Cancer Information Scanning and Seeking in the General Population

The amount of cancer-related information available in the media and other sources continues to increase each year. We wondered how people make use of such content in making specific health decisions. We studied both the information they actively seek (“seeking”) and that which they encounter in a less purposive way (“scanning”) through a nationally representative survey of adults aged 40–70 years (n = 2,489) focused on information use around three prevention behaviors (dieting, fruit and vegetable consumption, and exercising) and three screening test behaviors (prostate-specific antigen, colonoscopy, mammogram). Overall, respondents reported a great deal of scanning and somewhat less seeking (on average 62% versus 28% for each behavior), and they used a range of sources including mass media, interpersonal conversations, and the Internet, alongside physicians. Seeking was predicted by female gender, age of 55–64 vs. 40–44, higher education, Black race and Hispanic ethnicity, and being married. Scanning was predicted by older age, female gender, and education. Respondents were fairly consistent in their place on a typology of scanning and seeking across behaviors. Seeking was associated with all six behaviors, and scanning was associated with three of six behaviors.     

Effects of Serum Triglycerides on Prostate Cancer and Breast Cancer Risk: A Meta-Analysis of Prospective Studies

Epidemiological studies show conflicting results regarding the link between serum triglyceride and the risk of prostate cancer and breast cancer. Therefore, we performed a meta-analysis of prospective studies to clarify this association. We searched PubMed, EMBASE, the Chinese Biomedical Database (CBM), and the China National Knowledge Infrastructure (CNKI) database to identify relevant prospective studies of the relationship between serum triglyceride and prostate cancer and breast cancer risk. Study-specific estimates adjusting for potential confounders were combined to evaluate a summary relative risks (RRs) and 95% confidence intervals (95% CIs) using a fixed- or random-effects model. A total of 11 prospective studies (619,410 subjects and 15,691 incident prostate cancer patients) and 8 prospective studies (590,878 subjects and 12,177 incident breast cancer patients) were respectively included in our meta-analysis to assess the associations of serum triglyceride with prostate cancer and breast cancer risk. The pooled adjusted RR estimates for prostate cancer and breast cancer for the highest versus the lowest exposure levels of serum triglycerides were 0.95 (95% CI: 0.87–1.04) and 0.94 (95% CI: 0.87–1.00), respectively. Additionally, a dose–response analysis revealed that serum levels of triglycerides were not associated with the risk of prostate cancer and breast cancer. We found that serum triglyceride was not related to the risk of prostate cancer and breast cancer.     

Dairy Products and Prostate Cancer Risk

Differences in the frequency of consumption of 30 selected foods and in the estimated intake of total calories and selected nutrients in relation to alcohol drinking, tobacco smoking, and education were described using information obtained from 1,774 controls of a case‐control study of digestive tract cancers conducted in northern Italy. Heavy alcohol consumption, tobacco smoking, and lower level of education were associated with a diet poorer in several aspects, including lower consumption of fresh fruit and green vegetables and higher intake of specific indicator foods, such as sausages and canned meat. For instance, the mean number of portions of fresh fruit per week was 10.5 among male nondrinkers vs. 9.0 among heavy drinkers, 10.4 among male nonsmokers vs. 8.1 among heavy smokers, and 8.8 in less educated individuals vs. 10.7 among those more educated. Consequently, intake of ß‐carotene, ascorbic acid, and calcium tended to be inversely related to alcohol and tobacco and directly related to education. Most associations were stronger in males, for whom alcohol consumption was also more common in less educated individuals. Calorie intake was directly related to alcohol consumption, largely reflecting calories provided by alcohol itself. However, alcohol drinking was also directly related to fat consumption. In both sexes, there was a strong positive correlation between cigarette smoking and coffee drinking. These results provide quantitative documentation that alcohol drinking, tobacco smoking, and education, three of the major determinants of cancer risks, were also correlates of dietary patterns and, hence, may exert an important confounding or modifying effect on the diet and cancer relationship.     

Cancer Talk on Twitter: Community Structure and Information Sources in Breast and Prostate Cancer Social Networks

This study suggests taking a social networks theoretical approach to predict and explain patterns of information exchange among Twitter prostate and breast cancer communities. The authors collected profiles and following relationship data about users who posted messages about either cancer over 1 composite week. Using social network analysis, the authors identified the main clusters of interconnected users and their most followed hubs (i.e., information sources sought). Findings suggest that users who populated the persistent-across-time core cancer communities created dense clusters, an indication of taking advantage of the technology to form relationships with one another in ways that traditional one-to-many communication technologies cannot support. The major information sources sought were very specific to the community health interest and were grassroots oriented (e.g., a blog about prostate cancer treatments). Accounts associated with health organizations and news media, despite their focus on health, did not play a role in these core health communities. Methodological and practical implications for researchers and health campaigners are discussed.     

