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ABSTRACT: BACKGROUND: This longitudinal study describes the five year trajectories of health-related quality of life(HR-QOL) and life satisfaction in long term colorectal cancer survivors.Patients and methodsA population-based sample of 1966 colorectal cancer survivors were surveyed at six timepoints from five months to five years post-diagnosis. Predictor variables were: sociodemographicvariables, optimism; cancer threat appraisal; perceived social support. Qualityof life was assessed with the Functional Assessment of Cancer Therapy-Colorectal (HRQOL);and the Satisfaction with Life Scale. Growth mixture models were applied to identifytrajectory classes and their predictors. RESULTS: Distinct adjustment trajectories were identified for HR-QOL and life satisfaction. Loweroptimism, poorer social support, a more negative cognitive appraisal, and younger age wereassociated with poorer life satisfaction, while survivors with less than 8 years of educationhad higher life satisfaction. This pattern was similar for overall HR-QOL except thateducational level was not a significant predictor and later stage disease and female genderemerged as related to poorer outcomes. One in five survivors reported poorer constant HRQOL(19.2%) and a small group had poor life satisfaction (7.2%); 26.2% reported constanthigh HR-QOL and 48.8% had high constant life satisfaction. Socioeconomic disadvantageand remoteness of residence uniquely predicted poorer outcomes in the colorectal cancerspecific HR-QOL sub domain. CONCLUSION: Although HR-QOL and subjective cognitive QOL share similar antecedents their trajectorypatterns suggested they are distinct adjustment outcomes; with life satisfaction emerging astemporally stable phenomenon. Unique patterns of risk support suggest the need to accountfor heterogeneity in adjustment in longitudinal QOL studies with cancer survivors.
Health and Quality of Life Outcomes 03/2013; 11(1):46. · 2.11 Impact Factor
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ABSTRACT: OBJECTIVE: Heightened psychological distress after cancer is common but likely highly heterogeneous. This raises potential challenges in how and when to target services; however, data describing longitudinal patterns of distress are limited. This study describes the long term psychological outcomes for colorectal cancer (CRC) survivors and trajectories of adjustment over time. METHODS: A prospective survey of a population-based sample of 1966 CRC survivors assessed sociodemographic variables, perceived social support and psychological distress, including distress subtypes of anxiety, depression and somatization, at six time points from 5 months to 5 years post-diagnosis. RESULTS: Over the 5-year trajectory, the prevalence of high overall distress ranged between 44% and 32% but was greater for men compared with women (p < 0.001). Four distress trajectory styles within clusters were identified for overall distress and for each distress subtype with a constant low distress group providing the basis for comparison. Higher distress trajectories varied for overall distress and distress subtypes but were generally differentiated by gender, younger age, lower education, poor socioeconomic advantage, late disease stage and poor social support. CONCLUSIONS: For global distress, by comparison with women, men with CRC are vulnerable to distress, with men who are younger and with low education and poor social support being a priority for targeted intervention. While distress screening early in the cancer experience will identify those with a constant high distress trajectory, others with late emerging distress or caseness may be missed. On this basis, distress screening through the illness trajectory into long term survivorship seems warranted. Copyright © 2012 John Wiley & Sons, Ltd.
Psycho-Oncology 11/2012; · 3.34 Impact Factor
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Ali Amin Al Olama,
Zsofia Kote-Jarai,
Fredrick R Schumacher,
Fredrik Wiklund,
Sonja I Berndt,
Sara Benlloch,
Graham G Giles,
Gianluca Severi,
David E Neal,
Freddie C Hamdy, [......],
Shintaro Narita,
Guang-Wen Cao,
Chavdar Slavov,
Vanio Mitev,
Stephen Chanock,
Henrik Gronberg,
Christopher A Haiman,
Peter Kraft,
Douglas F Easton,
Rosalind A Eeles
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ABSTRACT: Genome-wide association studies (GWAS) have identified multiple common genetic variants associated with an increased risk of prostate cancer (PrCa), but these explain less than one third of the heritability. To identify further susceptibility alleles, we conducted a meta-analysis of four genome-wide association studies (GWAS) including 5,953 cases of aggressive PrCa and 11,463 controls (men without PrCa). We computed association tests for ~2.6M SNPs and followed up the most significant SNPs by genotyping 49,121 samples in 29 studies through the international PRACTICAL and BPC3 consortia. We not only confirmed the association of a PrCa susceptibility locus, rs11672691 on chromosome 19, but also showed an association with aggressive PrCa (OR=1.12 (95% CI 1.03-1.21), P=1.4x10(-8)). This report describes a genetic variant which is associated with aggressive prostate cancer, which is a type of prostate cancer associated with a poorer prognosis.
