Search

Financial hardship may affect up to 30% of cancer survivors, however, little research has addressed the effect of employment change on financial hardship. This study compared the self-reported financial hardship of middle-aged (45-64 years) colorectal cancer survivors ( n = 187) at 6 and 12 months following diagnosis with that of a matched general population group ( n = 355). Colorectal cancer survivors were recruited through the Queensland Cancer Registry, Australia; data from the Household Income and Labour Dynamics in Australia (HILDA) Survey were used for the general population group. Pearson chi-square tests were used to assess the differences in proportions between the two groups and McNemar tests to assess differences across time among the same group. Generalised linear modelling was performed to produce prevalence ratios. A higher proportion of workers with colorectal cancer reported financial strain (money shortage for living essentials) at 6 months (15%) but eased and was comparable to the comparison group at 12 months (7%). Middle-aged working cancer survivors who ceased or reduced work were more likely to report not being financially comfortable, compared with those who had continued work (adjusted prevalence ratio 1.66, 95% CI: 1.12, 2.44) at 12 months. Health professionals, employers and government services should address the impact of impaired employment on financial hardship among cancer survivors. [ABSTRACT FROM AUTHOR]

Purpose: Engaging in positive health behaviours can improve quality of life amongst cancer survivors, whether this facilitates return to work is unknown. We examined associations of health behaviours with return to work outcomes following a diagnosis of colorectal cancer in middle-aged men and women (45-64 years).Methods: We recruited 239 participants through the Queensland Cancer Registry between January 2010 and September 2011. Data were collected through telephone-administered interviews and postal questionnaires at 6 and 12 months post-diagnosis. Logistic regression examined likelihood of ceasing or reducing work, and Cox regression examined factors associated with time to return to work.Results: No significant associations were observed between health behaviours (fruit and vegetables consumption, alcohol consumption, smoking status, physical activity or sitting time) at 6 months and ceasing or reducing work at 12 months post-diagnosis. Participants who reported excessive sleep (≥9 h/day) were 2.69 times more likely to reduce work time or retire (relative to those sleeping the recommended 7 to <9 h/day; 95 % CI 1.06, 6.87, adjusted for cancer treatment). In Cox regression analysis, excessive sleep was associated with a longer work re-entry time (relative to sleeping 7 to <9 h/day; HR = 0.47; 95 % CI 0.22, 1.00, adjusted for education and cancer treatment).Conclusions: Further research into how excessive sleep might be related to return to work amongst colorectal cancer survivors is warranted. Interventions focused on achieving optimal sleep patterns may assist colorectal cancer survivors to return to work and should be tested in future studies. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

This study has used the structural equation modelling to examine the role of benefit-finding (BF) in the context of the stress and coping model. In the study, 1276 individuals diagnosed with colorectal cancer completed a written questionnaire and telephone interview at around 4.5 months (on average) and 12 months post-diagnosis. Analyses revealed that the final model fit the data, where stress, coping and BF accounted for 63% of the variance in Time 1 quality of life (QOL). Threat appraisal, coping resources, avoidant coping and BF directly impacted on Time 1 QOL, while threat appraisal, social support and approach coping directly impacted on BF. Approach coping and BF had differential relationships with stress, coping resources and outcomes, indicating that BF may not be a meaning-based coping strategy, as proposed by Folkman [Folkman, S. (1997). Positive psychological states and coping with severe stress. Social Science and Medicine, 45, 1207–1221]. Theoretical and clinical implications are discussed.

Background: The number of middle-aged working individuals being diagnosed with cancer is increasing and so too will disruptions to their employment. The aim of the Working After Cancer Study is to examine the changes to work participation in the 12 months following a diagnosis of primary colorectal cancer. The study will identify barriers to work resumption, describe limitations on workforce participation, and evaluate the influence of these factors on health-related quality of life., Methods/design: An observational population-based study has been designed involving 260 adults newly-diagnosed with colorectal cancer between January 2010 and September 2011 and who were in paid employment at the time they were diagnosed. These cancer cases will be compared to a nationally representative comparison group of 520 adults with no history of cancer from the general population. Eligible cases will have a histologically confirmed diagnosis of colorectal cancer and will be identified through the Queensland Cancer Registry. Data on the comparison group will be drawn from the Household, Income and Labour Dynamics in Australia (HILDA) Survey. Data collection for the cancer group will occur at 6 and 12 months after diagnosis, with work questions also asked about the time of diagnosis, while retrospective data on the comparison group will be come from HILDA Waves 2009 and 2010. Using validated instruments administered via telephone and postal surveys, data will be collected on socio-demographic factors, work status and circumstances, and health-related quality of life (HRQoL) for both groups while the cases will have additional data collected on cancer treatment and symptoms, work productivity and cancer-related HRQoL. Primary outcomes include change in work participation at 12 months, time to work re-entry, work limitations and change in HRQoL status., Discussion: This study will address the reasons for work cessation after cancer, the mechanisms people use to remain working and existing workplace support structures and the implications for individuals, families and workplaces. It may also provide key information for governments on productivity losses., Study Registration: Australian and New Zealand Clinical Trial Registry No. ACTRN12611000530921.

