Using Cancer Registration and Registry as search items with PubMed, a survey of the relevant literature for theyears 2006-2008 was performed. A total of 207 abstracts were scanned for core findings and classified under generalincidence and mortality, methodology and specific organ headings, these accounting for 27%, 5% and 68% of papers,respectively. Further sub-division into geographical area and country showed 34% from Europe, less than 1% fromAfrica, 42% from Asia (almost half in the APJCP), 2% from Australasia and the remaining 21% from the Americas.Breast cancer was the most common specific cancer covered, followed by colorectal and childhood, then lung andurinary tract, but clear differences were noted in the focus of different countries, partially reflecting variation inprevalence. The distributions across and within continents point to geographical areas and countries in whichassistance might allow a more comprehensive picture of cancer incidence and mortality to be generated, facilitatingworldwide efforts for cancer control. Variation within countries also appears to require more emphasis in the future.
Prostate cancer is the second leading cause of internal malignancy among men worldwide, with an annualincidence of 679,000 cases, and an annual mortality load of 220,000 deaths, making it the sixth leading cause ofcancer mortality among men. It is generally on the increase. Environmental and lifestyle factors may have anaetiological role in prostate cancer and hence may provide potential targets for future intervention. In fact,because of the disease high prevalence, slowly progressive nature, and long latency prostate cancer is a verygood candidate for chemoprevention. Dietary agents have gained considerable attention as chemopreventiveagents against prostate cancer. The methodology for this review included computerized literature searches ofthe PubMed database using the keywords “chemoprevention of prostate cancer” from 1992 to 2007 . This minireviewexamines the influence of plant-derived dietary agents for which articles reported statistically significanteffects in the management of prostate cancer.
The last two decades have witnessed a major drift in the interests of the scientific community towardsexplaining better means to containing the health risks of the human race. The century old chemotherapiesagainst various disorders have never been a success, albeit not a total failure. Such therapies have a majordrawback of side effects that give rise to unseen disorders that emerge as a new challenge. In this regard, theconcept of foodstuffs as natural medicines is very attractive. Epidemiological studies suggest that the vegeteranianfood habit is associated with reduced risk of cancer, cardiovascular and neurodegenerative disorders. Consistentwith this hypothesis is the fact that the incidence of these disorders is least in Asian populations where fruits,vegetables and spices are the major elements in the human diet. Recent research has shown that plant-derivedpolyphenolic compounds are promising nutraceuticals for control of various disorders such as cardiovascular,neurological and neoplastic disease. The richness of the polyphenolic contents of green tea and red wine hasmade them popular choice for associated anticancer and cardiovascular health benefits. The present article is abrief review of the promises plant polyphenols, bioactive components of our food, hold for the future.
Background: Breast cancer is the commonest cancer amongst Malaysian women but local survival data arescarce. The present study was therefore conducted to assess overall survival and prognostic factors in Malaysianbreast cancer patients. Methods: The research sample was a prospective cohort of 413 patients diagnosed withbreast cancer in the University of Malaya Medical Centre between 1993 to 1997. Survival data were obtainedfrom the National Registry of Birth and Deaths in December 2000. The clinico-pathological variables studiedwere age, ethnic group, stage, tumour size, lymph node status, oestrogen receptor status and grade. The datawas analysed utilizing Splus statistical software. The important prognostic factors were identified by fitting theCox’s proportional hazard model to the data set. Survival probabilities were estimated using the Kaplan-Meiermethod and differences were compared by the log-rank test. Results: The overall 5-year survival was 59.1%.The Cox’s proportional hazard model identified stage, lymph node status, size and grade as factors that correlatedwith prognosis. Age was not a significant prognostic factor. The Cox regression model by stepwise selectionshowed stage, nodal status and grade of tumour to be independent prognostic factors, whereas ethnicity, ageand ER status were not. Interpretation: The overall survival in our centre was low. Recognizing factors thataffect prognosis of breast cancer patients in Malaysia may improve delivery of health care to at-risk groups bystrategizing interventions as survival depends on early detection and effective treatment.
Objectives: To study the relation between genetic polymorphisms of methylenetetrahydrofolate reductase(MTHFR) C677T or A1298C and the susceptibility of colorectal cancer. Methods: We conducted a case-controlstudy with 315 cases of colorectal cancer and 371 population-based controls in Jiangsu province, China. Theepidemiological data were collected, and DNA of peripheral blood leukocytes was obtained from all of thesubjects. MTHFR C677T and A1298C genotypes were detected by PCR-RFLP method. Results: (1) When menand women were assessed together, the frequencies of the MTHFR C677T and A1298 genotypes or their alleleswere not significantly different between controls and colon cancer or rectal cancer cases. No significant relationwas observed between MTHFR C677T or A1298C polymorphisms and colon or rectal cancer susceptibility. (2)Among males, individuals who had MTHFR C677T T/T genotype were at a significantly higher risk of developingcolon cancer (age-, residence-, smoking, alcohol drinking-, tea consumption-adjusted OR=2.15, 95%CI: 1.07-4.33) compared with those who had C677T C allele. Individuals who had C677T T/T and A1298C A/A genotypeswere at an increased risk of developing colon cancer (adjusted OR=2.64, 95%CI: 1.20-5.81) compared withthose with C677T C allele and A1298C A/A genotypes among males. On the contrary, individuals who hadC677T T/T and A1298C A/A genotypes were at an decreased risk of developing rectal cancer (adjusted OR=0.47,95%CI: 0.22-1.03). Conclusions: These results in the present study suggested that polymorphisms of the MTHFRC677T could influence susceptibility to colon or rectal cancer and that there was a coordinated effect betweenMTHFR A1298C A/A and C677T T/T genotypes among males.
