JMIR Cancer最新文献

Unlabelled: Therapist-guided eHealth interventions have been shown to engage users more effectively and achieve better outcomes than self-guided interventions when addressing psychological symptoms. Building on this evidence, this viewpoint aimed to describe the adaptation of iConquerFear, a self-guided eHealth intervention targeting fear of cancer recurrence, into a therapist-guided version (TG-iConquerFear) tailored specifically for survivors of colorectal cancer (CRC). The goal was to optimize patient outcomes while minimizing the need for extensive resources. The adaptation process followed the Information System research framework, which facilitated a systematic integration of knowledge and iterative testing. Drawing on insights from the original iConquerFear development, as well as feedback from end users, oncologists, and therapists, we began by identifying areas for improvement. These insights formed the foundation for the first design cycle. Initial internal testing revealed the need for several adjustments to enhance the intervention. While the core concept of iConquerFear remained unchanged, we made significant modifications to improve access by optimizing the platform for mobile devices, to support adherence by expanding the exercises, and to equip therapists with tools such as reflective questions and a monitoring control panel. External field testing with 5 survivors of CRC provided further validation. Participants reported a high level of acceptability, and their feedback guided additional minor points to consider incorporating in future versions. This study illustrates how a self-guided eHealth intervention can be successfully adapted into a therapist-guided format for fear of cancer recurrence, tailored to meet the needs of survivors of CRC. The described approach serves as a valuable framework for integrating therapist guidance into similar interventions, ensuring their relevance and effectiveness for targeted populations.

Background: Though telehealth has been a promising avenue for engaging cancer survivors with health care and lifestyle programming, older and rural-dwelling cancer survivors may have additional challenges in accessing digital devices and tools that have not yet been described. This study aimed to use a robust, nationally representative sample collected in 2022 to provide an updated view of digital technology use and the use of technology for health in this population.

Objective: This study aimed to examine the prevalence of digital technology use for health-related activities among older cancer survivors in both rural and urban settings. The primary outcomes of interest included (1) internet access and use for health-related activities, (2) digital device ownership and use as a tool for health behaviors, (3) use of social media for health, and (4) use of telehealth.

Methods: A cross-sectional analysis of the National Cancer Institute's Health Information National Trends Survey Cycle 6 (HINTS 6) was completed to examine the prevalence of digital technology use among older cancer survivors. For analysis, the sample was restricted to cancer survivors over the age of 60 years (n=710). Unadjusted and adjusted logistic regression models were used to test the association between rurality and digital health tool use.

Results: Overall, 17% (125/710) of the sample lived in a rural area of the United States and the mean sample age was 73 (SD 8.2) years. Older cancer survivors, regardless of rural-urban status, reported a high prevalence of internet usage (n=553, 79.9%), digital device ownership (n=676, 94.9%), and social media use (n=448, 66.6%). In unadjusted models, rural survivors were less likely than urban survivors to report that they had used a health or wellness application in the previous year (odds ratio [OR] 0.56, 95% CI 0.32-0.97; P=.04). In adjusted models, rural survivors were more likely to report that they had shared personal health information on social media (OR 2.64, 95% CI 1.13-6.19; P=.03). There were no differences in the proportion of rural and urban respondents who reported receiving health services through telehealth in the previous year.

Conclusions: Regardless of the residential status, older cancer survivors report high internet and technology use for health-related activities. These results show promise for the feasibility of using digital technologies to implement supportive care and wellness programming with older cancer survivors.

Background: Breast cancer is a major health concern in various countries. Routine mammography screening has been shown to reduce breast cancer mortality, and Japan has set national targets to improve screening participation and increase public attention. However, collecting nationwide data on public attention and activity is not easy. Google Trends can reveal changes in societal interest, yet there are no reports on the relationship between internet search volume and nationwide participation rates in Japan.

Objective: This study aims to reveal and discuss the relationship between public awareness and actual behavior in breast cancer screening by examining trends in internet search volume for the keyword "breast cancer screening" and participation rates over a decade-long period.

Methods: This time-series study evaluated the association between internet search volume and breast cancer screening participation behavior among women aged 60-69 years in Japan from 2009 to 2019. Relative search volume (RSV) data for the search term "breast cancer screening (nyuugan-kenshin)" were extracted from Google Trends as internet search volume. Breast cancer screening and further assessment participation rates were based on government municipal screening data. Joinpoint regression analyses were conducted with weighted BIC to evaluate the time trends. An ethics review was not required because all data were open.

Results: The RSV for "breast cancer screening (nyuugan-kenshin)" peaked in June 2017 (100) and showed clear spikes in June 2016 (94), September (69), and October (77) 2015. No RSVs above 60 were observed except around these three specific periods, and the average RSV for the entire period was 30.7 (SD 16.2). Two statistically significant joinpoints were detected, rising in December 2013 and falling in June 2017. Screening participation rates showed a temporary increase in 2015 in a slowly decreasing trend, and no joinpoints were detected. Further assessment participation rates showed a temporary spike in 2015 in the middle of an increasing trend, with a statistically significant point of slowing increase detected in 2015. Post hoc manual searches revealed that Japanese celebrities' breast cancer diagnoses were announced on the relevant dates, and many Japanese media reports were found.

