Search Results (39)

Background: It is estimated that in Italy, there were 364,000 new diagnoses of neoplasms each year and that the overall incidence of blood cancers was 10% of these. Leukemia and lymphomas represented the ninth and eighth places, respectively, among the causes of death from neoplasia. Hematopoietic stem cell transplantation represented an effective treatment option for many of these malignancies, and not only that: benign and congenital diseases could also be treated. Objective: To assess knowledge among the Apulian population regarding stem cell donation and factors that could influence this choice, focusing especially on the knowledge of the residents of Puglia, Italy on how stem cells were harvested and their functions, their reasons for joining the National Registry, and the reasons that hold them back from making such a choice. Study Design: An observational and cross-sectional study was conducted, through snowball sampling methodology, until data saturation. An online survey was conducted, which included several Italian associations. The questionnaire administered contained five main sections, such as sociodemographic data, knowledge of the existence of National Registries and their adherence, the nationwide presence of various associations that promote donation, knowledge with respect to the structure, use and functions of stem cells, sources of procurement, such as bone marrow, peripheral blood and umbilical cord, and related procedures, beliefs, attitudes, values, and opinions of the Italian population regarding the topic, and degree of information and education regarding bone marrow donation. Results: A total of 567 Apulian citizens were enrolled. Of these, 75.3% were female and 96.8% were aged between 18 and 65 years. Most of participants were single (46.9%) and married (47.3%) and had a diploma (44.4%), and less had a degree (35.8%). Significant differences were recorded between gender, singles, and married participants, and participants with a diploma or a degree and the items proposed. Conclusions: A true culture of donation in our region was not clearly spread. Although something has been accomplished in recent years in terms of deceased donor donation, still a great deal needs to be achieved for living donation, which encountered a great deal of resistance. It has been deemed necessary to seek winning solutions to this issue in terms of communication and information campaigns, raising awareness and empowering citizens to express consciously their concerns about organs and tissues and to stand in solidarity with those who suffered. Full article

Background/Objectives: Despite the psychological benefits of breast reconstruction (BR) after mastectomy, uptake remains limited among women with breast cancer. This study explores psychosocial and personality predictors of BR intentions in the pre-mastectomy phase, aiming to inform strategies for mental health promotion in oncology care. Methods: This cross-sectional analysis used preoperative data from a longitudinal study at a university hospital in Greece. Women with primary breast cancer scheduled for mastectomy completed a battery of validated self-report measures, including the International Personality Item Big-Five Factor Markers (IPIP-BFFM), the Hospital Anxiety and Depression Scale (HADS), and the Short Form-36 Health Survey (SF-36). Demographic, clinical, and psychosocial data were also collected. Binary logistic regression was used to examine predictors of (a) BR information-seeking and (b) BR intention. Results: Seventy-four women participated (mean age = 61.1 years). Older age predicted lower BR intention (Exp(b) = 0.897, 95% CI: 0.829–0.970) and information-seeking (Exp(b) = 0.925, 95% CI: 0.859–0.997). Single/divorced status was associated with reduced BR information-seeking (Exp(b) = 0.053, 95% CI: 0.005–0.549). Openness to experience significantly predicted both outcomes (BR information-seeking: Exp(b) = 1.115, 95% CI: 1.028–1.209); BR intention: Exp(b) = 1.095, 95% CI: 1.016–1.181). Higher physical health-related QoL scores were associated with increased BR intention (Exp(b) = 1.039, 95% CI: 1.007–1.072), whereas higher mental health-related QoL (Exp(b) = 0.952, 95% CI: 0.912–0.994) and higher depression scores (Exp(b) = 0.797, 95% CI: 0.638–0.996) were linked to decreased BR intent. No psychological factor significantly predicted information-seeking. Conclusions: These findings underscore the value of psychosocial screening and personality-informed counseling prior to surgery. By identifying individuals less likely to seek information or consider BR, pre-mastectomy assessments can contribute to tailored, mental health-promoting interventions and support informed, patient-centered surgical decision-making. Full article

