716 results on '"Christoffer Johansen"'
Search Results
2. Changes in experienced quality of oncological cancer care during the COVID-19 pandemic based on patient reported outcomes – a cross-sectional study
- Author
-
Ninna Aggerholm-Pedersen, Lise Bech Jellesmark Thorsen, Nina Møller Tauber, Josefine Tingdal Danielsen, Katrine Løppenthin, Signe Borgquist, Christoffer Johansen, and Robert Zacharie
- Subjects
COVID-19 ,patient reported outcome ,questionaires ,Cancer ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Aim: The study aims to investigate the impact of the COVID-19 pandemic on cancer patients’ perceptions of the quality of their oncological treatment and care. Background: The COVID-19 pandemic disrupted healthcare delivery and oncological resources were repurposed, potentially leading to prolonged treatment and reduced access to innovative therapies and clinical trials. Still, little is known about how patients perceived the quality of their treatment. Methods: A cross-sectional study was conducted in the spring of 2020 among cancer patients at the Department of Oncology, Aarhus University Hospital and Rigshospitalet, Denmark. Patients were invited to complete an online questionnaire on clinical, socioeconomic, emotional, behavioural, and quality-related aspects of oncological cancer care. Patients who experienced reduced treatment quality and those who reported no or slight reductions were compared using multiple logistic regression, exploring the associations with patient characteristics, behaviours, and fear of cancer progression or recurrence. Results: A total of 2,040/5,372 patients experienced changes in their treatment plans during the pandemic, and 1,570/5,372 patients experienced reduced treatment quality, with 236 reporting a high degree of reduction. Patients with breast, head and neck, and upper gastrointestinal cancers were more likely to experience reduced treatment quality. Altered interactions with healthcare providers, along with isolation, lack of social support, and heightened fear of cancer progression, were significant risk factors for experiencing reduced cancer care quality. Interpretation: We identified subgroups of cancer patients needing targeted communication and care during health crises affecting cancer treatment. The findings underscore the importance of safeguarding the needs of vulnerable patient populations in future healthcare emergencies.
- Published
- 2024
- Full Text
- View/download PDF
3. The time has come for national clinical practice guidelines for managing late effects after cancer and cancer treatment
- Author
-
Robert Zachariae, Peer Christiansen, Ali Amidi, Lisa Wu, Lise Ventzel, Nina Tauber, Annika von Heymann, Bolette Skjødt Rafn, Janne Fassov, Therese Juul, Peter Christensen, and Christoffer Johansen
- Subjects
Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Published
- 2024
- Full Text
- View/download PDF
4. Compassionate Communication and Advance Care Planning to improve End-of-life Care in Treatment of Haematological Disease ‘ACT’: Study Protocol for a Cluster-randomized trial
- Author
-
Mary Jarden, Christoffer Johansen, Annika von Heymann, Cæcilie Borregaard Myrhøj, and Stine Novrup Clemmensen
- Subjects
Medicine - Abstract
Introduction To support the implementation of advance care planning and serious illness conversations in haematology, a previously developed conversation intervention titled ‘Advance Consultations Concerning your Life and Treatment’ (ACT) was found feasible. This study aims to investigate the effect of ACT on the quality of end-of-life care in patients with haematological malignancy and their informal caregivers.Methods and analysis The study is a nationwide 2-arm cluster randomised trial randomising 40 physician–nurse clusters across seven haematological departments in Denmark to provide standard care or ACT intervention. A total of 400 patients with haematological malignancies and their informal caregivers will be included. The ACT intervention includes an ACT conversation that centres on discussing the patient’s prognosis, worries, hopes and preferences for future treatment. The intervention is supported by clinician training and supervision, preparatory materials for patients and informal caregivers, and system changes including dedicated ACT-conversation timeslots and templates for documentation in medical records.This study includes two primary outcomes: (1) the proportion of patients receiving chemotherapy within the last 30 days of death and (2) patients’ and informal caregivers’ symptoms of anxiety (General Anxiety Disorder-7) at 3 6, 9, 12 and 18 months follow-up. Mixed effects models accounting for clusters will be used.Ethics and dissemination The Declaration of Helsinki and the European GDPR regulations as practised in Denmark are followed through all aspects of the study. Findings will be made available to the participants, patient organisations, funding bodies, healthcare professionals and researchers at national and international conferences and through publication in peer-reviewed international journals.Registration details The study is registered at ClinicalTrials.gov (NCT05444348). The Regional Ethics Committee of the Capital Region of Denmark (record no: 21067634) has decided that approval is not necessary as per Danish legislation. Study approval has been obtained from The Capital Region of Denmark Data Protection Agency (record no: P-2022-93).Trial registration number NCT05444348.
- Published
- 2024
- Full Text
- View/download PDF
5. Social inequality in cancer survivorship: Educational differences in health‐related quality of life among 27,857 cancer survivors in Denmark
- Author
-
Anne Katrine Graudal Levinsen, Trille Kristina Kjaer, Lau Caspar Thygesen, Thomas Maltesen, Erik Jakobsen, Ismail Gögenur, Michael Borre, Peer Christiansen, Robert Zachariae, Peter Christensen, Søren Laurberg, Peter deNully Brown, Lisbet Rosenkrantz Hölmich, Christoffer Johansen, Susanne K. Kjær, Lonneke van dePoll‐Franse, Lena Saltbæk, and Susanne Oksbjerg Dalton
- Subjects
cancer survivorship ,health‐related quality of life ,social inequality ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Background With a growing population of cancer survivors in Denmark, the evaluation of health‐related quality of life (HRQoL) has become increasingly important. We describe variations in HRQoL between educational groups in a national population of cancer survivors. Methods We conducted a cross‐sectional questionnaire study among breast, prostate, lung, and colon cancer survivors diagnosed in 2010–2019 in Denmark. We used the EORTC QLQ‐C30 to assess HRQoL including physical, role, emotional, cognitive, social functioning, and symptoms (fatigue, nausea and vomiting, pain, dyspnea, insomnia, appetite loss, constipation, diarrhea, and financial difficulties). Information on educational level and clinical data were extracted from national registers and clinical databases. Levels of impaired functioning and severe symptoms were identified using newly established thresholds for clinical importance. Multivariate logistic regression was used to examine associations between education and HRQoL. All statistical tests were 2‐sided. Results In total, 27,857 (42%) participated in the study. Up to 72% and 75% of cancer survivors with short education (≤9 years) reported impaired functioning and severe symptoms, respectively. Cancer survivors with short compared to long education (>12 years) were more likely to report impaired functioning and severe symptoms, with for example significantly higher odds ratios (ORs) for impaired physical function (breast OR = 2.41, 99% CI = 2.01–2.89; prostate OR = 1.81, 99% CI = 1.48–2.21; lung OR = 2.97, 99% CI = 1.95–4.57; and colon cancer OR = 1.69, 99% CI = 1.28–2.24). Conclusions Cancer survivors with short education are at greater risk of impaired HRQoL than survivors with long education 2–12 years after diagnosis. This underscores the need for systematic screening and symptom management in cancer aftercare, in order to reach all cancer survivors, also cancer survivors with short education.
- Published
- 2023
- Full Text
- View/download PDF
6. The iBLAD study: patient-reported outcomes in bladder cancer during oncological treatment: a multicenter national randomized controlled trial
- Author
-
Gry Assam Taarnhøj, Christoffer Johansen, Andreas Carus, Rikke Hedegaard Dahlrot, Line Hammer Dohn, Niels Henrik Hjøllund, Mark Bech Knudsen, Anders Tolver, Henriette Lindberg, and Helle Pappot
- Subjects
Patient-reported outcomes ,Bladder cancer ,Urothelial cancer ,Supportive care ,Quality of life ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background Patient-reported outcomes (PROs) are getting widely implemented, but little is known of the impact of applying PROs in specific cancer diagnoses. We report the results of a randomized controlled trial (RCT) of the active use of PROs in patients with locally advanced or metastatic bladder cancer (BC) undergoing medical oncological treatment (MOT) with focus on determining the clinical effects of using PROs during chemo- or immunotherapy compared to standard of care. Methods We recruited patients from four departments of oncology from 2019 to 2021. Inclusion criteria were locally advanced or metastatic BC, initiating chemo- or immunotherapy. Patients were randomized 1:1 between answering selected PRO-CTCAE questions electronically once weekly with a built-in alert-algorithm instructing patients of how to handle reported symptoms as a supplement to standard of care for handling of side effects (intervention arm (IA)) vs standard procedure for handling of side effects (control arm (CA)). No real-time alerts were sent to the clinic when PROs exceeded threshold values. Clinicians were prompted to view the completed PROs in the IA at each clinical visit. The co-primary clinical endpoints were hospital admissions and treatment completion rate. Secondary endpoints were overall survival (OS), quality of life (EORTC’s QLQ-C30 and QLQ-BLM30) and dose reductions. Results 228 patients with BC were included, 76% were male. 141 (62%) of the patients had metastatic disease. 51% of patients in the IA completed treatment vs. 56% of patients in the CA, OR 0.83 (95% CI 0.47–1.44, p = 0.51). 41% of patients in the IA experienced hospitalization vs. 32% in the CA, OR 1.48 (95% CI 0.83–2.65, p = 0.17). OS was comparable between the two arms (IA: median 22.3mo (95% CI 17.0-NR) vs. CA: median 23.1mo (95% CI 17.7-NR). Patient and clinician compliance was high throughout the study period (80% vs 94%). Conclusions This RCT did not show an effect of PRO on completion of treatment, hospitalizations or OS for BC patients during MOT despite a high level of patient and clinician compliance. The lack of real-time response to alerts remains the greatest limitation to this study.
- Published
- 2023
- Full Text
- View/download PDF
7. Mobile phone use and brain tumour risk – COSMOS, a prospective cohort study
- Author
-
Maria Feychting, Joachim Schüz, Mireille B. Toledano, Roel Vermeulen, Anssi Auvinen, Aslak Harbo Poulsen, Isabelle Deltour, Rachel B. Smith, Joel Heller, Hans Kromhout, Anke Huss, Christoffer Johansen, Giorgio Tettamanti, and Paul Elliott
- Subjects
Cell phones ,Radiofrequency fields ,Electromagnetic fields ,Non-ionizing radiation ,Brain neoplasms ,Cohort study ,Environmental sciences ,GE1-350 - Abstract
Background: Each new generation of mobile phone technology has triggered discussions about potential carcinogenicity from exposure to radiofrequency electromagnetic fields (RF-EMF). Available evidence has been insufficient to conclude about long-term and heavy mobile phone use, limited by differential recall and selection bias, or crude exposure assessment. The Cohort Study on Mobile Phones and Health (COSMOS) was specifically designed to overcome these shortcomings. Methods: We recruited participants in Denmark, Finland, the Netherlands, Sweden, and the UK 2007–2012. The baseline questionnaire assessed lifetime history of mobile phone use. Participants were followed through population-based cancer registers to identify glioma, meningioma, and acoustic neuroma cases during follow-up. Non-differential exposure misclassification was reduced by adjusting estimates of mobile phone call-time through regression calibration methods based on self-reported data and objective operator-recorded information at baseline. Hazard ratios (HR) and 95% confidence intervals (CI) for glioma, meningioma, and acoustic neuroma in relation to lifetime history of mobile phone use were estimated with Cox regression models with attained age as the underlying time-scale, adjusted for country, sex, educational level, and marital status. Results: 264,574 participants accrued 1,836,479 person-years. During a median follow-up of 7.12 years, 149 glioma, 89 meningioma, and 29 incident cases of acoustic neuroma were diagnosed. The adjusted HR per 100 regression-calibrated cumulative hours of mobile phone call-time was 1.00 (95 % CI 0.98–1.02) for glioma, 1.01 (95 % CI 0.96–1.06) for meningioma, and 1.02 (95 % CI 0.99–1.06) for acoustic neuroma. For glioma, the HR for ≥ 1908 regression-calibrated cumulative hours (90th percentile cut-point) was 1.07 (95 % CI 0.62–1.86). Over 15 years of mobile phone use was not associated with an increased tumour risk; for glioma the HR was 0.97 (95 % CI 0.62–1.52). Conclusions: Our findings suggest that the cumulative amount of mobile phone use is not associated with the risk of developing glioma, meningioma, or acoustic neuroma.
