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Data quality in a survey of registered medical cannabis users with cancer: nonresponse and measurement error. 癌症医用大麻登记使用者调查的数据质量:无响应和测量误差。
Pub Date : 2024-08-15 DOI: 10.1093/jncimonographs/lgad029
Jeanette Y Ziegenfuss, Helen M Parsons, Anne H Blaes, Bruce Lindgren, Julia Andersen, Susan Park, Patricia I Jewett, Arjun Gupta, Dylan M Zylla

Cannabis use among individuals with cancer is best understood using survey self-report. As cannabis remains federally illegal, surveys could be subject to nonresponse and measurement issues impacting data quality. We surveyed individuals using medical cannabis for a cancer-related condition in the Minnesota Medical Cannabis Program (MCP). Although survey responders are older, there are no differences by race and ethnicity, gender, or receipt of reduced cannabis registry enrollment fee. Responders made a more recent purchase and more recently completed an independent symptom assessment for the registry than nonresponders, suggesting some opportunity for nonresponse error. Among responders, self-report and MCP administrative data with respect to age, race, gender, registry certification, and cannabis purchase history were similar. Responders were less likely to report receipt of Medicaid than would be expected based on registry low-income enrollment eligibility. Although attention should be paid to potential for nonresponse error, surveys are a reliable tool to ascertain cannabis behavior patterns in this population.

了解癌症患者吸食大麻的最佳方式是通过调查自我报告。由于大麻在联邦法律上仍然是非法的,因此调查可能会受到无响应和测量问题的影响,从而影响数据质量。我们对明尼苏达医用大麻计划 (MCP) 中因癌症相关疾病而使用医用大麻的个人进行了调查。虽然调查对象年龄较大,但在种族和民族、性别或大麻注册费减免情况方面并无差异。与未回复者相比,回复者购买大麻的时间更近,完成独立症状评估的时间也更近,这表明存在一定的非回复误差。在应答者中,关于年龄、种族、性别、登记认证和大麻购买历史的自我报告数据与 MCP 管理数据相似。根据登记处的低收入登记资格,应答者报告接受医疗补助的可能性低于预期。虽然应注意可能出现的非响应误差,但调查是确定该人群大麻行为模式的可靠工具。
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引用次数: 0
Ethnic differences in the patterns, sources, and reasons for cannabis use among cancer patients at an NCI-Designated Cancer Center. NCI 指定癌症中心癌症患者吸食大麻的模式、来源和原因的种族差异。
Pub Date : 2024-08-15 DOI: 10.1093/jncimonographs/lgad037
Denise C Vidot, Amrit Baral, Nicolas Hernandez-Ortega, Bria-Necole A Diggs, Jessica Y Islam, Marlene Camacho-Rivera, Claudia Martinez, Frank Penedo

Objective: This study aims to describe patterns, sources, and reasons for cannabis use among cancer patients by ethnic group.

Methods: Data are from a cross-sectional study of 416 surveys collected via RedCap anonymously from adult cancer patients seen at a National Cancer Institute-designated comprehensive cancer center within the last 5 years. A harmonized survey was created with 11 other National Cancer Institute centers to assess cannabis use patterns, sources, and reasons for use. Sociodemographics and cancer details were also collected via self-report. Descriptive statistics by ethnic group were compared using χ2 and Fisher exact tests.

Results: Among the sample (age mean = 50.4 [15.7] years; 53% male; 8.3% lesbian, gay, bisexual, transgender, queer; 46.7% Hispanic and Latinx individuals), 69.6% reported lifetime use of cannabis, 33.7% began cannabis use after cancer diagnosis, 48.1% of those consuming cannabis did not have a prescription for cannabis, and 29.4% of cannabis users consumed daily. The frequency of cannabis use (P = .04) and reasons for cannabis use (P = .02) varied by ethnic group. Sleep and pain were the most prevalent reasons for use among the Hispanics and Latinx populations; pain, mental health management, and neuropathy were the most prevalent reasons for cannabis use among non-Hispanic White individuals.

Conclusions: Patterns and reasons for cannabis use differed among cancer patients by ethnic group in this exploratory cross-sectional study aimed to provide data for more rigorous study. Understanding these distinctions are pivotal in conducting more rigorous studies that address the unique needs of diverse populations utilizing cannabis for managing cancer-related symptoms.