Background/objectives: The COVID-19 pandemic affected cancer care globally. Our objective was to analyze the demographic and clinical characteristics of kidney cancer (KC) patients between the pre-COVID-19 and COVID-19 periods. We also aimed to assess how KC was discovered—incidentally or symptomatically—and identify factors predicting the mode of discovery and advanced-stage disease. Methods: This retrospective study analyzed data from 400 patients aged 18 years or older diagnosed with kidney cancer (KC) at a large regional Hungarian clinical center during two time periods: the pre-COVID-19 period (1 January 2019 to 15 March 2020) and the COVID-19 period (16 March 2020 to 13 May 2021). Demographic and clinical information, including the mode of cancer discovery, was collected for all patients. Results: During the pandemic, monthly kidney cancer diagnoses declined by 10.3%. The proportion of female patients rose significantly from 31.9% to 42.9% (p = 0.023). Incidental tumor detection decreased from 82.4% to 72.4% (p = 0.018), while symptomatic presentation increased from 14.2% to 19.4%, although not significantly (p = 0.166). Non-incidental detection was associated with a 3.42-fold increase in odds of advanced cancer pre-pandemic and a 2.03-fold increase during the pandemic. Symptomatic presentation raised these odds by 4.51 and 2.76 times, respectively. Conclusions: Our study revealed changes in kidney cancer detection during the pandemic, including a rise in the proportion of female patients and a decline in case numbers, likely due to reduced incidental findings. Non-incidental discovery and symptom presence remained predictors of advanced-stage disease, although the odds were lower. Various factors—such as changes in healthcare access and gender-related differences in health-seeking behavior—may possibly explain these changes. Our findings support the critical role of incidental detection in high-risk populations. Full article

As survival rates for teenagers and young adults (TYAs) with cancer exceed 80%, they are living longer post treatment, yet often experience prolonged health and quality of life concerns. Many TYAs also experience unmet support needs. This study aimed to identify TYAs support needs following treatment at a UK hospital and explore how and when TYAs prefer to receive support. This study involved two phases: Phase 1 involved semi-structured interviews with 16 TYAs, 1–6 years post-treatment, aged 16–25 years at time of treatment completion and examined their experiences of support services, and preferences for future care. Phase 2 consisted of co-design workshops with eight TYAs and feedback from five healthcare/allied professionals (HCAPs) to refine and develop recommendations. Phase 1 findings revealed six key themes: (1) survivorship as disrupted continuity; (2) negotiating legitimacy and relational safety in help seeking; (3) support offered vs. support sought: pathways of referral and self-initiation; (4) emotional readiness as context dependent and non-linear; (5) support as an ecosystem, not a moment; and (6) personalised autonomy in support engagement. Phase 2 findings informed recommendations that emphasise the importance of flexible, personalised, and accessible post-treatment support, with pathways of care/support that can adapt to TYAs changing needs and preferences over time. Full article

Differences in the lifestyle and health-service-seeking behavior of persons experiencing homelessness (PEH) are well known. However, a comprehensive estimation of the resulting healthcare utilization differences and health outcome impacts are so far under-researched, especially at the national level. We aim to close this gap of evidence for lung cancer within the Hungarian universal healthcare system. We analyzed lung cancer-related information for the PEH population in the Hungarian national central health insurance register dataset and a matched control population between 2015 and 2021. In this period, 11,857 people were registered as homeless for the majority of at least one year. To capture the effect of homelessness, we created a categorical “homelessness length index” (HLI) according to the proportion of time an individual experienced homelessness during the investigation period (HLI 0: 0; HLI 1: >0–1/3; HLI 2: >1/3–2/3; HLI 3: >2/3). PEH individuals were matched 1:5 with a non-PEH control sample adjusted for age, sex and region. We conducted Kaplan–Meier survival analysis and Cox proportional hazards (CPH) regression adjusted for age, sex, HLI and average lung cancer-related healthcare costs. Our final analysis sample consisted of 641 patients (233 PEH, 408 control) who were newly diagnosed with lung cancer during the observation period. The lung cancer prevalence in the PEH group was 1.97% as opposed to 0.69% in the control group. The Kaplan–Meier curve showed lower average survival times for the PEH group, compared to the control group. Lung cancer associated costs between diagnosis and death/censoring were substantially different with average per patient cumulative costs of EUR 3668 in the PEH group compared to EUR 6827 in the control group (2018 prices). This translated to an average 47% lower annual lung cancer-related healthcare cost per PEH patient. CPH analysis showed that after disease severity, the degree of time spent in homelessness had the most significant effect on mortality, with a HR of 1.47 associated with both HLI 2 and 3 (95% CI: 1.08–2.00 and 1.01–2.14, respectively). We find that in Hungary, homelessness is associated with a much higher lung cancer burden linked to a three-times-higher prevalence, lower overall survival and almost 50% lower annualized disease-specific healthcare costs. Worse outcomes are mainly driven by long-term homelessness. Results could not be further refined according to lifestyle-related factors due to data availability limitations. Full article

