bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementation of distress screening for breast cancer patients.
Authors: Bryant Jill , Silva Helen Colleen , Mapp Greg , Terrell Daphne 
Published: February 2017

196 Background: Cancer is a complex disease process. Patients experience psychological, social, financial, and behavioral issues that can interfere with their treatment plan and adversely affect their outcomes. Distress should be measured as the 6th Vital Sign. Consequences of distress can cause deterioration of Quality of Life; produce higher levels of pain; longer rehabilitation; reduced adherence to treatment with less efficacy; and shorter survival expectancy. Methods: Problem exists with a lack of screening patients’ level of distress during breast cancer experience within their cancer care continuum. Goal was to improve the prevalence of distress screening of breast cancer patients from 0% to 50% within 3 months. Cause and effect analysis showed evidence of areas for improvement. Improvements and interventions included: education on stress and psychosocial assessment; developing a distress screening tool; and developing inclusion criteria for patient screening. Screenings were completed on first follow-up visit after diagnosis with continuation of assessment every three months for the first year. A distress screening tool with a thermometer illustration was provided to the patients for them to rate amount of distress experienced in the past week. Scoring was “0 = no distress to 10 = extreme stress.” The tool also included Yes/No questions. A value of 4 or greater on the thermometer or any question marked “Yes” on the questionnaire was considered a positive screen. Results: In addition to developing a tool, a template was implemented in the electronic medical record. Opportunities for assistance with distress were discovered based on patients’ responses where interventions and follow-ups with the patient were provided. Conclusions: A process was developed and implemented to integrate and monitor on-site psychosocial distress screening and referral for provision of psychosocial care. A small number of patients analyzed met criteria during a short period of time. The percentage of distress screenings completed improved from 0% to 92%. [Table: see text]
Impact of health care costs on utilization of needed health care in the Childhood Cancer Survivor Study (CCSS).
Authors: Fair Douglas Beaty , Kirchhoff Anne C. , Nipp Ryan David , Leisenring Wendy M. , Nathan Paul C. , Oeffinger Kevin C. , Armstrong Gregory T. , Robison Leslie L. , Park Elyse 
Published: February 2017

20 Background: Survivors of childhood cancer face increased risks for morbidity and premature mortality due to the sequelae of their primary disease and its treatment. Survivors may be socioeconomically vulnerable, which could negatively impact their healthcare utilization. We investigated sociodemographic factors associated with forgoing needed healthcare due to cost among long-term survivors within the CCSS. Methods: From a survey of insured and uninsured survivors conducted in 2011-12, forgoing needed healthcare due to cost was determined by the question “In the past year, was there a time when you did any of the following because you were worried about the cost? (Yes/No)” with 10 response categories (e.g., skipping a test/treatment, postponing medical care, taking a smaller cost of a prescription). ‘Yes’ responses were summarized using a categorical outcome variable of 0, 1-2, or ≥ 3 instances of forgoing healthcare. Ordinal logistic regression models assessed the association of sociodemographic factors with increased instances of forgoing healthcare due to cost, including survey weights to account for stratified sampling. Results: Of 1,110 mailed surveys, we received 698 (64%) responses. Mean age at time of survey was 39.6 (range 24-60) years and average time since diagnosis was 31.3 (SD = 4.6) years. 23% of survivors reported 1-2 instances of foregoing needed healthcare and 31% reported 3 or more. Odds of more forgone needed healthcare due to costs were increased for those who were uninsured, female, and had a chronic medical condition. [Table: see text]
Young cancer survivors’ expectations of physicians for issues of mental health, interpersonal relationships, and reintegration to society.
Authors: Wang Ying , Camateros Pierre , Cheung Winson Y. 
Published: February 2017

208 Background: As patients transition from cancer treatment to survivorship, issues surrounding the social and mental health impacts of survivorship gain increased importance. In this study, we examined young cancer survivors’ expectations of their physicians with respect to mental health, interpersonal relationships, and reintegration back to work and school. We also explored factors associated with these expectations. Methods: We surveyed patients aged 20 to 39 years who were diagnosed with solid tumors, evaluated at any 1 of 5 regional cancer centers in British Columbia, and alive at 2 or more years after their diagnosis. We explored the relationship between patient factors and expectations, adjusting for confounders through the use of multivariate regression models. Results: With a survey response rate of 57%, a total of 447 patients were analyzed: median age was 35 years (IQR 31-38), 30% were men, and 89% had ECOG 0. Tumor sites included breast (222; 50%), testicular (126; 28%), gynecological (76; 17%), and colorectal (23; 5%). Decreasing levels of expectations of cancer specialist (CS) were seen with 72%, 48%, and 28% of patients indicating that their CS should have some to full responsibility on issues related to mental health, social counselling, and reintegration, respectively. Compared to CS, patients held much higher expectations of their primary care physician (PCP) taking some to full responsibility for these same issues (see Table). Expectations of their PCP were further increased when there was frequent contact between patient and PCP. Conclusions: The majority of young cancer survivors in our survey expected their PCP more than their CS to have a significant degree of responsibility for mental, interpersonal, and social issues arising from their cancer or treatment. Early integration of PCP into survivorship care models may augment the work provided by the psychosocial cancer team and ease the transition to survivorship for patients. [Table: see text]
Effect of the European Organization for Research and Treatment of Cancer (EORTC) on social life for cancer survivors in Europe.
Authors: Liu Lifang , Mosser Lotte , Reijneveld Jaap C. , Meunier Francoise 
Published: February 2017

