West Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-736818920170901Epidemiological Evidences on Dietary Flavonoids and Breast Cancer Risk: A Narrative Review230923285015210.22034/APJCP.2017.18.9.2309ENKatrinSakNGO Praeventio, Näituse 22-3, Tartu 50407, Estonia.Journal Article20170130 <br /> <span style="font-size: small;">Epidemiological studies on associations between intake of flavonoids and breast cancer risk are highly needed to assess the actual effects of flavonoids in humans. Experimental investigations </span><em><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">in vitro </span></span></em><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">conditions cannot detect and model the real action of these phytochemicals due to the limitations to consider absorption and metabolic biotransformation </span></span><span style="font-size: small;">as well as several complex interactions. Therefore, the data about association findings between intake of flavonoids </span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">and breast cancer risk are compiled and analyzed in the current review by evaluating both the results obtained using food composition databases as well as different biomarkers. Although several case-control studies demonstrate some </span></span><span style="font-size: small;">reduction in breast cancer risk related to high consumption of flavones and flavonols, large-scale prospective cohort studies with follow-up times of many years do not confirm these findings. Intake of isoflavones can be associated with </span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">a decrease in breast tumorigenesis only in Asian countries where the consumption of soy foods is high but not among </span></span><span style="font-size: small;">Western women with significantly lower ingestion amounts, suggesting the presence of so-called threshold level of effect. Besides doses, the timing of exposure to isoflavones seems also to be a significant factor as childhood and prepubertal age can be critical periods. Although women may need to consume high amounts of isoflavones typical to Asian diets to gain beneficial effects and protection against mammary carcinogenesis, it is still too early to give any specific recommendations to prevent breast tumors by diet rich in certain flavonoids. </span>West Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-736818920170901Biomarkers in Tumorigenesis Using Cancer Cell Lines: A Systematic Review232923375040810.22034/APJCP.2017.18.9.2329ENLizbethRaju KDepartment of Oral and Maxillofacial Pathology, Faculty of Dental Sciences, M.S.Ramaiah University of Applied Sciences, M S
R Nagar, Bangalore, Karnataka, India.DominicAugustineDepartment of Oral and Maxillofacial Pathology, Faculty of Dental Sciences, M.S.Ramaiah University of Applied Sciences, M S
R Nagar, Bangalore, Karnataka, India.Roopa SRaoDepartment of Oral and Maxillofacial Pathology, Faculty of Dental Sciences, M.S.Ramaiah University of Applied Sciences, M S
R Nagar, Bangalore, Karnataka, India.SowmyaS VDepartment of Oral and Maxillofacial Pathology, Faculty of Dental Sciences, M.S.Ramaiah University of Applied Sciences, M S
R Nagar, Bangalore, Karnataka, India.Vanishri CHaragannavarDepartment of Oral and Maxillofacial Pathology, Faculty of Dental Sciences, M.S.Ramaiah University of Applied Sciences, M S
R Nagar, Bangalore, Karnataka, India.ShwethaNambiarDepartment of Oral and Maxillofacial Pathology, Faculty of Dental Sciences, M.S.Ramaiah University of Applied Sciences, M S
R Nagar, Bangalore, Karnataka, India.KavithaPrasadDepartment of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, M.S.Ramaiah University of Applied Sciences, M S
R Nagar, Bangalore, Karnataka, India.KamranAwanCollege of Dental Medicine, Roseman University of Health Sciences, South Jordan, Utah.0000-0002-3831-7455ShankargoudaPatilDepartment of Maxillofacial surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia.0000-0001-7246-5497Journal Article20170518 <br /> <span style="font-size: small;">Cancer is a leading cause of death worldwide. Despite many research advancements in the field, the genetic changes </span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">regulating the transformation of normal oral cells into malignant cells have not been fully elucidated. Several studies have evaluated carcinogenesis at the molecular level. Cancer cell lines are commonly used in biomedical research because they provide an unlimited source of cells and represent various stages of initiation and progression of carcinogenesis in vitro. </span></span><strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Aims: </span></span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">The objective of the study was to review original research articles using cancer cell lines as a tool to understand carcinogenesis and to identify the genes involved in tumor development. Additionally, we also examined the application of the genes as predictive biomarkers. </span></span><strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Methods and Materials: </span></span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Several databases, including PubMed, Google Scholar, Ebsco, and Science Direct, were searched from 1985 to December 2016 using various combinations of the following key words: "mouth neoplasm", "cell lines", and "tumorigenesis". Original experimental studies published in English were included. We excluded letters to the editor, historic reviews, and unpublished data from the analysis. </span></span><strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Results: </span></span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">There were 17 studies (in vitro) included in the analysis. There were 14 genes and 4 miRNAs involved in malignant transformation of oral keratinocytes into cancer cells. The most commonly studied genes were p53, cyclin D1, and hTERT. </span></span><strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Conclusion: </span></span></strong><span style="font-size: small;">Additional reviews and studies are needed to identify a panel of genes specific to various </span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">potentially malignant disorders and to aid in the early detection of oral squamous cell carcinoma (OSCC) because tumorigenesis involves the mutation of multiple genes. Furthermore, improving advanced cost-effective diagnostic </span></span><span style="font-size: small;">methods may benefit the public health sector. </span>West Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-736818920170901Cervical Cancer Prevention Through HPV Vaccination in Low- and Middle-Income Countries in Asia233923435003310.22034/APJCP.2017.18.9.2339ENZheng QuanTohPneumococcal Research, Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, Victoria, Australia.Paul VLicciardiPneumococcal Research, Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, Victoria, Australia.Department of Paediatrics, University of Melbourne, Australia.Fiona MRussellPneumococcal Research, Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, Victoria, Australia.Centre for International Child Health, Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia.SuzanneGarlandDepartment of Obstetrics and Gynecology, University of Melbourne, The Royal Women’s Hospital and Murdoch Children’s Research Institute, Parkville, Victoria, Australia.Regional WHO HPV Reference Laboratory, Department of Microbiology and Infectious Disease, The Royal Women’s Hospital, Parkville, VIC 3052, Australia.TsetsegsaikhanBatmunkhNational Cancer Council, Ulaanbaatar, Mongolia.0000-0001-8730-6536Edward KMulhollandPneumococcal Research, Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, Victoria, Australia.Menzies School of Health Research, Department of Child Health, Darwin, NT 08111, Australia.London School of Hygiene and Tropical Medicine, University of London, WC1E 7HT, UK.Journal Article20170510 <br /> <span style="font-size: small;">Cervical cancer is ranked the first or second most common cancer in women of low- and middle-income countries </span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">(LMICs) in Asia. Cervical cancer is almost exclusively caused by human papillomavirus (HPV), and majority of the </span></span><span style="font-size: small;">cases can be prevented with the use of HPV vaccines. The HPV vaccines have demonstrated high vaccine efficacies </span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">against HPV infection and cervical cancer precursors in clinical and post-marketing studies, and are in use in most high-income countries. However, their use in LMICs are limited mainly due to the high costs and logistics in delivering multiple doses of the vaccine. Other issues such as the safety of the vaccines, social and cultural factors, as well as poor knowledge and awareness of the virus have also contributed to the low uptake of the vaccine. This mini-review focuses on the need for HPV vaccine implementation in Asia given the substantial disease burden and underuse of HPV vaccines in LMICs in this region. In addition, the progress towards HPV vaccine introduction, and barriers preventing further rollout of these essential, life-saving vaccines are also discussed in this article. </span></span>West Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-736818920170901Association between Microrna 146a and Microrna 196a2 Genes Polymorphism and Breast Cancer Risk in North Indian Women234523484990810.22034/APJCP.2017.18.9.2345ENVijay KumarBodalDepartment of Pathology, Government Medical College, Patiala, India.ShrutiSangwanMM Medical College Solan (Himachal), Patiala, India.ManjitBalMM Medical College Solan (Himachal), Patiala, India.MohanvirKaurDepartment of Pathology, Government Medical College, Patiala, India.SidarthSharmaThapar University Patiala,
Patiala, India.BhavleenKaurDepartment of Pathology, Government Medical College, Patiala, India.Journal Article20160926 <br /> <strong><span style="font-size: small;">Background: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Micro RNAs (miRNAs) are small, noncoding RNA molecules. They can function as either oncogenes or tumor suppressor genes. Single nucleotide polymorphisms (SNP) present in the pre-miRNA region could affect the </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">processing of miRNA and thus alter mature miRNA expression. The studies done so far had shown conflicting results </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">regarding association of two common polymorphisms i.e.hsa-miR-146 rs2910164 and hsa-miR-196a2 rs11614913 with breast cancer. OBJECTIVE: In the study, we examined the hsa-miR-146 rs2910164 and hsa-miR-196a2 rs11614913 SNP association with breast cancer patients in north Indian women. </span></span><strong><span style="font-size: small;">Materials and Methods: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">This study included 100 breast cancer patients and 100 controls and was done over a period of two years. Genotypes of the hsa-miR-146 </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">(rs2910164 G>C) and hsa-miR-196a2 (rs11614913 C>T) were identified by polymerase chain reaction – restriction </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">length polymorphism (PCR-RFLP) technique in peripheral blood DNA samples. </span></span><strong><span style="font-size: small;">Statistical analysis: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">We assessed the </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">strength of association of miRNA polymorphisms with breast cancer using Odds ratio (OR) along with 95% confidence </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">intervals. </span></span><strong><span style="font-size: small;">Results: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Heterozygous genotypes of hsa-miR-196a2 rs11614913 and combined hsa-miR-146 rs2910164 </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">& hsa-miR-196a2 polymorphism were associated with significantly increased risk of breast cancer (OR-1.7, 95% CI–1.00-3.18) and (OR-1.9, 95% CI-0.85-4.46) respectively. </span></span><strong><span style="font-size: small;">Conclusion: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Our study suggests that rs2910164 GC and rs11614913 CT genotypes may contribute to breast cancer susceptibility in north Indian women. </span></span>West Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-736818920170901Does Awareness on Tobacco Control Legislations Pertaining to Tobacco Sellers Lead to Compliance? – A Study from Chennai, India234923545002410.22034/APJCP.2017.18.9.2349ENDivyambika CatakapatriVenugopalDepartment of Oral Medicine and Radiology, Faculty of Dental Sciences, Sri Ramachandra University, Chennai, India.VidhubalaEDepartment of Psycho-Oncology, Cancer Institute, Chennai, India.0000-0003-1268-0114SundaramoorthyCDepartment of Psycho-Oncology, Cancer Institute, Chennai, India.Journal Article20161229 <br /> <strong><span style="font-size: small;">Background: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Tobacco Sellers (TS) are key stake holders in tobacco control and their compliance with the legislation is crucial to achieve the intended outcome. The current study was conducted to assess the awareness of the Cigarette and Other Tobacco Products Act (COTPA) among TS and their response. </span></span><strong><span style="font-size: small;">Methodology: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">TS (N=527) were randomly chosen from ten zones of Chennai city. A structured self-administered questionnaire was used to assess awareness and compliance regarding sections 4, 5 and 6. </span></span><strong><span style="font-size: small;">Results: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Awareness of COTPA sections-4, 5, 6a, 6b among the TS was 42.0%, 31.0%, 69.3% and 57.2%, respectively, and 65.4% were of the opinion that the tobacco menace can be controlled through legislation. One fourth of the sellers reported that they were contemplating stopping selling tobacco </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">and 13.4% had been requested by various people to stop doing so. The overall profit from tobacco sales was less than </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">10% for 58.1% of the sellers. There was no change in the sale trends of tobacco products and the smoking form of tobacco was reported to be highly sold (56.2%). Only 54.6% had displayed signboards mentioning the prohibition of smoking in public places as directed under section 4, and 90% of the sellers continued to supply accessories to smoker. In contravention of section-5, 85.6% continued to advertise tobacco in some form and total non-compliance with section-6a and 6b was observed. </span></span><strong><span style="font-size: small;">Conclusion: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Awareness on tobacco control legislations among TS was found to be moderate. Furthermore, compliance with the COTPA was minimal. </span></span>West Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-736818920170901Predictors of Colorectal Cancer Knowledge among Adults in the United Arab Emirates235523595015110.22034/APJCP.2017.18.9.2355ENShathaAl-SharbattiDepartment of Community Medicine Gulf Medical University Ajman, United Arab Emirates.JayakumaryMuttappallymyalilDepartment of Community Medicine Gulf Medical University Ajman, United Arab Emirates.JayadevanSreedharanDepartment of Community Medicine Gulf Medical University Ajman, United Arab Emirates.YasienAlmosawyThumbay Hospital Ajman, United Arab Emirates.Journal Article20170119 <br /> <strong><span style="font-size: small;">Objective: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">To assess knowledge regarding colorectal cancer (CRC) and to identify its predictors in the </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">UAE. </span></span><strong><span style="font-size: small;">Materials and Methods: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">A cross sectional study was conducted among subjects ≥ 50 years-old, using a validated self-administered questionnaire. Awareness of CRC risk factors, warning signs/symptoms (S/S), and screening methods was evaluated with a level of knowledge score for various areas. Low (poor) knowledge was defined as a </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">score below the corresponding average value. The Chi-square test and logistic regression were used in the statistical analysis. </span></span><strong><span style="font-size: small;">Results: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">The percentage of respondents who had poor knowledge score concerning risk factors, warning S/S and screening were 81.7%, 84.7% and 94.1% respectively. Male and lower education level subjects had significantly higher probability of low knowledge related to risk factors and warning S/S. Also respondents without a family history of CRC or personal history of polyps had a significantly higher probability of low knowledge concerning warning S/S compared to those who had a positive history. Significantly higher probability of low knowledge concerning screening </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">methods was noted among non-Arabs and subjects with a lower education level. </span></span><strong><span style="font-size: small;">Conclusion: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Most of the respondents </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">had poor knowledge. Gender, education level, family and personal history and ethnicity were found to be significant predictors of CRC knowledge. </span></span>West Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-736818920170901Oral Contraceptive Use May Modulate Global Genomic DNA Methylation and Promoter Methylation of APC1 and ESR1236123664985310.22034/APJCP.2017.18.9.2361ENMostafaMoradi SarabiBiochemistry and Genetics Department, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran.ParvinGhareghaniIslamic Azad University, Science and Research Branch. Shiraz, IranFatemehKhademiBiochemistry Depatment, Medical School, Shiraz University of Medical Sciences, Shiraz, Iran.FatemehZalBiochemistry Depatment, Medical School, Shiraz University of Medical Sciences, Shiraz, Iran.Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.Journal Article20170211 <br /> <strong><span style="font-size: small;">Background: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">There are challenging reports in the public health sphere regarding associations between oral contraceptive (OC) use and cancer risk. </span></span><strong><span style="font-size: small;">Methods: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">To evaluate possible effects of OCs on cancer susceptibility, we </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">quantified of global 5-methyl cytosine (5-mC) levels and assessed methylation patterns of CpG islands of two key </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">tumor suppressor genes, APC1 and ESR1, in serum of users by enzyme-linked immunosorbent assay and methylation </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">specific PCR methods, respectively. </span></span><strong><span style="font-size: small;">Results: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Our results indicated that OCs significantly decrease the level of global DNA methylation in users relative to control non-users. However, our data revealed no significant differences between CpG island methylation patterns for ESR1 and APC1 in healthy control and OC-treated women. However, we did find </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">a trend for hypermethylation of both tumor suppressor genes in OC users. </span></span><strong><span style="font-size: small;">Conclusion: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Our data suggest that the level </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">of 5-mC but not individual CpG island patterns is significantly influenced by OCs in our cross-section of adult users. </span></span>West Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-736818920170901Adherence to the Tobacco-Free School Policy in Rural India236723734985610.22034/APJCP.2017.18.9.2367ENNileshChatterjeeSalaam Mumbai Foundation, India.0000-0002-3467-8771RajashreeKadamSalaam Mumbai Foundation, India.DeepakPatilSalaam Mumbai Foundation, India.PriyamvadaTodankarNarotam Sekhsaria Foundation, India.Journal Article20170214 <br /> <strong><span style="font-size: small;">Background: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">In India, 267 million adults use tobacco with prevalence of 35% in rural areas and 13% among </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">those between 15 and 24 years. With 40% of India’s population below 19 years, tobacco-free schools (TFS) can be a </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">critical strategy for preventing tobacco-use among youth. This study examined the extent of and factors associated with complete adherence to national TFS guidelines among rural schools in the state of Maharashtra. </span></span><strong><span style="font-size: small;">Methods: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Trained observers visited 507 rural schools to check adherence to eleven TFS criteria and conducted a cross-sectional survey of school-level indicators. These data were coupled with school-based information from the District Information System for Education (DISE) to analyze factors associated with TFS-adherence. </span></span><strong><span style="font-size: small;">Results: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Only 11% of schools adhered to all eleven TFS criteria. Majority (72%) prohibited sale of tobacco inside and within 100 yards of the school; 63% displayed </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">no-smoking posters; and 59% banned tobacco use inside premises. However, only 18% consulted with state tobacco </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">advisor and only 28% of schools had tobacco prevention messages on school stationery. Bivariate analysis revealed that complete TFS-adherence was associated with participation of school in sports (p<0.001) and extra-curricular competitions (p<0.001); internet connectivity (p<0.005) and e-learning facilities (p<0.05); and teachers’ attendance </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">at capacity-building workshops (p<0.05). A logistic model identified competitive sports participation (OR=3.27, </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">p<0.005) as a key predictor of adherence to the TFS policy. </span></span><strong><span style="font-size: small;">Conclusion: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">This is the first study in India that measures and examines compliance among rural schools with national TFS guidelines; thus filling an existing gap in the tobacco </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">control literature. Schools that provide students and staff with opportunities for overall development seem more likely to implement tobacco-free guidelines. By understanding the hard-to-meet criteria, policy-makers and practitioners can support schools in becoming tobacco-free. Integrating tobacco control programs with overall development goals of the school is one way forward. </span></span>West Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-736818920170901Assessment of Adaptive Breast Cancer Screening Policies for Improved Mortality Reduction in Low to Middle Income Countries237523804971210.22034/APJCP.2017.18.9.2375ENBabanWaghDepartment of Physics, Indian Institute of Science, Bangalore, India.Department of Computational and Data Sciences, Indian Institute of Science, Bangalore, India.RameshChaluvarayaswamyKidwai Memorial Institute of Oncology, Bangalore, India.DebnathPalDepartment of Computational and Data Sciences, Indian Institute of Science, Bangalore, India.Journal Article20170310 <br /> <strong><span style="font-size: small;">Objective: T</span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">o investigate adaptive breast cancer screening policies using clinical breast examination for early detection and mortality reduction in low to middle income countries like India. </span></span><strong><span style="font-size: small;">Methods: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Using published data from </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">the Mumbai randomized cluster control trial (1998-2006), we first estimated the mean sojourn time at 5.9 years (95% Confidence Interval: 5.3-6.5) assuming 52% sensitivity of the test. The estimated mean sojourn time was used as a </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">"silent interval" in time varying cellular kinetics with the two stage deterministic clonal expansion model, and we found </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">age specific sojourn times in years as follows: 35-39. 0.8; 40-44, 1.0; 45-49, 1.8; 50-54, 3.2; and 55+, 5.9. Equipped with age specific sojourn times and sensitivity, we investigate adaptive screening policies for various year age groups </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">using different screening intervals, maintaining a constant screen count of 10 and a 6 state Markov transition model. </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">The rationale for using a fixed number of screens was to benchmark the effect of the screening interval. </span></span><strong><span style="font-size: small;">Result: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">We </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">found that annual screening at ages 35-39 and biennial from 41-49 would achieve a mortality reduction of 27.9%, while annual screening from 38-42 and triennial from 43-58 would achieve a mortality reduction of 25.5%. Biennial screening from 40-60 years of age showed a mortality reduction of 23.6%, indicating inclusion of annual screening might be effective. We demonstrated a modelling framework that could be applied to the final data of randomized controlled trials, such as the ongoing Mumbai and Trivandrum trials in India, for assessing efficacy of annual screening in younger </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">women. </span></span><strong><span style="font-size: small;">Conclusion: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">The framework could be useful to decide age groups that would yield maximal effectiveness in screening trials with selected screening intervals. Further, the framework could be adapted in other low to middle income countries for designing either screening trials or adaptive screening policies. </span></span>West Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-736818920170901Effects of Genistein and Synergistic Action in Combination with Tamoxifen on the HepG2 Human Hepatocellular Carcinoma Cell Line238123855002510.22034/APJCP.2017.18.9.2381ENMasumehSanaeiResearch Center for Non-communicable Diseases, Jahrom University of Medical Sciences, Jahrom, Iran.FraidoonKavoosiResearch Center for Non-communicable Diseases, Jahrom University of Medical Sciences, Jahrom, Iran.ShekoufehAtashpourDepartment of Pharmacology, Jahrom University of Medical Sciences, Jahrom, Iran.0000-0003-2777-1131SoheilaHaghighatStudent Of Research Committee, Jahrom University of Medical Sciences, Jahrom, Iran.Journal Article20170316 <br /> <strong><span style="font-size: small;">Introduction: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">The flavonoids comprise a diverse group of polyphenolic compounds with antioxidant activity that is present in edible plants like soybeans and soy products. In vivo studies have concentrated on the effects of flavonoids on cancer and genistein (GE), a soy-derived isoflavone, has been reported to reduce prostate, colon, hepatic and breast </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">adenocarcinoma risk. Tamoxifen (TAM) is an important drug for cancer treatment worldwide, which can induce apoptosis in various cancers, including examples in the liver, breast and ovaries. The aim of the present study was to evaluate the effects of GE and TAM, alone and in combination, on proliferation and apoptosis in the human hepatocellular carcinoma (HCC) HepG2 cell line. </span></span><strong><span style="font-size: small;">Materials and Methods: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">HepG 2 cells were treated with GE, TAM and GE/TAM and then </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">MTT and flow cytometry assays were conducted to determine effects on viability and apoptosis, respectively. </span></span><strong><span style="font-size: small;">Results: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">GE and TAM inhibited cell proliferation and induced apoptosis in the HepG 2 cell lines. Discussion: Our findings </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">clearly indicated that GE and TAM may exert inhibitory and apoptotic effects in liver cancer cells. </span></span><strong><span style="font-size: small;">Conclusion: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">GE </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">and TAM can significantly inhibit growth of HCC cells and play a significant role in apoptosis. </span></span>West Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-736818920170901Symptom Clusters and Quality of Life in Hospice Patients with Cancer238723934985710.22034/APJCP.2017.18.9.2387ENSuhaOmranAdult Health Department, Faculty of Nursing, Jordan University of Science and Technology, Jordan.YousefKhaderDepartment of Community Medicine, Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Jordan.SusanMcMillanThompson Professor of Oncology Nursing, College of