目的本研究旨在按种族群体描述癌症患者使用大麻的模式、来源和原因:数据来自一项横断面研究,该研究通过 RedCap 匿名收集了 416 份调查问卷,调查对象是过去 5 年内在美国国家癌症研究所指定的综合癌症中心就诊的成年癌症患者。我们与美国国家癌症研究所的其他 11 个中心共同制作了一份统一调查表,以评估大麻的使用模式、来源和原因。此外,还通过自我报告的方式收集了社会人口统计数据和癌症详情。使用χ2和费舍尔精确检验比较了各族裔群体的描述性统计数据:在样本中(平均年龄 = 50.4 [15.7] 岁;53% 为男性;8.3% 为女同性恋者、男同性恋者、双性恋者、跨性别者、同性恋者;46.7% 为西班牙裔和拉丁裔),69.6% 的人报告终生使用大麻,33.7% 的人在癌症确诊后开始使用大麻,48.1% 的大麻使用者没有大麻处方,29.4% 的大麻使用者每天使用大麻。使用大麻的频率(P = .04)和使用大麻的原因(P = .02)因种族群体而异。在西班牙裔和拉丁裔人群中,睡眠和疼痛是使用大麻最普遍的原因;在非西班牙裔白人中,疼痛、精神健康管理和神经病变是使用大麻最普遍的原因:在这项探索性横断面研究中,不同种族的癌症患者使用大麻的模式和原因各不相同,这项研究旨在为更严格的研究提供数据。了解这些区别对于开展更严谨的研究、满足利用大麻控制癌症相关症状的不同人群的独特需求至关重要。
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引用次数: 0
A survey of patients with cancer and oncology health-care professionals about cannabis use during treatment. 对癌症患者和肿瘤科医护人员在治疗期间使用大麻情况的调查。
Pub Date : 2024-08-15 DOI: 10.1093/jncimonographs/lgae007
Richard T Lee, Elyssa Kim, Prateek Mendiratta, Megan Farrell, Shalena Finklea, Lauren Huang, Erika Trapl, Stanton Gerson, Jennifer Cullen

Background: This study characterizes patient and health-care professional perspectives regarding medical cannabis use at a National Cancer Institute-Designated Cancer Center. Data evaluated included the prevalence and patterns of and reasons for cannabis use.

Methods: Patients with cancer undergoing treatment were recruited into a cross-sectional survey as part of a national National Cancer Institute-funded effort. Participants completed a survey about cannabis use, reasons for use, and types of cannabis. A health-care professional survey was also conducted to explore perspectives regarding patients' use of cannabis.

Results: A total of 313 patients with cancer (mean [SD] age = 60.7 [12.8] years) completed the survey (43% response rate) between 2021 and 2022. Of the respondents, 58% were female; identified as White (61%) and Black (23%); and had diverse cancer diagnoses. Nearly half of respondents (43%) had previously used cannabis, one-quarter (26%) had used cannabis since their cancer diagnosis, and almost 1 in 6 (17%) were actively using cannabis at the time of survey completion. The most common modes of ingestion were gummies (33%) and smoking (30%). The most commonly reported reasons for use were insomnia (46%), pain (41%), and mood (39%). For the 164 health-care professionals who completed the survey (25% response rate), the majority agreed that cannabis use (72%) is safe and beneficial for patients (57%). Four in 10 (39%) health-care professionals felt comfortable providing guidance to patients about cannabis use; however, only 1 in 8 (13%) felt knowledgeable about the topic of cannabis.

Conclusions: Approximately one-sixth of patients with cancer receiving treatment actively use cannabis for management of various cancer symptoms. Perceptions about cannabis use and education varied widely among health-care professionals.

背景:本研究描述了国家癌症研究所指定癌症中心的患者和医护人员对医用大麻使用的看法。评估的数据包括大麻使用的流行率、模式和原因:作为国家癌症研究所资助的一项全国性工作的一部分,招募了正在接受治疗的癌症患者参与横断面调查。参与者填写了一份关于大麻使用情况、使用原因和大麻种类的调查表。此外,还进行了一项医疗保健专业人员调查,以了解他们对患者使用大麻的看法:2021 年至 2022 年期间,共有 313 名癌症患者(平均 [SD] 年龄 = 60.7 [12.8] 岁)完成了调查(回复率为 43%)。在受访者中,58% 为女性;61% 为白人,23% 为黑人;癌症诊断多种多样。近一半的受访者(43%)以前吸食过大麻,四分之一的受访者(26%)在确诊癌症后吸食过大麻,近六分之一的受访者(17%)在完成调查时正在积极吸食大麻。最常见的吸食方式是软糖(33%)和吸烟(30%)。最常报告的使用原因是失眠(46%)、疼痛(41%)和情绪(39%)。在完成调查的 164 名医护专业人员中(回复率为 25%),大多数人(72%)同意使用大麻是安全的,对病人有益(57%)。每 10 名医护人员中就有 4 人(39%)认为可以为患者提供有关使用大麻的指导;然而,每 8 人中只有 1 人(13%)认为自己了解大麻的相关知识:大约六分之一接受治疗的癌症患者积极使用大麻来控制各种癌症症状。医护人员对大麻使用和教育的看法差异很大。
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引用次数: 0
Tobacco-cannabis co-use among cancer patients and survivors: findings from 2 US cancer centers. 癌症患者和幸存者中烟草和大麻的共同使用:美国两家癌症中心的研究结果。
Pub Date : 2024-08-15 DOI: 10.1093/jncimonographs/lgad035
Danielle M Smith, Jesse T Kaye, Kyle J Walters, Nicolas J Schlienz, Andrew J Hyland, Rebecca L Ashare, Rachel L Tomko, Jennifer Dahne, Aimee L McRae-Clark, Erin A McClure

Background: Cannabis use is prevalent among cancer patients and survivors and may provide some therapeutic benefits for this population. However, benefits may be attenuated when cannabis is co-used with tobacco, which is associated with more severe tobacco and cannabis use and adverse outcomes in noncancer populations. We compared cannabis use, primary mode of use, and therapeutic and/or nontherapeutic use among 3 groups of patients and survivors based on cigarette smoking status.

