West Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-73688320070301Physical Activity in the Prevention of the Most Frequent Chronic Diseases: an Analysis of the Recent Evidence32533824611ENJournal Article19700101The Japan Multi-institutional Collaborative Cohort Study (J-MICC Study) launched in 2005, supported bya research grant for Scientific Research on Special Priority Areas of Cancer from the Japanese Ministry ofEducation, Culture, Sports, Science and Technology. Although the main purpose is to confirm and detectgene-environment interactions of lifestyle-related diseases, mainly of cancer, through the cohort analyses, itincludes cross-sectional analyses on lifestyle factors, biomarkers, and genotypes, as well as confirmation/screening of new biomarkers usable for early diagnosis of cancer. The endpoints are cancer diagnosis and death.The participants diagnosed as cancer will be identified through population-based cancer registries, hospitalcancer registries, mail questionnaires, questionnaires at repeated visits, death certificates, health insurance data,and second survey questionnaires. Subjects are individuals aged 35 to 69 years enrolled from respondents tostudy announcements in specified areas, inhabitants attending health checkup examinations by localgovernments, visitors at health checkup centers, and patients at a cancer hospital. The number of subjects wasset to be 100,000 throughout Japan. The enrollment period is from April 2005 to March 2010. The second surveyis scheduled 5 years after their enrollment. The participants will be followed until 2025. The J-MICC CentralOffice is placed at Nagoya University Graduate School of Medicine. Ten participating research groups (CohortStudy Executing Groups) send baseline data and blood samples (buffy coat, serum, and plasma) anonymizedwith an identification number (J-MICC ID) to the Central Office. The data of second survey and follow-up willbe linked using J-MICC ID. This study is expected to produce many findings on lifestyle and genetic traitsassociated with lifestyle-related diseases including cancer among Japanese.https://journal.waocp.org/article_24611_dd9514e6afde96a47640912f338733c8.pdfWest Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-73688320070301Female Genital Warts33934724612ENJournal Article19700101Genital warts are a clinical manifestation of HPV types 6 and 11, and are estimated to affect 1% of sexuallyactive adults aged between 15 and 49. HPV leading to a broad spectrum of human diseases, ranging from benignwarts to malignant neoplasms, depending on the location of the lesion, the immune status of the patient and thetype of HPV. Current therapies for human papillomavirus-associated disease are based on the excision or ablationof involved tissue and are associated with a high frequency of recurrent disease, discomfort and costs.https://journal.waocp.org/article_24612_2e23ce9bd0c44fe1abf746ae82515a15.pdfWest Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-73688320070301Iran Cancer Incidence should be Corrected for Under-Ascertainment in Cancer Cases in the Elderly (Aged 65+)34834924613ENJournal Article19700101<br/><b>Objective</b>: This article is to calculate corrected Iran cancer incidence by a novel method to compensateunder-ascertainment of cancer cases in the very elderly (aged 65+). Study Design and Setting: Corrected agespecificrate for a certain cancer in age group 65+ was calculated from the age-specific rate of that cancer in agegroup 55-64 multiplied by the corresponding coefficient from reference cancer registry (sex- and age-specificcoefficients from Finnish Cancer Registry, a nation-wide registry with high validity of data). All cancer datawere obtained from GLOBOCAN 2002. <br/><b>Results</b>: The crude rate (and number of new cases) for “All sites excludingskin” was 13.6% (men 18.7%; women 8.1%) under-estimated. The under-enumeration was 18.9% for the agestandardizedrate (men 25.4%; women 11.8%). This means there were 58,000 new cancer cases (about 7,000more than original) in 2002. Corrected incidence for the year 2050 was 26.1% higher (men 32.8%; women17.3%) than the original estimate (49,000 more). Depending on cancer site and sex, percentage under-estimationvaried remarkably. <br/><b>Conclusion</b>: After correction, the estimates of number of new cases and incidence rates ofIran increase substantially. Without correction, cancer occurrence measures can be remarkably under-estimatedwhich may lead to inadequate resource allocation for control measures.https://journal.waocp.org/article_24613_d33b84336f96102f526e362152f188aa.pdfWest Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-73688320070301Can an Appointment-letter Intervention Increase Pap Smear Screening in Samliem, Khon Kaen , Thailand ?35335624614ENJournal Article19700101Our objective was to assess the efficiency of an appointment-letter intervention aimed to increase uptake ofcervical cancer screening in women between 35 and 65 years of age. From January, 2007, we randomly recruited320 women, not screened for at least 5 years, from the Samliem inner-city community, Khon Kaen, NortheastThailand. A total of 150 women 35, 40, 45, 50, 55, 60 and 65 years of age were assigned to the intervention groupaccording to Thai National Cancer Institute’s ( TNCI) strategy. A further 170 women between 36-39, 41-44, 46-49, 51-54, 56-59 and 61-64 years of age were assigned to the control group. Baseline interviews were conductedfor all women in both groups by one of the researchers in January, who also provided culturally-sensitive healtheducation emphasizing the need for screening. Then appointment letters were sent only to women in theintervention group in February, with the last date for an appointment being March 31st. In April of 2007,immediately post-intervention, screening-coverage interviews were performed in both groups for comparison.There was a significant increase in the Pap smear screening-coverage rate in the intervention group comparedwith the control group (44.67% vs. 25.88%, p=0.001). Therefore, the appointment-letter intervention produceda significant effect on increasing Pap smear coverage in this group of women.https://journal.waocp.org/article_24614_b0ef859473c3b46c21369b084be4cbf3.pdfWest Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-73688320070301Patho-epidemiology