Background Colorectal cancer reported the fourth most common cancer in Iran. The aim of this study was to describe the time trends of colorectal cancer mortality from 1990 to 2021, focusing on the effects of age, period, and cohort. Method Our data included the number of colorectal cancer deaths and population recorded by the global burden of disease (GBD) and categorized by 5‐year age groups from 1990 to 2021. Joinpoint regression and the age–period–cohort (APC) model were used to reflect temporal trend and effects of age, period, and cohort on colorectal cancer mortality, respectively. Results The crude mortality rate of colorectal cancer was significantly increased in men, with an average annual percentage change (AAPC) of 1.558% (95% confidence interval [CI]: 1.398%, 1.778%), while the crude mortality rate increased (AAPC = 1.340%; 95% CI: 1.215%, 1.465%) and the age‐standardized mortality rate decreased in women (AAPC = −0.307%; 95% CI: −0.460%, −0.152%). APC analysis showed that the risk of death increased with age in both genders (Coef 15–19 = −2.823 vs. Coef > 95 = 1.731 in men and Coef 15–19 = −2.628 vs. Coef > 95 = 1.964 in women) and time (Coef 1992–1996 = −0.385 vs. Coef 2017–2021 = 0.438 in men and Coef 1992–1996 = −0.271 vs. Coef 2017–2021 = 0.380 in women) and was lower in later‐born cohort (Coef 2002–2006 = −1.590 in men and Coef 2002–2006 = −1.543 in women) than earlier‐born cohort (Coef < 1901 = 1.458 in men and Coef < 1901 = 1.208 in women). Conclusions Due to the increasing trend from colorectal cancer mortality and age and period effects, it seems necessary to modify early detection strategies and increase public awareness to reduce the burden of this cancer.

Background Marital intimacy plays a significant role in patients’ quality of life. However, colorectal cancer (CRC) and ostomy surgery can disrupt this important aspect of life. Despite its significance, there is no specialized tool to assess marital intimacy in this population. Therefore, this study aims to develop and validate the Chinese Marital Intimacy Scale for CRC survivors with an ostomy (CRCO) (Ch‐MIS‐CRCO). Methods An observational cross‐sectional study was conducted following the instrument development procedures outlined by DeVellis, which include instrument formation and psychometric testing phase. Content validity was evaluated by content validity index (CVI), while construct validity was examined by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Convergent validity was assessed using correlations with the Lock and Wallace Marital Adjustment Test, Ostomy Adjustment Scale, and Stoma‐QOL. Known‐groups validity was evaluated across clinically relevant subgroups. Floor and ceiling effects were examined, and internal consistency reliability was assessed using Cronbach’s alpha. Results The initial 52‐item pool was refined through content validity assessment, pilot testing, item analysis, and EFA, resulting in a final 25‐item scale across four dimensions, with eigenvalues ranging from 1.62 to 8.83, explaining 63.09% of the total variance. The scale demonstrated excellent model fit ( χ 2 /df = 1.61; CFI = 0.95; TLI = 0.94; RMSEA = 0.05). Convergent validity was supported by significant correlations with the Lock and Wallace Marital Adjustment Test ( r = 0.49), Ostomy Adjustment Scale ( r = 0.55), and the Stoma‐QOL ( r = 0.59). Known‐groups validity was confirmed, with higher scores observed among patients without ostomy complications, those with complete self‐care ability, and those whose primary caregiver was their spouse (all p < 0.05). No floor or ceiling effects were detected. Internal consistency was high, with Cronbach’s α of 0.93 for the total scale and 0.85–0.90 for the subscales. Conclusion The Ch‐MIS‐CRCO demonstrates strong psychometric properties and can be effectively used to evaluate marital intimacy among CRC survivors with an ostomy, further helping to predict and improve patients’ quality of life.

