JNCI Cancer Spectrum最新文献

{"title":"Financial distress and medical financial hardship among young adult survivors of blood cancer.","authors":"Susan K Parsons, Rachel Murphy-Banks, Angie Mae Rodday, Michael E Roth, Kimberly Miller, Nadine Linendoll, Randall Chan, Howland E Crosswell, Qingyan Xiang, David R Freyer","doi":"10.1093/jncics/pkae071","DOIUrl":"10.1093/jncics/pkae071","url":null,"abstract":"<p><strong>Background: </strong>The long-term financial impact of cancer care has not been adequately addressed in young adults. As part of a remote intervention study, we describe medical financial distress and hardship among young adult survivors of blood cancer at study entry.</p><p><strong>Methods: </strong>Young adults were recruited from 6 US hospitals. Using a Research Electronic Data Capture link, young adults confirmed their eligibility-namely, currently 18 to 39 years of age, blood cancer diagnosis 3 or more years ago, off active treatment, and not on parent's insurance. Following consent, the baseline assessment was sent. The primary outcome measure, the Personal Financial Wellness Scale, measured financial distress (scored as severe, 1-2; high, 3-4; average, 5-6; and low to no, 7-10). Medical financial hardship encompassed material hardship, psychological impact, and coping behaviors. Descriptive summary statistics and linear regression were used.</p><p><strong>Results: </strong>Among the 126 participants, 54.5% came from minority racial or ethnic groups. Median time since diagnosis was 10 years (interquartile range = 6-16 years), with 56% having received a diagnosis when they were between 18 and 39 years of age. The overall mean (standard deviation) Personal Financial Wellness Scale score was 5.1 (2.4), but 49% reported severe or high distress. In multivariable analysis, female sex, Hispanic ethnicity, and lower income were strongly associated with worse Personal Financial Wellness Scale scores. Among participants with severe financial distress (n = 26), 72% reported 2 or more household material hardships, had worse scores across all psychological domains, and altered survivorship care because of cost (68%).</p><p><strong>Conclusions: </strong>Nearly half of long-term young adult cancer survivors reported severe or high levels of financial distress. Individuals with severe or high distress also reported more medical financial hardship than other participants. This finding highlights the need for ongoing financial intervention in this vulnerable population.</p><p><strong>Clinicaltrials.gov: </strong>NCT05620979.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11401610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141995749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of anxiety disorders in men with prostate cancer: a national cohort study.","authors":"Casey Crump, Pär Stattin, James D Brooks, Jan Sundquist, Kristina Sundquist, Weiva Sieh","doi":"10.1093/jncics/pkae087","DOIUrl":"10.1093/jncics/pkae087","url":null,"abstract":"<p><strong>Background: </strong>Men with prostate cancer (PC) may experience significant psychosocial distress from physical symptoms, treatment side effects, or fear of recurrence. However, little is known about the long-term risk of anxiety disorders in men with PC.</p><p><strong>Methods: </strong>A national cohort study was conducted of 180 189 men diagnosed with PC during 1998-2017 and 1 801 890 age-matched population-based control men in Sweden. Anxiety disorders were ascertained from nationwide outpatient and inpatient records through 2018. Cox regression was used to estimate hazard ratios (HRs) while adjusting for sociodemographic factors and prior psychiatric disorders. Subanalyses explored differences by PC treatment during 2005-2017.</p><p><strong>Results: </strong>In 7.8 million person-years of follow-up, 94 387 (5%) men were diagnosed with anxiety disorders. Men with high-risk PC had a nearly 2-fold higher risk of anxiety disorders than control men without PC (adjusted HR = 1.96, 95% CI = 1.87 to 2.05). This risk was highest in the first 3 months after PC diagnosis (adjusted HR = 2.99, 95% CI = 2.49 to 3.59) but remained significantly elevated 10 or more years later (adjusted HR = 1.53, 95% CI = 1.35 to 1.74). Those treated only with androgen deprivation therapy (ADT) had the highest risk of anxiety disorders (adjusted HR = 2.08, 95% CI = 1.93 to 2.25). Men with low- or intermediate-risk PC had a modestly increased risk (adjusted HR = 1.39, 95% CI = 1.34 to 1.44).