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Objective: Self-report is commonly used in epidemiologic studies; however, few data exist on the reliability and validity of this method for eliciting information related to the diagnosis of colorectal cancer. We examined the test-retest reliability and validity of colorectal cancer patients reporting on the process of their diagnosis., Study Design and Setting: One hundred and sixteen participants completed two telephone interviews, 1 month apart, and 95 general practitioners (GPs) completed a written questionnaire, to elicit information relating to key elements of the process of diagnosis of colorectal cancer., Results: Acute symptoms such as rectal bleeding had higher reliability and validity than more general symptoms. Colonoscopy was the most accurately recalled diagnostic test. Recall of diagnosis date, and date of colonoscopy, had high test-retest reliability. There were considerable differences between dates of diagnostic tests given by participants and GPs, but there was no evidence of a bias in a particular direction. Accuracy of recall did not diminish as time from diagnosis increased., Conclusion: This study confirms that self-reported symptoms, tests, and dates in the colorectal cancer diagnostic pathway are generally reliable; however, the validity of reported symptoms and tests can be moderate to poor.

Background: Psychological distress in cancer survivors can be detrimental to treatment adherence and self-care tasks and is associated with poor health behaviors and decreased overall quality of life. The prevalence, course, and predictors of psychological distress after the diagnosis of colorectal cancer are to date not well described., Methods: A prospective survey of 1822 colorectal cancer patients was undertaken assessing psychological distress and hypothesized predictors including optimism, cancer threat appraisal, social support, and physical activity at 6 and 12 months postdiagnosis. Logistic regression identified correlates of psychological distress at 12 months postdiagnosis., Results: The prevalence of global psychological distress was low: 8.3% and 6.7% at 6 and 12 months postdiagnosis, respectively. When baseline measures of independent variables were included in a logistic regression model, distress at 6 months postdiagnosis (odds ratio [OR]=10.84), comorbidities (OR=1.64), optimism (OR=0.93), cancer threat appraisal (OR=0.92), and social support (OR=0.94) were significantly associated with distress at 12 months postdiagnosis. A second logistic regression model that included concurrent measures of cancer threat appraisal, social support, and physical activity found that distress at 6 months postdiagnosis (OR=12.49), comorbidities (OR=1.64), optimism (OR=0.94), and concurrent cancer threat appraisal (OR=0.85) were significantly associated with distress at 12 months postdiagnosis., Conclusions: Distress screening at regular intervals is needed to efficiently detect colorectal cancer patients who require in-depth psychological intervention. Threat appraisal is a modifiable variable that should be included in interventions for colorectal cancer survivors. Further research is needed to investigate the potential for physical activity to reduce distress after cancer., (Copyright (c) 2008 American Cancer Society.)

Background: Physical activity can provide benefits to cancer survivors, including reduced symptoms and treatment side effects, improved overall quality of life, and decreased risk of other chronic diseases., Purpose: The aim of the study was to describe physical activity before and after diagnosis of colorectal cancer and to examine the associations with sociodemographic and disease-related variables., Methods: Telephone interviews were conducted with 1,996 colorectal cancer survivors recruited through a cancer registry., Results: In comparison to prediagnosis activity levels, there were 21% fewer participants meeting the physical activity and health guideline (150 min of moderate-intensity physical activity per week) postdiagnosis. Meeting the guideline postdiagnosis was associated with being male, living outside of the state capital city, having a higher education, having a healthy body mass index, not smoking, having had surgery only, and no reported fatigue. Attributes associated with a decrease in physical activity following diagnosis were being female, living within the state capital city, having a lower level of education, having a stoma, having adjuvant therapy, and experiencing fatigue., Conclusions: There is considerable scope for targeted interventions to increase the physical activity of colorectal cancer survivors, particularly for those groups that we have identified as being less active and/or have reduced their activity.

Objective: To examine the associations between physical activity and quality of life for colorectal cancer survivors; and to describe the associations of medical and sociodemographic attributes with overall quality of life, and their moderating effects on the relationships between physical activity and quality of life., Methods: Telephone interviews were conducted with 1,996 colorectal cancer survivors recruited through the Queensland Cancer Registry. Data were collected on current quality of life; leisure-time physical activity pre- and post-diagnosis; cancer treatment and side-effects; and general sociodemographic attributes. Hierarchical generalized linear models identified variables significantly associated with quality of life., Results: After controlling for sociodemographic variables, disease-specific variables, treatment side-effects, and pre-diagnosis leisure-time physical activity, there were significant differences in quality of life scores by post-diagnosis physical activity category. Compared to participants who were inactive after their diagnosis, those who were sufficiently active had a 17.0% higher total quality of life score. Physical activity also had a significant independent positive association with the physical well-being, functional well-being, and additional concerns subscales of the FACT-C., Conclusions: Our findings demonstrate that quite modest changes in leisure-time physical activity are associated with quality of life. Colorectal cancer survivors may benefit from a more active lifestyle.

