Predictors of retention in a cervical cancer survivorship study.

6132 Background: Women with cervical cancer experience numerous quality of life (QOL) disruptions. A completed pilot study indicated that QOL and key biomarkers could be improved with psychosocial telephone counseling (PTC). A confirmatory trial has recently completed accrual.The purpose of this study is to identify predictors of retention in this large biobehavioral trial, and examine retention differences between the pilot and confirmatory trial. Methods: Women with stage I – III cervical cancer diagnosed 9 – 30 months earlier were randomized to either PTC or usual care. PROs and biological specimens were collected prior to randomization (N=204), and 3 (T2) and 9 months post baseline. Sociodemographic, clinical and QOL variables were evaluated from baseline to T2 to identify predictors of study retention. Multiple measures, including the PROMIS Depression and Anxiety scales were entered into a multivariate stepwise logistic regression model to predict study retention. Results: In the multivariate model, being randomized to counseling (OR=4.4, 95% CI: 1.5-12.6), having clinically significant depression, defined as >1 SD above the 50th percentile (OR=4.2, 95% CI:1.7-10.5) and being single (OR=3.4, 95% CI: 1.3-9.2) were the most significant predictors of drop-out in the study overall. Among those in the counseling arm, depression is the strongest predictor of dropout, with a five times higher dropout rate (OR=5.2, 95% CI:1.9-15.6) than those with low to moderate levels of depression, or no depression. However, retention rates improved substantially overall from the pilot study (72%) to the confirmatory study (84%), in both study arms, and retention increased among Latinas from 60% in the pilot study to 83% in the current study, and from 52% to 81% among those with less than a high school education. Conclusions: Results from this analysis of predictors of retention indicate that enhanced attention to sociocultural disparities can improve study retention. Attending to baseline clinical depression may be a further consideration.

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Psychosocial Telephone Counseling for Survivors of Cervical Cancer: Results of a Randomized Biobehavioral Trial

Journal of Clinical Oncology ◽

10.1200/jco.2014.57.4079 ◽

2015 ◽

Vol 33 (10) ◽

pp. 1171-1179 ◽

Cited By ~ 19

Author(s):

Lari Wenzel ◽

Kathryn Osann ◽

Susie Hsieh ◽

Jo A. Tucker ◽

Bradley J. Monk ◽

...

Keyword(s):

Cervical Cancer ◽

Repeated Measures ◽

Statistical Significance ◽

Multivariable Analysis ◽

Telephone Counseling ◽

Longitudinal Change ◽

Categorical Variables ◽

Patient Reported ◽

Cytokine Levels ◽

Cancer Experience

Purpose Survivors of cervical cancer experience quality-of-life (QOL) disruptions that persist years after treatment. This study examines the effect of a psychosocial telephone counseling (PTC) intervention on QOL domains and associations with biomarkers. Patients and Methods We conducted a randomized clinical trial in survivors of cervical cancer, who were ≥ 9 and less than 30 months from diagnosis (n = 204), to compare PTC to usual care (UC). PTC included five weekly sessions and a 1-month booster. Patient-reported outcomes (PROs) and biospecimens were collected at baseline and 4 and 9 months after enrollment. Changes in PROs over time and associations with longitudinal change in cytokines as categorical variables were analyzed using multivariable analysis of variance for repeated measures. Results Participant mean age was 43 years; 40% of women were Hispanic, and 51% were non-Hispanic white. Adjusting for age and baseline scores, participants receiving PTC had significantly improved depression and improved gynecologic and cancer-specific concerns at 4 months compared with UC participants (all P < .05); significant differences in gynecologic and cancer-specific concerns (P < .05) were sustained at 9 months. Longitudinal change in overall QOL and anxiety did not reach statistical significance. Participants with decreasing interleukin (IL) -4, IL-5, IL-10, and IL-13 had significantly greater improvement in QOL than those with increasing cytokine levels. Conclusion This trial confirms that PTC benefits mood and QOL cancer-specific and gynecologic concerns for a multiethnic underserved population of survivors of cancer. The improvement in PROs with decreases in T-helper type 2 and counter-regulatory cytokines supports a potential biobehavioral pathway relevant to cancer survivorship.