Nursing,University of South Florida, United States.Journal Article20170320 <br /> <strong><span style="font-size: small;">Background: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Symptom control is an important part of palliative care and important to achieve optimal quality of life (QOL). Studies have shown that patients with advanced cancer suffer from diverse and often severe physical </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">and psychological symptoms. The aim is to explore the influence of symptom clusters on QOL among patients with </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">advanced cancer. </span></span><strong><span style="font-size: small;">Materials and Methods: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">709 patients with advanced cancer were recruited to participate in a clinical trial focusing on symptom management and QOL. Patients were adults newly admitted to hospice home care in one of two hospices in southwest Florida, who could pass mental status screening. The instruments used for data collection were the Demographic Data Form, Memorial Symptom Assessment Scale (MSAS), and the Hospice Quality of Life Index-14. </span></span><strong><span style="font-size: small;">Results: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Exploratory factor analysis and multiple regression were used to identify symptom clusters and their </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">influence on QOL. The results revealed that the participants experienced multiple concurrent symptoms. There were </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">four symptom clusters found among these cancer patients. Individual symptom distress scores that were the strongest </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">predictors of QOL were: feeling pain; dry mouth; feeling drowsy; nausea; difficulty swallowing; worrying and feeling </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">nervous. </span></span><strong><span style="font-size: small;">Conclusions: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Patients with advanced cancer reported various concurrent symptoms, and these form symptom </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">clusters of four main categories. The four symptoms clusters have a negative influence on patients’ QOL and required specific care from different members of the hospice healthcare team. The results of this study should be used to guide </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">health care providers’ symptom management. Proper attention to symptom clusters should be the basis for accurate planning of effective interventions to manage the symptom clusters experienced by advanced cancer patients. The health care provider needs to plan ahead for these symptoms and manage any concurrent symptoms for successful promotion of their patient’s QOL. </span></span>West Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-736818920170901Deregulation of miR-34a and Its Chaperon Hsp70 in Hepatitis C virus-Induced Liver Cirrhosis and Hepatocellular Carcinoma Patients239524015003010.22034/APJCP.2017.18.9.2395ENRasha HShehataDepartment of Tropical Medicine and Gastroenterology, Faculty of Medicine, Assiut University, Assiut, Egypt.Soha AAbdelmoneimDepartment of Tropical Medicine and Gastroenterology, Faculty of Medicine, Assiut University, Assiut, Egypt.AOsmanDepartment of Tropical Medicine and Gastroenterology, Faculty of Medicine, Assiut University, Assiut, Egypt.AhmedHassanainDepartment of Tropical Medicine and Gastroenterology, Faculty of Medicine, Assiut University, Assiut, Egypt.AmanyOsamaDepartment of Biochemistry, Faculty of Medicine, Assiut University, Assiut, Egypt.Sahar SAbdelmoneimDepartment of Cardiovascular Diseases, Faculty of Medicine, Assiut University, Assiut, Egypt.Eman AToraihGenetics Unit (Department of Histology and Cell Biology), Faculty of Medicine, Suez Canal University, Ismailia, Egypt.Journal Article20170330 <br /> <strong><span style="font-size: small;">Background: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">MicroRNA deregulation may occur during hepatocellular carcinoma (HCC) genesis and progression stages. MicroRNA-34a (miR-34a) functions as a tumor suppressor and is down-regulated or silenced in a variety of human cancers, while heat shock proteins (Hsps) play important roles in assisting protein folding and preventing both protein aggregation and transport across membranes. The present study aimed to evaluating serum expression of miR-34a and its target Hsp70 for early detection of HCC in patients with liver cirrhosis (LC), focusing on correlations with clinicopathological features. </span></span><strong><span style="font-size: small;">Methods: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">A total of 180 patients were included: 120 with HCC on top of LC (60 with either early or late HCC) and 60 patients with HCV-related LC. In addition, 60 healthy individuals were considered as controls. Real-time polymerase chain reactions were performed for expression profiling of serum miR-34a and Hsp70 and for allelic discrimination of the promotor variant (rs2763979, C/T). In addition, in silico analysis was carried out. </span></span><strong><span style="font-size: small;">Results: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">All participants were heterozygote for the promotor polymorphism. miR-34a serum levels were significantly under-expressed in LC and especially HCC patients as compared to controls. Associations with a high Child-Turcotte- Pugh (CTP) score, advanced cancer stage, and number of masses were noted. In contrast the target Hsp70 was significantly overexpressed in cancer patients but not in LC group and inversely correlated with miR-34a levels. </span></span><strong><span style="font-size: small;">Conclusion: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Utility </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">of circulating miRNAs as biomarkers for early detection of HCC was raised. Future large-scale studies are warranted to confirm the current findings. </span></span>West Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-736818920170901Colorectal Cancer Mortality in Relation to Glucose‒6‒Phosphate Dehydrogenase Deficiency and Consanguinity in Sardinia: A Spatial Correlation Analysis240324074971310.22034/APJCP.2017.18.9.2403ENGiovanni MarioPesDipartimento di Medicina Clinica e Sperimentale, University of Sassari, Sassari 07100, Italy.0000-0003-3265-2823GabrioBassottiDipartimento di Medicina, University of Perugia, 06156 Perugia, Italy.Maria PinaDoreDipartimento di Medicina Clinica e Sperimentale, University of Sassari, Sassari 07100, Italy.Baylor College of Medicine, 77030 Houston, Texas, USA.Journal Article20170401 <br /> <strong><span style="font-size: small;">Background: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Colorectal cancer (CRC) is one of the most diffuse malignancy in the world. In Southern Europe, the incidence and prevalence are lower than in most Western countries, although some hot spots of increased risk are emerging. In Sardinia, the cancer rate has risen steeply in the last years. Among risk factors for CRC, genomic </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">homozygosity has been postulated. Glucose-6-phosphate dehydrogenase (G6PD) deficiency has been hypothesized to </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">decrease CRC risk. In Sardinians, this disorder has a frequency of 12-24% due to selection by past malaria. In this study </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">the relationship between mortality for CRC, homozygosity and G6PD deficiency was analysed using spatial analysis. </span></span><strong><span style="font-size: small;">Methods: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">The spatial association between CRC mortality and G6PD deficiency and homozygosity was assessed in the </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">377 municipalities of the island using ordinary least squares regression and geographically weighted regression. Results: </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">A consanguinity index, available across all municipalities, was used as a proxy for homozygosity. A significant inverse correlation was found between CRC mortality and G6PD deficiency (ρ = ‒0.216; p = 0.002) whereas no association was found for consanguinity (ρ = ‒0.077; p = 0.498). The geographical map of CRC mortality showed a significant clustering in mountain areas compared to the population living in lowlands, whereas hot spot areas of G6PD deficiency </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">were observed on the south-western side of Sardinia. </span></span><strong><span style="font-size: small;">Conclusions: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">These results indicate that G6PD deficiency might </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">contribute to reduce colon carcinogenesis, and is in line with in vitro and in vivo studies. </span></span>West Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-736818920170901Perceived Barriers to Breast Cancer Screening among Saudi Women at Primary Care Setting240924175040510.22034/APJCP.2017.18.9.2409ENShaimaa BAbdel-AzizPublic Health and Community Medicine, Faculty of Medicine, Cairo University, Egypt.Tarek TawfikAminPublic Health and Community Medicine, Faculty of Medicine, Cairo University, Egypt.Mohammed BaqirAl-GadeebCollege of Medicine, King Faisal University, Saudi Arabia.Abdullah IAlhassarCollege of Medicine, King Faisal University, Saudi Arabia.AliAl-RamadanCollege of Medicine, King Faisal University, Saudi Arabia.MohammedAl-HelalCollege of Medicine, King Faisal University, Saudi Arabia.MohammadBu-MejdadCollege of Medicine, King Faisal University, Saudi Arabia.Lubna AbdulazizAl-HamadMinistry of Health, Al Hassa Health Directorate, Saudi Arabia.Eman HussainAlkhalafMinistry of Health, Al Hassa Health Directorate, Saudi Arabia.Journal Article20170405Introduction: Screening for breast cancer (BC) is of low rate in Saudi Arabia; although it is provided in the country free of charge to the population. This cross-sectional study aimed at investigating the perceived barriers towards BC screening in Al Hassa, Saudi Arabia. Participants and Methods: A total of 816 adult Saudi women aged ≥ 30 years attending for routine primary health services or accompanying patients at the selected primary health care centers (PHCs) were randomly selected from 12 PHCs (8 urban and four rural) using multi-stage sampling method. Participants were invited to personal interview using semi-structured data collection instrument including inquiries about socio-demographics, reproductive history, previous histories of diagnosed breast lesions and breast cancer. The perceived individual barriers towards screening, their attitudes, the reasons for not attending previously held screening campaigns in Al Hassa, were also included. Results: Low utilization of BC screening has being significantly associated with woman’s age (OR=2.55; 95% CI= 1.71-3.83), higher educational status (OR=2.98; 95% CI=2.05-4.34), higher family income (OR=1.96; 95% CI=1.31-2.93), using hormonal contraception (OR=1.46; 95% CI=0.99-2.13) and positive history of previous breast (OR=12.16; 95% CI=6.89-21.46), as shown by the results of the logistic regression model. Exploratory factor analysis showed that personal fears (especially fear of doctors/examiners, fear of hospitals and health facilities and fear of consequences/results) were the major factors that hinder women from utilizing the free of charge BC screening with high loading eigenvalue of 3.335, explaining 30.4% of the barriers. Conclusion: Educational interventions aim at improving breast cancer knowledge and addressing barriers should be incorporated as core component of the screening program in Saudi Arabia.West Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-736818920170901The Role of Health Volunteers in Training Women Regarding Coping Strategies Using Self-Efficacy Theory: Barriers and Challenges Faced by Health Volunteers in Empowerment of Women241924245002810.22034/APJCP.2017.18.9.2419ENMohammad HosseinKavehDepartment of Health Education and Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran.MoslemRokhbinDepartment of Health Education and Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran.ArashManiResearch Centre for Psychiatry and Behavioral Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.AhmadMaghsoudiDepartment of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran.Journal Article20170409 <br /> <strong><span style="font-size: small;">Introduction: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Psychological distress is among physical and mental health threats, and health volunteers can play </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">a critical role in empowerment of women. However, evidence has revealed a decline in health volunteers’ activities. Therefore, the present study aimed to investigate the challenges faced by health volunteers in empowerment of women. </span></span><strong><span style="font-size: small;">Methods: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">The participants’ knowledge level was assessed using a written test. Their perceived skills were also measured using Coping Inventory for Stressful Situations by Endler and Parker and Chesney’s Coping Self-efficacy Scale, respectively. The study data were entered into the SPSS statistical software, version 11.5 and were analyzed using chi-square, sample t-test, and Pearson’s correlation coefficient. </span></span><strong><span style="font-size: small;">Results: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">The results showed a considerable increase in the intervention group health volunteers’ knowledge about stress, as well as their self-efficacy. Besides, a significant correlation was observed between self-efficacy and task-oriented strategy scores. However, no significant increase was found in this group’s coping strategies. The results also indicated a significant increase in the intervention group women’s knowledge about stress, but no significant change was observed in other constructs. Some challenging factors, such as managerial, personal, and interpersonal factors, were also detected that might have affected the results. </span></span><strong><span style="font-size: small;">Discussion: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">This study caused no considerable change in coping with stress, except for increasing the women’s knowledge in this regard. Considering the challenges identified in this study, programs should be developed for researchers and health </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">center managers to improve this condition in future. </span></span>West Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-736818920170901Mammographic Appearances in Mongolia: Causal Factors for Varying Densities242524305015310.22034/APJCP.2017.18.9.2425ENDelgermaaDemchigMedical Image Optimization and Perception Group (MIOPeG)
Discipline of Medical Radiation Science, Faculty of Health Science, University of Sydney, Sydney, Australia.ClaudiaMello-ThomsMedical Image Optimization and Perception Group (MIOPeG)
Discipline of Medical Radiation Science, Faculty of Health Science, University of Sydney, Sydney, Australia.KhulanKhurelsukhDepartment of Diagnostic Radiology
United Family Intermed Hospital, Ulaanbaatar, Mongolia.AsaiRamishDepartment of Diagnostic Radiology
National Cancer Center, Ulaanbaatar, Mongolia.Patrick CBrennanMedical Image Optimization and Perception Group (MIOPeG)