- Published
- 2024
- Full Text
- View/download PDF
8. Blood sampling patterns in primary care change several years before a cancer diagnosis
- Author
-
Mathilde Egelund Christensen, Mia Klinten Grand, Margit Kriegbaum, Bent Struer Lind, Kirsten Grønbæk, Frederik Persson, Christoffer Johansen, and Christen Lykkegaard Andersen
- Subjects
Primary care ,early detection of cancer ,neoplasms ,epidemiologic studies ,public reporting of healthcare data ,clinical chemistry tests ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Published
- 2024
- Full Text
- View/download PDF
9. Examining the efficacy of treatments for arm lymphedema in breast cancer survivors: an overview of systematic reviews with meta-analysesResearch in context
- Author
-
Bolette Skjødt Rafn, Anne Bodilsen, Annika von Heymann, Maja Johannsen Lindberg, Sofia Byllov, Tine Ginnerup Andreasen, Christoffer Johansen, Peer Christiansen, and Robert Zachariae
- Subjects
Complex decongestive physiotherapy ,Exercise ,Laser therapy ,Kinesio taping ,Acupuncture ,Medicine (General) ,R5-920 - Abstract
Summary: Background: Lymphedema affects one in six breast cancer survivors making it a global healthcare challenge. There is considerable debate about the efficacy of different treatments for lymphedema. We aimed to summarize the current evidence for treatments for lymphedema in breast cancer survivors. Methods: In this overview of systematic reviews with meta-analyses (SRMAs), five databases were searched for SRMAs of randomised controlled trials (RCTs) reporting effects of medications, surgery, exercise, laser therapy, acupuncture, kinesio taping, or complex decongestive physiotherapy (CDP) for breast cancer-related lymphedema published from database inception up to March 7, 2023. Data extraction was performed for the SRMAs and RCTs, and SRMAs were appraised with AMSTAR2. Random effects meta-analyses of the RCTs provided estimates of the pooled effects sizes (Hedges’ g) for each treatment modality. This study is registered with PROSPERO, CRD42020184813. Findings: 1569 studies were identified by the search and eighteen SRMAs with 51 RCTs were included, investigating manual lymphatic drainage (MLD), compression pump, exercise, kinesio taping, laser, and acupuncture. Overall, the methodological quality of the SRMAs was low. SRMAs reached different conclusions for all treatment modalities, except for kinesio taping where the two SRMAs found no effect. The analysis of 40 RCTs with 1970 participants revealed a small effect across all interventions compared to any control (g = 0.20, p = 0.047, I2 = 0.79), corresponding to volume reductions of 119.7 ml (95% CI 135–104) and 88.0 ml (95% CI 99–77) in the intervention and control groups, respectively, and a small effect of exercise (g = 0.26, p = 0.022, I2 = 0.44). The between-group differences in volume reduction were small and did not reach statistical significance for any one treatment modality. Interpretation: Based on the available data, there is no evidence of superiority of any one treatment on volume reduction nor any solid research refuting these treatments. Thus, definitive conclusions to inform clinical practice about the efficacy of these treatments cannot be drawn. Due to poor-quality evidence, more research is needed to untangle the efficacy of each treatment component for different stages of lymphedema. Funding: Danish Cancer Society.
- Published
- 2024
- Full Text
- View/download PDF
10. Educational differences in healthcare use among survivors after breast, prostate, lung, and colon cancer – a SEQUEL cohort study
- Author
-
Anne Katrine Graudal Levinsen, Trille Kristina Kjaer, Thomas Maltesen, Erik Jakobsen, Ismail Gögenur, Michael Borre, Peer Christiansen, Robert Zachariae, Søren Laurberg, Peter Christensen, Niels Kroman, Signe Benzon Larsen, Thea Helene Degett, Lisbet Rosenkrantz Hölmich, Peter de Nully Brown, Christoffer Johansen, Susanne K. Kjær, Lau Caspar Thygesen, and Susanne Oksbjerg Dalton
- Subjects
Healthcare use ,Social inequality ,Survivorship ,Breast cancer ,Prostate cancer ,Lung cancer ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background Many cancer survivors experience late effects after cancer. Comorbidity, health literacy, late effects, and help-seeking behavior may affect healthcare use and may differ among socioeconomic groups. We examined healthcare use among cancer survivors, compared with cancer-free individuals, and investigated educational differences in healthcare use among cancer survivors. Methods A Danish cohort of 127,472 breast, prostate, lung, and colon cancer survivors from the national cancer databases, and 637,258 age- and sex-matched cancer-free individuals was established. Date of entry was 12 months after diagnosis/index date (for cancer-free individuals). Follow-up ended at death, emigration, new primary cancer, December 31st, 2018, or up to 10 years. Information about education and healthcare use, defined as the number of consultations with general practitioner (GP), private practicing specialists (PPS), hospital, and acute healthcare contacts 1–9 years after diagnosis/index date, was extracted from national registers. We used Poisson regression models to compare healthcare use between cancer survivors and cancer-free individuals, and to investigate the association between education and healthcare use among cancer survivors. Results Cancer survivors had more GP, hospital, and acute healthcare contacts than cancer-free individuals, while the use of PPS were alike. One-to-four-year survivors with short compared to long education had more GP consultations (breast, rate ratios (RR) = 1.28, 95% CI = 1.25–1.30; prostate, RR = 1.14, 95% CI = 1.10–1.18; lung, RR = 1.18, 95% CI = 1.13–1.23; and colon cancer, RR = 1.17, 95% CI = 1.13–1.22) and acute contacts (breast, RR = 1.35, 95% CI = 1.26–1.45; prostate, RR = 1.26, 95% CI = 1.15–1.38; lung, RR = 1.24, 95% CI = 1.16–1.33; and colon cancer, RR = 1.35, 95% CI = 1.14–1.60), even after adjusting for comorbidity. One-to-four-year survivors with short compared to long education had less consultations with PPS, while no association was observed for hospital contacts. Conclusion Cancer survivors used more healthcare than cancer-free individuals. Cancer survivors with short education had more GP and acute healthcare contacts than survivors with long education. To optimize healthcare use after cancer, we need to better understand survivors’ healthcare-seeking behaviors and their specific needs, especially among survivors with short education.
- Published
- 2023
- Full Text
- View/download PDF
11. P1177: ROUTINE CLINICAL FOLLOW-UP FOR RELAPSE DETECTION IN PATIENTS WITH LARGE B-CELL LYMPHOMA AFTER FIRST-LINE TREATMENT – DOES NOT MEET THE AIMS. A RETROSPECTIVE DANISH MULTICENTER STUDY
- Author
-
Therese Lassen, Torsten Holm Nielsen, Anne Ortved Gang, Lene Kongsgaard Nielsen, Annika Von Heymann, Christoffer Johansen, and Lars Møller Pedersen
- Subjects
Diseases of the blood and blood-forming organs ,RC633-647.5 - Published
- 2023
- Full Text
- View/download PDF
12. Optimising psychological treatment for pain after breast cancer: a factorial design study protocol in Denmark
- Author
-
Anders Bonde Jensen, Christoffer Johansen, Anne Speckens, Annika von Heymann, Yoon Frederiksen, Robert Zachariae, Cecilie Buskbjerg, Mia Skytte O'Toole, and Maja Johannsen
- Subjects
Medicine - Abstract
Introduction One in five breast cancer (BC) survivors are affected by persistent pain years after completing primary treatment. While the efficacy of psychological interventions for BC-related pain has been documented in several meta-analyses, reported effect sizes are generally modest, pointing to a need for optimisation. Guided by the Multiphase Optimization Strategy, the present study aims to optimise psychological treatment for BC-related pain by identifying active treatment components in a full factorial design.Methods and analysis The study uses a 2×3 factorial design, randomising 192 women with BC-related pain (18–75 years) to eight experimental conditions. The eight conditions consist of three contemporary cognitive–behavioural therapy components, namely: (1) mindful attention, (2) decentring, and (3) values and committed action. Each component is delivered in two sessions, and each participant will receive either zero, two, four or six sessions. Participants receiving two or three treatment components will be randomised to receive them in varying order. Assessments will be conducted at baseline (T1), session by session, every day for 6 days following the first session in each treatment component, at post-intervention (T2) and at 12-week follow-up (T3). Primary outcomes are pain intensity (Numerical Rating Scale) and pain interference (Brief Pain Inventory interference subscale) from T1 to T2. Secondary outcomes are pain burden, pain quality, pain frequency, pain catastrophising, psychological distress, well-being and fear of cancer recurrence. Possible mediators include mindful attention, decentring, and pain acceptance and activity engagement. Possible moderators are treatment expectancy, treatment adherence, satisfaction with treatment and therapeutic alliance.Ethics and dissemination Ethical approval for the present study was received from the Central Denmark Region Committee on Health Research Ethics (no: 1-10-72-309-40). Findings will be made available to the study funders, care providers, patient organisations and other researchers at international conferences, and published in international, peer-reviewed journals.Trial registration number ClinicalTrials.gov Registry (NCT05444101).
- Published
- 2023
- Full Text
- View/download PDF
13. Time trends in mobile phone use and glioma incidence among males in the Nordic Countries, 1979–2016
- Author
-
Isabelle Deltour, Aslak Harbo Poulsen, Christoffer Johansen, Maria Feychting, Tom Børge Johannesen, Anssi Auvinen, and Joachim Schüz
- Subjects
Glioma ,Mobile phones ,Cancer registry ,Modelling ,Environmental sciences ,GE1-350 - Abstract
Introduction: In the Nordic countries, the use of mobile phones increased sharply in the mid-1990s especially among middle-aged men. We investigated time trends in glioma incidence rates (IR) with the perspective to inform about the plausibility of brain tumour risks from mobile phone use reported in some case-control studies. Methods: We analysed IR of glioma in Denmark, Finland, Norway, and Sweden among men aged 40–69 years, using data from national cancer registries and population statistics during 1979–2016, using log-linear joinpoint analysis. Information on regular mobile phone use and amount of call-time was obtained from major studies of mobile phones in these countries. We compared annual observed incidence with that expected under various risk scenarios to assess which of the reported effect sizes are compatible with the observed IR. The expected numbers of cases were computed accounting for an impact of other factors besides mobile phone use, such as improved cancer registration. Results: Based on 18,232 glioma cases, IR increased slightly but steadily with a change of 0.1% (95 %CI 0.0%; 0.3%) per year during 1979–2016 among 40–59-year-old men and for ages 60–69, by 0.6 % (95 %CI 0.4; 0.9) annually. The observed IR trends among men aged 40–59 years were incompatible with risk ratios (RR) 1.08 or higher with a 10-year lag, RR ≥ 1.2 with 15-year lag and RR ≥ 1.5 with 20-year lag. For the age group 60–69 years, corresponding effect sizes RR ≥ 1.4, ≥2 and ≥ 2.5 could be rejected for lag times 10, 15 and 20 years. Discussion: This study confirms and reinforces the conclusions that no changes in glioma incidence in the Nordic countries have occurred that are consistent with a substantial risk attributable to mobile phone use. This particularly applies to virtually all reported risk increases reported by previous case-control studies with positive findings.