Methods: Survey data was collected from patients and survivors with cancer (n = 1732) at 2 US National Cancer Institute-designated cancer centers in states with varying cannabis regulatory policy. Prevalence of cannabis use (prior to diagnosis, after diagnosis, before treatment, after treatment), primary mode of use, and therapeutic and/or nontherapeutic use were assessed by cigarette smoking status (current, former, never) within and across centers using weighted bivariate analyses and multivariable logistic regression, controlling for demographic and clinical variables.

Results: Current cigarette use was associated with greater rates of cannabis use prior to diagnosis, after diagnosis, during treatment, and after treatment within each center (all P < .001) and in pooled analyses across centers (all P < .001). Primary mode of use, knowledge of cannabis products, and therapeutic and/or nontherapeutic use also statistically differed by tobacco status and study site.

Conclusions: Results illustrate the importance of conducting assessments for both tobacco and cannabis use among cancer patients during and after cancer treatment, regardless of the cannabis regulatory environment. Given previous data indicating harms from co-use and continued tobacco use during cancer treatment, this issue introduces new priorities for cancer care delivery and research.

背景:使用大麻在癌症患者和幸存者中很普遍,可能会为这一人群带来一些治疗益处。然而,当大麻与烟草同时使用时,其益处可能会减弱,而在非癌症人群中,大麻与烟草同时使用会导致更严重的烟草和大麻使用问题及不良后果。我们根据吸烟状况比较了 3 组患者和幸存者的大麻使用情况、主要使用方式以及治疗性和/或非治疗性使用情况:我们在美国国家癌症研究所指定的 2 个癌症中心收集了癌症患者和幸存者(n = 1732)的调查数据,这 2 个癌症中心所在州的大麻监管政策各不相同。使用加权双变量分析和多变量逻辑回归,在控制人口统计学和临床变量的情况下,根据中心内和中心间的吸烟状况(目前、以前、从未)评估了大麻使用的流行率(诊断前、诊断后、治疗前、治疗后)、主要使用方式以及治疗性和/或非治疗性使用:结果:在各中心内,目前吸烟与诊断前、诊断后、治疗期间和治疗后使用大麻的比例较高相关(均为 P 结论:在各中心内,目前吸烟与诊断前、诊断后、治疗期间和治疗后使用大麻的比例较高相关(均为 P):结果表明,无论大麻监管环境如何,在癌症治疗期间和治疗后对癌症患者进行烟草和大麻使用评估都非常重要。鉴于之前的数据表明在癌症治疗期间同时使用和继续使用烟草会造成危害,这一问题为癌症治疗和研究提出了新的优先事项。
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引用次数: 0
Concurrent substance use among cancer patients with and without a history of cannabis use since cancer diagnosis at an NCI-Designated Cancer Center in Florida. 佛罗里达州一家 NCI 指定癌症中心的癌症患者在确诊癌症后同时使用和未使用大麻的情况。
Pub Date : 2024-08-15 DOI: 10.1093/jncimonographs/lgad036
Jessica Y Islam, Oliver T Nguyen, Kea Turner, Yessica C Martinez, Omar Garcia Rodriguez, Diane Irlanda Rodriguez, Sahana Rajasekhara, Young D Chang, Brian D Gonzalez, Heather S L Jim, Kathleen M Egan

Background: Although substance use may have adverse impacts on cancer outcomes, little is known regarding patterns of concurrent substance use with cannabis among cancer patients. Our objective was to examine predictors of concurrent substance use with cannabis among cancer patients since their cancer diagnosis and explore perceptions of cannabis among these patients.

Methods: Patients treated at a National Cancer Institute-designated comprehensive cancer center were invited to participate in an electronic survey regarding medical cannabis from August to November 2021. Survey data were linked to internal data resources including electronic health records and patient intake forms to obtain history of substance use (defined as within at least 3 months of cancer diagnosis) of cigarettes, injection drugs, high levels of alcohol, or clinically unsupervised prescription drugs (total n = 1094). Concurrent substance users were defined as those with any reported substance use and cannabis use at the time of cancer diagnosis. We used descriptive statistics (χ2 or exact tests) to compare groups and estimated adjusted odds ratios (AORs) with 95% confidence intervals (CIs) to identify predictors of substance use among users and nonusers of cannabis.