of Cancer Cervix in Karachi South35736224615ENJournal Article19700101<br/><b>Introduction</b>: The present study was conducted with the objective of examining descriptive epidemiologicaland pathological characteristics of cancer cervix in Karachi South, an all urban district population of Karachi,Pakistan. Methodology: A total of 74 cases of cancer cervix, ICD-10 (International Classification of Diseases10th Revision) category C53 were registered at the Karachi Cancer Registry, for Karachi South, during a 3 yearperiod, 1st January, 1995 to 31st December 1997. <br/><b>Results</b>: The age standardized incidence rate (ASR) world andcrude incidence rate (CIR) per 100,000 were 6.81 (5.2, 8.43) and 3.22 (2.49 to 3.96). Cancer cervix accounted forapproximately 3.6% of all cancers in females and was the sixth malignancy in hierarchy. The mean age of thecancer cases was 53.27 years [standard deviation (SD) 11.6; 95% confidence interval (CI) 50.58, 55.96; range(R) 32-85 years)]. The distribution by religion was Muslims (90.5%), Christians (8.1%) and Hindus (1.4%).There were no cases reported in Parsees. The frequency distribution by ethnicity was Urdu speaking Mohajirs(20.3%), Punjabis (17.6%), Gujrati speaking Mohajirs (4.1%), memon Mohajirs (8.1%), Sindhis (10.8%), Baluchs(8.1%), Pathans (5.4%) and Afghan migrants (2.7%). The ethnicity was not known in approximately a fourth(23.0%) of the cases.The socio-economic distribution was 27.0% financially deprived class, 24.4% lower middleclass and 48.7% upper middle and affluent classes. The majority of the women were married (86.5%); a smallernumber were unmarried (2.7%) or widows (10.8%). The age-specific curves showed a gradual increase in riskfrom the fourth up till the seventh decade, followed by an actual apparent decrease in risk after 64 years of age.The peak incidence was observed in the 60-64 year age group. The morphological categorization was squamouscell carcinoma (86.5%), adenocarcinoma (10.9%) and adenosquamous carcinoma (2.6%). The majority ofcases presented with moderately differentiated or grade 2 lesions (45.9%). There were no in-situ cases.Approximately half the cancers (58.1%) had spread regionally and 8.1% to a distant site at the time of diagnosis.Odds ratios (OR) were calculated for socioeconomic residential categories, religion, ethnicity, age groups andeducation. The OR for socioeconomic residential categories ranged between 0.69 and 2.9 with a marginallyhigher risk in the lower [OR 2.09 (95% CI .97; 4.49)] and lower middle class [OR 2.08 (95%CI 0.95; 4.58)].Hindus [OR 1.2 (95% CI 0.18; 2.2)] had a slightly higher risk then the Muslims [OR 0.14 (95% CI 0.17; 1.2)]. Ahigher risk was also observed for Christians [OR 7.76 (95% CI 1.74; 34.5)]. <br/><b>Conclusion</b>: The incidence of cervicalcancer in Karachi South (1995-97) reflects a low risk population with a late presentation and a high stagedisease at presentation. It is suggested that cervical screening if implemented should focus on once a life timemethodology involving 36-45 year old women. This should be combined with HPV vaccination for the youngand public health education for all. A regular cervical screening program would require mobilization ofconsiderable financial, structural and human resources along with training for personnel. This may burden thealready stretched health resources of a developing country.https://journal.waocp.org/article_24615_7ee825728fd2bb01c74d6e3ba9ff142d.pdfWest Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-73688320070301Lymphovascular Space Invasion as a Prognostic Determinant in Uterine Cancer36336624616ENJournal Article19700101The objective of this study was to evaluate the clinical significance of lymphovascular space invasion (LVSI)in patients with uterine cancer in terms of lymph node metastasis, recurrence and survival rate. A total of 190patients with newly diagnosed uterine cancer who underwent total abdominal hysterectomy (TAH), bilateralsalpingo-oophorectomy (BSO), omentectomy, peritoneal washing or ascitic fluid collection, and pelvic/paraaorticlymph node sampling at Chiang Mai University Hospital between January 1999 and December 2004 wereevaluated. All medical records and histopathologic slides were retrospectively reviewed to determine therelationship between LVSI and clinicopathological characteristics. LVSI was present in 79 patients (42%) andsignificantly correlated with lymph node metastasis (p<0.001), BMI < 25 kg/m2 (p<0.001), advanced FIGOstage (p< 0.001), poor histologic grade (p<0.001), and deep uterine invasion (p<0.001). Patients with LVSI,when stratified by FIGO stage, also had a significant lower 5-year survival rate. For those who had diseaserecurrence, LVSI and histologic grade were found to be independent prognostic factors in a multivariate analysis.LVSI was one of the prognostic determinants for disease recurrence and associated with poor survival in patientswith uterine cancer.https://journal.waocp.org/article_24616_38a8eab721d9a6c85b713e55df7030fc.pdfWest Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-73688320070301Chronic Lymphocytic Leukemia at Recent 10 Years and Treatment Effects of Fludarabin36737124617ENJournal Article19700101<br/><b>Objective</b>: CLL (Chronic Lymphocytic Leukemia) is the most common form of leukemia in the westernworld and because of prolonged survival of patients, the prevalence is high. Chemotherapy is usually not indicatedin early and stable disease and using Chlorambucil with or without steroids has been the drug of choice in thetreatment of CLL for many years .Clinical studies have shown that using Fludarabin can cause a completeresponse in significant number of untreated and/or previously treated CLL patients. The aim of this study isevaluating of CLL patients and determining the effects of treatment with Fludarabin. <br/><b>Methods</b>: A retrospective(descriptive/cross sectional) study of CLL patients who admitted to Hematology and Oncology Research Centerof Tabriz university of Medical Sciences, between 1995-2005 was made and 126 patients enrolled. Collection ofdata was carried out according to special questionnaire and response to Fludarabin was analyzed by SPSS 11software. <br/><b>Results</b>: The patients mean age of diagnosis was 63.7 years (SD=8.9), 69.8% were males. Illness andfatigue were the commonest presenting symptoms in 54% and lymphadenopathy was the most common clinicalsign in 88.9%.Most of the patients were in stage C in Binet system (52.4%) and/or stage IV in Rai system(44.4%).Chemotherapy with chlorambucil and Prednisolone was the most common regimen used (60.3%) and49.2% of patients were in partial remission with this treatment. Forty two patients treated with Fludarabin and50% were in partial remission, 35% in static disease, 10% in progressive disease and 5% in complete remission(P=0.053). <br/><b>Conclusion</b>: The median survival with Fludarabin was 43.9 months (SD=27.2) and in the case ofChlorambucil+Prednisolone and CVP or Chop it was 45 months (SD=26.5) and 50 months (SD=32.2), respectively(P>0.05). P value in the relationship with survival and response to Fludarabin was more than 0.05.Above all,Fludarabin is the choice treatment as first and second line therapy, as well as for patients who have failedtherapy with standard regimens.https://journal.waocp.org/article_24617_ce139e2b13a2b5c968a9b2038d2a36b5.pdfWest Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-73688320070301Lack of Initiation Activity of 4-oxo-2-hexenal, a Peroxidation Product Generated from ?-3 Polyunsaturated Fatty Acids, in an In Vivo Five-Week Liver Assay37237424618ENJournal Article19700101Peroxidation products formed from polyunsaturated lipids have DNA damaging potential. 4-oxo-2-hexenal(4-OHE), generated by the oxidation of ω-3 fatty acids, has been demonstrated to be mutagenic in vitro asassessed in the Ames test. To examine the carcinogenic risk of 4-OHE in vivo, initiation activity was investigatedin a five-week liver assay, established to be effective for screening of carcinogenic potential of mutagens. Sevenweek-old male F344 rats underwent two-thirds partial hepatectomy (PH) and were administered 4-OHEintragastrically at doses of 128, 80, 64, 40, 32, 20, or 0 mg/kg body weight (b.w.) at 18 hours thereafter, thenbeing fed on diet containing 0.015% 2-acetylaminofluorene from weeks 2 to 4. All rats were given with 0.8 ml/kgb.w. CCl4 at week 3. At week 5, all survivors were sacrificed and initiation activity was assessed with referenceto induction of glutathione S-transferase placental form (GST-P) positive foci in the liver. Mortality wassignificantly increased to 72.7% in the 128 mg/kg b.w. dose group compared with 0.9% in the control group.However, the average number of GST-P positive foci in the “128” dose group was 3.26±1.66 foci/cm2, notsignificantly different from the control value (2.78±1.33). Areas of GST-P positive foci were also similar (1.11±0.5and 1.53±1.33 mm2/cm2 in “128” and the control groups, respectively). These results showed 4-OHE to have nosignificant initiation activity in vivo.https://journal.waocp.org/article_24618_3985fafa3eb59871a0f430e56305ff37.pdfWest Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-73688320070301Prostate-Specific Antigen Levels among Chinese, Malays and Indians in Singapore from a Community-Based Study37537824619ENJournal Article19700101The purpose of this study was to examine the distribution of prostate-specific antigen levels among Chinese,Malays and Indians in Singapore, taking the effect of age into consideration. The study was carried out as partof the Singapore Prostate Awareness Week from 23-26th February 2004. Men above 50 years old went to fourgovernment-restructured hospitals to participate in the study. Participants filled up a questionnaire and provided5 ml of blood for measurement of PSA levels using the Abbott IMx Total PSA assay (Abbott Laboratories).3,486 men responded to the study, comprising 92.8% Chinese, 3.0% Malays, 2.5% Indians and 1.8% Others.92.7% of them had PSA levels of 4 μg/L or less. There were no significant differences (p<0.05) between the meanPSA levels of Chinese (1.60 μg/L), Malays (1.39 μg/L), Indians (1.23 μg/L) and Others (1.70 μg/L). PSA levelswere significantly associated with age (Spearman’s r= 0.27, p<0.01). PSA levels increased with each 10-year agegroup and these trends were significant (p<0.0001) across both PSA group levels and age groupings. In the ≤50and >50-60 years age groups, the prevalence of PSA levels >4 μg/L were 1.1% and 3.7% respectively. This roserapidly to 11.3% and 23.5% for age groups >60-70 and >80 years respectively. Our study shows that the medianPSA levels in the Caucasian population in the USA are higher than those of Chinese, Malays and Indians inSingapore. PSA levels were positively associated with age. It may be more appropriate to offer PSA testing tomen who are >60 years old rather than the current >50 years.https://journal.waocp.org/article_24619_46c6a8e5b8850f593e59112c8fe739c3.pdfWest Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-73688320070301Appropriate Interval for Repeat Excision in Women Undergoing Prior Loop Electrosurgical Excision Procedure for Cervical Neoplasia37938224620ENJournal Article19700101The objective of the present study was to evaluate the impact of intervals on complications and pathologicalexamination in women undergoing a repeat loop electrosurgical excision procedure (LEEP) for cervical neoplasia.During October 2004 and January 2007, 78 women who had undergone repeat LEEP at Chiang Mai UniversityHospital, were prospectively evaluated. The mean age was 47.5 years (range; 27-69 years). The mean durationof uncomplicated vaginal bleeding was 4.4 days (range; 1-20 days). The occurrence of persistent vaginal bleedingwas noted in 9 women. Among 78 women, 2 (2.56%) and 7 (8.97%) experienced intraoperative and postoperativehemorrhage, respectively. Six (7.69%) had postoperative infection. These complications were not significantlydifferent from those observed in women undergoing first LEEP in the same period (P=0.56). There was nosignificant difference in the incidence of perioperative complications and the incidence of non-evaluable conemargins among women who undergoing repeat LEEP within 4-6 weeks, between 6-8 weeks, and more than 8weeks after first LEEP. In conclusion, repeat LEEP could be safely performed 4-12 weeks after the first procedurewithout any impact on pathological specimen examination.https://journal.waocp.org/article_24620_a144fdd625b0029ecccd8e743b5a1de0.pdfWest Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-73688320070301Knowledge and Attitudes of Physicians in Iran with Regard to Chronic Cancer Pain38338624621ENJournal Article19700101Background and aim: The knowledge and attitudes of health care professionals with regard to pain and itsimpact on the patient are among identified barriers that prevent health care professionals from providingeffective treatment for pain. The purpose of the present study was to evaluate knowledge about and attitudestowards cancer pain and its management in Iranian physicians with patient care responsibilities.