RESUMEN
The time patients wait before seeking help for cancer symptoms is among the most important factors contributing to diagnostic delays in cancer. We reviewed the association between time to help-seeking and three psychological factors: symptom knowledge, symptom interpretation, and beliefs about cancer. Forty-seven studies met the inclusion criteria, providing data from 22 countries concerning seven cancer sites. Better symptom knowledge was related to lower odds of a long help-seeking interval in both studies with healthy populations (OR = .73, 95% CI [.63, .84], k = 19) and patients (OR = .40, 95% CI [.23, .69], k = 12), and so was interpreting experienced symptoms as cancer-related (OR = .52, 95% CI [.36, .75], k = 13 studies with patients). More positive beliefs about cancer (i.e., that cancer is treatable) were associated with lower odds of a long help-seeking interval in both studies with healthy populations (OR = .70, 95% CI [.52, .92], k = 11) and with patients (OR = .51, 95% CI [.32, .82], k = 7). Symptom knowledge, interpretation, and beliefs about cancer are likely to be universal predictors of help-seeking and should be incorporated into theoretical models of patient help-seeking and interventions aiming to reduce delays.
Asunto(s)
Neoplasias/psicología , Aceptación de la Atención de Salud/psicología , Aceptación de la Atención de Salud/estadística & datos numéricos , Tiempo de Tratamiento/estadística & datos numéricos , Adulto , Anciano , Cultura , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Factores de TiempoRESUMEN
There is still insufficient data about the risk-benefit profile about recommending non-aspirin, non-steroidal anti-inflammatory drugs (NA-NSAIDs) for colorectal cancer (CRC) prevention, especially in people aged 40 years or older. This study specifically addressed the association between regular NA-NSAIDs use and CRC risk in the population aged 40 years or older, performing a comprehensive systematic review and meta-analysis of all published studies on this topic until April 2018, by a search of PubMed, Scopus and Web of science databases and clinical trial registries. Two reviewers independently selected studies based on predefined inclusion criteria and assessed study quality using the Newcastle-Otawa scale. The data was combined with the random effects model. Potential heterogeneity was calculated as Q statistic and I2 value. A total of 23 studies involving more than 1 million subjects contributed to the analysis. Pooled odds ratio (OR) of NA-NSAIDs effects on CRC risk was 0.74 (0.67-0.81), I2 = 75.9%, p < 0.001. Heterogeneity was explained by a number of variables including the quality of the studies. Significant protective effects of NA-NSAIDs use were found for women (risk reduction of 19%), higher doses (risk reduction of 18%), distal colon cancer (risk reduction of 22%) and white people (risk reduction from 31% to 41%). From the results NA-NSAIDs use appears to be CRC chemopreventive for a specific subgroup of the population.
Asunto(s)
Antiinflamatorios no Esteroideos/uso terapéutico , Neoplasias Colorrectales/prevención & control , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Oportunidad Relativa , RiesgoRESUMEN
PURPOSE: Thyroid cancer (TC) is the most common malignant disease of the endocrine system. The aim of this study was to analyze incidence and mortality trends of TC (C73 according to ICD-O-3) in Granada (Southern Spain) during the period 1985-2013, by sex, age, and histological type. METHODS: This is a population-based cross-sectional study. Incidence data were obtained from the population-based Cancer Registry of Granada. All newly diagnosed cases of thyroid cancer over the period 1985-2013 were included. Joinpoint regression analysis with age-standardized rates were used to estimate annual percentage change (APC), CI 95% and turning points in trends. Results are presented by sex, age group, and histological type. RESULTS: During the study period there were 1265 diagnosed cases of TC in Granada (72.6% in women). Incidence trends significantly increased in both men (APC: + 5.4%) and women (APC: + 4.7%). The most common histological types in both sexes were papillary (74.8%) and follicular (16.8%). The incidence has increased during the study period mainly due to papillary carcinoma, which has increased annually around 6% in both sexes. TC mortality trend during this period decreased in men (APC: -0.3%) and women (APC: -2.3%). CONCLUSION: Our data showed an increasing trend in incidence of thyroid cancer in Granada, especially in women between 55-64 years. Mortality showed a slight decrease trend during the study period in both sexes. Papillary carcinoma was the most common histological type, with an increase of the relative weight of papillary microcarcinomas. Our study is in accordance with the European and worldwide trends in thyroid cancer incidence and mortality and sex differences.