Results: Approximately 45% (n = 489) of the sample reported cannabis use since their cancer diagnosis. Of patients who reported using cannabis, 20% self-reported concurrent polysubstance use, while 8% of cannabis nonusers reported substance use (P < .001). Among patients who use cannabis, those who reported 2 or more self-reported treatment-related symptoms (eg, pain, fatigue) were more likely to have self-reported concurrent substance use (AOR = 3.15, 95% CI = 1.07 to 9.27) compared with those without any symptoms. Among nonusers, those with lower educational background were more likely to have a history of concurrent substance use (AOR = 3.74, 95% CI = 1.57 to 8.92). Patients who use cannabis with concurrent substance use were more likely to report improved sleep (P = .04), increased appetite (P = .03), and treatment of additional medical conditions (P = .04) as perceived benefits of cannabis use.

Conclusions: High symptom burden may be associated with concurrent substance use with cannabis among cancer patients.

背景:虽然药物使用可能会对癌症结果产生不利影响,但人们对癌症患者同时使用药物和大麻的模式知之甚少。我们的目的是研究癌症患者自癌症确诊以来同时使用大麻药物的预测因素,并探讨这些患者对大麻的看法:邀请在美国国家癌症研究所指定的综合癌症中心接受治疗的患者参与 2021 年 8 月至 11 月有关医用大麻的电子调查。调查数据与内部数据资源(包括电子健康记录和患者入院表)相连接,以获取使用香烟、注射毒品、大量饮酒或临床无监督处方药的药物史(定义为癌症诊断后至少 3 个月内)(总人数 = 1094)。同时使用药物者的定义是,在癌症确诊时使用过任何药物和大麻的人。我们使用描述性统计(χ2 或精确检验)对各组进行比较,并估算调整后的几率比(AORs)及 95% 的置信区间(CIs),以确定大麻使用者和非使用者使用药物的预测因素:约有 45% 的样本(n = 489)报告自癌症确诊以来使用过大麻。在报告使用大麻的患者中,有 20% 的人自我报告同时使用多种药物,而未使用大麻的人中有 8% 报告使用药物(P 结论:高症状负担可能与同时使用多种药物有关:癌症患者的高症状负担可能与同时使用大麻药物有关。
{"title":"Concurrent substance use among cancer patients with and without a history of cannabis use since cancer diagnosis at an NCI-Designated Cancer Center in Florida.","authors":"Jessica Y Islam, Oliver T Nguyen, Kea Turner, Yessica C Martinez, Omar Garcia Rodriguez, Diane Irlanda Rodriguez, Sahana Rajasekhara, Young D Chang, Brian D Gonzalez, Heather S L Jim, Kathleen M Egan","doi":"10.1093/jncimonographs/lgad036","DOIUrl":"10.1093/jncimonographs/lgad036","url":null,"abstract":"<p><strong>Background: </strong>Although substance use may have adverse impacts on cancer outcomes, little is known regarding patterns of concurrent substance use with cannabis among cancer patients. Our objective was to examine predictors of concurrent substance use with cannabis among cancer patients since their cancer diagnosis and explore perceptions of cannabis among these patients.</p><p><strong>Methods: </strong>Patients treated at a National Cancer Institute-designated comprehensive cancer center were invited to participate in an electronic survey regarding medical cannabis from August to November 2021. Survey data were linked to internal data resources including electronic health records and patient intake forms to obtain history of substance use (defined as within at least 3 months of cancer diagnosis) of cigarettes, injection drugs, high levels of alcohol, or clinically unsupervised prescription drugs (total n = 1094). Concurrent substance users were defined as those with any reported substance use and cannabis use at the time of cancer diagnosis. We used descriptive statistics (χ2 or exact tests) to compare groups and estimated adjusted odds ratios (AORs) with 95% confidence intervals (CIs) to identify predictors of substance use among users and nonusers of cannabis.</p><p><strong>Results: </strong>Approximately 45% (n = 489) of the sample reported cannabis use since their cancer diagnosis. Of patients who reported using cannabis, 20% self-reported concurrent polysubstance use, while 8% of cannabis nonusers reported substance use (P < .001). Among patients who use cannabis, those who reported 2 or more self-reported treatment-related symptoms (eg, pain, fatigue) were more likely to have self-reported concurrent substance use (AOR = 3.15, 95% CI = 1.07 to 9.27) compared with those without any symptoms. Among nonusers, those with lower educational background were more likely to have a history of concurrent substance use (AOR = 3.74, 95% CI = 1.57 to 8.92). Patients who use cannabis with concurrent substance use were more likely to report improved sleep (P = .04), increased appetite (P = .03), and treatment of additional medical conditions (P = .04) as perceived benefits of cannabis use.</p><p><strong>Conclusions: </strong>High symptom burden may be associated with concurrent substance use with cannabis among cancer patients.</p>","PeriodicalId":73988,"journal":{"name":"Journal of the National Cancer Institute. Monographs","volume":"2024 66","pages":"224-233"},"PeriodicalIF":0.0,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11303859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141899113","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
Overview of cancer patient perspectives on cannabis use during treatment. 癌症患者对治疗期间使用大麻的看法概览。
Pub Date : 2024-08-15 DOI: 10.1093/jncimonographs/lgae025
Kathy J Helzlsouer, Sonia M Rosenfield, Andrew N Freedman, Gary L Ellison