This study was undertaken to evaluate the incidence and independent predictors of unexpected invasivecancer of cervix in women with high-grade squamous intraepithelial lesions (HSIL) on Pap smear who hadundergone “see and treat” approach. Women with HSIL on cervical cytology undergoing colposcopy, followedby loop electrosurgical excision procedure (LEEP) at Chiang Mai University Hospital between January 2001and April 2006 were analyzed. During the study period, 446 women were identified. Mean age was 45.6 years(range, 25-78 years). One hundred and twenty-one (27.1%) women were postmenopausal. Unsatisfactorycolposcopy was observed in 357 (80.0%) women. Of the 446 women, 76 (17.04%, 95% CI= 13.67 to 20.86) hadinvasive lesions on LEEP specimens. Multivariate analysis revealed that unsatisfactory colposcopy andpremenopausal status were statistically significant independent predictors for invasive lesion on “see and treat”LEEP with an adjusted odds ratio of 4.68 (95%CI=1.82 to 12.03, P< 0.01) and 2.10 (95%CI=1.12 to 3.94, P=0.02),respectively. In conclusion, occult invasive lesion of the cervix was noted in 17% of women with HSIL Papsmear who underwent “see and treat” approach at our institute. Unsatisfactory colposcopy and premenopausalstatus were significant independent predictors of having such lesion.
This study was undertaken to evaluate the incidence and independent predictors for febrile morbidity afterradical hysterectomy and pelvic lymphadenectomy. Patients with FIGO stage IB-IIA cervical cancers who hadundergone RHPL at Chiang Mai University Hospital between January 2003 and December 2005, were reviewed.The clinical variables including the age at diagnosis, menopausal status, body mass index, previous cervicalconization, tumor size, preoperative chemotherapy, preoperative anemia, operative time, and estimated bloodloss were analyzed for prediction of postoperative febrile morbidity. During the study period, 357 women werereviewed. The mean age was 44.7 years. Sixty-five (18.2%) women were postmenopausal. The majority of women(77.3%) were in FIGO stage IB1. The most common histology was squamous cell carcinoma (69.2%). Febrilemorbidity was noted in 94 women (26.3%, 95% CI= 21.8-31.2) in whom 25 (7.0%) had urinary tract infection(19), abdominal wound infection (4), and vaginal cuff infection (2), respectively. Only massive blood loss (>1,500ml) was noted as the significantly independent predictor for febrile morbidity (aOR= 2.7, 95% CI=1.1-6.6,P=0.028). In conclusion, approximately one-fourth of the women undergoing RHPL at our institute hadpostoperative febrile morbidity. Only massive blood loss is a significant predictor for this complication.
Src homology 2 domain-containing protein tyrosine phosphatase-2 (SHP-2) of gastric epithelial cells interactswith cagA from Helicobacter pylori (H. pylori). Our previous studies found the AA genotype of a G/A singlenucleotide polymorphism at intron 3 (rs2301756) of PTPN11 gene, which encodes SHP-2, to be associated witha lower risk of gastric atrophy. The present study aimed to examine the association with gastric atrophy amongthe subjects of a case-control study of peptic ulcer disease (PUD) conducted in the Uzbek Republic. Cases were95 patients (61 males and 34 females) with PUD aged 16 to 85 years. Controls were 102 hospital volunteers (42males and 60 females) including 42 patients with miscellaneous diseases, aged 15 to 75 years. Gastric atrophywas evaluated with serum pepsinogens (PG1<70ng/ml and PG1/PG2<3). Polymorphisms of PTPN11 at intron 3(rs2301756) and intron10 (rs12229892) were genotyped with PCR with confronting two-pair primers (PCRCTPP).Anti-cagA IgG antibody was detected in 93.7% of cases and 77.5% in controls. Gastric atrophy wasobserved in 24.2% of the PUD patients and 33.3% in the controls. The A allele at intron 3 was completely linkedto the G allele at intron 10. The age, sex, and group (cases and controls) adjusted odds ratio of gastric atrophywas 0.18 (95% confidence interval, 0.04-0.86) for intron 3 GG genotype relative to AA genotype. Since thefinding was opposite to that among Japanese, the H. pylori strains and/or lifestyle in Uzbekistan might modifythe association.
A cross-sectional study was carried out to determine the knowledge and practices of 425 female secondaryschool teachers from 20 selected secondary schools in Selangor, Malaysia on breast cancer screening (BCS). Aself-administered, structured questionnaire was used for data collection. This study showed moderate to lowknowledge on breast cancer (BC) and BCS among teachers. Only 19%, 25% and 13.6% eligible women performedbreast self-examination (BSE), clinical breast examination (CBE) and mammography respectively, on a regularbasis. Level of breast cancer knowledge was significantly associated with BSE (p=0.000). Having heard/ readabout BCS, and regular visit with a physician were associated with BCS behaviors (P<0.05). There was noassociation between BCS behaviors (P>0.05 and age, family history of breast cancer, marital status or havinghealth insurance). Efforts are needed to increase knowledge and remove misconceptions about breast cancerand screening practices among Malaysian women.
