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The association between the mental health disorders, substance abuse, and tobacco use with head & neck cancer stage at diagnosis. 精神疾病、药物滥用和吸烟与头颈癌诊断阶段的关系。
IF 2.2 4区 医学 Q3 ONCOLOGY Pub Date : 2024-10-28 DOI: 10.1007/s10552-024-01921-0
Joanna Woersching, Janet H Van Cleave, Jason P Gonsky, Chenjuan Ma, Judith Haber, Deborah Chyun, Brian L Egleston

Purpose: Mental health disorders, substance abuse, and tobacco use are prevalent in the US population. However, the association between these conditions and head and neck cancer (HNC) stage is poorly understood. This research aims to uncover the relationship between pre-existing mental health disorders, substance abuse, and tobacco use and HNC stage at diagnosis in patients receiving care in an integrated, public safety-net healthcare system.

Methods: This study was a secondary data analysis of linked hospital tumor registries and electronic health record (EHR) data. The study's primary independent variables were the comorbidities of mental health disorders, substance abuse, and tobacco use. The dependent variable was HNC stage at diagnosis, operationalized as early stage (i.e., stages I, II, and III) and advanced stage (stage IV, IVA, IVB, or IVC). The analysis included multivariable logistic regression adjusted for covariates of demographic variables, tumor anato RESULTS: The study population consisted of 357 patients with median age of 59 years, and was primarily male (77%), diverse (Black or African American 41%; Hispanic 22%), and from neighborhoods with low income (median average annual household income $39,785). Patients with a history of mental health disorders with or without tobacco use had significantly lower odds of advanced stage HNC at diagnosis (adjusted OR = 0.35, 95% Confidence Interval [CI]: 0.17-0.72.) while patients with a history of substance abuse with or without tobacco use had significantly higher odds of advanced stage HNC at diagnosis (adjusted OR 1.41, 95% CI: 1.01-1.98) than patients with no history of mental health disorders, substance abuse, or tobacco use.

Conclusions: The relationship between HNC stage at diagnosis and the comorbidities of mental health disorders, substance abuse, or tobacco differs depending on the type and co-occurrence of these comorbidities. These findings demonstrate the need for innovative care delivery models and education initiatives tailored to meet the needs of patients with mental health disorders, substance abuse, and tobacco use that facilitate early detection of HNC.

目的:精神疾病、药物滥用和吸烟在美国人口中十分普遍。然而,人们对这些情况与头颈癌(HNC)分期之间的关系知之甚少。本研究旨在揭示在综合公共安全网医疗系统接受治疗的患者在确诊时已存在的精神疾病、药物滥用和烟草使用与 HNC 分期之间的关系:本研究是对关联的医院肿瘤登记和电子健康记录(EHR)数据进行的二次数据分析。研究的主要自变量是精神疾病、药物滥用和烟草使用等合并症。因变量是诊断时的 HNC 分期,分为早期(即 I 期、II 期和 III 期)和晚期(IV 期、IVA 期、IVB 期或 IVC 期)。结果:研究对象包括 357 名患者,中位年龄为 59 岁,主要为男性(77%)、多元化(黑人或非裔美国人 41%;西班牙裔美国人 22%)和低收入社区(家庭年均收入中位数为 39,785 美元)。与无精神障碍、药物滥用或烟草使用史的患者相比,有或无烟草使用史的精神障碍患者在诊断时患晚期HNC的几率明显较低(调整后OR = 0.35,95% 置信区间[CI]:0.17-0.72),而有或无烟草使用史的药物滥用患者在诊断时患晚期HNC的几率明显较高(调整后OR 1.41,95% CI:1.01-1.98):诊断时的 HNC 分期与精神疾病、药物滥用或吸烟等合并症之间的关系因合并症的类型和并发情况而异。这些发现表明,有必要针对精神疾病、药物滥用和烟草使用患者的需求,采取创新的护理模式和教育措施,以促进 HNC 的早期发现。
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引用次数: 0
The association between body mass index and vulvar and vaginal cancer incidence: findings from a large Norwegian cohort study. 体重指数与外阴癌和阴道癌发病率之间的关系:挪威一项大型队列研究的结果。
IF 2.2 4区 医学 Q3 ONCOLOGY Pub Date : 2024-10-27 DOI: 10.1007/s10552-024-01930-z
Dagfinn Aune, Marie Nordsletten, Tor Åge Myklebust, Trude Eid Robsahm, Bjørn Steen Skålhegg, Tom Mala, Sheraz Yaqub, Usman Saeed

Background: There is limited evidence of potential associations between body mass index (BMI) and risk of vulvar and vaginal cancer. We explored these associations in a large cohort of Norwegian women.

Methods: The analytical dataset included 889,441 women aged 16-75 years at baseline in 1963-1975. Multivariable Cox regression analyses were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations between BMI and vulvar and vaginal cancer incidence.

Results: During 30.1 million person-years of follow-up, 1748 incident vulvar and 408 incident vaginal cancer cases occurred. The HRs (95% CIs) for vulvar cancer for a BMI of 15- < 18.5, 18.5- < 25, 25- < 30, 30- < 35, ≥ 35 were 0.62 (0.38-1.01), 1.00 (reference), 1.23 (1.10-1.40), 1.43 (1.23-1.66) and 1.72 (1.35-2.20, ptrend < 0.001), and per 5 kg/m2 increment was 1.20 (1.13-1.26). The corresponding HRs (95% CIs) for vaginal cancer were 1.05 (0.52-2.15), 1.00, 0.89 (0.71-1.12), 0.95 (0.68-1.34), and 2.01 (1.29-3.13, ptrend < 0.001), respectively, and per 5 kg/m2 was 1.11 (0.99-1.25). The HR (95% CI) per 5 kg/m2 increase in BMI at ages 16-29 was 1.28 (1.07-1.54, n = 250 cases) for vulvar and 1.53 (1.11-2.11, n = 66 cases) for vaginal cancers. The HR (95% CI) per 5 kg/m2 for early-onset (< 50 years age at diagnosis) vulvar cancer was 0.92 (0.66-1.28, n = 87 cases) and 1.70 (1.05-2.76, n = 21 cases) for vaginal cancer.

