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41.
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Grant R. Williams Kathryn E. Weaver Glenn J. Lesser Emily Dressler Karen M. Winkfield Heather B. Neuman Anne E. Kazak Ruth Carlos Lucy J. Gansauer Charles S. Kamen Joseph M. Unger Supriya G. Mohile Heidi D. Klepin 《The oncologist》2020,25(12):1032-1038
BackgroundAmerican Society of Clinical Oncology guidelines recommend that patients ≥65 years of age starting chemotherapy undergo a geriatric assessment (GA) to inform and guide management; however, little is known about resources available in community oncology practices to implement these guidelines and to facilitate geriatric oncology research.Materials and MethodsOncology practices within the National Cancer Institute Community Oncology Research Program (NCORP) were electronically surveyed in 2017 regarding the availability of specialty providers, supportive services, and practice characteristics, as part of a larger survey of cancer care delivery research capacity.ResultsOf the 943 NCORP practices, 504 (54%) responded to the survey, representing 210 practice groups. The median new cancer cases per year ≥65 years of age was 457 (interquartile range 227–939). Of respondents, only 2.0% of practices had a fellowship‐trained geriatric oncologist on staff. Geriatricians were available for consultation or comanagement at 37% of sites, and of those, only 13% had availability within the oncology clinic (5% of overall). Practice size of ≥1,000 new adult cancer cases (ages ≥18) per year was associated with higher odds (1.81, confidence interval 1.02–3.23) of geriatrician availability. Other multidisciplinary care professionals that could support GA were variably available onsite: social worker (84%), nurse navigator (81%), pharmacist (77%), dietician (71%), rehabilitative medicine (57%), psychologist (42%), and psychiatrist (37%).ConclusionOnly a third of community oncology practices have access to a geriatrician within their group and only 5% of community sites have access within the oncology clinic. Use of primarily self‐administered GA tools that direct referrals to available services may be an effective implementation strategy for guideline‐based care.Implications for PracticeOnly a minority of community oncology practices in the U.S. have access to geriatric specialty care. Developing models of care that use patient‐reported measures and/or other geriatric screening tools to assess and guide interventions in older adults, rather than geriatric consultations, are likely the most practical methods to improve the care of this vulnerable population. 相似文献
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Javier Jarazo PhD Kyriaki Barmpa MSc Jennifer Modamio PhD Cláudia Saraiva PhD Sònia Sabaté-Soler MSc Isabel Rosety MSc Anne Griesbeck PhD Florian Skwirblies BSc Gaia Zaffaroni PhD Lisa M. Smits PhD Jihui Su BSc Jonathan Arias-Fuenzalida PhD Jonas Walter PhD Gemma Gomez-Giro PhD Anna S. Monzel PhD Xiaobing Qing PhD Armelle Vitali MSc Gerald Cruciani MSc Ibrahim Boussaad PhD Francesco Brunelli PhD Christian Jäger PhD Aleksandar Rakovic PhD Wen Li PhD Lin Yuan PhD Emanuel Berger PhD Giuseppe Arena PhD Silvia Bolognin PhD Ronny Schmidt PhD Christoph Schröder PhD Paul M.A. Antony PhD Christine Klein MD Rejko Krüger MD Philip Seibler PhD Jens C. Schwamborn PhD 《Movement disorders》2022,37(1):80-94
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Renée T. Fortner Anika Hüsing Laure Dossus Anne Tjønneland Kim Overvad Christina C. Dahm Patrick Arveux Agnès Fournier Marina Kvaskoff Matthias B. Schulze Manuela Bergmann Antonia Trichopoulou Anna Karakatsani Carlo La Vecchia Giovanna Masala Valeria Pala Amalia Mattiello Rosario Tumino Fulvio Ricceri Carla H. van Gils Evelyn M. Monninkhof Catalina Bonet José Ramón Quirós Maria-Jose Sanchez Daniel-Ángel Rodríguez-Palacios Aurelio B Gurrea Pilar Amiano Naomi E. Allen Ruth C. Travis Marc J. Gunter Vivian Viallon Elisabete Weiderpass Elio Riboli Rudolf Kaaks 《International journal of cancer. Journal international du cancer》2020,147(5):1325-1333
