an even greater risk. Identifying SDOH and mitigating underlying factors may help control HTN, the most typical disease process treated in all cardio-oncology clinics.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11368120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901784","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}
Paul C Dinh, Patrick O Monahan, Chunkit Fung, Howard D Sesso, Darren R Feldman, David J Vaughn, Robert J Hamilton, Robert Huddart, Neil E Martin, Christian Kollmannsberger, Sandra Althouse, Lawrence H Einhorn, Robert Frisina, James C Root, Tim A Ahles, Lois B Travis
No study has comprehensively examined associated factors (adverse health outcomes, health behaviors, and demographics) affecting cognitive function in long-term testicular cancer survivors (TC survivors). TC survivors given cisplatin-based chemotherapy completed comprehensive, validated surveys, including those that assessed cognition. Medical record abstraction provided cancer and treatment history. Multivariable logistic regression examined relationships between potential associated factors and cognitive impairment. Among 678 TC survivors (median age = 46; interquartile range [IQR] = 38-54); median time since chemotherapy = 10.9 years, IQR = 7.9-15.9), 13.7% reported cognitive dysfunction. Hearing loss (odds ratio [OR] = 2.02; P = .040), neuropathic pain (OR = 2.06; P = .028), fatigue (OR = 6.11; P < .001), and anxiety/depression (OR = 1.96; P = .029) were associated with cognitive impairment in multivariable analyses. Being on disability (OR = 9.57; P = .002) or retired (OR = 3.64; P = .029) were also associated with cognitive decline. Factors associated with impaired cognition identify TC survivors requiring closer monitoring, counseling, and focused interventions. Hearing loss, neuropathic pain, fatigue, and anxiety/depression constitute potential targets for prevention or reduction of cognitive impairment in long-term TC survivors.
{"title":"Cognitive function in long-term testicular cancer survivors: impact of modifiable factors.","authors":"Paul C Dinh, Patrick O Monahan, Chunkit Fung, Howard D Sesso, Darren R Feldman, David J Vaughn, Robert J Hamilton, Robert Huddart, Neil E Martin, Christian Kollmannsberger, Sandra Althouse, Lawrence H Einhorn, Robert Frisina, James C Root, Tim A Ahles, Lois B Travis","doi":"10.1093/jncics/pkae068","DOIUrl":"10.1093/jncics/pkae068","url":null,"abstract":"<p><p>No study has comprehensively examined associated factors (adverse health outcomes, health behaviors, and demographics) affecting cognitive function in long-term testicular cancer survivors (TC survivors). TC survivors given cisplatin-based chemotherapy completed comprehensive, validated surveys, including those that assessed cognition. Medical record abstraction provided cancer and treatment history. Multivariable logistic regression examined relationships between potential associated factors and cognitive impairment. Among 678 TC survivors (median age = 46; interquartile range [IQR] = 38-54); median time since chemotherapy = 10.9 years, IQR = 7.9-15.9), 13.7% reported cognitive dysfunction. Hearing loss (odds ratio [OR] = 2.02; P = .040), neuropathic pain (OR = 2.06; P = .028), fatigue (OR = 6.11; P < .001), and anxiety/depression (OR = 1.96; P = .029) were associated with cognitive impairment in multivariable analyses. Being on disability (OR = 9.57; P = .002) or retired (OR = 3.64; P = .029) were also associated with cognitive decline. Factors associated with impaired cognition identify TC survivors requiring closer monitoring, counseling, and focused interventions. Hearing loss, neuropathic pain, fatigue, and anxiety/depression constitute potential targets for prevention or reduction of cognitive impairment in long-term TC survivors.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11424079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141982321","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}