Conclusion: These results further support the associations between higher BMI and increased risk of vulvar and vaginal cancers, with suggestive stronger associations between BMI in early adulthood for both cancers and for early-onset vaginal cancer. Further studies are needed to elucidate these findings and investigate the underlying mechanisms.

背景:关于体重指数(BMI)与外阴癌和阴道癌风险之间潜在联系的证据有限。我们在一个大型挪威妇女队列中探讨了这些关联:分析数据集包括1963-1975年基线年龄在16-75岁之间的889,441名妇女。采用多变量考克斯回归分析来估计体重指数与外阴癌和阴道癌发病率之间的危险比(HRs)和95%置信区间(CIs):在3010万人年的随访期间,共发生了1748例外阴癌和408例阴道癌。BMI为15-趋势2增量时,外阴癌的HRs(95% CIs)为1.20(1.13-1.26)。阴道癌的相应 HRs(95% CI)分别为 1.05(0.52-2.15)、1.00、0.89(0.71-1.12)、0.95(0.68-1.34)和 2.01(1.29-3.13,趋势 2 为 1.11(0.99-1.25))。16-29 岁时体重指数每增加 5 kg/m2 的外阴癌和阴道癌的 HR(95% CI)分别为 1.28(1.07-1.54,n = 250 例)和 1.53(1.11-2.11,n = 66 例)。早发癌症每 5 kg/m2 的 HR 值(95% CI)(结论:早发癌症每 5 kg/m2 的 HR 值(95% CI)为 0.5:这些结果进一步证实了较高的体重指数与外阴癌和阴道癌风险增加之间的关联,并提示成年早期的体重指数与这两种癌症和早发阴道癌之间有更强的关联。需要进一步研究来阐明这些发现并调查其潜在机制。
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引用次数: 0
Discrimination in the medical setting among LGBTQ+ adults and associations with cancer screening. LGBTQ+ 成年人在医疗环境中受到的歧视以及与癌症筛查的关系。
IF 2.2 4区 医学 Q3 ONCOLOGY Pub Date : 2024-10-24 DOI: 10.1007/s10552-024-01927-8
Ashley E Stenzel, G Nic Rider, Olivia S Wicker, Allison C Dona, Deanna Teoh, B R Simon Rosser, Rachel I Vogel

Purpose: Lesbian, gay, bisexual, transgender, queer, and other sexual and gender diverse (LGBTQ+) individuals experience disparities in cancer screening. We examined whether experience of LGBTQ+ -related discrimination in medical settings was associated with cancer screening disparities.

Methods: Participants were recruited via social media for a cross-sectional survey study. Those who self-reported as LGBTQ+ , being 40+ years of age, and residing in the US were eligible. Participants reported their clinical and demographic characteristics, cancer screening history, and experiences of discrimination in a medical setting. We examined the odds (OR) of ever undergoing cancer screening by experienced discrimination, stratified by sex assigned at birth.

Results: Participants (n = 310) were on average 54.4 ± 9.0 years old and primarily White (92.9%). Most identified as lesbian (38.1%) or gay (40.0%) while 17.1% were transgender or gender diverse. Nearly half (45.5%) reported experiencing LGBTQ+ -related discrimination in the medical setting. Participants assigned female at birth with discriminatory experiences had significantly lower odds of ever undergoing colonoscopy/sigmoidoscopy compared to those without discriminatory experiences (OR: 0.37; 95% Confidence Interval (CI) 0.15-0.90). No significant differences in colonoscopy/sigmoidoscopy uptake were observed in those assigned male at birth by discriminatory experiences (OR: 2.02; 95% CI 0.59-6.91). Pap tests, mammogram, and stool colorectal cancer screening did not differ by discriminatory experience.

Conclusion: Discrimination in medical settings was commonly reported by LGBTQ+ individuals in this study. When treating LGBTQ+ patients, clinicians should ask about prior experiences and continue to promote cancer screening. Future studies should examine discrimination as a key driver of LGBTQ+ disparities in cancer screening.

目的:女同性恋者、男同性恋者、双性恋者、跨性别者、同性恋者和其他性与性别多元化者(LGBTQ+)在癌症筛查方面存在差异。我们研究了医疗环境中与 LGBTQ+ 相关的歧视经历是否与癌症筛查差异有关:我们通过社交媒体招募参与者,进行横断面调查研究。自称为 LGBTQ+、年龄在 40 岁以上、居住在美国的人符合条件。参与者报告了他们的临床和人口特征、癌症筛查史以及在医疗环境中遭受歧视的经历。我们根据出生时的性别分层,研究了曾接受过歧视的癌症筛查的几率(OR):参与者(n = 310)平均年龄为 54.4 ± 9.0 岁,主要为白人(92.9%)。大多数人认为自己是女同性恋(38.1%)或男同性恋(40.0%),17.1%是变性人或性别多元化者。近一半(45.5%)的人表示在医疗环境中遇到过与 LGBTQ+ 相关的歧视。与没有歧视经历的参与者相比,出生时被分配为女性且有歧视经历的参与者接受结肠镜/乙状结肠镜检查的几率明显较低(OR:0.37;95% 置信区间(CI):0.15-0.90)。出生时被歧视为男性的人群接受结肠镜/乙状结肠镜检查的比例没有明显差异(OR:2.02;95% 置信区间:0.59-6.91)。子宫颈抹片检查、乳房 X 光检查和粪便大肠癌筛查没有因歧视经历而有所不同:结论:在本研究中,LGBTQ+人群普遍报告在医疗环境中受到歧视。在为 LGBTQ+ 患者提供治疗时,临床医生应询问患者之前的经历,并继续推广癌症筛查。未来的研究应将歧视作为导致 LGBTQ+ 在癌症筛查中存在差异的一个关键因素进行研究。
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引用次数: 0
Motivating smoking cessation among patients with cancers not perceived as smoking-related: a targeted intervention. 激励非吸烟相关癌症患者戒烟:一项有针对性的干预措施。
IF 2.2 4区 医学 Q3 ONCOLOGY Pub Date : 2024-10-24 DOI: 10.1007/s10552-024-01931-y
Ursula Martinez, Thomas H Brandon, Graham W Warren, Vani N Simmons

