Patients’ willingness to defer resection of diminutive polyps: results of a multicenter survey

Endoscopy ◽  
2017 ◽  
Vol 50 (03) ◽  
pp. 221-229 ◽  
Author(s):  
Daniel von Renteln ◽  
Mickael Bouin ◽  
Alan Barkun ◽  
Audrey Weber ◽  
Douglas Robertson ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Cancer Risk ◽  
Patient Characteristics ◽  
Surveillance Colonoscopy ◽  
Factors Associated ◽  
Included Patient ◽  
Multicenter Survey ◽  
The Usa ◽  
History Of ◽  
Secondary Endpoints

Abstract Background and study aims Current colonoscopy practice requires removal of diminutive polyps. This is associated with costs, but the benefits to colorectal cancer (CRC) prevention remain unclear. The study aim was to understand patients’ willingness to defer resection of diminutive polyps and to examine the factors that influence patients’ decisions. Patients and methods Adults presenting for a colonoscopy were surveyed at three hospitals in the USA and Canada. Survey domains included: patient characteristics, risk perception, knowledge about CRC risk, willingness to defer polyp resection, and associated concerns. The primary endpoint was the proportion of patients who would be willing to participate in a clinical trial that deferred resection of diminutive polyps. Secondary endpoints included factors associated with willingness to defer diminutive polyp resection. Results 557 eligible individuals completed the survey (mean age 63; 61 % men), with 50 % of respondents being willing to participate in a randomized trial in which resection of diminutive polyps would be deferred until the next surveillance colonoscopy (95 % confidence interval [CI] 46 % – 55 %). Outside of a clinical trial, 57 % of participants would be agreeable to deferring resection of diminutive polyps (95 %CI 51 % – 63 %). Willingness to defer diminutive polyp resection was associated with higher education (P = 0.001), greater knowledge about cancer risk (P = 0.002), and a lower perception of cancer risk (all P < 0.001). Age, sex, income, a history of polyps, and a first-degree family member with CRC were not associated with willingness to defer diminutive polyp resection. Conclusions More than half of individuals undergoing a routine colonoscopy would be agreeable to deferring resection of diminutive polyps and participating in a trial to evaluate this approach.

scholarly journals Multivitamin supplement use and risk of invasive breast cancer

2009 ◽  
Vol 13 (10) ◽  
pp. 1540-1545 ◽  
Author(s):  
Johanna M Meulepas ◽  
Polly A Newcomb ◽  
Andrea N Burnett-Hartman ◽  
John M Hampton ◽  
Amy Trentham-Dietz
Keyword(s):  
Breast Cancer ◽  
Cancer Risk ◽  
Menopausal Status ◽  
Population Based ◽  
Supplement Use ◽  
Multivitamin Supplement ◽  
The Usa ◽  
History Of ◽  
Multivitamin Use ◽  
Hormone Use

AbstractObjectiveMultivitamin supplements are used by nearly half of middle-aged women in the USA. Despite this high prevalence of multivitamin use, little is known about the effects of multivitamins on health outcomes, including cancer risk. Our main objective was to determine the association between multivitamin use and the risk of breast cancer in women.DesignWe conducted a population-based case–control study among 2968 incident breast cancer cases (aged 20–69 years), diagnosed between 2004 and 2007, and 2982 control women from Wisconsin, USA. All participants completed a structured telephone interview which ascertained supplement use prior to diagnosis, demographics and risk factor information. Odds ratios and 95 % confidence intervals were calculated using multivariable logistic regression.ResultsCompared with never users of multivitamins, the OR for breast cancer was 1·02 (95 % CI 0·87, 1·19) for current users and 0·99 (95 % CI 0·74, 1·33) for former users. Further, neither duration of use (for ≥10 years: OR = 1·13, 95 % CI 0·93, 1·38, P for trend = 0·25) nor frequency (>7 times/week: OR = 1·00, 95 % CI 0·77, 1·28, P for trend = 0·97) was related to risk in current users. Stratification by menopausal status, family history of breast cancer, age, alcohol, tumour staging and postmenopausal hormone use did not significantly modify the association between multivitamin use and breast cancer.ConclusionsThe current study found no association between multivitamin supplement use and breast cancer risk in women.

