Referring survivors of endometrial cancer and complex atypical hyperplasia to bariatric specialists: a prospective cohort study
| Autor: | Chad M. Michener, Kathryn A. Maurer, Philip R. Schauer, Karen Cooper, Peter G. Rose, A.M. Jernigan |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
medicine.medical_specialty Bariatrics Referral Bariatric Surgery Article Atypical hyperplasia Cohort Studies Weight loss Surveys and Questionnaires medicine Bariatric Medicine Humans Obesity Prospective Studies Survivors Prospective cohort study Referral and Consultation Aged business.industry Endometrial cancer General surgery Obstetrics and Gynecology Middle Aged Patient Acceptance of Health Care medicine.disease Endometrial Neoplasms Endometrial Hyperplasia Physical therapy Female medicine.symptom business Attitude to Health Carcinoma Endometrioid Cohort study |
| Zdroj: | American journal of obstetrics and gynecology. 213(3) |
| ISSN: | 1097-6868 |
| Popis: | Objective The purpose of this study was to describe the acceptability of bariatric referrals when offered by gynecologic oncologists to women with a history of complex atypical hyperplasia or early-stage endometrial cancer and to detail compliance with referrals and weight loss attempts that are initiated 3 months after the referral. Study Design Obese women with complex atypical hyperplasia or early-stage endometrial cancer were approached for inclusion in this prospective cohort study. Those women who were not in the care of a bariatric specialist were offered a medical referral with or without a surgical referral. A survey was administered at inclusion and after 3 months. Results Of 121 women who were approached, 106 women were consented. Women reported that it was acceptable for their gynecologic oncologist to discuss weight loss (91.09%) and that a 10% loss of body weight would be beneficial (86.14%). Six women were already in the care of a bariatric specialist. Of the remaining 100 women, 43 accepted a referral: 35 of 100 medical and 8 of 66 surgical referrals that were offered. At 3 months, 17 women complied with a referral (16 medical and 1 surgical), and 59 women had initiated any weight loss attempt. On multivariate analysis, a higher initial weight ( P = .0403), Charlson Comorbidity Index ≥5 ( P = .0278), and shorter time from surgery to bariatric referral ( P = .0338) predicted acceptance of a referral. Conclusion Weight-loss counseling is well received by these women. After being offered bariatric referral, only 17% comply, but most women (59%) subsequently initiate a weight loss attempt. Referrals should be offered early in the course of cancer care to maximize acceptance. |
| Databáze: | OpenAIRE |
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