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Touré M, Sfairy SM, Bédard SK, McFadden N, Hanel R, Lemay F, He J, Pavic M, Poder TG. Cancer population norms using a new value set for the SF-6Dv2 based on the preferences of patients with breast or colorectal cancer in Quebec. Qual Life Res 2024; 33:1605-1619. [PMID: 38642218 DOI: 10.1007/s11136-024-03653-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2024] [Indexed: 04/22/2024]
Abstract
BACKGROUND Because health resources are limited, health programs should be compared to allow the most efficient ones to emerge. To that aim, health utility instruments have been developed to allow the calculation of quality-adjusted life-year (QALY). However, generic instruments, which can be used by any individual regardless of their health profile, typically consider the preferences of the general population when developing their value set. Consequently, they are often criticized for lacking sensitivity in certain domains, such as cancer. In response, the latest version of the Short Form 6-Dimension (SF-6Dv2) has been adapted to suit the preferences of patients with breast or colorectal cancer in the Canadian province of Quebec. By extension, our study's aim was to determine cancer population norms of utility among patients with breast or colorectal cancer in Quebec using the SF-6Dv2. METHOD To determine the cancer population norms, we exploited the data that were used in the development of a new value set for the SF-6Dv2. This value set was developed considering the preferences of patients with breast or colorectal cancer. Stratification by time of data collection (i.e., T1 and T2), sociodemographic variables (i.e., age, sex, body mass index, and self-reported health problems affecting quality of life), and clinical aspects (i.e., cancer site, histopathological classification, cancer stage at diagnosis, modality, and treatment characteristics) was performed. RESULTS In 353 observations, patients were more likely to have negative utility scores at T1 than at T2. Males had higher mean utility scores than females considering type of cancer and comorbidities. Considering the SF-6Dv2's dimensions, more females than males reported having health issues, most which concerned physical functioning. Significant differences by sex surfaced for all dimensions except "Role Limitation" and "Mental health." Patients with multifocal cancer had the highest mean and median utility values in all cancer sites considered. CONCLUSION Cancer population norms can serve as a baseline for interpreting the scores obtained by a given population in comparison to the situation of another group. In this way, our results can assist in comparing utility scores among cancer patients with different sociodemographic groups to other patients/populations groups. To our knowledge, our identified utility norms are the first for patients with breast or colorectal cancer from Quebec.
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Affiliation(s)
- Moustapha Touré
- Département d'économie, École de Gestion, Université de Sherbrooke, Sherbrooke, QC, Canada
- Centre de Recherche de l'IUSMM, CIUSSS de l'Est de L'île de Montréal, Montréal, QC, Canada
| | - Sarah-Maria Sfairy
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Suzanne K Bédard
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Nathalie McFadden
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Robert Hanel
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Frédéric Lemay
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
- Institut de Recherche sur le Cancer de l'Université de Sherbrooke, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Jie He
- Département d'économie, École de Gestion, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Michel Pavic
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
- Institut de Recherche sur le Cancer de l'Université de Sherbrooke, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Thomas G Poder
- Centre de Recherche de l'IUSMM, CIUSSS de l'Est de L'île de Montréal, Montréal, QC, Canada.
- Département de gestion, d'évaluation et de politiques de santé, École de santé publique, Université de Montréal, Montréal, QC, Canada.