218 Background: Cure is not a dream but a reality for a large group of cancer patients nowadays. In Europe around 4 million patients successfully lived beyond the 5th year after cancer diagnosis. With improved survival rate and an ageing population, there will be more survivors in the near future. They wish to enter or maintain in the job market, and to finance desired house and insurance. However, the lack of sufficient data and knowledge on the ability to perform gets in the way on their path to normal social life. Methods: From 2013 the EORTC set the scene addressing societal issues faced by cancer patients involving key stakeholders including cancer patients themselves, care givers, bankers, insurers, employers and policy makers. These efforts have matured into an innovative research infrastructure in Europe integrating existing patients’ cohorts, including data from clinical trials, (population-based) cancer registries, surveys and social media. The research scope covers from quantifying the magnitude of the problem, assessing the economic burden, to formulating evidence-based EU recommendations for rehabilitation of cancer survivors. Particularly, variation and inequality across member states will be extensively investigated. Results: EORTC has a long tradition of collection data and follow-up patients since 50 years. Currently he is forming a consortium with the European Commission Joint Research Center (EC-JRC), European Network of Cancer Registry (ENCR), and other key experts in EU on the project. Several nation-wide research models are being built to address country-specific questions that cancer survivors face. Conclusions: A sustainable research infrastructure with dedicated partners and network address cancer survivorship is being built in Europe. This joint effort saves repetition in collecting data that already exist, synergizes expertise and methodology in addressing cancer survivorship questions.
Cancer-related distress and unmet needs among newly diagnosed and longer-term cancer survivors from a community-based distress screening program.
Authors: Buzaglo Joanne S. , Miller Melissa F , Kennedy Victoria , Longacre Margaret , Golant Mitch , Robinson Patricia A. 
Published: February 2017

220 Background: As survival rates increase among cancer patients, quality of life needs become more salient. Cancer Support Source (CSS) is a distress screening, referral and follow up program that uses a validated distress screening tool and referral algorithm to link cancer patients to resources tailored to their needs. The objective of this study was to describe psychosocial concerns and unmet needs at different times since cancer diagnosis. Methods: English speaking cancer survivors (n = 905) across 26 affiliates of a nationwide cancer support organization participated in the CSS program by first completing a screening tool, including a 4 item depression subscale. Participants rated the level of concern (0 to 4) about 15 items and identified the help they wanted for each item (talk with a member of your health care team and/or connect you with online resources). We used regression analysis, adjusting for age, to examine differences by time since diagnosis ( < 1 y; ≥ 1 y) in level of distress; type of concerns (rated ≥ 2); and items selected to talk with the health care team. Results: The sample was 78% female, 10% Latino, 9% Black, and median age 57 y. 41% were breast cancer survivors, 6% lung, and 6% colorectal. More than half were within 1 y of their diagnosis (61%, n = 507); 39% ≥ 1 y (n = 331). Those newly diagnosed ( < 1 y) had significantly higher levels of distress (p = 0.011); increased risk for depression (p = 0.007); and more likely to be concerned about changes in work, school, or home life; body image; feeling nervous or afraid; worry about the future; and making a treatment decision (p < 0.05). Among those who indicated that an item was a concern, newly diagnosed patients were significantly more likely to want to talk to their health care team about pain; financial worries; exercising; feeling lonely or isolated; feeling nervous or afraid; and worry about the future (p < 0.05). Conclusions: These findings suggest that patients are more distressed and more likely to want to talk about their psychosocial needs within the first year of a cancer diagnosis. Future research should evaluate efforts to provide tailored resources within the first year of a diagnosis when distress levels are highest.
A pilot study of a low-intensity health education intervention on activity and quality-of-life measures for cancer survivors.
Authors: Basu Arnab , Bhattacharya Sreyasi , Miller Kenneth David 
Published: February 2017