<br/><b>Methods</b>: We surveyed 122 physicians in six university hospitals in Tehran. Fifty-five (45.1%) questionnaireswere completed. <br/><b>Results</b>: The majority of physicians (76%) recognized the importance of pain managementpriority and about one half of the physicians acknowledged the problem of inadequate pain management intheir settings. Most cited inability to access professionals who practice specialized methods in this field, andinadequate staff knowledge of pain management as barriers to good pain management. A large majority ofthem expressed dissatisfaction with their training for pain management in medical school and in residency.Furthermore a considerable widespread knowledge deficit among all medical subspecialties and all levels ofexperience was noted which was significantly more profound in the non-oncologists group and only correlatedpoorly with number of total treated patients in past 6 months. <br/><b>Conclusion</b>: The most significant barrier to theeffective management of pain in cancer patients in Iran is deficit in knowledge as identified in this survey. Acombination of an active continuing education program on both the international guidelines with routineprofessional education and dissemination of guidelines is needed to bring about significant improvement incancer pain control.https://journal.waocp.org/article_24621_909782829c5008b5303e23ce2a279c1c.pdfWest Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-73688320070301Prevalence and Characteristics of Late Postoperative Voiding Dysfunction in Early-Stage Cervical Cancer Patients Treated with Radical Hysterectomy38738924622ENJournal Article19700101<b>Background:</b> Although effective as a primary treatment for early-stage cervical cancer, radical hysterectomyis associated with significant long-term morbidities, most commonly, voiding dysfunction. <br/><b>Objective</b>: To examineprevalence and characteristics of voiding dysfunction following radical hysterectomy for early-stage cervicalcancer. <br/><b>Methods</b>: One hundred-eighty seven patients with FIGO stage IA2-IIA cervical cancer who underwentclass II-III radical hysterectomy with systematic pelvic lymphadenectomy between January 1, 2002 and June31, 2005 were interviewed with questionnaire on voiding function. Medical records were also reviewed foroperative and pathologic data. <br/><b>Results</b>: The prevalence of symptomatic bladder dysfunction was 25.1%. Therewas no statistically significant association between rates of bladder dysfunction and all examined clinical/operativefactors. The most common pattern of bladder dysfunction were incomplete emptying in 25 (13.4%) and urgencyand nocturia in 21 (11.2%) each. <br/><b>Conclusion</b>: Voiding dysfunction is a common and clinically significant longtermcomplication following radical hysterectomy. The pattern of dysfunction reflects combined surgicaldisruption of both parasympathetic and sympathetic innervations of the pelvis.https://journal.waocp.org/article_24622_1b79c26bfe02edbd9879193e14d0d74d.pdfWest Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-73688320070301Effect of Homeopathic Medicines on Transplanted Tumors in Mice39039424623ENJournal Article19700101Ultra low doses used in homeopathic medicines are reported to have healing potential for various diseasesbut their action remains controversial. In this study we have investigated the antitumour and antimetastaticactivity of selected homeopathic medicines against transplanted tumours in mice. It was found that Rutagraveolens 200c and Hydrastis canadensis 200c significantly increased the lifespan of Ehrlich Ascites Carcinomaand Dalton’s Lymphoma Ascites induced tumour-bearing animals by 49.7%, and 69.4% respectively. Moreoverthere was 95.6% and 95.8% reduction of solid tumour volume in Ruta 200c and Hydrastis 200c treated animalson the 31st day after tumour inoculation. Hydrastis 1M given orally significantly inhibited the growth of developedsolid tumours produced by DLA cells and increased the lifespan of tumour bearing animals. Some 9 out of 15animals with developed tumors were completely tumour free after treatment with Hydrastis 1M. Significantanti-metastatic activity was also found in B16F-10 melanoma-bearing animals treated with Thuja1M, Hydrastis1M and Lycopodium1M. This was evident from the inhibition of lung tumour nodule formation, morphologicaland histopathological analysis of lung and decreased levels of γ-GT in serum, a cellular marker of proliferation.These findings support that homeopathic preparations of Ruta and Hydrastis have significant antitumour activity.The mechanism of action of these medicines is not known at present.https://journal.waocp.org/article_24623_f0b14b22f69761b998773bc56f5bb262.pdfWest Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-73688320070301Risk Factors of Breast Cancer in North of Iran : A Case-Control in Mazandaran Province39539824624ENJournal Article19700101<br/><b>Introduction</b>: Breast cancer is the most common cancer among Iranian women. This study aimed to determinerisk factors for breast cancer in the north of Iran. <br/><b>Method</b>: A matched case-control study was conducted inMazandaran province of Iran in 2004 of 250 biopsy proven cases of breast cancer and 500 neighbor controlsthat were matched by age within a 3 year period. Statistical analysis was carried out using conditional logisticregression with the backward elimination method and crude and adjusted odds ratios with related 95% CIswere estimated with Stata 8.0 software <br/><b>Results</b>: Multivariate analysis showed that higher education (OR=4.70,95%CI: 