bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cancer patient attitudes and preferences towards smoking status assessment.
Authors: Eng Lawson , Liu Sophia Yijia , Zhang Qihuang , Farzanfar Delaram , Milne Robin , Yeung Sabrina , Brown M Catherine , Howell Doris , Xu Wei , Goldstein David Paul , Jones Jennifer M. , Selby Peter , Evans William K. , Giuliani Meredith Elana , Liu Geoffrey 
Published: May 2018

110 Background: Continued smoking after a cancer diagnosis is associated with poorer outcomes. As smoking cessation is an important part of cancer care, understanding pt attitudes towards smoking status assessment will help with integrating smoking cessation programs into survivorship care. Methods: Cancer pts were surveyed on their smoking history, assessment rates and attitudes/preferences towards smoking status assessment. Multivariate logistic regression models assessed for factors associated with screening preferences. Results: Among 501 pts, 115 smoked at diagnosis, 60% quit after; 53% had a tobacco related (lung/head and neck) cancer (TRC); 40% reported that their smoking status was assessed only on their first clinic visit, while 32% were assessed at a few visits and 12% all visits. Most felt smoking status should be assessed at the first visit (95%), while half (58%) felt it should be assessed each visit. Most felt comfortable with being assessed (96%), felt it was important for clinicians to be aware of smoking status (98%) and that smoking cessation discussions should occur at the first visit (87%). Most preferred being assessed by their oncologist (88%); less than half preferred being asked by another healthcare provider (44%), on paper (29%) or e-surveys (32%). Compared to ex/never smokers, current smokers were assessed more often at every/most visits (36% vs 20% P= 0.001) and were less comfortable with being assessed (88% vs 98% P< 0.001). Among current smokers, lung cancer pts were more agreeable (58%) to being assessed each visit compared to head/neck (aOR 2.48 95% CI [0.9-6.5] P= 0.06) and non TRCs (aOR 2.63 [1.0-6.8] P= 0.05). Among all, pts who are older (aOR 1.03 [1.0-1.1]), curative (aOR 1.92 [1.1-3.2]) and smoked less (aOR 0.98 per pkyr [0.97-0.99]) were more agreeable to assessment at each visit. Most pts also felt oncologists should screen for second hand smoke exposure (92%), felt its assessment was important (93%) and should help others who smoke to quit (68%). Conclusions: Most cancer pts felt that assessment of smoking status was important, were comfortable being assessed and preferred being assessed directly by their oncologist. Routine screening of those currently smoking is recommended to help with cessation.
Long-term risk of cardiovascular disease among colorectal cancer survivors in a population-based cohort study.
Authors: Baraghoshi David , Hawkins Makenzie L. , Abdelaziz Sarah , Park Jihye , Wan Yuan , Fraser Alison M , Smith Ken R , Deshmukh Vikrant , Newman Michael , Rowe Kerry G. , Snyder John , Lloyd Shane , Samadder Niloy Jewel , Hashibe Mia 
Published: May 2018

113 Background: In the United States, colorectal cancer is the fourth most common cancer and one of the leading causes of cancer death. Few studies have examined the relationship between colorectal cancer survivorship and long-term cardiovascular disease (CVD) risk. Methods: Individuals diagnosed with colorectal cancer were identified using the Utah Population Database. For a comparison group, up to 5 cancer-free individuals were matched by birth year, birth state, follow-up time and sex to each cancer case. For individuals with > 10 years of follow-up, we estimated CVD risk > 10 years after cancer diagnosis. Cox regression models were used to estimate hazard ratios (HR) and 95% Confidence Intervals. Results: Among 1,749 colorectal cancer survivors who had survived for at least 10 years, 1,001 (57.2%) were diagnosed with CVD > 10 years after cancer diagnosis. Compared to the general population, colorectal cancer survivors had an increased risk of CVD > 10 years after cancer diagnosis: HR = 2.84 (95% CI = 2.59, 3.11) for hypertension; HR = 2.66 (95% CI 2.37, 2.98) for diseases of the heart; HR = 3.91 (95% CI = 3.33, 4.58) for diseases of the arteries, arterioles and capillaries; HR = 2.58 (95% CI = 2.46, 2.99) for diseases of the veins and lymphatics; HR = 2.98 (95% CI = 2.36, 3.76) for cerebrovascular disease. Colorectal cancer survivors with ≥1 comorbidity had an increased risk of CVD > 10 years after cancer diagnosis compared to survivors with no comorbidities (HR = 1.7, 95% CI = 1.49, 1.95). Colorectal cancer survivors who were ≥65 years had an increased risk of CVD > 10 years after cancer diagnosis. Colorectal cancer survivors who were obese at the time of diagnosis had an increased risk of CVD > 10 years after cancer diagnosis when compared to survivors with normal BMIs (HR = 1.25; 95% CI = 1.06, 1.49). Conclusions: Compared to the general population, colorectal cancer survivors had an increased risk of CVD during the > 10 year follow-up period. Within colorectal cancer survivors, there was an increased risk of CVD for those that were older, had ≥1 comorbidity and were obese. The increased risk of CVD among survivors may be attributable to the lifestyle risk factors shared by colorectal cancer and CVD.
Cardiovascular disease risk after treatment-induced primary ovarian insufficiency in female survivors of Hodgkin lymphoma.
Authors: Van Leeuwen Flora , Krul Inge , Opstal-Van Winden Annemieke , Janus Cecile P.M. , Daniels Laurien , Maas Angela , Van Nimwegen Rianne , de Vries Simone , Hauptmann Michael , Józwiak Katarzyna , Aleman Berthe M.P. 
Published: May 2018