Online Cancer Information Seeking: Applying and Extending the Comprehensive Model of Information Seeking

This study applied the comprehensive model of information seeking (CMIS) to online cancer information and extended the model by incorporating an exogenous variable: interest in online health information exchange with health providers. A nationally representative sample from the Health Information National Trends Survey 4 Cycle 4 was analyzed to examine the extended CMIS in predicting online cancer information seeking. Findings from a structural equation model supported most of the hypotheses derived from the CMIS, as well as the extension of the model related to interest in online health information exchange. In particular, socioeconomic status, beliefs, and interest in online health information exchange predicted utility. Utility, in turn, predicted online cancer information seeking, as did information-carrier characteristics. An unexpected but important finding from the study was the significant, direct relationship between cancer worry and online cancer information seeking. Theoretical and practical implications are discussed.     

Reaching Rural Women: Breast Cancer Prevention Information Seeking Behaviors and Interest in Internet, Cell Phone, and Text Use

The purpose of this study was to examine the breast cancer prevention information seeking behaviors among rural women, the prevalence of Internet, cell, and text use, and interest to receive breast cancer prevention information cell and text messages. While growing literature for breast cancer information sources supports the use of the Internet, little is known about breast cancer prevention information seeking behaviors among rural women and mobile technology. Using a cross-sectional study design, data were collected using a survey. McGuire’s Input–Ouput Model was used as the framework. Self-reported data were obtained from a convenience sample of 157 women with a mean age of 60 (SD = 12.12) at a rural New Mexico imaging center. Common interpersonal information sources were doctors, nurses, and friends and common channel information sources were television, magazines, and Internet. Overall, 87 % used cell phones, 20 % had an interest to receive cell phone breast cancer prevention messages, 47 % used text messaging, 36 % had an interest to receive text breast cancer prevention messages, and 37 % had an interest to receive mammogram reminder text messages. Bivariate analysis revealed significant differences between age, income, and race/ethnicity and use of cell phones or text messaging. There were no differences between age and receiving text messages or text mammogram reminders. Assessment of health information seeking behaviors is important for community health educators to target populations for program development. Future research may identify additional socio-cultural differences.     

Breast Cancer Internet Information

Abstract

Breast cancer is the most common cancer among women in North America and Europe. Every woman is at risk. The two most important risk factors are being female and getting older. The earlier breast cancer is found, the more likely it can be cured. This article describes Web sites that provide information about prevention, risk factors, diagnosis, treatment, and coping with breast cancer.     

Seeking Help for Erectile Dysfunction After Treatment for Prostate Cancer

Prostate cancer survivors appear to have higher rates of seeking medical help for erectile dysfunction (ED) than other cohorts of sexually dysfunctional men; however, factors associated with help-seeking for ED after prostate cancer have not been investigated. A group of 1,188 men with ED after prostate cancer responded to a postal survey about their sexuality, including a new questionnaire developed to measure traditional masculine attitudes about sex that could inhibit help-seeking. Respondents had a mean age of 68 years and were an average of 4.3 years postdiagnosis of cancer. At the time of the survey, 46% had sought medical help for ED since their cancer treatment and 44% intended to seek help in the next year. A hierarchical backward selection logistic regression analysis was performed to determine factors correlated with seeking help for ED after prostate cancer. Blocks of factors were entered in to the analysis in order. Factors significant within each step were retained when calculating a final model. Out of 37 factors entered into the model, three retained significance: Men who sought help for ED were more likely to have had a prostate cancer treatment designed to spare sexual function and reported higher distress about postcancer ED. Even with all other factors taken into account, men who had more positive attitudes on the Help-Seeking Questionnaire were significantly more likely to have sought help for ED. A second logistic regression analysis examined correlates of intent to seek help for ED within the next year. Out of 38 factors entered into the analysis, six retained significance in the final model: Men intending to seek help had been treated more recently for their prostate cancer, were more dissatisfied with their sexual function, had higher levels of distress about postcancer ED and loss of sexual desire, and were more likely to have sought help for ED even before their prostate cancer was diagnosed. Even with these factors taken into account, positive attitudes on the Help-Seeking Questionnaire were significantly associated with help-seeking intentions. These results suggest that cognitive-behavioral interventions designed to challenge men's negative beliefs about seeking help for ED could potentially increase help-seeking behavior.     

