Predictors of cardiopulmonary fitness in cancer-affected and -unaffected women with a pathogenic germline variant in the genes BRCA1/2 (LIBRE-1).

Physical activity (PA) helps prevention and aftercare of sporadic breast cancer (BC), cardiopulmonary fitness (CPF) being an age-independent predictor of tumor-specific mortality. Therefore, we wanted to identify predictors of CPF (represented by peak oxygen uptake: VO2peak) in BRCA1/2 mutation carriers whose risk of developing BC is high. We used cross-sectional data from 68 BRCA1/2 germline mutation carrying women participating in the randomized, prospective, controlled clinical study LIBRE-1. Assessments included cardiopulmonary exercise testing, medical and lifestyle history plus socioeconomic status. Additionally, the participants completed a psychological questionnaire regarding their attitude, subjective norms, perceived behavior control and intention towards PA. A multivariate logistic regression model was used to identify predictors for participants reaching their age- and sex-adjusted VO2peak reference values. 22 participants (median age: 40 years, interquartile range (IQR) 33-46) were cancer-unaffected and 46 cancer-affected (median age: 44 years, IQR 35-50). The strongest predictor for reaching the reference VO2peak value was attitude towards PA (Odds Ratio 3.0; 95% Confidence Interval 1.3-8.4; p = 0.021). None of the other predictors showed a significant association. A positive attitude towards PA seems to be associated with VO2peak, which should be considered in developing therapeutic and preventive strategies.Trial registrations: NCT02087592; DRKS00005736.

The association between an anxiety disorder and cancer in medical history.

BACKGROUND: Cancer patients can feel depression and anxiety any time after a cancer diagnosis. The Generalized Anxiety Disorder Scale (GAD-7) is an instrument for the assessment of anxiety. The main objective of this work was to compare general anxiety levels between cancer survivors and individuals without a history of cancer in a population-based study (LIFE-ADULT) with 10,000 participants. METHODS: All participants (18-80 years) completed the GAD-7 and other psychological and medical questionnaires. A score of 10 or greater for GAD-7 (of total 21) indicates a probable generalized anxiety disorder. RESULTS: 954 participants reported a diagnosis of cancer in their medical history. In the multivariate analysis an anxiety disorder was associated with prior cancer diagnosis (OR: 1.8; 95% CI [1.4-2.4]), age -every additional year- (OR: 0.983; [0.976-0.991]), female gender (OR: 1.8; [1.5-2.2]) and low socioeconomic status (OR: 2.0; [1.7-2.5]) all p < 0.001. There were no significant associations between general anxiety and other comorbidities, such as myocardial infarction (OR: 1.0; p = 0.948), stroke (OR: 1.4; p = 0.237) or diabetes (OR: 1.0; p = 0.326). There was also no significant difference in anxiety disorder among cancer survivors regarding the time passed since the initial cancer diagnosis (OR: 1.1; [0.6-1.9], p = 0.804 comparing 5-10 years after a diagnosis of cancer vs. ≤5 years and OR: 0.6; [0.4-1.1], p = 0.107 comparing >10 vs. ≤5 years). LIMITATIONS: This study has a cross-sectional character, therefore, causal conclusions cannot be drawn. CONCLUSION: Cancer survivors may require screening for anxiety disorders and long-term professional psychosocial support.