114 Background: Female survivors of Hodgkin lymphoma (HL) treated with alkylating chemotherapy (CT) and/or pelvic radiotherapy (RT) have an increased risk of primary ovarian insufficiency (POI). Among women with a natural menopause, POI has been associated with increased risk of cardiovascular disease (CVD). We examined whether treatment-induced POI increases long-term CVD risk in HL survivors. Methods: From a large Dutch cohort of 5-year HL survivors, we selected 918 women who were treated before 41 years of age between 1965 and 2000. Data on HL treatment, menopausal status and cardiovascular events (ischemic heart disease (IHD), heart failure (HF) and valvular heart disease (VHD)) were obtained from medical records, general practitioners and patient questionnaires. CVD risks were estimated with Cox regression models using time-dependent covariates and attained age as the time scale. Results: After a median follow-up of 24 years, 299 out of 918 women (33%) had developed POI (median menopausal age, 34 years). We identified 463 cardiovascular events in 300 women, of whom 85 developed CVD after POI. POI was not associated with subsequent CVD risk (HR:0.85, 95% CI 0.62-1.16) compared with a menopausal age of ≥40 years. Compared with women who reached menopause at ages ≥50 years, the HRs for menopausal ages of < 30 years, 30-39 and 40-49 years were 0.90 (95% CI 0.52-1.56), 0.87 (95% CI 0.57-1.33) and 0.96 (95% CI 0.64-1.44), respectively. Furthermore, a short duration of intact ovarian function after HL treatment ( < 5 years) did not increase CVD risk compared to a long duration (≥25 years) (HR:0.72, 95% CI 0.44-1.20). 177 women had used HRT, of whom 115 (65%) with POI (median duration of HRT use, 8.3 years). Women who used HRT for ≥5 years did not have a higher CVD risk than non-HRT users (HR 1.02, 95% CI 0.64-1.62). Similar results were found in analyses with IHD, HF and VHD as separate outcomes. Conclusions: POI and duration of post-treatment intact ovarian function did not affect CVD risk in HL survivors, suggesting that an early artificial menopause does not increase CVD risk.
Fertility preservation use and outcomes among young adult cancer survivors.
Authors: Rosenberg Shoshana M. , Partridge Ann H. , Poorvu Philip Daniel , Casillas Jacqueline N. , Ganz Patricia A. , Jacobs Linda A. , McCabe Mary S. , Overholser Linda , Palmer Steven C , Rajotte Emily Jo , Risendal Betsy C , Rosenstein Donald , Syrjala Karen Leslie , Baker K. Scott 
Published: May 2018