Introduction In the context of the COVID‐19 pandemic, scientific societies of oncology issued guidelines to limit the spread of the virus, in particular by limiting the prescription of cancer treatments with palliative intent. This qualitative study adopts a psychosocial perspective to explore how oncologists experienced these guidelines, and what this reveals about their representations and practices concerning end‐of‐life treatments. Methods Conducted in a comprehensive cancer center, the study is based on a mixed‐method strategy involving 10 semistructured interviews with oncologists and observation of 13 consultations. Results The oncologists stated that they were complying with the guidelines, which was perceived as an external argument of authority that made it easier to announce the cessation of treatment. The analysis highlights the sacralization of chemotherapy, a shared feeling of guilt at the idea of stopping cancer treatments, and a representation of palliative care as the moment when there is “nothing more to be done.” Discussion The fact that the oncologists reported that previous practices had been reinstated once the health crisis had passed reveals the psychosocial logics at work in their decision‐making and communication practices. This study recommends the creation of workshops to raise awareness of the psychosocial factors that influence chemotherapy prescriptions in the advanced stages of the disease.

Background A common side effect of breast cancer treatment is breast cancer–related lymphedema (BCRL), which is associated with many symptoms, such as swelling, heaviness, tightness, pain, discomfort and poor quality of life. The breast cancer and lymphedema symptom experience index (BCLE‐SEI) captures the presence of BCRL‐related symptoms and distress. However, the BCLE‐SEI is not available in Marathi, one of the most commonly spoken Indian languages. The purpose of this study was to translate and validate the BCLE‐SEI in Marathi. Methodology The BCLE‐SEI was forward‐ and backward‐translated, and the consolidated back translation was checked for equivalence following established guidelines. The BCLE‐SEI‐Marathi was then validated among 169 Marathi‐speaking women with or at risk of developing BCRL. Content validity, structural validity, internal consistency, test–retest reliability, construct validity (through hypothesis testing) and known group validity were tested. Three different thresholds were used when testing known group validity. Results Content validity of the BCLE‐SEI‐Marathi was confirmed by 98% of the participants. Exploratory factor analysis identified two factors in the symptom occurrence subscale and three factors in the symptom distress subscale, which explained 49% and 53.8% of the total sample variance, respectively. Internal consistency of dimensions (factors) ranged from α = 0.82 to 0.94. Construct validity was established through hypothesis testing. The test–retest reliability was strong (Spearman’s rho of 0.88 ( p < 0.01, 95% CI: 0.8–0.9)). The BCLE‐SEI total score was able to distinguish the participants with BCRL from those at risk for BCRL. Conclusion This study demonstrated that the BCLE‐SEI‐Marathi questionnaire is a valid and reliable tool to assess the occurrence and distress of symptoms in Marathi‐speaking women with or at risk of BCRL. Trail Registration: Clinical Trials Registry India: CTRI/2017/11/010326

Introduction Gestational trophoblastic neoplasia (GTN) is a rare, malignant form of gestational trophoblastic disease (GTD), and international guidelines recommend centralisation of care for best outcomes. The Western Australian Trophoblastic Centre (WATC) was established in 2023 aiming to provide centralised, person‐centred care coordinated by a specialist nurse within a multidisciplinary team. This project aimed to describe the patient population and evaluate lived experience and satisfaction in this new model of care. Methods An observational descriptive study utilised a review of service data to describe the profile of service users and a cross‐sectional survey to collect quantitative and qualitative evaluation data. Data underwent descriptive statistical and content analysis. Results The review determined 172 people accessed the WATC from January 2023 to April 2024. The majority were treated for a partial mole (50%) or a complete mole (38%). Sixty‐six service users responded to the survey. Descriptive analysis revealed an extremely high level of service satisfaction across all areas of care. The few reports of dissatisfaction related to awareness of psychological and external services and support for family member needs. Survey participants expressed mixed preference for face‐to‐face and telephone appointments. Within open‐ended responses, participants commonly expressed satisfaction with empathetic and supportive care delivered by the specialist nurse, information provision and having access to a contact person through the service. Suggestions for improvement were associated with practical issues, such as parking and logistical challenges in attending appointments, and communication. Conclusions Satisfaction with this centralised service model for the management of GTD was extremely high, emphasising the person‐centred approach coordinated by a specialist nurse. This evaluation validates service continuation in its current form and supports wider implementation of similar models in other centres for people accessing care for GTD management.