- Published
- 2022
- Full Text
- View/download PDF
14. Sexual Activity in Couples Dealing With Breast Cancer. A Cohort Study of Associations With Patient, Partner and Relationship-Related Factors
- Author
-
Nina Rottmann, Pia Veldt Larsen, Christoffer Johansen, Mariët Hagedoorn, Susanne Oksbjerg Dalton, and Dorte Gilså Hansen
- Subjects
breast cancer ,sexual activity ,couples ,patient ,partner ,relationship ,Psychology ,BF1-990 - Abstract
ObjectiveBreast cancer may profoundly affect a couple’s sex life. The present study examines whether patient-, partner- and relationship-related characteristics are associated with sexual activity of couples following breast cancer diagnosis in the treatment phase and over time.MethodsWomen with breast cancer and their male cohabiting partners participated in a longitudinal study in Denmark. Logistic regression was used to examine associations of patient-, partner- and relationship-related characteristics at baseline (≤4 months following surgery) with couples’ sexual activity at baseline, 5 and 12 months later. The longitudinal analyses were stratified for couples’ sexual activity status at baseline.ResultsA total of 722, 533 and 471 couples were included in the analyses at baseline, 5- and 12-months follow-up, respectively. Older age, depressive symptoms and lower vitality of patients were associated with lower odds of couples’ sexual activity at baseline; chemotherapy treatment and older age of patients were associated with lower odds at 5-months follow-up in couples who were not sexually active at baseline. Higher ratings of emotional closeness, affectionate behavior and satisfaction with dyadic coping were associated with higher odds for sexual activity at baseline and over time in couples who were sexually active at baseline.ConclusionSexual counseling during cancer treatment and rehabilitation should include a couple perspective. Relationship-related variables may be a protective factor for remaining sexually active after breast cancer diagnosis. Interventions could focus on strengthening these factors. Health professionals also need to consider the patients’ breast cancer treatment, vitality, and emotional distress in counselling on sexuality.
- Published
- 2022
- Full Text
- View/download PDF
15. Feasibility of Using Wearables for Home Monitoring during Radiotherapy for Head and Neck Cancer—Results from the OncoWatch 1.0 Study
- Author
-
Cecilie Holländer-Mieritz, Emma Balch Steen-Olsen, Claus Andrup Kristensen, Christoffer Johansen, Ivan Richter Vogelius, and Helle Pappot
- Subjects
wearables ,smartwatch ,home monitoring ,patient-generated health data ,radiotherapy ,head and neck cancer ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Background: Consumer wearables allow objective health data monitoring, e.g., of physical activity and heart rate, which might change over a cancer treatment course. Patients with head and neck cancer (HNC) receiving radiotherapy (RT) with curative intent typically experience side effects such as pain, decreased appetite, and dehydration, which may lead to hospitalizations. Therefore, health data monitoring could be important to understand a patient’s condition outside the hospital. The OncoWatch 1.0 study investigated the feasibility of using smartwatches for patients with HNC receiving RT. Methods: This study was a prospective, single-cohort feasibility study. The inclusion criteria were patients ≥ 18 years of age who planned to receive curatively intended radiotherapy for HNC. Consenting patients were asked to wear a smartwatch during RT and until two weeks after the end of RT. The primary endpoint was adherence. The secondary endpoints were data acquisition and variations in heart rate and physical activity. Results: Ten patients were included, with a median age of 62 years and eight males. The adherence rate for wearing the watch >12 h/d over the study period was 31%. The data acquisition rate was 61%. Conclusions: Although the primary endpoint was not reached, new knowledge has been established, including the secure data setup and key points that need to be addressed in future studies.
- Published
- 2023
- Full Text
- View/download PDF
16. Follow-Up Care for Breast and Colorectal Cancer Across the Globe: Survey Findings From 27 Countries
- Author
-
Michelle A. Mollica, Deborah K. Mayer, Kevin C. Oeffinger, Youngmee Kim, Susan S. Buckenmaier, Sudha Sivaram, Catherine Muha, Nur Aishah Taib, Elisabeth Andritsch, Chioma C. Asuzu, Ovidiu V. Bochis, Sheila Diaz, Maria Die Trill, Patricia J. Garcia, Luigi Grassi, Yosuke Uchitomi, Asim Jamal Shaikh, Michael Jefford, Hyun Jeong Lee, Christoffer Johansen, Emmanuel Luyirika, Elizabeth Jane Maher, Maria Madeline B. Mallillin, Theoneste Maniragaba, Anja Mehnert-Theuerkauf, C. S. Pramesh, Sabine Siesling, Orit Spira, Jonathan Sussman, Lili Tang, Nguyen V. Hai, Suayib Yalcin, and Paul B. Jacobsen
- Subjects
Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
PURPOSEThe purpose of this study was to describe follow-up care for breast and colorectal cancer survivors in countries with varying levels of resources and highlight challenges regarding posttreatment survivorship care.METHODSWe surveyed one key stakeholder from each of 27 countries with expertise in survivorship care on questions including the components/structure of follow-up care, delivery of treatment summaries and survivorship care plans, and involvement of primary care in survivorship. Descriptive analyses were performed to characterize results across countries and variations between the WHO income categories (low, middle, high). We also performed a qualitative content analysis of narratives related to survivorship care challenges to identify major themes.RESULTSSeven low- or /lower-middle-income countries (LIC/LMIC), seven upper-middle-income countries (UMIC), and 13 high-income countries (HICs) were included in this study. Results indicate that 44.4% of countries with a National Cancer Control Plan currently address survivorship care. Additional findings indicate that HICs use guidelines more often than those in LICs/LMICs and UMICs. There was great variation among countries regardless of income level. Common challenges include issues with workforce, communication and care coordination, distance/transportation issues, psychosocial support, and lack of focus on follow-up care.CONCLUSIONThis information can guide researchers, providers, and policy makers in efforts to improve the quality of survivorship care on a national and global basis. As the number of cancer survivors increases globally, countries will need to prioritize their long-term needs. Future efforts should focus on efforts to bridge oncology and primary care, building international partnerships, and implementation of guidelines.
- Published
- 2020
- Full Text
- View/download PDF
17. Cost-effectiveness analysis of systematic fast-track transition from oncological treatment to specialised palliative care at home for patients and their caregivers: the DOMUS trial
- Author
-
Christine Marie Bækø Halling, Rasmus Trap Wolf, Per Sjøgren, Hans Von Der Maase, Helle Timm, Christoffer Johansen, and Jakob Kjellberg
- Subjects
Cancer ,Informal Care ,Economic evaluation ,Effectiveness ,Utility ,QALY ,Special situations and conditions ,RC952-1245 - Abstract
Abstract Background While hospitals remain the most common place of death in many western countries, specialised palliative care (SPC) at home is an alternative to improve the quality of life for patients with incurable cancer. We evaluated the cost-effectiveness of a systematic fast-track transition process from oncological treatment to SPC enriched with a psychological intervention at home for patients with incurable cancer and their caregivers. Methods A full economic evaluation with a time horizon of six months was performed from a societal perspective within a randomised controlled trial, the DOMUS trial ( Clinicaltrials.gov : NCT01885637). The primary outcome of the health economic analysis was a incremental cost-effectiveness ratio (ICER), which is obtained by comparing costs required per gain in Quality-Adjusted Life Years (QALY). The costs included primary and secondary healthcare costs, cost of intervention and informal care from caregivers. Public transfers were analysed in seperate analysis. QALYs were measured using EORTC QLQ-C30 for patients and SF-36 for caregivers. Bootstrap simulations were performed to obtain the ICER estimate. Results In total, 321 patients (162 in intervention group, 159 in control group) and 235 caregivers (126 in intervention group, 109 in control group) completed the study. The intervention resulted in significantly higher QALYs for patients when compared to usual care (p-value = 0.026), while being more expensive as well. In the 6 months observation period, the average incremental cost of intervention compared to usual care was €2015 per patient (p value
- Published
- 2020
- Full Text
- View/download PDF
18. Electronic reporting of patient-reported outcomes in a fragile and comorbid population during cancer therapy – a feasibility study
- Author
-
Gry Assam Taarnhøj, Henriette Lindberg, Line Hammer Dohn, Lise Høj Omland, Niels Henrik Hjøllund, Christoffer Johansen, and Helle Pappot
- Subjects
Patient-reported outcomes ,ePRO ,Bladder cancer ,Chemotherapy ,Immunotherapy ,Feasibility ,Computer applications to medicine. Medical informatics ,R858-859.7 - Abstract
Abstract Background Electronic collection of patient-reported outcomes (ePROs) is becoming widespread in health care, but the implementation into routine cancer care during therapy remains to be seen. Especially, little is known of the use and success of electronic reporting during active cancer treatment in fragile and comorbid patients. The aim of this study was to test the feasibility of ePRO and its incorporation into routine cancer care, measured by physician compliance, for a fragile and comorbid bladder cancer (BC) population receiving chemo- or immunotherapy. Methods All BC patients initiating treatment for locally advanced or metastatic bladder cancer at Rigshospitalet or Herlev Hospital, Denmark, were approached during an 8 month period. Exclusion criteria were patients not speaking Danish or not being signed up for electronic communication with health authorities. Enrolled patients were prompted to complete weekly ePROs from home. Patients completed the European Organisation for Research and Treatment of Cancer’s general quality of life questionnaire, QLQ-C30, and the module for muscle-invasive bladder cancer QLQ-BLM30, the Hospital Anxiety and Depression Scale, HADS, and selected items from the Patient Reported-Outcomes version of the Common Terminology Criteria of Adverse Events (PRO-CTCAE), in total 158 questions weekly. If failing to report when prompted, patients were sent two e-mail reminders. Patients were informed that the physician would have an overview of the reported ePROs at their following clinical visits. Physicians were at all clinical visits informed to look at the ePROs in a software solution separate from the medical records. Physicians were logged to check their compliance to the task. No continuous surveillance of ePROs was established. Results Of 91 patients screened for enrolment, 19 patients (21%) were not found eligible for standard treatment, eight patients (9%) were not signed up for electronic communication with the health authorities and nine patients (10%) declined participation. Another six patients did not meet other inclusion criteria. In total 49 BC patients were enrolled, 29 initiating chemotherapy and 20 initiating immunotherapy. A total of 466 electronic questionnaires were completed. The overall adherence of the patients to complete ePROs was at an expected level for an elderly cancer population (75%) and remained above 70% until the 6th cycle of treatment. The physician’ compliance was in contrast low (0–52%) throughout the course of treatment. Conclusions Electronic reporting of PROs is feasible in a fragile and comorbid population of patients during routine active cancer treatment. Despite clear implementation strategies the physician compliance remained low throughout the study proving the need for further implementation strategies.
