Lower treatment intensity and poorer survival in metastatic colorectal cancer patients who live alone

Cavalli-Björkman, Nina; Qvortrup, Camilla; Sebjørnsen, S; Pfeiffer, Per; Wentzel‐Larsen, Tore; Glimelius, Bengt; Sørbye, Halfdan

doi:10.1038/bjc.2012.186

Cited by 44 publications

(43 citation statements)

References 33 publications

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“…Socioeconomic factors [19–21], less access to health care, high-risk sexual practices [22,23], host immunity/genetics [24], and tobacco and alcohol consumption[25, 26] have all been linked to racial differences [18]. However the reason for racial disparities between incidence and outcome is still not fully elucidated.…”

Section: Introductionmentioning

confidence: 99%

Racial disparities in Human Papillomavirus (HPV) associated head and neck cancer

Jiron

Sethi

Ali-Fehmi

et al. 2014

American Journal of Otolaryngology

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Purpose Poorer survival from head and neck squamous cell carcinoma (HNSCC) in African Americans (AA) may be due to disparity in the prevalence of Human Papillomavirus (HPV) but earlier studies often failed to control other etiological factors. We aimed to elucidate whether racial disparities in HPV prevalence and overall survival were due to confounding from smoking or alcohol use. Materials and Methods 385 patients with SCC of the mouth, pharynx, nose, or larynx who had surgical resection at Wayne State University affiliated hospitals were identified through a population-based cancer registry. Formalin fixed paraffin embedded tissue blocks were used to determine the presence of HPV DNA and its genotype using a sensitive broad-spectrum PCR technique. Patients’ demographics, tumor characteristics and vital status were obtained through record linkage with the registry data and smoking and alcohol information was abstracted from medical record. Cox’s proportional hazard model and unconditional logistic models were employed to analyze the overall survival and tumor HPV-positivity, respectively. Results HPV positivity in oropharyngeal cancer was substantially lower in AA than in other racial groups (odds ratio 0.14, 95% confidence interval (CI) 0.05–0.37) and adjustment for smoking or alcohol did not change this association. However, a significantly increased hazard ratio of death in AA oropharyngeal cancer patients (univariable hazard ratio (HR) 2.55, 95% CI 1.42–4.59) decreased to almost unity (HR 1.49, 95% CI 0.75–2.93) after adjustment for HPV and smoking. Conclusions Lower HPV prevalence in AA largely accounts for their poorer survival from oropharyngeal cancer, but not other HNSSC.

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Section: Introductionmentioning

confidence: 99%

Racial disparities in Human Papillomavirus (HPV) associated head and neck cancer

Jiron

Sethi

Ali-Fehmi

et al. 2014

American Journal of Otolaryngology

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“…Another 288 persons were excluded because of a cancer diagnosis prior to the survey date in 1985. Since the method used to identify network types in this sample was previously validated in the Jewish population [15], the current study focused only on the Jewish respondents (n = 3679).…”

Section: Study Populationmentioning

confidence: 99%

“…Ethnic origin was categorized into four groups by continent of birth: Europe, North Africa, Africa, Asia and Israeli born (reference group). Five distinct social networks were defined among the survey population by means of cluster analysis that was based upon a previously published methodology [15].…”

Section: Variable Definitionsmentioning

confidence: 99%

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Prediagnostic self-assessed health and extent of social networks predict survival in older individuals with cancer: A population based cohort study

Rottenberg

Litwin

Manor

et al. 2014

Journal of Geriatric Oncology

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“…Such social support may impact outcomes among patients. Indeed, a recent study found that patients’ living alone more often had synchronous metastases at presentation and were less often treated with combination chemotherapy than those cohabitating [14]. …”

Section: Discussionmentioning

confidence: 99%

ecancermedicalscience

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BackgroundIn contrast to clinical trials, patient web forums provide a unique opportunity for patients to spontaneously post their experiences and thoughts about diseases and treatments. This study explored the impact of colorectal cancer (CRC) treatments in these forums.MethodsThis was a systematic cross-sectional qualitative analysis. Two active CRC web forums were identified based on four criteria: active for ≥five years, >12,000 total posts, >20 individuals currently browsing, and ≥10 new posts/day. All relevant threads (set of messages focusing on a topic) relating to treatment posted in July and December 2010 and February to March 2011 were reviewed and coded using MaxQDA software. A content analysis was performed identifying key themes.ResultsThe threads included 1522 posts by 264 individuals. Demographics were identified for 83% of the posters. Of these, 83% were CRC patients and 17% were family members; 76% were females, and the mean patient age was 49 years. The majority had advanced cancer (44% stage IV or metastatic, 40% stage III). The most common themes were side effects (62.3% of posts), treatment response (13%), and impact on personal, social, and work lives, and emotional distress (23.9%). The posters came to the online forums to have an emotional outlet, share experience, and seek advice. The emotional impacts primarily exemplified resilience and positive coping strategies. Formal knowledge regarding the likelihood of treatment response, magnitude of benefit, or side effects was lacking, which lead to uncertainty and anxiety. However, patients expressed appreciation for the availability of treatment options and the hope they provide.ConclusionOnline CRC communities provide patients with convenient and valuable emotional support and disease information. CRC and treatments may have profound impacts beyond efficacy and toxicity. Systematic information and decision tools may help to minimise uncertainties and help patients manage expectations and emotional distress.

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Lower treatment intensity and poorer survival in metastatic colorectal cancer patients who live alone

Cited by 44 publications

References 33 publications

Racial disparities in Human Papillomavirus (HPV) associated head and neck cancer

Racial disparities in Human Papillomavirus (HPV) associated head and neck cancer

Prediagnostic self-assessed health and extent of social networks predict survival in older individuals with cancer: A population based cohort study

ecancermedicalscience

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