Objective: To describe the process of colorectal cancer diagnosis in Queensland, and to determine factors associated with time to diagnosis., Design, Setting and Participants: Cross-sectional study of 1996 patients with colorectal cancer recruited through the Queensland Cancer Registry. Data were collected by computer-assisted telephone interview between May 2003 and August 2005., Main Outcome Measures: Time to diagnosis: pre-presentation time (time from first noticing a symptom to first presenting to a doctor); and post-presentation time (time between the first presentation and diagnosis)., Results: Most patients (90%) had experienced symptoms before being diagnosed with colorectal cancer; only 2% of patients were diagnosed by faecal occult blood testing. Older participants and those who experienced abdominal pain had the shortest time from symptom onset to their first doctor consultation, while participants with a change in bowel habit, or rectal bleeding, and those without private health insurance tended to wait longer to see a doctor. Participants who experienced abdominal pain were diagnosed more quickly, whereas those who experienced a change in bowel habit, women, and those without private health insurance experienced a longer time to diagnosis., Conclusions: The strong association between not having health insurance and longer post-presentation times is concerning. The other hypothesised predictors of time to diagnosis were not as strongly associated as we anticipated.

Purpose: This study was conducted to examine the test-retest reliability of a measure of prediagnosis physical activity participation administered to colorectal cancer survivors recruited from a population-based state cancer registry., Methods: A total of 112 participants completed two telephone interviews, 1 month apart, reporting usual weekly physical activity in the year before their cancer diagnosis. Intraclass correlation coefficients (ICC) and standard error of measurement (SEM) were used to describe the test-retest reliability of the measure across the sample; the Bland-Altman approach was used to describe reliability at the individual level. The test-retest reliability for categorized total physical activity (active, insufficiently active, sedentary) was assessed using the kappa statistic., Results: When the complete sample was considered, the ICC ranged from 0.40 (95% CI: 0.24, 0.55) for vigorous gardening to 0.77 (95% CI: 0.68, 0.84) for moderate physical activity. The SEM, however, were large, indicating high measurement error. The Bland-Altman plots indicated that the reproducibility of data decreases as the amount of physical activity reported each week increases. The kappa coefficient for the categorized data was 0.62 (95% CI: 0.48, 0.76)., Conclusion: Overall, the results indicated low levels of repeatability for this measure of historical physical activity. Categorizing participants as active, insufficiently active, or sedentary provides a higher level of test-retest reliability.

The evaluation of a community-based screening programme for melanoma (SkinWatch) in 18 regional communities (total adult population >30 years 63 035) in Queensland, Australia is described. The aim of the SkinWatch programme was to promote whole-body skin screening for melanoma by primary care physicians. The programme included community education, education and support for local medical practitioners and open-access skin screening clinics. Programme delivery was achieved through assistance of local volunteers. All programme activities and resources were recorded for process evaluation. A baseline telephone survey (n = 3110) and a telephone survey four months after programme launch (n = 680) assessed community awareness of the SkinWatch programme and, 37 face-to-face interviews with community members, doctors and community leaders were conducted to assess satisfaction with the programme. A sample of 1043 of 16,383 residents who attended the skin screening clinics provided as part of the programme were interviewed to assess reasons for attending, and positive and negative aspects of SkinWatch programme. Community awareness of the SkinWatch programme increased by over 30% (p < 0.001) within four months of the start of the programme. Interview participants described the SkinWatch programme as a useful service for the communities and 90% stated they would revisit the clinics. A total of 43% of all attendees were over 50 years old, and nearly 50% were men. These findings demonstrate the acceptability and feasibility of a community-based screening programme for melanoma in rural areas. Volunteers were instrumental in increasing community ownership of and involvement in the SkinWatch programme.

This report describes spectator recall of SunSmart skin cancer prevention advertising displayed on the Brisbane Cricket Ground scoreboard at intermittent periods throughout the 1999/2000 cricket season and the sun-protective behaviors of these spectators. Two hundred and thirty-one spectators were asked a series of five questions about their recall of SunSmart advertising and their present sunscreen usage. Respondents' sun-protective behavior observed at the time of questioning was also recorded. The SunSmart advertising was seen by 15.6% of respondents. Recall of the SunSmart advertising was higher amongst spectators observed to have high levels of sun protection than amongst spectators with low levels of sun protection. Females were more likely than males to recall the SunSmart advertising. The efficacy of health-promoting advertising in the sports setting has yet to be established and therefore results cannot be compared against accepted benchmarks. This study contributes baseline data that will enable such comparisons to be made. The increase in recent years of health-promoting advertising at sports events, often as part of a comprehensive sponsorship program, necessitates the need for further research in this area.

Namoratunga, a megalithic site in northwestern Kenya, has an alignment of 19 basalt pillars that are nonrandomly oriented toward certain stars and constellations. The same stars and constellations are used by modern eastern Cushitic peoples to calculate an accurate calendar. The fact that Namoratunga dates to about 300 B.C. suggests that a prehistoric calendar based on detailed astronomical knowledge was in use in eastern Africa.

1-, 3-, and 5-substituted pyrazolo[3,4-d]pyrimidines and pyrazolo[3,4-b]pyridines related to allopurinol were synthesized and evaluated as xanthine oxidase inhibitors. Among these compounds, 4-hydroxypyrazolo[3,4-b]pyridine-5-carboxylic acids 12 were found to possess potency in the same order of allopurinol. The influence of the substitutions on the enzyme inhibitory effect and the bulk tolerance of the enzyme-inhibitor complex are discussed.