- Published
- 2020
- Full Text
- View/download PDF
19. Patient reported symptoms associated with quality of life during chemo‐ or immunotherapy for bladder cancer patients with advanced disease
- Author
-
Gry A. Taarnhøj, Christoffer Johansen, Henriette Lindberg, Ethan Basch, Amylou Dueck, and Helle Pappot
- Subjects
chemotherapy ,immunotherapy ,Patient‐reported outcomes ,quality of life ,urinary bladder neoplasms ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Background Bladder cancer (BC) patients with advanced disease have poor outcomes. The use of patient‐reported outcomes (PROs) could lead to improvements in symptom management and hence quality of life (QoL). The aim of this study is to report correlations between selected PROs and QoL and thus to present symptoms that influence QoL. Identification of these symptoms during treatment can lead to earlier symptom management and thus secure improvements in QoL. Methods BC patients in chemo‐ or immunotherapy for locally advanced or metastatic disease reported weekly PROs for the duration of their treatment. The PROs included EORTC QLQ‐C30 and QLQ‐BLM30 and 45 selected PRO‐CTCAE items. Spearman's correlation analysis was performed for all PRO‐CTCAE items and QLQ‐C30 global QoL and subdomains. Results In this study, 78 BC patients reported 724 questionnaires. Spearman's analysis showed significant correlations between almost all PRO‐CTCAE items and the expected domain of QoL. The PRO‐CTCAE items with the strongest correlations with QoL were anxiety (F, frequency item) and emotional function (rs = −0.603, P
- Published
- 2020
- Full Text
- View/download PDF
20. Couple Counseling and Pelvic Floor Muscle Training for Men Operated for Prostate Cancer and for Their Female Partners: Results From the Randomized ProCan Trial
- Author
-
Randi V. Karlsen, Pernille E. Bidstrup, Annamaria Giraldi, Helle Hvarness, Per Bagi, Susanne Vahr Lauridsen, Vanna Albieri, Marie Frederiksen, Eva Krause, Ulla Due, and Christoffer Johansen
- Subjects
Couple Counseling ,Pelvic Floor Muscle ,Physiotherapy ,Surgery ,Prostate Cancer ,Sexual Dysfunction ,Medicine - Abstract
ABSTRACT: Introduction: Patients with prostate cancer (PC) who undergo radical prostatectomy (RP) experience impaired sexual and urinary function. Aim: To compare the effect of early couple counseling and pelvic floor muscle training (PFMT) with usual care for sexual and urinary dysfunction after RP. Methods: The ProCan study was a randomized controlled trial (RCT) with two parallel treatment arms and 1:1 allocation. Between January 2016 and December 2017, candidates for RP were invited to a longitudinal questionnaire study and provided baseline measures before surgery. Patients who underwent RP, had a female partner, and were sexually active were invited to the ProCan RCT. Couples who provided informed consent were allocated to usual care or usual care and up to six couple counseling sessions, up to three instructions in PFMT and a video home-training program. All couples filled in follow-up questionnaires at 8 and 12 months and non-participants provided 12 months’ follow-up. Linear mixed-effect models and 95% confidence intervals were used to measure effects of the intervention. Main Outcome Measure: Primary outcome was erectile function, measured with The International Index of Erectile Function, at 8 and 12 months follow-up. Secondary outcomes were sexual and urinary function and use of treatment for erectile dysfunction (ED) by patients; sexual function in female partners; and relationship function, health-related quality of life, anxiety, depression, and self-efficacy in both patients and female partners. Results: Thirty-five couples were randomized. No significant effect of the intervention was found on erectile function at 8 months (estimated difference in change, 1.41; 95% CI; –5.51 ; 8.33) or 12 months (estimated difference in change, 0.53; 95% CI; –5.94; 6.99) or in secondary outcomes, except for significantly increased use of ED treatment at 8 months. Conclusion: We found no effect of early couple counseling and PFMT, possibly because of the limited number of participants. Karlsen RV, Bidstrup PE, Giraldi A, et al. Couple Counseling and Pelvic Floor Muscle Training for Men Operated for Prostate Cancer and for Their Female Partners. Results From the Randomized ProCan Trial. Sex Med 2021;9:100350.
- Published
- 2021
- Full Text
- View/download PDF
21. Meta-Analyses of Splicing and Expression Quantitative Trait Loci Identified Susceptibility Genes of Glioma
- Author
-
C. Pawan K. Patro, Darryl Nousome, The Glioma International Case Control Study (GICC), Rose K. Lai, Elizabeth B. Claus, Dora Il’yasova, Joellen Schildkraut, Jill S. Barnholtz-Sloan, Sara H. Olson, Jonine L. Bernstein, Christoffer Johansen, Robert B. Jenkins, Beatrice S. Melin, Margaret R. Wrensch, Richard S. Houlston, and Melissa L. Bondy
- Subjects
glioma ,quantitative trait loci ,eQTL ,SQTL ,summary data based mendelian randomization analyses ,GWAS ,Genetics ,QH426-470 - Abstract
BackgroundThe functions of most glioma risk alleles are unknown. Very few studies had evaluated expression quantitative trait loci (eQTL), and insights of susceptibility genes were limited due to scarcity of available brain tissues. Moreover, no prior study had examined the effect of glioma risk alleles on alternative RNA splicing.ObjectiveThis study explored splicing quantitative trait loci (sQTL) as molecular QTL and improved the power of QTL mapping through meta-analyses of both cis eQTL and sQTL.MethodsWe first evaluated eQTLs and sQTLs of the CommonMind Consortium (CMC) and Genotype-Tissue Expression Project (GTEx) using genotyping, or whole-genome sequencing and RNA-seq data. Alternative splicing events were characterized using an annotation-free method that detected intron excision events. Then, we conducted meta-analyses by pooling the eQTL and sQTL results of CMC and GTEx using the inverse variance-weighted model. Afterward, we integrated QTL meta-analysis results (Q < 0.05) with the Glioma International Case Control Study (GICC) GWAS meta-analysis (case:12,496, control:18,190), using a summary statistics-based mendelian randomization (SMR) method.ResultsBetween CMC and GTEx, we combined the QTL data of 354 unique individuals of European ancestry. SMR analyses revealed 15 eQTLs in 11 loci and 32 sQTLs in 9 loci relevant to glioma risk. Two loci only harbored sQTLs (1q44 and 16p13.3). In seven loci, both eQTL and sQTL coexisted (2q33.3, 7p11.2, 11q23.3 15q24.2, 16p12.1, 20q13.33, and 22q13.1), but the target genes were different for five of these seven loci. Three eQTL loci (9p21.3, 20q13.33, and 22q13.1) and 4 sQTL loci (11q23.3, 16p13.3, 16q12.1, and 20q13.33) harbored multiple target genes. Eight target genes of sQTLs (C2orf80, SEC61G, TMEM25, PHLDB1, RP11-161M6.2, HEATR3, RTEL1-TNFRSF6B, and LIME1) had multiple alternatively spliced transcripts.ConclusionOur study revealed that the regulation of transcriptome by glioma risk alleles is complex, with the potential for eQTL and sQTL jointly affecting gliomagenesis in risk loci. QTLs of many loci involved multiple target genes, some of which were specific to alternative splicing. Therefore, quantitative trait loci that evaluate only total gene expression will miss many important target genes.
- Published
- 2021
- Full Text
- View/download PDF
22. Distribution of hospital care among pediatric and young adult Hodgkin lymphoma survivors—A population‐based cohort study from Sweden and Denmark
- Author
-
Ingrid Glimelius, Annika Englund, Klaus Rostgaard, Karin E. Smedby, Sandra Eloranta, Peter de Nully Brown, Christoffer Johansen, Peter Kamper, Gustaf Ljungman, Lisa Lyngsie Hjalgrim, and Henrik Hjalgrim
- Subjects
Hodgkin lymphoma ,hospitalizations ,late adverse effects ,relapse ,survivorship ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract The burden of late effects among Hodgkin lymphoma (HL) survivors treated according to contemporary protocols remains poorly characterized. We used nation‐wide registers to assess number of inpatient bed‐days and specialist outpatient visits among 1048 HL‐patients (
- Published
- 2019
- Full Text
- View/download PDF
23. Patient-reported outcomes item selection for bladder cancer patients in chemo- or immunotherapy
- Author
-
Gry Assam Taarnhøj, Henriette Lindberg, Christoffer Johansen, and Helle Pappot
- Subjects
Patient-reported outcomes ,Item selection ,Bladder cancer ,Chemotherapy ,Immunotherapy ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background Selection of specific patient-reported outcomes (PROs) for cancer patients requires careful consideration to the purpose and population at aim. Here we report the process of choosing which items to include in a bladder cancer population in chemo- or immunotherapy based on the Patient-Reported Outcomes Version of the Common Terminology Criteria of Adverse Events (PRO-CTCAE). Methods Initial PRO-CTCAE symptoms were chosen through 1) medical record audit 2) patient interviews 3) summary of product characteristics from European Medicines Agency and Food and Drug Administration for the applied chemotherapies, and 4) toxicity reporting from Phase 2 and 3 trials for immunotherapies applied in patients with urothelial cancer. The selected questions were applied in a prospective cohort of 78 bladder cancer patients receiving chemo- or immunotherapy at Rigshospitalet and Herlev Hospital, Denmark. Symptoms tested in this population were selected for the final module if they appeared in ≥3 of the following groupings a) the most prevalent PRO-CTCAE symptoms grade ≥ 2 overall during treatment b) the PRO-CTCAE symptoms reported in conjunction with hospital admissions or mentioned in focus group interviews discussing which symptoms were prevalent in this patient group with specialized c) nurses or d) physicians. The authors also included symptoms in the final module if they were present in two of the above groups and defined as actionable by clinicians. Results From the initial selection of PRO-CTCAE symptoms, a total of 45 PRO-CTCAE symptoms explored by 84 PRO-CTCAE questions were retrieved. Through the second selection process based on the described criteria, the study group agreed on 15 PRO-CTCAE symptoms explored by 30 PRO-CTCAE items to be appropriate and relevant for the bladder population during medical oncological treatment. Conclusions The selection of disease specific PROs in a bladder cancer population was feasible. The process revealed several steps of selection needed in order to reach a final module for clinical application.
- Published
- 2019
- Full Text
- View/download PDF
24. Using general practitioners to recruit individuals with low socioeconomic position to preventive health checks is feasible: a cross sectional study
- Author
-
Nina Kamstrup-Larsen, Susanne Oksbjerg Dalton, Marie Broholm-Jørgensen, Lars Bruun Larsen, Janus Laust Thomsen, Christoffer Johansen, and Janne Schurmann Tolstrup
- Subjects
health check ,uptake ,non-attendance ,general practitioner ,social inequality ,socioeconomic factors ,prevention ,Public aspects of medicine ,RA1-1270 - Abstract
Objective: To test whether demographic and health-related characteristics are associated with non-attendance of preventive health checks offered to individuals with low levels of education using proactive recruitment by the general practitioners. Design: A cross-sectional study. Setting: 32 general practice clinics in Copenhagen, Denmark. Subjects: A total of 549 individuals aged 45–64, with low levels of education, enrolled in the intervention group of a randomised controlled trial on preventive health checks offered by general practitioner. Main outcome measures: Non-attendance of the preventive health checks. Methods: (i) Descriptive characteristics of attendees and non-attendees and (ii) crude and adjusted multi-level logistic regression to examine associations of individual characteristics with non-attendance of preventive health checks. Results: Overall, 33% did not attend the prescheduled preventive health checks at their general practitioners. Non-attendees were more likely to live without a partner, be of non-Western origin, be daily smokers, have poor self-rated health, have higher pulmonary symptoms score, have increased level of stress, have low levels of self-efficacy, have metabolic risk factors or non-communicable diseases and have had no contact with their general practitioner within the past year. Conclusion: The findings suggest that, it is feasible to use general practitioners for recruiting individuals for preventive health checks. However, even in a trial targeting individuals with low levels of education, there are differences between attendees and non-attendees, with a more adverse health behaviour profile and worse health status observed among the non-attendees.KEY POINTS Current awareness • Non-attendance of preventive health checks offered to the general population is associated with low socioeconomic position and adverse health behaviours. Main statements • It is feasible to use general practitioners proactively in recruitment to preventive health checks offered to individuals with low socioeconomic positions. • In a trial targeting individuals with low levels of education, there were differences between attendees and non-attendees. • Non-attendance was associated with daily smoking, poor self-rated health, high stress and no contact with the general practitioner within the last year. Trial registration: ClinicalTrials.gov identifier: NCT01979107.