Purpose: Smoking after cancer impairs cancer treatment outcomes and prognosis, regardless of cancer type. Prior data suggest that patients with cancers other than lung or head/neck cancer had lower cessation motivation, which in turn predicted lower smoking abstinence. This study evaluated feasibility for a future efficacy trial and assessed the acceptability of brief self-help materials, targeted by cancer type, to enhance cessation motivation.

Methods: Patients had a diagnosis of skin melanoma, breast, bladder, colorectal, or gynecological cancers within ≤ 6 months, smoked ≥ 1 cigarette in the past month, and were not currently participating in a cessation program. After completing a baseline assessment, participants received the booklet corresponding to their cancer type. Follow-ups were conducted 1 week and 1 month post-intervention.

Results: Among 118 patients potentially eligible, 109 were successfully contacted and 53 patients were eligible and all consented. Among consenting patients, 92.5% completed baseline, and 90.6% received the intervention. Among patients receiving the intervention, 91.7% completed all study procedures and follow-up. At 1 month, 87.5% reported reading the booklet and 92.8% rated it as good/excellent. Motivation to quit smoking increased over time among those with lower motivation at baseline, 33.3% sought smoking cessation assistance, and 25.0% were smoke-free 1 month post-intervention.

Conclusion: This study demonstrated the feasibility and acceptability of the first intervention developed for patients with cancers not typically associated with smoking. This low-cost and easy to disseminate intervention has potential to increase motivation to quit smoking among patients with cancers not typically perceived as smoking-related.

目的:无论癌症类型如何,癌症后吸烟都会影响癌症治疗效果和预后。先前的数据表明,除肺癌和头颈部癌症外,其他癌症患者的戒烟动机较低,这反过来又预示着戒烟率较低。本研究评估了未来疗效试验的可行性,并评估了针对癌症类型的简短自助材料的可接受性,以提高戒烟动机:患者在≤6个月内确诊患有皮肤黑色素瘤、乳腺癌、膀胱癌、结肠直肠癌或妇科癌症,在过去一个月内吸烟≥1支,且目前未参加戒烟计划。完成基线评估后,参与者会收到与其癌症类型相对应的手册。干预后1周和1个月进行随访:在 118 名可能符合条件的患者中,109 人被成功联系上,53 名患者符合条件并全部同意。在同意的患者中,92.5%完成了基线治疗,90.6%接受了干预。在接受干预的患者中,91.7%完成了所有研究程序和随访。1个月后,87.5%的患者表示阅读了戒烟手册,92.8%的患者对手册的评价为 "好"/"优秀"。在基线戒烟动机较低的患者中,戒烟动机随着时间的推移而增加,33.3%的患者寻求戒烟帮助,25.0%的患者在干预后1个月内不再吸烟:这项研究证明了首个针对非典型吸烟癌症患者的干预措施的可行性和可接受性。这项干预措施成本低、易于推广,有望提高非典型吸烟相关癌症患者的戒烟积极性。
{"title":"Motivating smoking cessation among patients with cancers not perceived as smoking-related: a targeted intervention.","authors":"Ursula Martinez, Thomas H Brandon, Graham W Warren, Vani N Simmons","doi":"10.1007/s10552-024-01931-y","DOIUrl":"https://doi.org/10.1007/s10552-024-01931-y","url":null,"abstract":"<p><strong>Purpose: </strong>Smoking after cancer impairs cancer treatment outcomes and prognosis, regardless of cancer type. Prior data suggest that patients with cancers other than lung or head/neck cancer had lower cessation motivation, which in turn predicted lower smoking abstinence. This study evaluated feasibility for a future efficacy trial and assessed the acceptability of brief self-help materials, targeted by cancer type, to enhance cessation motivation.</p><p><strong>Methods: </strong>Patients had a diagnosis of skin melanoma, breast, bladder, colorectal, or gynecological cancers within ≤ 6 months, smoked ≥ 1 cigarette in the past month, and were not currently participating in a cessation program. After completing a baseline assessment, participants received the booklet corresponding to their cancer type. Follow-ups were conducted 1 week and 1 month post-intervention.</p><p><strong>Results: </strong>Among 118 patients potentially eligible, 109 were successfully contacted and 53 patients were eligible and all consented. Among consenting patients, 92.5% completed baseline, and 90.6% received the intervention. Among patients receiving the intervention, 91.7% completed all study procedures and follow-up. At 1 month, 87.5% reported reading the booklet and 92.8% rated it as good/excellent. Motivation to quit smoking increased over time among those with lower motivation at baseline, 33.3% sought smoking cessation assistance, and 25.0% were smoke-free 1 month post-intervention.</p><p><strong>Conclusion: </strong>This study demonstrated the feasibility and acceptability of the first intervention developed for patients with cancers not typically associated with smoking. This low-cost and easy to disseminate intervention has potential to increase motivation to quit smoking among patients with cancers not typically perceived as smoking-related.</p>","PeriodicalId":9432,"journal":{"name":"Cancer Causes & Control","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142495661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The role of ethnic enclaves and neighborhood socioeconomic status in invasive breast cancer incidence rates among Asian American, Native Hawaiian, and Pacific Islander females in California. 加利福尼亚州亚裔美国人、夏威夷原住民和太平洋岛民女性浸润性乳腺癌发病率中种族飞地和邻里社会经济地位的作用。
IF 2.2 4区 医学 Q3 ONCOLOGY Pub Date : 2024-10-23 DOI: 10.1007/s10552-024-01907-y
Alya Truong, Meg McKinley, Scarlett Lin Gomez, Mi-Ok Kim, Salma Shariff-Marco, Iona Cheng

Purpose: Few studies have examined whether the incidence rates of invasive breast cancer among Asian American, Native Hawaiian, and Pacific Islander (AANHPI) populations differ by the neighborhood social environment. Thus, we examined associations of ethnic enclave and neighborhood socioeconomic status (nSES) with breast cancer incidence rates among AANHPI females in California.

