• Asian Pacific Journal of Cancer Prevention
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• v.14 no.5
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• pp.3017-3021
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• 2013

Background: Health Related Quality of Life (HRQoL) is an important aspect in identifying cancer patients' perceptions of being diagnosed with cancer and the assessment of treatment outcomes. The present study aimedto assess the profile and predicators of HRQoL of Malaysian oncology patients. Materials and Methods: A cross sectional study adopting the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) was conducted. All cancer patients attending Penang General Hospital between August-November 2011 were approached. Descriptive statistics were used to assess demographic and disease related characteristics of the patients. All analyses were performed using SPSS v 16.0. Results: Three hundred and ninety three cancer patients met the inclusion criteria and were enrolled in the study. The mean age was 53.9 ($SD{\pm}13$) years. The cohort was dominated by females (n=260, 66.2%). Nearly half (n=190, 48.3%) of the participants were of Malay ethnicity, practicing Islam as their religion (n=194, 494%). Two hundred and ninety six (n=296, 75.3%) had beene diagnosed with cancer within six months to 3 years previously. The most common primary cancer site was breast (n=143, 36.4%). The mean Global Health Status (GHS) score was 60.7 (SD=21.3). Females (mean GHS score of 62.3, p=0.035) with Malay ethnicity (mean GHS score of 63.8, p=0.047), practicing Islam as their religion (mean GHS score of 63.0, p=0.011) had better GHS scores. Patients having medical insurance had good scores (mean 65.6, p-0.021). Marital status was significantly associated with GHS scores (p=0.022). Bone cancer patientshad the lowest mean GHS score of 49.2 (p=0.044). Patients at very advanced stages of cancer featured a low GHS mean score of 52.2 (p<0.001). Conclusions: The present study identified many demographic and disease related factors which may contribute to the HRQoL of cancer patients, pointing to the necessity for improved management of disease symptoms and provision of psychological and financial support.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.5
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• pp.2991-2999
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• 2013

Background: Introduction of the HPV vaccine is a forefront primary prevention method in reducing the incidence of carcinogenic human papillomavirus (HPV) and cervical cancer. The Malaysia government has implemented the National HPV immunisation programme since 2010, supplying HPV vaccine free to targeted 13 year olds. This study aimed to explore the level of knowledge among mothers on cervical cancer, HPV, HPV vaccine and National HPV (NHPV) immunisation programme since its' implementation. It also assessed acceptance of mothers towards HPV vaccine being administered to their daughter, son or themselves. Materials and Methods: A cross sectional study was conducted on 155 respondents using self-administered questionnaires; conducted in December 2012 at the Obstetrics and Gynaecology Clinic in a teaching hospital in Kuala Lumpur. Respondents were selected using a multistage sampling technique. Results: A response rate of 100% was obtained. Overall, 51.0% of mothers had good knowledge, with 55% having good knowledge of cervical cancer, 54.2% for both HPV and the National HPV immunisation programme and 51.0% for the HPV vaccine. Regression analyses showed that ethnicity was associated with knowledge on cervical cancer (p=0.003) while education was associated with knowledge on HPV (p=0.049). Three factors are associated with knowledge of the National HPV immunisation programme; ethnicity (p=0.017), mothers' education (p=0.0005) and number of children (p=0.020). The acceptance of HPV vaccine to be administered among daughter was the highest at 87.1%, followed by for mothers themselves at 73.5%, and the least is for sons 62.6%. Conclusions: This study found that the overall level of knowledge was moderate. Adequate information on cervical cancer, HPV, HPV vaccination and the National HPV immunisation programme should be provided to mothers in order to increase acceptance of the HPV vaccine which can reduce the disease burden in the future.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.6
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• pp.3799-3804
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• 2013

Background: Colorectal cancer is the second most common cancer in Malaysia. The prognosis of the disease is excellent if detected at an early stage, but the majority of Malaysian patients present at late stages. We aimed to assess the awareness of cancer warning signs and anticipated delay in help-seeking as possible contributors to this phenomenon. Materials and Methods: A population-based cross-sectional survey using the Colorectal Cancer Awareness Measure was initiated in Perak, Malaysia. A total of 2,379 respondents aged 18 years and above were recruited using a multi-stage sampling in five locations. Analysis of covariance was used to examine independent sociodemographic predictors of scores for symptom awareness. Results: Younger age, being female, a higher education, and higher income were significantly associated with better scores for both recall and recognition of warning symptoms. Among the ethnic groups, Malays had better recognition of symptoms whereas Chinese recalled the most symptoms. Passing bloody stool was associated with the least anticipated delay and unexplained anal pain had the highest anticipated delay. Conclusions: The level of awareness across all ethnicities in Malaysia is generally low, especially among minorities. Targeted public education, which is culturally and linguistically appropriate, should be developed to encourage early help-seeking and improve clinical outcomes.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.10
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• pp.4797-4802
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• 2016

