Genetic counseling and disclosure of results.
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Biomedical subjects
Publications and source records attributed to Suzanne M Mahon.
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Endometrial cancer, cancer of the lining of the uterus, is the most common gynecologic malignancy in the United States, with an estimated 40,880 new cases diagnosed in 2005 (American Cancer Society [ACS], 2005a). Fortunately, mortality rates for endometrial cancer are relatively low, with 96% of women living five years or longer after being diagnosed with localized disease. Most women (72%) are diagnosed with localized disease (Ries et al., 2002) because early-stage, localized disease most often presents with abnormal uterine bleeding, leading many women to seek prompt medical attention, ultimately resulting in early detection (ACS, 2005a).
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Parts I through III of this series of articles gave an introduction to some of the issues requiring attention when performing clinical studies and summarizing the results statistically as well as clinically. Statistical methods have been described for the identification of statistically significant differences and associations between an experimental group and a control group or over the course of time after an intervention. The next article will address the methods used for the determination of the strength or magnitude of these identified statistically significant differences.
Cervical cancer is the second most common cancer among women worldwide, with significantly higher rates in developing areas, especially in Africa, the Caribbean, and Latin America (Parkin, Bray, Ferlay, & Pisani, 2005). In contrast, incidence and mortality rates of cervical cancer in the United States have declined significantly among women of all ethnic and racial groups; it is not among the top 10 leading causes of new cancer cases in women (American Cancer Society [ACS], 2006b; Edwards et al.,2005).
Increased survival from cancer has been a result of improved treatment and the earlier detection of cancer. This column will provide a focus on wellness for patients with cancer, their caretakers, and health professionals. This inaugural column provides a review of a basic epidemiologic principle--risk assessment, which is central to wellness.
OBJECTIVE: To provide an overview of the incidence, epidemiology, and appropriate screening for second primary malignancies, as well as the nursing implications of tertiary cancer prevention. DATA SOURCES: Published review articles, book chapters, research reports, and the clinical experience of the author. CONCLUSION: Many persons successfully treated for malignancy are at risk for a second malignancy. This risk is related to shared risk factors, genetic predisposition, and the toxic effects of therapy. Persons particularly at risk are those who have been successfully treated for breast, gynecologic, colorectal, skin, and lymphoma malignancies. IMPLICATIONS FOR NURSING PRACTICE: Nurses need to be knowledgeable regarding the principles of tertiary prevention, be able to identify persons at risk, and provide appropriate patient education and psychosocial support on how to manage the risk and detect second malignancies early.
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Researchers often try to use a randomization technique in an attempt to reduce bias and ensure that treatment and control groups are as similar as possible. This article has provided an overview of how researchers might use parametric and nonparametric statistics when analyzing data and looking for differences between groups. Researchers must consider the types of data and choose the tests that are appropriate for the variable types to draw appropriate conclusions. The next article in this series will address comparison of more than two groups and repeated measures and other design issues.
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