Background:

Cancer survivors suffering from comorbid diseases experience lower levels of health-related quality of life. Clinicians should become more aware of the impact of comorbidity on HRQoL and provide necessary psychological support to assist self-management of comorbid diseases.

BackgroundImproving questionnaire response rates is an everlasting issue for research. Today, the Internet can easily be used to collect data quickly. However, collecting data on the Internet can lead to biased samples because not everyone is able to access or use the Internet. The older population, for example, is much less likely to use the Internet. The Patient-Reported Outcomes Following Initial Treatment and Long-Term Evaluation of Survivorship (PROFILES) registry offers a platform to collect Web-based and paper questionnaires and to try different measures to improve response rates.ObjectiveIn this study, our aim was to study the influence of two methods of invitation on the response rate. Our second aim was to examine the preference of questionnaire mode of administration (paper or Web-based) for the older patient in particular.MethodsTo test these two invitational methods, 3406 colorectal cancer patients between ages 18 and 85 years received an invitation containing an access code for the Web-based questionnaire. They could also request a paper questionnaire with an included reply card (paper-optional group). In contrast, 179 randomly selected colorectal cancer patients received a paper questionnaire with the invitation (paper-included group). They could also choose to fill out the Web-based questionnaire with the included access code.ResultsResponse rates did not differ between the paper-optional and the paper-included groups (73.14%, 2491/3406 and 74.9%, 134/179, P=.57). In the paper-optional group, online response was significantly higher when compared to the paper-included group (41.23%, 1027/2491 vs 12.7%, 17/134, P<.001). The majority of online respondents responded after the first invitation (95.33%, 979/1027), which was significantly higher than the paper respondents (52.19%, 764/1464, P<.001). Respondents aged 70 years and older chose to fill out a paper questionnaire more often (71.0%, 677/954). In the oldest age group (≥80 years), 18.2% (61/336) of the respondents filled out a Web-based questionnaire.ConclusionsThe lack of difference in response rates between invitation modes implies that researchers can leave out a paper questionnaire at invitation without lowering response rates. It may be preferable not to include a paper questionnaire because more respondents then will fill out a Web-based questionnaire, which will lead to faster available data. However, due to respondent preference, it is not likely that paper questionnaires can be left out completely in the near future.

Use of proton pump inhibitors and histamine-2 receptor antagonists and risk of gastric cancer in two population-based studies.

Objective: To examine the association between breakfast consumption and physical activity in a well-characterised sample of English children. Design: Cross-sectional study using food diaries to record breakfast consumption and accelerometry to assess physical activity. Setting: Norfolk county, England. Subjects: Children (n 1697) aged 9-10 years from the SPEEDY (Sport, Physical Activity and Eating behaviour: Environmental Determinants in Young people) study. Results: Boys who consumed a poor-quality breakfast based on dairy product, cereal and fruit intakes spent approximately 7 min more time in moderate-to-vigorous physical activity (MVPA) during weekday afternoons and evenings compared with those who did not consume breakfast (P , 0?05). On weekend days, boys who consumed a poor-or good-quality breakfast spent approximately 6 and 5 min less time respectively being sedentary during the mornings compared with breakfast nonconsumers (P , 0?05). Boys who consumed a good-quality breakfast spent almost 3 min more in MVPA during the morning on weekend days compared with nonconsumers, and boys who consumed a poor-or good-quality breakfast were 22 % and 16 % more active overall respectively than breakfast non-consumers (P , 0?05). During the rest of the day, boys who consumed a good-quality breakfast spent about 11 min less time being sedentary (P , 0?05) and 7 min more time in MVPA (P , 0?01). Conclusions: Although some associations between breakfast consumption and physical activity were detected for boys, the present study does not provide strong evidence that failing to consume breakfast, or having a low energy intake at breakfast time, is detrimental to children's physical activity levels. Keywords Breakfast consumption Physical activity Sedentary behaviours ChildrenRegular breakfast consumption has been found to be associated with improved overall diet, including greater micronutrient intakes and better diet quality, in school-aged children (1)(2)(3)(4) . For example, in Belgian 13-18-year-olds, higher intakes of fruit, vegetables, bread, milk, milk products and fruit juices have been associated with the consumption of a high-quality breakfast, while soft drinks intake has been shown to be significantly lower compared with consumers of a less nutritious breakfast (4) . Missing breakfast has also been associated with decreases in attention, memory and school performance (5,6) , all important factors in children's development. In addition, there are indications that breakfast patterns are linked to overweight and obesity (7)(8)(9)(10)(11)(12) . It is of concern that a decline in breakfast consumption has been observed in recent years. For example, between 1965 and 1991, there is evidence of decreasing rates of breakfast consumption among American children. Declines were highest among older adolescents (15-18-year-olds), with daily consumption rates decreasing by 14?8 % and 19?7 % in boys and girls, respectively (9) . In a recent multicountry study, over 30 % of 11-15-year-old children did not eat breakfas...

