RESUMO
Colon cancer is the third cause of cancer deaths. Although colon cancer survival time has increased in recent years, the mortality rate is still high. The Cox model is the most common regression model often used in medical research in survival analysis, but most of the time the effect of at least one of the independent factors changes over time, so the model cannot be used. In the current study, the survival function for colon cancer patients in Tehran is estimated using non-parametric Bayesian model. In this survival study, 580 patients with colon cancer who were recorded in the Cancer Research Center of Shahid Beheshti University of Medical Sciences since April 2005 to November 2006 were studied and followed up for a period of 5 years. Survival function was plotted with non-parametric Bayesian model and was compared with the Kaplan-Meier curve. Of the total of 580 patients, 69.9% of patients were alive. 45.9% of patients were male and the mean age of cancer diagnosis was 65.12 [SD= 12.26] and 87.7 of the patients underwent surgery. There was a significant relationship between age at diagnosis and sex and the survival time while there was a non-significant relationship between the type of treatment and the survival time. The survival functions corresponding to the two treatment groups cross, in comparison with the patients who had no surgery in the first 30 months, showed a higher level of risk in the patients who underwent a surgery. After that, the survival probability for the patients undergoing a surgery has increased. The study showed that survival rate has been higher in women and in the patients who were below 60 years at the time of diagnosis
Assuntos
Humanos , Masculino , Feminino , Sobrevida , Estatísticas não Paramétricas , Teorema de Bayes , Taxa de SobrevidaRESUMO
The main purpose of this study was to assess the effects of daily physical activity on exercise tolerance ability using the six minute walk test in healthy female students. The participants in this field study were 252 healthy girls, 9-12 years old, studying in an elementary school in Tehran from March to June 2011. A three months daily physical activity protocol, with 15 minutes exercise per day, was designed as a curricular-based exercise intervention program. The six minute walk test was used as a tool to measure exercise tolerance ability before and after the intervention. Paired t-test, ANOVA and correlation tests were used when appropriate. The participants, with mean age of 10.6 [SD = 1.1], formed different body mass index groups known as underweight, normal, at risk and overweight with 8.3, 60.7, 18.7, and 12.3% respectively. The mean of the distances moved along in a six minute walk test, before and after the intervention, increased from 833.4 meter to 923.3 meter, indicating 10% increase and the difference was found to be statistically significant [P<0.001]. However, analysis of mean differences of the walked distances, before and after the intervention, showed no statistically significant difference for the body mass index groups [P> 0.05]. A 15-minutes daily physical activity could enhance the exercise tolerance of school-age girls; the activity, as an easy and inexpensive form of intervention, is recommended to students
RESUMO
Cancer is the second cause of death in the world, and colon cancer is the third cause of death and is one of the most common cancers which will cure with early diagnosis, treatment and sufficient follow up. Assessing factors which affect this cancer is important for prolonging patient survival. Socioeconomic factors are among effective factors of cancer morbidity and mortality. Because mortality rates for colon cancers vary by socioeconomic characteristics, this study has been performed to recognize the relationship between socioeconomic factors with treatment and follow up of colon cancer. This was a cross-sectional, descriptive study for patients with colon cancer registered in Cancer Research Center of Shahid Beheshti University of Medical Sciences from April 2005 to November 2006. Patients were selected randomly, and the study was conducted using questionnaires filled by interviewing the patients via phone [if a patient was dead, the questions were asked from their family members]. Data analysis was done using SPSS [version 19] software. The study was performed on 520 colon cancer patients with age range of 23-88 years. The mean age of the patients was 63 [S.D. = 11.8] and the median age was 64.Two hundred thirty seven [45.4%] patients were female and 283[54.4%] were male. Using Chi- square test, age< 60 [P=0.002] and female gender [P=0.034] had a significant correlation with complete treatment and there was a significant relationship between complete follow up and age< 60 [P=0.037], academic education [P=0.02] and having insurance [P=0.021]. Multiple logistic regression tests were used to evaluate concurrent effects of variables on treatment and follow up. Correlated variables to complete treatment include: age< 60 [P=0.001], and female gender [P = 0.023].The Odds Ratio [OR] of completing treatment for patients under 60 years of age versus patients above 60 years was 3.13 [95% C.I. 1.55 to 6.34], and the OR of completing treatment for women versus men was 1.91[95% C.I. 1.33 to 2.74]. Correlated variables to follow up were academic education [P = 0.018] and having insurance [P = 0.046]. The OR of cancer follow up in illiterate patients versus college-educated patients was 0.45[95% C.I. 0.24 to 0.82], and the OR of cancer follow up in patients without insurance versus patients with health was 0.46[95% C.I. 0.21 to 0.98]. Age is a correlated factor on completing colon cancer treatment. Women have more complete colon cancer treatment than men. Academic education and having insurance were the most important factors among socioeconomic factors observed in a five-year follow up after treatment. As the population of the old is increasing, executing effective interventions to improve treatment and follow up procedures for old patients is of prime importance. It seems that increasing the insurance contribution in follow up measures may lead to increase in the regular follow up and may affect patients' survival.