Human Molecular Genetics 10/2012; · 7.64 Impact Factor
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Journal of the American Academy of Dermatology 07/2012; 67(1):e57-8. · 3.99 Impact Factor
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ABSTRACT: BACKGROUND: This study systematically review the evidence on the influence of stigma and nihilism on lung cancer patterns of care; patients' psychosocial and quality of life (QOL) outcomes; and how this may link to public health programs. METHODS: Medline, EMBASE, ProQuest, CINAHL and PsycINFO databases were searched. The inclusion criteria were: included lung cancer patients and/or partners or caregivers and/or health professionals (either at least 80% of participants had lung cancer or were partners or caregivers of lung cancer patients, or there was a lung cancer specific sub-group focus or analysis), assessed stigma or nihilism with respect to lung cancer and published in English between 1st January 1999 and 31st January 2011. Trial quality and levels of evidence were assessed. RESULTS: Eighteen articles describing 15 studies met inclusion criteria. The seven qualitative studies were high quality with regard to data collection, analysis and reporting; however most lacked a clear theoretical framework; did not address interviewer bias; or provide a rationale for sample size. The eight quantitative studies were generally of low quality with highly selected samples, non-comparable groups and low participation rates and employed divergent theoretical and measurement approaches. Stigma about lung cancer was reported by patients and health professionals and was related to poorer QOL and higher psychological distress in patients. Clear empirical explorations of nihilism were not evident. There is qualitative evidence that from the patients' perspectives public health programs contribute to stigma about lung cancer and this was supported by published commentary. CONCLUSIONS: Health-related stigma presents as a part of the lung cancer experience however there are clear limitations in the research to date. Future longitudinal and multi-level research is needed and this should be more clearly linked to relevant theory.
BMC Cancer 05/2012; 12(1):184. · 3.01 Impact Factor
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ABSTRACT: BACKGROUND: Prostate cancer is the most common cancer in men in the Western world with well-described negative effects from treatments. However, outcomes are highly heterogeneous. A Phase 3 trial of a psycho-educational intervention was undertaken, aiming to reduce cancer-specific and decision-related distress and improve quality of life for men newly diagnosed with localised prostate cancer. METHODS: Seven hundred forty (81.7%) men were recruited after diagnosis and before treatment and randomised to a tele-based nurse-delivered five-session psycho-educational intervention (N = 372) or usual care (N = 368). Participants were assessed before treatment and 2, 6, 12 and 24 months post-treatment. Outcome measures included cancer-specific and decision-related distress, cognitive judgmental adjustment, subjective well-being, and domain-specific and health-related quality of life. Social support was assessed as a potential moderator. RESULTS: No unconditioned effects were found. Classification analyses on pre-randomisation measures distinguished three subgroups: younger, higher education and income men (N = 290); younger, lower education and income men (N = 106); and older men (N = 344). Younger, higher education and income men showed positive intervention effects for cancer-specific distress ( p = 0.008) and mental health ( p = 0.042). By contrast, for younger, lower education men, participation in the intervention was associated with decreases in cognitive judgmental adjustment over time ( p = 0.006). CONCLUSIONS: Response to intervention and adjustment over time varied according to previous sexual functioning, age, educational level and income. How to best intervene with younger, low education, low income men with prostate cancer is a critical future research question. Copyright © 2012 John Wiley & Sons, Ltd.
Psycho-Oncology 05/2012; · 3.34 Impact Factor
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ABSTRACT: Long-term (≥5 years) quality of life after colorectal cancer is not well described. The present study assessed quality of life (QOL) and psychological distress in colorectal cancer survivors more than 5 years to describe changes over time and antecedents of long-term outcomes.