Background: Ovarian cancer is a major global health issue, ranking among the foremost causes of cancer-related death in women. Despite its prevalence, epidemiology data and survival analysis pertinent to Indonesia are few. This study seeks to address the information gap by analyzing the demographic characteristics, clinical aspects, and survival outcomes of ovarian cancer patients in Indonesia from 2010 to 2020. Methods: This observational study utilized data from the Indonesian Cancer Database. This study included patients with a confirmed diagnosis of ovarian cancer. Data collected included age, parity, overall survival, geographic distribution, ethnicity, occupation, FIGO stage, tumor types, category, and degree of differentiation. Descriptive statistics were used to summarize the data, and Kaplan–Meier survival curves were employed to estimate survival probabilities over time. Results: The study cohort comprised 1065 patients with ovarian cancer. The cohort’s mean age was 52.41 (12.56) years, with 45.35% of patients residing in Jakarta. A majority were unemployed (75.77%) and of Javanese ethnicity (61.88%). Serous carcinoma (68.26%) was the most prevalent tumor types, while a high percentage of unknown FIGO stages (66.95%) limited staging data. The survival median time varied, with significant survival variation observed across tumor types, degrees of differentiation, and FIGO stages. Patients with serous carcinoma showed aggressive behavior with a median survival of 1 month, whereas clear cell carcinoma had a median survival of 9 months. Conclusions: This study highlights the need for improved early detection and equitable access to care to enhance survival outcomes for ovarian cancer patients in Indonesia. Full article

Colorectal cancer (CRC) ranks third in terms of global cancer prevalence and is the second most common cause of cancer-related mortality. Although CRC rates are decreasing in the United States, inequalities still exist despite the effectiveness of invasive screening methods, such as colonoscopy, flexible sigmoidoscopy, and computed tomography (CT) colonography in detecting colorectal cancer. Many current interventions promoting CRC screening do not utilize a modern theory-based approach, which has led to the low utilization of these screening methods. This cross-sectional study aims to address the lack of theory-based treatments for promoting visual CRC screening examinations by applying the multi-theory model (MTM) of health behavior change to explicate the health-related factors for individuals to seek visual colorectal cancer screening examinations for CRC screening. A 57-item validated questionnaire assessing MTM constructs and CRC screening was administered online. The survey questionnaire was administered to a sample of 640 adults from the United States. The participants were between the ages of 45 and 75 years. Hierarchical multiple regression was used to assess the relationship between MTM constructs with the initiation and sustenance of CRC screening behaviors. Out of the total participants in this nationwide sample, 71.4% (n = 457) reported that they had undergone a visual CRC screening examination. MTM subscales, specifically participatory dialogue, changes in the physical environment along with age, recommendation for CRC screening from a healthcare provider, and previous experience with colonoscopy, were found to be significant factors in predicting the initiation of visual CRC screening behavior. These factors accounted for 22% of the variation in initiation among this group (R² = 0.222, F = 3.521, p < 0.001). The MTM can be a valuable framework for designing educational media, information media, social media platforms, and clinical interventions to promote visual colorectal cancer screening examinations. Full article

Gastrointestinal cancers (GIC), encompassing colonic, rectal, and gastric malignancies, rank among the most prevalent cancer types globally, contributing significantly to cancer-related mortality. In the scientific literature, various syndromes associated with colorectal and gastric cancers have been elucidated, highlighting the intricate interplay between genetic factors and disease manifestation. The primary objective of this study was to conduct a genetic exploration aimed at elucidating these associations and identifying shared genetic determinants across these cancer types. Notably, considerable research has focused on the KRAS gene mutations, polymorphisms in nucleic acids, the Wnt signaling pathway, and the role of chemokine ligands in tumorigenesis. While investigations into natural plant extracts as potential therapeutic agents are still in their nascent stages, they represent a promising avenue for future research. Ongoing studies are essential to uncover suitable biomarkers that could facilitate the identification and understanding of the genetic links between these GIC. This exploration not only seeks to enhance our comprehension of the underlying genetic architecture but also aims to inform the development of targeted therapies and preventive strategies. Full article

Laryngeal cancer poses a substantial challenge in head and neck oncology, and there is a growing focus on customized medicine techniques. The present state of gene expression indicators in laryngeal cancer and their potential to inform tailored therapy choices are thoroughly examined in this review. We examine significant molecular changes, such as TP53, CDKN2A, PIK3CA, and NOTCH1 mutations, which have been identified as important participants in the development of laryngeal cancer. The study investigates the predictive and prognostic significance of these genetic markers in addition to the function of epigenetic changes such as the methylation of the MGMT promoter. We also go over the importance of cancer stem cell-related gene expression patterns, specifically CD44 and ALDH1A1 expression, in therapy resistance and disease progression. The review focuses on indicators, including PD-L1, CTLA-4, and tumor mutational burden (TMB) in predicting immunotherapy responses, highlighting recent developments in our understanding of the intricate interactions between tumor genetics and the immune milieu. We also investigate the potential for improving prognosis accuracy and treatment selection by the integration of multi-gene expression panels with clinicopathological variables. The necessity for uniform testing and interpretation techniques is one of the difficulties, in implementing these molecular insights into clinical practice, that are discussed. This review seeks to provide a comprehensive framework for promoting personalized cancer therapy by combining the most recent data on gene expression profiling in laryngeal cancer. Molecularly guided treatment options may enhance patient outcomes. Full article