Background Oral mucositis/stomatitis is a common adverse event during cancer treatment that can disrupt oral functioning and adherence to treatment. Datopotamab deruxtecan (Dato‐DXd), a TROP2‐directed antibody‐drug conjugate, has shown promise in treating solid tumors. It has been associated with oral mucositis/stomatitis in clinical trials for breast and lung cancer (TROPION program). Currently, there is a lack of formalized guidelines for managing Dato‐DXd‐associated oral mucositis/stomatitis. The present study employed a modified Delphi approach to establish expert consensus on preventing, diagnosing, monitoring, and treating oral mucositis/stomatitis secondary to Dato‐DXd and to improve patient care and clinical outcomes. Materials and Methods A four‐stage modified Delphi study engaging 15 oncology experts from Europe and Canada was used to establish consensus on managing Dato‐DXd‐induced oral mucositis/stomatitis in lung and breast cancer patients. Experts were selected based on their roles as investigators in Dato‐DXd clinical trials, including but not limited to TROPION‐PanTumor01, TROPION‐Lung01, TROPION‐Lung05, and TROPION‐Breast01, and their experience managing cancer treatment–associated oral mucositis/stomatitis. The Delphi process included an initial meeting, two anonymized surveys, an in‐person consensus meeting, and virtual one‐to‐one sessions for absentees. Results Expert consensus was reached on recommendations for managing Dato‐DXd‐associated oral mucositis/stomatitis, and experts highlighted the importance of establishing guidance to improve patient quality of life and clinical outcomes. Key recommendations included prophylactic dexamethasone mouthwash, patient education, and behavioral changes. Early detection through self‐checks and monitoring was emphasized, and recommended treatment strategies were tailored to oral mucositis/stomatitis severity. Treatment recommendations included dose modifications and discontinuation for severe cases. Conclusions This study offers expert guidance on managing Dato‐DXd‐associated oral mucositis/stomatitis, filling a crucial gap in patient care. Ongoing efforts to generate Dato‐DXd‐specific data will facilitate the creation of standardized, evidence‐based protocols to improve patient safety and treatment outcomes.

Background Despite the strong emphasis in recent scientific literature on the pharmacological features of CAR‐T cells, patients’ quality of life (QoL) and needs, by contrast, have received little attention. Aim This study aims to investigate patients’ perspectives on their QoL and needs in a referral centre for CAR‐T cell treatment in Italy. Methods This is a descriptive, qualitative and prospective study conducted at a single centre. Patients were recruited from a list of those who underwent the treatment or who were eligible to do so. Patients were asked to participate in a semistructured interview. The number of people to be interviewed was not predetermined but was established continuously until meaning saturation was achieved. The interviews were audio recorded, transcribed verbatim, and analysed through constructivist lenses using reflexive thematic analysis. Results Participants were 12 patients (age mean: 57.88; SD = 9.62; range = 39–70) enrolled in an Italian Comprehensive Cancer Center. From the analysis of the interviews, 7 themes were identified: (1) therapeutic journey to reach CAR‐T cell therapy; (2) CAR‐T cell images; (3) perception of the quality of care received; (4) three challenging moments; (5) emerging issues to address; (6) coping strategies and (7) needs. Some themes have been organised into subthemes that detail their specific aspects. Starting from the quotations, 41 needs have been identified and organised into 5 macro areas: (1) needs during hospitalisation; (2) existential needs; (3) needs for improving QoL; (4) need for quality and quantity of information and (5) needs for care. The list of needs has been transformed into a checklist, serving as a preliminary step for subsequent studies aimed at identifying and quantifying the needs of patients. Conclusions Results indicate that the QoL of patients undergoing CAR‐T cell therapy is impaired during hospitalisation and in the subsequent months following infusion. Physical symptoms including fatigue, drowsiness, cognitive slowing or dysfunction emerged. Nonetheless, patients employ various coping strategies to cope with these challenging periods. A multitude of needs, often unaddressed, has emerged. For this matter, a first draft for a checklist of needs has been realised. Should future studies validate its structure, this tool may prove beneficial in both clinical and research settings to identify and monitor patients’ needs throughout the continuum of their treatment pathway.

