Health behaviours and cancer prevention among Polish women

?LUSARSKA B., ZARZYCKA D., WYSOKI?SKI M., SADURSKA A., ADAMSKA‐KU?MICKA I. & CZEKIRDA M. (2010) European Journal of Cancer Care 19 , 786–794
Health behaviours and cancer prevention among Polish women The problem of early prophylaxis of cancer is especially important, mainly due to the results of epidemiological studies, which show high death rates due to cancer among Polish women. The objective of the study was the recognition of health behaviours with respect to cancer prophylaxis reported by the women examined, as well as the determination of the range of expectations concerning health education in the area analysed. The study was conducted in the form of a diagnostic survey and covered 242 female inhabitants of the city of Lublin situated in the Central–Eastern Region of Poland, aged 40–65. The results of the study showed that the respondents most often evaluated their health as generally ‘good’ or ‘mediocre’. Approximately 20% of women in the study had a family history of cancer. The women examined performed self‐examination of the breast less frequently than they visited a gynaecologist for a health check‐up, cytological tests and mammography. Only a small group of women had densimetric examinations performed. More than a half of the respondents mentioned that they eagerly read educational materials concerning health, and acquired information which contributed to the development of health promoting attitudes.     

Individual and dyadic predictors of body image in women with breast cancer

Objective: Previous studies examining the body image among breast cancer (BC) patients have primarily focused on their psychosocial adjustment or on the predictive value of body image on quality of life. Little is known about predictors of body image. Methods: The present study investigated how much body image in women with BC is determined by individual factors (surgery type, medical treatments, disease stage, women's age, depressive symptoms) and by dyadic variables (relationship satisfaction and duration, dyadic coping). Furthermore, two different aspects of women's body image were assessed: self‐ acceptance and perceptions of partners' acceptance. Ninety‐eight German women with early stage BC and their partners participated. Results: Individual and dyadic aspects of body image were differentially related to body image. Women's depressive symptoms and men's marital satisfaction predicted women's self‐acceptance, but not women's perceptions of their partners' acceptance of their appearance. Female's relationship satisfaction and perspective on common dyadic coping predicted women's perceptions of their partner's acceptance of their appearance. Conclusions: The findings suggest interventions that include strategies to reduce women's depressive symptoms and build relationship satisfaction, might reduce body image difficulties in women after BC. © 2009 John Wiley & Sons, Ltd.     

Disparities in survival among women with invasive cervical cancer

BACKGROUND:

In this study, the authors sought to understand the effects of patient race, ethnicity, and socioeconomic status (SES) on outcomes for cervical cancer.

METHOD:

The Florida Cancer Data System and the Agency for Health Care Administration data sets (1998‐2003) were merged and queried. Survival outcomes for patients with invasive cervical cancer were compared between different races, ethnicities, and community poverty levels.

RESULTS:

In total, 5367 patients with cervical cancers were identified. The overall median survival was 43 months. Significantly longer survival was observed for Caucasians (47.1 months vs 28.8 months for African Americans [AA]; P < .001), Hispanics (52.8 months vs 41.6 months for non‐Hispanics; P < .001), the insured (63 months vs 41.2 months for uninsured; P < .001), and patients from more affluent communities (53.3 months where <5% lived in poverty vs 36.9 months where >15% lived in poverty; P < .001). Surgery was associated with dramatically improved survival. AA women who were diagnosed with cervical cancer were significantly less likely to undergo surgical treatment with curative intent compared with Caucasian women (P < .001). However, on multivariate analysis, independent predictors of poorer outcomes were insurance status, tumor stage, tumor grade, and treatment. Neither race, nor ethnicity, nor SES was an independent predictor of poorer outcome.

CONCLUSIONS:

Race, ethnic, and SES disparities in cervical cancer survival were explained by late‐stage presentation and under‐treatment. Earlier diagnosis and greater access to surgery and other treatments would significantly improve the survival of women with cervical cancer. Cancer 2009. © 2008 American Cancer Society.     