Expanding legal access to medical cannabis across the United States increases availability and use of cannabis products to manage cancer-related symptoms and treatment side effects despite the lack of research-based evidence on its potential benefits and harms. To address knowledge gaps in how cancer patients access and use cannabis, their perceived risks and benefits with its use, and whether cancer patients discuss cannabis use with their healthcare providers during treatment, the National Cancer Institute (NCI) supported 12 NCI-designated comprehensive cancer centers to conduct surveys, which included NCI standardized core questions on cannabis use during treatment, among their cancer patient populations. This overview highlights key results from the articles contained in the monograph, which includes a summary of the results of core questions across all centers and reports from individual or groups of cancer centers on survey results related to the sourcing of cannabis, associated cost, behavioral factors associated with cannabis use (such as smoking, drinking, or using other substances), patient-provider communication on cannabis use during treatment, ethnic variations in patterns, sources, and reasons for cannabis use as well as methodologic concerns related to survey data analysis. The results of these surveys of cannabis use after the diagnosis of cancer lay the groundwork for much-needed research to answer the questions of benefits and harms, including potential interactions with cancer treatments for cancer patients.

尽管缺乏有关大麻潜在益处和危害的研究证据,但在美国各地扩大医用大麻的合法使用范围,增加了大麻产品的供应和使用,以控制癌症相关症状和治疗副作用。为了解决癌症患者如何获取和使用大麻、他们对使用大麻的风险和益处的认识、以及癌症患者在治疗期间是否与他们的医疗服务提供者讨论大麻使用情况等方面的知识差距,美国国家癌症研究所(NCI)支持 12 个 NCI 指定的综合癌症中心在其癌症患者群体中开展调查,其中包括 NCI 关于治疗期间大麻使用情况的标准化核心问题。本概述重点介绍了专著所载文章中的主要结果,其中包括所有中心核心问题的结果摘要,以及个别癌症中心或癌症中心小组关于以下方面调查结果的报告:大麻来源、相关费用、与使用大麻有关的行为因素(如吸烟、饮酒或使用其他物质)、治疗期间患者与提供方就使用大麻问题进行的沟通、使用大麻的模式、来源和原因方面的种族差异以及与调查数据分析有关的方法学问题。这些关于癌症确诊后使用大麻情况的调查结果为亟需开展的研究奠定了基础,以便回答癌症患者使用大麻的益处和害处问题,包括与癌症治疗可能产生的相互作用。
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引用次数: 0
Perceptions, prevalence, and patterns of cannabis use among cancer patients treated at 12 NCI-Designated Cancer Centers. 12 个 NCI 指定癌症中心接受治疗的癌症患者对大麻的看法、流行程度和使用模式。
Pub Date : 2024-08-15 DOI: 10.1093/jncimonographs/lgae029
Gary L Ellison, Kathy J Helzlsouer, Sonia M Rosenfield, Yun Kim, Rebecca L Ashare, Anne H Blaes, Jennifer Cullen, Neal Doran, Jon O Ebbert, Kathleen M Egan, Jaimee L Heffner, Richard T Lee, Erin A McClure, Corinne McDaniels-Davidson, Salimah H Meghani, Polly A Newcomb, Shannon Nugent, Nicholas Hernandez-Ortega, Talya Salz, Denise C Vidot, Brooke Worster, Dylan M Zylla

Background: The legal climate for cannabis use has dramatically changed with an increasing number of states passing legislation legalizing access for medical and recreational use. Among cancer patients, cannabis is often used to ameliorate adverse effects of cancer treatment. Data are limited on the extent and type of use among cancer patients during treatment and the perceived benefits and harms. This multicenter survey was conducted to assess the use of cannabis among cancer patients residing in states with varied legal access to cannabis.

Methods: A total of 12 NCI-Designated Cancer Centers, across states with varied cannabis-access legal status, conducted surveys with a core questionnaire to assess cannabis use among recently diagnosed cancer patients. Data were collected between September 2021 and August 2023 and pooled across 12 cancer centers. Frequencies and 95% confidence intervals for core survey measures were calculated, and weighted estimates are presented for the 10 sites that drew probability samples.

Results: Overall reported cannabis use since cancer diagnosis among survey respondents was 32.9% (weighted), which varied slightly by state legalization status. The most common perceived benefits of use were for pain, sleep, stress and anxiety, and treatment side effects. Reported perceived risks were less common and included inability to drive, difficulty concentrating, lung damage, addiction, and impact on employment. A majority reported feeling comfortable speaking to health-care providers though, overall, only 21.5% reported having done so. Among those who used cannabis since diagnosis, the most common modes were eating in food, smoking, and pills or tinctures, and the most common reasons were for sleep disturbance, followed by pain and stress and anxiety with 60%-68% reporting improved symptoms with use.