Methods: A total of 14,738 AANHPI females diagnosed with invasive breast cancer in 2008-2012 were identified from the California Cancer Registry. AANHPI ethnic enclaves (culturally distinct neighborhoods) and nSES were assessed at the census tract level using 2007-2011 American Community Survey data. Breast cancer age-adjusted incidence rates and incidence rate ratios (IRRs) were estimated for AANHPI ethnic enclave, nSES, and their joint effects. Subgroup analyses were conducted by stage of disease.

Results: The incidence rate of breast cancer among AANHPI females living in lowest ethnic enclave neighborhoods (quintile (Q)1) were 1.21 times (95% Confidence Interval (CI) 1.11, 1.32) that of AANHPI females living highest ethnic enclave neighborhoods (Q5). In addition, AANHPI females living in highest vs. lowest SES neighborhoods had higher incidence rates of breast cancer (Q5 vs. Q1 IRR = 1.30, 95% CI 1.22 to 1.40). The incidence rate of breast cancer among AANHPI females living in low ethnic enclave + high SES neighborhoods was 1.32 times (95% CI 1.25, 1.39) that of AANHPI females living in high ethnic enclave + low SES neighborhoods. Similar patterns of associations were observed for localized and advanced stage disease.

Conclusion: For AANHPI females in California, incidence rates of breast cancer differed by nSES, ethnic enclave, when considered independently and jointly. Future studies should examine whether the impact of these neighborhood-level factors on breast cancer incidence rates differ across specific AANHPI ethnic groups and investigate the pathways through which they contribute to breast cancer incidence.

研究目的很少有研究探讨亚裔美国人、夏威夷原住民和太平洋岛民(AANHPI)人群的浸润性乳腺癌发病率是否因邻里社会环境而有所不同。因此,我们研究了加利福尼亚州亚裔美国人、夏威夷原住民和太平洋岛民女性中种族飞地和邻里社会经济地位(nSES)与乳腺癌发病率的关系:方法:我们从加利福尼亚州癌症登记处确认了 2008-2012 年期间确诊为浸润性乳腺癌的 14738 名亚裔美国人和菲律宾人女性。利用 2007-2011 年美国社区调查数据,在人口普查区层面评估了 AANHPI 族群飞地(文化独特的社区)和 nSES。根据 AANHPI 族群飞地、nSES 及其联合效应估算了乳腺癌年龄调整后发病率和发病率比 (IRR)。按疾病阶段进行了分组分析:结果显示:生活在最低族群飞地社区(五分位数(Q)1)的亚裔美国人和菲律宾人女性的乳腺癌发病率是生活在最高族群飞地社区(Q5)的亚裔美国人和菲律宾人女性的1.21倍(95% 置信区间(CI)为1.11, 1.32)。此外,生活在社会经济地位最高社区的亚裔美国人和加拿大人女性与生活在社会经济地位最低社区的亚裔美国人和加拿大人女性相比,乳腺癌发病率更高(Q5与Q1相比,IRR=1.30,95% CI为1.22至1.40)。生活在低种族飞地+高社会经济地位社区的亚裔美国人和加拿大人女性的乳腺癌发病率是生活在高种族飞地+低社会经济地位社区的亚裔美国人和加拿大人女性的1.32倍(95% CI 1.25,1.39)。在局部和晚期疾病中也观察到类似的关联模式:对于加利福尼亚州的亚裔美国人和海地人女性而言,如果单独或共同考虑,乳腺癌的发病率因nSES和族裔飞地而异。未来的研究应考察这些邻里层面的因素对乳腺癌发病率的影响是否因特定的亚裔、夏威夷和太平洋岛屿族裔群体而异,并调查这些因素导致乳腺癌发病率的途径。
{"title":"The role of ethnic enclaves and neighborhood socioeconomic status in invasive breast cancer incidence rates among Asian American, Native Hawaiian, and Pacific Islander females in California.","authors":"Alya Truong, Meg McKinley, Scarlett Lin Gomez, Mi-Ok Kim, Salma Shariff-Marco, Iona Cheng","doi":"10.1007/s10552-024-01907-y","DOIUrl":"https://doi.org/10.1007/s10552-024-01907-y","url":null,"abstract":"<p><strong>Purpose: </strong>Few studies have examined whether the incidence rates of invasive breast cancer among Asian American, Native Hawaiian, and Pacific Islander (AANHPI) populations differ by the neighborhood social environment. Thus, we examined associations of ethnic enclave and neighborhood socioeconomic status (nSES) with breast cancer incidence rates among AANHPI females in California.</p><p><strong>Methods: </strong>A total of 14,738 AANHPI females diagnosed with invasive breast cancer in 2008-2012 were identified from the California Cancer Registry. AANHPI ethnic enclaves (culturally distinct neighborhoods) and nSES were assessed at the census tract level using 2007-2011 American Community Survey data. Breast cancer age-adjusted incidence rates and incidence rate ratios (IRRs) were estimated for AANHPI ethnic enclave, nSES, and their joint effects. Subgroup analyses were conducted by stage of disease.</p><p><strong>Results: </strong>The incidence rate of breast cancer among AANHPI females living in lowest ethnic enclave neighborhoods (quintile (Q)1) were 1.21 times (95% Confidence Interval (CI) 1.11, 1.32) that of AANHPI females living highest ethnic enclave neighborhoods (Q5). In addition, AANHPI females living in highest vs. lowest SES neighborhoods had higher incidence rates of breast cancer (Q5 vs. Q1 IRR = 1.30, 95% CI 1.22 to 1.40). The incidence rate of breast cancer among AANHPI females living in low ethnic enclave + high SES neighborhoods was 1.32 times (95% CI 1.25, 1.39) that of AANHPI females living in high ethnic enclave + low SES neighborhoods. Similar patterns of associations were observed for localized and advanced stage disease.</p><p><strong>Conclusion: </strong>For AANHPI females in California, incidence rates of breast cancer differed by nSES, ethnic enclave, when considered independently and jointly. Future studies should examine whether the impact of these neighborhood-level factors on breast cancer incidence rates differ across specific AANHPI ethnic groups and investigate the pathways through which they contribute to breast cancer incidence.</p>","PeriodicalId":9432,"journal":{"name":"Cancer Causes & Control","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142495664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Associations of social support, living arrangements, and residential stability with cancer screening in the United States. 美国癌症筛查与社会支持、生活安排和居住稳定性的关系。
IF 2.2 4区 医学 Q3 ONCOLOGY Pub Date : 2024-10-18 DOI: 10.1007/s10552-024-01913-0
Jordan Baeker Bispo, Hyunjung Lee, Ahmedin Jemal, Farhad Islami