Predictors of timely follow‐up after abnormal cancer screening among women seeking care at urban community health centers

BACKGROUND:

We sought to measure time and identify predictors of timely follow‐up among a cohort of racially/ethnically diverse inner city women with breast and cervical cancer screening abnormalities.

METHODS:

Eligible women had an abnormality detected on a mammogram or Papanicolaou (Pap) test between January 2004 and December 2005 in 1 of 6 community health centers in Boston, Massachusetts. Retrospective chart review allowed us to measure time to diagnostic resolution. We used Cox proportional hazards models to develop predictive models for timely resolution (defined as definitive diagnostic services completed within 180 days from index abnormality).

RESULTS:

Among 523 women with mammography abnormalities and 474 women with Pap test abnormalities, >90% achieved diagnostic resolution within 12 months. Median time to resolution was longer for Pap test than for mammography abnormalities (85 vs 27 days). Site of care, rather than any sociodemographic characteristic of individuals, including race/ethnicity, was the only significant predictor of timely follow‐up for both mammogram and Pap test abnormalities.

CONCLUSIONS:

Site‐specific community‐based interventions may be the most effective interventions to reduce cancer health disparities when addressing the needs of underserved populations. Cancer 2010. © 2010 American Cancer Society.     

Intakes of folate,methionine, vitamin B6, and vitamin B12 with risk of esophageal and gastric cancer in a large cohort study

Background:

Nutrients in the one-carbon metabolism pathway may be involved in carcinogenesis. Few cohort studies have investigated the intakes of folate and related nutrients in relation to gastric and esophageal cancer.

Methods:

We prospectively examined the association between self-reported intakes of folate, methionine, vitamin B6, and vitamin B12 and gastric and esophageal cancer in 492 293 men and women.

Results:

We observed an elevated risk of esophageal squamous cell carcinoma with low intake of folate (relative risk (95% confidence interval): Q1 vs Q3, 1.91 (1.17, 3.10)), but no association with high intake. Folate intake was not associated with esophageal adenocarcinoma, gastric cardia adenocarcinoma, or non-cardia gastric adenocarcinoma. The intakes of methionine, vitamin B6, and vitamin B12 were not associated with esophageal and gastric cancer.

Conclusion:

Low intake of folate was associated with increased risk of esophageal squamous cell carcinoma.     

Was the drop in mammography rates in 2005 associated with the drop in hormone therapy use?

BACKGROUND:

In 2005, mammography rates in the United States dropped nationally for the first time among age‐eligible women. An increased risk of breast cancer related to hormone therapy (HT) use reported in 2002 led to a dramatic drop in its use by 2005. Because current users of HT also tend to have higher mammography rates, the authors examined whether concurrent drops in HT and mammography use were associated.

METHODS:

Multivariate logistic regression was used to test for an interaction between HT use and survey year, controlling for a range of measurable factors in data from the 2000 and 2005 National Health Interview Surveys (NHIS).

RESULTS:

Women ages 50 to 64 years were more likely to report a recent mammogram if they also reported more education, a usual source of care, private health insurance, any race except non‐Hispanic Asian, talking with an obstetrician/gynecologist or other physician in the past 12 months, or were currently taking HT. Women aged ≥65 years were more likely to report a recent mammogram if they also reported younger age (ages 65‐74 years), more education, a usual source of care, having Medicare Part B or other supplemental Medicare insurance, excellent health, any race except non‐Hispanic Asian, talking with an obstetrician/gynecologist or other physician in the past 12 months, or were currently taking HT.

CONCLUSIONS:

The change in HT use was associated with the drop in mammography use for women ages 50 to 64 years but not for women aged ≥65 years. NHIS data explained 70% to 80% of the change in mammography use. Cancer 2011;. © 2011 American Cancer Society.