Background: Breast cancer (BC) is the top cancer among women worldwide and has been the most frequent malignancy among Kazakhstan women over the past few decades. Information on clinical and histopathological features of metastatic breast cancer (MBC), as well as the distribution of molecular subtypes is limited for Kazakh people. Materials and Methods: The present observational retrospective study was carried out at Regional Oncologic Dispensaries in the North-East Region of Kazakhstan (in Semey and Pavlodar cities). Сlinical and histopathological data were obtained for a total of 570 MBC patients in the 10 year period from 2004-2013, for whom data on molecular subtype were available for 253. Data from hospital charts were entered into SPSS 20 for analysis by one-way ANOVA analysis of associations of different variables with 1-5 year survival. Pearson correlation and linear regression models were used to examine the relation between parameters with a p-value < 0.05 considered statistically significant. Results: No significant relationships were evident between molecular subtype and survival, site of metastases, stage or ethnicity. Young females below the age of 44 were slightly more likely to have triple negative lesions. While the ductal type greatly predomonated, luminal A and B cases had a higher percentage with lobular morphology. Conclusions: In this select group of metastatice brease cancer, no links were noted for survival with molecular subtype, in contrast to much of the literature.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.2
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• pp.839-843
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• 2016

Background: Prostate cancer is second most common cancer in men overall in the world, whereas it is the third most common cancer in men and the sixth most common cancer in Iran. Few studies have been conducted on the epidemiology of prostate cancer in Iran. Since ethnicity of Iranian men is different from Asian people and given the epidemiologic and demographic transition taking place in Iran, this study aimed to investigate trends of incidence and morphology of prostate cancer during 2003 - 2008 in the country. Materials and Methods: Data were collected retrospectively reviewing all new prostate cancer patients in the Cancer Registry Center of the Health Deputy for Iran during a 6-year period. Also carcinoma, NOS and adenocarcinoma, NOS morphology were surveyed. Trends analysis of incidence and morphology was by joinpoint regression. Results: During the six years a total of 16,071 cases of prostate cancer were recorded in Iran. Most were adenocarcinomas at 95.2 percent. Trend analysis of incidence (ASR) There was a significant increase incidence, with annual percentage change (APC) of 17.3% and for morphology change percentage trends there was a significant decrease in adenocarcinoma with an APC of -1.24%. Conclusions: Prostate cancer is a disease of older men and the incidence is increasing in Iran. The most common morphology is adenocarcinoma this appears to be decreasing over time. Due to the changing lifestyles and the aging of the population, epidemiological studies and planning assessment of the etiology of prostate cancer and its early detection are essential.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.16
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• pp.6767-6772
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• 2014

Several studies have suggested associations between MDM2 (mouse double minute 2 homolog) polymorphisms and leukemia risk, but they reported contradictory results. For better understanding of the effect of MDM2 T309G polymorphism on leukemia risk, we performed a meta-analysis. All eligible studies were identified through a search of PubMed, Web of Science, EMBASE, and Chinese Biomedical Literature (CBM) databases before May 2014. Assessment of associations between the MDM2 T309G polymorphism and leukemia risk was conducted by odds ratios (ORs) and 95% confidence intervals (95% CIs). Finally, a total of 11 publications covering 12 case-control studies with 2, 362 cases and 5, 562 controls concerning MDM2 T309G polymorphism with respect to leukemia were included in the meta-analysis. Significant associations were found between MDM2 T309G polymorphism and leukemia risk in four models in overall populations (G vs T: OR=1.29, 95% CI=1.11-1.49, p=0.001; GG vs TT: OR=1.67, 95% CI=1.21-2.30, p=0.002; GG vs TG/TT: OR=1.56, 95% CI=1.21-2.00, p=0.001; GG/TG vs TT: OR=1.28, 95% CI=1.05-1.57, p=0.015). In the sub-group analysis according to ethnicity, increased leukemia risks were observed in three genetic models among Asians but not Caucasians. In conclusion, the results of our meta-analysis suggest that the MDM2 T309G polymorphism can increase the risk of leukemia, especially among Asian populations.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.6
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• pp.2571-2576
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• 2014

Background: Published studies on the association between the exonuclease 1 (EXO1) Glu589Lys polymorphism and cancer susceptibility have yielded conflicting results. Thus, a meta-analysis of published studies was performed to assess the possible association. Materials and Methods: All eligible case-control studies published up to January 2013 on the association between the EXO1 Glu589Lys polymorphism and cancer susceptibility were identified by searching PubMed, Web of Science, Science Direct and hand search. Either fixed-effect or random-effect models were used to calculate pooled odds ratios (ORs) with 95% confidence intervals (CIs) using the Comprehensive Meta-Analysis software version 2.2. Results: A total of 4,391 cancer cases and 4,339 controls from 10 studies were included. Overall, no significant association between the EXO1 Glu589Lys polymorphism and cancer susceptibility was observed in either genetic model. However; in subgroup analyses by cancer type, a significant association between EXO1 Glu589Lys and lung cancer risk was found (Lys vs Glu: OR=1.23, 95%CI=1.07-1.41, $p_{heterogeneity}$=0.05). Further, subgroup analysis by ethnicity indicated that there was a statistically increased cancer risk in Asians (Lys vs Glu: OR=1.42, 95%CI=1.30-1.55, $p_{heterogeneity}$=0.07; Lys/Lys vs Glu/Glu: OR=1.93, 95%CI=1.20-3.12, $p_{heterogeneity}$=0.01; Lys/Lys+Glu/Lys vs Glu/Glu: OR=1.52, 95%CI=1.37-1.68, $p_{heterogeneity}$=0.42; Lys/Lys vs Glu/Lys+Glu/Glu: OR=1.68, 95%CI=1.07-2.65, $p_{heterogeneity}$=0.02). However, significant association was absent in Caucasians. Conclusions: This meta-analysis suggests, for the first time, that the EXO1 Glu589Lys polymorphism is not associated with overall cancer susceptibility, although marginal associations were found for lung cancer and Asian subgroups. Additional well-designed studies with larger sample size focusing on different ethnicities and cancer types are needed to confirm these findings.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.12
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• pp.7149-7154
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• 2013