Background/Objectives: The diminished quality of life experienced by cancer patients impacts not only the individuals but also the broader healthcare system. Despite the effect that cancer has on quality of life both during and after treatment, quality of life assessments are not yet commonly implemented, and the specific factors influencing quality of life are not well understood. The aim of this study was to conduct comprehensive multifactorial analysis to identify the factors that influence the quality of life in cancer patients. Methods: This study comprised a cohort of 108 patients diagnosed with cancer. The EORTC QLQ C-30 and EORTC QLQ-INFO 25 questionnaires were used to interview participants, along with questions related to disease course and lifestyle factors. Results: Differences were found in various subdomains among male versus female, individuals who solicited nutritional information in cancer themselves versus those who did not, individuals who reported consulting a dietitian versus those who did not, individuals who reported a recent decrease in their food intake versus those who did not report it. The results of the stepwise multiple regression show the following factors as the most important factors affecting their quality of life: patients soliciting nutritional information, reduced food intake, types of nutrition support, age, gender, seeking consultation with a dietitian, place of residence, and education level. Conclusions: In addition to sociodemographic variables and those related to the location, course, and treatment of cancer, including type of cancer, the variable related to patients’ declared need for soliciting nutritional information and seeking consultation with a dietitian may also influence quality of life. Therefore, the above factors in determining the quality of life and well-being of patients should also be considered in a holistic approach to patient care. Full article

Gastric cancer (GC) remains a significant public health concern because of its lethality, underscoring the need for deeper insights into its molecular mechanisms. Recent studies have increasingly highlighted the role of epigenetic modifications as critical players in cancer progression. Despite their importance, research specifically addressing epigenetic factors in GC is relatively scarce. This paper seeks to bridge that gap by examining recent literature that elucidates the epigenetic landscape associated with GC. The investigation of long noncoding RNAs (lncRNAs) has revealed their substantial involvement in gene dysregulation and epigenetic alterations within GC tumors. Notably, lncRNAs such as LINC00853 and LINC01266 have been identified as significant contributors to the epigenetic modulation of gene expression. Furthermore, the overexpression of KAT5 and GPX4 has been shown to mitigate the antiproliferative effects resulting from the depletion of circRHOT1, suggesting a complex interplay between these molecules in GC pathophysiology. Another pivotal aspect of epigenetic regulation in GC involves modifications in N6-methyladenosine (m6A), which play crucial roles in mRNA maturation processes such as splicing, export, degradation, and translation. m6A modifications are known for their influence on various cancer-related pathways, thus presenting a potential avenue for targeted interventions. Our findings indicate that the most pronounced instances of epigenetic dysregulation in GC can be traced back to the effects of long lncRNAs and alterations in m6A modification patterns. This underscores the urgent need for comprehensive investigations into these epigenetic factors, as a deeper understanding could lead to enhanced diagnostic markers and innovative therapeutic strategies. The integration of genetic and epigenetic considerations is essential for advancing the field of GC research. This synthesis of recent findings concerning epigenetic regulation offers valuable insights that could inform future studies and therapeutic developments. There is a critical need for ongoing research to elucidate the complexities of epigenetic modifications in GC, ultimately improving patient outcomes through tailored interventions. Full article

Chemotherapy poses both physical and psychological challenges for patients, prompting many to seek answers independently through online resources. This study investigates German Google search behavior regarding chemotherapy-related terms using Google AdWords data from September 2018 to September 2022 to gain insights into patient concerns and needs. A total of 1461 search terms associated with “chemotherapy” were identified, representing 1,749,312 to 28,958,400 search queries. These terms were categorized into four groups based on frequency and analyzed. Queries related to “adjuvant” and “neoadjuvant” chemotherapy, as well as “immunotherapy”, suggest potential confusion among patients. Breast cancer emerged as the most searched tumor type, with hair loss, its management, and dermatological issues being the most searched side effects. These findings underscore the role of search engines such as Google in facilitating access to healthcare information and provide valuable insights into patient thoughts and needs. Healthcare providers can leverage this information to deliver patient-centric care and optimize treatment outcomes. Full article