scholarly journals Behavioural Risk Factors Associated With Prostate Cancer: The Prostate Cancer Transatlantic Consortium (CaPTC) Cohort Study

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 5s-5s
Author(s):  
C.A. Oladoyinbo ◽  
O.O. Akinbule ◽  
A.A. Sobo ◽  
O.O. Bolajoko ◽  
I.E. Bassey ◽  
...  
Keyword(s):  
Physical Activity ◽  
Prostate Cancer ◽  
Risk Factors ◽  
Alcohol Consumption ◽  
West African ◽  
Activity Level ◽  
Factors Associated ◽  
The Usa ◽  
History Of ◽  
The Mean

Background: Studies have linked genetic susceptibility to prostate cancer (CaP) to African heritage and familial disease. Also, lifestyle factors, general and central obesity have been identified as risk factors for CaP. Aim: To assess the behavioral risk factors associated with CaP among West-African men and US West African immigrants. Methods: The cross-sectional study was conducted among 480 respondents recruited from Nigeria, Cameroon and the United States. The CaPTC Familial Project study instrument was used to collect data on the background information of respondents, country specific residence information, physical activity level, smoking and alcohol consumption pattern, family and personal history of cancer and other types of cancers and knowledge of CaP. Anthropometric measurements were taken. Data were analyzed using SPSS version 20. Results: Majority (85.6%) were recruited from Nigeria, 5.5% from Cameroon and 8.9% from the USA and the mean age is 48.2±9.9. About three quarters (74.4%) have been married only once while 10.8% have been married for about 2-5 times. Few (3.3%) of the respondent's wives had cancer and 0.2% had cervical cancer. Less than 1% of respondent's daughters had cancer, 4.6% of their uncles had cancer. Among the respondent's full brothers and sisters, 0.4% had cancer and 1.5% of their birth mothers had cancer. Also a few (2.3%) of respondent's fathers had cancer and 11.9% of their paternal grandparents had one type of cancer. About 17.2% of respondents have been diagnosed of a prostate condition and 5.9% were diagnosed of CaP with 47.1% of those with CaP are from Nigeria, 49.6% from the USA and 3.3% from Cameroon. One-quarter (25.6%) have smoked at least once in their lifetime, 2.5% smoke daily and the mean age at which smoking commenced is 26.6±19.4. More than half (55.4%) had consumed alcohol at least once in their lifetime and the mean age at which alcohol consumption started is 9.9±11.9. Only 9.8% had adequate knowledge about CaP and 61.0% poor knowledge. About a quarter (25.5%) were obese with 3.3% being morbidly obese. One-third (32.3%) are involved in moderate physical activity and 17.9% in rigorous physical activity. No significant difference ( P = 0.492) was observed in the physical activity level from the different locations. However, a significant relationship was observed between alcohol consumption, smoking, body mass index and country of residence ( P = 0.001, 0.035 and 0.001 respectively). Cigarette smoking and alcohol consumption (frequency and quantity) was significantly higher among respondents from the USA. Obesity was also significantly higher among the respondents from Nigeria and the USA. Although not statistically significant, family history of cancer was more among respondents from Nigeria and the USA. Conclusion: Obesity, smoking, alcohol consumption seems to be a common practice among respondents from Nigeria and USA.

scholarly journals 118 Demographics and Real World Healthcare Cost and Utilization for Patients With Probable Tardive Dyskinesia

CNS Spectrums ◽  
2018 ◽  
Vol 23 (1) ◽  
pp. 75-75
Author(s):  
Michael Polson ◽  
Chuck Yonan ◽  
Ted Williams
Keyword(s):  
Tardive Dyskinesia ◽  
Claims Data ◽  
Prolonged Exposure ◽  
Patient Characteristics ◽  
Major Depressive ◽  
Included Patient ◽  
Comorbidity Burden ◽  
History Of ◽  
Study Population ◽  
Funding Acknowledgements