1.71-12.88), late menopause (OR=4.18, 95%CI: 2.54-6.88), history of induced abortion (OR=1.62, 95%CI:1.13-2.31), positive first-degree family history of breast cancer (OR=3.14, 95%CI: 1.37-7.20), and BMI (OR=1.02,95%CI: 1.01-1.03) were risk factors for breast cancer. Furthermore, having more episodes of full term pregnancy(OR=0.87, 95%CI: 0.80-0.95), longer duration of breast feeding (OR=0.993, 95%CI: 0.989-0.997) and paritymore than 2 were shown to be protective factors. <br/><b>Conclusions</b>: Our study revealed the role of some modifiabledeterminants of breast cancer that can be focused by public health intervention in the northern community ofIran. Accordingly, the women who have one or more of the following risk factors should take the special attentionto risk of breast cancer: obesity, being menopause, positive family history of breast cancer and history of inducedabortion. The protective effect of longer duration of breast feeding should be encouraged too.https://journal.waocp.org/article_24624_ff674aa89f09d3f5fd94b37ee6733c26.pdfWest Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-73688320070301Pediatric Brain Tumours at a Tertiary Care Hospital in Karachi39940424625ENJournal Article19700101The objectives of this study were to determine the epidemiology of brain tumors during infancy and childhoodand to define and segregate childhood brain tumors vis-à-vis their morphological characteristics. The presentstudy includes pediatric brain tumors, ICD-10 category C71 encountered during 10 years (January 1989 throughDecember 1998) at a tertiary care hospital in Karachi. Eighty one cases were included, 58 (71.6%) in males and23 (28.4%) in females with a male to female ratio of 2.5:1. The cases were divided into 3 age groups eachcovering five years of life (0-4, 5-9, 10-14 years), with the greatest number in the second age group i.e. 5-9 yearsfollowed by the third age group and the 0-4 year age group. The mean age for all cases, both genders was 8.8years (95% CI 7.9; 9.6) with a marginal variation for cases occurring in the cerebrum and cerebellum. Themalignancies occurred at a younger age in the males for each subcategory by site and morphology. Themorphological distribution of cases was astrocytoma (28 cases, 34.6%), primitive neuroectodermal tumor orPNET (40 cases; 49.4%), ependymoma (8 cases, 10%), mixed glioma (4 cases; 5%) and a case ofoligodendroglioma. The 81 malignancies included in this study were further categorized by site into two groups,supratentorial (27 cases; 33.3%) and infratentorial (54 cases; 66.7%). The morphological categorization ofsupratentorial tumors was astrocytoma (17 cases; 63%), ependymoma (5 cases; 18.5%), mixed glioma (2 cases;7.4%). PNET with rhabdoid differentiation, oligodendroglioma and pinealoblastoma comprised 1 case (3.7%)each. The 17 supratentorial astrocytoma were sub-categorized as follows - pilocytic astrocytoma (5 cases; 29.4%),grade II astrocytoma (6 cases; 35.3%); grade III astrocytoma (2 cases; 11.8%), anaplastic astrocytoma (1 case;5.9%) and glioblastoma multiforme (3 cases; 17.7%). The morphological categorization of infratentorial tumorswas astrocytoma (11 cases; 20.4%), medulloblastoma (38 cases; 70.4%), ependymoma (3 cases; 5.6%) and mixedglioma - astroependymoma (2 cases, 3.7%). The morphological sub-categorization of infratentorial astrocytomawas pilocytic astrocytoma (7 cases, 63.6%), with gemistocytic astrocytoma, grade II, grade III and anaplasticastrocytoma comprising 1 (9.1%) case each. The morphological categorization of medulloblastoma was classicalmedulloblastoma (15 cases; 39.5%), desmoplastic medulloblastoma (8 cases; 21.1%), medulloblastoma withastrocytic differentiation (12 cases; 31.5%), medulloblastoma with neural differentiation (2 cases; 5.3%), andneuroblastic medulloblastoma (1 case; 2.6%). The pediatric brain tumors in Karachi reflect a developing countryscenario, with a strong male predisposition and a late presentation with a peak in the 5-9 year age group. Thereis a predominance of medulloblastoma and a paucity of astrocytomas. The current study is a single institutionstudy and needs cautious interpretation. Population-based studies are required to determine the cancer burdendue to pediatric malignancies of the brain in this population and for the morphological categorization of braintumors in Karachi.https://journal.waocp.org/article_24625_8ba15df6d0fe8ca0c07cd543eef00cbd.pdfWest Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-73688320070301Cancer Incidence in the Middle Eastern Population of California , 1988-200440541124626ENJournal Article19700101International statistics suggest lower cancer incidence in the Middle East and Middle Eastern (ME) immigrantsin Europe, Australia, and Canada, but little is known from the United States. This study compares cancer ratesin ME population with other race/ethnic groups in California from 1988 through 2004. ME cases in Californiacancer registry were identified by surname and ME population was estimated from U.S. Census data. Cancerrates for ME countries was obtained from Globocan. The ME incidence rate ratios for all sites combined in maleand female were 0.77 and 0.82, respectively and were statistically significant. ME rates were significantly lowerfor cancers of the colon, lung, skin melanoma, female breast and prostate, and were significantly higher forcancers of the stomach, liver, thyroid, leukemia, and male breast. Cancer incidence in ME population in Californiawas 2.4 times higher than rates in home countries. Incidence trends in ME males remained fairly stable but infemales shows a slight decline in recent years. Cancer incidence in ME population is lower than non-Hispanicwhite and non-Hispanic Black, but is higher than rates for Hispanics and Asians, and ME countries. Improveddata quality, chronic infections, acculturation, and access to screening services are some of the factors responsiblefor the observed patterns.https://journal.waocp.org/article_24626_f587dda61a79b991563fd83db189463b.pdfWest Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-73688320070301Comparing Cox Regression and Parametric Models for Survival of Patients with Gastric Carcinoma41241624627ENJournal Article19700101<b>Background:</b> Researchers in medical sciences