scholarly journals Is Cancer History Related to Neurologic Specialty Care in Patients with Dementia?

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 610-611
Author(s):  
Mackenzie Fowler ◽  
Kristen Triebel ◽  
Gabrielle Rocque ◽  
Ryan Irvin ◽  
Richard Kennedy ◽  
...  

Abstract Background The incidence and prevalence of aging-related diseases such as dementia and cancer are increasing, as are cancer survival rates. Cancer and its treatments have been associated with cognitive effects for those who later develop dementia. Guidelines have suggested that cancer patients return to follow-up in primary care following remission and be referred to specialists for cognitive complications, but it is unclear how well these guidelines are followed. Methods Electronic health record data at the University of Alabama at Birmingham were extracted from July 2003 May 2020. Rates of specialty care utilization on or after dementia diagnosis were compared by cancer history status in adults 50 years old or older at dementia diagnosis. Predictors of specialty care utilization were examined using logistic regression. Results Rate of specialty care utilization was lower for those with cancer history compared to those without on the date of dementia diagnosis (11.3% vs. 17.1%) and after diagnosis (13.5% vs. 19.2%). Older age at dementia diagnosis, non-Hispanic Black race, anticholinergic burden, socioeconomic status, and vascular risk factors were associated with lower odds of specialty care utilization. Dementia medication use was associated with higher odds of specialty care utilization on and after dementia diagnosis. Conclusions Cancer survivors with a dementia diagnosis are less likely to utilize specialty care than those with no history of cancer. Several factors predicted specialty care utilization. Additional studies should assess potential barriers in referring cancer survivors to specialty care for cognitive impairment.

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Ahmed A Hassoon ◽  
Lawrence Appel ◽  
Hsin-Chieh Yeh

In 2017 161,000 new cases of prostate cancer diagnosed in the U.S. With improved survival from prostate cancer, cardiovascular disease has emerged as competing cause of morbidity and mortality. However, few studies have assessed CVD risk factors among prostate cancer survivors. We analyzed National Health and Nutrition Examination Survey (NHANES) from 1999-2014 to assess CVD risk factors, as defined by AHA/ACC, in adult men with and without a history of prostate cancer. A total of 602 men, age 50 years and older, with prostate cancer history and 8,226 men without cancer history were included in the analysis. Among men with prostate cancer history, the mean (SE) age at survey was 72.3(0.4); 41% of the survivors had their diagnoses less than 5 years ago, while 31% survived more than 10 years after diagnosis. Compared to men without cancer, prostate cancer survivors were older (mean age 72 (0.4) vs 62y (0.1)), but with similar education level ( p =0.41). For CVD risk factors, prostate cancer survivors were less likely to be current smokers (6.5% vs 20.3%), but more likely to have hypertension and on anti-hypertensive medication (95.6% vs 88.9%) with age-adjusted prevalence odds ratio of 1.53 ([95% CI, 1.2 - 1.9]; p =0.001) and 1.78 ([95% CI, 1.1 - 2.9]; p =0.024), respectively. There were no differences in lipids profiles between men with and without prostate cancer. In stratified analysis, non-Hispanic blacks’ survivors have almost two times the prevalence of hypertension compared to non-Hispanic blacks free of cancer, with age-adjusted prevalence odds ratio of 1.9 ([95% CI, 1.2 - 2.96]; p=0.005). In conclusion, CVD risk factors were prevalent in prostate cancer survivors. Improving cardiovascular health through lifestyle change and preventive strategies is a public health priority, particularly among non-Hispanic Blacks.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S649-S650
Author(s):  
Giancarlo Pasquini ◽  
Brent J Small ◽  
Jacqueline Mogle ◽  
Martin Sliwinski ◽  
Stacey B Scott

Abstract Breast cancer survivors may experience accelerated decline in cognitive functioning compared to same-aged peers with no cancer history (Small et al., 2015). Survivors may show important differences in mean-level performance or variability in cognitive functioning compared to those without a history of cancer (Yao et al., 2016). This study compared ambulatory cognitive functioning in a sample of breast cancer survivors and an age-matched community sample without a history of cancer (n_cancer=47, n_non-cancer=105, age range: 40-64 years, M=52.13 years). Participants completed three cognitive tasks measuring working memory, executive functioning, and processing speed up to five times per day for 14 days. Results indicated no mean-level differences in cognitive performance on the three tasks between cancer survivors and those without cancer history (p’s>.05). Unexpectedly, women without cancer history showed more variability than survivors on working memory but not on the other two tasks. Across both groups, those without a college education performed worse on executive functioning (B=-0.05, SE=0.03, p<.05) and working memory (B=0.94, SE=0.36, p<.05) compared to those that completed college. Additionally, older age was associated with slower processing speed (B=31.67, SE=7.44, p<.001). In sum, this study did not find mean-level group differences in cognitive functioning between cancer survivors and age-matched women without a history of cancer. Contrary to hypotheses, those without a history of cancer were more variable on working memory. Results suggested similarities in cognitive functioning in the two samples and that education and age are important predictors of cognitive functioning independent of cancer history.