</p><p><strong>Conclusions: </strong>In this large national cohort, men with PC had substantially increased risk of anxiety disorders, especially those with high-risk PC and treated only with ADT. Men with PC need close monitoring for timely detection and treatment of anxiety symptoms, particularly shortly after PC diagnosis.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11512143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Germline reflex BRCA1/2 testing following tumor-only comprehensive genomic profiling: why, when, and how.","authors":"Giulia Maneri, Camilla Nero, Luciano Giacò, Giovanni Scambia, Angelo Minucci","doi":"10.1093/jncics/pkae096","DOIUrl":"10.1093/jncics/pkae096","url":null,"abstract":"<p><p>The majority of tumor comprehensive genomic profiling (CGP) currently does not include a matched normal control. The use of a tumor-only CGP approach needs the development of a strategy to refine germline pathogenic/likely pathogenic variants (gP/LPVs) calls, so as to limit the performance of unnecessary germline reflex tests and instead successfully identify patients who are carriers of likely gP/LPVs. Guidelines have been developed for the identification of gP/LPVs in BRCA1/2 genes on the basis of tumor-only CGP results and for the evaluation of the appropriateness of performing germline reflex BRCA1/2 testing. In this study, an algorithm to assist decision-making for germline reflex testing of BRCA1/2 variants following tumor-only CGP is proposed.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11512647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Structural racism and inequity in cancer clinical trial participation: time for solutions.","authors":"Abhijit Pal, Rayan Saleh Moussa, Ben Smith, Bernadette Brady, Deme Karikios, Frances Boyle, Wei Chua","doi":"10.1093/jncics/pkae089","DOIUrl":"https://doi.org/10.1093/jncics/pkae089","url":null,"abstract":"","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survival prediction in sigmoid colon cancer patients with liver metastasis: a prospective cohort study.","authors":"Shuai Shao, Dan Tian, Mingyang Li, Shanshan Wu, Dong Zhang","doi":"10.1093/jncics/pkae080","DOIUrl":"10.1093/jncics/pkae080","url":null,"abstract":"<p><strong>Background: </strong>Sigmoid colon cancer is a common type of colorectal cancer, frequently leading to liver metastasis. Predicting cause-specific survival and overall survival in patients with sigmoid colon cancer metastasis to liver is challenging because of the lack of suitable models.</p><p><strong>Methods: </strong>Patients with sigmoid colon cancer metastasis to liver (2010-2017) in the Surveillance, Epidemiology, and End Results (SEER) Program were recruited. Patients were split into training and validation groups (7:3). Prognostic factors were identified using competing risk and Cox proportional hazards models, and nomograms for cause-specific survival and overall survival were developed. Model performance was evaluated with the concordance index and calibration curves, with a 2-sided P value less than .05 considered statistically significant.</p><p><strong>Results: </strong>A total of 4981 sigmoid colon cancer with liver metastasis patients were included, with a median follow-up of 20 months (interquartile range [IQR] = 9-33 months). During follow-up, 72.25% of patients died (68.44% from sigmoid colon cancer, 3.81% from other causes). Age, race, grade, T stage, N stage, surgery, chemotherapy, carcinoembryonic antigen, tumor deposits, lung metastasis, and tumor size were prognostic factors for cause-specific survival and overall survival. The models demonstrated good discrimination and calibration performance, with C index values of 0.79 (95% confidence interval [CI] = 0.78 to 0.80) for cause-specific survival and 0.74 (95% CI = 0.73 to 0.75) for overall survival. A web-based application for real-time cause-specific survival predictions was created, accessible at https://shuaishao.shinyapps.io/SCCLM/.</p><p><strong>Conclusion: </strong>Prognostic factors for sigmoid colon cancer with liver metastasis patients were identified based on the SEER database, and nomograms for cause-specific survival and overall survival showed good performance. A web-based application was developed to predict sigmoid colon cancer with liver metastasis-specific survival, aiding in survival risk stratification.