Racial and Ethnic Variations in Knowledge and Attitudes about Genetic Testing

This study was designed to shed light on whether differences in utilization of genetic testing by African-Americans, Latinos, and non-Hispanic Whites are due primarily to different preferences, or whether they instead reflect other values and beliefs or differential access. It explores the values, attitudes, and beliefs of African-Americans, Latinos, and non-Hispanic Whites with respect to genetic testing by means of a telephone survey of representative samples of these three groups. The study finds clear evidence that Latinos and African-Americans are, if anything, more likely to express preferences for both prenatal and adult genetic testing than White respondents. At the same time, they hold other beliefs and attitudes that may conflict with, and override, these preferences in specific situations. African-Americans and Latinos are also less knowledgeable about genetic testing than non-Hispanic Whites, and they are less likely to have the financial resources or insurance coverage that would facilitate access to testing.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/63127/1/109065704323016012.pd

Low socioeconomic status and mental health outcomes in colorectal cancer survivors:Disadvantage? advantage? … or both?

Objective The goal of this study is to examine the relationship between socioeconomic status (SES) and both positive and negative mental health (MH) outcomes in a population-based sample of colorectal cancer survivors. On the basis of theoretical conceptualizations of trauma and posttraumatic growth, low SES was hypothesized to be positively associated with both greater negative MH outcomes (e.g., distress) and greater positive MH outcomes (e.g., growth). Methods Colorectal cancer survivors (n = 1300; 57% male; mean age 69.4 and 4.0 years post-diagnosis) were recruited using a regional, population-based cancer registry in the Netherlands and completed a questionnaire assessing current negative and positive MH outcomes. Low, medium, and high SES respondents were identified using an area-level indicator of SES based on aggregated individual fiscal data on monetary home value and household income. Results Analysis of covariance and logistic regression analyses indicated that low SES was a risk factor for greater negative MH outcomes. Relative to high SES survivors, low SES survivors reported poorer status on nine indices of MH, and high SES survivors were about 50% less likely to report clinically important levels of anxiety and depression. Results provided partial support for the hypothesis low SES was a ‘risk’ factor for greater positive MH outcomes. Relative to high SES survivors, low SES survivors reported greater positive MH outcomes on 2 of 5 positive MH indices examined (Positive Self-Evaluation, Meaning of Cancer). Conclusions Study findings are the first to suggest that low SES might increase the likelihood of both greater negative as well as positive MH outcomes in cancer survivors

Prolonged impact of chemotherapy on fatigue in breast cancer survivors: a longitudinal comparison with radiotherapy-treated breast cancer survivors and noncancer controls

Item does not contain fulltextBACKGROUND: In this study, the authors examined the influence of prior treatment on the course of fatigue in breast cancer survivors. Patients who received chemotherapy were expected to have greater fatigue than patients who received radiotherapy and noncancer controls 6 months after the completion of treatment, but they were expected to recover to levels similar to those of the other 2 groups 3 years later. METHODS: Patients with stage 0 through II breast cancer completed the Fatigue Symptom Inventory (FSI) and the Profile of Mood States Fatigue Scale (POMS-FAT) 6 months (T1) and 42 months (T2) after completing chemotherapy with or without radiotherapy (the CT group; n = 103) or radiotherapy only (the RT group; n = 102). An age-matched group of women with no history of cancer (the NC group; n = 193) was assessed over a similar interval. RESULTS: A significant (P = .041) group x time effect for FSI severity scores revealed that fatigue worsened over time in the CT group but remained stable and lower in the RT and NC groups. There also were significant group effects for FSI days (P < .001) and POMS-FAT (P = .010) scores, indicating that fatigue was significantly greater across time in the CT group than in the NC group (POMS-FAT) or the RT and NC groups (FSI days). CONCLUSIONS: Contrary to expectations, fatigue did not diminish over time in patients with breast cancer who received chemotherapy. This finding has important implications for patient education and for fatigue monitoring during follow-up. The authors concluded that future research should seek to examine possible mechanisms to explain the apparent prolonged impact of chemotherapy on fatigue in breast cancer survivors

Multiple primary cancer survivors have poorer health status and well-being than single primary cancer survivors:A study from the population-based PROFILES registry

Objective The health status and psychosocial well-being of multiple primary cancer (MPC) survivors are under-researched. Methods In total, 3615 survivors identified from the Eindhoven Cancer Registry between 2008 and 2009 were assessed. About one in six survivors had survived MPC (n = 556). All survivors completed questionnaires on health status (SF-36/European Organization of Research and Treatment of Cancer quality of life module), mental health (Hospital Anxiety and Depression Scale) and impact of cancer (Impact of Cancer). Results Compared with single primary cancer survivors, MPC survivors reported significantly poorer scores on general health and higher symptom scores on diarrhoea and fatigue. Significantly more MPC survivors met the subclinical cut-off score of ≥8 points on the Hospital Anxiety and Depression Scale depression subscale (27% vs. 19%, p = 0.0001). MPC survivors also reported significantly greater negative impact of cancer (namely body changes and life interferences) and positive impact of health awareness on their lives. All results were adjusted for age at survey, time since last diagnosis, sex, comorbidity, body mass index and marital status. In secondary analyses, MPC survivors with different primary cancer combinations or time interval between primary cancer diagnoses had comparable health status and psychosocial well-being. Conclusion Multiple primary cancer survivors reported a poorer health status and, in general, experienced a greater negative impact of cancer on their psychosocial well-being than single primary cancer survivors