- Published
- 2019
- Full Text
- View/download PDF
25. Exposure to loud noise and risk of vestibular schwannoma: results from the INTERPHONE international case‒control study
- Author
-
Isabelle Deltour, Brigitte Schlehofer, Amélie Massardier-Pilonchéry, Klaus Schlaefer, Bruce Armstrong, Graham G Giles, Jack Siemiatycki, Marie-Elise Parent, Daniel Krewski, Mary McBride, Christoffer Johansen, Anssi Auvinen, Tiina Salminen, Martine Hours, Lucile Montestrucq, Maria Blettner, Gabriele Berg-Beckhoff, Siegal Sadetzki, Angela Chetrit, Susanna Lagorio, Ivano Iavarone, Naohito Yamaguchi, Toru Takebayashi, Alistair Woodward, Angus Cook, Tore Tynes, Lars Klaeboe, Maria Feychting, Stefan Lönn, Sarah Fleming, Anthony J Swerdlow, Minouk J Schoemaker, Monika Moissonnier, Ausrele Kesminiene, Elisabeth Cardis, Joachim Schüz, and INTERPHONE Study Group
- Subjects
vestibular schwannoma ,interphone ,case‒control study ,acoustic neuroma ,epidemiology ,exposure ,noise ,noise exposure ,international ,loud noise ,Public aspects of medicine ,RA1-1270 - Abstract
OBJECTIVE: Studies of loud noise exposure and vestibular schwannomas (VS) have shown conflicting results. The population-based INTERPHONE case‒control study was conducted in 13 countries during 2000–2004. In this paper, we report the results of analyses on the association between VS and self-reported loud noise exposure. METHODS: Self-reported noise exposure was analyzed in 1024 VS cases and 1984 matched controls. Life-long noise exposure was estimated through detailed questions. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using adjusted conditional logistic regression for matched sets. RESULTS: The OR for total work and leisure noise exposure was 1.6 (95% CI 1.4–1.9). OR were 1.5 (95% CI 1.3–1.9) for only occupational noise, 1.9 (95% CI 1.4–2.6) for only leisure noise and 1.7 (95% CI 1.2–2.2) for exposure in both contexts. OR increased slightly with increasing lag-time. For occupational exposures, duration, time since exposure start and a metric combining lifetime duration and weekly exposure showed significant trends of increasing risk with increasing exposure. OR did not differ markedly by source or other characteristics of noise. CONCLUSION: The consistent associations seen are likely to reflect either recall bias or a causal association, or potentially indicate a mixture of both.
- Published
- 2019
- Full Text
- View/download PDF
26. Multimodal prehabilitation in colorectal cancer patients to improve functional capacity and reduce postoperative complications: the first international randomized controlled trial for multimodal prehabilitation
- Author
-
Stefanus van Rooijen, Francesco Carli, Susanne Dalton, Gwendolyn Thomas, Rasmus Bojesen, Morgan Le Guen, Nicolas Barizien, Rashami Awasthi, Enrico Minnella, Sandra Beijer, Graciela Martínez-Palli, Rianne van Lieshout, Ismayil Gögenur, Carlo Feo, Christoffer Johansen, Celena Scheede-Bergdahl, Rudi Roumen, Goof Schep, and Gerrit Slooter
- Subjects
Prehabilitation ,Colorectal surgery ,Functional capacity ,Enhanced recovery after surgery ,Comprehensive complication index ,Postoperative complications ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Background Colorectal cancer (CRC) is the second most prevalent type of cancer in the world. Surgery is the only curative option. However, postoperative complications occur in up to 50% of patients and are associated with higher morbidity and mortality rates, lower health related quality of life (HRQoL) and increased expenditure in health care. The number and severity of complications are closely related to preoperative functional capacity, nutritional state, psychological state, and smoking behavior. Traditional approaches have targeted the postoperative period for rehabilitation and lifestyle changes. However, recent evidence shows that the preoperative period might be the optimal moment for intervention. This study will determine the impact of multimodal prehabilitation on patients’ functional capacity and postoperative complications. Methods/design This international multicenter, prospective, randomized controlled trial will include 714 patients undergoing colorectal surgery for cancer. Patients will be allocated to the intervention group, which will receive 4 weeks of prehabilitation (group 1, prehab), or the control group, which will receive no prehabilitation (group 2, no prehab). Both groups will receive perioperative care in accordance with the enhanced recovery after surgery (ERAS) guidelines. The primary outcomes for measurement will be functional capacity (as assessed using the six-minute walk test (6MWT)) and postoperative status determined with the Comprehensive Complication Index (CCI). Secondary outcomes will include HRQoL, length of hospital stay (LOS) and a cost-effectiveness analysis. Discussion Multimodal prehabilitation is expected to enhance patients’ functional capacity and to reduce postoperative complications. It may therefore result in increased survival and improved HRQoL. This is the first international multicenter study investigating multimodal prehabilitation for patients undergoing colorectal surgery for cancer. Trial registration Trial Registry: NTR5947 – date of registration: 1 August 2016.
- Published
- 2019
- Full Text
- View/download PDF
27. Long-term effect of mobile phone use on sleep quality: Results from the cohort study of mobile phone use and health (COSMOS)
- Author
-
Giorgio Tettamanti, Anssi Auvinen, Torbjörn Åkerstedt, Katja Kojo, Anders Ahlbom, Sirpa Heinävaara, Paul Elliott, Joachim Schüz, Isabelle Deltour, Hans Kromhout, Mireille B. Toledano, Aslak Harbo Poulsen, Christoffer Johansen, Roel Vermeulen, Maria Feychting, and Lena Hillert
- Subjects
Cohort study ,Cell phone ,Sleep disturbance ,Insomnia ,Electromagnetic fields ,Environmental sciences ,GE1-350 - Abstract
Background: Effects of radiofrequency electromagnetic field exposure (RF-EMF) from mobile phone use on sleep quality has mainly been investigated in cross-sectional studies. The few previous prospective cohort studies found no or inconsistent associations, but had limited statistical power and short follow-up. In this large prospective cohort study, our aim was to estimate the effect of RF-EMF from mobile phone use on different sleep outcomes. Materials and methods: The study included Swedish (n = 21,049) and Finnish (n = 3120) participants enrolled in the Cohort Study of Mobile Phone Use and Health (COSMOS) with information about operator-recorded mobile phone use at baseline and sleep outcomes both at baseline and at the 4-year follow-up. Sleep disturbance, sleep adequacy, daytime somnolence, sleep latency, and insomnia were assessed using the Medical Outcome Study (MOS) sleep questionnaire. Results: Operator-recorded mobile phone use at baseline was not associated with most of the sleep outcomes. For insomnia, an odds ratio (OR) of 1.24, 95% CI 1.03–1.51 was observed in the highest decile of mobile phone call-time (>258 min/week). With weights assigned to call-time to account for the lower RF-EMF exposure from Universal Mobile Telecommunications Service (UMTS, 3G) than from Global System for Mobile Communications (GSM, 2G) the OR was 1.09 (95% CI 0.89–1.33) in the highest call-time decile. Conclusion: Insomnia was slightly more common among mobile phone users in the highest call-time category, but adjustment for the considerably lower RF-EMF exposure from the UMTS than the GSM network suggests that this association is likely due to other factors associated with mobile phone use than RF-EMF. No association was observed for other sleep outcomes. In conclusion, findings from this study do not support the hypothesis that RF-EMF from mobile phone use has long-term effects on sleep quality.
- Published
- 2020
- Full Text
- View/download PDF
28. Increased neonatal level of arginase 2 in cases of childhood acute lymphoblastic leukemia implicates immunosuppression in the etiology
- Author
-
Amalie B. Nielsen, Mi Zhou, Adam J. de Smith, Rong Wang, Lucie McCoy, Helen Hansen, Libby Morimoto, Kirsten Grønbæk, Christoffer Johansen, Scott C. Kogan, Catherine Metayer, Paige M. Bracci, Xiaomei Ma, and Joseph L. Wiemels
- Subjects
Diseases of the blood and blood-forming organs ,RC633-647.5 - Published
- 2019
- Full Text
- View/download PDF
29. Community-based football in men with prostate cancer: 1-year follow-up on a pragmatic, multicentre randomised controlled trial.
- Author
-
Eik Dybboe Bjerre, Thomas Hindborg Petersen, Anders Bojer Jørgensen, Christoffer Johansen, Peter Krustrup, Bente Langdahl, Mads Hvid Poulsen, Søren Sørensen Madsen, Peter Busch Østergren, Michael Borre, Mikael Rørth, Klaus Brasso, and Julie Midtgaard
- Subjects
Medicine - Abstract
BACKGROUND:Physical exercise has been shown to be effective in relation to fatigue, aerobic fitness, and lower body strength in men with prostate cancer. However, research into the clinically relevant effects of interventions conducted in heterogeneous patient populations and in real-life clinical practice settings is warranted. METHODS AND FINDINGS:We conducted a pragmatic, multicentre, parallel randomised controlled trial in 5 Danish urological departments. Recruitment began in May 2015, the first participant was randomised in June 2015, and the last participant was included in February 2017. In total, 214 men with prostate cancer were randomly assigned to either 6 months of free-of-charge football training twice weekly at a local club (football group [FG]) (n = 109) or usual care (usual care group [UG]) (n = 105), including brief information on physical activity recommendations at randomisation. Participants were on average 68.4 (SD 6.2) years old, 157 (73%) were retired, 87 (41%) were on castration-based treatment, 19 (9%) had received chemotherapy, and 41 (19%) had skeletal metastases at baseline. In this 1-year follow-up study, we evaluated the effects of community-based football training on the following outcomes: primary outcome, quality of life; secondary outcomes: continuation of football after 6 months, hip and lumbar spine bone mineral density (BMD), mental health score, fat and lean body mass, and safety outcomes, i.e., fractures, falls, and hospital admissions. Intention to treat (ITT) and per protocol (PP) analyses were conducted. No statistically significant between-group difference was observed in change in prostate-cancer-specific quality of life (ITT: 1.9 points [95% CI -1.9 to 5.8], p = 0.325; PP: 3.6 points [95% CI -0.9 to 8.2], p = 0.119). A statistically significant between-group difference was observed in change in total hip BMD, in favour of FG (0.007 g/cm2 [95% CI 0.004 to 0.013], p = 0.037). No differences were observed in change in lumbar spine BMD or lean body mass. Among patients allocated to football, 59% chose to continue playing football after the end of the 6-month intervention period. At 1-year follow-up in the PP population, FG participants had more improvement on the Mental Component Summary (2.9 [95% CI 0.0 to 5.7], p = 0.048 points higher) than UG participants, as well as a greater loss of fat mass (-0.9 kg [95% CI -1.7 to -0.1], p = 0.029). There were no differences between groups in relation to fractures or falls. Hospital admissions were more frequent in UG compared to FG (33 versus 20; the odds ratio based on PP analysis was 0.34 for FG compared to UG). There were 3 deaths in FG and 4 in UG. Main limitations of the study were the physically active control group and assessment of physical activity by means of self-report. CONCLUSIONS:In this trial, participants allocated to football appeared to have improved hip BMD and fewer hospital admissions. Men who played football more than once a week for 1 year lost fat mass and reported improved mental health. Community-based football proved to be acceptable, even when club membership was not subsidised. TRIAL REGISTRATION:ClinicalTrials.gov NCT02430792.
- Published
- 2019
- Full Text
- View/download PDF
30. Sex-specific glioma genome-wide association study identifies new risk locus at 3p21.31 in females, and finds sex-differences in risk at 8q24.21
- Author
-
Quinn T. Ostrom, Ben Kinnersley, Margaret R. Wrensch, Jeanette E. Eckel-Passow, Georgina Armstrong, Terri Rice, Yanwen Chen, John K. Wiencke, Lucie S. McCoy, Helen M. Hansen, Christopher I. Amos, Jonine L. Bernstein, Elizabeth B. Claus, Dora Il’yasova, Christoffer Johansen, Daniel H. Lachance, Rose K. Lai, Ryan T. Merrell, Sara H. Olson, Siegal Sadetzki, Joellen M. Schildkraut, Sanjay Shete, Joshua B. Rubin, Justin D. Lathia, Michael E. Berens, Ulrika Andersson, Preetha Rajaraman, Stephen J. Chanock, Martha S. Linet, Zhaoming Wang, Meredith Yeager, GliomaScan consortium, Richard S. Houlston, Robert B. Jenkins, Beatrice Melin, Melissa L. Bondy, and Jill. S. Barnholtz-Sloan
- Subjects
Medicine ,Science - Abstract
Abstract Incidence of glioma is approximately 50% higher in males. Previous analyses have examined exposures related to sex hormones in women as potential protective factors for these tumors, with inconsistent results. Previous glioma genome-wide association studies (GWAS) have not stratified by sex. Potential sex-specific genetic effects were assessed in autosomal SNPs and sex chromosome variants for all glioma, GBM and non-GBM patients using data from four previous glioma GWAS. Datasets were analyzed using sex-stratified logistic regression models and combined using meta-analysis. There were 4,831 male cases, 5,216 male controls, 3,206 female cases and 5,470 female controls. A significant association was detected at rs11979158 (7p11.2) in males only. Association at rs55705857 (8q24.21) was stronger in females than in males. A large region on 3p21.31 was identified with significant association in females only. The identified differences in effect of risk variants do not fully explain the observed incidence difference in glioma by sex.
