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4. Identifying and describing cancer survivors: Implications for cancer survivorship research and clinical care

Author

Doose, Michelle, Mollica, Michelle A, Attai, Deanna J, Nasso, Shelley Fuld, Elena, Joanne W, Jacobsen, Paul B, Tonorezos, Emily S, and Nekhlyudov, Larissa

Subjects
Health Services and Systems, Nursing, Health Sciences, Cancer, Rehabilitation, 7.1 Individual care needs, Management of diseases and conditions, Cancer Survivors, Cross-Sectional Studies, Humans, Neoplasms, Surveys and Questionnaires, Survivors, United States, cancer survivors, cross-sectional studies, health surveys, surveys and questionnaires, Oncology and Carcinogenesis, Public Health and Health Services, Oncology & Carcinogenesis, Oncology and carcinogenesis, Public health
Abstract

BackgroundGathering information directly from cancer survivors has advanced our understanding of the cancer survivorship experience. However, it is unknown whether surveys can distinguish important subgroups of cancer survivors. This study aimed to describe the current landscape of survey questions used to identify and describe cancer survivors in national cross-sectional studies.MethodsUsing publicly available databases, the authors identified national cross-sectional surveys used in the United States within the past 15 years that included a question on self-reported history of cancer. After abstracting questions and response items used to identify cancer survivors, they conducted a descriptive analysis.ResultsThe authors identified 14 national cross-sectional surveys, with half administered to the general population and the other half administered to cancer survivors. The most common question used to identify cancer survivors was "Have you ever been told by a doctor or other health professional that you had cancer?" Most surveys had questions asking participants to identify a single cancer type (n = 11), multiple prior cancer diagnoses or types (n = 11), and the time from diagnosis (n = 12). Treatment questions varied from active treatment status to specific treatments received. Questions addressing cancer stage (n = 2), subtypes (n = 1), metastatic status (n = 3), and recurrence (n = 4) were less frequently included.ConclusionsThere is no standard method for assessing self-reported cancer history, and this limits the ability to distinguish among potentially important subgroups of survivors. Future cross-sectional surveys that capture nuanced data elements, such as cancer types, stages/subtypes, metastatic/recurrent status, and treatments received, can help to fill important gaps in cancer survivorship research and clinical care.

Published
2022

5. Using Behavioral Science to Address COVID-19 Vaccine Hesitancy Among Cancer Survivors: Communication Strategies and Research Opportunities

Author

Vanderpool, Robin C., Gaysynsky, Anna, Chou, Wen-Ying Sylvia, and Tonorezos, Emily S.

Subjects
Cancer survivors -- Beliefs, opinions and attitudes, Behavioral health care -- Usage, Psychology and mental health
Abstract

Due to cancer survivors' increased vulnerability to complications from COVID-19, addressing vaccine hesitancy and improving vaccine uptake among this population is a public health priority. However, several factors may complicate efforts to increase vaccine confidence in this population, including the underrepresentation of cancer patients in COVID-19 vaccine trials and distinct recommendations for vaccine administration and timing for certain subgroups of survivors. Evidence suggests vaccine communication efforts targeting survivors could benefit from strategies that consider factors such as social norms, risk perceptions, and trust. However, additional behavioral research is needed to help the clinical and public health community better understand, and more effectively respond to, drivers of vaccine hesitancy among survivors and ensure optimal protection against COVID-19 for this at-risk population. Knowledge generated by this research could also have an impact beyond the current COVID-19 pandemic by informing future vaccination efforts and communication with cancer survivors more broadly., Author(s): Robin C. Vanderpool [sup.1] , Anna Gaysynsky [sup.1] [sup.2] , Wen-Ying Sylvia Chou [sup.1] , Emily S. Tonorezos [sup.3] Author Affiliations: (1) grid.48336.3a, 0000 0004 1936 8075, Health Communication [...]