221 Background: There is an increasing need for effective targeted health education interventions for cancer survivors related to dietary habits, physical activity and cancer related psychosocial challenges. Methods: We designed an educational program for cancer survivors (n=37 ) presenting for outpatient follow up visits. The program was composed of a 30-60 minute survivorship visit and a series of six 7-10 minute video tutorials shown two at a time either remotely or in person every two months over a six month period about the importance of diet, physical activity and psychosocial aspects of cancer survivorship. Baseline assessments of perceived state of health, physical activity, diet, and the Impact of cancer were made through a series of validated questionnaires, including SF-12, IPAQ, FRDHQ and IOC. Patients were then sent another follow-up survey in approximately 1 year to be filled online; those who could not respond were followed up by phone. Weight and height data were registered during 1 year follow-up visit. Results: 37 Patients initially participated in the study, of these, all 37 either replied/were followed up after a 1 year time period. 87% were women and 70% were African American, 25(66%) of patients had a prior diagnosis of breast carcinoma, 4 (11%) had a prior diagnosis of colorectal Carcinoma. 16 (43%), 13(35%) and 7(18%) of patients had <5 , 5-10 and >10 years since last surgery/chemotherapy. We demonstrated that this type of low intensity intervention is feasible in a medically underserved group of cancer survivors. There was a trend towards an improved Physical Composite Score (25.1 vs 43.1) and Mental Composite Score (54.1 vs 58.1) on the SF-12 questionnaire at the time of follow-up, indicating improved health and functional well being. There were no large noticeable differences in fat related dietary habits. Due to a small sample size, stated differences did not reach the threshold of statistical significance. Conclusions: Our pilot study suggests that a low intensity intervention is feasible and may be associated with improvement in health behaviors in cancer survivors. Larger studies are needed to explore the efficacy of this, and similar interventions.
A single-center survey of health-related quality of life among acute myeloid leukemia survivors in first complete remission.
Authors: Cheng Mok-Chung Jennifer , Smith B. Douglas , Hourigan Christopher Simon , Gojo Ivana , Pratz Keith William , Blackford Amanda , Smith Thomas J. 
Published: February 2017

223 Background: To better understand adult acute myeloid leukemia (AML) survivorship and health related quality of life, we piloted a survey exploring patient reported outcomes for patients in first complete remission (CR) to determine if patients feel the survey is relevant to their overall well-being. Methods: A cross-sectional survey measuring: quality of life, physical, role, emotional, cognitive, social functioning (EORTC QLQ-C30 v 3.0); physical, psychological, social, and spiritual well-being (Quality of Life-Cancer Survivor (QOL- CS) scale); fatigue (Functional Assessment of Chronic Illness Therapy – Fatigue Scale (FACIT-Fatigue)); anxiety and depression (Hospital Anxiety and Depression Scale (HADS)); sociodemographic and 5 open-ended questions. Results: 18 participants completed the survey; mean age was 57.2 years. Nine patients were in CR for <2 years, and 9 were in CR for ≥2 years. Participants scored well on the EORTC QLQ-C30 and reported symptoms ranging from 11% (constipation) to 83% (fatigue). The FACIT-Fatigue (worst 0-best 52) mean score was 28.7 and median score was 33.5 (normal ≥30). On the HADS anxiety scale, 2 participants scored in the abnormal range. One scored in the abnormal range on the depression scale. On the QOL-CS, participants scored above 6 out of 10 in all domains, with exceptions of the psychological subscales of distress and fear (Table 1). Most participants felt the survey was completely or mostly relevant (88.8%) in understanding their quality of life. Most felt the length was optimal (77.8%). Conclusions: Most survivors scored well on quality of life and well-being, but with ongoing fatigue, distress, and fear of future tests and recurrence. Few consistently scored worse on the scales. There may be a population coping less well and it would be informative for survivorship programs to prospectively characterize their medical and psychosocial-spiritual needs. [Table: see text]
Health-related quality of life in breast cancer patients prior to and 3 years following adjuvant radiotherapy: Comparison between conventional and short-course, image-guided radiotherapy.
Authors: Adriaenssens Nele , De Ridder Mark , Lamote Jan , Fontaine Christel , Van Parijs Hilde , Storme Guy , Versmessen Harijati , Miedema Geertje , De Greve Jacques , Vinh-Hung Vincent 
Published: February 2017