Conclusion: This geographically diverse survey demonstrates that patients use cannabis regardless of its legal status. Addressing knowledge gaps concerning benefits and harms of cannabis use during cancer treatment is critical to enhance patient-provider communication.

背景:随着越来越多的州通过立法将医疗和娱乐使用大麻合法化,大麻使用的法律环境发生了巨大变化。在癌症患者中,大麻通常被用来改善癌症治疗的不良反应。关于癌症患者在治疗期间使用大麻的程度和类型以及对其益处和危害的认识,相关数据十分有限。这项多中心调查旨在评估居住在各州合法使用大麻的癌症患者使用大麻的情况:共有 12 个 NCI 指定的癌症中心在大麻合法使用状况各不相同的各州进行了调查,使用核心问卷评估最近确诊的癌症患者使用大麻的情况。数据收集时间为 2021 年 9 月至 2023 年 8 月,12 个癌症中心的数据汇总在一起。计算了核心调查指标的频率和 95% 的置信区间,并给出了抽取概率样本的 10 个地点的加权估计值:调查对象自确诊癌症以来使用大麻的总体比例为 32.9%(加权),各州的大麻合法化状况略有不同。认为使用大麻最常见的好处是止痛、改善睡眠、缓解压力和焦虑以及治疗副作用。报告的风险较少,包括无法驾驶、难以集中注意力、肺部损伤、成瘾和对就业的影响。大多数人报告称,与医疗服务提供者交谈感觉舒适,但总体而言,只有 21.5% 的人报告称曾与医疗服务提供者交谈过。在确诊后使用过大麻的人中,最常见的方式是食用、吸食、药片或酊剂,最常见的原因是睡眠障碍,其次是疼痛、压力和焦虑,60%-68%的人表示使用大麻后症状有所改善:这项具有地域多样性的调查表明,无论大麻的法律地位如何,患者都会使用大麻。解决癌症治疗期间使用大麻的益处和害处方面的知识差距对于加强患者与提供者之间的沟通至关重要。
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引用次数: 0
The SEER Program's longstanding commitment to making cancer resources available. SEER 计划长期致力于提供癌症资源。
Pub Date : 2024-08-01 DOI: 10.1093/jncimonographs/lgae028
Patricia K Murphy, Mark E Sellers, Sarah H Bonds, Susan Scott

The Surveillance, Epidemiology, and End Results (SEER) Program, an authoritative source of cancer statistics in the United States, has been funded by the National Cancer Institute (NCI) since 1973. The goals of SEER include measuring the cancer burden in the United States, making the results available, and supporting cancer research. These goals render products that serve as resources for different audiences, such as cancer registrars, researchers, and the public. Cancer registrars have access to a dedicated tab on the SEER website for questions, assistance with cancer coding, and training and technical resources such as SEER*Rx and SEER Data Management System (SEER*DMS). For researchers, SEER provides access to databases and software such as SEER*Stat and other linked databases such as SEER-Medicare that may offer answers to emerging issues in the field of cancer outcomes, cancer burden, health disparities, healthcare access, diagnosis, and prevention. The public can access cancer materials such as the SEER Cancer Stat Facts sheets, SEER*Explorer, and Did You Know? video series to learn more about cancer. SEER continues to update its resources with and ahead of legislation such as the Plain Writing Act and 21st Century Integrated Digital Experience Act (IDEA) to improve both clarity and user experience. Moving forward, SEER continues to promote awareness of SEER resources, remains accessible and understandable across all audiences, and standardizes how new resources are shared with these groups. The longstanding commitment to making cancer resources available is fundamental to the value of SEER, as evidenced by testimonials from members of various audience types.

监测、流行病学和最终结果(SEER)计划是美国癌症统计数据的权威来源,自 1973 年以来一直由美国国家癌症研究所(NCI)资助。SEER 的目标包括衡量美国的癌症负担、提供结果和支持癌症研究。这些目标为癌症登记人员、研究人员和公众等不同受众提供了资源产品。癌症登记员可以访问 SEER 网站上的一个专门标签,了解有关癌症编码的问题和帮助,以及 SEER*Rx 和 SEER 数据管理系统 (SEER*DMS) 等培训和技术资源。对于研究人员,SEER 提供了访问 SEER*Stat 等数据库和软件以及 SEER-Medicare 等其他链接数据库的途径,这些数据库和软件可为癌症结果、癌症负担、健康差异、医疗保健获取、诊断和预防领域的新问题提供答案。公众可以访问 SEER 癌症统计事实表、SEER*Explorer 和 Did You Know?SEER 继续根据《普通写作法案》(Plain Writing Act)和《21 世纪综合数字体验法案》(21st Century Integrated Digital Experience Act,IDEA)等立法更新其资源,以提高清晰度和用户体验。展望未来,SEER 将继续提高 SEER 资源的知名度,使所有受众都能获取和理解这些资源,并规范与这些群体共享新资源的方式。长期致力于提供癌症资源是 SEER 价值的根本所在,各类受众成员的评价就是证明。
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引用次数: 0
Virtual Pooled Registry-Cancer Linkage System: an improved method for ascertaining cancer diagnoses. 虚拟汇集登记-癌症链接系统:确定癌症诊断的改进方法。
Pub Date : 2024-08-01 DOI: 10.1093/jncimonographs/lgae005
Dennis Deapen, Castine Clerkin, William Howe, Don Green, Christopher J Johnson, Betsy A Kohler, Annelie M Landgren, Anca Preda, Joanne Elena, Lynne Penberthy