Published
2023
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10. Risk of increased mortality in underweight survivors: A brief report from the Childhood Cancer Survivor Study

Author

Tonorezos, Emily S., primary, Chou, Joanne F., additional, Moskowitz, Chaya S., additional, Leisenring, Wendy M., additional, Friedman, Danielle Novetsky, additional, Sklar, Charles A., additional, Dilley, Kimberly J., additional, Hudson, Melissa M., additional, Mertens, Ann, additional, Armstrong, Gregory T., additional, Robison, Leslie L., additional, Meacham, Lillian R., additional, and Oeffinger, Kevin C., additional

Published
2024
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11. Exercise and QUality diet After Leukemia (EQUAL): A randomized weight loss trial among adult survivors of childhood leukemia in the Childhood Cancer Survivor Study

Author

Friedman, Danielle Novetsky., primary, Chou, Joanne F., additional, Clark, Jeanne M., additional, Moskowitz, Chaya S., additional, Ford, Jennifer S., additional, Armstrong, Gregory T., additional, Mubdi, Nidha Z., additional, McDonald, Aaron, additional, Nathan, Paul C., additional, Sklar, Charles A., additional, Ramanathan, Lakshmi V., additional, Robison, Leslie L., additional, Oeffinger, Kevin C., additional, and Tonorezos, Emily S., additional

Published
2024
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13. Coronary Artery Disease in Young Women After Radiation Therapy for Breast Cancer: The WECARE Study

Author

Bernstein, Jonine L., Capanu, Marinela, Orlow, Irene, Robson, Mark, Olsen, Jørgen H., Malone, Kathleen E., Stovall, Marilyn, Blackmore, Kristina, Harris, Irene, Langballe, Rikke, O’Brien, Cecilia, Weathers, Rita, West, Michele, Hunter, Lisa, Goldstein, Judy, Ramos, Elaine, Carlson, Lauren E., Watt, Gordon P., Tonorezos, Emily S., Chow, Eric J., Yu, Anthony F., Woods, Meghan, Lynch, Charles F., John, Esther M., Mellemkjӕr, Lene, Brooks, Jennifer D., Knight, Julia A., Reiner, Anne S., Liang, Xiaolin, Smith, Susan A., Bernstein, Leslie, Dauer, Lawrence T., Cerviño, Laura I., Howell, Rebecca M., Shore, Roy E., and Boice, John D., Jr.

Published
2021
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17. Impact of risk-based therapy on late morbidity and mortality in neuroblastoma survivors: a report from the Childhood Cancer Survivor Study.

Author

Friedman, Danielle Novetsky, Goodman, Pamela J, Leisenring, Wendy M, Diller, Lisa R, Cohn, Susan L, Howell, Rebecca M, Smith, Susan A, Tonorezos, Emily S, Wolden, Suzanne L, Neglia, Joseph P, Ness, Kirsten K, Gibson, Todd M, Nathan, Paul C, Turcotte, Lucie M, Weil, Brent R, Robison, Leslie L, Oeffinger, Kevin C, Armstrong, Gregory T, Sklar, Charles A, and Henderson, Tara O

Subjects
NEUROBLASTOMA, CHILDHOOD cancer, CANCER survivors, STEM cell transplantation, MORTALITY, REGRESSION analysis
Abstract

Background Early efforts at risk-adapted therapy for neuroblastoma are predicted to result in differential late effects; the magnitude of these differences has not been well described. Methods Late mortality, subsequent malignant neoplasms (SMNs), and severe/life-threatening chronic health conditions (CHCs), graded according to CTCAE v4.03, were assessed among 5-year Childhood Cancer Survivor Study (CCSS) survivors of neuroblastoma diagnosed 1987-1999. Using age, stage at diagnosis, and treatment, survivors were classified into risk groups (low [n = 425]; intermediate [n = 252]; high [n = 245]). Standardized mortality ratios (SMRs) and standardized incidence ratios (SIRs) of SMNs were compared with matched population controls. Cox regression models estimated hazard ratios (HRs) and 95% confidence intervals for CHC compared with 1029 CCSS siblings. Results Among survivors (49.8% male; median age = 21 years, range = 7-42; median follow-up = 19.3 years, range = 5-29.9), 80% with low-risk disease were treated with surgery alone, whereas 79.1% with high-risk disease received surgery, radiation, chemotherapy ± autologous stem cell transplant (ASCT). All-cause mortality was elevated across risk groups (SMRhigh = 27.7 [21.4-35.8]; SMRintermediate = 3.3 [1.7-6.5]; SMRlow = 2.8 [1.7-4.8]). SMN risk was increased among high- and intermediate-risk survivors (SIRhigh = 28.0 [18.5-42.3]; SIRintermediate = 3.7 [1.2-11.3]) but did not differ from the US population for survivors of low-risk disease. Compared with siblings, survivors had an increased risk of grade 3-5 CHCs, particularly among those with high-risk disease (HRhigh = 16.1 [11.2-23.2]; HRintermediate = 6.3 [3.8-10.5]; HRlow = 1.8 [1.1-3.1]). Conclusion Survivors of high-risk disease treated in the early days of risk stratification carry a markedly elevated burden of late recurrence, SMN, and organ-related multimorbidity, whereas survivors of low/intermediate-risk disease have a modest risk of late adverse outcomes. [ABSTRACT FROM AUTHOR]