Endometrial cancer (EC) incidence rates vary ~10-fold worldwide, in part due to variation in EC risk factor profiles. Using an EC risk model previously developed in the European EPIC cohort, we evaluated the prevention potential of modified EC risk factor patterns and whether differences in EC incidence between a European population and low-risk countries can be explained by differences in these patterns. Predicted EC incidence rates were estimated over 10 years of follow-up for the cohort before and after modifying risk factor profiles. Risk factors considered were: body mass index (BMI, kg/m2), use of postmenopausal hormone therapy (HT) and oral contraceptives (OC) (potentially modifiable); and, parity, ages at first birth, menarche and menopause (environmentally conditioned, but not readily modifiable). Modeled alterations in BMI (to all ≤23 kg/m2) and HT use (to all non-HT users) profiles resulted in a 30% reduction in predicted EC incidence rates; individually, longer duration of OC use (to all ≥10 years) resulted in a 42.5% reduction. Modeled changes in not readily modifiable exposures (i.e., those not contributing to prevention potential) resulted in ≤24.6% reduction in predicted EC incidence. Women in the lowest decile of a risk score based on the evaluated exposures had risk similar to a low risk countries; however, this was driven by relatively long use of OCs (median = 23 years). Our findings support avoidance of overweight BMI and of HT use as prevention strategies for EC in a European population; OC use must be considered in the context of benefits and risks. 相似文献
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Overbeek Kasper A. Cahen Djuna L. Kamps Anne Konings Ingrid C. A. W. Harinck Femme Kuenen Marianne A. Koerkamp Bas Groot Besselink Marc G. van Eijck Casper H. Wagner Anja Ausems Margreet G. E. van der Vlugt Manon Fockens Paul Vleggaar Frank P. Poley Jan-Werner van Hooft Jeanin E. Bleiker Eveline M. A. Bruno Marco J. 《Familial cancer》2020,19(3):247-258
Familial Cancer - In high-risk individuals participating in a pancreatic cancer surveillance program, worrisome features warrant for intensified surveillance or, occasionally, surgery. Our... 相似文献
50.
Peter D. Baade David C. Whiteman Monika Janda Anne E. Cust Rachel E. Neale Bernard Mark Smithers Adele C. Green Kiarash Khosrotehrani Victoria Mar H. Peter Soyer Joanne F. Aitken 《International journal of cancer. Journal international du cancer》2020,147(5):1391-1396
There is little long-term follow-up information about how the number of melanoma deaths and case fatality vary over time according to the measured thickness of melanoma at diagnosis. This population-based longitudinal cohort study examines patterns and trends in case fatality among 44,531 people in Queensland (Australia) diagnosed with a single invasive melanoma (International Classification of Diseases for Oncology, third revision [ICD-O-3], C44, Morphology 872–879) between 1987 and 2011, including 11,883 diagnosed between 1987 and 1996, with up to 20 years follow-up (to December 2016). The 20-year case fatality increased by thickness, with the percentage of melanoma deaths within 20 years of diagnosis being up to 4.8% for melanomas with measured thickness <0.80 mm, 10.6% for tumors 0.8 to <1.0 mm and generally more than 30% for melanomas measuring 3 mm and more. For melanomas <1.0 mm, most deaths occurred between 5 and 20 years after diagnosis, whereas for thicker melanomas the reverse was true with most deaths occurring within the first 5 years. Five-year case fatality decreased over successive calendar time periods for melanomas <1.0 mm, but not for melanomas ≥1.0 mm. These findings demonstrate that the time course for fatal melanomas varies markedly according to tumor thickness at diagnosis. Improved understanding of the patient factors and characteristics of melanomas, in addition to tumor thickness, which increase the likelihood of progression, is needed to guide clinical diagnosis, communication with patients and ongoing surveillance pathways of patients with potentially fatal lesions. 相似文献