Search

Background: Patients with cancer are at increased risk of diabetes mellitus (DM). Previous studies on the prevalence and prognostic impact of DM in cancer survivors were limited by small sample sizes or short follow-up times. We aimed to compare the patient-reported prevalence of DM in long-term cancer survivors (LTCS), who survived 5 years or more after cancer diagnosis, with that in cancer-free controls, and to estimate the mortality risk among LTCS according to DM status., Methods: Our population-based cohort comprised 6952 LTCS diagnosed with breast, colorectal, or prostate cancer between 1994 and 2004, recruited in 2008-2011 (baseline), and followed until 2019. A total of 1828 cancer-free individuals served as controls. Multivariable logistic regression was used to compare the prevalence of DM in LTCS and controls, and according to covariates at baseline. Mortality among LTCS according to DM was assessed by Cox proportional hazards regression., Results: A total of 962 (13.8%) LTCS at baseline reported DM. Prevalence of DM in LTCS was not higher than in cancer-free controls, both at baseline (odds ratio, 0.80; 95% CI, 0.66-0.97) and at follow-up (odds ratio, 0.83; 95% CI, 0.67-1.04). Prevalence of DM in LTCS was associated with cancer site, older age, lower education, higher socioeconomic deprivation, higher body mass index, physical inactivity, other comorbidities, and poorer prognosis (adjusted hazard ratio [all-cause mortality] = 1.29; 95% CI, 1.15-1.44)., Conclusion: DM in LTCS is prevalent, but not higher than in cancer-free population controls. Cancer survivors with concurrent DM are at a potentially higher risk of death., Plain Language Summary: Cancer and diabetes mellitus (DM) are two serious threats to global health. In our study, prevalence of DM in long-term cancer survivors who survived 5 years or more after cancer diagnosis was not higher than in cancer-free controls. This should not be interpreted as an indication of a lower risk of DM in cancer survivors. Rather, it highlights the potentially poor prognosis in diabetic cancer survivors. Therefore, keeping a continuous satisfactory DM and hyperglycemia management is essential during long-term cancer survivorship., (© 2023 The Authors. Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society.)

Objective: To evaluate the psychosocial situation of breast cancer (BC) patients with dependent children, with regard to who used family-centered psychosocial support (PS) services, reasons against using it, as well as existing, unmet needs, and current PS need., Methods: Data were collected via survey and patient files during an inpatient rehabilitation program for mothers with BC, who were accompanied by a child <12 years. Descriptive statistics and tests for statistical significance were used., Results: Out of the total of 561 patients, 23.0% had used family-centered PS services before. Common reasons against it were enough support, no anticipated need and organizational issues. Patients stated a high number of unmet needs. The most urgent ones related to their children. About 59.3% of mothers stated a current PS need (PSN) and 33.3% a need for their children. Little social support and a worse maternal HRQOL, but not time since diagnosis, were related to a higher PSN in mothers and children (bivariate association)., Conclusion: Among BC patients with dependent children, clinicians need to take the whole family and their support needs into account. They should know about the existing organizational barriers, which need to be overcome with the help of tailored offers. Patients with low HRQOL, little social support and single-mothers (with regard to children's PSN) need special attention as these can be indicators of high PSN., (© 2020 The Authors. Psycho-Oncology published by John Wiley & Sons Ltd.)

Objective: Several therapies for localised prostate cancer (PC) are available; all yield similar survival rates. However, each therapy has significant side effects that can influence patients' health-related quality of life (HRQoL) in the long run., Methods: The study sample included 911 survivors with localised PC, 5-15 years post-diagnosis who were identified from the population-based CAESAR + study in Germany. HRQoL was assessed using the EORTC QLQ-C30 and EORTC QLQ-PR25 questionnaires. The association between type of therapy and HRQoL was assessed with multivariable linear regression and global F-test adjusting for age, time since diagnosis and comorbidities., Results: Overall, survivors treated with radical prostatectomy (RP) or radiotherapy (RT) alone reported the best HRQoL and the lowest symptom burden. Conversely, survivors treated with androgen deprivation therapy (ADT) (& RP/RT) or RP & RT (in combination) reported the worst HRQoL and the highest symptom burden. Significant differences among treatment groups in HRQoL were found for global health status (p = 0.041), social functioning (p = 0.007), urinary symptoms (p = 0.035), bowel symptoms (p = 0.017) and hormonal treatment-related symptoms (p < 0.001) among other symptoms., Conclusions: Long-term localised PC survivors formerly treated with a combination of RP and RT or with ADT report poorer HRQoL and more symptoms than patients treated with either RP or RT alone., (© 2019 John Wiley & Sons Ltd.)

Objective: We examined psychosocial and informational services used by long-term survivors of breast, colon and prostate cancer in immigrants versus non-immigrants., Methods: Patients were sampled from population-based cancer registries in Germany. They completed a questionnaire assessing immigration biography, service use and socio-demographic characteristics., Results: Data of 6143 cancer survivors were collected of whom 383 (6%) were immigrants. There was no evidence of an association between immigration status and service use. However, immigration biography played a role when patients' and their parents' birthplace were taken into account. When parents were born outside Europe, survivors less frequently used information from the Internet (ORadj 0.4, 95% CI 0.2; 0.8). Web-based information (ORadj 0.7, 95% CI 0.5; 0.9) was less frequently used when the participant was born outside Germany., Conclusion: The differences in the use of psychosocial and informational services between immigrants and non-immigrants seem to be generally small. Acculturation may play a role in service uptake. In survey-based health services research, investigators should not stratify by census-defined immigration status, but rather by cultural background., (Copyright © 2014 John Wiley & Sons, Ltd.)

Background: Fear of recurrence (FoR) is a widespread problem among breast cancer survivors. So far, little is known about prevalence, determinants, and consequences of FoR specifically in long-term breast cancer survivors, even though it was found to be one of the most important concerns in this group., Methods: Analyses are based on data of several population-based cohorts of long-term breast cancer survivors, recruited by six German cancer registries. Overall, 2671 women were included in the analyses. FoR was assessed using the short form of the Fear of Progression Questionnaire. Potential determinants of moderate/high FoR and the association with depression and quality of life (QoL) were explored via multiple logistic and linear regression., Results: Even though the majority of women reported low levels of FoR (82%), a substantial percentage experienced moderate (11%) and high (6%) FoR. Younger age (odds ratio = 3.00, confidence intervals = 1.91-4.73 for women below age 55 years) and considering oneself as a tumor patient (odds ratio = 3.36, confidence intervals = 2.66-4.25) were found to exhibit the strongest associations with moderate/high FoR. Overall, psychosocial and sociodemographic factors played a far bigger role in FoR than clinical factors. Higher FoR was associated with higher depression and lower QoL., Conclusion: Fear of recurrence (mostly low levels) is highly prevalent among long-term breast cancer survivors and can negatively affect QoL and well-being. Therefore, it should be given appropriate consideration in research and clinical practice. As specifically younger women tended to be impacted by FoR, it is crucial to be particularly attentive to specific needs of younger survivors., (Copyright © 2013 John Wiley & Sons, Ltd.)