115 Background: Fertility is a critical survivorship issue for young adults (YA) with cancer. Data regarding use of fertility preservation (FP) and fertility outcomes in this population are limited. Methods: In 2013-2014, 868 patients, aged 18-39, 1-5 years post diagnosis (dx) of an invasive cancer completed a survey about the impacts of cancer and treatment including fertility. Descriptive statistics were used to characterize FP options pursued, reasons for not undergoing FP, and pregnancy outcomes. Logistic regression was used to identify factors associated with pre- treatment FP. Results: Median age at dx was 32. Most respondents were female (73%), married (61%), with a college degree (71%). Breast (28%), thyroid (15%), and lymphoma (13%) were the most common dx. 13% (77/614) of women and 36% (82/231) of men reported FP attempts prior to treatment, including 57% of testicular, 39% of lymphoma, 27% of leukemia, and 18% of breast cancer survivors. In men, sperm banking (96%) was the most common approach; in women, embryo (47%) and oocyte (23%) cryopreservation. Of those who did not pursue FP (N=686), 19% reported lack of information on risks/options as the reason. In multivariable analyses, FP was associated (p<0.05) with male gender, younger age, chemotherapy, being married, and having a college degree; survivors who had children prior to dx were less likely to pursue FP (Table). Of 60 men who tried to father a pregnancy, 42 (70%) were successful and 37 (88%) conceived naturally. Of 114 women who attempted pregnancy, 83 (73%) were successful, 76 (92%) conceived naturally. Conclusions: Some YA patients are not aware of treatment risks and FP options, indicating that fertility may be under-addressed. In our sample, nearly all patients who reported attempting pregnancy within 5 years of dx conceived naturally, suggesting that a risk stratified approach may help optimize use of FP services. [Table: see text]
Patient-reported survivorship care practices and late effects after treatment of Hodgkin (HL) and non-Hodgkin lymphoma (NHL).
Authors: Frick Melissa , Vachani Carolyn , Hampshire Margaret K. , Bach Christina , Arnold-Korzeniowski Karen , Metz James M. , Hill-Kayser Christine E. 
Published: May 2018

119 Background: Multimodal treatment of HL and NHL yields excellent outcomes, however, survivors are at risk for developing myriad late- and long-term effects (LLTEs). We describe survivorship care practices and LLTEs reported by HL/ NHL survivors. Methods: From a convenience sample of 964 HL (37%) and NHL (63%) cancer survivors using a publicly available Internet-based survivorship care plan (SCP) tool between 2011-2016, we examined cancer care and toxicity profile data. Results: Of all survivors, 67% were female and 84% were Caucasian; median age of diagnosis was 28y for HL and 49y for NHL survivors with median fu of 5y and 2y, respectively. 88% were free of cancer, 9% with recurrent or secondary malignancy, and 3% with metastatic disease. Chemotherapy was delivered to 89% of HL and 94% of NHL survivors, and radiation (RT) to 64% and 28%, respectively. Of those receiving RT, 96% (n = 217) HL and 61% (n = 106) NHL survivors received chest/mantle RT. Few reported receipt of previous SCP (13%) or treatment summary (4%). Most reported continued care from an oncologist (49%) or in combination with a PCP (19%). A shift to PCP management alone was observed, increasing from 2% of survivors if < 2y fu to 30% once ≥2y fu. Survivors who received chest RT reported: hyper- or hypothyroidism (35%), thyroid nodules (8%), speaking/swallowing changes (20%), heart disease (14%), pulmonary fibrosis/pneumonitis (12%), and skin cancers within the RT field (9%). 6 of 321 (2%) who received chest RT reported secondary breast cancers, compared to zero in the group not receiving chest RT with median time to breast cancer 20.5y (R 6-32 years). Receipt of chemotherapy was associated with: chronic fatigue (56%), cognitive change (56%), peripheral neuropathy (35%), sexual changes (15% of males, 35% of females), and heart disease (10%). Conclusions: While this population achieves excellent disease outcomes, survivors report a substantial burden of LLTEs, suboptimal delivery of survivorship information, and transitions of care in follow-up. Multiple opportunities thus exist through which SCPs may be used to improve awareness regarding survivorship/ LLTEs and communicate follow-up care plans between survivors and treatment teams.
Availability of therapeutic sexual aids for cancer survivors: A survey of major cancer centers.
Authors: Bober Sharon , Michaud Alexis L , Recklitis Christopher J. 
Published: May 2018

