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  • 1. Brenner, Darren R
    et al.
    Yannitsos, Demetra H
    Farris, Megan S
    Johansson, Mattias
    Genetic Epidemiology Group, International Agency for Research on Cancer, Lyon, France.
    Friedenreich, Christine M
    Leisure-time physical activity and lung cancer risk: a systematic review and meta-analysis2016In: Lung Cancer, ISSN 0169-5002, E-ISSN 1872-8332, Vol. 95, p. 17-27Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: We conducted a systematic review and meta-analysis of the association between recreational physical activity and lung cancer risk to update previous analyses and to examine population subgroups of interest defined by smoking status and histology.

    MATERIALS AND METHODS: We searched the PubMed database for studies up to May 2015. Individual study characteristics were abstracted including study design, number of cases, assessment of recreational physical activity and type and level of adjustment for confounding factors. Combined effect estimates were calculated for the overall associations and across subgroups of interest.

    RESULTS: We identified 28 studies that were eligible for inclusion in the meta-analysis. The overall analysis indicated an inverse association between recreational physical activity and lung cancer risk (Relative Risk (RR), 0.76; 95% Confidence Interval (CI), 0.69-0.85, p-value: <0.001). Similar inverse associations with risk were also noted for all evaluated histological subtypes, including adenocarcinoma (RR, 0.80; 95% CI, 0.72-0.88), squamous (RR, 0.80; 95% CI, 0.71-0.90) and small cell (RR, 0.79; 95% CI, 0.66-0.94). When we examined effects by smoking status, inverse associations between recreational physical activity and lung cancer risk were observed among former (RR, 0.77; 95% CI, 0.69-0.85) and current smokers (RR, 0.77; 95% CI, 0.72-0.83), but not among never smokers (RR, 0.96; 95% CI, 0.79-1.18).

    CONCLUSION: Results from this meta-analysis suggest that regular recreational physical activity may be associated with reduced risk of lung cancer. Only four studies examining never smokers were identified, suggesting the need for additional research in this population.

  • 2.
    Lövgren, Malin
    et al.
    The Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden.
    Tishelman, Carol
    Stockholms Sjukhem Foundation, Research & Development Unit/Palliative Care, Stockholm, Sweden.
    Sprangers, Mirjam
    Department of Medical Psychology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
    Koyi, Hirsh
    The Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Stockholm, Sweden.
    Hamberg, Katarina
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Symptoms and problems with functioning among women and men with inoperable lung cancer-A longitudinal study2008In: Lung Cancer, ISSN 0169-5002, E-ISSN 1872-8332, Vol. 60, no 1, p. 113-124Article in journal (Refereed)
    Abstract [en]

    The aim of this study is to compare the prevalence and intensity of symptoms and problems with functioning between women and men with inoperable lung cancer (LC) during 3 months post-diagnosis. One hundred and fifty-nine patients completed the EORTC QLQ C-30+LC13 at three time points: close to diagnosis and prior to treatment, and one, and 3 months later. Descriptive cross-sectional analyses and longitudinal analyses using repeated measure ANOVA were conducted. These patients reported many and intense symptoms and problems with functioning. The most salient finding from the cross-sectional analysis was that women reported both more, and more intense problems with emotional functioning close to diagnosis. Statistically significant improvements over time were found in both men and women with regard to emotional functioning, dyspnea, insomnia, cough, pain in arm/shoulder, while physical functioning, fatigue, constipation, dysphagia, peripheral neuropathy and alopecia deteriorated significantly over time. The longitudinal analyses suggest that, with the exception of emotional functioning, gender differences were not only related to biological sex alone, but were also found to be related to other components of the patients' life situation, such as education, age, civil status and type of LC. Sensitivity to different symptom experiences and responses to those experiences between and within women and men is also necessary in the management of symptoms in patients with inoperable LC.

  • 3.
    Salander, Pär
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Creating "denial" typologies is ontologically questionable2011In: Lung Cancer, ISSN 0169-5002, E-ISSN 1872-8332, Vol. 71, no 3, p. 372-373Article in journal (Refereed)
  • 4.
    Salander, Pär
    Umeå University, Faculty of Social Sciences, Department of Social Work. Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    We should avoid vague conceptualisations and circular outcomes:  (Letters to the editor)2010In: Lung Cancer, ISSN 0169-5002, E-ISSN 1872-8332, Vol. 70, no 2, p. 226-Article in journal (Refereed)
  • 5.
    Salander, Pär
    et al.
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Henriksson, Roger
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Severely diseased lung cancer patients narrate the importance of being included in a helping relationship2005In: Lung Cancer, ISSN 0169-5002, E-ISSN 1872-8332, Vol. 50, no 2, p. 155-162Article in journal (Refereed)
    Abstract [en]

    Because patients with advanced lung cancer have a poor prognosis, healthcare staff should treat and support them with sensitivity without placing them under necessary strain. A common way of revealing patients’ psychological needs is to rely on questionnaires where predefined potential problem areas are examined. Another and less common way of detecting their needs is to focus on the patients’ concrete everyday-experiences in their contacts with health care. In this study, 23 consecutive patients with advanced non-small cell lung cancer were asked to describe their experiences in dealing with their healthcare providers. Data were analysed qualitatively by categorising the incidents according to content. It emerged that ‘being connected to health care’ and being ‘acknowledged as a person’ were by far the most prominent dimensions. Very few incidents were directly related to ‘information’. The results suggest that in oncology it is important to call attention to the fact that the patient-physician relationship cannot be reduced to the communication of information. Other dimensions are worth considering.

