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☐ ☆ ✇ Evidence-Based Nursing

Behaviours as biomarkers? Disentangling causality between vitamin D, sedentary behaviours and mortality is necessary for preventing recurrence and cardiovascular disease in cancer survivors

Por: Giorgi Rossi · P. · Bonvicini · L. — Junio 19th 2025 at 10:25

Commentary on: Yu Y, Cheng S, Huang H, et al. Joint association of sedentary behaviour and vitamin D status with mortality among cancer survivors. BMC Med 2023;21:411.

Implications for practice and research

  • Results support National Institute for Health and Care Excellence recommendations7 in defining vitamin D levels below 50 nmol/L as insufficient and highlight sitting time over 6 hours/day as a possible determinant of mortality in cancer survivors.

  • Biological mediators linking sedentary behaviours, vitamin D and health outcomes should be investigated to understand the underlying causal link.

    • Context

    Many observational studies showed that sedentary behaviours1 and low serum levels of vitamin D2 are independent risk factors for mortality in cancer survivors. Nevertheless, data from trials on vitamin D supplementation3 and interventions promoting physical activity4 did not obtain the effect on mortality in cancer survivors that...
    ☐ ☆ ✇ PLOS ONE Medicine&Health

    Self-blaming as a barrier to lung cancer screening and smoking cessation programs in Italy. A qualitative study

    Por: Luca Ghirotto · Eugenio Paci · Claudia Bricci · Silvia Marini · Valentina Bessi · Matías Eduardo Díaz Crescitelli · Ermanno Rondini · Francesco Pistelli · Giuseppe Gorini · Sandra Bosi · Paolo Giorgi Rossi · the Working Group — Marzo 5th 2025 at 15:00

    by Luca Ghirotto, Eugenio Paci, Claudia Bricci, Silvia Marini, Valentina Bessi, Matías Eduardo Díaz Crescitelli, Ermanno Rondini, Francesco Pistelli, Giuseppe Gorini, Sandra Bosi, Paolo Giorgi Rossi, the Working Group

    Background

    Lung cancer screening (LCS) combined with smoking cessation programs is a critical strategy for reducing lung cancer mortality. Understanding the perspectives of cigarette users and former ones on these interventions is essential for enhancing their acceptability and effectiveness. This study aimed to explore, in Italy, the perceptions and experiences of individuals eligible for LCS within the context of a smoking cessation program.

    Methods and findings

    This multicenter qualitative study was conducted in two Italian regions as part of a larger project the Italian League against Cancer promoted. Using purposive sampling, we included (a) cigarette users and former ones who participated in an Italian trial, ITALUNG study, and (b) cigarette users who had been offered individual or group smoking cessation interventions and were theoretically eligible for screening in the following years (aged 50–70, ≥15 pack-years). Data were collected through open-ended semi-structured interviews and focus group meetings and analyzed using reflexive thematic analysis. The data analysis yielded six themes covering participants’ views on the interactions between the two types of interventions (screening and smoking cessation program). Across their data, we generated the following themes: (i) depreciation and fatalism toward the risk of smoking, (ii) self-blaming and ethicality, (iii) ambivalent impact of the screening on smoking, (iv) LCS-related information and concerns, (v) teachable and motivating moments, and (vi) non-stigmatizing communication and testimony by professionals.

    Conclusions

    Our study underscores the importance of avoiding stigma and respecting the dignity of cigarette users in implementing LCS and smoking cessation programs. Clear communication and supportive interactions with healthcare providers are crucial for enhancing the acceptability and effectiveness of these interventions. Future research should focus on quantifying these findings and exploring additional factors influencing the acceptability and effectiveness of combined LCS and smoking cessation programs.

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