Discipline of Medical Radiation Science, Faculty of Health Science, University of Sydney, Sydney, Australia.Journal Article20170411 <br /> <strong><span style="font-size: small;">Objective: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Mammographic density (MD) is a significant risk factor for breast cancer and an important determinant for establishing efficiency of any screening program. Currently, the distribution and influential factors of MD is unknown </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">among Mongolian women. This work aims to characterize MD of Mongolian women. </span></span><strong><span style="font-size: small;">Methods: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">The ethical approval was obtained from Research Ethics Board of the University of Sydney (2014/973) and National Ethic Committee from Ministry of Mongolia (2015/04). We recruited 1985 women aged 16-83 from the National Cancer Center in Mongolia for whom MD and age of each woman was known. From this total group, 983 women also had additional available details on height, weight, body mass index (BMI) and area of residency. We investigated the association of each of these variables with breast density, which was assessed by using the Breast Imaging Reporting and Data System (BIRADS) lexicon. Univariate and multivariate regression analyses were conducted to explore the importance of these variables as predictors of MD. </span></span><strong><span style="font-size: small;">Results: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Category B (33%) was the most common type of MD, whereas 25%, 18% and 24% of women belonged to the category A, C and D respectively. The univariate analysis demonstrated that, younger </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">women had more dens breasts than their older counterparts (OR=6.8). Also, increased MD was significantly (p<0.05) </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">associated with decreased weight (OR=4.5), increased height (OR=0.4) and lower BMI (OR=13.2). Urban women had </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">significantly higher MD compared with rural counterparts (OR=2.2). In the multivariate analysis, 75% of variation in </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">MD was explained by age (OR=4.5) and BMI (OR=7.3). </span></span><strong><span style="font-size: small;">Conclusion: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">A high proportion of Mongolian women have very high density breasts and age and body size are key factors determining MD among these women. </span></span>West Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-736818920170901Screening Cervical Cancer by the Pap Test – Relevance of Age Ranges Recommended by the Brazilian Programme for Prevention and Control243124355002910.22034/APJCP.2017.18.9.2431ENDiogo Do NascimentoFrancoPost-Graduate Programme in Health Sciences, State University of Maringá, Paraná, Brazil.Adriana Cunha VargasTomázPost-Graduate Programme in Health Sciences, State University of Maringá, Paraná, Brazil.Angela Andréia FrancaGravenaPost-Graduate Programme in Health Sciences, State University of Maringá, Paraná, Brazil.Sandra MarisaPellosoPost-Graduate Programme in Health Sciences, State University of Maringá, Paraná, Brazil.0000-0001-8455-6839Márcia Edilaine LopesConsolaroPost-Graduate Programme in Health Sciences, State University of Maringá, Paraná, Brazil.Department of Clinical Analysis and Biomedicine, State University of Maringá, Paraná, Brazil.Journal Article20170418 <br /> <strong><span style="font-size: small;">Objective: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">To evaluate screening by the Papanicolaou smear (Pap) and the frequency of cervical abnormalities in the age range recommended by the Brazilian programme for prevention and control of cervical cancer (CC) in the years 2012 and 2013 in a high prevalence city. </span></span><strong><span style="font-size: small;">Methods: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">This retrospective study covered results of Pap examinations </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">performed on women aged ≥12 years residing in urban areas of the city of Maringá, Paraná in Brazil. The examinations </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">were performed in the years 2012 and 2013 for the System of Public Health (SPH) which maintains a city database. The age ranges were grouped as recommended into <15-24, 25-64, and >64 years. </span></span><strong><span style="font-size: small;">Results: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">A total 40,866 women were screened, 19,606 in 2012 and 21,260 in 2013. The Pap exams performed for the age range 25-64 years accounted for 80.7% of the total in 2012 and 80.3% in 2013 (p=0.13), while those for 64 years age group in 2013 (8.46%) than in 2012 (7.52%) (p<0.001). A total of 1,354 (3.31%) women presented with abnormal test results, with atypical squamous </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">cells of undetermined significance (ASC-US) as the most prevalent finding (2.12%) in 2012, while in 2013 it was LSIL (1.56%) (p</span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">in both years. </span></span><strong><span style="font-size: small;">Conclusions: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">This study detected a significant expansion of women screened for CC in age ranges not </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">recommended by the Brazilian government. </span></span></span>West Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-736818920170901Cancer Incidence in Saudi Arabia: 2012 Data from the Saudi Cancer Registry243724445015410.22034/APJCP.2017.18.9.2437ENShoukiBazarbashiKing Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.0000000289138158HayaAl-EidTherapeutic services, Ministry of Health, Riyadh, Saudi Arabia.JoanMinguetEuropean
Institute of Cancer Research (EICR), Spain.Journal Article20170421 <br /> <strong><span style="font-size: small;">Background: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">In order to most appropriately allocate healthcare and research funding for cancer, it is important to have accurate population-based incidence data. The Saudi Cancer Registry (SCR) provides such information, covering the time period from 1994 to the present day. The current report concerns an overview of cancer incidence statistics for Saudi Arabia in 2012. </span></span><strong><span style="font-size: small;">Methods: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">The SCR collects data from healthcare facilities throughout the Kingdom of Saudi Arabia. All newly diagnosed cases of cancer are recorded, with information on site and histology. For the present report, age-standardised and age-specific incidence rates (ASR, AIR, respectively) were calculated, with attention to gender-specific and regional differences. </span></span><strong><span style="font-size: small;">Results: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">The total number of incident cases of cancer identified by the SCR in 2012 was 14,336, with 6,791 (47.5%) among males and 7,545 (52.6%) among females. Of this total, 11,034 cases (76.9%) occurred in patients of Saudi origin. For Saudi males, the overall ASR (inc. all cancer sites) was 78.1 per 100,000 people, while that for females was 86.7. Incidence varied by region, with the Eastern region and Riyadh displaying the highest ASRs for both males and females, and Hail and Jazan displaying the lowest. Incidence varied by gender, with colorectal cancer (13.3%), non-Hodgkin lymphoma (NHL; 8.4%), and leukaemia (8.2%) being the most common types in males, and breast (25.8%), thyroid (11.7%), and colorectal cancers (9.3%) being the most common in females. </span></span><strong><span style="font-size: small;">Conclusions: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">This analysis of cancer incidence in Saudi Arabia demonstrated significant differences according to gender, age, and region of the Kingdom. The data should help ensure the most appropriate allocation of resources, with the aim of minimising the healthcare burden associated with cancer. </span></span>West Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-736818920170901Knowledge and Attitudes towards Cervical Cancer Screening amongst University of Botswana Female Students244524505003110.22034/APJCP.2017.18.9.2445ENRoyTaperaDepartment of Environmental Health, School of Public Health, University of Botswana, Private Bag UB 712, Gaborone, Botswana.EricManyalaDepartment of Environmental Health, School of Public Health, University of Botswana, Private Bag UB 712, Gaborone, Botswana.PatienceErickDepartment of Environmental Health, School of Public Health, University of Botswana, Private Bag UB 712, Gaborone, Botswana.Titus MMaswabiDepartment of Environmental Health, School of Public Health, University of Botswana, Private Bag UB 712, Gaborone, Botswana.TshephangTumoyagaeDepartment of Environmental Health, School of Public Health, University of Botswana, Private Bag UB 712, Gaborone, Botswana.BontleMbongweDepartment of Environmental Health, School of Public Health, University of Botswana, Private Bag UB 712, Gaborone, Botswana.BaemediLetsholoDepartment of Environmental Health, School of Public Health, University of Botswana, Private Bag UB 712, Gaborone, Botswana.Journal Article20170422 <br /> <strong><span style="font-size: small;">Background: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Cervical cancer is the leading cause of cancer deaths in Botswana. More than two-thirds of cases occur in HIV-infected women, in a nation with a high HIV prevalence of 17%. Even though cancer screening is free in health facilities, cervical cancer screening is low. The objective of this study was to assess the knowledge and attitudes of University of Botswana female students on cervical cancer screening. </span></span><strong><span style="font-size: small;">Methods: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">A cross-sectional study was conducted among University of Botswana female students to elicit information about their knowledge and attitudes on cervical cancer screening. </span></span><strong><span style="font-size: small;">Results: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">A total of 335 students completed the questionnaire and all reported that they were aware of cervical cancer. The awareness was mostly through brochures, posters and other printed material. Regarding cervical cancer risk 315 (94%) attributed cervical cancer to smoking and 301 (89.9%) to early sexual debut. The majority of students 329 (98.2 %) were aware of cervical cancer screening. Papanicolaou (Pap) smear was the most popular screening test reported by 160 (47.8%) of the respondents as compared to Human Papilloma Virus testing (HPV) reported by 106 (31.6 %) of the respondents. The overall Pap smear screening rate was 92 of 335 students (27.5%). Those who perceived themselves to be at risk of contracting cervical cancer 203 (60.6%) where 1.8 times more likely to go for Pap smear </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">than those who perceived to be safe, (Adjusted Odds Ratio [AOR] 1.834; 95% Confidence Interval [CI]; 1.094-3.067), </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">(P = 0.02). </span></span><strong><span style="font-size: small;">Conclusions: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Pap smear screening uptake is low amongst University of Botswana female students. The likely reason for this could be because students do not perceive themselves to be susceptible to cancer so the lesser the likelihood of engaging in preventive behaviours. There is urgent need for university based cancer education campaign </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">on cervical cancer screening benefits and incorporating these campaigns into the existing university medical services </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">to increase uptake of screening programs offered. </span></span>West Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-736818920170901Potential Diagnostic and Prognostic Value of Lymphocytic Mitochondrial DNA Deletion in Relation to Folic Acid Status in HCV-Related Hepatocellular Carcinoma245124575040610.22034/APJCP.2017.18.9.2451ENAbdel-RhamanN ZekriVirology and Immunology Unit, Cancer Biology Department, National Cancer Institute, Cairo University, Cairo, Egypt.HosnySalamaEndemic Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt.EmanMedhatEndemic Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt.SherifHamdyEndemic Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt.Zeinab KHassanVirology and Immunology Unit, Cancer Biology Department, National Cancer Institute, Cairo University, Cairo, Egypt.Yasser MabroukBakrVirology and Immunology Unit, Cancer Biology Department, National Cancer Institute, Cairo University, Cairo, Egypt.Amira Salah El-DinYoussefVirology and Immunology Unit, Cancer Biology Department, National Cancer Institute, Cairo University, Cairo, Egypt.DoaaSalehDepartment of public health, Faculty of Medicine, Cairo University, Cairo, Egypt.RamySaeedYassin Abdel Ghaffar Charity Hospital, Cairo University, Cairo, Egypt.DaliaOmranEndemic Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt.Journal Article20170427 <br /> <strong><span style="font-size: small;">Objective: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">We assessed the possibility of using mitochondrial (mt) DNA deletion as a molecular biomarker for disease progression in HCV-related hepatocellular carcinoma (HCC) and to identify its association with folic acid status. </span></span><strong><span style="font-size: small;">Methods: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Serum folic acid and lymphocytic mtDNA deletions were assessed in 90 patients; 50 with HCC, 20 with liver cirrhosis (LC), and 20 with chronic hepatitis C (CHC) compared to 10 healthy control subjects. The diagnostic accuracy of mtDNA deletions frequency was evaluated using receiver-operating characteristic (ROC) curve analysis Survival analysis was performed using the Kaplan-Meier method. Differences in the survival rates were compared using log-rank test. </span></span><strong><span style="font-size: small;">Result: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Our data revealed a significant elevation of mtDNA deletions frequency in the HCC </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">group compared to the other groups (</span></span><em><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">P-value </span></span></em><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><0.01). Also, our data showed a significant correlation between folate deficiency and high frequency of mtDNA deletions in patients with HCV-related HCC when compared to the other </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">groups (r= -0.094 and </span></span><em><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">P-value </span></span></em><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><0.05). Moreover, the size of the hepatic focal lesion in the HCC patients was positively correlated with mtDNA deletions (r= 0.09 and </span></span><em><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">P-value </span></span></em><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><0.01). The median survival time for the HCC patients with </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">high frequency of mtDNA deletions (ΔCt ≥3.9; 5.7+ 0.6 months) was significantly shorter than those with low mtDNA deletions frequency (ΔCt < 3.9; 11.9+ 0.04 months, </span></span><em><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">P-value </span></span></em><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><0.01). </span></span><strong><span style="font-size: small;">Conclusion: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Our data provided an evidence that lymphocytic mtDNA deletion could be used as non-invasive biomarker for disease progression and patients’ survival in </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">HCV-related HCC. Also, our findings implied a causal relationship between the folate deficiency and the high mtDNA </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">deletions frequency among Egyptian patients with HCV related HCC. </span></span>West Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-736818920170901Characteristics of De Novo Acute Myeloid Leukemia Patients in Palestine: Experience of An-Najah National University Hospital245924645003210.22034/APJCP.2017.18.9.2459ENZiadAbuhelwaDepartment of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine.QasemAl ShaerDepartment of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine.SariTahaDepartment of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine.KhubaibAyoubDepartment of Internal Medicine, An-Najah National University Hospital, Nablus, Palestine.RiadAmerDepartment of Hematology/oncology, An-Najah National University Hospital, Nablus, Palestine.Journal Article20170430 <br /> <strong><span style="font-size: small;">Objective: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">To describe the characteristics of de novo acute myeloid leukemia (AML) in the Palestinian population. </span></span><strong><span style="font-size: small;">Study design and setting: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">A retrospective chart review study was conducted at An-Najah National University Hospital (NNUH) during the period of January, 2014 to December, 2016. </span></span><strong><span style="font-size: small;">Methodology: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">The medical records of AML patients treated at NNUH were reviewed. All patients at least 16 years of age diagnosed with de novo AML and started on induction chemotherapy were included. Descriptive statistics were employed to analyze the data. </span></span><strong><span style="font-size: small;">Results: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Out of 88 </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">patients diagnosed with AML during the study period, 64 had de novo AML and were included. Median age at diagnosis was 36 years, with a male to female ratio of 1.13:1. Two thirds of the cases were from the West Bank and the remainder were from Gaza. Major complaints at presentation were fatigue (64.1%), fever (46.9%), respiratory tract infections (39.1%) and bruising (28.1%). Hepatomegaly was present in 23.4% and splenomegaly in 34.4%. At presentation, the median white blood cells (WBC) count, hemoglobin (Hb) concentration and platelet count were 30. 