Objective: To determine the spectrum of malignant lymphoma in our set up, according to the WHOclassification. Methods: All the cases diagnosed as malignant lymphoma, during the year 2005, were retrievedfrom the institution based tumour registry record and classified according to WHO criteria depending on theimmunohistochemical results of a panel of lymphoma markers. Results: The male to female ratio was 2.5: 1 foralmost all types of malignant lymphomas. The age range was 3 to 80 years. The frequency of Hodgkin’s lymphoma,Burkitt’s lymphoma and lymphoblastic lymphoma were higher amongst the children, whereas follicularlymphomas, mantle cell lymphoma and CLL/SLL were more frequently reported in 5th, 6th and 7th decades.Of the total cases 62% were nodal and 38% extranodal (majority in the GI tract). Non Hodgkin’s lymphomawas more (73%) frequent than Hodgkin’s disease. Mixed cellularity and nodular sclerosis were the mainhistological variants of Hodgkin’s disease. Conclusions: Immunohistochemistry is not very frequently used inour set up and that also at very few centres. Therefore, its application should be encouraged to raise the qualityof data on lymphoid neoplasms and contribute to their control.
Nasopharyngeal carcinoma (NPC) is a common public health problem in Thailand. Glutathione S-transferaseM1 gene deletion (GSTM1 null genotype) carriers have been reported to be at increased risk and therefore thisparameter is a potential marker for screening of NPC high-risk individuals. However, the conventional polymerasechain reaction (C-PCR) assay commonly used for GSTM1 null genotype detection is not suitable for mass screeningsince it is inconvenient, time consuming and unsafe due to the use of a toxic chemical. Currently, real-time PCR(R-PCR) assay is recommended for quicker and safer detection of various genetic polymorphisms. The aim ofthis study was to develop a SYBR green I R-PCR assay combined with melting curve analysis for GSTM1polymorphism detection in Thai NPC patients. The results were compared to those from the C-PCR assay usingDNA samples from peripheral blood leukocytes of 120 Thai NPC patients. The frequencies of GSTM1polymorphism detected by the R-PCR and the C-PCR were the same. Forty-eight individuals that were GSTM1+in the R-PCR assay showed 2 peaks with melting points of 82.5˚C and 87.5˚C that correlated with the appearanceof 2 DNA bands in the C-PCR assay (i.e., one for GSTM1 at 215 base pairs (bp) and one for β-globin at 268 bp).By contrast, 72 individuals that were GSTM1- in the R-PCR assay showed 1 peak with a melting point of 87.5˚Cthat correlated with the appearance of 1 DNA band for β-globin at 268 bp in the C-PCR assay. The R-PCR assayusing SYBR Green I and melting curve analysis for GSTM1 polymorphism detection was as reliable as the CPCRassay but was quicker and safer and more amenable to large scale screening in Thai NPC cases.
The purpose of this study was to identify factors that influence starting and quitting smoking among Japanesemale adolescents aged 15-18. Two thousand and twelve senior high school boys in Fukuoka City, Japan, answeredunsigned self-administrated anonymous questionnaires in July 2001. Odds ratios (ORs) and their 95 % confidenceintervals (CIs) were computed to assess the strength of associations between students’ smoking status and alcoholconsumption habits. Additionally, the link between a students’ smoking status and parental influence (parentalsmoking) was also assessed. Approximately 90% of the students, both current and ex-smokers, had ever smokedprior to senior high school while 77% of the students (smokers and non-smokers) had the experience of drinkingalcohol prior to admission to senior high school. After adjustment for school year (i.e., freshman, sophomore,junior, senior), academic education level, after-school club activities, time of first drinking experience and thefrequency of drinking, there was a significant increased risk to become a smoker when one parent is a smoker(OR = 1.67, 95% CI = 1.18-2.37) or when both parents are smokers (OR = 2.94, 95% CI = 1.66-5.18) comparedto both parents being non-smokers. The consumption of alcohol prior to entering senior high school wassignificantly associated with more than 2.5-fold greater risk for the onset of smoking when compared to the riskof becoming a smoker when alcohol consumption started after entering senior high school. An increased frequencyof drinking was also associated with starting smoking (OR =14.00, 95% CI = 8.08-24.26; 2-3 times/week vs.never). Similarly, an increase in drinking frequency resulted in less likelihood of smoking cessation. For instance,the data showed that, the subjects were 1/3 less likely to quit smoking. Paternal smoking had a significantimpact on whether or not a child would quit smoking (OR = 0.55, 95% CI = 0.38-0.81) as compared to a childthat had paternal and maternal non-smokers. This study suggested that drinking habits started earlier thansmoking habits among adolescents. Many students had already experienced drinking before admission tosenior high school, while the experience of smoking mostly typically started after admission to high school.These data show the urgency of developing anti-smoking educational programs that could be developed andintroduced prior to admission to high school.
Despite having one of the highest smoking rates among men, information about secondhand smoke (SHS)exposure among Korean adults is lacking. This study describes SHS exposure among Korean men and women.The results were derived from a population-based, cross-sectional telephone survey conducted with 332 adultnonsmokers in Seoul. Sixty-eight percent of nonsmokers were exposed to SHS during a typical day. Exposurewas most common in locations other than home and work, where 57% of respondents were exposed, comparedto 26% at home and 25% at work. However, among those exposed, the greatest dose of exposure occurred atwork (9 cigarettes/day), followed by at home (6 cigarettes/day). Men were more likely to be exposed to SHS atwork than women. For men, lack of home smoking bans and strong belief in traditional Korean values wereindependently associated with SHS exposure in any location. For women, younger age, family members’ smoking(non-spouse), and having fewer sources of anti-SHS messages were independently associated with SHS exposureanywhere. The results highlight the need for strong, comprehensive SHS control measures, such as a completeban of smoking in all workplaces and public places, as well as public health campaigns to promote home smokingbans and non-smoking norms.