1995 ◽  
Vol 26 (2) ◽  
pp. 12-16 ◽  
Author(s):  
John V. Conti

Job discrimination against persons with a history of cancer is common and is found at all skill levels and throughout all fields of employment. Irrational fears, lack of current information, and distortions in perception prevent counselors, and society in general, from viewing the work potential of persons with a cancer history objectively. Due to significant improvements in the treatment of some forms of cancer, there is a large new group of young cancer survivors in need of guidance and advocacy to enter or re-enter the job market. Legal protections are in place but largely unused by cancer survivors. Suggestions are offeredfor increasing individual and systemic advocacy for this population, and some recommendations for future effort are made.


2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18085-e18085
Author(s):  
Maryam Doroudi ◽  
Diarmuid Coughlan ◽  
Matthew P. Banegas ◽  
K Robin Yabroff

e18085 Background: Financial hardships experienced by cancer survivors in the United States have become significant social and public health issues. Few studies have assessed the underlying financial holdings, including ownership and values of assets and debts, of individuals following a cancer diagnosis. This study assessed the association between a cancer history and asset ownership, debt, and net worth. Methods: We identified 1,603 cancer survivors and 34,915 individuals without a history of cancer aged 18-64 from the nationally representative Medical Expenditure Panel Survey (MEPS) Household Component and Asset sections (years 2008-2011). Descriptive statistics were used to assess demographic characteristics, cancer history, asset ownership, debt, and net worth by cancer history. Regression analysis was conducted to assess the association between cancer history and net worth, stratified by age group (18-34, 35-44, 45-54, and 55-64 years) to reflect stages of the life-course. Results: Asset ownership was least common for cancer survivors and individuals without a cancer history in the 18-34 age group and most common in the 55-64 age group. Cancers survivors aged 45-54 had a lower proportion of home ownership than individuals without a cancer history (59% vs 67%; p = 0.001). Nearly 20% of all respondents reported at least some debt. The proportion of cancer survivors with debt was higher than individuals without a history of cancer, especially in the 18-34 age group (41% vs 27%; p < 0.001), although it did not vary by age group. When asset and debt values were combined to assess net worth, cancer survivors aged 45-54 were significantly more likely to have a negative net worth and significantly less likely to have a positive net worth than those individuals without a history of cancer in fully adjusted models. Findings on net worth were similar in the 18-34 age group, although only statistically significant in unadjusted and partially adjusted models. Conclusions: We found that cancer history is associated with asset ownership, debt, and net worth, especially in those aged 45-54 years. Longitudinal studies to assess patterns of financial holdings throughout the cancer experience are warranted.


2015 ◽  
Vol 12 (5) ◽  
pp. 675-679 ◽  
Author(s):  
Allison Ottenbacher ◽  
Mandi Yu ◽  
Richard P. Moser ◽  
Siobhan M. Phillips ◽  
Catherine Alfano ◽  
...  

Background:Evidence is building that strength training may reduce complications associated with cancer such as fatigue, muscle wasting, and lymphedema, particularly among breast and prostate cancer survivors. Population estimates are available for rates of aerobic physical activity; however, data on strength training in this population are limited. The objective of this study was to identify rates of meeting public health recommendations for strength training and aerobic activity among cancer survivors and individuals with no cancer history.Methods:Data from the Health Information National Trends Survey (HINTS), Iteration 4 Cycle 1 and Cycle 2 were combined to conduct the analyses. Missing data were imputed, and weighted statistical analyses were conducted in SAS.Results:The proportion of individuals meeting both strength training and aerobic guidelines were low for both cancer survivors and those without a history of cancer. The odds of meeting strength training guidelines were significantly lower for women with a history of any cancer except breast, compared with women with no history of cancer (OR: 0.70, 95% CI: 0.51−0.96).Conclusions:More work needs to be done to understand why women with cancers other than breast, may be less inclined to engage in aerobic physical activity and strength training.


2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 9009-9009 ◽  
Author(s):  
Lisa Sprod ◽  
Supriya Gupta Mohile ◽  
Lin Fan ◽  
Michelle Christine Janelsins ◽  
Luke Joseph Peppone ◽  
...  

9009 Background: Functional limitations (FL) increase with age, as does cancer incidence. Treatments for cancer may exacerbate age-related FL. Physical activity (PA) reduces the risk of recurrence of some cancers and may improve survival. FL may reduce PA participation in geriatric cancer survivors (>65 yrs.) which could increase the risk of recurrence and reduce survival. This investigation describes and compares patterns of PA and FL in geriatric cancer survivors versus those without a cancer history. Methods: Using a national sample of community-dwelling elders (> 65 yrs.) from the 2003 Medicare Current Beneficiary Survey (N=14,887), we characterized the differences between cancer survivors and those without a cancer history in FL, current amount of PA, and current amount of PA compared to PA one year prior. Respondents rated FL on a 1-5 scale (1=no difficulty, 5=can’t do): stooping, crouching, or kneeling (stoop), carrying objects up to 10 lbs (lift), extending arms above shoulder level (reach), grasping small objects (grasp), and walking ¼ of a mile (walk). Frequency of walking for a least 10 minutes (1-5 rating scale; 1=daily, 5=never), weekly participation in PA, exercise, or sports (yes/no), and time spent doing moderate or vigorous PA (hrs/wk) were reported. Multivariate logistic regression was used to determine associations. Results: Of the 14,887 participants, 2,603 (6%) reported a history of cancer. Compared to those without a cancer history, a greater proportion of cancer survivors reported having difficulty or being unable to stoop, lift, reach, grasp or walk (all p<0.01). Cancer survivors who had more FL were less likely to engage in PA (all p<0.01). Cancer survivors reported a lower frequency of walking at least 10 minutes at a time (p<0.01). Cancer survivors were more likely to decrease PA from the previous year (p<0.01) and spent less time doing moderate (p=0.01) or vigorous activity (p<0.01) than those without a cancer history. Conclusions: Older cancer survivors engage in less PA and are at greater risk of FL than those without a history of cancer. This may lead to reduced independence, a greater risk of cancer recurrence, and reduced survival. Therefore, PA interventions are important in this population.