Conclusions: This study found a notable association between internet search activity and celebrity cancer media reports and a temporal association with screening participation in breast cancer screening in Japan. Celebrity cancer media reports triggered internet searches for cancer screening, but this did not lead to long-term changes in screening participation behavior. This finding suggests what information needs to be provided to citizens to encourage participation in screening.

Background: Male breast cancer (MBC) is an uncommon disease. Few studies have discussed the prognosis of MBC due to its rarity.

Objective: This study aimed to develop a nomogram to predict the overall survival of patients with MBC and externally validate it using cases from China.

Methods: Based on the Surveillance, Epidemiology, and End Results (SEER) database, male patients who were diagnosed with breast cancer between January 2010, and December 2015, were enrolled. These patients were randomly assigned to either a training set (n=1610) or a validation set (n=713) in a 7:3 ratio. Additionally, 22 MBC cases diagnosed at the First Affiliated Hospital of Guangxi Medical University between January 2013 and June 2021 were used for external validation, with the follow-up endpoint being June 10, 2023. Cox regression analysis was performed to identify significant risk variables and construct a nomogram to predict the overall survival of patients with MBC. Information collected from the test set was applied to validate the model. The concordance index (C-index), receiver operating characteristic (ROC) curve, decision curve analysis (DCA), and a Kaplan-Meier survival curve were used to evaluate the accuracy and reliability of the model.

Results: A total of 2301 patients with MBC in the SEER database and 22 patients with MBC from the study hospital were included. The predictive model included 7 variables: age (hazard ratio [HR] 1.89, 95% CI 1.50-2.38), surgery (HR 0.38, 95% CI 0.29-0.51), marital status (HR 0.75, 95% CI 0.63-0.89), tumor stage (HR 1.17, 95% CI 1.05-1.29), clinical stage (HR 1.41, 95% CI 1.15-1.74), chemotherapy (HR 0.62, 95% CI 0.50-0.75), and HER2 status (HR 2.68, 95% CI 1.20-5.98). The C-index was 0.72, 0.747, and 0.981 in the training set, internal validation set, and external validation set, respectively. The nomogram showed accurate calibration, and the ROC curve confirmed the advantage of the model in clinical validity. The DCA analysis indicated that the model had good clinical applicability. Furthermore, the nomogram classification allowed for more accurate differentiation of risk subgroups, and patients with low-risk MBC demonstrated substantially improved survival outcomes compared with medium- and high-risk patients (P<.001).

Conclusions: A survival prognosis prediction nomogram with 7 variables for patients with MBC was constructed in this study. The model can predict the survival outcome of these patients and provide a scientific basis for clinical diagnosis and treatment.

Background: The lack of information and awareness about clinical trials, as well as misconceptions about them, are major barriers to cancer clinical trial participation. Digital and social media are dominant sources of health information and offer optimal opportunities to improve public medical awareness and education by providing accurate and trustworthy health information from reliable sources. Infotainment, material intended to both entertain and inform, is an effective strategy for engaging and educating audiences that can be easily disseminated using social media and may be a novel way to improve awareness of and recruitment in clinical trials.

Objective: The purpose of this study was to evaluate whether an infotainment video promoting a clinical trial, disseminated using social media, could drive health information seeking behaviors.

Methods: As part of a video series, we created an infotainment video focused on the promotion of a specific cancer clinical trial. We instituted a dissemination and marketing process on Facebook to measure video engagement and health information seeking behaviors among targeted audiences who expressed interest in breast cancer research and organizations. To evaluate video engagement, we measured reach, retention, outbound clicks, and outbound click-through rate. Frequencies and descriptive statistics were used to summarize each measure.

Results: The video substantially increased health information seeking behavior by increasing viewership from 1 visitor one month prior to launch to 414 outbound clicks from the video to the clinical trial web page during the 21-day social media campaign period.

Conclusions: Our study shows that digital and social media tools can be tailored for specific target audiences, are scalable, and can be disseminated at low cost, making it an accessible educational, recruitment, and retention strategy focused on improving the awareness of clinical trials.

Unlabelled: While patient-reported outcome measures are regularly incorporated into phase 3 clinical trials, they have been infrequently used in early phase trials. However, the patient's perspective is vital to fully understanding dose toxicity and selecting an optimal dose. This viewpoint paper reviews the rationale for and practical approach to collecting patient-reported outcome data in early phase oncology drug development and the rationale for electronic collection.

This Viewpoint proposes a robust framework for developing a medical chatbot dedicated to radiotherapy education, emphasizing accuracy, reliability, privacy, ethics, and future innovations. By analyzing existing research, the framework evaluates chatbot performance and identifies challenges such as content accuracy, bias, and system integration. The findings highlight opportunities for advancements in natural language processing, personalized learning, and immersive technologies. When designed with a focus on ethical standards and reliability, large language model-based chatbots could significantly impact radiotherapy education and health care delivery, positioning them as valuable tools for future developments in medical education globally.