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Predictors of significant emotional distress in cervical cancer patients.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.6632 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. 6632-6632

Author(s):

Kathryn Osann ◽

Susie Hsieh ◽

Edward L. Nelson ◽

David Cella ◽

Lari B. Wenzel

Keyword(s):

Cervical Cancer ◽

Cancer Patients ◽

Emotional Distress ◽

Telephone Counseling ◽

Depression And Anxiety ◽

Logistic Regression Models ◽

Counseling Intervention ◽

Trial Outcome Index ◽

Significant Depression ◽

Outcome Index

6632 Background: Cervical cancer patients experience serious quality of life (QOL) disruptions, which may include persistent emotional distress. Predictors of persistent or significant depression and anxiety are examined in this study. Methods: A randomized trial tested the efficacy of a psychosocial telephone counseling intervention designed to improve QOL and decrease emotional distress.The FACT-Cx Trial Outcome Index (FACT-Cx-TOI), depression and anxiety (PROMIS short forms) were collected at baseline (T1), 4 months (T2) and 9 months (T3) post enrollment. Multivariate linear and logistic regression models were used to identify predictors of distress at follow-up. Tested predictors included demographic information, stage, treatment assignment, and baseline FACT-Cx TOI and PROMIS scores. Results: 115 women were randomized to PTC and 89 to usual care, with 82% compliance for T2 and 75% at T3. PTC patients experienced a significantly greater reduction in depression from T1 to T2 compared to UC (p=0.014). At baseline, 45% of participants reported depression T-scores above 55 (0.5 SD above the US general population average), and 26% reported levels greater than 60 (>1 SD worse than average). PTC patients were significantly less likely to have depression scores >55 at T2, and significantly more likely to improve by ≥5 points at T2 after adjusting for baseline and disease characteristics. Participation in PTC, higher baseline depression and higher baseline TOI were significant independent predictors of improvement in depression from T1 to T2. Conclusions: Early identification of patients with poor QOL and significant depression can inform supportive care interventions, with potential to improve health outcomes. Funding Source: NCI R01 CA118136-01. Clinical trial information: NCT00496106.

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Exposure to Arsenic and Environmental Tobacco Smoke in A Hospitalized Population Group Diagnosed with Cervical Cancer-Preliminary Results From A Pilot Study

International Journal of Scientific Research ◽

10.15373/22778179/march2014/147 ◽

2012 ◽

Vol 3 (3) ◽

pp. 71-73

Author(s):

Iulia Adina Neamtiu ◽

◽

Irina Dumitrascu ◽

Cristian Pop

Keyword(s):

Cervical Cancer ◽

Pilot Study ◽

Environmental Tobacco Smoke ◽

Tobacco Smoke ◽

Population Group ◽

Preliminary Results

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A Pilot Study of Quantitative Tumor Oxygen Measurements in Cervical Cancer

Case Medical Research ◽

10.31525/ct1-nct03970083 ◽

2019 ◽

Author(s):

Keyword(s):

Cervical Cancer ◽

Pilot Study ◽

Oxygen Measurements

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Plasma Exosomal miRNA Levels after Radiotherapy Are Associated with Early Progression and Metastasis of Cervical Cancer: A Pilot Study

Journal of Clinical Medicine ◽

10.3390/jcm10102110 ◽

2021 ◽

Vol 10 (10) ◽

pp. 2110

Author(s):

Oyeon Cho ◽

Do-Wan Kim ◽

Jae-Youn Cheong

Keyword(s):

Cervical Cancer ◽

Pilot Study ◽

Biological Functions ◽

Patients With Cancer ◽

Initial Stage ◽

Exosomal Mirnas ◽

Early Progression ◽

Before And After ◽

Microenvironmental Factors ◽

Exosomal Mirna

Plasma exosomal miRNAs are key regulators of cell-cell interactions associated with several biological functions in patients with cancer. This pilot study aimed to investigate the log2 fold change (log2FC) of the expression of exosomal miRNAs and related mRNAs in the blood of patients with cervical cancer to identify prognostic markers better than those currently available. We sequenced plasma exosomal RNA from 56 blood samples collected from 28 patients with cervical cancer, who had been treated with concurrent chemoradiotherapy (CCRT). Changes in the expression of miRNAs and mRNAs before and after CCRT were represented as log2FC. Their biological functions were studied by miRNA-mRNA network analysis, using ingenuity pathway analysis, after the selection of two groups of miRNAs, each associated with early progression (EP) and metastasis, also described as initial stage. Seven patients experienced EP, three of whom died within four months after progression. Reduced levels of miR-1228-5p, miR-33a-5p, miR-3200-3p, and miR-6815-5p and increased levels of miR-146a-3p in patients with EP revealed unresolved inflammation, with accompanying increased expression of PCK1 and decreased expression of FCGR1A. Increased levels of miR-605-5p, miR-6791-5p, miR-6780a-5p, and miR-6826-5p and decreased levels of miR-16-1-3p (or 15a-3p) were associated with the degree of metastasis and led to the systemic activation of myeloid, endothelial, and epithelial cells, as well as neurons, phagocytes, and platelets. Log2FCs in the expression of miRNAs and mRNAs from plasma exosomes after CCRT are associated with EP and metastasis, reflecting unresolved inflammation and systemic microenvironmental factors, respectively. However, this study, supported by preliminary data insufficient to reach clear conclusions, should be verified in larger prospective cohorts.