often tend to prefer Cox semi-parametric instead of parametricmodels for survival analysis because of fewer assumptions but under certain circumstances, parametric modelsgive more precise estimates. The objective of this study was to compare two survival regression methods - Coxregression and parametric models - in patients with gastric adenocarcinomas who registered at Taleghani hospital,Tehran. <br/><b>Methods</b>: We retrospectively studied 746 cases from February 2003 through January 2007. Gender, ageat diagnosis, family history of cancer, tumor size and pathologic distant of metastasis were selected as potentialprognostic factors and entered into the parametric and semi parametric models. Weibull, exponential andlognormal regression were performed as parametric models with the Akaike Information Criterion (AIC) andstandardized of parameter estimates to compare the efficiency of models. <br/><b>Results</b>: The survival results fromboth Cox and Parametric models showed that patients who were older than 45 years at diagnosis had an increasedrisk for death, followed by greater tumor size and presence of pathologic distant metastasis. <br/><b>Conclusion</b>: Inmultivariate analysis Cox and Exponential are similar. Although it seems that there may not be a single modelthat is substantially better than others, in univariate analysis the data strongly supported the log normal regressionamong parametric models and it can be lead to more precise results as an alternative to Cox.https://journal.waocp.org/article_24627_ebe3312e5286863e0b3f2b84277d66fb.pdfWest Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-73688320070301Tobacco Use among Students and School Personnel in India41742124628ENJournal Article19700101<b>Background:</b> Tobacco usage is addictive and causative for several diseases and premature death. Concertedefforts by the individual and society are needed for control and for surveillance. The habit is initiated duringearly youth and this age group requires constant monitoring and timely appropriate action to curtail usage. TheWHO FCTC has recommended actions to monitor and limit the tobacco use in young age groups. One of theactions is to examine the prevalence of tobacco habits in school children 13-15 years of age and of personnelemployed in schools. <br/><b>Methods</b>: WHO & CDC designed the study systems for Global Youth Tobacco Survey(GYTS) and Global School Personnel Survey (GSPS). In 2006 we conducted GYTS and GSPS in several partsof the country. The schools were chosen by strict sampling procedure and a well structured, self-administeredquestionnaire was used to obtain information on tobacco usage from 13 to 15 year old students of chosen schoolsand personnel of these schools. <br/><b>Results</b>: Current use of any tobacco product was 14.1% among students (17.3%boys, 9.8% girls) and among school personnel it was 29.2%(35.0% males and 13.7% females). The prevalencewas highest among male students in North East (34%) and the lowest was 4.9% among female students ofwestern states. Cigarettes and Bidi smoking were more prevalent among boys. Smokeless tobacco use prevalencerate varied between 20% and 4.5% among boys and between 21.5% and 1.6% among girl students. Amongmale school personnel, the prevalence varied from 57.9% in NE to 25.7% in South. Among females 26.5% weretobacco users in the NE and in Western region it was 6.6%. <br/><b>Conclusion</b>: It is essential to adopt forceful strategies,which are area specific, in order to undo the harm inflicted by tobacco use upon the individuals & society.Periodic surveys for surveillance of trends are essential to evaluate the outcome of programmes among studentsand school personnels.https://journal.waocp.org/article_24628_dfb6c959b15cf60353c2dc0b7d5dfd37.pdfWest Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-73688320070301The Risk Factors of Prostate Cancer: A Multicentric Case-Control Study in Iran42242824629ENJournal Article19700101Prostate cancer (PC), in Iran, is the third most frequently diagnosed visceral cancer among men and theseventh most common underlying cause of cancer mortality. We evaluated the relation between speculatedfactors and PC risk using data from a multicentric case-control study conducted in Iran from 2005 to 2007 on130 cases of incident, clinicopathologically confirmed PC, and 75 controls admitted to the same network ofhospitals without any malignant disease. Odds ratios (OR) and corresponding 95% confidence intervals (CIs)were estimated using conditional logistic regression models. The risk of PC was increased with aging (OR: 5.35,95% CI: 2.17-13.19; P<0.0001), and with the number of sexual intercourse ≥2 times/week (OR: 3.14, 95% CI:1.2-8.2; P=0.02). One unit elevation in serum estradiol and testosterone concentration was related to increase(OR: 1.04, 95% CI: 1.01-1.06; P=0.006) and decrease (OR: 0.79; 95% CI: 0.64-0.96; P=0.02) of PC risk,respectively. Cases were less likely to have a history of diabetes (OR: 0.34, 95% CI: 0.12-0.98; P=0.04). Increasingin dietary consumption of lycopene and fat was associated with declined (OR: 0.45, 95% CI: 0.09-2.12) andincreased (OR: 2.38, 95% CI: 0.29-19.4) PC development, respectively. Other factors including educationallevel, marriage status, dietary meat consumption, vasectomy and smoking have not been shown to affect PCrisk in the Iranian population. Our study adds further information on the potential risk factors of PC and is thefirst epidemiologic report from Iran. However, justification of these results requires more well-designed studieswith a larger number of participants.https://journal.waocp.org/article_24629_70e670f278d333fea94482ddf0f85223.pdfWest Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-73688320070301Chinese and Vietnamese Adult Male Smokers' Perspectives Regarding Facilitators of Tobacco Cessation Behavior42943524630ENJournal Article19700101<br/><b>Introduction</b>: National surveys show a low prevalence of tobacco cigarette smoking within the Asian American/Pacific Islander population. However, smoking rates loom higher when data is disaggregated by ethnicity andgender. Nevertheless, few data are available on how smokers in this population quit smoking. The aim of thisstudy was to collect first-hand perspectives