Objective Chemotherapy‐induced sensory peripheral neuropathy (CIPN) is common among colorectal cancer (CRC) survivors. The aim of this study was to examine whether CIPN is associated with both psychological distress (ie, anxiety and depression) and fatigue and whether the relationship between CIPN and fatigue can (partly) be explained by psychological distress. Methods All CRC survivors diagnosed between 2000 and 2009 as registered by the population‐based Netherlands Cancer Registry (Eindhoven region) were eligible for participation. Chemotherapy‐treated survivors completed questions on CIPN (EORTC QLQ‐CIPN20), psychological distress (HADS), and fatigue (FAS) on average 5.6 years after diagnosis. Simple and multiple mediation analyses were performed to examine anxiety and depression as possible mediators in the association between CIPN and fatigue. Results Survivors with high (ie, upper 30% of scores) CIPN (n = 172) reported more anxiety and depressive symptoms and more fatigue compared with those with low CIPN (n = 299). Furthermore, among survivors with high CIPN, those who were anxious, depressed, or both reported more fatigue compared with those without psychological distress. These differences were clinically relevant. Finally, mediation analyses showed that while CIPN was directly associated with fatigue, the relationship between CIPN and fatigue was also significantly mediated by both anxiety and depression. Conclusions CRC survivors with high CIPN report more fatigue, especially those who are also anxious and/or depressed. More research is needed on the direction of the relationship between CIPN, psychological distress, and fatigue. For now, the treatment of fatigue should also focus on addressing psychological distress, as treating fatigue alone might not be sufficient.

We examined the incidence of cardiovascular disease (CVD) among 32 757 cancer survivors and age‐, gender‐, and geographically matched cancer‐free controls during a follow‐up period of 1‐13 years, and explored whetherCVD incidence differed by received cancer treatment, traditional cardiovascular risk factors, age, or gender. Adult 1‐year cancer survivors without a history ofCVD diagnosed with breast (n = 6762), prostate (n = 4504), non‐Hodgkin (n = 1553), Hodgkin (n = 173), lung and trachea (n = 2661), basal cell carcinoma (BCC; n = 12 476), and colorectal (n = 4628) cancer during 1999‐2011 were selected from the Netherlands Cancer Registry and matched to cancer‐free controls without a history ofCVD. Drug dispenses and hospitalizations from thePHARMO Database Network were used as proxy forCVD. Data were analyzed using Cox regression analyses. Prostate (HR: 1.17; 95%CI: 1.01‐1.35) and lung and trachea (HR: 1.48; 95%CI: 1.10‐1.97) cancer survivors had an increased risk for developingCVD compared to cancer‐free controls. This increased risk among lung and trachea cancer survivors remained statistically significant after including traditional cardiovascular risk factors and cancer treatment information (HR: 1.41; 95%CI: 1.06‐1.89). Among prostate cancer survivors, the increased risk of incidentCVD was limited to those who received hormones and those without traditional cardiovascular risk factors. Breast, non‐Hodgkin,BCC, and colorectal cancer survivors showed no increasedCVD risk compared to cancer‐free controls. There was an increased risk of incidentCVD among prostate, and lung and trachea cancer survivors compared to age‐, gender‐ and geographically matched cancer‐free controls. Studies including longer follow‐up periods are warranted to examine whether cancer survivors are at increased risk of long‐term incidentCVD.

PurposeThe ‘Patient Reported Outcomes Following Initial treatment and Long-term Evaluation of Survivorship’ (PROFILES) registry collects patient-reported outcomes (PROs) from short- and long-term cancer survivors in the Netherlands, in a population-based setting. The aim of this analysis is to assess the generalizability of observational PRO research among cancer survivors by comparing socio-demographic and clinical characteristics, and survival of participants and non-participants in cancer survivors invited for questionnaire research through the PROFILES registry.MethodsBetween 2008 and 2015, cancer survivors with different cancer diagnoses (N = 14,011) were invited to participate in PROFILES registry studies, of whom 69% (N = 9684) participated. Socio-demographic and clinical characteristics and survival data, collected through the Netherlands Cancer Registry, were associated with participation versus non-participation in multivariable logistic regression analyses and cox proportional hazard regression models, respectively.ResultsParticipants had a significantly better survival compared to non-participants (HR = 1.47, P < .01). Participation was associated with male gender, being 60–70 years old, high socio-economic status, receiving any treatment, receiving radiotherapy, having no comorbidities, and a cancer diagnosis 2–3 years before invitation. Sensitivity analysis demonstrates that the health-related quality of life (HRQoL) might be up to 1.3 points lower (scale 0–100) using hot deck imputation compared to non-imputed participant data.ConclusionsCancer survivors not participating in observational PROs research significantly differ from participants, with respect to socio-demographic and clinical characteristics, and survival. Their HRQoL scores may be systematically lower compared to participants. Therefore, even in PRO studies with relatively high participation rates, observed outcomes may represent the healthier patient with better outcomes.