A prospective survey of a population-based sample of 763 colorectal cancer patients assessed socio-demographic variables, health behaviors, optimism, threat appraisal, and perceived social support at 5 months post-diagnosis as predictors of QOL and psychological distress 5 years post-diagnosis.
QOL improved over time (P < 0.01 for each measure); however, measures of psychological distress remained stable (P > 0.07 for each measure). Risk factors for poorer QOL and/or greater psychological distress included: later stage disease, having a permanent stoma, rectal cancer, fatigue, smoking, being single, low social support, low optimism, and a more negative cancer threat appraisal. Being women, having a pet, having a private health insurance, and receiving both surgery and adjuvant treatment were protective.
Consistent with response shift theory, the antecedents of QOL after colorectal cancer are multifactorial and include predisposing socio-demographic, medical, and psychological variables. Psychosocial interventions that target both social support and threat appraisal may be effective for this patient group. Additional stepped-up support may be needed for people from a poorer social environment who have multiple risk factors for poorer adjustment. Health system effects require further investigation.
Quality of Life Research 12/2011; 21(9):1551-64. · 2.30 Impact Factor
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ABSTRACT: Five novel prostate cancer risk loci were identified in a recent genome-wide association study (GWAS) of Japanese persons (Takata et al., Nat Genet. 2010;42(9):751-754). Those authors proposed that apart from population-specific linkage disequilibrium patterns, limitations of GWAS single nucleotide polymorphism (SNP) prioritization and/or study design could explain the lack of identification of these loci in GWAS previously conducted among Caucasians. Thus, the authors undertook a replication study in 1,357 prostate cancer patients and 1,403 healthy Australian males of European descent (2004-2008). The rs12653946 SNP at 5p15 was found to be significantly associated with prostate cancer risk (odds ratio = 1.20, 95% confidence interval: 1.07, 1.34; P = 0.002). On the basis of linkage disequilibrium calculations, the rs12653946 SNP represents an independent locus, distinct from the previously identified TERT-CLPTM1L cancer nexus region. Further, analysis from AceView (Thierry-Mieg and Thierry-Mieg, Genome Biol. 2006;7(suppl 1):S12) indicated that rs12653946 falls within the intron of a testis-expressed gene strongly predicted to translate a conceptual 8.1-kilodalton protein named tojy.aApr07. The authors' findings suggest that follow-up of apparently ethnicity-specific risk associations are warranted in order to highlight risk-associated loci for experimental studies and for incorporation into future risk prediction models for prostate cancer.
American journal of epidemiology 11/2011; 174(12):1391-5. · 5.59 Impact Factor
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ABSTRACT: We examine the relationships between geographic remoteness, area disadvantage and risk of advanced colorectal cancer.
Multilevel models were used to assess the area- and individual-level contributions to the risk of advanced disease among people aged 20-79 years diagnosed with colorectal cancer in Queensland, Australia between 1997 and 2007 (n=18,561).
Multilevel analysis showed that colorectal cancer patients living in inner regional (OR=1.09, 1.01-1.19) and outer regional (OR=1.11, 1.01-1.22) areas were significantly more likely to be diagnosed with advanced cancer than those in major cities (P=0.045) after adjusting for individual-level variables. The best-fitting final model did not include area disadvantage. Stratified analysis suggested this remoteness effect was limited to people diagnosed with colon cancer (P=0.048) and not significant for rectal cancer patients (P=0.873).
Given the relationship between stage and survival outcomes, it is imperative that the reasons for these rurality inequities in advanced disease be identified and addressed.