from adult male Chinese and Vietnamese current and former smokerswho were patients at a community clinic in Seattle, Washington, in order to understand the facilitators towardsmoking cessation and the methods that they might use to quit smoking. <br/><b>Methods</b>: A telephone survey wasadministered to age-eligible male Chinese and Vietnamese clinic patients who were current or former smokers.A total of 196 Chinese and 198 Vietnamese (N=394) adult male current and former smokers were contactedfrom a pool culled from the clinic database. <br/><b>Results</b>: Descriptive analysis using SPSS software revealed ethnicityspecificdifferences between current and former smokers regarding influences on smoking cessation behavioras well as uptake and endorsement of cessation methods. Family encouragement and physician recommendationswere significant facilitators on the cessation process. Will power and self-determination were frequentlymentioned by both Vietnamese and Chinese smokers as helpful methods to quit smoking. Vietnamese smokerswere more resourceful than Chinese smokers in their use of smoking cessation methods. <br/><b>Conclusion</b>: Even withaccess to cessation classes at a health clinic, half of current smokers indicated that they had no intention to quit.Such attitudes underscore the need for promotion of effective smoking cessation programs as well as successfulstrategies for reaching smokers. These conclusions are particularly important for Chinese smokers, who werecomparatively less resourceful in their use of smoking cessation methods. Future studies should explore integratingthe concept of will power with current mainstream state-of-the-art smoking cessation programs.https://journal.waocp.org/article_24630_bf7394178ec5e8400173c984513e7ead.pdfWest Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-73688320070301Study of the Interaction Surface for the c-Src – Imatinib Complex by a Molecular Dicing Technique43643724631ENJournal Article19700101With the beginning of the new millennium, a new and exciting era for cancer therapy has begun with theappearance of molecular targeted drugs. Imatinib is a clinically well-tolerated small molecule that exerts selective,dual inhibition of the transforming growth factor beta (TGFbeta) and platelet-derived growth factor (PDGF)pathways. Imatinib is also suggested as a chemopreventive for recurrent and metastatic malignancies. Aninteresting point to be clarified regarding the mechanism of imatinib is its interaction with c-Src. Fortunately,complexing of c-Src and imatinib has recently reported, which provides a basis for further study of the interactionsbetween the two molecules. In the present study, the author used the technique named molecular dicing to studythe interaction surface between the two molecules. Accordingly, the interaction surface in c-Scr and imatinibcould be identified.https://journal.waocp.org/article_24631_3ef34189826528b4ce7bbab353550c37.pdfWest Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-73688320070301Association of CYP1A1, CYP1A2, GSTM1 and NAT2 Gene Polymorphisms with Colorectal Cancer Risk and Smoking43844424632ENJournal Article19700101We investigated CYP1A1*2A, CYP1A1*2C, CYP1A2*1C, CYP1A2*1F, GSTM1 and NAT2 genepolymorphisms, involving enzymes which metabolize many carcinogens, with reference to colorectal cancerrisk. The distribution of these genotypes was not associated with risk overall. However, the CYP1A1*2A T/Cgenotype showed a significant association with colorectal cancer risk in never-smokers (odds ratio [OR], 3.06;95% confidence interval [95% CI], 1.11-8.40; p = 0.030). The risk of the NAT2 rapid genotype in never-smokerswas also statistically significantly increased (OR, 5.38; 95%CI, 1.80-16.1; p = 0.003). Furthermore, the jointeffects of NAT2 rapid plus other genotypes were associated with colorectal cancer overall (OR, 3.12; 95%CI,1.15-8.51; p = 0.026, for NAT2 rapid plus combined CYP1A1*2C Ile/Val and Val/Val, OR, 3.25; 95%CI, 1.09-9.74; p = 0.035, for NAT2 rapid plus CYP1A2*1C G/G, and OR, 4.20; 95%CI, 1.09-16.1; p = 0.037, for NAT2rapid plus GSTM1 null, respectively). In never-smokers, the joint effects of NAT2 rapid plus other genotypeswere remarkable (OR, 15.9; 95%CI, 1.87-135.8; p = 0.011, for NAT2 rapid plus combined CYP1A1*2A T/Cand C/C, OR, 5.71; 95%CI, 1.49-21.9; p = 0.011, for NAT2 rapid plus combined CYP1A1*2C Ile/Val and Val/Val, and OR, 9.14; 95%CI, 2.05-40.7; p = 0.004, for NAT2 rapid plus CYP1A2*1F A/A, respectively). The jointeffect of CYP1A2*1F A/A plus CYP1A2*1C G/G genotypes was also increased in never-smokers (OR, 6.16;95%CI, 1.26-30.1; p = 0.025). Our findings suggest that the CYP1A1*2A T/C and NAT2 rapid genotypes isassociated with colorectal cancer susceptibility without smoking exposure. These results also indicate that theNAT2 in combination with CYP1A1*2C, CYP1A2*1C, or GSTM1 genotypes may strongly confer susceptibilityto colorectal cancer. In particular, the combination of NAT2 plus CYP1A1*2A, CYP1A1*2C, or CYP1A2*1Fgenotypes, and that of CYP1A2*1F plus CYP1A2*1C genotype may define a group of persons who are geneticallysusceptible to colorectal cancer in never smokers.https://journal.waocp.org/article_24632_da84c8f132685545618789d95be106b2.pdfWest Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-73688320070301Cancer Cachexia: Pathophysiologic Aspects and Treatment Options44545124633ENJournal Article19700101Cancer cachexia is a syndrome characterized with progressive weight loss and abnormal wasting of fat andmuscle tissue, and affects 40 to 85% of all terminally ill patients, accounting more than 20% of all cancer deaths.Current treatment for cancer cachexia principally depends on its prevention rather than reversing the presentdisease state, and the clinical results are far from being satisfactory. Although the exact mechanism andpredisposing factors have yet to be clarified in detail, our growing knowledge about the pathophysiology andbiochemical changes considering this life threatening condition should help in development of future therapeuticstrategies. In the present paper, the current preclinical and clinical features considering the pathophysiologyand treatment of cancer related cachexia are