134 Background: Treatment-related sexual dysfunction is a distressing problem for many cancer survivors. Cancer treatment guidelines recommend therapeutic aids for sexual health rehabilitation (e.g., vaginal dilators, moisturizers, vacuum erection device). However, survivors often don't know how or where to access sexual aids or may be uncomfortable procuring them. 25 NCI-designated Cancer Centers/NCCN-member institutions were surveyed about availability of sexual aids and resources for survivors. Methods: Using phone and internet, potential sources of aids/resources at each center (e.g, custom boutiques, specialty retail shops) were identified. Relevant retail staff at each center were approached by phone and using a structured script, study staff queried about the availability of aids/resources. Separate calls were made regarding aids for men and women. Additional inquiry included access to aids elsewhere at the cancer center and recommendations for accessing resources if none were available. Results: Of the 25 cancer centers contacted, 23 responded about men and 22 responded about women. Two centers never responded to multiple attempts. Of the centers contacted, 87% reported having no sexual aids for men and 72% had no aids for women. One center carried a vacuum device and two had penile support rings. Six centers had some aids for women, most commonly reported were personal lubricants, moisturizers and dilators. One center stood out, having several types of aids for men and women. Additional recommendations were limited to suggesting a local pharmacy or doing an internet search. Conclusions: In contrast to other widely available cancer care products, e.g., wigs and prosthetics, availability of sexual aids and resources at major cancer centers is very low. The stark absence of sexual aids underscores the cultural taboos around cancer-related sexual dysfunction. Efforts to improve availability of sexual aids for survivors would likely promote sexual health rehabilitation and validate this under addressed aspect of cancer survivorship.
Psychosexual functioning in sexually active female survivors of childhood cancer.
Authors: Bjornard Kari L. , Howell Carrie R , Klosky James L. , Chemaitilly Wassim , Srivastava Deo Kumar , Brinkman Tara M. , Green Daniel M. , Willard Victoria W , Jacola Lisa M , Krasin Matthew J. , Hudson Melissa M. , Robison Leslie L. , Ness Kirsten K. 
Published: May 2018

136 Background: Childhood cancer survivors (CCS) may be at risk for low psychosexual function. We estimated the prevalence of low psychosexual function among female CCS, and evaluated associations with treatment exposures. Methods: 712 female CCS (mean age at assessment 31.2±7.71 years, at diagnosis 7.00±5.58 years; 31.3% acute lymphoblastic leukemia, 12.5% Hodgkin lymphoma) and 122 non-cancer controls enrolled in the St. Jude Lifetime Cohort Study completed a clinical assessment, reported sexual activity with or without a partner in the preceding month, and filled out the Sexual Functioning Questionnaire (SFQ) (25 items averaged to create overall and subscale scores ranging 0-5; lower is worse). CCS with SFQ scores < 10th percentile of controls were classified as low function. Linear models, adjusted for age, were used to compare SFQ scores. Associations between CCS characteristics and psychosexual function were evaluated using logistic regression. Results: 19.9% of CCS had low psychosexual function with a lower mean overall SFQ score than controls (3.19 vs. 3.47, effect size 0.4; p < 0.01). The most common impairments among CCS were performance problems (27.4%), orgasm (24.2%), satisfaction (17.6%), interest (17.2%), desire (15.4%), and arousal (12.5%). Survivors with low function reported poor quality of life in both physical (21.1% vs. 12.7%, p = 0.01) and mental health (36.5% vs. 18.2%, p < 0.01) domains compared to those without. Untreated hypogonadism was associated with low function (OR 3.20, 95% CI 1.69-6.42) for the performance problems subscale. Compared to controls, CCS with germ cell tumors (OR 8.82, 95% CI 3.17-24.50), renal tumors (OR 4.49, 95% CI 1.89-10.67) and leukemia (OR 3.09, 95% CI 1.50-6.38) were at greatest risk for low function. Though 40.7% of CCS perceived a higher risk for low psychosexual function compared to other women their age, only 2.9% reported receiving an intervention. Conclusions: Low psychosexual function is prevalent among female CCS. CCS with low psychosexual function also report poorer quality of life and more psychological symptoms. Research is necessary to identify additional risk factors that characterize high-risk survivors who would benefit from targeted screening and intervention.
Utilization of the sexual health service from the prostate cancer supportive care program: A chart review.
Authors: Bossio Jennifer , Zarowski Christine , Elliott Stacy , Hedden Lindsay , Pollock Phil , Spillane Maria , Wu Eugenia , Nunez Natalie , Branch Anna , Goldenberg Larry , Higano Celestia S. 
Published: May 2018