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Implementation of Remote Interventions in Older Adults: Lessons Learned During COVID-19 Isolation

Innovation in Aging ◽

10.1093/geroni/igaa057.3476 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 950-950

Author(s):

Jamie Rincker ◽

Jessica Wallis ◽

Angela Fruik ◽

Alyssa King ◽

Kenlyn Young ◽

...

Keyword(s):

Older Adults ◽

Weight Loss ◽

Nutrition Education ◽

Underserved Populations ◽

Smart Phone ◽

Dropout Rate ◽

Lessons Learned ◽

Drop Out ◽

Electronic Submission ◽

Weight Loss Interventions

Abstract Recommendations for older adults to socially isolate during the COVID-19 pandemic will have lasting impacts on body weight and physical activity. Due to the pandemic, two in-person RCT weight-loss interventions in obese older adults with prediabetes, Veterans Achieving Weight Loss and Optimizing Resilience-Using Protein (VALOR-UP, n=12) and the Egg-Supplemented Pre-Diabetes Intervention Trial (EGGSPDITE, n=7), were converted to remote formats and weekly nutrition (EGGSPDITE and VALOR-UP) and exercise (VALOR-UP only) classes were delivered using synchronous videoconference technology (Webex); classes were accessed via tablet/desktop/laptop or smart phone. Steps taken to transition participants to remote formats included technology training, implementation of staff tech-support, and delivery of nutrition education, tablets, scales, and exercise bands. The time to successfully transition participants was 1 week for early adopters (n=10) and up to 4 weeks for those with significant technology barriers (n=9); their difficulties included internet access, camera and microphone access and use, and electronic submission of weight and food records. Even with these challenges, in the first 3 months of remote delivery, participant dropout rate was low (10.5%, n=2), attendance was high (87.6% nutrition class (n=19); 76.4% exercise class (VALOR-UP, n=12)), and weight loss was successful (>2.5% loss (n=13); >5% loss (n=8)), showing that lifestyle interventions can be successfully adapted for remote delivery. Remote interventions also have potential for use in non-pandemic times to reach underserved populations who often have high drop-out rates due to caretaker roles, transportation limitations, and work schedules. These barriers were significantly reduced using a virtual intervention platform.

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Integration of Family Planning Counselling to Mass Screening Campaign for Cervical Cancer: Experience from Guinea

Obstetrics and Gynecology International ◽

10.1155/2018/3712948 ◽

2018 ◽

Vol 2018 ◽

pp. 1-6

Author(s):

D. W. A. Leno ◽

F. D. Diallo ◽

A. Delamou ◽

F. D. Komano ◽

M. Magassouba ◽

...

Keyword(s):

Cervical Cancer ◽

Family Planning ◽

Mass Screening ◽

Local Treatment ◽

Cost Effective ◽

Cross Sectional Study ◽

Cross Sectional ◽

Capital Cities ◽

Long Acting ◽

Cancer Experience

Aim. To assess feasibility of integrating family planning counselling into mass screening for cervical cancer in Guinea. Methodology. This was a descriptive cross-sectional study conducted over a month in Guinea regional capital cities. The targeted population comprised women aged 15 to 49 years. Nearly 4000 women were expected for the screening campaigns that utilized VIA and VIL methods with confirmation of positive tests through biopsy. A local treatment was immediately performed when the patient was eligible. Results. Overall 5673 women aged 15 to 60 years were received, a surplus of 42% of the expected population. 92.3% of women were aged 15–49 years and 90.1% were 25–49 years. Long-acting methods were the most utilized (89.2% of family planning users). 154 precancerous and cancerous lesions were screened, a global positivity rate of 2.7%. Conclusion. Integration of counselling and family planning services provision during cervical cancer mass screening is a feasible strategy. A cost-effective analysis of this approach would help a better planning of future campaigns and its replication in other contexts.

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