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11476935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The silent struggle: anxiety in men with prostate cancer.","authors":"Zhiyu Qian, Stephan M Korn, Quoc-Dien Trinh","doi":"10.1093/jncics/pkae094","DOIUrl":"https://doi.org/10.1093/jncics/pkae094","url":null,"abstract":"","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11512141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The intersection of travel burdens and financial hardship in cancer care: a scoping review.","authors":"Arrianna Marie Planey, Lisa P Spees, Caitlin B Biddell, Austin Waters, Emily P Jones, Hillary K Hecht, Donald Rosenstein, Stephanie B Wheeler","doi":"10.1093/jncics/pkae093","DOIUrl":"10.1093/jncics/pkae093","url":null,"abstract":"<p><strong>Background: </strong>In addition to greater delays in cancer screening and greater financial hardship, rural-dwelling cancer patients experience greater costs associated with accessing cancer care, including higher cumulative travel costs. This study aimed to identify and synthesize peer-reviewed research on the cumulative and overlapping costs associated with care access and utilization.</p><p><strong>Methods: </strong>A scoping review was conducted to identify relevant studies published after 1995 by searching 5 electronic databases: PubMed, Scopus, Cumulative Index of Nursing and Allied Health Literature (CINAHL), PsycInfo, and Healthcare Administration. Eligibility was determined using the PEO (Population, Exposure, and Outcomes) method, with clearly defined populations (cancer patients), exposures (financial hardship, toxicity, or distress; travel-related burdens), and outcomes (treatment access, treatment outcomes, health-related quality of life, and survival/mortality). Study characteristics, methods, and findings were extracted and summarized.</p><p><strong>Results: </strong>Database searches yielded 6439 results, of which 3366 were unique citations. Of those, 141 were eligible for full-text review, and 98 studies at the intersection of cancer-related travel burdens and financial hardship were included. Five themes emerged as we extracted from the full texts of the included articles: 1) Cancer treatment choices, 2) Receipt of guideline-concordant care, 3) Cancer treatment outcomes, 4) Health-related quality of life, and 5) Propensity to participate in clinical trials.</p><p><strong>Conclusions: </strong>This scoping review identifies and summarizes available research at the intersection of cancer care-related travel burdens and financial hardship. This review will inform the development of future interventions aimed at reducing the negative effects of cancer-care related costs on patient outcomes and quality of life.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11519048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse social determinants of health elevate uncontrolled hypertension risk: a cardio-oncology prospective cohort study.","authors":"Priyanshu Nain, Nickolas Stabellini, Omar M Makram, Johnathan Rast, Sandeep Yerraguntla, Gaurav Gopu, Aditya Bhave, Lakshya Seth, Vraj Patel, Stephanie Jiang, Sarah Malik, Ahmed Shetewi, Alberto J Montero, Jennifer Cullen, Neeraj Agarwal, Xiaoling Wang, Bonnie Ky, Lauren A Baldassarre, Neal L Weintraub, Ryan A Harris, Avirup Guha","doi":"10.1093/jncics/pkae064","DOIUrl":"10.1093/jncics/pkae064","url":null,"abstract":"<p><p>The role of social determinants of health (SDOH) in controlling hypertension (HTN) in cancer patients is unknown. We hypothesize that high SDOH scores correlate with uncontrolled HTN in hypertensive cancer patients. In our prospective study, patients completed the Protocol for Responding to & Assessing Patients' Assets, Risks & Experiences questionnaire. After integrating home and clinic blood pressure readings, uncontrolled HTN was defined as systolic blood pressure greater than or equal to 140 mm Hg and/or diastolic blood pressure greater than or equal to 90 mm Hg. Using Cox regression, we analyzed the impact of SDOH on HTN control, adjusting for relevant factors. The study involved 318 participants (median age 66.4, median follow-up 166 days, SDOH score 6.5 ± 3.2), with stress, educational insecurity, and social isolation as prevalent adverse SDOH. High SDOH scores led to 77% increased risk of uncontrolled HTN (adjusted hazards ratio = 1.77; 95% confidence interval = 1.10 to 2.83, P = .018). Urban residents with high SDOH scores were at an even greater risk. Identifying SDOH and mitigating underlying factors may help control HTN, the most typical disease process treated in all cardio-oncology clinics.