British Journal of Cancer 09/2011; 105(7):1039-41. · 5.04 Impact Factor
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ABSTRACT: Objective
Cancer survivor identity has become a dominant paradigm in describing people with cancer and in driving the focus of programmes and research in supportive care. This study investigated antecedents of survivor identity adoption and population-based prevalence.MethodsA prospective survey of a population-based sample of 1966 (57% response) patients with colorectal cancer assessed socio-demographic variables, health behaviours, optimism, benefit finding, cancer threat appraisal, psychological distress and satisfaction with life at 5 months post-diagnosis as predictors of survivor identity 5 years subsequently. Prevalence of survivor identity at 5 years post-diagnosis and psychological and lifestyle outcomes (n = 786) were later assessed.ResultsFifty-five per cent of people identified as a cancer survivor, 39.4% as a person who had had (or has) cancer, 1.4% as a cancer patient and 1.2% as a cancer victim. People who were older and who reported higher personal growth after diagnosis were more likely to assume a survivor identity at 5 years. At 5 years, survivors had higher benefit finding and better satisfaction with life. Cancer survivors uniquely reported a significant decrease in somatization and acceptance, and increases in satisfaction with life and physical activity over time.Conclusions
For patients with colorectal cancer, the cancer survivor identity is common but not universal 5 years after diagnosis; and may evolve from looking for benefit after cancer through personal growth. People who adopt a cancer survivor identity report more positive adjustment outcomes after cancer and this has implications for the design of clinical and community support interventions. Copyright © 2011 John Wiley & Sons, Ltd.
Psycho-Oncology 05/2011; · 3.34 Impact Factor
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ABSTRACT: This study investigated time trends and latitude differentials in the thickness distributions of invasive melanomas diagnosed in Australia between 1990 and 2006 using data from population-based cancer registries. Trends in incidence rates were calculated by sex, age group, thickness, year at diagnosis and latitude. For thin (<1.00 mm) melanomas the increase was very pronounced during the early 1990s (1990-1996, annual percentage change and 95% confidence interval: males +5.6(+3.5,+7.7); females +4.1(+1.7,+6.5), but then incidence rates became stable among both males (+0.6(-0.1,+1.4)) and females (-0.0(-0.9,+0.9)) of all ages between 1996 and 2006. In contrast, incidence of thick (>4.00 mm) melanomas continued to increase over the entire period (males +2.6(+1.9,+3.4); females +1.6(+0.6,+2.6)). Recent reductions in the incidence of thin melanomas were observed among young (<50 years) males and females, contrasted by an increase in thin melanomas among older people, and increases in thick melanomas among most age groups for males and elderly (75+) females. A strong latitude gradient in incidence rates was observed, with rates being highest in northern, more tropical areas and lowest in the most southern regions. However, the magnitude of the increase in thick melanomas was most pronounced in southern parts of Australia. The observed trends in thin melanomas can most likely be attributed to the impact of early detection and skin awareness campaigns. However, these efforts have not impacted on the continued increase in the incidence of thick melanomas, although some increase may be due to earlier detection of metastasising melanomas. This highlights the need for continued vigilance in early detection processes.
International Journal of Cancer 02/2011; 130(1):170-8. · 5.44 Impact Factor
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Zsofia Kote-Jarai,
Ali Amin Al Olama,
Graham G Giles,
Gianluca Severi,
Johanna Schleutker,
Maren Weischer,
Daniele Campa,
Elio Riboli,
Tim Key,
Henrik Gronberg, [......],
James Farnham,
Heiko Muller,
Dietrich Rothenbacher,
Norihiko Tsuchiya,
Shintaro Narita,
Guang-Wen Cao,
Chavdar Slavov,
Vanio Mitev,
Douglas F Easton,
Rosalind A Eeles
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ABSTRACT: Prostate cancer (PrCa) is the most frequently diagnosed male cancer in developed countries. We conducted a multi-stage genome-wide association study for PrCa and previously reported the results of the first two stages, which identified 16 PrCa susceptibility loci. We report here the results of stage 3, in which we evaluated 1,536 SNPs in 4,574 individuals with prostate cancer (cases) and 4,164 controls. We followed up ten new association signals through genotyping in 51,311 samples in 30 studies from the Prostate Cancer Association Group to Investigate Cancer Associated Alterations in the Genome (PRACTICAL) consortium. In addition to replicating previously reported loci, we identified seven new prostate cancer susceptibility loci on chromosomes 2p11, 3q23, 3q26, 5p12, 6p21, 12q13 and Xq12 (P = 4.0 × 10(-8) to P = 2.7 × 10(-24)). We also identified a SNP in TERT more strongly associated with PrCa than that previously reported. More than 40 PrCa susceptibility loci, explaining ∼25% of the familial risk in this disease, have now been identified.
