and gender to gain more insight into tailored risk prediction and communication of risk to general practitioners (GPs) and/or participants. Methods: In this retrospective study, data was used of 57,421 participants who underwent a colonoscopy after a positive FIT in the Flemish CRC screening programme between October 2013 until July 2016. Analyses were performed with multinomial logistic regression to predict the probability of normal or noncancerous lesions, precancerous lesions, in situ or invasive cancers. Additionally, odds ratios (OR) were established to visualize the magnitude of the differences between risk profiles within a population with positive FIT, based upon a combination of the quantitative FIT, age and gender. Results: The amount of false positive FIT results followed up by colonoscopy is $27%, where $20% are not followed up at all by colonoscopy within 6 months after a positive FIT. Based on our risk profile calculation, we found a significant difference between the risk of having a normal outcome, a precancerous lesion, an in situ or an invasive cancer. For example, the detection of invasive cancer was 58 (OR) times more likely in a male of 74 years old with a FIT result of ! 1,000 ng/ml compared to a woman of 56 years old with a FIT result of 75 ng/ml. Conclusion: The differences in precancerous lesions or CRC according to our calculated risk profiles, justifies an approach where participants with a positive FIT are not all treated in the same way, based on a binary FIT. Participants and/or their GPs should be informed about individual risks. This will promote informed decision to an extent where participants and/or professionals can make decisions on follow-up. How to communicate this personalised information to participants needs to be discussed and tested. Contrary to the participant, professionals such as GPs should be provided with extra insight in the risk differences per patient, which supports their clinical decision making. The approach above could be extended by adding simple risk factors such as BMI, diet, alcohol intake, family history etc., creating the opportunity to more accurately discriminate between participants with a normal outcome, precancerous lesion, in situ or invasive cancer. Colonoscopy follow up based upon the quantitative FIT, combined with age, gender and additional risk factors instead of upon a binary FIT result only, will probably increase accuracy.
Introduction: Burnout is an unwanted outcome of chronic occupational stressors. Oncology staff is expected to suffer from burnout more than other health-care professionals. The aim of this survey was to determine the prevalence of burnout among Moroccan oncologists and to determine potential causal factors. Methods: We conducted a cross-sectional analytical study using an online self-administered questionnaire to oncologists in Morocco. We used the Maslach Burnout Inventory and additional questions exploring work and lifestyle factors. The questionnaire was sent in January 2018. Results: A total of 100 oncologists answered the questionnaire with predominance of women (75%), young participants (74%), and medical oncologists (60%). Eighty-five percent of the oncologists showed evidence of burnout. The rates of high scores of emotional exhaustion, depersonalization, and low scores of personal accomplishment were, respectively, 57%, 44%, and 56%. In the univariate linear analysis, age younger than 35 years (p = 0.014), being in residency training (p = 0.004), not having extra professional activities (p = 0.009), having an experience less than 10 years (p = 0.02) and estimating vacation time as not adequate (p = 0.05) were all significantly associated with increased burnout scores. In the multivariate analysis, only age <35 years (p = 0.028), being in residency training (p = 0.026), and having an experience less than 10 years (p = 0.01) were independent risk factors of burnout. Conclusion: These findings reveal that burnout in oncologists is higher than those reported internationally. Multidimensional interventions should be implemented to reduce burnout rates among Moroccan oncologists.
Le mésothéliome malin primitif de l´ovaire (MMPO) est une tumeur extrêmement rare qui peut se développer à partir des cellules mésothéliales. Cette néoplasie est causée principalement par une exposition à l´amiante ou à d´autres agents cancérigènes. Un bilan d´extension préopératoire comportant une tomodensitométrie, une imagerie par résonance magnétique et une tomographie par émission de positons est essentiel pour la stadification de la maladie. Le diagnostic positif anatomopathologique repose sur un panel immunohistochimique. Le MMPO reste une maladie exceptionnelle impliquant une stratégie thérapeutique multidisciplinaire, au sein de laquelle la chimiothérapie a permis d´améliorer la prise en charge et le pronostic de ces malades. Nous présentons dans cet article le cas d´une patiente ayant subi une chirurgie suboptimale, complétée par une chimiothérapie adjuvante, aboutissant à une réponse complète radiologique, avec une survie sans maladie de plus d´une année.
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