Objective: Increasing scientific evidence suggests that common variants in the PALB2 gene may confer susceptibility to breast cancer, but many studies have yielded inconclusive results. This meta-analysis aimed to derive a more precise estimation of the relationship between PALB2 genetic variants and breast cancer risk. Methods: An extensive literary search for relevant studies was conducted in PubMed, Embase, Web of Science, Cochrane Library, CISCOM, CINAHL, Google Scholar, CNKI and CBM databases from their inception through September 1st, 2013. A meta-analysis was performed using the STATA 12.0 software and crude odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Results: Six case-control studies were included with a total of 4,499 breast cancer cases and 6,369 healthy controls. Our meta-analysis reveals that PALB2 genetic variants may increase the risk of breast cancer (allele model: OR>1.36, 95%CI: 1.20~1.52, P < 0.001; dominant model: OR>1.64, 95%CI: 1.42~1.91, P < 0.001; respectively). Subgroup analyses by ethnicity indicated PALB2 genetic variants were associated with an increased risk of breast cancer among both Caucasian and Asian populations (all P < 0.05). No publication bias was detected in this meta-analysis (all P > 0.05). Conclusion: The current meta-analysis indicates that PALB2 genetic variants may increase the risk of breast cancer. Thus, detection of PALB2 genetic variants may be a promising biomarker approach.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.3
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• pp.1077-1082
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• 2016

Background: The three standard biomarkers used in breast cancer are the estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2). The Ki-67 index, a proliferative marker, has been shown to be associated with a poorer outcome, and despite absence of standardization of pathological assessment, is widely used for therapy decision making. We aim to study the role of the Ki-67 index in a group of Asian women with breast cancer. Materials and Methods: A total of 450 women newly diagnosed with Stage 1 to 3 invasive breast cancer in a single centre from July 2013 to Dec 2014 were included in this study. Univariable and multivariable logistic regression was used to determine the association between Ki-67 (positive defined as 14% and above) and age, ethnicity, grade, mitotic index, ER, PR, HER2, lymph node status and size. All analyses were performed using SPSS Version 22. Results: In univariable analysis, Ki -67 index was associated with younger age, higher grade, ER and PR negativity, HER2 positivity, high mitotic index and positive lymph nodes. However on multivariable analysis only tumour size, grade, PR and HER2 remained significant. Out of 102 stage 1 patients who had ER positive/PR positive/HER2 negative tumours and non-grade 3, only 5 (4.9%) had a positive Ki-67 index and may have been offered chemotherapy. However, it is interesting to note that none of these patients received chemotherapy. Conclusions: Information on Ki67 would have potentially changed management in an insignificant proportion of patients with stage 1 breast cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.4
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• pp.1111-1113
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• 2012

The ER-/PR+ breast tumor may be the result of a false ER negative result. The aim of this study was to investigate whether there is a difference in patient and tumor characteristics of the ER-/PR+ phenotype in an Asian setting. A total of 2629 breast cancer patients were categorized on the basis of their age, ethnicity, tumor hormonal receptor phenotype, grade and histological type. There were 1230 (46.8%) ER+/PR+, 306 (11.6%) ER+/PR-, 122 (4.6%) ER-/PR+ and 972 (37%) ER-/PR-. ER-/PR+ tumors were 2.5 times more likely to be younger than 50 years at diagnosis (OR: 2.52; 95% CI: 1.72-3.67). Compared to ER+/PR+ tumors, the ER-/PR+ phenotype was twice more likely to be associated with grade 3 tumors (OR:2.02; 95%CI: 1.00-4.10). In contrast, compared to ER-/PR- tumors, the ER-/PR+ phenotype was 90% less likely to be associated with a grade 3 tumor (OR: 0.12; 95%CI:0.05-0.26), and more likely to have invasive lobular than invasive ductal histology (OR: 3.66; 95%CI: 1.47-9.11). These results show that the ER-/PR+ phenotype occurs in a younger age group and is associated with intermediate histopathological characteristics compared to ER+/PR+ and ER-/PR- tumors. This may imply that it is a distinct entity and not a technical artifact.