Background: The National Cancer Institute funds many large cohort studies that rely on self-reported cancer data requiring medical record validation. This is labor intensive, costly, and prone to underreporting or misreporting of cancer and disparity-related differential response. US population-based central cancer registries identify incident cancer within their catchment area, yielding all malignant neoplasms and benign brain and central nervous system tumors with standardized data fields. This manuscript describes the development, implementation, and features of a system to facilitate linkage between cohort studies and cancer registries and the release of cancer registry data for matched cohort participants.

Methods: The Virtual Pooled Registry-Cancer Linkage System (VPR-CLS) provides an online system to link cohorts with multiple state cancer registries by 1) securely transmitting a study file to registries, 2) providing an optimized linkage algorithm to generate preliminary match counts, and 3) providing a streamlined process and templated forms for submitting and tracking data requests for cohort participants who matched with registries.

Results: In 2022, the VPR-CLS launched with 45 registries, covering 95% of the US state populations and Puerto Rico. Registries have linked with 15 studies having 14 273-10.9 million participants. Except in 1 study, linkage sensitivity ranged from 87.0% to 99.9%. Numerous registries have adopted the VPR-CLS templated institutional review board-registry application (n = 39), templated data use agreement (n = 25), and central institutional review board (n = 16).

Conclusions: The VPR-CLS markedly improves ascertainment of cancer outcomes and is the preferred approach for determination of outcomes from cohort studies, postmarketing surveillance, and clinical trials.

背景:美国国家癌症研究所(National Cancer Institute)资助了许多大型队列研究,这些研究依赖于需要病历验证的自我报告癌症数据。这种方法劳动强度大、成本高,而且容易出现少报或误报癌症以及与差异相关的不同反应。美国以人口为基础的中央癌症登记处可识别其覆盖范围内的癌症事件,通过标准化的数据字段获得所有恶性肿瘤以及良性脑和中枢神经系统肿瘤的数据。本手稿介绍了一个系统的开发、实施和特点,该系统旨在促进队列研究与癌症登记之间的联系,并发布匹配队列参与者的癌症登记数据:虚拟汇集登记处-癌症链接系统(VPR-CLS)提供了一个在线系统,通过以下方式将队列研究与多个州立癌症登记处链接起来:1)安全地将研究文件传输给登记处;2)提供优化的链接算法以生成初步的匹配计数;3)提供简化的流程和模板表格,用于提交和跟踪与登记处匹配的队列参与者的数据请求:2022 年,VPR-CLS 启动了 45 个登记处,覆盖了美国 95% 的州和波多黎各人口。登记处已与 15 项研究建立联系,共有 14 273-1090 万名参与者。除一项研究外,链接灵敏度从 87.0% 到 99.9% 不等。许多登记处采用了VPR-CLS模板机构审查委员会-登记处应用程序(39人)、模板数据使用协议(25人)和中央机构审查委员会(16人):结论:VPR-CLS 明显改善了癌症结果的确定,是确定队列研究、上市后监测和临床试验结果的首选方法。
{"title":"Virtual Pooled Registry-Cancer Linkage System: an improved method for ascertaining cancer diagnoses.","authors":"Dennis Deapen, Castine Clerkin, William Howe, Don Green, Christopher J Johnson, Betsy A Kohler, Annelie M Landgren, Anca Preda, Joanne Elena, Lynne Penberthy","doi":"10.1093/jncimonographs/lgae005","DOIUrl":"10.1093/jncimonographs/lgae005","url":null,"abstract":"<p><strong>Background: </strong>The National Cancer Institute funds many large cohort studies that rely on self-reported cancer data requiring medical record validation. This is labor intensive, costly, and prone to underreporting or misreporting of cancer and disparity-related differential response. US population-based central cancer registries identify incident cancer within their catchment area, yielding all malignant neoplasms and benign brain and central nervous system tumors with standardized data fields. This manuscript describes the development, implementation, and features of a system to facilitate linkage between cohort studies and cancer registries and the release of cancer registry data for matched cohort participants.</p><p><strong>Methods: </strong>The Virtual Pooled Registry-Cancer Linkage System (VPR-CLS) provides an online system to link cohorts with multiple state cancer registries by 1) securely transmitting a study file to registries, 2) providing an optimized linkage algorithm to generate preliminary match counts, and 3) providing a streamlined process and templated forms for submitting and tracking data requests for cohort participants who matched with registries.</p><p><strong>Results: </strong>In 2022, the VPR-CLS launched with 45 registries, covering 95% of the US state populations and Puerto Rico. Registries have linked with 15 studies having 14 273-10.9 million participants. Except in 1 study, linkage sensitivity ranged from 87.0% to 99.9%. Numerous registries have adopted the VPR-CLS templated institutional review board-registry application (n = 39), templated data use agreement (n = 25), and central institutional review board (n = 16).</p><p><strong>Conclusions: </strong>The VPR-CLS markedly improves ascertainment of cancer outcomes and is the preferred approach for determination of outcomes from cohort studies, postmarketing surveillance, and clinical trials.</p>","PeriodicalId":73988,"journal":{"name":"Journal of the National Cancer Institute. Monographs","volume":"2024 65","pages":"191-197"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11300027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141895008","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
NCI SEER-Linked Virtual Tissue Repository Pilot. NCI SEER 链接虚拟组织库试点。
Pub Date : 2024-08-01 DOI: 10.1093/jncimonographs/lgae034
Pamela Sanchez, Alison L Van Dyke, Valentina I Petkov, Yao Yuan, Sarah Bonds, Connor Valenzuela, Alyssa W Tuan, Radim Moravec, Sean F Altekruse, Aatur D Singhi, Kate M Serdy, Yun Wu, Rosemary D Cress, Jennifer A Doherty, Lloyd Mueller, Brenda Y Hernandez, Charles F Lynch, Thomas C Tucker, Xiao-Cheng Wu, Lynn Matrisian, Lynne Penberthy