Purpose: Social support has been linked to increased use of preventive care services. Living arrangements and residential stability may be important structural sources of social support, but few studies have examined their impact on cancer screening.

Methods: Data were from the 2021 National Health Interview Survey. Participants were classified as up-to-date or not with female breast cancer (BC), cervical cancer (CVC), and colorectal cancer (CRC) screening recommendations. Multivariable logistic regression was used to model associations between screening and residential stability (< 1 year, 1-3 years, 4-10 years, 11-20 years, or > 20 years), living arrangement (with spouse/partner only, children only, both, or neither), and perceived social support (rarely/never, sometimes, usually, or always available), overall and stratified by sex (CRC) and age group (CVC).

Results: The adjusted odds of BC (odds ratio [OR]  0.61, 95% CI 0.45-0.81) and CVC (OR 0.76, 95% CI 0.60-0.96) screening were lowest for those who reported never/rarely vs. always having social support. The adjusted odds of BC (OR 1.44, 95% CI 1.22-1.70) and CRC (ORFEMALE = 1.42, 95% CI 1.20-1.68; ORMALE = 1.61, 95% CI 1.35-1.90) screening were higher for those living with a spouse/partner only vs. those living with neither spouse/partner nor children. Less residential stability was associated with increased CVC screening among females 21-34 years of age, but not BC or CRC screening.

Conclusions: Social support measures were associated with screening to varying degrees by site and age, but higher perceived social support and living with a spouse/partner only demonstrated a consistent positive association. Interventions that mobilize social support networks and address the unmet social needs of parents/caregivers may improve cancer control.

目的:社会支持与预防保健服务使用率的提高有关。生活安排和居住稳定性可能是社会支持的重要结构性来源,但很少有研究探讨它们对癌症筛查的影响:数据来自 2021 年全国健康访谈调查。参与者被分为是否符合女性乳腺癌(BC)、宫颈癌(CVC)和结直肠癌(CRC)筛查建议。多变量逻辑回归用于模拟筛查与居住稳定性(20 年)、居住安排(仅与配偶/伴侣、仅与子女、两者或两者均无)以及感知到的社会支持(很少/从未、有时、通常或始终可用)之间的关系,并按性别(CRC)和年龄组(CVC)进行分层:报告从未/很少获得社会支持与报告总是获得社会支持的人群接受 BC(几率比 [OR] 0.61,95% CI 0.45-0.81)和 CVC(OR 0.76,95% CI 0.60-0.96)筛查的调整后几率最低。仅与配偶/伴侣居住的人群与既无配偶/伴侣也无子女居住的人群相比,BC(OR 1.44,95% CI 1.22-1.70)和 CRC(ORFEMALE = 1.42,95% CI 1.20-1.68;ORMALE = 1.61,95% CI 1.35-1.90)筛查的调整后几率更高。居住稳定性较低与 21-34 岁女性的 CVC 筛查增加有关,但与 BC 或 CRC 筛查无关:结论:社会支持措施与筛查的相关程度因地点和年龄而异,但较高的社会支持感知和仅与配偶/伴侣同住显示出一致的正相关。动员社会支持网络并解决父母/照顾者未得到满足的社会需求的干预措施可能会改善癌症控制。
{"title":"Associations of social support, living arrangements, and residential stability with cancer screening in the United States.","authors":"Jordan Baeker Bispo, Hyunjung Lee, Ahmedin Jemal, Farhad Islami","doi":"10.1007/s10552-024-01913-0","DOIUrl":"https://doi.org/10.1007/s10552-024-01913-0","url":null,"abstract":"<p><strong>Purpose: </strong>Social support has been linked to increased use of preventive care services. Living arrangements and residential stability may be important structural sources of social support, but few studies have examined their impact on cancer screening.</p><p><strong>Methods: </strong>Data were from the 2021 National Health Interview Survey. Participants were classified as up-to-date or not with female breast cancer (BC), cervical cancer (CVC), and colorectal cancer (CRC) screening recommendations. Multivariable logistic regression was used to model associations between screening and residential stability (< 1 year, 1-3 years, 4-10 years, 11-20 years, or > 20 years), living arrangement (with spouse/partner only, children only, both, or neither), and perceived social support (rarely/never, sometimes, usually, or always available), overall and stratified by sex (CRC) and age group (CVC).</p><p><strong>Results: </strong>The adjusted odds of BC (odds ratio [OR]  0.61, 95% CI 0.45-0.81) and CVC (OR 0.76, 95% CI 0.60-0.96) screening were lowest for those who reported never/rarely vs. always having social support. The adjusted odds of BC (OR 1.44, 95% CI 1.22-1.70) and CRC (OR<sub>FEMALE</sub> = 1.42, 95% CI 1.20-1.68; OR<sub>MALE</sub> = 1.61, 95% CI 1.35-1.90) screening were higher for those living with a spouse/partner only vs. those living with neither spouse/partner nor children. Less residential stability was associated with increased CVC screening among females 21-34 years of age, but not BC or CRC screening.</p><p><strong>Conclusions: </strong>Social support measures were associated with screening to varying degrees by site and age, but higher perceived social support and living with a spouse/partner only demonstrated a consistent positive association. Interventions that mobilize social support networks and address the unmet social needs of parents/caregivers may improve cancer control.</p>","PeriodicalId":9432,"journal":{"name":"Cancer Causes & Control","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142458613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Exploring estrogen-related mechanisms in ovarian carcinogenesis: association between bone mineral density and ovarian cancer risk in a multivariable Mendelian randomization study. 探索卵巢癌发生的雌激素相关机制:多变量孟德尔随机研究中骨矿物质密度与卵巢癌风险之间的关联。
IF 2.2 4区 医学 Q3 ONCOLOGY Pub Date : 2024-10-18 DOI: 10.1007/s10552-024-01926-9
Karen M Tuesley, Penelope M Webb, Melinda M Protani, Peter Donovan, Susan J Jordan, Suzanne Dixon-Suen