reviewed.https://journal.waocp.org/article_24633_4fb9966eca60d702730e83d533620012.pdfWest Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-73688320070301Cancer Registration in Pakistan : Contemporary State of Affairs45245624634ENJournal Article19700101An estimated 7.6 million mortalities were attributed to cancers in 2005 across the globe, and the figures keepmounting. The existing prevalence rate for all reportable cancers is at 25 million, projected to ascend to 30million around year 2020. Some 70% of these will burden the health care services in under-resourced countries.However, reliable statistics on the incidence, prevalence, mortality and survival rates (five and ten year) arelimited. A National Cancer Control Program (NCCP) inPakistan has existed since 1994, but little is known tothe public and negligible information has been made available to medical services providers. We have a povertyof local bio-medical literature related to the specialties like oncology and cancer epidemiology. Only 175 papersare indexed by Pakmedinet, seven being relevant to the cancer registration in Pakistan, an impetus forprogrammed documentation, and to serve as a foundation for approach to Cyber-medicine. Infrastructure andample requisite manpower exists locally and a number of local institutions as well as outside sources are teamingup. However, there are still quite a few issues to be looked into, including the question of who will own the dataarising from this pooling of assets? A community-based approach is mandatory to allay public concerns overconfidentiality and possible use of the registry data. Already, there are hurdles in attaining public approvalafter the intentions to found a National Cancer Registry were ventilated by the Pakistan Medical ResearchCouncil.https://journal.waocp.org/article_24634_39adf6b78178e2c1d673e305a315ebfc.pdfWest Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-73688320070301Use of Lay Health Workers in a Community-Based Chronic Disease Control Program45746124635ENJournal Article19700101The increasing burden of non-communicable diseases in the developing world, and in particular diabetes,cancer and circulatory diseases, is an unfortunate fact of life. At the same time infection-related diseases, includingsexually transmitted HIV-AIDS and HPV-dependent cervical cancer, remain important. One approach toalleviating the resultant stress on national health provision is to expand the knowledge base at the communitylevel with contributions by lay health workers (LHWs). Here we take a brief look at the available literature andpropose a model for intervention incorporating two way dialogue with the general populace to find effectivemeans to package expertise in the medical/research community for lay consumption. Our argument is thatparticular attention should be paid to socioeconomic and behavioural aspects and to disease surveillance at thelocal level in order to be able to accurately assess the impact of interventions. For this purpose, we need tomarshal volunteers from within communities taking account of their problems and motivations. Included areprovision of assistance in setting up physical exercise programs, quit tobacco campaigns, alcohol awarenessprograms, running disease screening exercises and general help by providing advice as to risk and protectivefactors and clinical treatments, with an especial focus on palliative care.https://journal.waocp.org/article_24635_ecf89c85b21669605e784e2d3bdec746.pdfWest Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-73688320070301Are There any Real Helicobacter pylori Infection-negative Gastric Cancers in Asia ?46246324636ENJournal Article19700101The great variability in gastric cancer rates across Asia, with very high incidences in Japan and Korea, andexceedingly low incidences in ethnic Malays, whether in Malaysia or Indonesia, appears largely due to variationin Helicobacter pylori infection rates. While between 2% and 10.6% of gastric cancers in a recent Japanesesurvey were considered to be negative for bacterial infection on the basis of seropositivity and H. pylori-dependentmucosal atrophy, it is notoriously difficult to preclude past infection. The situation is greatly complicated byreported differences in the etiology of gastric cardia and non-cardia cancers. In the Western world there doappear to be tumours arising close to the esophageal-gastric junction which are not related to H. pylori andassociated inflammation, but in most Asian populations these appear to be very rare. Therefore preventiveefforts, and particularly screening, should be focused on markers of bacterial infection, with avoidance ofunnecessary exposure to X-ray radiation.https://journal.waocp.org/article_24636_e7fc50546c931651a5b9a800410dd16d.pdfWest Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-73688320070301Cooperation Partners in Information Sharing within the Context of an Asian Cancer Network46446524637ENJournal Article19700101It would be a great mistake to analyze the health situation in Asia relying on the focus on individualisminherent in the sense of values of Europeans and Americans. Cooperation across fields is indispensable foreffective control of the epidemic of disease we are facing in the 21st century. We need to concentrate efforts onbringing together specialists, not only within the various areas of medical practice, but also across such fields aseconomics, politics and information technology (IT). Asia differs from Europe and America in that it does nothave any group political structure and therefore we must rely on voluntary integration of our efforts if we are toachieve the most effective application of our combined resources. Non-intervention in internal affairs is naturallya very important condition for success. Sharing of information while abiding by national regulations regardingmedical data confidentiality does pose difficulties, but gentle persuasion to standardize processes with a sharedcommitment to overcoming problems should reduce opposition. Our common purpose in maintaining healthysocieties, whether we be scientists, medical staff, economists, computer specialists or politicians, provides thebond. Ways and means by which this bond can be strengthened deserve our attention.https://journal.waocp.org/article_24637_4a7aab02f95681391b13e7aae4dfe530.pdf