Published
2024
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19. Primary Care Utilization and Cardiovascular Screening in Adult Survivors of Childhood Cancer

Author

Ohlsen, Timothy J. D., primary, Chen, Yan, additional, Baldwin, Laura-Mae, additional, Hudson, Melissa M., additional, Nathan, Paul C., additional, Snyder, Claire, additional, Syrjala, Karen L., additional, Tonorezos, Emily S., additional, Yasui, Yutaka, additional, Armstrong, Gregory T., additional, Oeffinger, Kevin C., additional, and Chow, Eric J., additional

Published
2023
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23. Ototoxicity associated with high‐dose carboplatin for patients with previously treated germ cell tumors

Author

Funt, Samuel A., primary, Knezevic, Andrea, additional, Wilson, Kaamilah, additional, Bromberg, Maria, additional, Budnick, Amy, additional, O’Connor, Kerri L., additional, McHugh, Deaglan J., additional, Larsen, Erik, additional, Bajorin, Dean F., additional, Motzer, Robert J., additional, Tonorezos, Emily S., additional, Patil, Sujata, additional, and Feldman, Darren R., additional

Published
2023
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24. Non-Small-Cell Lung Cancer After Mantle Radiation: A Case Report and Brief Review

Author

Lopez, Carlos A. and Tonorezos, Emily S.

Subjects
Medical research, Medicine, Experimental, Cancer -- Care and treatment, Lung cancer, Non-small cell -- Care and treatment -- Research, Health
Abstract

Survivors of childhood and young adult cancer are at risk for developing subsequent malignant neoplasms, including lung cancer. As survival rates in this group continue to improve and patients enter later decades in life, determining the optimal surveillance and counseling strategies with regards to subsequent cancers remains a challenge. In this case report, we present a non-Hodgkin lymphoma survivor who was incidentally found to have non-small-cell lung cancer 30 years after undergoing treatment that included mantle radiation. We discuss the treatment-related risk factors for lung cancer in this population and potential implications for long-term follow-up., Introduction As a result of improving treatment and supportive care, the population of childhood and young adult cancer survivors is expected to continue to rise over the coming years.[1] Childhood [...]

Published
2019

30. Long-Term Morbidity and Mortality Among Survivors of Neuroblastoma Diagnosed During Infancy: A Report From the Childhood Cancer Survivor Study

Author

Friedman, Danielle Novetsky, primary, Goodman, Pamela J., additional, Leisenring, Wendy M., additional, Diller, Lisa R., additional, Cohn, Susan L., additional, Howell, Rebecca M., additional, Smith, Susan A., additional, Tonorezos, Emily S., additional, Wolden, Suzanne L., additional, Neglia, Joseph P., additional, Ness, Kirsten K., additional, Gibson, Todd M., additional, Nathan, Paul C., additional, Weil, Brent R., additional, Robison, Leslie L., additional, Oeffinger, Kevin C., additional, Armstrong, Gregory T., additional, Sklar, Charles A., additional, and Henderson, Tara O., additional

Published
2022
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34. Underdiagnosis and Undertreatment of Modifiable Cardiovascular Risk Factors Among Survivors of Childhood Cancer

