Cancer-specific beliefs and survival in nonmetastatic colorectal cancer patients

Motivation and mortality in older women with early stage breast cancer: A longitudinal study with ten years of follow-up

OBJECTIVES

The Getting Out of Bed Scale (GOB) was validated as a health-related quality of life (HRQoL) variable in older women with early stage breast cancer, suggesting its potential as a concise yet powerful measure of motivation. The aim of our project was to assess the association between GOB and mortality over 10years of follow-up.

MATERIALS AND METHODS

We studied 660 women ≥65-years old diagnosed with stage I-IIIA primary breast cancer. Data were collected over 10years of follow-up from interviews, medical records, and death indexes.

RESULTS

Compared to women with lower GOB scores, women with higher GOB had an unadjusted hazard ratio (HR) of all-cause mortality of 0.78 at 5years, 95% confidence interval (CI) (0.52, 1.19) and 0.77 at 10years, 95%CI (0.59, 1.00). These associations diminished after adjusting for age and stage of breast cancer, and further after adjusting for other HRQoL variables including physical function, mental health, emotional health, psychosocial function, and social support. Unadjusted HRs of breast cancer-specific mortality were 0.92, 95%CI (0.49, 1.74), at 5years, and 0.82, 95%CI (0.52, 1.32), at 10years. These associations also decreased in adjusted models.

CONCLUSION

Women with higher GOB scores had a lower hazard of all-cause mortality in unadjusted analysis. This effect diminished after adjusting for confounding clinical and HRQoL variables. GOB is a measure of motivation that may not be independently associated with cancer mortality, but reflects other HRQoL variables making it a potential outcome to monitor in older patients with cancer.

Illness perceptions are associated with mortality among 1552 colorectal cancer survivors: a study from the population-based PROFILES registry

Purpose

Cancer survivors construct perceptions of illness as a (mal)adaptive mechanism. These perceptions motivate/drive subsequent self-management behaviors toward symptoms and treatment that influence health outcomes. Negative illness perceptions have been associated with increased mortality in other chronically ill groups. However, this association is under-researched in cancer survivors. We aimed to explore the association between illness perceptions and mortality in stage I–III progression-free colorectal cancer (CRC) survivors.

Methods

We used data from the population-based Patient Reported Outcomes Following Initial treatment and Long Term Evaluation of Survivorship (PROFILES) registry of two CRC survivorship studies conducted in 2009 and 2010. We accessed clinical data from the Netherlands Cancer Registry, and mortality data from municipal personal records database. Follow-up was until 31 December 2014. Survivors (n = 1552) completed the Brief Illness Perception Questionnaire. Cox proportional hazard models estimated the association between illness perceptions and mortality.

Results

Negative illness perceptions on consequences (adjusted hazard ratio (HR_adj) 1.60, 95 % confidence interval (CI) 1.14–2.25) and emotion (HR_adj 1.65, 95 % CI 1.18–2.31) were associated with higher mortality, after adjusting for demographic, clinical, and lifestyle factors. Smoking and inadequate physical activity were independently associated with mortality for all Brief Illness Perception Questionnaire (BIPQ) dimensions.

Conclusions

Survivors’ perceptions of their illness are important as these perceptions may influence health outcomes during survivorship period. Clinical practice needs to identify and address maladaptive illness perceptions to support more adaptive self-management behaviors and enhance survivorship.

Implications for cancer survivors

Cancer survivors may benefit from interventions that address potentially maladaptive perceptions and encourage more adaptive self-management behaviors.

An integrated view of cultural perceptions of cancer among Arab people in Israel

The aim of this study was to review published studies on the cultural aspects of screening and care of Arab cancer patients living in Israel. The literature published from the beginning of recording, available up to December 2012, was systematically reviewed. Fifteen studies on perceptions of cancer screening and five studies on different aspects of coping with cancer were identified. Non-attendance of screening for early detection of breast or colorectal cancer was reported to be associated with higher personal barriers (the health belief model) and higher cultural and social barriers. Perceptions of cancer risk, causes, outcomes and personal responsibility were widespread from traditional to more modern biomedical views, and sometimes integrated. Among breast cancer patients, effects of a collective and family centred way of life and strong support by one's spouse were evident, followed by a change towards closer spousal relations. Religious coping strategies were the most prevalent among breast cancer patients and were related to better well-being. An integration of traditional and modern perceptions of cancer, attitudes towards screening and coping with cancer were evident. More research is needed in order to advance a culturally competent care of cancer patients and of interventions that encourage screening for the early detection of cancer.

The prognostic role of cancer-specific beliefs among prostate cancer survivors

OBJECTIVE

The objective of this study is to evaluate the association between cancer-specific beliefs and survival among men newly diagnosed with prostate cancer.

METHODS

Based on data from a biracial cohort monitored for mortality for up to 15 years, we investigated the association between beliefs and survival among 251 men newly diagnosed with prostate cancer between 1987 and 1990. We examined patients' beliefs related to efficacy of regular checkups for detection, potential negative treatment effects, and perceived curability of cancer. Cox proportional hazards models were adjusted for sociodemographic variables, medical care measures, clinical factors, and lifestyle.

RESULTS

In a fully adjusted model, not believing that most cancers can be cured was associated with an increased risk of death from any cause (Hazard Ratio = 1.62; 95% confidence interval = 1.11, 2.38). Beliefs regarding the efficacy of checkups or potential negative treatment effects were not associated with survival.

CONCLUSIONS

Prostate cancer patients who reported not believing that most cancers are curable experienced poorer survival after adjusting for a wide array of prognostic factors and potential confounders. Future research to identify underlying behavioral (medical protocol adherence, lifestyle) and physiological (immune and endocrine regulation) mechanisms of this association would translate into improved intervention strategies for cancer survivors.

Introduction: charting the landscape of cancer survivors' health-related outcomes and care

The field of cancer survivorship is characterized by a complex and rapidly evolving landscape. This supplement presents a series of data-driven articles selected to highlight the breadth of new knowledge in this area of the cancer control continuum that were presented at the Fourth Biennial Cancer Survivorship Research Conference in Atlanta, Georgia, June 2008. Included in the volume is research on the biobehavioral impact of cancer; studies on quality-of-life and economic outcomes; and work focused on caregivers, understudied populations, and healthcare providers.