Aims: To assess self-reported lifetime prevalence of cardiovascular disease (CVD) among colorectal cancer survivors, and examine the cross-sectional and prospective associations of lifestyle factors with co-morbid CVD., Methods: Colorectal cancer survivors were recruited (n=1966). Data were collected at approximately 5, 12, 24 and 36 months post-diagnosis. Cross-sectional findings included six CVD categories (hypercholesterolaemia, hypertension, diabetes, heart failure, kidney disease and ischaemic heart disease (IHD)) at 5 months post-diagnosis. Longitudinal outcomes included the probability of developing (de novo) co-morbid CVD by 36 months post-diagnosis. Lifestyle factors included body mass index, physical activity, television (TV) viewing, alcohol consumption and smoking., Results: Co-morbid CVD prevalence at 5 months post-diagnosis was 59%, and 16% of participants with no known CVD at the baseline reported de novo CVD by 36 months. Obesity at the baseline predicted de novo hypertension (odds ratio [OR]=2.20, 95% confidence intervals [CI]=1.09, 4.45) and de novo diabetes (OR=6.55, 95% CI=2.19, 19.53). Participants watching >4h of TV/d at the baseline (compared with <2h/d) were more likely to develop ischaemic heart disease by 36 months (OR=5.51, 95% CI=1.86, 16.34)., Conclusion: Overweight colorectal cancer survivors were more likely to suffer from co-morbid CVD. Interventions focusing on weight management and other modifiable lifestyle factors may reduce functional decline and improve survival., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

This longitudinal study investigated relations between benefit-finding domains and outcome measures. Participants were 1,757 individuals diagnosed with colorectal cancer. A written questionnaire and telephone interview were completed at 5-months (Time 1) and 12-months post-diagnosis (Time 2). Exploratory and confirmatory factor analyses revealed three psychometrically sound factors: personal growth, interpersonal growth, and acceptance. Results of regression analyses were conducted and found that Time 1 benefit-finding domains accounted for significant amounts of variance in Time 1 positive affect and cancer-related quality of life (both the aggregate score and its social/family, functional, and colorectal cancer-specific well-being subscales). Time 1 personal growth also predicted Time 1 psychological distress. After controlling for Time 1 positive affect, personal growth continued to predict Time 2 positive affect. Results delineate the benefit-finding domains in the context of colorectal cancer and their differential links with outcome measures cross-sectionally, and longitudinally. These findings have implications for theory building and the measurement of benefit-finding.

Objective: This longitudinal study developed and confirmed the factor structure of the 32-item Coping with Colorectal Cancer (CCRC) measure. Reliability and validity of the measure were also assessed., Methods: Participants were 1800 individuals diagnosed with colorectal cancer (CRC). A written questionnaire and a telephone interview were completed at 5 (Time 1) and 12 months post-diagnosis (Time 2)., Results: Exploratory and confirmatory factor analyses revealed eight mostly empirically distinct subscales: Positive Perceptual Change, Religion/Spirituality, Rumination, Acceptance, Humour, Palliative, Seeking Social Support, and Lifestyle Reorganisation. Internal reliabilities were adequate and comparable to other coping measures, and test-retest analyses showed moderate temporal stability of the subscales. Cross-sectional and longitudinal regression analyses were conducted to establish criterion-related validity. As hypothesised, after controlling for demographics, disease/treatment, and stress/coping variables, regression analyses showed that CCRC subscales uniquely predicted Time 1 quality of life (QOL) outcomes (positive affect, cancer-related QOL, psychological distress). After controlling for Time 1 QOL, Seeking Social Support coping continued to predict Time 2 positive affect., Conclusions: Results demonstrated the preliminary validity and reliability of the CCRC subscales, and have extended the cancer coping research by revealing new relations between coping subscales and QOL in a mixed-gender, older population with CRC.