AbstractBackgroundTardive dyskinesia (TD) is a movement disorder associated with prolonged exposure to antipsychotics. The current study was designed to describe demographics and comorbidities for patients with a dyskinesia diagnosis as probable TD (cohort 1), patients likely to have undiagnosed/uncoded TD (cohort 2), and a control population.MethodsThis retrospective study analyzed Medicaid claims data from July 2013-March 2017. For a pool of patients with a history of 3 months or more of taking an antipsychotic, three cohorts were evaluated: cohort 1 (ICD-9/10 codes for dyskinesia); cohort 2 (propensity score matching to cohort 1); and cohort 3 (patients withschizophrenia, major depressive disorder [MDD], and/or bipolar disorder [BD] and history of ≤2 antipsychotic medications). Outcomes included patient characteristics, Charlson Comorbity Index (CCI) and healthcare utilization (pre-and post [12-month] period).ResultsCohort sizes and characteristics were: cohort 1 (n=1,887; female, 68%; mean age, 42 years; MDD, 17%; BD, 48%); cohort 2 (n=1,572; female, 58%; mean age, 39 years; MDD, 22%; BD, 48%); cohort 3 (n=25,949; female, 67%; mean age, 40 years; MDD, 11%; BD, 49%). Cohorts 1 and 2 had higher comorbidity burden than cohort 3 (mean pre-index CCIs: 0.68, 0.79, and 0.47, respectively; p<0.001 for each cohort). After 12 months, mean per member per year healthcare costs were higher in cohort 1 and2 compared to cohort 3 ($21,293, $18,988, and $11,522, respectively), as were mean claims per member per year (185, 138, and 109, respectively).ConclusionIn the study population, patients likely suffering from TD, ICD-9/10 code-confirmed or unconfirmed, have a higher overall comorbidity burden and healthcareutilization than those who probably do not have TD.Funding AcknowledgementsThis study was funded by Neurocrine Biosciences, Inc.

Factors associated with hematuric struvite crystalluria in cats

2018 ◽  
Vol 21 (10) ◽  
pp. 922-930
Author(s):  
Chika C Okafor ◽  
David L Pearl ◽  
Shauna L Blois ◽  
Sandra L Lefebvre ◽  
Mingyin Yang ◽  
...  
Keyword(s):  
Clinical Importance ◽  
Urine Ph ◽  
Factors Associated ◽  
The Usa ◽  
History Of ◽  
Dry Diet ◽  
First Time ◽  
Time Diagnosis ◽  
General Care

Objectives The aim of the study was to identify any dietary, signalment, geographic and clinical factors associated with hematuric struvite crystalluria (HSC) in a population of cats that visit general care veterinary hospitals in the USA. Methods In total, 4032 cats that had a first-time diagnosis of HSC and 8064 control cats with no history of hematuria or crystalluria were identified from medical records of all cats examined between 2007 and 2011 at 790 US veterinary hospitals. Extracted variables included age, sex, neuter status, breed, diet, urinalysis results and history of cystitis. Potential associations between these variables and HSC were estimated. Results Controlling for other factors, young cats fed a dry diet had an increased likelihood of HSC relative to young cats fed a non-dry diet. However, as age increased, the likelihood of HSC declined for cats fed a dry diet and increased for cats fed a non-dry diet. Moreover, the odds of HSC were significantly greater when cats were unneutered (vs neutered; odds ratio [OR] 45.52) or had a thin (vs heavy) body condition (OR 23.81), diagnosis of cystitis (OR 2.84), urine protein concentration >30 mg/dl (OR 4.72), alkaline (vs neutral) urine pH (OR 3.34), pyuria (OR 23.67) or bacteriuria (OR 2.24). Conclusions and relevance The present study provides estimates of the strengths of association between HSC and certain signalment and clinical characteristics of cats. This information could help clinicians to perform a more directed screening for struvite crystalluria in certain cat populations. Follow-up studies that build on the findings of this study could explore the clinical importance of HSC in cats.