2009 ◽  
Vol 27 (6) ◽  
pp. 904-910 ◽  
Author(s):  
Apostolia-Maria Tsimberidou ◽  
Sijin Wen ◽  
Peter McLaughlin ◽  
Susan O'Brien ◽  
William G. Wierda ◽  
...  

Purpose Other malignancies have been reported to occur with increased frequency in chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL). The aim of this study was to determine the frequency, outcomes, and factors associated with other cancers in patients with CLL/SLL. Patients and Methods We reviewed the records of consecutive patients with previously untreated CLL/SLL seen at The University of Texas M. D. Anderson Cancer Center from 1985 to 2005. The number of second cancers observed was compared with the number expected from the Surveillance, Epidemiology, and End Results database. Results Among 2,028 patients, 324 (16%) had a history of other cancers and 227 (11.2%) developed other malignancies during the follow-up period. Overall, 625 cancers were observed in 551 patients, including skin (30%), prostate (13%), breast (9%), melanoma (8%), lymphoma (8%), gastrointestinal (9%), lung (6%), and other cancers (17%). The risk of a second cancer was 2.2 times higher than the expected risk. The response rates in patients with and without a history of other cancers were 86% and 92%, respectively (P = .04), and the 5-year survival rates were 70% and 82%, respectively (P < .001). In Cox analysis, independent factors predicting development of new cancers were older age, male sex, and elevated levels of β2-microglobulin, lactate dehydrogenase, and creatinine. In patients who were treated for CLL/SLL, the treatment regimen did not affect the risk of subsequent cancer (P = .49). Conclusion Patients with CLL/SLL have more than twice the risk of developing a second cancer and an increased frequency of certain cancer types. Awareness of risk factors could permit early detection.


2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 121-121
Author(s):  
Changchuan Jiang ◽  
Lei Deng ◽  
Qian Wang ◽  
Stuthi Perimbeti ◽  
Xuesong Han

121 Background: Lack of transportation delayed medical care for approximately 6 million Americans in 2017. Prior studies showed cancer survivors tend to have more healthcare service use, higher medical cost, and adverse clinical outcomes. It is important to understand the prevalence of, risk factors for, and long-term health consequences of transportation barrier to health care among cancer survivors. Methods: We identified cohorts of adult with history of cancer (n = 25,317) and adults without history of cancer (n = 422,797) from the 2000-2014 National Health Interview Survey (NHIS). Transportation barriers were measured as medical care delay due to lack of transportation in the past 12 months using a survey question. The prevalence of transportation barriers was estimated using multivariable logistic models. Risk of mortality estimated with weighted Cox’s proportional hazards models with age as the time scale, adjusting for sex, race/ethnicity, educational attainment, marital status, region, comorbidities, and survey year. All analyses accounted for complex survey design using SAS statistical software, version 9.4 (SAS Institute Inc.), and SAS callable SUDAAN 11.0.3. Results: After adjustment for sociodemographic factors and comorbidities, the prevalence of transportation barrier were significantly higher among cancer survivors than among respondents without cancer history (2.1% vs 1.6%, p = 0.001, adjusted odd ratio [OR], 1.22; 95% confidence interval (95CI): 1.10-1.35). Cancer survivors with transportation barrier were more likely to be younger, female, Hispanic or Asian/Pacific Islander, less educated, unmarried, public insurance beneficiary or uninsured, and with more comorbidities. Among all participants, cancer survivors with transportation barrier had the highest adjusted mortality risk (hazard ratio [HR]: 2.12, 95CI: 1.81-2.49); followed by cancer survivors without transportation barrier (HR: 1.53, 95CI: 1.42-1.65); and adults without a cancer history with transportation barrier (HR: 1.50; 95CI: 1.45-1.55) compared with adults with neither a cancer history nor transportation barrier. Conclusions: Transportation barriers to health care had a disproportionate impact on cancer survivors, especially those who are underserved, and who have more medical needs. Increased risk of mortality was observed among adults with and without a cancer history who delayed care due to lack of transportation. It highlights the need for efforts to mitigate transportation barriers to medical care during a time of rapid change in transportation and telehealth technology.


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