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11368120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive function in long-term testicular cancer survivors: impact of modifiable factors.","authors":"Paul C Dinh, Patrick O Monahan, Chunkit Fung, Howard D Sesso, Darren R Feldman, David J Vaughn, Robert J Hamilton, Robert Huddart, Neil E Martin, Christian Kollmannsberger, Sandra Althouse, Lawrence H Einhorn, Robert Frisina, James C Root, Tim A Ahles, Lois B Travis","doi":"10.1093/jncics/pkae068","DOIUrl":"10.1093/jncics/pkae068","url":null,"abstract":"<p><p>No study has comprehensively examined associated factors (adverse health outcomes, health behaviors, and demographics) affecting cognitive function in long-term testicular cancer survivors (TC survivors). TC survivors given cisplatin-based chemotherapy completed comprehensive, validated surveys, including those that assessed cognition. Medical record abstraction provided cancer and treatment history. Multivariable logistic regression examined relationships between potential associated factors and cognitive impairment. Among 678 TC survivors (median age = 46; interquartile range [IQR] = 38-54); median time since chemotherapy = 10.9 years, IQR = 7.9-15.9), 13.7% reported cognitive dysfunction. Hearing loss (odds ratio [OR] = 2.02; P = .040), neuropathic pain (OR = 2.06; P = .028), fatigue (OR = 6.11; P < .001), and anxiety/depression (OR = 1.96; P = .029) were associated with cognitive impairment in multivariable analyses. Being on disability (OR = 9.57; P = .002) or retired (OR = 3.64; P = .029) were also associated with cognitive decline. Factors associated with impaired cognition identify TC survivors requiring closer monitoring, counseling, and focused interventions. Hearing loss, neuropathic pain, fatigue, and anxiety/depression constitute potential targets for prevention or reduction of cognitive impairment in long-term TC survivors.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11424079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141982321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond lung cancer screening, an opportunity for early detection of chronic obstructive pulmonary disease and cardiovascular diseases.","authors":"Sébastien Gendarme, Bernard Maitre, Sam Hanash, Jean-Claude Pairon, Florence Canoui-Poitrine, Christos Chouaïd","doi":"10.1093/jncics/pkae082","DOIUrl":"10.1093/jncics/pkae082","url":null,"abstract":"<p><strong>Background: </strong>Lung cancer screening programs concern smokers at risk for cardiovascular diseases (CVDs) and chronic obstructive pulmonary disease (COPD). The LUMASCAN (LUng Cancer Screening, MArkers and low-dose computed tomography SCANner) study aimed to evaluate the acceptability and feasibility of screening for these 3 diseases in a community population with centralized organization and to determine low-dose computed tomography (CT) markers associated with each disease.</p><p><strong>Methods: </strong>This cohort enrolled participants meeting National Comprehensive Cancer Network criteria (v1.2014) in an organized lung cancer-screening program including low-dose CT scans; spirometry; evaluations of coronary artery calcifications (CACs); and a smoking cessation plan at inclusion, 1, and 2 years; then telephone follow-up. Outcomes were the participation rate and the proportion of participants affected by lung cancer, obstructive lung disease, or CVD events. Logistic-regression models were used to identify radiological factors associated with each disease.</p><p><strong>Results: </strong>Between 2016 and 2019, a total of 302 participants were enrolled: 61% men; median age 58.8 years; 77% active smoker; 11% diabetes; 38% hypertension; and 27% taking lipid-lowering agents. Inclusion, 1-year, and 2-year participation rates were 99%, 81%, 79%, respectively. After a median follow-up of 5.81 years, screenings detected 12 (4%) lung cancer, 9 of 12 via low-dose CT (78% localized) and 3 of 12 during follow-up (all stage IV), 83 (27%) unknown obstructive lung disease, and 131 (43.4%) moderate to severe CACs warranting a cardiology consultation. Preexisting COPD and moderate to severe CACs were associated with major CVD events with odds ratios of 1.98 (95% confident interval [CI] = 1.00 to 3.88) and 3.27 (95% CI = 1.72 to 6.43), respectively.</p><p><strong>Conclusion: </strong>The LUMASCAN study demonstrated the feasibility of combined screening for lung cancer, COPD, and CVD in a community population. Its centralized organization enabled high participation and coordination of healthcare practitioners.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11472859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287440","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}