Author

Chow, Eric J., primary, Chen, Yan, additional, Armstrong, Gregory T., additional, Baldwin, Laura‐Mae, additional, Cai, Casey R., additional, Gibson, Todd M., additional, Hudson, Melissa M., additional, McDonald, Aaron, additional, Nathan, Paul C., additional, Olgin, Jeffrey E., additional, Syrjala, Karen L., additional, Tonorezos, Emily S., additional, Oeffinger, Kevin C., additional, and Yasui, Yutaka, additional

Published
2022
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35. Use and correlates of carotid ultrasound in survivors of childhood cancer: A report from the Childhood Cancer Survivor Study.

Author

Bryce, Yolanda C, primary, Armstrong, Gregory T., additional, Leisenring, Wendy M., additional, Whitton, Jillian, additional, Chow, Eric Jessen, additional, Weil, Brent R., additional, Dieffenbach, Bryan, additional, Howell, Rebecca M., additional, Oeffinger, Kevin C., additional, Nathan, Paul C., additional, and Tonorezos, Emily S., additional

Published
2022
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37. Long-Term Morbidity and Mortality Among Survivors of Neuroblastoma Diagnosed During Infancy: A Report From the Childhood Cancer Survivor Study.

Author

Friedman, Danielle Novetsky, Goodman, Pamela J., Leisenring, Wendy M., Diller, Lisa R., Cohn, Susan L., Howell, Rebecca M., Smith, Susan A., Tonorezos, Emily S., Wolden, Suzanne L., Neglia, Joseph P., Ness, Kirsten K., Gibson, Todd M., Nathan, Paul C., Weil, Brent R., Robison, Leslie L., Oeffinger, Kevin C., Armstrong, Gregory T., Sklar, Charles A., and Henderson, Tara O.

Published
2023
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44. Coronary artery disease surveillance among childhood, adolescent and young adult cancer survivors: A systematic review and recommendations from the International Late Effects of Childhood Cancer Guideline Harmonization Group

Author

van Dalen, Elvira C., primary, Mulder, Renée L., additional, Suh, Eugene, additional, Ehrhardt, Matthew J., additional, Aune, Gregory J., additional, Bardi, Edit, additional, Benson, Bradley J., additional, Bergler-Klein, Jutta, additional, Chen, Ming H., additional, Frey, Eva, additional, Hennewig, Ulrike, additional, Lockwood, Liane, additional, Martinsson, Ulla, additional, Muraca, Monica, additional, van der Pal, Helena, additional, Plummer, Chris, additional, Scheinemann, Katrin, additional, Schindera, Christina, additional, Tonorezos, Emily S., additional, Wallace, W. Hamish, additional, Constine, Louis S., additional, Skinner, Roderick, additional, Hudson, Melissa M., additional, Kremer, Leontien C.M., additional, Levitt, Gill, additional, and Mulrooney, Daniel A., additional

Published
2021
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45. Coronary Artery Disease in Young Women After Radiation Therapy for Breast Cancer

Author

Carlson, Lauren E., primary, Watt, Gordon P., additional, Tonorezos, Emily S., additional, Chow, Eric J., additional, Yu, Anthony F., additional, Woods, Meghan, additional, Lynch, Charles F., additional, John, Esther M., additional, Mellemkjӕr, Lene, additional, Brooks, Jennifer D., additional, Knight, Julia A., additional, Reiner, Anne S., additional, Liang, Xiaolin, additional, Smith, Susan A., additional, Bernstein, Leslie, additional, Dauer, Lawrence T., additional, Cerviño, Laura I., additional, Howell, Rebecca M., additional, Shore, Roy E., additional, Boice, John D., additional, Bernstein, Jonine L., additional, Capanu, Marinela, additional, Orlow, Irene, additional, Robson, Mark, additional, Olsen, Jørgen H., additional, Malone, Kathleen E., additional, Stovall, Marilyn, additional, Blackmore, Kristina, additional, Harris, Irene, additional, Langballe, Rikke, additional, O’Brien, Cecilia, additional, Weathers, Rita, additional, West, Michele, additional, Hunter, Lisa, additional, Goldstein, Judy, additional, and Ramos, Elaine, additional