Nature Genetics 01/2011; 43(8):785-91. · 35.53 Impact Factor
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Jyotsna Batra,
Felicity Lose,
Tracy O'Mara,
Louise Marquart,
Carson Stephens,
Kimberly Alexander,
Srilakshmi Srinivasan,
Rosalind A Eeles,
Douglas F Easton,
Ali Amin Al Olama, [......],
David E Neal,
Freddie C Hamdy,
Jenny L Donovan,
Suzanne Chambers,
Robert A Gardiner, Joanne Aitken,
John Yaxley,
Mary-Anne Kedda,
Judith A Clements,
Amanda B Spurdle
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ABSTRACT: Kallikrein 15 (KLK15)/Prostinogen is a plausible candidate for prostate cancer susceptibility. Elevated KLK15 expression has been reported in prostate cancer and it has been described as an unfavorable prognostic marker for the disease.
We performed a comprehensive analysis of association of variants in the KLK15 gene with prostate cancer risk and aggressiveness by genotyping tagSNPs, as well as putative functional SNPs identified by extensive bioinformatics analysis. METHODS AND DATA SOURCES: Twelve out of 22 SNPs, selected on the basis of linkage disequilibrium pattern, were analyzed in an Australian sample of 1,011 histologically verified prostate cancer cases and 1,405 ethnically matched controls. Replication was sought from two existing genome wide association studies (GWAS): the Cancer Genetic Markers of Susceptibility (CGEMS) project and a UK GWAS study.
Two KLK15 SNPs, rs2659053 and rs3745522, showed evidence of association (p<0.05) but were not present on the GWAS platforms. KLK15 SNP rs2659056 was found to be associated with prostate cancer aggressiveness and showed evidence of association in a replication cohort of 5,051 patients from the UK, Australia, and the CGEMS dataset of US samples. A highly significant association with Gleason score was observed when the data was combined from these three studies with an Odds Ratio (OR) of 0.85 (95% CI = 0.77-0.93; p = 2.7×10(-4)). The rs2659056 SNP is predicted to alter binding of the RORalpha transcription factor, which has a role in the control of cell growth and differentiation and has been suggested to control the metastatic behavior of prostate cancer cells.
Our findings suggest a role for KLK15 genetic variation in the etiology of prostate cancer among men of European ancestry, although further studies in very large sample sets are necessary to confirm effect sizes.
PLoS ONE 01/2011; 6(11):e26527. · 4.09 Impact Factor
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Alan C Geller,
Rüdiger Greinert,
Craig Sinclair,
Martin A Weinstock, Joanne Aitken,
Mathieu Boniol,
Marcus Capellaro,
Jean-Francois Doré,
Mark Elwood,
Suzanne W Fletcher, [......],
Sara Gandini,
Allan C Halpern,
Alexander Katalinic,
Robin Lucas,
Ashfag A Marghoob,
Sandra Nolte,
Joachim Schüz,
Margaret A Tucker,
Beate Volkmer,
Eckhard Breitbart
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ABSTRACT: Skin cancer incidence is increasing worldwide in white populations and mortality rates have not declined throughout most of the world. An extraordinarily high proportion of at-risk individuals have yet to be screened for melanoma but guidelines from esteemed bodies do not currently endorse population-based screening. Evidence for the effectiveness of skin cancer screening is imperative. To this end, scientists in Germany have launched a nationwide skin cancer screening campaign. Herein, we review pilot screening data from Schleswig-Holstein, discuss the launch of the major new national initiative, review issues related to evaluation of that program, and propose seven recommendations from the International Task Force on Skin Cancer Screening and Prevention that was held in Hamburg, Germany, on September 24 and 25, 2009.
Cancer epidemiology. 04/2010; 34(3):355-8.
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ABSTRACT: Abstract
Background
In Australia, associations between geographic remoteness, socioeconomic disadvantage, and colorectal cancer (CRC) survival show that survival rates are lowest among residents of geographically remote regions and those living in disadvantaged areas. At present we know very little about the reasons for these inequalities, hence our capacity to intervene to reduce the inequalities is limited.
