Functional Limitations in Elderly Female Cancer Survivors

Sweeney, Carol; Schmitz, Kathryn H.; Lazovich, De Ann; Virnig, Beth A; Wallace, Robert B.; Folsom, Aaron R.

doi:10.1093/jnci/djj130

Cited by 193 publications

(110 citation statements)

References 43 publications

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“…Although prevalence odds ratios for outcomes with high prevalence will be farther from the null than prevalence risk ratios, we used odds ratios as a primary analysis measures in order to control for confounders. Prevalence odds ratios are considered a valid way to present prevalence data, although the prevalence odds ratio can be difficult to interpret [20][21][22]. Linear tests for trend were done by including the categorical variable as a continuous variable in the logistic regression analysis.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and predictors of cancer screening among American Indian and Alaska native people: the EARTH study

Schumacher

Slattery

Lanier

et al. 2008

Cancer Causes Control

105

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Purpose-The purpose of this study was to examine the prevalence rates for cervical, breast, and colorectal cancer screening among American Indian and Alaska Native people living in Alaska and in the Southwest US, and to investigate predictive factors associated with receiving each of the cancer screening tests. Methods-We used the Education and Research Towards Health (EARTH)Study to measure selfreported cancer screening prevalence rates among 11,358 study participants enrolled in [2004][2005][2006][2007]. We used prevalence odds ratios to examine demographic, lifestyle and medical factors associated with receiving age-and sex-appropriate cancer screening tests.Results-The prevalence rates of all the screening tests were higher in Alaska than in the Southwest. Pap test in the past 3 years was reported by 75.1% of women in Alaska and 64.6% of women in the Southwest. Mammography in the past 2 years was reported by 64.6% of women aged 40 years and older in Alaska and 44.0% of those in the Southwest. Colonoscopy or sigmoidoscopy in the past 5 years was reported by 41.1% of study participants aged 50 years and older in Alaska and by 11.7% of those in the Southwest US. Multivariate analysis found that location (Alaska versus the Southwest), higher educational status, income and the presence of one or more chronic medical condition predicted each of the three screening tests. Additional predictors of Pap test were age (women aged 25-39 years more likely to be screened than older or younger women), marital status (ever married more likely to be screened), and language spoken at home (speakers of American Indian Alaska Native language only less likely to be screened). Additional predictors of mammography were age (women aged 50 years and older were more likely to be screened than those aged 40-49 years), positive family history of breast cancer, use of smokeless tobacco (never users more likely to be screened), and urban/rural residency (urban residents more likely to be screened). Additional predictors of colonoscopy/sigmoidoscopy were age (men and women aged 60 years and older slightly more likely to be screened than those aged 50-59 years), family history of any cancer, family history of colorectal cancer, former smoking, language spoken at home (speakers of American Indian Alaska Native language less likely to be screened), and urban/rural residence (urban residents more likely to be screened).

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Section: Discussionmentioning

confidence: 99%

Prevalence and predictors of cancer screening among American Indian and Alaska native people: the EARTH study

Schumacher

Slattery

Lanier

et al. 2008

Cancer Causes Control

105

View full text Add to dashboard Cite

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“…These estimates were based on pooled data from 2 studies each for breast cancer-specific (3, 4) and allcause mortality (3, 5). Irwin and colleagues reported reductions of 29% for breast cancer-specific and 39% for overall mortality among the most-versus least-active women prediagnosis.Unfortunately, physical activity levels decline after diagnosis (6) and functional status remains lower among a substantial minority of breast cancer survivors for over 5 years after diagnosis (7,8). These issues make it difficult to conclude that data on prediagnosis physical activity are relevant for examining the mortality benefit of exercise in survivors.…”

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confidence: 99%

Exercise for Secondary Prevention of Breast Cancer: Moving from Evidence to Changing Clinical Practice

Schmitz

2011

Cancer Prevention Research

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Relating to the report of Irwin and colleagues in this issue of the journal (beginning on page 522), this perspective discusses exercise training interventions as secondary prevention in breast cancer survivors. Burgeoning observational evidence indicates that prescribing aerobic exercise of 3 hours or more per week could have meaningful mortality and morbidity benefits for breast cancer survivors. Adherence to this exercise prescription, however, will require an infrastructure to guide survivors and to address the common clinical treatment sequelae that might interfere with survivors' ability to regularly perform this level of activity (e.g., symptoms related to estrogen deprivation, arthralgias due to aromatase inhibitors, fatigue, lymphedema, chemotherapy-induced peripheral neuropathy, osteoporosis, upper-extremity functional impairments, and overall functional decline). On the basis of cardiac rehabilitation, a model is proposed to integrate exercise prescription into breast cancer survivor clinical care, with referral to community-based programs for most women. Cancer Prev Res; 4(4); 476-80. Ó2011 AACR.The article by Irwin and colleagues appearing elsewhere in this issue of the journal (1) adds to prior strong prospective observational studies demonstrating decreased overall and disease-specific mortality among more versus less physically active breast cancer survivors. A 2010 meta-analysis included 6 prior studies on this topic (2). As with the study of Irwin and colleagues, the meta-analysis analyzed distinct effects of physical activity measured pre-versus postdiagnosis. The meta-analysis summary estimates of the reduction of breast cancer-specific and all-cause mortality for the women who self-reported the most compared to the least pre-diagnosis physical activity were 7% and 18%, respectively. These estimates were based on pooled data from 2 studies each for breast cancer-specific (3, 4) and allcause mortality (3, 5). Irwin and colleagues reported reductions of 29% for breast cancer-specific and 39% for overall mortality among the most-versus least-active women prediagnosis.Unfortunately, physical activity levels decline after diagnosis (6) and functional status remains lower among a substantial minority of breast cancer survivors for over 5 years after diagnosis (7,8). These issues make it difficult to conclude that data on prediagnosis physical activity are relevant for examining the mortality benefit of exercise in survivors. In short, the women who are active before diagnosis may not be able to be active after diagnosis. Therefore, it is of interest to understand whether physical activity after diagnosis confers benefits. In the 2010 metaanalysis, summary estimates based on pooled effects from 4 studies (3, 9-11) showed that breast cancer-specific mortality was reduced 34% and all-cause mortality was reduced 41% for the women who reported being most versus least active postdiagnosis. Irwin and colleagues observed mortality reductions of 39% (breast cancer-specific) and 46% (overall) among w...

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“…En conclusion, il est nécessaire de souligner l'importance des répercussions fonctionnelles des traitements en cancérologie et de leur impact sur l'autonomie dans la population âgée (24,25). L'évaluation gériatrique approfondie (EGA) ou comprehensive geriatric assessment (CGA) (24) représente un moyen d'apprécier ces différents volets.…”

Section: Resultsunclassified

Le cancer du sein métastatique chez la femme âgée : revue synthétique de l’ensemble des options thérapeutiques

Brain

2007

Cancer Du Sein Avancé

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Functional Limitations in Elderly Female Cancer Survivors

Abstract: Our findings support the need to target elderly cancer survivors for interventions to maintain or regain physical function.

Cited by 193 publications

References 43 publications

Prevalence and predictors of cancer screening among American Indian and Alaska native people: the EARTH study

Prevalence and predictors of cancer screening among American Indian and Alaska native people: the EARTH study

Exercise for Secondary Prevention of Breast Cancer: Moving from Evidence to Changing Clinical Practice

Le cancer du sein métastatique chez la femme âgée : revue synthétique de l’ensemble des options thérapeutiques

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