Background: Estrogen may play a role in epithelial ovarian cancer (EOC) carcinogenesis, with effects varying by EOC histotype. Measuring women's long-term exposure to estrogen is difficult, but bone mineral density (BMD) may be a reasonable proxy of longer-term exposure. We examined this relationship by assessing the association between genetic predisposition for higher BMD and risk of EOC by histotype.

Methods: We used Mendelian randomization (MR) to assess associations between genetic markers for femoral neck and lumbar spine BMD and each EOC histotype. We used multivariable MR (MVMR) to adjust for probable pleiotropic traits, including body mass index, height, menarcheal age, menopausal age, smoking, alcohol intake, and vitamin D.

Results: Univariable analyses suggested greater BMD was associated with increased risk of endometrioid EOC (per standard deviation increase; lumbar spine OR = 1.21; 95% CI 0.93,1.57, femoral neck: OR = 1.25; 0.99,1.57), but sensitivity analyses indicated that pleiotropy was likely. Adjustment using MVMR reduced the magnitude of estimates slightly (lumbar spine: OR = 1.13; 95% CI 1.00,1.28, femoral neck: OR = 1.18; 1.03,1.36). Results for lumbar spine BMD and high-grade serous EOC were also suggestive of an association (univariable MR: OR = 1.16; 95% CI 1.03,1.30; MVMR: OR = 1.06; 0.99,1.14).

Conclusion: Our study found associations between genetic predisposition to higher BMD, a proxy for long-term estrogen exposure, and risk of developing endometroid and high-grade serous EOC cancers. These findings add to existing evidence of the relationship between estrogen and increased risk of EOC for certain histotypes.

背景:雌激素可能在上皮性卵巢癌(EOC)的癌变过程中发挥作用,其影响因 EOC 组织型而异。测量女性长期暴露于雌激素的情况很困难,但骨矿物质密度(BMD)可能是长期暴露的一个合理替代指标。我们通过评估骨密度较高的遗传易感性与不同组织类型的 EOC 风险之间的关系来研究这种关系:我们使用孟德尔随机法(MR)评估了股骨颈和腰椎 BMD 遗传标记与每种 EOC 组织类型之间的关联。我们使用多变量 MR(MVMR)来调整可能的多效应性状,包括体重指数、身高、初潮年龄、绝经年龄、吸烟、酒精摄入量和维生素 D:单变量分析表明,BMD越大,罹患子宫内膜异位症风险越高(每标准差增加;腰椎OR = 1.21; 95% CI 0.93,1.57,股骨颈OR = 1.25; 0.25%CI):OR=1.25;0.99,1.57),但敏感性分析表明可能存在多重效应。使用 MVMR 进行调整后,估计值的幅度略有下降(腰椎:OR = 1.13; 95% CI 1.00,1.28,股骨颈:OR = 1.18; 1.03,1.36)。腰椎 BMD 和高级别浆液性 EOC 的结果也提示两者之间存在关联(单变量 MR:OR = 1.16;95% CI 1.03,1.30;MVMR:OR = 1.06;0.99,1.14):我们的研究发现,遗传易感性较高的 BMD(雌激素长期暴露的代表)与患子宫内膜癌和高级别浆液性 EOC 癌的风险之间存在关联。这些发现补充了雌激素与某些组织类型的 EOC 风险增加之间关系的现有证据。
{"title":"Exploring estrogen-related mechanisms in ovarian carcinogenesis: association between bone mineral density and ovarian cancer risk in a multivariable Mendelian randomization study.","authors":"Karen M Tuesley, Penelope M Webb, Melinda M Protani, Peter Donovan, Susan J Jordan, Suzanne Dixon-Suen","doi":"10.1007/s10552-024-01926-9","DOIUrl":"https://doi.org/10.1007/s10552-024-01926-9","url":null,"abstract":"<p><strong>Background: </strong>Estrogen may play a role in epithelial ovarian cancer (EOC) carcinogenesis, with effects varying by EOC histotype. Measuring women's long-term exposure to estrogen is difficult, but bone mineral density (BMD) may be a reasonable proxy of longer-term exposure. We examined this relationship by assessing the association between genetic predisposition for higher BMD and risk of EOC by histotype.</p><p><strong>Methods: </strong>We used Mendelian randomization (MR) to assess associations between genetic markers for femoral neck and lumbar spine BMD and each EOC histotype. We used multivariable MR (MVMR) to adjust for probable pleiotropic traits, including body mass index, height, menarcheal age, menopausal age, smoking, alcohol intake, and vitamin D.</p><p><strong>Results: </strong>Univariable analyses suggested greater BMD was associated with increased risk of endometrioid EOC (per standard deviation increase; lumbar spine OR = 1.21; 95% CI 0.93,1.57, femoral neck: OR = 1.25; 0.99,1.57), but sensitivity analyses indicated that pleiotropy was likely. Adjustment using MVMR reduced the magnitude of estimates slightly (lumbar spine: OR = 1.13; 95% CI 1.00,1.28, femoral neck: OR = 1.18; 1.03,1.36). Results for lumbar spine BMD and high-grade serous EOC were also suggestive of an association (univariable MR: OR = 1.16; 95% CI 1.03,1.30; MVMR: OR = 1.06; 0.99,1.14).</p><p><strong>Conclusion: </strong>Our study found associations between genetic predisposition to higher BMD, a proxy for long-term estrogen exposure, and risk of developing endometroid and high-grade serous EOC cancers. These findings add to existing evidence of the relationship between estrogen and increased risk of EOC for certain histotypes.</p>","PeriodicalId":9432,"journal":{"name":"Cancer Causes & Control","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142458615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Lymphoma in Sub-Saharan Africa: a scoping review of the epidemiology, treatment challenges, and patient pathways. 撒哈拉以南非洲地区的淋巴瘤:流行病学、治疗挑战和患者途径的范围界定综述。
IF 2.2 4区 医学 Q3 ONCOLOGY Pub Date : 2024-10-17 DOI: 10.1007/s10552-024-01922-z
Obsie T Baissa, Tomer Ben-Shushan, Ora Paltiel