scholarly journals Factors influencing participation and long-term commitment to self-monitoring of blood pressure in a large remote clinical trial: The treatment in morning versus evening (TIME) study

2021 ◽  
Author(s):  
Keeran Vickneson ◽  
Amy Rogers ◽  
Thineskrishna Anbarasan ◽  
David A. Rorie ◽  
Thomas M. MacDonald ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Clinical Trial ◽  
Positive Family History ◽  
Active Participation ◽  
Time Study ◽  
Antihypertensive Medications ◽  
Factors Associated ◽  
History Of ◽  
Family History Of Hypertension

AbstractThis study investigates factors associated with active participation, and long-term commitment, to home blood pressure monitoring (HBPM) in the TIME study, a remote clinical trial assessing the effectiveness of morning vs. evening dosing of antihypertensive medications on cardiovascular outcomes in adults with hypertension. Participants reporting HBPM ownership were invited to submit blood pressure (BP) measurements three-monthly. Factors associated with active participation (submitting at least one set of BP measurements), and longer-term commitment (at least six sets of BP measurements), were analysed using multivariable logistic regression. 11,059 participants agreed to provide BP measurements, of whom 7646 submitted. Active participation was associated with age (adjusted odds ratio (AOR) per decade, 1.29; 95% CI 1.23–1.36), positive family history of hypertension (AOR 1.11; 95% CI 1.01–1.21), number of antihypertensive medications (AOR, 1.10; 95% CI 1.04–1.16), and lower deprivation (AOR per decile, 1.03; 95% CI 1.01–1.05). People with higher body mass index (BMI) and smokers were less likely to participate (AOR, 0.91 (per increase of 5.0 kg/m2) and 0.63 respectively; all p < 0.001). 3,655 participants (47.8%) submitted measurements beyond one year. Non-modifiable risk factors – age (AOR per decade, 1.29; 95% CI 1.21–1.37) and positive family history of hypertension (AOR, 1.15; 95% CI 1.03–1.27) – were positively associated with longer-term commitment. Higher BMI (AOR per 5.0 kg/m2, 0.89; 95% CI 0.85–0.93), smoking (AOR 0.60, 95% CI 0.44–0.82) and higher baseline systolic blood pressure (AOR per mmHg, 0.99; 95% CI 0.98–0.99) were negatively associated. This study provides insight into factors that influence HBPM use.

scholarly journals Trends and Efficacy of Interferon-Free Anti–hepatitis C Virus Therapy in the Region of High Prevalence of Elderly Patients, Cirrhosis, and Hepatocellular Carcinoma: A Real-World, Nationwide, Multicenter Study of 10 688 Patients in Japan

2019 ◽  
Vol 6 (5) ◽  
Author(s):  
Hidenori Toyoda ◽  
Masanori Atsukawa ◽  
Haruki Uojima ◽  
Akito Nozaki ◽  
Hideyuki Tamai ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatitis C ◽  
Real World ◽  
Odds Ratio ◽  
Patient Characteristics ◽  
Exact Matching ◽  
Factors Associated ◽  
High Prevalence ◽  
History Of ◽  
Over Time