- Published
- 2018
- Full Text
- View/download PDF
31. Impact of atopy on risk of glioma: a Mendelian randomisation study
- Author
-
Linden Disney-Hogg, Alex J. Cornish, Amit Sud, Philip J. Law, Ben Kinnersley, Daniel I. Jacobs, Quinn T. Ostrom, Karim Labreche, Jeanette E. Eckel-Passow, Georgina N. Armstrong, Elizabeth B. Claus, Dora Il’yasova, Joellen Schildkraut, Jill S. Barnholtz-Sloan, Sara H. Olson, Jonine L. Bernstein, Rose K. Lai, Minouk J. Schoemaker, Matthias Simon, Per Hoffmann, Markus M. Nöthen, Karl-Heinz Jöckel, Stephen Chanock, Preetha Rajaraman, Christoffer Johansen, Robert B. Jenkins, Beatrice S. Melin, Margaret R. Wrensch, Marc Sanson, Melissa L. Bondy, and Richard S. Houlston
- Subjects
Mendelian randomisation ,Allergy ,Cancer ,Glioma ,Risk ,Medicine - Abstract
Abstract Background An inverse relationship between allergies with glioma risk has been reported in several but not all epidemiological observational studies. We performed an analysis of genetic variants associated with atopy to assess the relationship with glioma risk using Mendelian randomisation (MR), an approach unaffected by biases from temporal variability and reverse causation that might have affected earlier investigations. Methods Two-sample MR was undertaken using genome-wide association study data. We used single nucleotide polymorphisms (SNPs) associated with atopic dermatitis, asthma and hay fever, IgE levels, and self-reported allergy as instrumental variables. We calculated MR estimates for the odds ratio (OR) for each risk factor with glioma using SNP-glioma estimates from 12,488 cases and 18,169 controls, using inverse-variance weighting (IVW), maximum likelihood estimation (MLE), weighted median estimate (WME) and mode-based estimate (MBE) methods. Violation of MR assumptions due to directional pleiotropy were sought using MR-Egger regression and HEIDI-outlier analysis. Results Under IVW, MLE, WME and MBE methods, associations between glioma risk with asthma and hay fever, self-reported allergy and IgE levels were non-significant. An inverse relationship between atopic dermatitis and glioma risk was found by IVW (OR 0.96, 95% confidence interval (CI) 0.93–1.00, P = 0.041) and MLE (OR 0.96, 95% CI 0.94–0.99, P = 0.003), but not by WME (OR 0.96, 95% CI 0.91–1.01, P = 0.114) or MBE (OR 0.97, 95% CI 0.92–1.02, P = 0.194). Conclusions Our investigation does not provide strong evidence for relationship between atopy and the risk of developing glioma, but findings do not preclude a small effect in relation to atopic dermatitis. Our analysis also serves to illustrate the value of using several MR methods to derive robust conclusions.
- Published
- 2018
- Full Text
- View/download PDF
32. TEDDI: radiotherapy delivery in deep inspiration for pediatric patients − a NOPHO feasibility study
- Author
-
Anni Young Lundgaard, Lisa Lyngsie Hjalgrim, Laura Ann Rechner, Mirjana Josipovic, Morten Joergensen, Marianne Camille Aznar, Anne Kill Berthelsen, Lise Borgwardt, Christoffer Johansen, Annika Loft, Akmal Safwat, Leila Vaalavirta, Lena Specht, and Maja Vestmoe Maraldo
- Subjects
Deep inspiration breath-hold ,Pediatric patients ,Radiotherapy ,Medical physics. Medical radiology. Nuclear medicine ,R895-920 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Background Radiotherapy (RT) delivered in deep inspiration breath-hold (DIBH) is a simple technique, in which changes in patient anatomy can significantly reduce the irradiation of the organs at risk (OARs) surrounding the treatment target. DIBH is routinely used in the treatment of some adult patients to diminish the risk of late effects; however, no formalized studies have addressed the potential benefit of DIBH in children. Methods/Design TEDDI is a multicenter, non-randomized, feasibility study. The study investigates the dosimetric benefit of RT delivered in DIBH compared to free breathing (FB) in pediatric patients. Also, the study aims to establish the compliance to DIBH and to determine the accuracy and reproducibility in a pediatric setting. Pediatric patients (aged 5–17 years) with a tumor in the mediastinum or upper abdomen with the possible need of RT will be included in the study. Written informed consent is obligatory. Prior to any treatment, patients will undergo a DIBH training session followed by a diagnostic PET/CT- or CT-staging scan in both DIBH and FB. If the patient proceeds to RT, a RT planning CT scan will be performed in both DIBH and FB and two separate treatment plans will be calculated. The superior treatment plan, i.e. equal target coverage and lowest overall dose to the OARs, will be chosen for treatment. Patient comfort will be assessed daily by questionnaires and by adherence to the respiratory management procedure. Discussion RT in DIBH is expected to diminish irradiation of the OARs surrounding the treatment target and thereby reduce the risk of late effects in childhood cancer survivors. Trial registration The Danish Ethical Committee (H-16035870, approved November 24th 2016, prospectively registered). The Danish Data Protection Agency (2012–58-0004, approved January 1st 2017, prospectively registered). Registered at clinicaltrials.gov (NCT03315546, October 20th 2017, retrospectively registered).
- Published
- 2018
- Full Text
- View/download PDF
33. Risk of Pharmacological or Hospital Treatment for Depression in Patients with Colorectal Cancer–Associations with Pre-Cancer Lifestyle, Comorbidity and Clinical Factors
- Author
-
Trille Kristina Kjaer, Ida Rask Moustsen-Helms, Vanna Albieri, Signe Benzon Larsen, Thea Helene Degett, Anne Tjønneland, Christoffer Johansen, Susanne K. Kjaer, Ismail Gogenur, and Susanne Oksbjerg Dalton
- Subjects
colorectal cancer ,depression ,late effects ,cancer survivorship ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
We investigated the risk of depression in colorectal cancer (CRC) patients and associated risk factors. The 1324 patients with CRC and 6620 matched cancer-free participants from the Diet, Cancer and Health study were followed for up to 16 years for either a first hospitalization for depression or antidepressant prescription after diagnosis of CRC cancer or study entry date. Information on the outcome and covariates was retrieved from the Danish Colorectal Cancer Group database, the national health registries and questionnaires. Cumulative incidence of depression was estimated, and Cox regression models were used to evaluate the association between risk factors and depression incidence. During follow-up, 191 (14.4%) patients with CRC and 175 (2.6%) cancer-free comparison persons experienced depression. After adjustments, in the first year after cancer diagnosis, patients with CRC had a 12-fold higher hazard compared with the cancer-free population (HR, 12.01; 95% CI, 7.89–18.28). The risk decreased during follow-up but remained significantly elevated with an HR of 2.65 (95% CI, 1.61–4.36) after five years. Identified risk factors were presence of comorbidities, advanced disease stage and use of radiotherapy, while life style factors (pre-cancer or at diagnosis) and chemotherapy did not seem to contribute to the increased risk.
- Published
- 2021
- Full Text
- View/download PDF
34. Patient-Reported Outcomes, Health-Related Quality of Life, and Clinical Outcomes for Urothelial Cancer Patients Receiving Chemo- or Immunotherapy: A Real-Life Experience
- Author
-
Gry Assam Taarnhøj, Henriette Lindberg, Christoffer Johansen, and Helle Pappot
- Subjects
urothelial cell carcinoma ,bladder cancer ,quality of life ,patient-reported outcomes ,side effects ,chemotherapy ,Medicine - Abstract
Patients with urothelial cell carcinoma (UCC) often have comorbidities, which cause trouble for the completion of oncological treatment, and little is known about their quality of life (QoL). The aim of the present study was to obtain and describe patient-reported outcomes (PRO) and QoL data from UCC patients in the treatment for locally advanced muscle-invasive or metastatic UCC. A total of 79 patients with UCC completed four questionnaires (EORTC QLQ-C30, QLQ-BLM30, HADS, and select PRO-CTCAE™ questions) once weekly during their treatment. From those, 26 patients (33%) underwent neoadjuvant treatment for local disease while 53 patients (67%) were treated for metastatic disease. Of all patients, 54% did not complete the planned treatment due to progression, nephrotoxicity, death, or intolerable symptoms during treatment. The five most prevalent PRO-CTCAE grade ≥ 2 symptoms were frequent urination (37%), fatigue (35%), pain (31%), dry mouth (23%), and swelling of the arms or legs (23%). The baseline mean overall QoL was 61 (±SD 24) for all patients (neoadjuvant (73, ±SD 19) and metastatic (54, ±SD 24)) and remained stable over the course of treatment for both groups. A stable overall QoL was observed for the patients in this study. More than half of the patients did not, however, complete the planned treatment. Further supportive care is warranted for bladder cancer patients.
- Published
- 2021
- Full Text
- View/download PDF
35. Feasibility and acceptability of electronic symptom surveillance with clinician feedback using the Patient-Reported Outcomes version of Common Terminology Criteria for Adverse Events (PRO-CTCAE) in Danish prostate cancer patients
- Author
-
Christina Baeksted, Helle Pappot, Aase Nissen, Niels Henrik Hjollund, Sandra A. Mitchell, Ethan Basch, Pernille Envold Bidstrup, Susanne Oksbjerg Dalton, and Christoffer Johansen
- Subjects
PRO-CTCAE ,Feasibility ,Prostate cancer ,Symptom surveillance ,Electronic reporting ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background The aim was to examine the feasibility, acceptability and clinical utility of electronic symptom surveillance with clinician feedback using a subset of items drawn from the Patient-Reported Outcomes version of Common Terminology Criteria for Adverse Events (PRO-CTCAE) in a cancer treatment setting. Methods Danish-speaking men with castration-resistant metastatic prostate cancer receiving treatment at the Department of Oncology, Rigshospitalet, Copenhagen between March 9, 2015 and June 8, 2015 were invited to participate (n = 63 eligible). Participants completed the PRO-CTCAE questionnaire on tablet computers using AmbuFlex software at each treatment visit in the outpatient clinic. In total, 22 symptomatic toxicities (41 PRO-CTCAE items), corresponding to the symptomatic adverse-events profile associated with the regimens commonly used for prostate cancer treatment (Docetaxel, Cabazitaxel, Abiraterone, Alpharadin), were selected. Participants’ PRO-CTCAE responses were presented graphically to their treating oncologists via an AmbuFlex dashboard, for real-time use to enhance the patient-clinician dialogue that occurs during the consultation prior to each treatment cycle. Technical and clinical barriers and acceptability were evaluated through semi-structured interviews with both patients and oncologists. Patients receiving active treatment at the end of the study period completed an evaluation questionnaire. Results Fifty-four out of sixty-three (86%) eligible patients were enrolled. The PRO-CTCAE questionnaire was completed a total of 168 times by 54 participants (median number per patient was 3, range 1–5). Eight surveys were missed, resulting in a compliance rate of 97%. At the end of the study period, 35 patients (65%) were still receiving active treatment and completed the evaluation questionnaire. Patients reported that their PRO-CTCAE responses served as a communication tool. Oncologists stated that the availability of the PRO-CTCAE self-reports during the consultation improved patient-clinician communication about side effects. Conclusion Electronic capture of symptomatic toxicities using PRO-CTCAE and the submission of self-reports to clinicians prior to consultation were feasible among metastatic prostate cancer patients receiving chemotherapy in an outpatient setting, and this procedure was acceptable to both patients and clinicians. Continued research, including a cluster-randomized trial, will evaluate the effects of submitting patients’ PRO-CTCAE results to clinicians prior to consultation on the quality of side-effects management and resultant clinical outcomes.