Objective: To assess the prevalence and factors associated with a histologic diagnosis of high grade squamousintraepithelial lesion (HSIL) and invasive cervical cancer in patients with low grade squamous intraepitheliallesion (LSIL) cervical pap smear findings. Methods: Medical records (including cytology reports, colposcopicimpression, and pathologic results from cervical biopsy, endocervical curetting, cervical conization orhysterectomy) of 226 women with LSIL from conventional cervical pap smears during January 2001 to December2005, who subsequently underwent colposcopic evaluation at our institution, were reviewed. Results: Mean ageof the patients was 39.0 years. The incidences of LSIL, HSIL, microinvasive cervical cancer were 58.8%, 15.0%,1.3% respectively. No associations were found between age, parity, contraception, anti-HIV or menstrual statusand the detection of HSIL/invasive cervical cancer. Conclusion: Approximately 16.3 % of LSIL pap smear casesturn out to be HSIL or invasive cervical cancer from histologic diagnosis.
Objective: The essential assumption of random missing age behind the “conventional method” of handlingcancer patients of unknown age does not often hold. This article is to introduce four alternative methods basedon more acceptable assumptions. Methods: More cases with unknown age are allocated to the older age-groupsin all the new methods. In the “weighting method,” cases of unknown age are distributed according to distributionof cases of known age, whereas in the “last-group method,” all of them are added to the oldest age-group. In the“progressive method,” unknown-age cases are added to the age-groups above 60 progressively (weighting=1/63,2/63, 4/63, 8/63, 16/63, and 32/63), whereas in the “additive method,” they are allocated to the age-groups above60 additively (weighting=1/21, 2/21, 3/21, 4/21, 5/21, and 6/21). Data were from the Cancer in Five Continentdatabase, vol. VIII. Results: Age-standardized rates for “All sites” in Zaragoza (Spain), Cali (Colombia), Algiers(Algeria), and Gambia showed that results by all the methods differed, the magnitude ranging from 0.1 to 3.1%depending on the method, registry, sex, and the defined last age-group. Conclusion: Conventional and weightingmethods are not based on acceptable assumptions. The last-group method is not stable because it depends onthe defined age-group as last (65+, 75+ or 85+). Both progressive and additive methods have more acceptableassumptions. The progressive method is preferable above all others because it can produce an age-specific curvewith the expected exponential increase.
Objective: In a previous article, we reported the prevalence rates of oral mucosal lesions in this hospitalfrom 1990-2001. This study was planned to study the spectrum of potentially malignant and malignant orallesions in Allahabad, North India in the subsequent years till 2007 and to assess change in pattern of prevalence,if any. Materials and Methods: This is a single institutional retrospective study in and around Allahabad from1990 to 2007. Data was collected year wise with reference to age, sex, site involved and histopathological findings.Results: 1,151 oral biopsies were reviewed. Of these, 365 biopsies were benign, 344 were potentially malignantand 442 were malignant. The buccal mucosa was the most frequently involved site in benign and premalignantlesions, however in malignant lesions, the tongue was most common site. Oral submucous fibrosis constitutedthe highest number of patients in premalignant group, while in malignant group, squamous cell carcinoma wasmost prevalent. Conclusion: This study showed that potentially malignant and malignant oral lesions werewidespread in the patients visiting the hospital in this region.
Trends in cancers of the central nervous system in both sexes in five Indian population based cancer registries(Mumbai, Chennai, Bangalore, Delhi & Bhopal) were evaluated over a period of the last two decades. For thispurpose we applied a model that fits the data is the logarithm of Y=ABx which represents a Linear Regressionmodel. This approach revealed an increasing trend in cancers of nervous system in both sexes throughout theentire period of observation in almost all registries. As CNS cancers are increasing, analytic epidemiologicalstudies should be planned in a near future on a priority basis to understand the etiology of these cancers indepth.
This article provides an overview of aspects of the burden of cancer in the elderly, in India highlightingcertain demographic and epidemiological data. In India the normal retirement age is 60 years, so the definitionof the elderly, in India is considered above the age of 60 years. Information on the aging of the Indian populationis based on various census figures, cancer incidence figures are taken from Mumbai registry data. Men andwomen aged ≥ 60 years are at high risk for major cancers. Men have a risk 15 times greater risk and in women8 times greater risk than the persons having age < 60 years. Lung and prostate cancers are most prominentcancer in men having age ≥ 60 years while in women breast is the leading site followed by cervix and ovary in thesame age group. Demographic and epidemiologic data characterize the aging / cancer interface. The changingdemographic structures underscore the current incidence imperative for elderly; suggesting a starting demandwill be made in the future requiring physician’s abilities and skills to meet these needs.