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Lee R, Holmes D. Barriers and recommendations for colorectal cancer screening in Africa. Glob Health Action 2023; 16:2181920. [PMID: 36820646 PMCID: PMC9970240 DOI: 10.1080/16549716.2023.2181920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Colorectal cancer (CRC) is the third most common cancer worldwide. The incidence of CRC is rising in low- and middle-income countries but decreasing in high-income countries due to the widespread use of surveillance colonoscopy. In Africa, the implementation of screening programs remains a challenge, even in countries, such as Ghana that have established CRC screening guidelines. OBJECTIVE The purpose of this review was to identify the barriers and recommend strategies for implementing CRC screening in African countries. METHODS A literature search using PubMed was conducted with the following search terms: colorectal neoplasm, early detection of cancer, mass screening, colonoscopy, faecal occult blood test, faecal immunochemical test (FIT) and Africa. After inclusion and exclusion criteria were applied, a total of 13 articles were reviewed. RESULTS The most common barriers reported were limited endoscopic capacity, poor knowledge of CRC and CRC screening, health care factors, cultural factors and sociodemographic factors. Recommendations to increase the availability of CRC screening tests were to include the use of FITs, to provide more training for health care providers, and to expand educational programs for patients, physicians, and religious/community leaders. CONCLUSION The primary barrier to screening for CRC in Africa is the limited endoscopic capacity, specifically the lack of infrastructure and trained personnel, which requires systematic changes by governing bodies. In addition, health care professionals should be involved in educating patients about CRC and CRC screening. Further research is needed to clarify the factors related to subtypes of CRC and to explore the feasibility of using FITs in Africa.
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Affiliation(s)
- Rebecca Lee
- Department of Family Medicine, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, USA,CONTACT Rebecca Lee Department of Family Medicine, Jacobs School of Medicine and Biomedical Sciences State University of New York at Buffalo, Buffalo, NY, USA
| | - David Holmes
- Department of Family Medicine, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, USA,ECMC Family Health Center, Williamsville, NY, USA
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Touré M, Pavic M, Poder TG. Second Version of the Short Form 6-Dimension Value Set Elicited From Patients With Breast and Colorectal Cancer: A Hybrid Approach. Med Care 2023; 61:536-545. [PMID: 37308990 DOI: 10.1097/mlr.0000000000001880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Quality-adjusted life-year instruments help comparison among programs by capturing their effects in terms of utility. Generic instruments are applicable to everyone, and for this reason, they are known to lack sensitivity when measuring gains in some domains. Specific instruments tend to fill this gap but, in domains like cancer, existing instruments are either nonpreferences-based or based on the general population's preferences. PATIENTS AND METHODS This study describes the development of a new value set for a well-known and highly used generic instrument, the Second Version of the Short Form 6-Dimension, to better consider the preferences of patients with cancer. In this aim, a hybrid approach combining the time trade-off and the discrete choice experiment was used. The population of interest was the Quebec population, Canada, with breast or colorectal cancer. Their preferences were elicited in 2 periods: before (T1) and 8 days after the beginning of a chemotherapy procedure (T2). RESULTS A total of 2808 observations for the time trade-off and 2520 observations for the discrete choice experiment were used. The parsimonious model encompassing the 2 periods was the preferred model. The new value set allows a greater utility range than the EQ-5D-5L and the Second Version of the Short Form 6-Dimension reference value sets and helps in better considering patients experiencing severe health situations. A good correlation between these 2 instruments and other specific cancer instruments (ie, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, QLU-C10D, and Functional Assessment of Cancer Therapy-General) was observed. Significative differences in utility values were also noted within periods and types of cancer.