Methods/Design
This study, the first of its type in Australia, examines the association between CRC survival and key area- and individual-level factors. Specifically, we will use a multilevel framework to investigate the possible determinants of area- and individual-level inequalities in CRC survival and quantify the relative contribution of geographic remoteness, socioeconomic and demographic factors, disease stage, and access to diagnostic and treatment services, to these inequalities. The multilevel analysis will be based on survival data relating to people diagnosed with CRC in Queensland between 1996 and 2005 (n = 22,723) from the Queensland Cancer Registry (QCR), area-level data from other data custodians such as the Australian Bureau of Statistics, and individual-level data from the QCR (including extracting stage from pathology records) and Queensland Hospitals. For a subset of this period (2003 and 2004) we will utilise more detailed, individual-level data (n = 1,966) covering a greater range of risk factors from a concurrent research study. Geo-coding and spatial technology will be used to calculate road travel distances from patients' residence to treatment centres. The analyses will be conducted using a multilevel Cox proportional hazards model with Level 1 comprising individual-level factors (e.g. occupation) and level 2 area-level indicators of remoteness and area socioeconomic disadvantage.
Discussion
This study focuses on the health inequalities for rural and disadvantaged populations that have often been documented but poorly understood, hence limiting our capacity to intervene. This study utilises and develops emerging statistical and spatial technologies that can then be applied to other cancers and health outcomes. The findings of this study will have direct implications for the targeting and resourcing of cancer control programs designed to reduce the burden of colorectal cancer, and for the provision of diagnostic and treatment services.
BMC Cancer. 01/2010;
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ABSTRACT: This study examined the quality of life (QOL), measured by the Functional Assessment of Cancer Therapy (FACT) questionnaire, among urban (n = 277) and non-urban (n = 323) breast cancer survivors and women from the general population (n = 1140) in Queensland, Australia.
Population-based samples of breast cancer survivors aged < 75 years who were 12 months post-diagnosis and similarly-aged women from the general population were recruited between 2002 and 2007.
Age-adjusted QOL among urban and non-urban breast cancer survivors was similar, although QOL related to breast cancer concerns was the weakest domain and was lower among non-urban survivors than their urban counterparts (36.8 versus 40.4, P < 0.01). Irrespective of residence, breast cancer survivors, on average, reported comparable scores on most QOL scales as their general population peers, although physical well-being was significantly lower among non-urban survivors (versus the general population, P < 0.01). Overall, around 20%-33% of survivors experienced lower QOL than peers without the disease. The odds of reporting QOL below normative levels were increased more than two-fold for those who experienced complications following surgery, reported upper-body problems, had higher perceived stress levels and/or a poor perception of handling stress (P < 0.01 for all).
Results can be used to identify subgroups of women at risk of low QOL and to inform components of tailored recovery interventions to optimize QOL for these women following cancer treatment.
Health and Quality of Life Outcomes 01/2010; 8:3. · 2.11 Impact Factor
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Rosalind A Eeles,
Zsofia Kote-Jarai,
Ali Amin Al Olama,
Graham G Giles,
Michelle Guy,
Gianluca Severi,
Kenneth Muir,
John L Hopper,
Brian E Henderson,
Christopher A Haiman, [......],
Manuel Luedeke,
Klara Stefflova,
Anna M Ray,
Ethan M Lange,
Jim Farnham,
Humera Khan,
Chavdar Slavov,
Atanaska Mitkova,
Guangwen Cao,
Douglas F Easton
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ABSTRACT: Prostate cancer (PrCa) is the most frequently diagnosed cancer in males in developed countries. To identify common PrCa susceptibility alleles, we previously conducted a genome-wide association study in which 541,129 SNPs were genotyped in 1,854 PrCa cases with clinically detected disease and in 1,894 controls. We have now extended the study to evaluate promising associations in a second stage in which we genotyped 43,671 SNPs in 3,650 PrCa cases and 3,940 controls and in a third stage involving an additional 16,229 cases and 14,821 controls from 21 studies. In addition to replicating previous associations, we identified seven new prostate cancer susceptibility loci on chromosomes 2, 4, 8, 11 and 22 (with P = 1.6 x 10(-8) to P = 2.7 x 10(-33)).