乳源县瑶族妇女乳腺癌危险因素的调查及高危人群的普查

目的调查乳源瑶族自治县瑶族妇女乳腺癌的危险因素。方法以2012年3月至2014年3月我院收集的1 504例乳源瑶族妇女作为研究对象,并以20³9岁,≥40岁作为年龄段分组,对两组研究对象采取问卷调查、乳腺临床检查、乳腺B超BI-RADS分级、乳腺钼靶BI-RADS分级等筛查方法。结果 2039岁,≥40岁作为年龄段分组,对两组研究对象采取问卷调查、乳腺临床检查、乳腺B超BI-RADS分级、乳腺钼靶BI-RADS分级等筛查方法。结果 20³9岁瑶族妇女乳腺B超筛查人数:742人;乳腺B超BIRADS分级:B0级3人,B1级648人,B2级63人,B3级28人,B4级0人,B5级0人,B6级0人;≥40岁瑶族妇女乳腺B超筛查人数:762人;乳腺B超BI-RADS分级:B0级0人,B1级637人,B2级102人,B3级15人,B4级8人,B5级0人,B6级0人。结论我县瑶族妇女基本上没有明显的乳腺癌高危因素,且通过乳腺临床检查、乳腺超声、乳腺钼靶进行乳腺癌普查可以提高乳腺癌的诊断率,降低假阴性率,对乳腺癌的筛查具有重要的指导意义。     

Living in the Context of Poverty and Trajectories of Breast Cancer Worry,Knowledge, and Perceived Risk after a Breast Cancer Risk Education Session

ObjectivesThe purpose of this paper was to demonstrate how living in neighborhoods with high levels of poverty (while controlling for personal income) impacts personal characteristics, which in turn impacts retention of breast cancer risk knowledge and changes in worry and perceived risk.MethodsThe data from this project come from a larger, National Cancer Institute-funded study that included a pretest, a breast cancer risk education session, a posttest, the option of an individualized risk assessment via the Gail Model and three follow-up phone calls over the next 9 months.ResultsThe percent of individuals living below poverty in the community in which the participant resided was predictive of the personal characteristics assessed, and these characteristics were predictive of changes in breast cancer worry and knowledge across time.ConclusionDifferentiation of self and monitoring, two of the individual characteristics that seem to allow people to process and use information to make “rational” decisions about health care, seem to be impacted by the necessity for adaptation to a culture of poverty. Thus, as a health care community, we need to tailor our messages and our recommendations with an understanding of the complex intersection of poverty and health care decision making.     

前列腺癌危险因素配比病例对照研究

为了解前列腺癌发病的影响因素对１３７例经组织病理学检查确诊的前列腺癌患者及其医院对照进行了１∶１配比调查，运用ＳＡＳ软件对资料进行统计学分析。单因素分析结果显示夫妻分居、肝病史、丧偶或离异、吸烟、饮酒、职业性毒物接触史是前列腺癌发病的危险因素；体力锻炼是一项保护性因素；多因素分析结果显示前列腺癌危险因素（比值比，９５％可信区间）有丧偶或离异（６．２９，２．０４—１９．３８）、肝病史（４．９０，１．３０—１８．４０）、夫妻分居（２．９１，１．３２—６．４１）；保护性因素有体力锻炼（０．３８，０．２０—０．７２）。     

重庆市人群肺癌、肝癌和乳腺癌危险因素研究

对９０９对病例对照的人户调查进行单因素和多因素分析。研究表明吸烟、空气污染、职业危害、肺部疾患既往史、不良心理等是肺癌的危险因素。而本次研究获得吸烟与肺癌死亡相对危险度的剂量效应关系;再次证明二者之间存在着因果关系。肝癌的危险因素有乙型肝炎病毒感染、饮水污染、家族史和社会心理因素先前也腺癌的危险因素则有乳腺良性病史、职业接触、结婚年龄等。     

Nutrient Pathways and Breast Cancer Risk: The Long Island Breast Cancer Study Project