Background and Objectives: This study aims to assess the health status and factors influencing healthy choices among children and young people in Romania, as well as the efficacy of related health education programs. Through understanding these dynamics, the study seeks to provide insights that can shape targeted interventions, policies, and educational strategies to improve this demographic’s overall health and well-being. Materials and Methods: For this study, we performed a literature review of original published papers on the health status, healthy habits, health education, predisposition to making healthy choices in the future, and accessibility to the paediatric health system of Romanian children and young people, as well as the effects of different types of educational interventions on this demographic in Romania. Results: The prevalence of dental caries is high in Romania. In terms of eating habits and nutritional status, a worrying proportion of children are overweight or obese, which can lead to a variety of future physical and psychological problems. In terms of physical activity, few adolescents demonstrate regular fitness practices. Romania presents an increase in alcohol and tobacco consumption among adolescents. The mental health of students has become a pressing public health concern, exacerbated by the COVID-19 pandemic. The use of social networks is linked to mental health issues among young people. Romania still has one of the highest rates of sexually transmitted diseases and faces a high incidence of cervical cancer, with a mortality rate three times higher than the EU average. High rates of teenage pregnancies are linked to limited information about sexuality and a lack of access to family planning at a young age. There are large discrepancies in the accessibility of medical services between urban and rural areas. Conclusions: Romania faces significant obstacles to providing high-quality healthcare to children and young people. Improving nutrition, immunisation rates, and access to medical services represent essential areas for enhancing the health of children and young people in Romania. Full article

Background: The purpose of this study is to evaluate the knowledge, attitudes, and behaviours (KAB) of health and non-health-related students at university concerning oral health. Materials and Methods: This cross-sectional study with a 3-month duration in 2023 was conducted amongst King Khalid University (KKU) students. This study used a self-administered, anonymous web-based survey with a simple random sampling strategy as part of its cross-sectional design. The questionnaire had four sections totalling 26 questions to evaluate KAB. A chi-square test was used to evaluate significant differences between categories. Results: Of the 845 respondents who completed the survey, 43.78% were health-related students, while 56.21% were non-health-related students. The completed responses included bacteria causing gingival problems (60.81% vs. 36%), fizzy soft drinks adversely affecting teeth (67.83% vs. 40%), tobacco chewing or smoking possibly causing oral cancer (68.37% vs. 44%), white patches or dental plaque on teeth (61.89% vs. 41.47%), brushing teeth twice a day to improve oral health (81.62% vs. 42.52%), keeping teeth clean (64.86% vs. 41.68%), improper brushing leading to gum disease (70% vs. 40.63%), brushing with fluoridated toothpaste to prevent tooth decay (63% vs. 40%), bleeding gums denoting gum infection (26.98% vs. 21.30%), the importance of teeth similar to any body part (61.62% vs. 37.89%), prioritising teeth as other parts of the body (61.05% vs. 36.21%), brushing teeth twice daily (55.67% vs. 37.05%), and routine dental check-ups (55.40% vs. 14.10%) for health and non-health-related students, respectively (p < 0.05). Conclusion: The results of the current study demonstrated less oral health KAB in non-health-related students than in health-related students. Nonetheless, healthcare students provided erroneous information regarding oral health. Therefore, we urge the appropriate authorities to offer health and non-health-related students the best oral health promotion programmes and services, thereby seeking to improve their oral health knowledge while stressing the importance of practising excellent oral hygiene. Full article

Safety-net hospitals (SNHs) and facilities are the cornerstone of healthcare services for the medically underserved. The burden of chronic liver disease—including end-stage manifestations of cirrhosis and liver cancer—is high and rising among populations living in poverty who primarily seek and receive care in safety-net settings. For many reasons related to social determinants of health, these individuals often present with delayed diagnoses and disease presentations, resulting in higher liver-related mortality. With recent state-based policy changes such as Medicaid expansion that impact access to insurance and critical health services, an overview of the body of literature on SNH care for chronic liver disease is timely and informative for the liver disease community. In this narrative review, we discuss controversies in the definition of a SNH and summarize the known disparities in the cascade of the care and management of common liver-related conditions: (1) steatotic liver disease, (2) liver cancer, (3) chronic viral hepatitis, and (4) cirrhosis and liver transplantation. In addition, we review the specific impact of Medicaid expansion on safety-net systems and liver disease outcomes and highlight effective provider- and system-level interventions. Lastly, we address remaining gaps and challenges to optimizing care for vulnerable populations with chronic liver disease in safety-net settings. Full article