Objective: The present study prospectively assessed the influence of medical, socio-demographic, psychological, and lifestyle variables on physical, social/family, emotional, functional well-being and colorectal cancer-specific concerns in a population-based sample of colorectal cancer survivors., Methods: Participants (n=1822) were assessed at 6 and 24 months post-diagnosis. Predictor variables assessed at 6 months included socio-demographic and medical variables, symptoms/side-effects, body mass index, physical activity, optimism, social support, and cancer threat appraisal. Quality of life (QOL) was assessed at 6 and 24 months post-diagnosis using the Functional Assessment of Cancer Therapy - Colorectal (FACT-C)., Results: For each QOL subscale and for the overall FACT-C scale, 6 month scores were the strongest predictor of QOL scores at 24 months post-diagnosis (e.g. beta=0.447, p < 0.001 for overall QOL). Socio-demographic, medical, and psychosocial variables, but not lifestyle variables, differentially predicted domain specific QOL. Only cancer threat appraisal was associated with all five QOL domains., Conclusion: Cancer threat appraisal presents as a potentially modifiable variable for interventions seeking to improve QOL. Symptom management and lifestyle strategies to ameliorate the effects of co-morbidities, disease stage and troublesome symptoms such as faecal incontinence on QOL should also be included., ((c) 2008 John Wiley & Sons, Ltd.)

Goal: A better understanding of health behaviors after a cancer diagnosis is important, as these behaviors are related to physical functioning, disease recurrence, development of second primary cancers, and risk of other chronic diseases. Body weight and health behaviors (smoking status, alcohol consumption, and physical activity) were examined in a population-based sample of colorectal cancer survivors and compared to a matched population group., Materials and Methods: Data were collected by telephone interviews pre-diagnosis (retrospectively reported), 6 and 12 months post-diagnosis for colorectal cancer survivors (n = 1,250). Comparison data were from a population-based cancer risk survey (n = 6,277)., Results: Colorectal cancer survivors were most likely to be overweight/obese pre-diagnosis (66%) than at 6 months (54%) or 12 months post-diagnosis (61%). There was little variation from 6 to 12 months in the proportion of current smokers (7% and 8%, respectively) or high-risk drinkers (both 22%). The greatest changes were for physical activity, with 53% of survivor's sufficiently active pre-diagnosis, 32% at 6 months, and 38% at 12 months post-diagnosis. At 12 months, colorectal cancer survivors were more likely than the comparison group to be: underweight (OR = 2.14, 95% CI = 1.38-3.31); a former smoker (OR = 1.44, 95% CI = 1.26-1.63); a low-risk (OR = 1.25, 95% CI = 1.09-1.44) or high-risk drinker (OR = 1.70, 95% CI = 1.43-2.03); and insufficiently active (OR = 1.57, 95% CI = 1.34-1.83) or inactive (OR = 2.76, 95% CI = 2.39-3.19). However, colorectal cancer survivors were significantly less likely to be a current smoker (OR = 0.68, 95% CI = 0.54-0.85)., Conclusions: Our findings show particular scope for physical activity interventions for colorectal cancer survivors. Improving the general health of cancer survivors should help to decrease morbidity in this population and associated health system expenditure.

Objective: To investigate the reliability of collecting colorectal stage information from pathology reports and general practitioners in Queensland, Australia., Methods: A longitudinal study of colorectal cancer survivors conducted in 2003 and 2004 (n=1966, response rate=57%) obtained stage information from clinical specialists (n=1334), general practitioners (GP) (n=1417) and by extracting stage from pathology reports (n=1484). Reliability of stage information was determined by comparing stage from GPs and pathology reports with that reported by the clinical specialists, using a weighted kappa., Results: GPs and pathology reports each had a similar level of agreement with clinical specialists, with kappa scores of 0.77 (0.75-0.80) (n=1042) and 0.78 (0.75-0.81) (n=1152), respectively. Results were similar when restricting to records staged by all three methods (n=847). GPs had similar levels of agreement with clinical specialists within each stage, although pathology reports tended to under-stage patients in Stage D (0.37). Collapsing stage into two categories (A or B, C or D) increased the reliability estimates from the pathology reports to 0.91 (0.88-0.93), but there was little change in GP estimates 0.79 (0.75-0.83)., Conclusions: Extractions from pathology reports are a valid source of broad stage information for colorectal cancer., Implications: In the absence of clinical stage data, access to pathology records by population-based cancer registries enables a more accurate assessment of survival inequalities in colorectal cancer survival.

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 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.