Abstract Background We investigated changes in patient characteristics, rate of sustained virologic response (SVR), and factors associated with SVR after anti-hepatitis C virus (HCV) therapy with direct-acting antiviral (DAA) regimens in real-world practice in Japan, where patients with HCV are characterized by older age and high prevalence of cirrhosis and hepatocellular carcinoma (HCC). Methods Changes in patient characteristics and SVR rates were evaluated from medical records among 10 688 patients who started interferon (IFN)-free DAA therapy between September 2014 and June 2018 in a nationwide, multicenter study. Factors associated with failure of SVR were analyzed. In particular, effects of cirrhosis or history of HCC on SVR were assessed by exact matching. Results Patient age was becoming younger and baseline liver fibrosis was becoming milder over time. Overall SVR rate was 95.4%. The SVR rates increased over time in patients without a history of IFN-free DAA therapy. Multivariate analysis revealed that cirrhosis was unfavorably associated with achievement of SVR in both patients with genotype 1 (odds ratio, 1.68; 95% confidence interval [CI], 1.27–2.21) and genotype 2 (odds ratio, 1.69; 95% CI, 1.01–2.78). Comparisons after exact matching showed that the SVR rate was significantly lower in patients with cirrhosis than without it, whereas patients with and without a history of HCC had similar SVR rates. Conclusions Background characteristics of patients who undergo IFN-free DAA therapy are changing in Japan. Patients without a history of IFN-free DAA therapy have high SVR rates. Exact matching confirmed that cirrhosis significantly influences the achievement of SVR in real-world settings.

Experiences of cancer patients with outpatient care in the USA: a population-based study

2020 ◽  
Vol 9 (13) ◽  
pp. 959-967
Author(s):  
Omar Abdel-Rahman
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Cancer Patients ◽  
Outpatient Care ◽  
Healthcare Providers ◽  
Multivariable Logistic Regression Analysis ◽  
Factors Associated ◽  
The Usa ◽  
History Of ◽  
History Of Cancer

Aim: To evaluate the patterns of cancer patients-assessed quality of outpatient care in the USA. Materials & methods: Medical Expenditure Panel Survey datasets for the years 2011, 2013, 2015 and 2017 were accessed and adult participants with a history of cancer diagnosis were reviewed. Participants’ assessments of different quality indicators of healthcare providers were reviewed. Multivariable logistic regression analysis for factors associated with a better overall rating of healthcare was then conducted. Results: A total of 8050 participants with a history of cancer were included. Within multivariable logistic regression analysis, factors associated with the better rating of healthcare included; older age (odds ratio [OR]: 1.017; 95% CI: 1.010–1.025), higher income OR (OR: 2.385; 95% CI: 1.735–3.277) and better self-reported health status (OR: 6.691; 95% CI: 3.928–11.396). Conclusion: Cancer patients with older age, higher income and better health status were more likely to be satisfied with the outpatient care they received. The biggest area for potential improvement of patient satisfaction seems to be related to the time spent with healthcare providers.

scholarly journals Risk Factors for Premenopausal Breast Cancer in Bangladesh

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Javaid Iqbal ◽  
Tahmina Ferdousy ◽  
Rahela Dipi ◽  
Reza Salim ◽  
Wei Wu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Premenopausal Women ◽  
Breast Cancer Diagnosis ◽  
Age At Menarche ◽  
Premenopausal Breast Cancer ◽  
Factors Associated ◽  
History Of

Background. The incidence of premenopausal breast cancer is rising throughout South Asia. Our objective was to determine the role of risk factors associated with Westernization for premenopausal breast cancer in Bangladesh.Methods. We conducted a matched case-control study between January 1, 2007, and December 31, 2010, at four hospitals in Bangladesh. Cases were premenopausal women diagnosed with invasive breast cancer. Controls were premenopausal women with no personal history of breast cancer. Logistic regression was used to calculate the odds ratios (OR) for breast cancer.Results. We identified 129 age-matched pairs. The mean age of breast cancer diagnosis was 37.5 years. Each year decrease in the age of menarche significantly increased the risk of breast cancer (OR = 1.67, 95% CI 1.09–2.56,P=0.02). The risk was also increased with a current body mass index of ≥25 kg/m2(OR = 5.24, 95% CI 1.10–24.9,P=0.04). Age at first childbirth, parity, and breastfeeding were not significantly associated with premenopausal breast cancer risk (P>0.05).Conclusions. Age at menarche and adult weight gain were associated with premenopausal breast cancer risk. Other factors associated with Westernization may not be relevant to premenopausal breast cancer risk in Bangladesh.

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