The relative importance of biochemical pathways has not been previously examined when considering the influence of diet on breast cancer risk. To address this issue, we used interview data from a population-based sample of 1463 breast cancer cases and 1500 controls. Dietary intake was assessed shortly after diagnosis using a 101-item food frequency questionnaire. Age- and energy-adjusted odds ratios (ORs) for individual micro- and macronutrients were estimated with logistic regression. Hierarchical modeling was used to account for biologically plausible nutrient pathways (1-carbon metabolism, oxidative stress, glycemic control, and phytoestrogens). Effect estimates from hierarchical modeling were more precise and plausible compared to those from multivariable models. The strongest relationship observed was for the glycemic control pathway, but confidence intervals (CI) were wide [OR (95% CI): 0.86 (0.62, 1.21)]. Little or no effect was observed for the 1-carbon metabolism, oxidative stress, and phytoestrogen pathways. Associations were similar when stratified by supplement use. Our approach that emphasizes biochemical pathways, rather than individual nutrients, revealed that breast cancer risk may be more strongly associated with glycemic control factors than those from other pathways considered. Our study emphasizes the importance of accounting for multiple nutrient pathways when examining associations between dietary intake and breast cancer.     

Dietary Carbohydrate and Prostate Cancer Risk: A Meta-Analysis

Carbohydrate intake has been inconsistently associated with risk of prostate cancer. We review and quantitatively summarize the evidence from observational studies in a meta-analysis. We searched the PubMed database for observational studies related to the association of carbohydrate intake and prostate cancer risk up to December 25, 2013. Summary relative risks (RRs) were estimated by the use of a random effects model. We included 13 case-control studies with 4,367 cases and 6,205 controls, and 5 cohort studies with 3,679 cases and 74,115 participants in this meta-analysis. The summary RR of prostate cancer for the highest vs. the lowest carbohydrate intake was 1.06 [95% confidence interval (CI): 0.93–1.20, I² = 46.8%] for all included studies. In the subgroup analyses stratified by study design, the summary RRs for the highest vs. the lowest carbohydrate intake were 1.04 (95% CI: 0.87–1.23) for case-control studies and 1.06 (95% CI: 0.88–1.28) for cohort studies. For the 5 studies that reported results for advanced prostate cancer, the summary RR was 0.92 (95% CI: 0.71–1.20). This meta-analysis of observational studies indicates that there is no association between carbohydrate intake and prostate cancer risk. Further studies are needed to confirm our findings.     

PRISM: A Planned Risk Information Seeking Model

Exposure to celebrities through the media can have an important influence on the public's health-related attitudes, beliefs, and behavior. The announcement by Los Angeles Lakers' basketball star Magic Johnson that he tested positive for HIV infection was intended to promote HIVIAIDS prevention, particularly among adolescents and young adults. The present study analyzes how previous knowledge of Johnson acquired through the media affected the public's responses to his announcement and appeal for HIVIAIDS prevention. The study also assesses how emotional involvement with Johnson through parasocial interaction affected the public's perceptions of HIVIAIDS risk and high-risk behaviors. Results indicate that those who had a greater degree of emotional involvement with Johnson were more likely to show an increase in their personal concern about AIDS, concern about the risk of AIDS to heterosexuals, and intention to reduce high-risk sexual behaviors. In contrast, simply knowing about Johnson by watching him play basketball, hearing him speak, or reading about him had no measurable impact on the public's responses to his HIV disclosure. Implications of these findings suggest involvement with a celebrity through media exposure is an important mediating variable in persuasive communication, and celebrities can effectively endorse health-related messages.     

饮食与前列腺癌危险性关系的病例对照研究

目的：评价不同食物的食和频度或习惯与前列腺癌危险性的关系。方法：设计饮食频度问郑,采用以医院为基础的频数配比病例对照研究方法。对149例经组织病理学或细胞学检查确诊的前列腺癌患者及按频数配比要求选配的196例对照者的饮食情况进行调查,通过SAS（6．12）软件对资料进行分析,结果：单因素分析显示;主食大米、牛奶、猪肉、禽肉、动物肝、蛋类、青绿菜及豆类食品与前列腺癌有统计学关联（P＜0．05）;多因素逐步非条件Logistic回归分析结果显示,牛奶、猪肉、蛋类的食用习惯或频度与前列腺癌危险性增加有关（P＜0．05）;水果,青绿菜、豆类食品的食用频度则与前列腺癌危险性降低有关联（P＜0．05）;未发现鱼类、牛羊肉、喜食咸、喜食辛辣食物等食用频度或习惯与前列腺癌有关。结论：牛奶、猪肉及蛋类等富含脂肪类食物是中国居民前列腺癌重要的危险因素;水果、青绿菜及豆类食品则是重要的保护性因素。