Background: Colonoscopy is one of the methods of choice for screening relatives of patients with colorectal cancer. Objective: To evaluate the rate of adherence to colonoscopy in first-degree relatives of patients with colorectal cancer and describe the lesions found. Methods: A prospective, cross-sectional, multicentre, nationwide study was conducted. The study population was composed of first-degree relatives of patients with colorectal cancer selected randomly from the EPICOLON study. Seventy-four index patients were included. These had 342 living first-degree relatives (parents, siblings and children), of whom 281 were interviewed. Results: The adherence rate was 38% (107/281). Adherence was greater in families with a higher degree of familial aggregation for colorectal cancer (88.9% for Amsterdam vs 33.3% for Bethesda and sporadic cancer; p,0.05), an index patient aged under 65 years (60% for patients ,65 years vs 32.9% for patients >65 years; p,0.05) and an index patient who was female (46.2% for women vs 31% for men; p = 0.28). Adherence was also greater in relatives under 65 years (54% in patients ,65 years vs 18% in patients >65 years; p = 0.05), in female relatives (49% in female relatives vs 27.3% in male relatives; p,0.05) and in siblings and children (40% in siblings and children vs 13% in parents; p,0.05). Lesions were found in 26% (28/107) of the study population. Nine (8.4%) individuals had a total of 18 advanced lesions. Conclusions: These results indicate that adherence to colonoscopy in our population of first-degree relatives was low. The adherence was more frequently associated with a higher degree of familial aggregation, a relative age of under 65 years, a sibling or offspring relationship, and female sex.
Introduction
Although there is literature on sexuality in gender dysphoria, few studies have been done prior to genital sex reassignment surgery (SRS).
Aims
To evaluate the perception of sexual QoL in gender-dysphoric patients before genital SRS and the possible factors associated to this perception.
Methods
The final sample consisted of 67 male-to-female and 36 female-to-male gender-dysphoric adults consecutively attended in a gender unit who had not undergone genital SRS; 39.8% was receiving cross-sex hormonal treatment, and 30.1% had undergone breast augmentation or reduction. Sexual QoL was assessed using the sexual activity facet of the World Health Organization Quality of Life (WHOQOL)-100. Sociodemographic (age, gender, partner relationship) and clinical data (being on hormonal treatment and having undergone any breast surgery) were recorded from the clinical records. Depressive symptoms were assessed using the negative feelings facet of the WHOQOL-100. Personality was assessed using the Revised NEO-Five Factor Inventory.
Main Outcome Measures
Sexual QoL, negative feelings, hormonal treatment, partner relationship, personality.
Results
The mean score of the sexual facet was 10.01 (standard deviation = 4.09). More than 50% of patients rated their sexual life as “poor/dissatisfied” or “very poor/very dissatisfied,” around a quarter rated it as “good/satisfied” or “very good/very satisfied,” and the rest had a neutral perception. Three variables were significantly associated with a better sexual QoL: less negative feelings (β = −0.356; P < 0.001), being on hormonal treatment (β = 0.216; P = 0.018), and having a partner (β = 0.206; P = 0.022). Age, sex, having undergone some breast surgery, and personality factors were not associated with their perception.
Conclusion
This study indicates that before genital SRS, about half of gender-dysphoric subjects perceived their sexual life as “poor/dissatisfied” or “very poor/very dissatisfied.” Moreover, receiving hormonal treatment, low negative feelings, and having a partner are related to a better subjective perception of sexual QoL.
We present a case of hepatotoxicity induced by an aromatase-inhibiting hormonal antineoplastic drug (anastrazol) in an elderly woman. This is the first reported case in the literature.
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