137 Background: Sexual dysfunction and psychological distress are two of the most important unmet supportive care needs of prostate cancer (PC) patients (pts). The Sexual Health Service (SHS) from the Prostate Cancer Supportive Care Program at the Vancouver Prostate Centre addresses the sexual recovery needs of PC pts and their partners via education and clinical service. This study explores patient characteristics and needs to better understand SHS utilization. Methods: Data was obtained from patient charts, semi-structured interviews, and patient-reported outcome measures from July 2013-June 2017. Analyses include descriptive statistics and pre-post comparisons via parametric (paired t-tests) or non-parametric (Wilcoxon) tests. Results: Data from 667 pts was analysed. Average age was 65yrs ( SD= 7.3, 43-88yrs) and most were in a relationship (79.6%; mean length = 30.5 yrs, SD= 15.2yrs, 9 mos–68yrs). Appointments were attended with partners (42.3%) or alone (56%) and most pts had undergone surgery for their PC (81.8%). Other treatments included radiation (18.2%), androgen deprivation therapy (13.3%), chemotherapy (1.0%), some had multiple treatments. Average time since end of PC treatment to first SHS appointment was 18 mos ( SD= 25.7mos; range, 0-17yrs). At the first SHS appointment, mean self-reported erectile functioning indicated severe dysfunction (IIEF scores: M =6.39, SD= 5.22). Pts reported significant decreases following PC treatment in: quality of erections, orgasm intensity, sexual desire, partner’s sexual desire, men’s sexual self-view, sexual body image and overall sexual satisfaction ( p’s < .01). Patients also reported lower levels of partner intimacy ( p= .003). At first SHS appointment, 34.5% of patients reported one significant ongoing life stressor, and 23.8% reported more than one. Most common life stressors were health (29.4%), family (23.8%), work (15.3%), relationship (8.8%) and financial (6.9%). Conclusions: Analyses support the need for the SHS, as pts report declines in all realms of sexual wellbeing and ongoing life stressors. Findings improve our understanding of the long-term impacts of PC treatment and guide future treatment offerings.
Designing a survivorship and supportive care center at a comprehensive cancer center.
Authors: Amato Katharine , Glaser Kathryn M. , Beaupin Lynda M. , Rokitka Denise A. , Reid Mary E. 
Published: May 2018

159 Background: Unmet physical, psychosocial, and other support needs of cancer survivors may lead to increased distress, anxiety, and decreased quality of life. Survivorship Clinics may be tailored for specific issues identified through a needs assessment. Methods: An invitation to complete a web-based survey was mailed to 35,420 active patients at a comprehensive cancer center in November 2015. The survey domains included demographics, cancer history, comorbidities, lifestyle, cancer prevention, spiritual and emotional support, symptom management, and interest in specific services. Results: 1,054 surveys were completed. The majority of respondents were female (55.2%; n = 582/1054), had Stage I cancer at diagnosis (43.9%; n = 360/820), and had completed treatment (69.0%; n = 727/1054). Genitourinary (23.0%; n = 238/1034) and breast (20.5%; n = 212/1034) were the most common cancer types among the respondents. Participants identified an average of 4.60 side effects experienced during or after treatment (n = 804); the most common were fatigue (64.5%), pain (37.3%), weight change (33.4%), sleep disturbance (30.2%), and gastrointestinal problems (29.4%). One third of participants reported having a physical side effect that caused anxiety and emotional distress (33.3%; n = 331/995), in particular, sexual function (69.7%; n = 136/195) and cognitive dysfunction (43.6%; n = 85/195). A total of 23.9% of participants had financial concerns due to costs of cancer treatment (n = 238/955). Participants were interested in integrative therapies, most notably yoga (75.1%; n = 289/385), acupuncture (72.4%; n = 155/214), aerobics (62.3%; n = 240/385), Swedish massage (60.5%; n = 225/372), aromatherapy (60.2%; n = 224/372), and homeopathy (55.1%; n = 118/214). Most respondents endorsed wanting information on nutrition (81.5%; n = 380/466). Conclusions: Cancer survivors report vast physical and psychosocial needs during and after cancer treatment, and they have a high interest in nutrition education and integrative therapies. Improved care coordination from a dedicated cancer survivorship and supportive care clinic at a comprehensive cancer center may specifically address survivors’ issues.