Background: The Surveillance, Epidemiology, and End Results (SEER) Program with the National Cancer Institute tested whether population-based cancer registries can serve as honest brokers to acquire tissue and data in the SEER-Linked Virtual Tissue Repository (VTR) Pilot.

Methods: We collected formalin-fixed, paraffin-embedded tissue and clinical data from patients with pancreatic ductal adenocarcinoma (PDAC) and breast cancer (BC) for two studies comparing cancer cases with highly unusual survival (≥5 years for PDAC and ≤30 months for BC) to pair-matched controls with usual survival (≤2 years for PDAC and ≥5 years for BC). Success was defined as the ability for registries to acquire tissue and data on cancer cases with highly unusual outcomes.

Results: Of 98 PDAC and 103 BC matched cases eligible for tissue collection, sources of attrition for tissue collection were tissue being unavailable, control paired with failed case, second control that was not requested, tumor necrosis ≥20%, and low tumor cellularity. In total, tissue meeting the study criteria was obtained for 70 (71%) PDAC and 74 (72%) BC matched cases. For patients with tissue received, clinical data completeness ranged from 59% for CA-19-9 after treatment to >95% for margin status, whether radiation therapy and chemotherapy were administered, and comorbidities.

Conclusions: The VTR Pilot demonstrated the feasibility of using SEER cancer registries as honest brokers to provide tissue and clinical data for secondary use in research. Studies using this program should oversample by 45% to 50% to obtain sufficient sample size and targeted population representation and involve subspecialty matter expert pathologists for tissue selection.

背景:美国国家癌症研究所(National Cancer Institute)的监测、流行病学和最终结果(SEER)计划测试了基于人群的癌症登记处是否可以作为诚实的中间人,在 SEER 链接虚拟组织库(VTR)试点中获取组织和数据:我们收集了胰腺导管腺癌(PDAC)和乳腺癌(BC)患者的福尔马林固定、石蜡包埋组织和临床数据,用于两项研究,将生存期极不寻常(PDAC≥5年,BC≤30个月)的癌症病例与生存期正常(PDAC≤2年,BC≥5年)的配对对照进行比较。成功的定义是登记处能够获得具有高度异常结果的癌症病例的组织和数据:在符合组织采集条件的98例PDAC和103例BC配对病例中,组织采集的损耗来源包括组织无法获得、与失败病例配对的对照、未申请的第二个对照、肿瘤坏死≥20%以及肿瘤细胞度较低。总共有 70 例(71%)PDAC 和 74 例(72%)BC 配对病例获得了符合研究标准的组织。对于获得组织的患者,临床数据的完整性从治疗后CA-19-9的59%到边缘状态、是否接受放疗和化疗以及合并症的>95%不等:VTR试点项目证明了利用SEER癌症登记处作为诚信中介提供组织和临床数据供研究二次使用的可行性。使用该计划进行的研究应超量抽样 45%-50%,以获得足够的样本量和目标人群代表性,并让亚专科病理专家参与组织选择。
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引用次数: 0
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Journal of the National Cancer Institute. Monographs
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