Objectives: To perform a cost‐effectiveness analysis based on primary data from a cohort of patients with localized prostate cancer followed throughout 10 years, comparing radical prostatectomy, brachytherapy, and external beam radiotherapy (EBRT) and applying disease‐specific utilities, from a national health system’s perspective. Materials and Methods: Patients diagnosed with localized prostate cancer were consecutively recruited in 2003–2005 from 10 Spanish hospitals ( n = 674) (ClinicalTrials.gov number: NCT01492751). The expanded prostate cancer index composite (EPIC) and short‐form 36 (SF‐36) questionnaires were administered through telephone interviews before treatment and annually during follow‐up. The outcome measures to evaluate the incremental cost‐effectiveness ratio between treatments (ICER) were quality‐adjusted life‐years (QALYs), calculated by the patient‐oriented prostate utility scale (PORPUS) utility index, obtained with a mapping from the EPIC and the SF‐36, and survival data. Ten‐year medical activities were used to derive costs. Both unweighted and propensity score‐weighted analyses were performed. Results: The weighted mean of 10‐year QALYs was the highest for radical prostatectomy (8.53), followed by brachytherapy (8.49) and external radiotherapy (8.20), but the difference was only statistically significant with the latter. Costs were significantly higher for brachytherapy (€21,348) than radical prostatectomy (€12,281) and EBRT (€7,560). Compared to EBRT, the weighted ICER for radical prostatectomy was €14,169/QALY gained and €48,417/QALY for brachytherapy. Conclusion: Our findings support that radical prostatectomy was the most cost‐effective alternative, but the differences in effectiveness among the three treatments were small. The incremental cost of radical prostatectomy and brachytherapy compared to EBRT, however, does not justify restricting these alternatives. Trial Registration: ClinicalTrials.gov identifier: NCT01492751

This retrospective study aimed to determine the risk factors for venous thromboembolism (VTE) in patients undergoing radical hysterectomy for cervical cancer. Data from 366 patients who underwent radical surgery between June 2020 and December 2021 were collected from medical records. The patients were divided into a thrombosis group and a nonthrombotic group based on the presence or absence of VTE. Multivariate analyses revealed that age greater than 45 years, open radical hysterectomy surgery, an operation time exceeding 4 hours, intraoperative blood transfusion, and postoperative plasma D‐dimer levels greater than 2.0 mg/L were significant independent risk factors for postoperative VTE, which could be used to help identify patients at an increased risk of VTE.

Background: Disruptions in activity‐rest rhythms are common in terminal cancer patients, yet continuous monitoring of these changes is challenging. The effects of opioids and psychotropic drugs on sleep quality remain inadequately understood. Objectives: (i) To objectively evaluate temporal changes in diurnal (8:00 a.m.–8:00 p.m.) and nocturnal (8:00 p.m.–8:00 a.m.) activity‐rest rhythms over the final 2 weeks of life in terminal cancer patients using a nonwearable actigraph and (ii) to assess the adjusted impact of opioid and psychotropic drug use on these rhythms. Design: A longitudinal study. Settings/Participants: Twenty‐six terminal cancer patients in a Japanese palliative care unit. Measurements: A nonwearable actigraph was placed under the mattress to continuously monitor activity‐rest rhythms. Measured parameters included time in bed (TIB: minutes), total sleep time (TST), wake after sleep onset (WASO), sleep efficiency (SE: 0%–100%), activity score (0–960 counts/min; higher values indicate greater activity), and movement index (MI: percentage of time moving in bed; higher values suggest restlessness). Results: As death approached, diurnal TIB and SE increased, indicating reduced daytime activity. Nocturnal sleep metrics fluctuated irregularly, with an increase in MI, suggesting deteriorating sleep quality. Opioid users exhibited a higher MI and lower SE both day and night compared to nonusers. Psychotropic drug users showed a decreased nocturnal MI and improved SE. Conclusion: Terminal cancer patients experience decreased daytime activity and unstable nocturnal sleep as death nears. Opioid use correlates with inadequate rest, while psychotropic drugs may enhance nocturnal sleep quality. Continuous nonwearable monitoring offers valuable insights for optimizing end‐of‐life care.