Background: Breast Cancer is the second most common cancer among Iranian women. This study wasconducted to define the outcome of breast cancer which had been registered by Tehran Cancer Registry. Methods:All Tehranian breast cancer which registered from 1998 to 2001 was selected; the repeated cases were excludedaccording to their common name, family name, and Father's name. A simple data collection form was used tocomplete the demographic and diagnostic time and survival situation of the cases by five educated technicianswith using phone interviews with patients or their families. All data were entered in Access file and then exportedto SPSS-11.5, for descriptive and analytic analysis, p value was significant under 0.05. Since there were somecases had not phone number or the phone numbers were not accessible; 360 cases were selected with SimpleRandom Sampling and their hospital files were reviewed to complete the demographic and location situationsdata. Kaplan- Meier regression model was used for computing the survival. Results: Of the 7098 records, 4416records were interviewed by phone. This phone interviews were succeeded among 2358 cases; Tehranian andother cities were defined in 986 and 1372 records respectively. The Tehranian cases were estimated 36.9%(CI95%: 31.9%-41.8%). The mean age of patients was 51.3±12.5, 31.4% of them was under 40 years old, theincidence rate of breast cancer in 100.000 women was estimated 17.09CI95 %( 15.67-18.50). Infiltrating ductcarcinoma was the most morphology (68.4%). Right, left, and both breast involvement were seen in 48.6%CI95%( 43.4%-53.8%), 46.1%CI95 %( 41.0%-51.2%), 0.3%CI95 %( 0.1%-0.5%) respectively. The tumor size over2 centimeters was seen in 63.6% of cases at diagnostic time. Lymphadenopathy and metastasis were seen in48.3% CI95 %( 43.1%-53.5%), and 19.7 % CI95% (15.6%-23.8%) of cases. The median survival was 5.0 yearsCI95 %( 4.9 years -5.1 years). Conclusion: This retrospective survival study was shown the seven years followup from 1998 to 2005, women which were diagnosed in 1998, 1999, 2000, and 2001; 55.9%, 61.4%, 60.3%, 66%were alive respectively. Interventional projects for increasing the survival rate, early detection, and effectivetreatment of breast cancer were recommended.
The genotoxicity induced by mitomycin C (MMC) was found to be decreased by aspirin on alkaline singlecell gel electrophoresis (SCG) assay in multiple organs of mice. Aspirin at doses of 0.5, 5 and 50 mg/kg andMMC at 2 mg/kg were administered and then liver, lung, kidney, spleen, colon and bone marrow were sampledafter 3 h. Significant protective effects of aspirin against MMC-induced genotoxicity was observed in all but thebone marrow, where no change was evident. The results suggest that the radical scavenging ability of aspirinprevents danage by MMC-induced reactive oxygen species (ROS) in multiple organs.
Objective: To evaluate the clinicopathological characteristics and survival analysis in endometrialadenocarcinoma women younger than the age of 40 years compare to older women. Methods: Medical recordsof 423 endometrial adenocarcinoma patients who received primary surgical treatment at King ChulalongkornMemorial Hospital during 1996-2005 were reviewed. The patients were divided into two groups; 40 years of ageor younger (group A, 42 patients) and older than 40 years (group B, 381 patients). Results: Up to 10% (42/423)of endometrial adenocarcinoma patients were younger than the age of 40 years. The higher incidence ofnulliparous and obesity (BMI > 30 kg/m2) was significantly demonstrated in group A (81%/34.1% and 52.4%/25.2%, respectively). However, obesity was an only independent factor in multivariate analysis. No significantdifference in surgical stage distribution and the other pathologic characteristics was demonstrated betweenboth groups. However, poor histologic grade (grade 3) and deep myometrial invasion (myometrial invasionmore than 50%) tended to be found more frequent in the patients older than the age of 40 years, although therewas no statistical significance (16% versus 4.7% and 31% versus 14.3%, respectively). Moreover, synchronousovarian cancer seemed to be higher in young patients (7.1% and 2.9%, p > .05). Median time to follow was 63months (range 0 – 145 months). Five years disease free survival and 5 years overall survival were 87.3% and92.4% in group A versus 83.8% and 88.0% in group B without statistical significance between both groups.Conclusions: Obesity was the only independent factor associated with endometrial adenocarcinoma in youngpatients. Distribution of the surgical stage and the other pathologic characteristics were similar between bothgroups without survival benefit in young patients.
Previously, we have shown that the telomerase RNA component hTR is highly expressed in the epithelium ofnon-dysplastic Oral Lichen Planus (OLP) lesions (11). We concluded that it is possible that this high expressionmight be related to the increased cellular proliferation seen in OLP rather than being an indicator of potentialmalignant transformation. In the present study, and in order to confirm our finding in the previous study thathTR might be a marker for cellular proliferation in OLP, we analysed OLP biopsies known to be positive forRNA component of Telomerase (hTR) for the expression of Ki-67 as a marker for cellular proliferation. FourteenOLP tissue biopsies known to be positive for telomerase RNA component hTR, were investigated using animmunohistochemical approach to determine the rate of cellular proliferation in OLP, looking at the expressionof Ki-67 protein as a marker for cellular proliferation. A statistically significant increase was found between Ki-67 expression in OLP in comparison to normal control buccal mucosa samples. The expression of hTR componentin OLP might thus be a marker for cellular proliferation.
The methylthioadenosine phosphorylase (MTAP) gene is a tumour suppressor gene, located on chromosome9p21, 100 kb telomeric of the p15 and p16 genes, which are often deleted in tumor cells. The role of MTAPprotein expression in the genesis of cutaneous squamous cell carcinoma (SCC) is currently not known. In aprevious study we have shown the frequent occurrence of allelic imbalance / loss of heterozygosity (AI/LOH) incutaneous SCCs using AI/LOH markers flanking the p15, p16, and MTAP genes and demonstrated reduction inp15 and p16 protein expression in comparison to normal human skin. The present study is a continuation to ourprevious studies, aimed at determining possible roles played by MTAP protein expression in the genesis ofcutaneous SCC. The expression of MTAP protein was detected using immunohistochemical approach in 109micro array cutaneous SCC and 20 normal human skin tissue samples. The expression of MTAP was notsignificantly different in the cutaneous SCC cases as compared with normal human skin. This may indicate thatMTAP protein expression does not contribute to the genesis of cutaneous SCC.