     

  • 6.
    Salander, Pär
    et al.
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Lilliehorn, Sara
    Umeå University, Faculty of Social Sciences, Department of Social Work. Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    To carry on as before: a meta-synthesis of qualitative studies in lung cancer2016In: Lung Cancer, ISSN 0169-5002, E-ISSN 1872-8332, Vol. 99, p. 88-93Article in journal (Refereed)
    Abstract [en]

    As a complement to quantitative studies, qualitative studies give us a better understanding of how persons affected by lung cancer live their everyday lives and how they deal with the obvious strain of having lung cancer. Because qualitative studies are based on only a few participants in specific contexts, the purpose of the present study is to synthesize knowledge from these qualitative studies to get a more general picture of the everyday lives of patients with lung cancer. A search on PubMed, CINAHL, Medline and PsychInfo yielded 383 hits. After exclusion we found 16 studies that focused on how these patients lived, reflected, and dealt with their new life situation. These studies comprised 393 interviews with 283 patients with primary lung cancer, and the findings from these studies were synthesized into a core process with subcategories. The overarching process was that the patients were eager "to carry on as before". They wanted to resume their former everyday life, and their views on their relationships with their bodies and side effects of treatments, their families, the health care staff, and with dying and death were very much related to how these could assist the core process. The synthesis presented here suggests that health care in consultations with patients with lung cancer should defer to the importance of the patient's core idea that life carries on despite the fact that it will probably soon come to an end.

  • 7.
    Sjödin, Anna
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Guo, Dongsheng
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Sørhaug, Sveinung
    Bjermer, Leif
    Henriksson, Roger
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Hedman, Håkan
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Dysregulated secretoglobin expression in human lung cancers2003In: Lung Cancer, ISSN 0169-5002, E-ISSN 1872-8332, Vol. 41, no 1, p. 49-56Article in journal (Refereed)
    Abstract [en]

    Lipophilins A, B, C, mammaglobin, and uteroglobin are members of the secretoglobin family of small, secreted, proteins. The functions of these proteins are not well understood but uteroglobin has been implicated in the development of cancers. Uteroglobin is known to be highly expressed in normal lung and down-regulated in lung cancers but expression of the other secretoglobins in normal lung and lung neoplasms have not been investigated. Therefore, we developed quantitative real-time reverse transcription (RT-) PCR assays for the different secretoglobins and evaluated their expression in normal and neoplastic lung tissues. The secretoglobin transcript levels were quantitated by real-time RT-PCR in samples from three normal lungs, 24 lung tumors including six small cell lung carcinomas, seven adenocarcinomas, and five squamous cell carcinomas, and in cell lines from three small cell lung carcinomas and one mesothelioma. Uteroglobin was confirmed to be abundantly expressed in normal lung and the different lung tumors showed down-regulated uteroglobin expression. Of the other secretoglobins, only lipophilin C was detected in normal lung, albeit at low levels. The lung tumors, however, frequently showed neo- or up-regulation of lipophilins A, B, C, and mammaglobin. The results constitute the first quantitative evaluation of secretoglobin expression in normal and neoplastic human lung tissues and demonstrate dysregulation in various human lung cancers. These findings could have important biological and diagnostic implications.

  • 8. Winkler, Volker
    et al.
    Ng, Nawi
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Tesfaye, Fikru
    Becher, Heiko
    Predicting lung cancer deaths from smoking prevalence data2011In: Lung Cancer, ISSN 0169-5002, E-ISSN 1872-8332, Vol. 74, no 2, p. 170-177Article in journal (Refereed)
    Abstract [en]

    Reliable data on lung cancer burden is not available from most developing countries as cancer registration is lacking. In a previously proposed model to estimate lung cancer deaths in those countries using smoking prevalence data, we estimated the current yearly number of lung cancer deaths in Ethiopia as 3356, a figure far above the WHO estimate of 1343 and the GLOBOCAN of 748. Our aim was to further develop and validate our estimation procedure. We included additional data on risk estimates for lung cancer mortality of ex-smokers and an approximation of duration of smoking into our model and reanalysed study results on non-smoker mortality, thus building two improved models. For validation the number of lung cancer deaths in Germany (2006), the UK (2006), Canada (2004), and Utah, USA (2000) were estimated based on all three models and compared to the observed number of deaths in these countries. We found that the refined model with a modified estimate of lung cancer mortality rates in non-smokers and a more detailed incorporation of smoking dose categories estimates rather well the observed lung cancer deaths in the above countries. With this model, the updated estimate of yearly lung cancer deaths in Ethiopia is 2946 deaths, close to the previous reported estimate. If Ethiopian lung cancer mortality rates in never-smokers and smoking relative risks are the same as in industrialised countries, our models suggests that WHO lung cancer deaths may be underestimated in Ethiopia.

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