Published
2021
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46. Coronary artery disease surveillance among childhood, adolescent and young adult cancer survivors : A systematic review and recommendations from the International Late Effects of Childhood Cancer Guideline Harmonization Group

Author

van Dalen, Elvira C., Mulder, Renee L., Suh, Eugene, Ehrhardt, Matthew J., Aune, Gregory J., Bardi, Edit, Benson, Bradley J., Bergler-Klein, Jutta, Chen, Ming H., Frey, Eva, Hennewig, Ulrike, Lockwood, Liane, Martinsson, Ulla, Muraca, Monica, Pal, Helena van der, Plummer, Chris, Scheinemann, Katrin, Schindera, Christina, Tonorezos, Emily S., Wallace, W. Hamish, Constine, Louis S., Skinner, Roderick, Hudson, Melissa M., Kremer, Leontien C. M., Levitt, Gill, Mulrooney, Daniel A., van Dalen, Elvira C., Mulder, Renee L., Suh, Eugene, Ehrhardt, Matthew J., Aune, Gregory J., Bardi, Edit, Benson, Bradley J., Bergler-Klein, Jutta, Chen, Ming H., Frey, Eva, Hennewig, Ulrike, Lockwood, Liane, Martinsson, Ulla, Muraca, Monica, Pal, Helena van der, Plummer, Chris, Scheinemann, Katrin, Schindera, Christina, Tonorezos, Emily S., Wallace, W. Hamish, Constine, Louis S., Skinner, Roderick, Hudson, Melissa M., Kremer, Leontien C. M., Levitt, Gill, and Mulrooney, Daniel A.

Abstract

Background: Coronary artery disease (CAD) is a concerning late outcome for cancer survivors. However, uniform surveillance guidelines are lacking. Aim: To harmonise international recommendations for CAD surveillance for survivors of childhood, adolescent and young adult (CAYA) cancers. Methods: A systematic literature review was performed and evidence graded using the Grading of Recommendations, Assessment, Development and Evaluation criteria. Eligibility included English language studies, a minimum of 20 off-therapy cancer survivors assessed for CAD, and 75% diagnosed prior to age 35 years. All study designs were included, and a multidisciplinary guideline panel formulated and graded recommendations. Results: 32 of 522 identified articles met eligibility criteria. The prevalence of CAD ranged from 0 to 72% and was significantly increased compared to control populations. The risk of CAD was increased among survivors who received radiotherapy exposing the heart, especially at doses >15 Gy (moderate-quality evidence). The guideline panel agreed that healthcare providers and CAYA cancer survivors treated with radiotherapy exposing the heart should be counselled about the increased risk for premature CAD. While the evidence is insufficient to support primary screening, monitoring and early management of modifiable cardiovascular risk factors are recommended. Initiation and frequency of surveillance should be based on the intensity of treatment exposures, family history, and presence of co-morbidities but at least by age 40 years and at a minimum of every 5 years. All were strong recommendations. Conclusion: These systematically assessed and harmonised recommendations for CAD surveillance will inform care and guide research concerning this critical outcome for CAYA cancer survivors.

Published
2021
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50. Disparities in cardiovascular risk factors by race/ethnicity among adult survivors of childhood cancer: A report from the Childhood Cancer Survivorship Study (CCSS).

Author

Noyd, David H, primary, Yasui, Yutaka, additional, Li, Nan, additional, Chow, Eric Jessen, additional, Bhatia, Smita, additional, Landstrom, Andrew, additional, Gilchrist, Susan, additional, Tonorezos, Emily S., additional, Zullig, Leah L., additional, Casillas, Jacqueline N., additional, Berkman, Amy Madelon, additional, Ness, Kirsten K., additional, Mulrooney, Daniel A., additional, Leisenring, Wendy M., additional, Howell, Carrie R., additional, Shoag, Jamie Michelle, additional, Kirchhoff, Anne C., additional, Howell, Rebecca M., additional, Armstrong, Gregory T., additional, and Oeffinger, Kevin C., additional

Published
2021
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