Recent studies suggest that cyclooxygenese-2 (COX-2) enzyme activation may play a role inhepatocarcinogenesis. However, the clinical significance of COX-2 expression in hepatocellular carcinoma (HCC)remains obscure. This study evaluated COX-2 expression in hepatitis B and hepatitis C virus related HCC andin HCC patients with an unknown etiology. Liver tissue samples of 31 patients with HCC (27 men and 4 women;age range, 48-75 years) were analyzed. COX-2 expression was evaluated by immunohistochemically in thetumor tissues. Patient data including age, sex, Child score, stage, grade of the tumor and survival were analyzed.Of these patients 19 were positive for hepatitis B virus (HBV), 6 were positive for hepatitis C virus (HCV) and 6patients were negative for all viral markers and other etiologic factors. COX-2 staining were evaluated in 2groups (group 1: COX-2 expression less than 25% (grades 1-2 COX-2 expression), and group 2: Cox-2 expression25% or more (grades 3-5 COX-2 expression). COX-2 expression was shown in all HCC samples with positive ornegative viral markers. No difference was found between degree of COX-2 expression and the etiology of HCC.COX-2 expression was not correlated with number of lesion or stage of the disease or grade of the tumor. COX-2 expression was not related with Child score of the patients. Median survival of all patients was 32 months.Median survival of patients did not differ according to patient’s viral marker status. No difference was observedin median survival of patients in group 1 and 2. As a result, COX-2 system seem to be shared part inhepatocarcinogenesis regardless factors that initiate the disease. Although COX-2 expression appears to beindependent of disease’s characteristics’, treatments that target this system appear to be feasible in themanagement of HCC.
Background: The International Collaborative Epidemiological Study of Host and Environmental Factorsfor Stomach and Colorectal Cancers in Southeast Asian Countries (SEACs) has been conducted in Viet Namfrom 2003 to 2008 on a case-control basis. For further effective primary prevention, we examined gastric andcolorectal cancer mortality nationwide ineight regions of Viet Nam in 2005-06. Methods: Both demographicdata and lists of all deaths in 2005-06 were obtained from all 10,769 commune health stations in Viet Nam. Fiveindicators included name, age, sex, date of death and cause of death was collected for each case. We selected onlycommunes having the list of deaths with clear cause for each case and crude mortality rate for all causes from300-600/100,000 as published by the Ministry of Health for a reasonable accuracy and completeness. Obtaineddata for all causes, all cancers, stomach and colorectal cancer deaths as well as demographic information wereprocessed using Excel software and exported to STATA 8.0 for estimation of world age-standardized cancermortality rates per 100,000. Results: Data were available for 1,246 gastric cases, (819 male and 427 female) withage-standardized mortality rates from 12.7 to 31.3 per 100,000 in males and from 5.9 to 10.3 per 100,000 infemales in the 8 regions of the country. For colorectal cancers, 542 cases (268 male and 274 female) gavemortality rates from 4.0 to 11.3 per 100,000 in males and from 3.0 to 7.8 per 100,000 in females. Discussion:Stomach cancer mortality in males in the region of North East in the North Viet Nam (2005-06) was higher thanthat in Japan (2002) (31.3 versus 28.7 per 100,000) while colorectal cancer in Viet Nam was lower. While prevalenceof Helicobacter pyloris infection in Viet Nam was from 70-75% in both males and females, the stomach cancerrate in males was significantly higher than in females, 31.3 versus 6.8 per 100,000, suggesting an influence ofother environmental risk factors. Whether protective factors are operating against colorectal cancer in VietNam now needs to be explored.
Introduction: Febrile neutropenia (FN) is a major complication of chemotherapy, costly in terms of morbidity,mortality and associated financial expenditure. The present study was conducted with the goal of highlightingFN as a serious problem in Pakistan, with the longer term objective of improved cancer survival, reduction inlength of stay (LOS) in hospital, morbidity, mortality and costs in our existing developing country scenario.Methods: A cross-sectional descriptive study was conducted on patients, ≥18 years, admitted with FN as aconsequence of chemotherapy at a referral hospital in Karachi from 1st September 2006 to 30th April 2007.Results: A total of 80 patients [43 (53.8%) males and 37 (46.2%) females] were selected. The mean age was 47.4(SD ±16.6; range 18-79) years. Sixty eight patients (86%) were ≤ 65 years, 50% were ≤ 50 years. Overall, inhospitalmortality was 11%; 4% for patients on granulocyte colony stimulating factor (G-CSF) prophylaxis asagainst 20% for those without. The cause of death was either pneumonia or septic shock. Mean LOS was 7.53(SD ±3.8; range 2-17) days. Hematological malignancies, older age, severity of dehydration, pneumonia andculture positivity were significantly associated with LOS and death. Those above 50 years of age were 1.5 timesas likely to be hospitalized longer and > three times as likely to die. Bacteremia conferred a 5-fold and pneumoniaan 8-fold increase in the risk of death. Conclusion: The results of this study indicate that age, vital instability,dehydration, high creatinine, culture positivity and hematological malignancies are high risk factors inchemotherapy induced FN. Identification of FN risk factors with poor outcomes may help in devising protocolsfor modified dosage or including GCFs initially. This may help reduce the cost of cancer care as well as mortalityand morbidity. Prospective studies of FN in multiple centers in Pakistan may be beneficial in evaluating theserisk factors further.