5x10</span></span><span style="font-family: Times New Roman,Times New Roman; font-size: xx-small;"><span style="font-family: Times New Roman,Times New Roman; font-size: xx-small;">9</span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">/L, 9.3g/ dL, and 39.5 x10</span></span><span style="font-family: Times New Roman,Times New Roman; font-size: xx-small;"><span style="font-family: Times New Roman,Times New Roman; font-size: xx-small;">9</span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">/L, respectively. According to the French American British (FAB) classification, M4 was the most common subtype (32.8%) followed by M3 (21.9%). After a single cycle of induction chemotherapy complete remission (CR) was seen in 26 (41.9%) and non-remission (NR) in 17 (27.4%), while 19 patients (30.6%) died during the first admission for induction. </span></span><strong><span style="font-size: small;">Conclusion: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">The characteristics of de novo AML in Palestinian patients are comparable to published data elsewhere. M4 was the most common subtype. The outcome of the first cycle of induction chemotherapy was slightly inferior to the published data for M3 patients. Further studies are warranted to identify possible causes. </span></span>West Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-736818920170901Risk Factors Predicting Colorectal Cancer Recurrence Following Initial Treatment: A 5-Year Cohort Study246524704993410.22034/APJCP.2017.18.9.2465ENMohammadZare-BandamiriDepartment of Epidemiology, Faculty of Public Health, Shiraz University of Medical Sciences, Shiraz, Iran.MohammadFararoueiShiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.ShadiZohouriniaDepartment of Radiation Oncology, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.NimaDaneshiDepartment of Epidemiology, Faculty of Public Health, Shiraz University of Medical Sciences, Shiraz, Iran.MostafaDianatinasabShiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.Journal Article20170513<strong><span style="font-size: small;">Purpose: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Recurrence is one of the most important factors influencing survival of colorectal cancer patients. </span></span><strong><span style="font-size: small;">Subjects and Methods: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">In this cohort study, clinical and demographic characteristics of 561 patients with colorectal cancer were </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">collected from 2010 to 2015. Medical records and telephone interviews were used to define the patient’s clinical status </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">including the date of any recurrence during the study period. The multivariate Cox model was used as the main strategy for analyzing data. </span></span><strong><span style="font-size: small;">Results: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Some 239 (42.6%) patients experienced cancer recurrence during the 5-year follow-up period. Those with an older age at diagnosis had a higher risk of cancer recurrence than their younger counterparts [Hazard Ratio (HR) >70 y /</span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">treatment did not significantly predict recurrence. </span></span><strong><span style="font-size: small;">Conclusion: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Access to enhanced medical services including cancer diagnosis at an early stage and optimal treatment is needed to improve the survival and quality of life of CRC patients. </span></span></span>West Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-736818920170901The Effect of New Therapeutic and Diagnostic Agents on the Prognosis of Hepatocellular Carcinoma in Japan – An Analysis of Data from the Kanagawa Cancer Registry247124765006110.22034/APJCP.2017.18.9.2471ENRenaKanekoDepartment of Gastroenterology, Japan Organization of Occupational Health and Safety Kanto Rosai Hospital, Japan.NatsukoNakazakiDepartment of Gastroenterology, Japan Organization of Occupational Health and Safety Kanto Rosai Hospital, Japan.RisaOmoriDepartment of Gastroenterology, Japan Organization of Occupational Health and Safety Kanto Rosai Hospital, Japan.YuichiroYanoDepartment of Gastroenterology, Japan Organization of Occupational Health and Safety Kanto Rosai Hospital, Japan.MasazumiOgawaDepartment of Gastroenterology, Japan Organization of Occupational Health and Safety Kanto Rosai Hospital, Japan.YuzuruSatoDepartment of Gastroenterology, Japan Organization of Occupational Health and Safety Kanto Rosai Hospital, Japan.0000-0003-3424-3871Journal Article20170520 <br /> <strong><span style="font-size: small;">Objective: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Notable advances in diagnostic imaging modalities and therapeutic agents have contributed to improvement in the prognosis of hepatocellular carcinoma (HCC) over the past decade. However, knowledge concerning their epidemiological contribution remains limited. The present study investigated the effect of emerging diagnostic and therapeutic agents on HCC prognosis, using the largest regional cancer registry in Japan. </span></span><strong><span style="font-size: small;">Methods: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Using data </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">from the Kanagawa Cancer Registry, the five-year survival rate of patients with liver cancer was estimated according to the International Statistical Classification of Diseases and Related Health Problems (10th Edition). </span></span><strong><span style="font-size: small;">Result: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">A total of </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">40,276 cases of HCC (from 1976 to 2013) were identified. The prognosis markedly improved after the introduction of new devices into the diagnosis and treatment of HCC (p<0.01). The trend of survival rate varied significantly between </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">institutions with many registered patients (high-volume centers) (p<0.01). </span></span><strong><span style="font-size: small;">Conclusion: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">The five-year survival rate of </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">patients with HCC in Kanagawa has markedly improved in recent years. This improvement in survival may be attributed to the advances in surveillance and intervention for the treatment of HCC. </span></span>West Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-736818920170901A Polymorphism Located Near PMAIP1/Noxa Gene Influences Susceptibility to Hodgkin Lymphoma Development in South India247724834985910.22034/APJCP.2017.18.9.2477ENDimpal NThakkarDepartment of Pharmacology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Gorimedu, Puducherry, India.SunithaKodidelaDepartment of Pharmacology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Gorimedu, Puducherry, India.SandhiyaSelvarajanDepartment of Clinical Pharmacology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Gorimedu, Puducherry, India.BiswajitDubashiDepartment of Medical Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Gorimedu, Puducherry, India.StevenDkharDepartment of Clinical Pharmacology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Gorimedu, Puducherry, India.Journal Article20170604 <br /> <strong><span style="font-size: small;">Background: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Single nucleotide polymorphisms (SNPs) in DNA repair and Toll-like receptor (</span></span><em><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">TLR</span></span></em><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">) genes have been reported to be associated with Hodgkin Lymphoma (HL) risk. Since such associations may be ethnicity dependent, polymorphisms in </span></span><em><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">TLR4 </span></span></em><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">rs1554973, Xeroderma pigmentosum C (</span></span><em><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">XPC</span></span></em><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">) rs2228000, rs2228001 and a variant near </span></span><em><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">PMAIP1/Noxa </span></span></em><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">gene rs8093763 were here investigated with regard to HL susceptibility in a south Indian population. Normative frequencies of SNPs were established and compared with data for 1000 genome populations. </span></span><strong><span style="font-size: small;">Methods: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">We conducted a case control study consisting of 200 healthy volunteers and 101 cases with HL. DNA samples were genotyped using real-time PCR. Linkage disequilibrium (LD) analysis between rs2228000 and rs2228001 was performed using HaploView (version 4.2). </span></span><strong><span style="font-size: small;">Results: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Among the studied variants, we observed that a variant rs8093763 located near </span></span><em><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">PMAIP1/Noxa </span></span></em><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">gene was associated with HL risk (OR=1.72 and 95% CI=1.004-2.93). The major allele frequencies of </span></span><em><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">XPC </span></span></em><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">(rs2228000 and rs2228001), </span></span><em><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">TLR4 </span></span></em><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">(rs1554973) and </span></span><em><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">PMAIP1/NOXA </span></span></em><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">(rs8093763) variants were 79%, 66%, 67% </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">and 59% respectively. The studied frequencies were significantly different from 1000 genome populations. </span></span><strong><span style="font-size: small;">Conclusion: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">The results suggest that a variant rs8093763 located near the </span></span><em><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">PMAIP1/Noxa </span></span></em><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">gene may modify risk of HL. We found variation in distribution of polymorphic frequencies between the study population and 1000 genome populations. The results may help identify individual risk of development of HL in our south Indian population. </span></span>West Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-736818920170901Demographic Characteristics, Survival and Prognostic Factors of Early Breast Cancer Patients with Type 2 Diabetes Mellitus: A Hospital-Based Cohort Study248524914986110.22034/APJCP.2017.18.9.2485ENBitaBehrouziDepartment of Physiology, University of Toronto, St George Campus, Toronto, Canada.Mohammad AliMohagheghiCancer Research Center, Surgical Oncology Department, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.SanambarSadighiCancer Research Center, Medical Oncology-Hematology Department, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.Journal Article20170605 <br /> <strong><span style="font-size: small;">Objective: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">With increasing prevalence of type 2 diabetes mellitus and breast cancer in Iran, we aimed to search hospital registries of breast cancer patients to investigate type 2 diabetes mellitus association with survival outcomes of early breast cancer after adjustment of confounding factors. </span></span><strong><span style="font-size: small;">Methods: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">In a retrospective cohort study conducted from July 2003 to Feb 2014 and followed up until death or December 2016, female patients with early breast cancer who have been treated for the first time at the Cancer Institute of Iran, were divided to diabetic and non-diabetic groups. Primary and secondary outcomes were relapse free survival (RFS) and overall survival (OS). SPSS version 23 was used for analysis of data. Other variables included age, tumor stage, hormone receptor status, tumor subtype, and patient’s body mass index (BMI). </span></span><strong><span style="font-size: small;">Result: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">From a total of 1021 patients, 218 (21.4%) had type 2 diabetes mellitus. Diabetic patients had a higher mean age (53.31 vs 47.00), higher mean BMI (31.13 vs 29.15), lower HER2 expression (20.8% vs 32.1%) and higher frequency of luminal A subtype (61.1% vs 51.0). Overall, after adjustment of other variables, diabetes status did not affect RFS or OS independently. However, in luminal A subgroup, patients with diabetes mellitus had significantly lower survival outcomes of OS (135.277 vs 154.701) and RFS (114.107 vs 133.612) as well as OS higher hazard ratio of 1.830 and RFS hazard ratio of 1.663 compared to non-diabetic patients. BMI, hormone receptor status and tumor stage significantly affected the survival of the patients. </span></span><strong><span style="font-size: small;">Conclusion: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">In the present study, in addition to known breast cancer risk factors, BMI and type 2 diabetes mellitus had an independent impact on survival of the patients, highlighting the importance of health issues such as obesity and diabetes suboptimal performance in the treatment outcomes of early breast cancer patients in Iran. </span></span>West Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-736818920170901Immunohistopathological Study of c-FLIP Protein in Mycosis Fungoides249324995040910.22034/APJCP.2017.18.9.2493ENGhada FawzyRezk HassanLecturer of Dermatology and Venereology, Faculty of Medicine, Tanta University, 31111, Tanta, Egypt.KarimaMareyDepartment of Pathology, Faculty of Medicine, Tanta University, 31111, Tanta, Egypt.Journal Article20170608 <br /> <strong><span style="font-size: small;">Background: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Mycosis fungoides (MF) is the commonest variant of primary cutaneous T cell lymphoma with several clinicopathologic variants. Defective apoptotic mechanism may be important in the pathogenesis and progression of MF. c-FLIP protein is an important anti-apoptotic marker and chemotherapeutic resistant factor. This study aimed to evaluate the c-FLIP expression in MF and its role in the pathogenesis of MF. </span></span><strong><span style="font-size: small;">Methods: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Twenty patients of MF and ten normal persons were included in this study. Skin biopsies were obtained from both patients and controls. They were studied and examined immunohistochemically for the expression of CD4 and c-FLIP. </span></span><strong><span style="font-size: small;">Results: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">c-FLIP