Purpose: Improving cancer outcomes in Sub-Saharan Africa (SSA) requires effective implementation of evidence-based strategies. This scoping review maps the evidence on lymphoma epidemiology, treatment challenges, and patient pathways in SSA from 2011 to 2022.

Methods: A comprehensive three-step search was conducted without language restrictions.

Results: Eighty-four publications were included, 83% published after 2017. Southern and Eastern Africa led in output. Most studies were chart reviews (47.6%) and cohort studies (25%). NHL accounted for over 80% of cases, with an age-standardized rate (ASR) reaching 10.9/100,000, while HL had an ASR of 0.4-2.3/100,000. Compared to studies in Europe and US, SSA studies reported lower incidence rates, higher HIV comorbidity, and younger median ages. Diagnosis is often delayed, incomplete and lacks sub-classification with HIV and tuberculosis further complicating care. One-year survival rates are around 50% for NHL and over 75% for HL. Treatment is well-tolerated with an acceptable treatment-related mortality rate. However, outcomes are affected by diagnostic delays, late presentations, and treatment abandonment. Non-clinical aspects of care such as financial constraints negatively impact patient pathways.

Conclusion: Addressing diagnostic delays, misdiagnosis, and treatment abandonment is crucial. Strengthening care access, diagnostics, and integrating innovative strategies including a multidisciplinary approach and re-designing efficient clinical diagnostic pathways are vital.

目的:改善撒哈拉以南非洲地区(SSA)的癌症治疗效果需要有效实施循证策略。本范围界定综述描绘了 2011 年至 2022 年撒哈拉以南非洲地区淋巴瘤流行病学、治疗挑战和患者治疗途径方面的证据:方法:在不受语言限制的情况下进行了三步综合检索:结果:共收录84篇论文,其中83%发表于2017年之后。南部和东部非洲的产出居首位。大多数研究为图表回顾(47.6%)和队列研究(25%)。NHL病例占80%以上,年龄标准化比率(ASR)达到10.9/100,000,而HL的年龄标准化比率为0.4-2.3/100,000。与欧洲和美国的研究相比,非洲撒哈拉以南地区的研究报告发病率较低,HIV合并症较高,中位年龄较小。诊断往往延迟、不完整,并且缺乏与艾滋病毒和结核病的亚分类,使护理工作更加复杂。NHL 的一年存活率约为 50%,HL 的一年存活率超过 75%。治疗耐受性良好,治疗相关死亡率尚可接受。然而,诊断延误、晚期发病和放弃治疗都会影响治疗效果。医疗的非临床方面(如经济限制)对患者的治疗路径产生了负面影响:结论:解决诊断延误、误诊和放弃治疗问题至关重要。结论:解决诊断延误、误诊和放弃治疗问题至关重要。加强医疗服务、诊断和整合创新战略(包括多学科方法和重新设计高效的临床诊断路径)至关重要。
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引用次数: 0
Disparities in lung cancer screening utilization at two health systems in the Southeastern USA. 美国东南部两个医疗系统肺癌筛查利用率的差异。
IF 2.2 4区 医学 Q3 ONCOLOGY Pub Date : 2024-10-15 DOI: 10.1007/s10552-024-01929-6
Soumya J Niranjan, Desiree Rivers, Rekha Ramachandran, JEdward Murrell, Kayleigh C Curry, Mohammed Mubasher, Eric Flenaugh, Mark T Dransfield, Sejong Bae, Isabel C Scarinci

Purpose: Low-dose computed tomography lung cancer screening is effective for reducing lung cancer mortality. It is critical to understand the lung cancer screening practices for screen-eligible individuals living in Alabama and Georgia where lung cancer is the leading cause of cancer death. High lung cancer incidence and mortality rates are attributed to high smoking rates among underserved, low income, and rural populations. Therefore, the purpose of this study is to define sociodemographic and clinical characteristics of patients who were screened for lung cancer at an Academic Medical Center (AMC) in Alabama and a Safety Net Hospital (SNH) in Georgia.

