Pegington Mary, Adams Judith E, Bundred Nigel J, Campbell Anna M, Howell Anthony, Howell Sacha J, Speed Shaun, Wolstenholme Jane, Harvie Michelle N
1 University Hospital of South Manchester, Manchester, UK.
2 University of Manchester, Manchester, UK.
Integr Cancer Ther. 2018 Mar;17(1):131-137. doi: 10.1177/1534735416687850. Epub 2017 Jan 23.
Excess weight at breast cancer diagnosis and weight gain during treatment are linked to increased breast cancer specific and all-cause mortality. The Breast-Activity and Healthy Eating After Diagnosis (B-AHEAD) trial tested 2 weight loss diet and exercise programmes versus a control receiving standard written advice during adjuvant treatment. This article identifies differences in characteristics between patients recruited from the main trial site to those of the whole population from that site during the recruitment period and identifies barriers to recruitment. A total of 409 patients with operable breast cancer were recruited within 12 weeks of surgery. We compared demographic and treatment factors between women recruited from the main trial coordinating site (n = 300) to the whole breast cancer population in the center (n = 532). Uptake at the coordinating site was 42%, comparable to treatment trials in the unit (47%). Women recruited were younger (55.9 vs 61.2 years, P < .001), more likely to live in least deprived postcode areas (41.7% vs 31.6%, P = .004), and more likely to have screen-detected cancers (55.3% vs 48.7%, P = .026) than the whole breast cancer population. The good uptake highlights the interest in lifestyle change around the time of diagnosis, a challenging time in the patient pathway, and shows that recruitment at this time is feasible. Barriers to uptake among older women and women with a lower socioeconomic status should be understood and overcome in order to improve recruitment to future lifestyle intervention programs.
乳腺癌诊断时超重以及治疗期间体重增加与乳腺癌特异性死亡率和全因死亡率升高相关。乳腺癌诊断后的活动与健康饮食（B - AHEAD）试验比较了两种减肥饮食和运动方案与辅助治疗期间接受标准书面建议的对照组。本文确定了在招募期间从主要试验地点招募的患者与该地点整个人口的特征差异，并确定了招募障碍。在手术的12周内共招募了409例可手术乳腺癌患者。我们比较了从主要试验协调地点招募的女性（n = 300）与中心的整个乳腺癌人群（n = 532）之间的人口统计学和治疗因素。协调地点的参与率为42%，与该科室的治疗试验（47%）相当。与整个乳腺癌人群相比，招募的女性更年轻（55.9岁对61.2岁，P <.001），更有可能居住在最不贫困的邮政编码区域（41.7%对31.6%，P =.004），并且更有可能是通过筛查发现的癌症（55.3%对48.7%，P =.026）。良好的参与率突出了在诊断时对生活方式改变的兴趣，这在患者就医过程中是一个具有挑战性的时期，并且表明此时招募是可行的。为了改善未来生活方式干预项目的招募，应该了解并克服老年女性和社会经济地位较低女性参与的障碍。