expression </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">was significantly increased in patients when compared to controls in both epidermis and dermis. There were positive </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">correlations between c-FLIP expression and CD4+ expression in both epidermal and dermal lesions of patients group. </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">There were statistically significant positive correlations between c-FLIP expression (in both dermal and epidermal lesions) and the age of patients. c-FLIP expression increased with the tumor progression but with no statistical significance. </span></span><strong><span style="font-size: small;">Conclusion: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Defective regulation of apoptosis has been considered as a main cause for accumulation of clonal T cells, and it was related to an increased expression of c-FLIP which may have a role in the pathogenesis of MF. Also, c-FLIP may have prognostic information in MF as its level increased with both age of the patients and tumor progression. </span></span>West Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-736818920170901Role Playing for Improving Women’s Knowledge of Breast Cancer Screening and Performance of Breast Self-Examination250125054986210.22034/APJCP.2017.18.9.2501ENMitraSavabi EsfahaniDepartment of Midwifery and Reproductive Health, Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.FaribaTaleghaniNursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.MahnazNorooziDepartment of Midwifery and Reproductive Health, Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.MaryamTabatabaeianCancer Prevention Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.Journal Article20170609 <br /> <strong><span style="font-size: small;">Background: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">To enhance knowledge and performance of screening as a strategy to control breast cancer, use of effective teaching methods is necessary. The objective of this study was to determine the effect of role-playing on knowledge of breast cancer screening and performance of breast self-examination (BSE). </span></span><strong><span style="font-size: small;">Methods: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">A quasi experimental design was used. Women enrolled in community cultural centers (n=314) were randomly divided into two educational </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">groups: role playing (intervention) and lecture (control). Data were collected using a structured questionnaire before </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">and after intervention. Reliability of the questionnaire was determined as 0.80 by Cronbach’s alpha. The women were followed up regarding performance of BSE one month later. </span></span><strong><span style="font-size: small;">Results: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Of the 314 women, 113 (36%) and 132 (42%) had low and medium levels of knowledge, respectively. More than a third (38.2%) reported that TV and radio were </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">the most important information sources for breast cancer and screening. There were significant differences between </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">mean scores of knowledge before and after the intervention in both groups, but change was greater with role playing (31.3±1.9 as compared to 23.5±1.3) (P=0.001). After a month of educational intervention, 75.7% and 69.8% of those in role playing and control groups had undergone BSE. </span></span><strong><span style="font-size: small;">Conclusion: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">It appears that application of a role playing method by providers improves women’s knowledge and behavior with respect to breast cancer screening. </span></span>West Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-736818920170901Significance of Compression in Binucleation while Differentiating Reactive Cellular Changes Between Human Papillomavirus and Candida Infections250725114937610.22034/APJCP.2017.18.9.2507ENMitsuakiOkodoDepartment of Medical technology, Faculty of Health Sciences, Kyorin University, Japan.KaoriOkayamaSchool of Medical Technology, Faculty of Health Science, Gumma Paz University, Japan.TadasiFukuiFukui Maternity Clinic, Japan.NatsukoShiinaILABO Cyto STD Laboratory, Inc, Japan.TimothyCanizILABO Cyto STD Laboratory, Inc, Japan.HiromiYabusakiILABO Cyto STD Laboratory, Inc, Japan.MasahikoFujiiGenki Plaza Medical Center for Health Care, Japan.Journal Article20170610 <br /> <strong><span style="font-size: small;">Purpose: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Binucleation is a reactive cellular change (RCC) in Pap smears due to </span></span><em><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Candida </span></span></em><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">infection. However, the origin of these binucleated cells as RCCs remains unclear. The purpose of this study was to examine binucleation in patients negative for intraepithelial lesion or malignancy (NILM) and infected with </span></span><em><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Candida </span></span></em><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">and those infected with high-risk human papillomavirus (hr-HPV) and to clarify the origin of the binucleated cells. </span></span><strong><span style="font-size: small;">Methods: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">A total of 115 endocervical swab specimens with a combined diagnosis of NILM, </span></span><em><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Candida </span></span></em><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">infection, and RCCs were used for this study. Pap smears were used to identify binucleated cells and then separate them into two groups, compression-positive and compression-negative. In addition, hr-HPV was detected using polymerase chain reaction (PCR) with a specific primer on the DNA extracted from the remaining residual cytology specimens. To make the hr-HPV-infected binucleated cells visible, an </span></span><em><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">in situ </span></span></em><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">PCR assay was performed on the Pap smear. </span></span><strong><span style="font-size: small;">Result: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Of the 115 specimens, 69.6% contained binucleated cells, 26 (32.5%) showed only the compressed form, 35 (43.8%) showed only the non-compressed form, and 19 showed both the compressed and non-compressed forms of binucleated cells. Also, 34 specimens (29.6%) were positive for hr-HPV. The sensitivity and specificity of compression-positive binucleated cells were 91.2% and 82.7% (p < 0.001), but they were not significant in the compression-negative group (p = 0.156). Also, 34 cases with hr-HPV contained 99 compression-positive and 24 compression-negative cells. The hr-HPV-positive cells accounted for 68 (68.7%) of the 99 compression-positive and 2 (8.3%) of the 24 compression-negative binucleated cells as determined </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">by an </span></span><em><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">in situ </span></span></em><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">PCR assay for hr-HPV. The relationship between compression and hr-HPV was statistically significant (p < 0.001). </span></span><strong><span style="font-size: small;">Conclusion: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Compression-positive binucleated cells may be present as a result of hr-HPV infection and not RCC, which is caused due to inflammation in NILM cases infected with </span></span><em><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Candida</span></span></em><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">. </span></span>West Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-736818920170901Cytology-Based Screening During Antenatal Care as a Method for Preventing Cervical Cancer251325185015510.22034/APJCP.2017.18.9.2513ENPaula BrunoMonteiroPublic Health Graduate Program, Federal University of Ceará (UFC), Fortaleza, Brazil.Marcelo PraxedesMonteiro FilhoGynecology and Obstetrics Resident, University of São Paulo (USP), São Paulo, Brazil.Jéssica TeixeiraDe FigueiredoDepartment of Family and Community Health, Ministry of Health, Fortaleza, Brazil.Maria Vieira De LimaSaintrainPublic Health Graduate Program, University of Fortaleza (UNIFOR), Fortaleza, Brazil.Zenilda VieiraBrunoDepartment of Gynecology and Obstetrics, Federal University of Ceará (UFC), Fortaleza, Brazil.Francisco Herlânio CostaCarvalhoDepartment of Medical Sciences, Federal University of Ceará (UFC), Fortaleza, Brazil.Journal Article20170614 <br /> <strong><span style="font-size: small;">Background: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Cervical cancer is one of the most serious threats to women’s lives. Therefore, the present study aimed to know the dynamics in the collection of cytologic samples during antenatal care as a method of cervical cancer screening and to identify the factors associated with its performance. </span></span><strong><span style="font-size: small;">Material and Methods: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Analytical cross-sectional study carried out with pregnant and postpartum women in Fortaleza, Ceará, Northeastern Brazil. Data were collected using a questionnaire addressing sociodemographic variables, antenatal care, pregnancy and cytology-based screening for cervical cancer during antenatal care. Measures of central tendency were calculated and the Chi-squared test and </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Fisher’s exact test were used with a significance level of 5%. </span></span><strong><span style="font-size: small;">Results: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Participants were 229 pregnant women and 89 postpartum women. Age ranged 18 to 43 years, with a mean of 27.9 years (SD=6.1). Only 35 (11%) participants had Pap smears during antenatal care. A total of 283 women did not have Pap smears during pregnancy; of these, 229 (80.9%) did not have the test because of lack of clear information from the health professional, 25 (8.8%) for fear of bleeding or abortion, and 29 (10.3%) because they had had the test before pregnancy. Undergoing cytology-based screening for cervical cancer was associated with high-risk pregnancy (p=0.002), antenatal care provided by a physician (p=0.003), knowledge about the possibility of having the test during pregnancy (p<0.001) and paid job (p=0.043). </span></span><strong><span style="font-size: small;">Conclusion: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">The percentage of cytology-based screening for cervical cancer during antenatal care was low. Therefore, health </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">education is suggested to improve this figure. However, receiving antenatal care at MEAC, having consultations with a physician, and knowing that it is possible to have a Pap smear during pregnancy were significant protective factors </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">for undergoing cytology screening during pregnancy. </span></span>West Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-736818920170901Triptolide promotes senescence of prostate cancer cells through induction of histone methylation and heterochromatin formation251925264987010.22034/APJCP.2017.18.9.2519ENOusmanTamgueUniversity of Cape Town, Institute of Infectious Diseases and Molecular Medicine (IDM),
Division of Immunology, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa.College of Life Science, Northwest A&F University, 3 Taicheng Road, Yangling, 712100, China.MingLeiCollege of Life Science, Northwest A&F University, 3 Taicheng Road, Yangling, 712100, China.Institute of Biophysics, Chinese Academy of Science, China.Journal Article20170617Background: Triptolide is a medicinal herb-derived diterpene triepoxide with potent anti-tumor activity against a wide range of tumors. The anti-tumor mechanism of this small molecule has been correlated mainly with its ability to inhibit and inactivate subunits of RNA polymerase II, thereby suppressing global gene transcription. Epigenetic imbalance including histone methylation are well known to play important role in Prostate cancer (PCa) onset and progression. The goal of this study was to investigate whether Triptolide performs its anti-PCa activities by reshaping the histone methylation landscape in PCa cells.Methods: Triptolide-treated PCa cell lines were analyzed by RT-qPCR and western blotting to measure the expression of histone methylases; demethylases and associated histone marks. Detection of senescence was done using Senescence Associated β-Galactosidase Staining. Apoptosis and cell cycle analysis were performed by flow cytometry. Senescence –associated heterochromatine foci were detected by Immunofluorescence. Chromatin Immunoprecipitation associated to qPCR (CHIP-qPCR) was used to measure the accumulation of histone marks on the promoters of target genes.Cell viability was assessed using the CCK-8 assay. Results: We found that Triptolide enhances H3K27me3 level by down-regulating JMJD3 and UTX. Triptolide also enhances H3K9me3 level through up-regulation of SUV39H1. Furthermore, Triptolide up-regulates the expression of HP1α. These events promote heterochromatin formation and deposition on the promoters of E2F1-target genes, which correlates with suppression of gene transcription, decreased cell viability and induction of a senescence-like phenotype in PCa cells. Conclusions: Our results indicate that Triptolide performs its anti-tumor effects including PCa cell senescence at least partially through increasing the levels of repressive histone H3 methylation and formation of repressive chromatin state in PCa cells. Our study suggests Triptolide is a potential epigenetic anti-PCa drugWest Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-736818920170901Prognostic Value of Cancer Stem Cell Markers CD44 and ALDH1/2 in Gastric Cancer Cases252725314987110.22034/APJCP.2017.18.9.2527ENFatmaSenelDepartment of Pathology,Kayseri Education and Research Hospital, University of Health Sciences, Istanbul, Turkey.TubaDilay Kökenek UnalDepartment of Pathology,Kayseri Education and Research Hospital, University of Health Sciences, Istanbul, Turkey.HaticeKaramanDepartment of Pathology,Kayseri Education and Research Hospital, University of Health Sciences, Istanbul, Turkey.MevludeInancDepartment of Medical Oncology, Kayseri Education and Research Hospital, University of Health Sciences, Istanbul,Turkey.AynurAytekinDepartment of Radiation Oncology, Kayseri Education and Research Hospital, University of Health Sciences, Istanbul, Turkey.Journal Article20170619 <br /> <strong><span style="font-size: small;">Purpose: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">To determine expression levels of CD44 and ALDH1/2, known cancer stem cell (CSC) markers, in stomach adenocarcinomas and assess relationships with clinicopathologic parameters and prognosis. </span></span><strong><span style="font-size: small;">Methods: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Eighty patients diagnosed with gastric cancer between the years 2011-2015 were included in this study of clinicopathologic characteristics, postoperative prognostic indexes and stem cell marker CD44 and ALDH1/2 expression in paraffin-embedded tumour sections analyzed immunohistochemically. Clinicopathologic parameters were evaluated using the chi-square test and t-test. Survival analyses were conducted using Kaplan-Meier statistics. </span></span><strong><span style="font-size: small;">Results: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">We </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">observed positive CD44 and ALDH1/2 staining in 45.0 % and 67.5% of tumour tissues, respectively, but not in normal gastric mucosa. Recurrence-free survival (RFS) was found to be shorter in cases with high levels of CD44 expression (p=0.004). Similarly, short RFS was observed in patients with high levels of CD44 and ALDH1/2 co-expression (p=0.004). Furthermore, tumour invasion depth was found to correlate with high CD44 and ALDH1/2 co-expression </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">(p=0.028). </span></span><strong><span style="font-size: small;">Conclusion: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">The cancer stem cell markers CD44 and ALDH1/2 may indicate poor patient prognosis and </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">play a role in tumour development and invasion. </span></span>West Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-736818920170901Policy-Relevant Context of Waterpipe Tobacco Smoking among University Students in Six Countries Across the Eastern Mediterranean Region: A Qualitative Study253325404992910.22034/APJCP.2017.18.9.2533ENRamzi GSalloumDepartment of Health Outcomes and Policy, College of Medicine, University of Florida, Gainesville, FL, USA.NiveenAbu-RmeilehInstitute of Community and Public Health, Birzeit University, Birzeit, Palestine.RandahHamadehCollege of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain.JustinThomasDepartment of Natural Science and Public Health, College of Sustainability Sciences and Humanity, Zayed University, Abu Dhabi, United Arab Emirates.AyaMostafaDepartment of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.AfzalhusseinYusufaliDubai Medical College, Dubai, United Arab Emirates.Khalid AKheirallahDepartment of Public Health and Community Medicine, School of Medicine, Jordan University of Science and Technology, Irbid, Jordan.Mark MMacaudaDepartment of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.Ryan PTheisDepartment of Health Outcomes and Policy, College of Medicine, University of Florida, Gainesville, FL, USA.LamaEl KadiDepartment of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.Evan JJohnsonDepartment of Health Outcomes and Policy, College of Medicine, University of Florida, Gainesville, FL, USA.Muhammad WDarawadDepartment of Clinical Nursing, School of Nursing, University of Jordan, Amman, Jordan.0000-0003-3314-7933RimaNakkashDepartment of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.Journal Article20170625 <br /> <strong><span style="font-size: small;">Background: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Waterpipe tobacco smoking rates in the Eastern Mediterranean region are some of the highest worldwide, especially among young people. This study aimed to improve our knowledge of the policy-relevant context of waterpipe smoking among six countries in the Eastern Mediterranean region. </span></span><strong><span style="font-size: small;">Methods: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">In-depth interviews were conducted in Bahrain, Egypt, Jordan, Lebanon, Palestine, and the United Arab Emirates. Participants were young adult university students (18-29 years) from both genders who had ever smoked the waterpipe, recruited from universities participating in this study. Directed content analysis was used to analyze the transcripts. </span></span><strong><span style="font-size: small;">Results: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">A total of 53 in-depth interviews were conducted in Arabic in 2016. Findings were organized around 5 themes: waterpipe product characteristics; patterns of waterpipe smoking; the waterpipe café setting; perceived health consequences; and health warning labels. Waterpipe smoking was commonly perceived as a safe alternative to cigarettes. Waterpipe tobacco was reported to be widely accessible and affordable to young participants. There is a lack of knowledge among waterpipe smokers about the associated health effects. Warning labels are effective at communicating health risks associated with waterpipe smoking. </span></span><strong><span style="font-size: small;">Conclusions: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Regulatory frameworks for waterpipe tobacco smoking should be developed and </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">enforced, including waterpipe-specific health warning labels that elucidate the harmful effects of waterpipe smoking. </span></span>West Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-736818920170901Automatic Classification on Bio Medical Prognosisof Invasive Breast Cancer254125445015610.22034/APJCP.2017.18.9.2541ENSountharrajanSDepartment of Computer Science and Engineering, Bannari Amman Institute of Technology, India.KarthigaMDepartment of Computer Science and Engineering, Bannari Amman Institute of Technology, India.SuganyaEDepartment of Computer Science and Engineering, Bannari Amman Institute of Technology, India.RajanCDepartment of Information
Technology, K S Rangasamy College of Technology, India.Journal Article20170704 <br /> <span style="font-size: small;">Breast Cancer one of the appalling diseases among the middle-aged women and it is a foremost threatening death </span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">possibility cancer in women throughout the world. Earlier prognosis and preclusion reduces the conceivability of death. </span></span><span style="font-size: small;">The proposed system beseech various data mining techniques together with a real-time input data from a biosensor device to determine the disease development proportion. Surface acoustic waves (SAW) biosensor empowers a label-free, worthwhile and straight detection of HER-2/neu cancer biomarker. The output from the biosensor is fed into the </span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">proposed system as an input along with data collected from Winconsin dataset. The complete dataset are processed </span></span><span style="font-size: small;">using data mining classification algorithms to predict the accuracy. The exactness of the proposed model is improved </span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">by ranking attributes by Ranker algorithm. The results of the proposed model are highly gifted with an accuracy of </span></span><span style="font-size: small;">79.25% with SVM classifier and an ROC area of 0.754 which is better than other existing systems. The results are used </span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">in designing the proper drug thereby improving the survivability of the patients. </span></span>West Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-736818920170901Psychological Distress and Resilience in Women Diagnosed with Breast Cancer in Greece254525504990110.22034/APJCP.2017.18.9.2545ENEvangelos CFradelosState Mental Hospital of Attica, Department of Nursing, Faculty of Human Movement and Quality of life, University of Peloponnese, Sparta, Greece.Ioanna VPapathanasiouDepartment of Nursing, Technological Educational Institute of Thessaly, Larisa, Greece.AikateriniVenetiTheagenio Oncology Hospital Thessaloniki, Greece.AristidesDaglasHellenic Regulatory Body of Nurses, Athens, Greece.EleniChristodoulouPublic Institute of Vocational Education “Sotiria”, Thoracic Diseases
General Hospital of Athens, Athens, Greece.SofiaZygaState Mental Hospital of Attica, Department of Nursing, Faculty of Human Movement and Quality of life, University of Peloponnese, Sparta, Greece.MichaelKourakosDirector Of Nursing, General Hospital and Quot, Asklepieio and Quot, Voulas, Greece.Journal Article20170713 <br /> <strong><span style="font-size: small;">Background: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Breast cancer is the most frequent type of cancer among women worldwide, especially in developed countries. To be diagnosed with breast cancer and undergo cancer treatment can be a very stressful event. It is estimated that one-third of cancer patients are dealing with psychological problems, such as anxiety and depression and resilience is a way of coping and overcome life stressors such cancer diagnosis. Purpose: The purpose of this study was to examine resilience in women diagnosed with breast cancer and its association with depression and anxiety. </span></span><strong><span style="font-size: small;">Methods: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">A cross-sectional study was conducted, 144 women diagnosed with breast cancer answered a questionnaire consisted of four parts: Sociodemographic data, the Patient Health Questionnaire Two-Item Depression Scale, the Generalized Anxiety Disorder Questionnaire and the Connor-Davidson Resilience Scale 25. </span></span><strong><span style="font-size: small;">Results: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">The majority of the sample belongs to age group 51- 60 years, with the mean age of 53.5 SD±11.7 years. The 59.5% of patients were residents of an urban area, 56.8% were married and 36.5% has 2 children. The mean value of CD-RISC25 was 65.3 SD±17.9, meaning a moderate resilience of cancer patients. The 54.5% of respondents indicated a depressed mood. The anxiety severity measured with the GAD-2, where the mean was 2.1 and 46.8% of patients suffered from high anxiety. </span></span><strong><span style="font-size: small;">Conclusions: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">According to our results, resilience can negative influence depressive symptomatology. Moreover, lower levels of </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">depression can lead to fewer anxiety symptoms. </span></span>West Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-736818920170901No Evaluation of Serum P53 Levels in Iraqi Female Breast Cancer Patients255125535015710.22034/APJCP.2017.18.9.2551ENFerdous AJabirCollege of Medicine, University of Al-Qadisiyah, Iraq.WisamHoidyChemistry Department, College of Education, University of Al-Qadisiyah, Iraq.Journal Article20170715 <br /> <span style="font-size: small;">Breast cancer is the most common cancer diagnosed and the second leading cause of cancer death among Iraqi </span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">women. The population was exposed to high levels of depleted uranium following the first and second Gulf Wars and this might be a risk factor. Protein 53 (p53) or Tumor protein 53 (Tp53) was originally defined as an oncogenic protein. The aim of the study was to evaluate P-53 serum concentrations in fifty Iraqi female breast cancer patients and twenty five healthy volunteers using the ELISA technique. All these patients attended the Teaching Hospital of AL Diwaniyah </span></span><span style="font-size: small;">during the period between June 2016 to March 2017. The mean values for TP53 concentration in patients with breast cancer and apparently healthy groups were 47+33.5 U/ml and 27. 8+12.7 U/ml, respectively. The results showed no </span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">significantly difference , in contrast to most studies conducted elsewhere in the world. </span></span>West Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-736818920170901The Prognostic Factors of Biochemical Recurrence-Free Survival Following Radical Prostatectomy255525595015810.22034/APJCP.2017.18.9.2555ENViroteChalieopanyarwongDivision of Urology, Department of Surgery, Faculty of Medicine, Songklanagarind Hospital, Prince of Songkla University,
Songkhla, Thailand.WorapatAttawettayanonDivision of Urology, Department of Surgery, Faculty of Medicine, Songklanagarind Hospital, Prince of Songkla University,
Songkhla, Thailand.WatidKanchanawanichkulDivision of Urology, Department of Surgery, Faculty of Medicine, Songklanagarind Hospital, Prince of Songkla University,
Songkhla, Thailand.ChoosakPripatnanontDivision of Urology, Department of Surgery, Faculty of Medicine, Songklanagarind Hospital, Prince of Songkla University,
Songkhla, Thailand.Journal Article20170716 <br /> <strong><span style="font-size: small;">Objective: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">To evaluate outcomes, biochemical recurrence-free survival (BCRFS) and to identify parameters </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">influencing BCRFS of radical prostatectomy (RP) and bilateral pelvic lymph node dissection in a single-institution. </span></span><strong><span style="font-size: small;">Methods: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">A retrospective review of prostate cancer (PC) patients received RP was identified from the medical records. </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Data was collected from 2007 to 2016. 178 patients received RP were enrolled in a study. These patients were evaluated </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">on efficacy of RP by using prostate-specific antigen (PSA) to analyze BCRFS and compared with Gleason score, </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">pathologic staging, margin status and lymph node status with BCRFS. </span></span><strong><span style="font-size: small;">Results: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">The median follow up was 32.5 months </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">(n = 178). Sixty-nine patients had extracapsular extension on pathologic results whereas 93 patients were classified as </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">a high risk group. The median time for biochemical recurrence (BCR) was 22.3 months. The 3-year BCRFS in patients </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">with a Gleason score 6, 3+4, 4+3, 8 and 9-10 were 85.8%, 84.6%, 78.7%, 53.3% and 35.8% . Multivariate analysis </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">showed that extracapsular extension was independently associated with BCRFS. </span></span><strong><span style="font-size: small;">Conclusions: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">New group grading system indicates impact on BCRFS on univariate analysis but show negative impact on a multivariate Cox regression, only pathologic staging was independently associated with the cancer control outcome. </span></span>West Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-736818920170901Distribution and Role of N-acetyltransferase 2 Genetic Polymorphisms in Bladder Cancer Risk in a Lebanese Population256125685015910.22034/APJCP.2017.18.9.2561ENRamiNasrDivision of Urology, Department of Surgery, American University of Beirut Faculty of Medicine, Beirut, Lebanon.SallyTemrazDivision of Hematology and Oncology, Department of Internal Medicine, American University of Beirut Faculty of Medicine, Beirut, Lebanon.DeborahMukherjiDivision of Hematology and Oncology, Department of Internal Medicine, American University of Beirut Faculty of Medicine, Beirut, Lebanon.0000-0002-0192-5828AliShamseddineDivision of Hematology and Oncology, Department of Internal Medicine, American University of Beirut Faculty of Medicine, Beirut, Lebanon.ReemAkikaDepartment of Pharmacology and Toxicology, American University of Beirut Faculty of Medicine, Beirut, Lebanon.SehrishAbbasiDepartment of Pharmacology and Toxicology, American University of Beirut Faculty of Medicine, Beirut, Lebanon.RajaKhauliDivision of Urology, Department of Surgery, American University of Beirut Faculty of Medicine, Beirut, Lebanon.MuhammadBulbulDivision of Urology, Department of Surgery, American University of Beirut Faculty of Medicine, Beirut, Lebanon.HaniTamimDepartment of Internal Medicine and Clinical Research Institute, Faculty of Medicine, American University of Beirut Medical CenterNathalie KZgheibDepartment of Pharmacology and Toxicology, American University of Beirut Faculty of Medicine, Beirut, Lebanon.0000-0002-0571-768XJournal Article20170717 <br /> <strong><span