Methods: A retrospective cohort study of screen-eligible patients was constructed using electronic health records between 2015 and 2020 seen at an Academic Medical Center (AMC) and a Safety Net Hospital (SNH) separately. Chi-square tests and Student t tests were used to compare screening uptake across patient demographic and clinical variables. Bivariate and multivariate logistic regressions determined significant predictors of lung cancer screening uptake.

Results: At the AMC, 67,355 were identified as eligible for LCS and 1,129 were screened. In bivariate analyses, there were several differences between those who were screened and those who were not screened. Screening status in the site at Alabama-those with active tobacco use are significantly more likely to be screened than former smokers (OR: 3.208, p < 0.01). For every 10-unit increase in distance, the odds of screening decreased by about 15% (OR: 0.848, p < 0.01). For every 10-year increase in age, the odds of screening decrease by about 30% (OR: 0.704, p < 0.01). Each additional comorbidity increases the odds of screening by about 7.5% (OR: 1.075, p < 0.01). Those with both private and public insurance have much higher odds of screening compared to those with only private insurance (OR: 5.403, p < 0.01). However, those with only public insurance have lower odds of screening compared to those with private insurance (OR: 0.393, p < 0.01). At the SNH-each additional comorbidity increased the odds of screening by about 11.9% (OR: 1.119, p = 0.01). Notably, those with public insurance have significantly higher odds of being screened compared to those with private insurance (OR: 2.566, p < 0.01).

Conclusion: The study provides evidence that LCS has not reached all subgroups and that additional targeted efforts are needed to increase lung cancer screening uptake. Furthermore, disparity was noticed between adults living closer to screening institutions and those who lived farther.

目的:低剂量计算机断层扫描肺癌筛查可有效降低肺癌死亡率。在阿拉巴马州和佐治亚州,肺癌是导致癌症死亡的主要原因,了解符合筛查条件的人的肺癌筛查方法至关重要。肺癌发病率和死亡率高的原因是服务不足、低收入和农村人口吸烟率高。因此,本研究旨在确定在阿拉巴马州学术医学中心(AMC)和佐治亚州安全网医院(SNH)接受肺癌筛查的患者的社会人口学和临床特征:利用2015年至2020年间分别在学术医疗中心(AMC)和安全网医院(SNH)就诊的电子健康记录,对符合筛查条件的患者进行回顾性队列研究。采用卡方检验(Chi-square tests)和学生 t 检验(Student t tests)比较不同患者人口统计学和临床变量的筛查接受率。双变量和多变量逻辑回归确定了肺癌筛查接受率的重要预测因素:在AMC,有67,355人被确定为符合肺癌筛查条件,其中1,129人接受了筛查。在双变量分析中,接受筛查者与未接受筛查者之间存在一些差异。阿拉巴马州筛查点的筛查情况--主动吸烟者接受筛查的几率明显高于曾经吸烟者(OR:3.208,p 结论):该研究提供的证据表明,肺癌筛查并未覆盖所有亚群,因此需要采取更多有针对性的措施来提高肺癌筛查率。此外,研究还发现,居住在离筛查机构较近和较远的成年人之间存在差异。
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引用次数: 0
Methylation-based immune deconvolution in prostate cancer patients before and after radical prostatectomy. 根治性前列腺切除术前后前列腺癌患者基于甲基化的免疫解旋。
IF 2.2 4区 医学 Q3 ONCOLOGY Pub Date : 2024-10-10 DOI: 10.1007/s10552-024-01924-x
Lauren M Hurwitz, Maeve Bailey-Whyte, Michael A Daneshvar, Cathy D Vocke, Julian Custer, Bríd M Ryan, Stefan Ambs, Peter A Pinto, Emily L Rossi

Purpose: Surgery, an established short-term immunosuppressive event, may spur dissemination of circulating tumor cells and promote the growth of micrometastases. Whether surgical treatment for prostate cancer (i.e., radical prostatectomy) leads to long-term immune changes is unknown.

Methods: We characterized intra-individual changes in circulating immune cell subsets across a six-month period using serial blood samples from prostate cancer patients pre- and post-radical prostatectomy (n = 11), and from a comparison group managed with active surveillance (n = 8). Immune cell subsets for each patient at each time point were deconvoluted using genome-wide methylation data.

Results: There were no statistically significant intra-individual changes in immune cell proportions from pre- to six months post-radical prostatectomy. There were also no intra-individual changes in immune cell proportions in the active surveillance group, and no differences between treatment groups in immune cell changes over time.

Conclusion: We observed no meaningful changes in circulating immune cell subsets six months after radical prostatectomy, suggesting that surgery-induced immune changes may not be long-lasting.

目的:手术是一种公认的短期免疫抑制事件,可能会刺激循环肿瘤细胞的扩散并促进微转移灶的生长。前列腺癌手术治疗(即根治性前列腺切除术)是否会导致长期免疫变化尚不清楚:我们利用前列腺癌患者在前列腺癌根治术前后(11 人)的连续血液样本,以及接受积极监测的对比组(8 人)的连续血液样本,描述了循环免疫细胞亚群在 6 个月内的个体内变化。利用全基因组甲基化数据对每位患者在每个时间点的免疫细胞亚群进行去卷积:结果:从根治性前列腺切除术前到术后六个月,免疫细胞比例在个体内部没有统计学意义上的显著变化。积极监测组的免疫细胞比例在个体内也没有变化,不同治疗组的免疫细胞随时间的变化也没有差异:结论:我们观察到根治性前列腺切除术后六个月,循环免疫细胞亚群没有发生有意义的变化,这表明手术引起的免疫变化可能不会持久。
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引用次数: 0
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