Background: Breast cancer is the most common malignant tumor in females. Many studies have been carriedout in order to assess the reproductive risk factors. Particular attention has focused on information regardingfertility, including breastfeeding, age at first birth and number of live births. These factors are highly correlatedwith each other. The objective of this study was to employ latent variables to reduce the confounding effect ofthis correlation with a logistic regression analysis. Methods: The investigation drew upon results from a datasetbelonged to a hospital based case-control study covering 303 breast cancer patients and 303 hospital controls.Data were collected through interview and reproductive variables included age at first full-term pregnancy andlive birth, number of pregnancies and live births, and total length of breast feeding. Latent variables weregenerated using factor analysis and principal components analysis. Results: The study revealed that for bothlatent variable approaches the odds ratios of two latent variables significantly indicated a protective impact ofnumber of pregnancy and live birth and breastfeeding and a prognostic relation with age at first pregnancy orlive birth. Conclusion: The findings suggest that breastfeeding and decreasing age at first live birth have protectiveinfluences on breast cancer risk. Also using statistical model with latent variables in the presence of collineardata leads to reliable results.
Studies were undertaken to determine whether bovine lactoferrin (bLF) and related compounds, shown toprevent carcinogenesis in the colon and other organs in rats, have any toxic effects in long-term feeding studies.In experiment I, male F344/DuCrj rats received a basal diet containing 0.2% bLF for 40 weeks. No adversefindings were noted, furthermore, serum triglyceride level was significantly decreased to 72% of the controllevel, suggesting preventive effects against the metabolic syndrome. In experiment II, male and female F344/DuCrj rats were fed a basal diet containing 0.02, 0.2, 2.0 and 5.0% bLF, 2.0% bLF hydrolysate (bLF-H) or 0.1%lactoferricin (LFcin), a peptide derived from bLF, for 60 weeks in males and 65 weeks in females. No toxicologicaleffects, including carcinogenicity, were evident in either sex. The results of the studies provide subjective supportfor safety of clinical studies of bLF for supplement use.
Background and aims: The aim of this study was to calculate survival rates and analyze patterns of survivalin gastric cancer. Methods: A total number of 746 patients with gastric cancer registered in the Cancer RegistryCenter of Research Center of Gastroenterology and Liver Disease of Shahid Beheshti University of MedicalSciences, Iran, from Dec 21, 2001 to Dec 21, 2006 were investigated. 1- to 5-year survival rates were estimatedusing life-table method and compared by Wilcoxon (Gehan) test. P <0.05 was considered as statistically significant.All calculations were carried out with SPSS (version13.0) statistical software. Results: There were 530 malepatients with a mean age of 60.5±12.6 years and 216 females with a mean age of 57.5±13.5 years. Of the total, 454died and 285 were censored during the investigation. The median survival time was 24.2 months and survivalrates at one, two, third, fourth and five years after diagnosis were 73.6, 50.2, 40.6, 33.2 and 29.7%, respectively.Stages of tumor, histology grade, histologic type of cancer, tumor size, age at diagnosis and surgery approachwere independent prognostic factors . However, variables such as sex (P=.533), body mass index (P=.214),ethnicity (P=.092), and level of education (P=.762) did not shown significant effects on survival. Conclusion:Early detection of patients at lower age and with primary stages and grades of tumor is important to increasepatient’s life expectancy.
The association between an exposure of interest (risk factor) and a disease may be confounded by the actionof other separate factors as well as by interactions between risk factors exerting an impact. Crude measures ofeffect may be misleading in such situations. Levels of the potential confounding factor could be estimated usingstratified analysis. Uniformity of the stratum-specific effect estimates can be assessed by performing chi-squaretests for heterogeneity. If the effect is uniform across strata, we can calculate a pooled adjusted summary estimateof the effect using the Mantel-Haenzel (M-H) method. Confidence intervals for the adjusted estimate and theM-H chi-square test are calculated to assess the significance. If the effect is not uniform (presence of interaction),we report stratum-specific estimates, confidence intervals and chi-square for each estimate. In the present paper,assessment of the level of confounding and interaction between risk factors are illustrated using a case-controlstudy of lung cancer conducted at the Regional Cancer Centre, Trivandrum.
Background and aims: Regardless of the fact that cancers of GI tract have been reported to be the mostcommon fatal neoplasms in East Azerbaijan, there is a serious lack of population-based studies in this region.Methods: A comprehensive search was therefore undertaken to prospectively register all cases of cancer occurringin the province during March 2006-2007. Diagnosis of cancer was based on histopathology of primary lesions in84.0% of cases, clinical investigation and ultrasound in 7.2%, only clinical investigation in 5.4%, and histologyof metastasis in 2.9. Less than 1% were based on cytology and death certificates in one official year. Results: Atotal of 4,922 cancers (mean age 60.2+18.13 years) were diagnosed during this population-based study. Of these,56.8% (2114) were in males. ASRs for all cancers in males and females were 164.3 and 130.6 respectively. Thetop five sites for cancer in males (excluding skin cancer) according to the calculated ASR (world) were stomach(26.0), bladder (15.7), esophagus (12.4), colon and rectum (11.6) and blood (10.8); in females, they were breast(23.5), esophagus (11.7), stomach (11.6), colon and rectum (9.7) and nervous system (5.5). Conclusion: This firstcomprehensive report on cancer incidence in East Azerbaijan, documents particularly high incidence rates foresophageal and gastric cancer across the sexes.
The purpose of the present study was to assess the ovarian cancer incidence rate among women of reproductiveage in Kyrgyzstan. Sources of data were records of all patients who were first diagnosed as suffering fromovarian cancer at reproductive age (15-49) during the period 1999-2006. Descriptive and analytical methods ofonco-epidemiology were applied. It was established that the ovarian cancer incidence among general femalepopulation of reproductive age equaled 4.3±0.3 per 100,000 population. Incidence rate was increasing in dynamics.Average age of patients in this category was 37.9±0.5. Analysis of age indicators demonstrated that incidencerate was higher within later reproductive age (40-49) at 11.2±0.60/0000. Incidence among the two main ethnicpopulation groups was analyzed: Kyrgyz and Russian. Whereas rates appeared to be increasing in the former,the latter demonstrated paradoxical decrease.