style="font-size: small;">Background: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">In Lebanon, bladder cancer (BC) has an unusually high prevalence. Individuals who are exposed to aromatic amines from smoking or certain occupations and carrying the slow N-acetyl transferase 2 (NAT2) acetylator’ phenotype may be at a higher risk. </span></span><strong><span style="font-size: small;">Methods: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Data and DNA from 115 Lebanese BC cases and 306 controls were examined. Ten NAT2 single nucleotide polymorphisms were genotyped, seven of which were then included in haplotype and phenotype analysis. </span></span><strong><span style="font-size: small;">Results: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">BC patients were more likely to be males (87.8% vs. 54.9%) and current smokers (60.9% vs. 26.5%) when compared to controls. In both groups, most participants had the slow NAT2 acetylator phenotype (66.1% of BC cases vs 62.7% of controls; P=0.302) with the NAT2*5B and *6A haplotypes being the most common. The </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">odds ratio (95%CI) of having BC among slow NAT2 acetylators was 1.157 (0.738-1.815) and remained non-significant </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">after adjustment [1.097 (0.666-1.806)]. Sensitivity analysis with a subgroup of 113 cases and 84 controls for which </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">occupational history was available revealed a statistically significant association between slow NAT2 acetylators and </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">BC in females only. The sample size was however very small and the CI quite wide. </span></span><strong><span style="font-size: small;">Conclusions: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">This is the first </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">study to evaluate the distribution of NAT2 haplotypes and their potential role in BC in a Lebanese population. The </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">absence of any significant association may be due to the relatively small sample size, the unavailability of matching </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">by gender, and the lack of evaluation of genetic interactions with extent of active and passive smoking, exposure to environmental pollutants, diet, and other genes. The potential association limited to females needs further evaluation. </span></span>West Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-736818920170901Risk Factors for Incomplete Excision after Loop Electrosurgical Excision Procedure (LEEP) in Abnormal Cervical Cytology256925725016110.22034/APJCP.2017.18.9.2569ENTreerinYingyongwatthanawitthayaDepartment of Obstetrics and Gynaecology, Prapokklao Hospital, Chanthaburi, ThailandWatcharinChirdchimDepartment of Obstetrics and Gynaecology, Prapokklao Hospital, Chanthaburi, ThailandChanyaThamrongwuttikulDepartment of Obstetrics and Gynaecology, Prapokklao Hospital, Chanthaburi, ThailandPanyaSananpanichkulDepartment of Obstetrics and Gynecology, Prapokklao hospital, Chanthaburi, Thailand.Journal Article20170719 <br /> <strong><span style="font-size: small;">Objective: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">To investigate the risk factors related to incomplete excision after loop electrosurgical excision procedure (LEEP) in abnormal cervical cytology. </span></span><strong><span style="font-size: small;">Methods: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">This retrospective cohort study was performed during September 2010 to February 2017. The study population was patients with abnormal cervical cytology who treated by LEEP at Prapokklao hospital, Chanthaburi. From the medical records, data were collected include age, menopausal status, parity, body mass index, HIV infection, history of smoking, cervical cytology and characteristics of LEEP histopathology such as number of specimen, size and glandular involvement. Risk factors were investigated using multivariable risk ratio from risk ratio regression. </span></span><strong><span style="font-size: small;">Result: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Five hundred cases of LEEP were done during this period and 322 cases were analyzed. Complete excision of the LEEP specimens found nearly half of the cases (46.9%). Multiple pieces </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">of specimen was the risk factor for incomplete excision of LEEP (adjusted risk ratio [aRR] = 1.29, 95% confidence </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">interval [CI] = 1.06-1.58; P = 0.013). </span></span><strong><span style="font-size: small;">Conclusion: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">The number of specimen from LEEP more than one piece was the risk factor for incomplete excision. Alternative methods such as cold knife conization (CKC), needle excision of the </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">transformation zone (NETZ) or contoured loop excision of the transformation zone (C-LETZ) should be justified when </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">all lesions could not be operated by single sweep. </span></span>West Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-736818920170901Human Papillomavirus Investigation in Head and Neck Squamous Cell Carcinoma: Initial Report from the Low Risk HPV Types Associations257325794993910.22034/APJCP.2017.18.9.2573ENMohammad HadiKarbalaie NiyaDepartment of Virology, Iran University of Medical Sciences, Tehran, Iran.FahimehSafarnezhad TameshkelGastrointestinal and Liver Diseases Research Center (GILDRC), Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran.MahshidPanahiGastrointestinal and Liver Diseases Research Center (GILDRC), Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran.FarahBokharaei SalimDepartment of Virology, Iran University of Medical Sciences, Tehran, Iran.HIV Laboratory of National Center, Deputy of Health, Iran University of Medical Sciences, Tehran, Iran.Seyed Hamid RezaMonavariDepartment of Virology, Iran University of Medical Sciences, Tehran, Iran.HosseinKeyvaniDepartment of Virology, Iran University of Medical Sciences, Tehran, Iran.Gastrointestinal and Liver Diseases Research Center (GILDRC), Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran.Journal Article20170723 <br /> <strong><span style="font-size: small;">Background: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Head and neck squamous cell carcinomas (HNSCC) are a major health issue in many parts of the world. Recently, attention has focused on the human papilloma virus (HPV) as a potential causative agent for HNSCC. This study aimed to survey HPV occurrence in HNSCCs as part of a comprehensive molecular epidemiology approach. </span></span><strong><span style="font-size: small;">Methods: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">In this retrospective study, patients were recruited from hospitals affiliated to the Iran University of Medical Sciences, Tehran, Iran. Formalin-fixed paraffin-embedded (FFPE) blocks were subjected to DNA isolation by QIAamp® DNA FFPE Tissue Kit and nested PCR, HPV-16 specific conventional PCR, and extra INNO-LiPA HPV genotyping assays were subsequently performed. PCR products were purified with a High Pure PCR Product Purification Kit and sequenced with an ABI 3730 XL sequencer. CLC Main Workbench 5 and MEGA5 bioinformatics software was used </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">to analyze the raw data and to create the phylogenetic tree. SPSS v.20 was applied for statistical analysis. </span></span><strong><span style="font-size: small;">Results: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">A total of 156 FFPE blocks were collected from 2011 to 2017. Total mean age (y) of participants was 60.5 ± 12.6; </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">77.6 % (121/156) being men and 22.4% (35/156) e women. Overall, 5/156 (3.2%) patients (3 females and 2 males) </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">were found to be HPV positive using the three methods. HPV genotyping revealed HPV types 16, 2, 27, and 43 in </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">these malignancies. Tumor location and lymph node involvement indicated significant differences between the sexes. </span></span><strong><span style="font-size: small;">Conclusion: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Although high risk HPV genotypes have been associated with HNSCCs, our findings indicate a potential </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">of low risk HPV types to also contribute to such malignancies. </span></span>West Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-736818920170901Generalized Linear Mixed Model Analysis of Urban-Rural Differences in Social and Behavioral Factors for Colorectal Cancer Screening258125895016210.22034/APJCP.2017.18.9.2581ENKeshengWangDepartment of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA.XuefengLiuDepartment of Systems Leadership and Effectiveness Science, School of Nursing, University of Michigan, Ann Arbor, MI 48109-5482, USA.MuyiwaAtegboleDepartment of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA.XinXieDepartment of Economics and Finance, College of Business and Technology, East Tennessee State University, Johnson City, TN 37614, USA.YingLiuDepartment of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA.ChunXuDepartment of Health and Biomedical Sciences, College of Health Affairs, University of Texas Rio Grande Valley, Brownsville, TX 78520, USA.ChangchunXieDivision of Biostatistics and Bioinformatics, Department of Environmental Health, University of Cincinnati, Cincinnati, OH 45267, USA.ZhanxinShaSchool of Kinesiology, College of Health, University of Southern Mississippi, Hattiesburg, MS 39406, USA.Journal Article20170731 <br /> <strong><span style="font-size: small;">Objective: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Screening for colorectal cancer (CRC) can reduce disease incidence, morbidity, and mortality. However, </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">few studies have investigated the urban-rural differences in social and behavioral factors influencing CRC screening. The </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">objective of the study was to investigate the potential factors across urban-rural groups on the usage of CRC screening. </span></span><strong><span style="font-size: small;">Methods: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">A total of 38,505 adults (aged ≥40 years) were selected from the 2009 California Health Interview Survey </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">(CHIS) data - the latest CHIS data on CRC screening. The weighted generalized linear mixed-model (WGLIMM) was used to deal with this hierarchical structure data. Weighted simple and multiple mixed logistic regression analyses in </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">SAS ver. 9.4 were used to obtain the odds ratios (ORs) and their 95% confidence intervals (CIs). </span></span><strong><span style="font-size: small;">Results: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">The overall </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">prevalence of CRC screening was 48.1% while the prevalence in four residence groups - urban, second city, suburban, and town/rural, were 45.8%, 46.9%, 53.7% and 50.1%, respectively. The results of WGLIMM analysis showed that there was residence effect (p<0.0001) and residence groups had significant interactions with gender, age group, education </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">level, and employment status (p<0.05). Multiple logistic regression analysis revealed that age, race, marital status, education level, employment stats, binge drinking, and smoking status were associated with CRC screening (p<0.05). </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Stratified by residence regions, age and poverty level showed associations with CRC screening in all four residence </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">groups. Education level was positively associated with CRC screening in second city and suburban. Infrequent binge drinking was associated with CRC screening in urban and suburban; while current smoking was a protective factor in urban and town/rural groups. </span></span><strong><span style="font-size: small;">Conclusions: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Mixed models are useful to deal with the clustered survey data. Social factors and behavioral factors (binge drinking and smoking) were associated with CRC screening and the associations were affected by living areas such as urban and rural regions. </span></span>West Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.Asian Pacific Journal of Cancer Prevention1513-736818920170901OPN b and c Isoforms Doubtless Veto Anti-angiogenesis Effects of Curcumin in Combination with Conventional AML Regiment259125995016310.22034/APJCP.2017.18.9.2591ENAkramMirzaeiHematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.Seyed HamidGhaffariHematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.MohsenNikbakhtHematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.HoseinKamranzadeh FoumaniHematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.MohammadVaeziHematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.SaeedMohammadiHematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.KamranAlimoghaddamHematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.ArdeshirGhavamzadehHematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.Journal Article20170802 <br /> <span style="font-size: small;">Osteopontin (OPN) is an extracellular structural protein that is secreted by osteoblasts and hematopoietic cells. It suppresses the proliferation of hematopoietic stem and also plays an important role in promoting survival and drug resistance in leukemic stem cells (LSCs). Since the role of OPN isoforms in AML angiogenesis are remaining controversial, in the present study, we aimed to evaluate whether curcumin (CUR), as a known natural component with anti-angiogenesis effects, in a combination of AML conventional regiment has the potency to preclude induced anti-angiogenesis effects of OPN isoforms or not? Leukemia cells were treated with different concentration of CUR </span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">and AML conventional drugs alone and/or in combination with together to find effective doses and IC50 values. </span></span><span style="font-size: small;">Percentages of apoptotic cells were evaluated by Annexin/PI staining and mRNA levels of OPN isoforms and AKT/ </span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">VEGF-A and VEGF-C/ STAT3/ β-catenin/ CXCR4/ IL-6/ KDR gene expression were investigated by Real Time-PCR method. Moreover, to confirm OPN gene expression data, we investigated the effect of simvastatin and OPN siRNA </span></span><span style="font-size: small;">as an OPN inhibitor on the cell proliferation and induction of apoptosis in the indicated cell lines. Our data display </span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">that Ara-c (2μM and 1μM in KG-1 and U937 cell lines respectively), CUR (40μM in both cell lines), and also their combination significantly increased the percentage of apoptotic cells. Moreover, the mRNA level of OPN isoforms were </span></span><span style="font-size: small;">down regulated in the KG-1and U937 cell lines treated with Ara-c while, upregulated in KG-1and U937 cell lines treated with CUR and its combination. Our results suggest that despite anti-angiogenesis effects of CUR, AML cells probably evade from anti-angiogenesis effects of CUR via induction of OPN b and c isoform and related molecular pathways. </span>