247 Background: Breast cancer is nowadays the most common cause of cancer death in the female population. A very commonly used treatment is radiotherapy (RT). Due to improvements of medical imaging and RT, a combination can be used resulting in image guided radiotherapy (TT). The aim of the present study is to investigate the difference in health related quality of life (HRQoL) of breast cancer patients before and 3 years after post-operative conventional radiotherapy (CRT) and TT. Methods: 120 participating patients were randomly allocated to either CRT or TT. The CRT group received 50Gy/25 fractions over a 5 week period (2Gy/fraction) and an additional boost of 16Gy in 8 fractions over 2 weeks. The TT group received 42 Gy in 15 fractions over 3 weeks (2.8 Gy/fraction) and simultaneously an integrated boost of 0,6Gy/fraction. HRQoL was evaluated using the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 and -BR23 (breast cancer module). Questionnaires were filled in before treatment (T0), right after finishing RT (T1) and at 3 months (T2), 1 year (T3), 2 years (T4) and 3 years (T5) follow up. Results: At T1 no statistically significant differences between the two treatment arms were found except global health status for which TT group scored worse than CRT. At T5, less severe constipation, diarrhoea, breast symptoms, upset by hair loss and more severe insomnia was found in TT compared to CRT, but the differences did not reach significance. Functional scales were comparable in treatment arms. Conclusions: Between the two treatment arms, no statistically significant differences were found at T5 but clinically meaningful differences in symptom scales favoured TT. Our study confirms the preliminary results of Versmessen et al. (BMC Cancer, 2012) in particular that a shorter more intensive fractionation schedule, using TT did not impair HRQoL in breast cancer patients. Clinical trial information: NCT00459628.
Advancing Survivors’ Knowledge (ASK) about skin cancer study: A randomized intervention within the Childhood Cancer Survivor Study (CCSS).
Authors: Keske Robyn , Armstrong Gregory T. , Davine Jessica , Gibson Todd M. , Mertens Ann , McDonald Aaron , Marghoob Ashfaq A. , Daniel Casey , Geller Alan 
Published: February 2017

255 Background: Adult survivors of childhood cancer who received radiation therapy have high rates of basal cell carcinoma and melanoma compared with the general population. Both the National Cancer Institute and Children’s Oncology Group Guidelines recommend regular skin self-checks and annual clinical skin exams for survivors. The ongoing ASK randomized intervention trial aims to identify strategies, including use of mobile health technology, which may improve early detection practices. Methods: Participants previously treated with radiation and had no previous history of skin cancer were identified, and eligible participants are currently being enrolled. 800 participants are being randomized into: (1) patient activation and education (PAE) including targeted print and web-based materials and monthly text messages prompting skin checks and driving participants to the ASK website; (2) PAE + physician activation (PAE + MD) adding targeted physician activation/educational materials about survivors’ increased skin cancer risk and recommendations for conducting full-body skin examinations; (3) PAE + MD + teledermoscopy (PAE + MD +TD). The TD group receives a dermatoscope that attaches to their smartphone to photograph suspect moles for review by the study dermatologist. Results: To date, 1,302 survivors are eligible. In the first five months of recruitment, 80% of the initial 400 eligible participants have responded to the study invitation and 248 participants (62%) have enrolled. Twenty-six percent of participants have visited the website and 12 images of suspicious moles have been submitted for review. Completion of recruitment is anticipated by spring 2016. Conclusions: The ASK study addresses screening barriers by providing educational and motivational information for both survivors and physicians on the value of regular and thorough skin examinations. It also determines whether use of innovative mobile health technology activates survivors to conduct skin self-examinations, request physician examinations, and obtain treatment when worrisome lesions are found. Clinical trial information: NCT 02046811.
Survivors preferences about the role of the oncologist and primary care provider.
Authors: Tralongo Paolo , Giuliano Sebastiano Rametta , Di Mari Anna Maria , Bordonaro Sebastiano , Romano Fabrizio , Pumo Vitalinda , Iacono Margherita , Lanteri Eleonora , Tralongo Antonino Carmelo , Roccaro Sebastiana , Iemmolo Sebastiana 
Published: February 2017

259 Background: Oncologist and Primary Care Provider are both involved in cancer patients follow-up. Patient's preference is an important issue. Aims This observational study was made to investigate: a) if and how long after the diagnosis the patient prefers to be followed by PCPs, Oncologist or both; b) if they prefer to be followed in the same institute where they received acute phase care; c) if it's important to receive recommendations about their lifestyle. Methods: 150 patients were recruited between May and June 2015 in the transient phase. They were affected by different tumors (breast, colon, prostate, melanoma, gynecological cancers and lymphoma disease) 53 pts under 3 years, 38 pts 5 years, 59 pts 7 years since the diagnosis. A questionnaire investigating the aims of the study was administered. Results: Among the pts on 3 years follow-up, only one preferred to be followed by the PCPs for logistical reasons; 24/53 patients after 5 years follow-up preferred PCPs and 18/53 preferred to be followed only by the oncologist because of more competence. In the 5 and 7 years follow-up 80/97 pts preferred to be exclusively followed by the oncologist for these reasons: A) poor PCPs involvement during the acute phase. B) oncologist expertise in acute phase, follow-up and possible relapse; c) lack of interest shown by the PCPs for survivorship care plan. All pts (150) gave positive response on receiving advices about their lifestyle (diet, sport activities, etc...). For 63% of the patients a unique structure would be suitable for receiving follow-up too. Conclusions: The preferences of patients, followed in the transient phase, suggest that fear of relapse guides patient's choice and the relationship with the oncologist offers security.