- Published
- 2017
- Full Text
- View/download PDF
36. Female chromosome X mosaicism is age-related and preferentially affects the inactivated X chromosome
- Author
-
Mitchell J. Machiela, Weiyin Zhou, Eric Karlins, Joshua N. Sampson, Neal D. Freedman, Qi Yang, Belynda Hicks, Casey Dagnall, Christopher Hautman, Kevin B. Jacobs, Christian C. Abnet, Melinda C. Aldrich, Christopher Amos, Laufey T. Amundadottir, Alan A. Arslan, Laura E. Beane-Freeman, Sonja I. Berndt, Amanda Black, William J. Blot, Cathryn H. Bock, Paige M. Bracci, Louise A. Brinton, H Bas Bueno-de-Mesquita, Laurie Burdett, Julie E. Buring, Mary A. Butler, Federico Canzian, Tania Carreón, Kari G. Chaffee, I-Shou Chang, Nilanjan Chatterjee, Chu Chen, Constance Chen, Kexin Chen, Charles C. Chung, Linda S. Cook, Marta Crous Bou, Michael Cullen, Faith G. Davis, Immaculata De Vivo, Ti Ding, Jennifer Doherty, Eric J. Duell, Caroline G. Epstein, Jin-Hu Fan, Jonine D. Figueroa, Joseph F. Fraumeni, Christine M. Friedenreich, Charles S. Fuchs, Steven Gallinger, Yu-Tang Gao, Susan M. Gapstur, Montserrat Garcia-Closas, Mia M. Gaudet, J. Michael Gaziano, Graham G. Giles, Elizabeth M. Gillanders, Edward L. Giovannucci, Lynn Goldin, Alisa M. Goldstein, Christopher A. Haiman, Goran Hallmans, Susan E. Hankinson, Curtis C. Harris, Roger Henriksson, Elizabeth A. Holly, Yun-Chul Hong, Robert N. Hoover, Chao A. Hsiung, Nan Hu, Wei Hu, David J. Hunter, Amy Hutchinson, Mazda Jenab, Christoffer Johansen, Kay-Tee Khaw, Hee Nam Kim, Yeul Hong Kim, Young Tae Kim, Alison P. Klein, Robert Klein, Woon-Puay Koh, Laurence N. Kolonel, Charles Kooperberg, Peter Kraft, Vittorio Krogh, Robert C. Kurtz, Andrea LaCroix, Qing Lan, Maria Teresa Landi, Loic Le Marchand, Donghui Li, Xiaolin Liang, Linda M. Liao, Dongxin Lin, Jianjun Liu, Jolanta Lissowska, Lingeng Lu, Anthony M. Magliocco, Nuria Malats, Keitaro Matsuo, Lorna H. McNeill, Robert R. McWilliams, Beatrice S. Melin, Lisa Mirabello, Lee Moore, Sara H. Olson, Irene Orlow, Jae Yong Park, Ana Patiño-Garcia, Beata Peplonska, Ulrike Peters, Gloria M. Petersen, Loreall Pooler, Jennifer Prescott, Ludmila Prokunina-Olsson, Mark P. Purdue, You-Lin Qiao, Preetha Rajaraman, Francisco X. Real, Elio Riboli, Harvey A. Risch, Benjamin Rodriguez-Santiago, Avima M. Ruder, Sharon A. Savage, Fredrick Schumacher, Ann G. Schwartz, Kendra L. Schwartz, Adeline Seow, Veronica Wendy Setiawan, Gianluca Severi, Hongbing Shen, Xin Sheng, Min-Ho Shin, Xiao-Ou Shu, Debra T. Silverman, Margaret R. Spitz, Victoria L. Stevens, Rachael Stolzenberg-Solomon, Daniel Stram, Ze-Zhong Tang, Philip R. Taylor, Lauren R. Teras, Geoffrey S. Tobias, David Van Den Berg, Kala Visvanathan, Sholom Wacholder, Jiu-Cun Wang, Zhaoming Wang, Nicolas Wentzensen, William Wheeler, Emily White, John K. Wiencke, Brian M. Wolpin, Maria Pik Wong, Chen Wu, Tangchun Wu, Xifeng Wu, Yi-Long Wu, Jay S. Wunder, Lucy Xia, Hannah P. Yang, Pan-Chyr Yang, Kai Yu, Krista A. Zanetti, Anne Zeleniuch-Jacquotte, Wei Zheng, Baosen Zhou, Regina G. Ziegler, Luis A. Perez-Jurado, Neil E. Caporaso, Nathaniel Rothman, Margaret Tucker, Michael C. Dean, Meredith Yeager, and Stephen J. Chanock
- Subjects
Science - Abstract
It is unclear how often genetic mosaicism of chromosome X arises. Here, the authors examine women with cancer and cancer-free controls and show that X chromosome mosaicism occurs more frequently than on autosomes, especially on the inactive X chromosome, but is not linked to non-haematologic cancer risk
- Published
- 2016
- Full Text
- View/download PDF
37. Cohort Profile: The Danish Testicular Cancer Late Treatment Effects Cohort (DaTeCa-LATE)
- Author
-
Michael Kreiberg, Mikkel Bandak, Jakob Lauritsen, Julie Wang Skøtt, Nanna Borup Johansen, Mads Agerbaek, Niels Vilstrup Holm, Christoffer Johansen, and Gedske Daugaard
- Subjects
testicular cancer ,germ cell cancer ,cohort profile ,cohort study ,cancer late effects ,late effects ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
The cohort was set up in order to analyze late effects in long-term testicular cancer survivors (TCS) and to contribute to the design of future follow-up programs addressing and potentially preventing late effects. Data for this cross-sectional study were collected between January 1, 2014, and December 31, 2016, among living Danish TCS and 60% agreed to participate in the cohort (N = 2,572). Mean time since testicular cancer (TC) diagnosis was 18 years (range 7–33) and mean age of participants was 53 years (range 25–95). Data consist of results of a questionnaire with patient reported outcomes which covers a broad range of items on late-effects. The study also included data obtained through linkages to Danish registries, a biobank, and clinical data from hospital files and pathology reports originating from the Danish Testicular Cancer Database (DaTeCa). The treatment during the observation period has been nearly the same for all stages of TC and is in agreement with today’s standard treatment, this allows for interesting analysis with a wide timespan. We have extensive data on non-responders and are able to validate our study findings. Data from a Danish reference population (N = 162,283) allow us to compare our findings with a Danish background population. The cohort can easily be extended to access more outcomes, or include new TCS. A limitation of the present study is the cross-sectional design and despite the large sample size, The Danish Testicular Cancer Late Treatment Effects Cohort (DaTeCa-LATE) lacks statistical power to study very rare late effects. Since it was voluntary to participate in the study we have some selection bias, for instance, we lack responders who were not in a paired relationship, but we would still argue that this cohort of TCSs is representative for TCSs in Denmark.Collaboration and data accessResearches interested in collaboration with the DaTeCa-LATE study group please contact Professor Gedske Daugaard kirsten.gedske.daugaard@regionh.dk.
- Published
- 2018
- Full Text
- View/download PDF
38. Beyond treatment – Psychosocial and behavioural issues in cancer survivorship research and practice
- Author
-
Neil K. Aaronson, Vittorio Mattioli, Ollie Minton, Joachim Weis, Christoffer Johansen, Susanne O. Dalton, Irma M. Verdonck-de Leeuw, Kevin D. Stein, Catherine M. Alfano, Anja Mehnert, Angela de Boer, and Lonneke V. van de Poll-Franse
- Subjects
Psychosocial ,Behavioural ,Cancer ,Survivorship ,Medicine ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
The population of cancer survivors has grown steadily over the past several decades. Surviving cancer, however, is not synonymous with a life free of problems related to the disease and its treatment. In this paper we provide a brief overview of selected physical and psychosocial health problems prevalent among cancer survivors, namely pain, fatigue, psychological distress and work participation. We also address issues surrounding self-management and e-Health interventions for cancer survivors, and programmes to encourage survivors to adopt healthier lifestyles. Finally, we discuss approaches to assessing health-related quality of life in cancer survivors, and the use of cancer registries in conducting psychosocial survivorship research. We highlight research and practice priorities in each of these areas. While the priorities vary per topic, common themes that emerged included: (1) Symptoms should not be viewed in isolation, but rather as part of a cluster of interrelated symptoms. This has implications for both understanding the aetiology of symptoms and for their treatment; (2) Psychosocial interventions need to be evidence-based, and where possible should be tailored to the needs of the individual cancer survivor. Relatively low cost interventions with self-management and e-Health elements may be appropriate for the majority of survivors, with resource intensive interventions being reserved for those most in need; (3) More effort should be devoted to disseminating and implementing interventions in practice, and to evaluating their cost-effectiveness; and (4) Greater attention should be paid to the needs of vulnerable and high-risk populations of survivors, including the socioeconomically disadvantaged and the elderly.
- Published
- 2014
- Full Text
- View/download PDF
39. Online interaction. Effects of storytelling in an internet breast cancer support group
- Author
-
Mette Terp Høybe, Christoffer Johansen, and Tine Tjørnhøj-Thomsen
- Subjects
Sociology (General) ,HM401-1281 - Abstract
The internet provides new ways of forming social relationships among people with breast cancer and is increasingly used for this purpose. This qualitative study, using ethnographic case-study method, aimed to explore how support groups on the internet can break the social isolation that follows cancer and chronic pain, by analysing the storytelling emerging on the Scandinavian Breast Cancer Mailing list. Using participant observation and face-to-face or online interviews of participants, we investigated the motivations of 15 women who chose the internet to counteract social isolation after breast cancer. The results showed that the women were empowered by the exchanges of knowledge and experience within the support group. The internet was considered a means for finding ways of living with breast cancer. Our study suggests that internet support groups have important potential for the rehabilitation of cancer patients.
- Published
- 2008
- Full Text
- View/download PDF
40. Spiritualitet og buddhisme som behandling - En systematisk læsning af 63 selvpræsentationer hos kvinder med brystcancer før og efter mindfulnessintervention
- Author
-
Jakob Rindum Danelund, Tina Bihal, Henrik Flyger, Signe Maria Kay, Sadia Khan, Christian Gaden Jensen, Sivi Svenning Jensen, Christoffer Johansen, Line Neustrup, Anne Pedersen, Hanne Wurtzen, and Peter Elsass
- Subjects
Breastcancer ,Mindfulness ,Intervention ,Spirituality ,Self-presentation ,Qualitative Method ,Philosophy. Psychology. Religion - Abstract
ENGLISH ABSTRACT: Mindfulness flows over the West. It is often branded as a method rooted in Buddhism, but in academical research its relations to a series of Buddhist and spiritual concepts remain undefined. We’ve conducted a systematic reading of 63 self-presentations from women with breast cancer that have participated in mindfulness intervention. Through a simple count of words and meaning units we find that patients describe the effect as becoming more attentive of the present moment and not worrying about the past or the future as much as before. But in a linguistic analysis we find that beginner-meditators are strikingly unarticulated. Common phrases about ‘being more present in the now with an accepting attitude’ may be related to spiritual experiences, but are more frequently inserted in a phenomenology of attention in recent neuroscience. This branch of research lacks qualitative studies that can provide a better understanding of how the mindfulness-phenomenology is related to neuroscience, spirituality and religion. DANSK RESUME: Mindfulness bølgen strømmer ind over Vesten. Den markedsføres ofte som en metode, der har rødder i buddhisme; men set ud fra universitære forskningssammenhænge er dets forhold til en række buddhistiske og spirituelle begreber uafklarede. Vi har foretaget en systematisk læsning af 63 selvpræsentationer hos kvinder med brystkræft, som har gennemgået mindfulness intervention. Ved en simpel optælling af udsagn finder vi, at patienterne beskriver udbyttet som at være blevet mere opmærksomme på det nuværende øjeblik og ikke bekymre sig i ligeså høj grad om fortid eller fremtid som før behandlingen. Men ved en sproglig analyse finder vi, at begynder-meditatorerne er påfaldende uformulerede. Italesættelser om ‘at være mere tilstede i nu’et med en accepterende holdning’ kan dække over spirituelle oplevelser, men sættes hyppigere ind i en fænomenologi om opmærksomhedsfænomener knyttet til nyere neuroscience. Men denne forskning savner flere kvalitative undersøgelser for at kunne begrunde, hvorledes mindfulness fænomenologien sættes i relation til neuroscience og til spiritualitet og religion.