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Affiliation(s)
- Moustapha Touré
- Department of Economics, Business School, Université de Sherbrooke, Sherbrooke
- Centre de Recherche de l'IUSMM, CIUSSS de l'Est de L'île de Montréal, Montréal
| | - Michel Pavic
- Department of Medicine Faculté de médecine et des sciences de la santé, Université de Sherbrooke
- Centre de recherche du CHUS, CIUSSS de l'Estrie - CHUS, Sherbrooke
| | - Thomas G Poder
- Centre de Recherche de l'IUSMM, CIUSSS de l'Est de L'île de Montréal, Montréal
- Centre de recherche du CHUS, CIUSSS de l'Estrie - CHUS, Sherbrooke
- Department of Management, Evaluation and Health Policy, School of Public Health, Université de Montréal, Montréal, QC, Canada
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Viscaino M, Torres Bustos J, Muñoz P, Auat Cheein C, Cheein FA. Artificial intelligence for the early detection of colorectal cancer: A comprehensive review of its advantages and misconceptions. World J Gastroenterol 2021; 27:6399-6414. [PMID: 34720530 PMCID: PMC8517786 DOI: 10.3748/wjg.v27.i38.6399] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 04/26/2021] [Accepted: 09/14/2021] [Indexed: 02/06/2023] Open
Abstract
Colorectal cancer (CRC) was the second-ranked worldwide type of cancer during 2020 due to the crude mortality rate of 12.0 per 100000 inhabitants. It can be prevented if glandular tissue (adenomatous polyps) is detected early. Colonoscopy has been strongly recommended as a screening test for both early cancer and adenomatous polyps. However, it has some limitations that include the high polyp miss rate for smaller (< 10 mm) or flat polyps, which are easily missed during visual inspection. Due to the rapid advancement of technology, artificial intelligence (AI) has been a thriving area in different fields, including medicine. Particularly, in gastroenterology AI software has been included in computer-aided systems for diagnosis and to improve the assertiveness of automatic polyp detection and its classification as a preventive method for CRC. This article provides an overview of recent research focusing on AI tools and their applications in the early detection of CRC and adenomatous polyps, as well as an insightful analysis of the main advantages and misconceptions in the field.
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Affiliation(s)
- Michelle Viscaino
- Department of Electronic Engineering, Universidad Tecnica Federico Santa Maria, Valpaiso 2340000, Chile
| | - Javier Torres Bustos
- Department of Electronic Engineering, Universidad Tecnica Federico Santa Maria, Valpaiso 2340000, Chile
| | - Pablo Muñoz
- Hospital Clinico, University of Chile, Santiago 8380456, Chile
| | - Cecilia Auat Cheein
- Facultad de Medicina, Universidad Nacional de Santiago del Estero, Santiago del Estero 4200, Argentina
| | - Fernando Auat Cheein
- Department of Electronic Engineering, Universidad Técnica Federico Santa María, Valparaiso 2340000, Chile
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Huijbers A, Mesker WE, Mertens BJ, Bladergroen MR, Deelder AM, van der Burgt YEM, Tollenaar RAEM. Case-controlled identification of colorectal cancer based on proteomic profiles and the potential for screening. Colorectal Dis 2014; 16:907-13. [PMID: 25243779 DOI: 10.1111/codi.12782] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2014] [Accepted: 05/17/2014] [Indexed: 01/25/2023]
Abstract
AIM Colorectal cancer (CRC) screening programmes detect early cancers but unfortunately have limited sensitivity and specificity. Mass spectrometry-based determination of serum peptide and protein profiles provides a new approach for improved screening. METHOD Serum samples were obtained from 126 CRC patients before treatment and 277 control individuals. An additional group of samples from 50 CRC patients and 82 controls was used for validation. Peptide and protein enrichments were carried out using reverse-phase C18 and weak-cation exchange magnetic beads in an automated solid-phase extraction and spotting procedure. Profiles were acquired on a matrix-assisted laser desorption/ionization time-of-flight system. Discriminant rules using logistic regression were calibrated for the peptide and protein signatures separately, followed by combining the classifications to obtain double cross-validated predicted class probabilities. Results were validated on an identical patient set. RESULTS A discriminative power was found for patients with CRC representative for all histopathological stages compared with controls with an area under the curve of 0.95 in the test set (0.93 for the validation set) and with a high specificity (94-95%). CONCLUSION The study has shown that a serum peptide and protein biomarker signature can be used to distinguish CRC patients from healthy controls with high discriminative power. This relatively simple and cheap test is promising for CRC screening.
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Affiliation(s)
- A Huijbers
- Department of Surgery, Leiden Universal Medical Center, Leiden, The Netherlands
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