The use of tobacco remains a significant public health concern among Asian American (AA) adolescents.Understanding the factors that affect smoking progression among Chinese and Vietnamese adolescents inparticular, may help in illuminating potential interventions that can be implemented to maximize scarceprogramming and resources. This study is a longitudinal cohort study with data collected in California viatelephone over a two-year period. 1,270 Chinese and Vietnamese American adolescents were recruited viatelephone listings from one southern and four northern California counties. Main outcomes were smokingsusceptibility and change in smoking status. Examination of these adolescents indicated that in both groups:boys were more likely than girls to become susceptible to smoking, risk behaviors were associated with becomingsmokers, having been susceptible at baseline was associated with susceptibility and smoking at follow-up, andthe influence of friends was a predictor of susceptibility and smoking.
A case control study was carried out to investigate associations between breast cancer risk, antioxidantstatus and oxidative stress among women in Klang Valley and Selangor. A total of 57 newly diagnosed casesaged 30 to 66 years old participated and were matched for age and ethnicity with 139 controls with no diagnosisof cancer or other chronic diseases. An interview based questionnaire designed to collect information ondemographic and socioeconomic status, as well as reproductive, medical and dietary history was used.Anthropometric measurements including weight, height, waist and hip circumference were made and a 10 mlfasting venous blood sample was taken for glucose testing and analysis of plasma vitamin antioxidants andmalondialdehyde. Hair and toenail samples were taken for selenium analysis. Results showed that the meanintake of vitamin A, vitamin E and selenium among cases (606.8±334.8μg/d, 6.1± 2.4 g/d, 56.9 ± 16.2 μg/d) waslower than controls (724.7 ± 414 μg/day, 6.9 ± 3.0 g/d, 60.8 ± 17.5 μg/d, respectively) (p<0.05 for all parameters).A similar trend was noted for plasma vitamin A and E and also selenium in hair and toenails. Poor antioxidantstatus as indicated by low plasma vitamin A (<284.3 μg/l or <366.3 μg/l) increased risk of breast cancer byapproximately two fold, whilst low plasma vitamin E (<2.5 mg/dl, <2.8 mg/dl and <3.1 mg/dl) increased the riskby two to three fold [Adjusted OR 2.97 (95% CI 1.38-3.48), 2.32 (95% CI 1.07-2.41) and 2.12 (95% CI 1.00-4.21)]. Cases had a greater level of malondialdehyde 4.4 ± 1.1 mmol/g protein), an indicator of oxidative stress,as compared to controls (3.2 ± 1.7 mmol/g protein)(p<0.05). A high level of MDA (≥4.8 mmol/g protein) wasassociated with breast cancer [Adjusted OR 6.82 (95% CI 1.95-23.9)]. It is concluded that a poor antioxidantstatus and high oxidative stress are associated with breast cancer risk. Thus, it is essential for Malaysian womento obtain a good antioxidant status by consuming a diet rich in vitamins A and E as well as selenium and adopthealthy behaviour to reduce oxidative stress in order to prevent breast cancer.
During the past thousands of years, food systems, and thus human diets, have been and are shaped byclimate, terrain, seasons, location, culture, and technology. In this context, many types of diet patterns haveemerged. Nowadays, numerous epidemiological studies are being conducted in many countries in order to findrelationships between empirically identified dietary factors and the occurrence of illnesses. Today, some dietarypatterns are described as healthy eating models while others are generally qualified as unhealthy.
Despite the mountain of information generated by researchers, the cancer problem has not significantlydeclined and perhaps in certain situations it is gradually increasing, affecting those who are previously at lowrisk. There is a tendency to believe that positive outcomes can always be expected once intervention activities,like exercise promotion, are carried out, but practical experience gives rise to serious doubt. A greaterunderstanding of the biological mechanisms operating in the physical activity‚ cancer relation, completemeasurement of physical activity through a subject’s life, assessment of all potential confounders and associationmodifiers are needed to confirm a protective role of physical activity in cancer development and allow specificexercise prescriptions for community-based prevention in particular cancer sites. Furthermore, the mostimportant impetus of any community intervention approach should be oriented in the form of ‘from people tothe people’. More emphasis needs to be placed on effective management and parameters for assessment ofmanagement success.
There appear to be some differences between the patterns of brain tumor epidemiology in Iran and westerncountries. Thus, the prevalence of glioma was earlier estimated to be about 45% of all brain tumors, somewhatlow in comparison to the western reports at that time, but almost the same as in Southeast Asian countries. Asimilar low figure was also obtained more recently indicating that the earlier estimate was not simply due to thelack of medical facilities resulting in under-reporting of this particularly malignant form of cancer. There mayalso be differences regarding incidences of central nervous system (CNS) tumors in females between Iran andWestern countries. Clearly this is an area which deserves epidemiological research.
Primary malignant lymphoma of the cervix is a rare disease. Because the number of reports of this cancer islimited, there is no consensus on its management, prognosis or the efficacy of various treatments. Primarymalignant lymphoma of the cervix stage Ib was diagnosed in a 25-year-old woman. The patient was treated with6 courses of CHOP chemotherapy (cyclophosphamide, doxorubicin, vincristine, and prednisone). Clinical andpathological responses were complete. This case supports current thinking in that, in selected young patientswith primary malignant lymphoma of the cervix who desire to preserve fertility and ovarian functions,combination chemotherapy regimens such as CHOP are the treatment of choice.