- Published
- 2015
- Full Text
- View/download PDF
41. Distance to high-voltage power lines and risk of childhood leukemia--an analysis of confounding by and interaction with other potential risk factors.
- Author
-
Camilla Pedersen, Elvira V Bräuner, Naja H Rod, Vanna Albieri, Claus E Andersen, Kaare Ulbak, Ole Hertel, Christoffer Johansen, Joachim Schüz, and Ole Raaschou-Nielsen
- Subjects
Medicine ,Science - Abstract
We investigated whether there is an interaction between distance from residence at birth to nearest power line and domestic radon and traffic-related air pollution, respectively, in relation to childhood leukemia risk. Further, we investigated whether adjusting for potential confounders alters the association between distance to nearest power line and childhood leukemia. We included 1024 cases aged
- Published
- 2014
- Full Text
- View/download PDF
42. Mobile phones and multiple sclerosis--a nationwide cohort study in Denmark.
- Author
-
Aslak Harbo Poulsen, Egon Stenager, Christoffer Johansen, Joan Bentzen, Søren Friis, and Joachim Schüz
- Subjects
Medicine ,Science - Abstract
We investigated the risk of, prognosis of and symptoms of multiple sclerosis (MS) among all Danish residents who owned a mobile phone subscription before 1996. Using the Danish Multiple Sclerosis Registry and Civil Registration System, study subjects were followed up for MS through 2004. Poisson models were used to calculate incidence rate ratios (IRR, age range: 18-64 years) and mortality rate ratios (MRR, age range: 18+) and to compare presenting symptoms among subscribers and all non-subscribers. A total of 405 971 subscription holders accrued four million years of follow up, with men accounting for 86% of the observation time. Among subscription holding men, the IRR of MS was close to unity, overall as well as 13+ years after first subscription (IRR 1.02, 95% CI: 0.48-2.16). Among women, the IRR was 3.43 (95% CI: 0.86-13.72) 13+ years after first subscription, however, based on only two cases. Presenting symptoms of MS differed between subscribers and non-subscribers (p = 0.03), with slightly increased risk of diplopia in both genders (IRR: 1.38, 95% CI: 1.02-1.86), an increased risk of fatigue among women (IRR: 3.02, 95% CI: 1.45-6.28), and of optic neuritis among men (IRR: 1.38, 95% CI: 1.03-1.86). Overall the MRR was close to one (MRR: 0.91, 95%CI 0.70-1.19) among MS-patients with a subscription and although we observed some increased MRR estimates among women, these were based on small numbers. In conclusion, we found little evidence for a pronounced association between mobile phone use and risk of MS or mortality rate among MS patients. Symptoms of MS differed between subscribers and nonsubscribers for symptoms previously suggested to be associated with mobile phone use. This deserves further attention, as does the increased long-term risk of MS among female subscribers, although small numbers and lack of consistency between genders prevent causal interpretation.
- Published
- 2012
- Full Text
- View/download PDF
43. Risks for central nervous system diseases among mobile phone subscribers: a Danish retrospective cohort study.
- Author
-
Joachim Schüz, Gunhild Waldemar, Jørgen H Olsen, and Christoffer Johansen
- Subjects
Medicine ,Science - Abstract
The aim of this study was to investigate a possible link between cellular telephone use and risks for various diseases of the central nervous system (CNS). We conducted a large nationwide cohort study of 420 095 persons whose first cellular telephone subscription was between 1982 and 1995, who were followed through 2003 for hospital contacts for a diagnosis of a CNS disorder. Standardized hospitalization ratios (SHRs) were derived by dividing the number of hospital contacts in the cohort by the number expected in the Danish population. The SHRs were increased by 10-20% for migraine and vertigo. No associations were seen for amyotrophic lateral sclerosis, multiple sclerosis or epilepsy in women. SHRs decreased by 30-40% were observed for dementia (Alzheimer disease, vascular and other dementia), Parkinson disease and epilepsy among men. In analyses restricted to subscribers of 10 years or more, the SHRs remained similarly increased for migraine and vertigo and similarly decreased for Alzheimer disease and other dementia and epilepsy (in men); the other SHRs were close to unity. In conclusion, the excesses of migraine and vertigo observed in this first study on cellular telephones and CNS disease deserve further attention. An interplay of a healthy cohort effect and reversed causation bias due to prodromal symptoms impedes detection of a possible association with dementia and Parkinson disease. Identification of the factors that result in a healthy cohort might be of interest for elucidation of the etiology of these diseases.
- Published
- 2009
- Full Text
- View/download PDF
44. Psycho-Social Oncology. Future perspectives
- Author
-
Christoffer Johansen
- Subjects
Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 ,Psychology ,BF1-990 - Abstract
Sin resumen
- Published
- 2003
45. Association of patient-reported pain with survival in bladder cancer: a post-hoc analysis of the iBLAD trial
- Author
-
Dag Rune Stormoen, Gry Assam Taarnhøj, Rasmus Blechingberg Friis, Christoffer Johansen, and Helle Pappot
- Subjects
Oncology ,Radiology, Nuclear Medicine and imaging ,Hematology ,General Medicine - Abstract
Association of patient-reported pain with survival in bladder cancer: a post-hoc analysis of the iBLAD trial
- Published
- 2023
46. Effects on long-term survival of psychosocial group intervention in early-stage breast cancer: follow-up of a randomized controlled trial
- Author
-
Anne Marie Kirkegaard, Susanne Oksbjerg Dalton, Ellen Helle Boesen, Randi V. Karlsen, Henrik Flyger, Christoffer Johansen, and Annika von Heymann
- Subjects
Oncology ,Radiology, Nuclear Medicine and imaging ,Hematology ,General Medicine - Published
- 2023
47. Are education and cohabitation associated with health-related quality of life and self-management during breast cancer follow-up? A longitudinal study
- Author
-
Randi V. Karlsen, Beverley Lim Høeg, Susanne Oksbjerg Dalton, Lena Saltbæk, Christian Dehlendorff, Christoffer Johansen, Mads Nordahl Svendsen, and Pernille E. Bidstrup
- Subjects
Oncology ,Radiology, Nuclear Medicine and imaging ,Hematology ,General Medicine - Published
- 2023
48. The long-term burden of a symptom cluster and association with longitudinal physical and emotional functioning in breast cancer survivors
- Author
-
Freja Ejlebæk Ebbestad, Gunn Ammitzbøll, Trine Allerslev Horsbøll, Ingelise Andersen, Christoffer Johansen, Bo Zehran, and Susanne Oksbjerg Dalton
- Subjects
Oncology ,Radiology, Nuclear Medicine and imaging ,Hematology ,General Medicine - Abstract
Fatigue, insomnia and pain are some of the most common and distressing symptoms experienced during breast cancer (BC) treatment and survivorship. The symptoms have been found to impact one another and to form a symptom cluster, and greater severity of the symptoms may be negatively associated with physical and emotional functioning in survivorship. In exploratory analyses from a randomized controlled trial examining the effect of progressive resistance training on the development of lymphedema after BC, we aimed to examine the burden of the symptom cluster fatigue-pain-insomnia, and its prognostic value for long-term symptom severity as well as emotional and physical functioning Latent profile analysis was used to identify groups with similar severity of pain, fatigue and insomnia among 158 patients with BC two weeks after surgery. Mixed effects Tobit regression models were used to estimate fatigue, pain, insomnia, and physical and emotional functioning 20 weeks, 1 year and 3.5 years after surgery. Two symptom burden groups were identified: 80% of women had a low severity while 20% of women had a high severity of the three symptoms after BC surgery. 3.5 years later, the women with high symptom burden post-surgery still had higher pain, insomnia and fatigue scores than women with low symptom burden. High symptom burden post-surgery was associated with worse physical functioning 3.5 years later, while emotional functioning was only negatively impacted during the first year. These findings warrant larger studies investigating if symptom burden early in BC trajectory can be used for risk stratification for persistent symptoms and diminished physical functioning with the purpose of developing and implementing targeted interventions.
- Published
- 2023
49. Sarcopenia and loss of muscle mass in patients with lung cancer undergoing chemotherapy treatment: a systematic review and meta-analysis
- Author
-
Sandra Jensen, Zina Bloch, Morten Quist, Tobias Tuse Dunk Hansen, Christoffer Johansen, Helle Pappot, Charlotte Suetta, and Bolette Skjødt Rafn
- Subjects
Oncology ,Radiology, Nuclear Medicine and imaging ,Hematology ,General Medicine - Published
- 2023
50. Cardiovascular risk factors, radiation therapy, and myocardial infarction among lymphoma survivors
- Author
-
Talya Salz, Emily C. Zabor, Peter De Nully Brown, Susanne Oksbjerg Dalton, Nirupa J. Raghunathan, Matthew J. Matasar, Richard Steingart, Henrik Hjalgrim, Lena Specht, Andrew J. Vickers, Kevin C. Oeffinger, and Christoffer Johansen
- Subjects
Adult ,Lymphoma ,Lymphoma, Non-Hodgkin ,Myocardial Infarction ,Hematology ,General Medicine ,Middle Aged ,Oncology ,Cardiovascular Diseases ,Risk Factors ,Heart Disease Risk Factors ,Humans ,Radiology, Nuclear Medicine and imaging ,Survivors - Abstract
Mediastinal radiation is associated with increased risk of myocardial infarction (MI) among non-Hodgkin lymphoma (NHL) survivors.To evaluate how preexisting cardiovascular risk factors (CVRFs) modify the association of mediastinal radiation and MI among a national population of NHL survivors with a range of CVRFs.Using Danish registries, we identified adults diagnosed with lymphoma 2000-2010. We assessed MI from one year after diagnosis through 2016. We ascertained CVRFs (hypertension, dyslipidemia, and diabetes), vascular disease, and intrinsic heart disease prevalent at lymphoma diagnosis. We used multivariable Cox regression to test the interaction between preexisting CVRFs and receipt of mediastinal radiation on subsequent MI.Among 3151 NHL survivors (median age 63, median follow-up 6.5 years), 96 were diagnosed with MI. Before lymphoma, 32% of survivors had ≥1 CVRF. 8.5% of survivors received mediastinal radiation. In multivariable analysis, we found that mediastinal radiation (HR = 1.96; 95% CI = 1.09-3.52), and presence of ≥1 CVRF (HR = 2.71; 95% CI = 1.77-4.15) were associated with an increased risk of MI. Although there was no interaction on the relative scale (Patients with CVRFs have an importantly higher risk of subsequent MI if they have mediastinal radiation. Routine evaluation of CVRFs and optimal treatment of preexisting cardiovascular disease should continue after receiving cancer therapy. In patients with CVRFs, mediastinal radiation should only be given if oncologic benefit clearly outweighs cardiovascular harm.
- Published
- 2022
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.