Tracey DiSipio

Survivorship research in advanced gynecological cancer: A scoping review of cohort studies

AbstractBackgroundRecent calls to action highlight the need to address gaps in our understanding of survivorship for those living with advanced gynecological cancer to support optimal care. To ensure future research fills these knowledge gaps, we need to understand the breadth of existing survivorship research in this patient group, including the outcomes assessed, the populations included and the duration and retention in follow‐up.MethodsWe conducted a systematic scoping review searching PubMed, PsychINFO, and CINAHL during the month of November 2022 to identify prospective cohort studies measuring survivorship outcomes among participants with advanced (stage III–IV) gynecological cancer, or in cohorts in which ≥50% of participants had advanced cancer, or which provide results separately for patients with advanced cancer. Articles were screened, and data extracted using a standard form.ResultsWe assessed 33 articles from 21 unique studies, which overall included 6023 participants with gynecological cancer. Of these, 45% had cervical cancer, 44% ovarian, 10% endometrial/uterine, and 1% vaginal/vulvar cancer. The most frequently measured survivorship outcome was quality of life. Of the 33 articles, most reported on participant age (n = 31), but relatively few reported on comorbidities (n = 10), physical status (n = 6), ethnic background (n = 4), the country of birth (n = 2), or the area of participant residence (n = 2). None included details on indigenous status. Recruitment proportions ranged from 48% to 100%. Retention proportions ranged from 15% to 97%.ConclusionOur findings highlight gaps in survivorship research for advanced gynecological cancers and emphasize the need for future studies to include and describe the experiences of diverse and underrepresented groups.

Guidelines for the prevention and diagnosis of vaginal and vulvar cancers: A systematic review

Variation in care is known to exist for those diagnosed with vaginal and vulvar cancers. Guidelines are integral to providing a consistent, quality standard of care. To provide an evidence-based background for vaginal and vulvar cancers, a systematic review was conducted to identify available guidelines relevant to prevention and early detection; presentation, initial investigations and referral; and diagnosis. We conducted a systematic search of databases (CINAHL, Cochrane Library, Embase, PubMed, Scopus, Web of Science) and targeted websites (n = 23) to identify guidelines published in English within the past 10 years (from 2013 onwards) relevant to either vaginal or vulvar cancers and pertaining to the first three steps of the cancer care continuum. We screened the guidelines, extracted recommendations and statements, and assessed their quality using standard forms. A total of 45 guidelines were included in this review (33 evidence-based, 12 consensus-based). Guidelines were developed by a range of professional organisations and across countries. Guidelines covered multiple topics including prevention and early detection (n = 37; 82 %), presentation, initial investigations and referral (n = 24; 53 %), and diagnosis (n = 23; 51 %). Common and consistent guideline recommendations and statements were identified. Example recommendation topics included risk factors, management of precursor conditions, signs and symptoms, initial tests and referral, and diagnostic workup. Few timeframes were specified. This review has collated relevant and current guidelines available to health professionals from prevention to diagnosis of vaginal and vulvar cancers. Our synthesis demonstrates consistency but a lack of specificity in the available recommendations/statements.

Exploring Women's Experiences of Information Across Their Endometrial Cancer Diagnosis and Treatment: A Qualitative Analysis

ABSTRACT Background Access to timely and appropriate information is a key component of quality cancer care. Aims This study aimed to fill an important gap regarding the information experiences of women with endometrial cancer from diagnosis to treatment. Methods This study is based on 24 interviews with women diagnosed with endometrial cancer in Queensland, Australia in 2022–2023. Reflexive thematic analysis was used to provide an in‐depth exploration of women's accounts of information across their diagnosis and treatment journeys. Results The researchers identified three implicit and socially constructed assumptions women negotiated when it came to information. These included: (1) the physical body is of central importance; (2) more information is better; and (3) medical knowledge is most credible. These assumptions were not always upheld or accepted; at times, they were rejected by women and ultimately shaped how women made sense of, and spoke about, their experiences of information. Conclusions Together, these findings point to the need for women to be supported to engage with contextually sensitive information regarding their cancer. In particular, health professionals should be actively involved in ensuring women understand their cancer (including treatment side‐effects and risk of recurrence), are supported with psycho‐social impacts, and that alternative and holistic sources of information are acknowledged alongside medical information. These findings point to the need for health professionals to reflect on their own communication practices and how they may reinforce assumptions that shape women's experiences of endometrial cancer.