Preventive oncology & epidemiology最新文献

Background: The Together for Health-Virginia (T4H-VA) Research Program aimed to advance cancer prevention, education, and outreach in Virginia. Creating a representative and inclusive cohort is critical to the program's mission and quality of outcomes. The T4H-VA Research Program utilized a multi-modal sampling approach to improve population health assessment. The current study describes the technology-based, non-probability platform developed for this purpose and compares differences between the probability-based (mail-based) and non-probability-based (e-cohort) methods with respect to participant demographics, health characteristics, and health information and technology use.

Methods: T4H-VA is a research registry focusing on 54 counties within the Massey Comprehensive Cancer Center (MCCC) catchment area in Richmond, VA. Adult residents proficient in English were eligible. For the probability-based sampling, surveys were mailed to residents within the catchment area. For the non-probability sampling, an online study platform was developed and surveys were completed through the web/mobile app.

Results: Both cohorts fell short of recruitment goals. The study yielded 1158 participants (M=57, SD=16 years; 55.0% female; 72.1% White); 899 (77.6%) were sampled through the probability, mail-based approach. Participants who identified as "other" race were significantly less likely to be sampled by the non-probability method. Significant differences emerged, including health protective (greater moderate and high physical activity) and risk factors (greater alcohol consumption and personal history of cancer) in the non-probability, e-cohort relative to the probability sample. E-Cohort participants were significantly more likely to report using electronic health records.

Discussion: Overall difficulties in recruiting were caused, at least in part, by the onset of the COVID-19 pandemic and related factors. The e-cohort, which used exclusively digital recruitment strategies, fell significantly short of recruitment goals. This suggests in-person and mail-based strategies remain important for recruitment. Moreover, instead of favoring a singular approach, a combined approach to survey sampling may capitalize on the strengths of each sampling mode to increase diversity in sociodemographic and health risk characteristics.

To evaluate the association of neighborhood level economic, environmental, and social indicators with lung cancer (LC) incidence and mortality. Data for adult incident LC cases in Allegheny County, Pennsylvania, diagnosed between 2015-2019 were obtained from Pennsylvania cancer registry. Cases were summarized at census-tract level. Publicly available data on neighborhood deprivation index (NDI), built environment, and racial isolation at census-tracts were linked to cases. Poisson regression was used to compute relative risk (RR) for LC incidence and mortality, adjusting for covariates. A total of 3256 LC cases were included in the analyses. About 68% were ≥65 years, 54% female, 14% Black or African American, and 63% deceased. Results of the multivariable model found that increasing quintiles (Q) of NDI were significantly associated with increasing risk of LC incidence and mortality. The RRs (95% confidence interval) of LC incidence for Q2, Q3, Q4 and Q5 were 1.36 (1.21-1.52), 1.55 (1.40-1.72), 1.68 (1.51-1.87), 2.08 (1.82-2.38), respectively, compared with Q1 (P trend <0.01). The corresponding RRs for LC mortality were 1.46 (1.27-1.68), 1.63 (1.42-1.88), 1.74 (1.51-2.01), 2.04 (2.02-2.88) (P trend <0.01). Targeted interventions for LC prevention and early detection in high NDI neighborhoods may be more effective to reduce LC health disparities.

Background: Distributing CRC screening through pharmacies, a highly accessible health service, may create opportunities for more equitable access to CRC screening. However, providing CRC screening in a new context introduces a substantial implementation challenge.

Methods: We conducted 23 semi-structured interviews with community pharmacists practicing in Washington state and North Carolina about distributing fecal immunochemical tests (FIT) to patients in the pharmacy. The Consolidated Framework for Implementation Research (CFIR) was used to guide analysis.

Results: Pharmacists believed that delivering FITs was highly compatible with their environment, workflow, and scope of practice. While knowledge about FIT eligibility criteria varied, pharmacists felt comfortable screening patients. They identified standardized eligibility criteria, patient-facing educational materials, and continuing education as essential design features. Pharmacists proposed adapting existing pharmacy electronic health record systems for patient reminders/prompts to facilitate FIT completion. While pharmacists felt confident that they could discuss test results with patients, they also expressed a need for stronger communication and care coordination with primary care providers.

Discussion: When designing a pharmacy-based CRC screening program, pharmacists desired programmatic procedures to fit their current knowledge and context. Findings indicate that if proper attention is given to multi-level factors, FIT delivery can be extended to pharmacies.

Background: Perceived cognitive impairments(PCI) are the most common complications that Non-Central Nervous System (Non-CNS) cancers survivors experience. Studies have suggested that those who expreience fear of cancer recurrence (FCR) tend to report cognitive problems; however, this association has not been examined.

Methods: Participants (n = 6,714) were enrolled in the Women's Health Initiative Life and Longevity After Cancer study. FCR was assessed using the Cancer Worry Scale and PCI was assessed using the PCI subscale of FACT-Cog. The association between FCR and PCI was analyzed using univariable and multivariable logistic regression models. A cut off score of ≥ 14 is indicative of high FCR and below 14 indicating low FCR. Scores lower than 60 indicated PCI.

Result: The multivariable model showed that higher FCR corresponded to an increase in odds of PCI (OR = 1.15, p < 0.001). We also found that older age at diagnosis (p < 0.001), less social support (p = 0.01), over ten pounds of weight gain after cancer treatment (p = 0.02), and mild or worse anxiety (p < 0.001) were also associated with increased odds of PCI from the multivariable analysis.

Discussion: Our findings indicate that survivors with higher FCR demonstrated poorer cognitive performance than those with lower FCR. These results suggest that those with higher FCR are more likely to report PCI.

Despite robust evidence linking alcohol, processed meat, and red meat to colorectal cancer (CRC), public awareness of nutrition recommendations for CRC prevention is low. Marginalized populations, including those in rural areas, experience high CRC burden and may benefit from culturally tailored health information technologies. This study explored perceptions of web-based health messages iteratively in focus groups and interviews with 48 adults as part of a CRC prevention intervention. We analyzed transcripts for message perceptions and identified three main themes with subthemes: (1) Contradictory recommendations, between the intervention's nutrition risk messages and recommendations for other health conditions, from other sources, or based on cultural or personal diets; (2) reactions to nutrition risk messages, ranging from aversion (e.g., "avoid alcohol" considered "preachy") to appreciation, with suggestions for improving messages; and (3) information gaps. We discuss these themes, translational impact, and considerations for future research and communication strategies for delivering web-based cancer prevention messages.