Nature Genetics 09/2009; 41(10):1116-21. · 35.53 Impact Factor
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ABSTRACT: Colorectal cancer survivors may suffer from a range of ongoing psychosocial and physical problems that negatively impact on quality of life. This paper presents the study protocol for a novel telephone-delivered intervention to improve lifestyle factors and health outcomes for colorectal cancer survivors.
Approximately 350 recently diagnosed colorectal cancer survivors will be recruited through the Queensland Cancer Registry and randomised to the intervention or control condition. The intervention focuses on symptom management, lifestyle and psychosocial support to assist participants to make improvements in lifestyle factors (physical activity, healthy diet, weight management, and smoking cessation) and health outcomes. Participants will receive up to 11 telephone-delivered sessions over a 6 month period from a qualified health professional or 'health coach'. Data collection will occur at baseline (Time 1), post-intervention or six months follow-up (Time 2), and at 12 months follow-up for longer term effects (Time 3). Primary outcome measures will include physical activity, cancer-related fatigue and quality of life. A cost-effective analysis of the costs and outcomes for survivors in the intervention and control conditions will be conducted from the perspective of health care costs to the government.
The study will provide valuable information about an innovative intervention to improve lifestyle factors and health outcomes for colorectal cancer survivors.
ACTRN12608000399392.
BMC Cancer 09/2009; 9:286. · 3.01 Impact Factor
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ABSTRACT: Australia records the highest incidence of skin cancer in the world. In response to this, public education campaigns have incorporated messages about reducing sun exposure and avoiding sunburn. This study sought to describe the prevalence of and factors associated with sunburn in Queensland residents.
The Queensland Cancer Risk Study was a population-based, cross-sectional survey of 9,298 respondents conducted via computer-assisted telephone interview during 2004. Sunburn prevalence and its association with socio-demographics and skin cancer risk variables were examined.
More than two-thirds (70.4%) of respondents reported at least one episode of sunburn in the past 12 months, and one in 10 respondents reported at least one episode of severe sunburn in the past 12 months. Experiences of sunburn on two or more occasions were reported more frequently by males than females (57.6% versus 46.5%, p<0.001), and by nearly two-thirds (65.8%) of those aged 20-39 years compared to 48.0% of 40-59 year olds, and 26.7% of 60-75 year olds (p<0.001). Episodes of sunburn were strongly associated with being male (OR=2.20 95%CI 1.84-2.63) and being aged 20 to 39 years compared to 60 to 75 years (OR=9.79, 95%CI=7.66-12.50).
Sunburn remains highly prevalent among Queensland residents particularly among men and in the younger age groups.
Health promotion journal of Australia: official journal of Australian Association of Health Promotion Professionals 08/2009; 20(2):102-6. · 0.59 Impact Factor
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ABSTRACT: To investigate the prospective relationships between television viewing time and weight gain in the 3 years following colorectal cancer diagnosis for 1,867 colorectal cancer survivors (body mass index (BMI) > or = 18.5 kg/m(2)).
BMI, television viewing time, physical activity, and socio-demographic and clinical covariates were assessed at baseline (5 months), 24 months and 36 months post-diagnosis. Multiple linear regression was used to study independent associations between baseline television viewing time and BMI at 24 and 36 months post-diagnosis.
At both follow-up time points, there was a significant increase in mean BMI for participants reporting > or =5 h/day of television viewing compared to those watching <3 h/day at baseline (24 months: 0.72 kg/m(2) (0.31, 1.12), p < 0.001; 36 months: 0.61 kg/m(2) (0.14, 1.07), p = 0.01), independent of baseline BMI, gender, age, education, marital status, smoking, cancer site, cancer disease stage, treatment mode and co-morbidities. Additional adjustment for baseline physical activity did not change results.
These findings suggest that a greater emphasis on decreasing television viewing time could help reduce weight gain among colorectal cancer survivors. This, in turn, could contribute to a risk reduction for co-morbid conditions such as type 2 diabetes and cardiovascular disease.
Cancer Causes and Control 06/2009; 20(8):1355-62. · 2.88 Impact Factor
