• Journal of Radiation Protection and Research
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• 제42권2호
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• pp.130-140
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• 2017

Background: With the need for a domestic level 3 probabilistic safety assessment (PSA), it is essential to develop a Korea-specific code. Health effect assessments study radiation-induced impacts; in particular, long-term health effects are evaluated in terms of cancer risk. The objective of this study was to analyze the latest cancer risk models developed by foreign organizations and to compare the methodology of how they were developed. This paper also provides suggestions regarding the development of Korean cancer risk models. Materials and Methods: A review of cancer risk models was carried out targeting the latest models: the NUREG model (1993), the BEIR VII model (2006), the UNSCEAR model (2006), the ICRP 103 model (2007), and the U.S. EPA model (2011). The methodology of how each model was developed is explained, and the cancer sites, dose and dose rate effectiveness factor (DDREF) and mathematical models are also described in the sections presenting differences among the models. Results and Discussion: The NUREG model was developed by assuming that the risk was proportional to the risk coefficient and dose, while the BEIR VII, UNSCEAR, ICRP, and U.S. EPA models were derived from epidemiological data, principally from Japanese atomic bomb survivors. The risk coefficient does not consider individual characteristics, as the values were calculated in terms of population-averaged cancer risk per unit dose. However, the models derived by epidemiological data are a function of sex, exposure age, and attained age of the exposed individual. Moreover, the methodologies can be used to apply the latest epidemiological data. Therefore, methodologies using epidemiological data should be considered first for developing a Korean cancer risk model, and the cancer sites and DDREF should also be determined based on Korea-specific studies.

• Asian Pacific Journal of Cancer Prevention
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• 제17권12호
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• pp.5107-5111
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• 2016

Background: Epidemiological studies have indicated an increasing incidence of radiation induced secondary cancer (SC) in breast cancer patients after radiotherapy (RT), most commonly in the contra-lateral breast (CLB). The present study was conducted to estimate the SC risk in the CLB following 3D conformal radiotherapy techniques (3DCRT) including wedge field and forward intensity modulated radiotherapy (fIMRT) based on the organ equivalent dose (OED). Material and Methods: RT plans treating the chest wall with conformal wedge field and fIMRT plans were created for 30 breast cancer patients. The risks of radiation induced cancer were estimated for the CLB using dose-response models: a linear model, a linear-plateau model and a bell-shaped model with full dose response accounting for fractionated RT on the basis of OED. Results: The plans were found to be ranked quite differently according to the choice of model; calculations based on a linear dose response model fIMRT predict statistically significant lower risk compared to the enhanced dynamic wedge (EDW) technique (p-0.0089) and a non-significant difference between fIMRT and physical wedge (PW) techniques (p-0.054). The widely used plateau dose response model based estimation showed significantly lower SC risk associated with fIMRT technique compared to both wedge field techniques (fIMRT vs EDW p-0.013, fIMRT vs PW p-0.04). The full dose response model showed a non-significant difference between all three techniques in the view of second CLB cancer. Finally the bell shaped model predicted interestingly that PW is associated with significantly higher risk compared to both fIMRT and EDW techniques (fIMRT vs PW p-0.0003, EDW vs PW p-0.0032). Conclusion: In conclusion, the SC risk estimations of the CLB revealed that there is a clear relation between risk associated with wedge field and fIMRT technique depending on the choice of model selected for risk comparison.

• Asian Pacific Journal of Cancer Prevention
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• 제17권8호
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• pp.3741-3745
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• 2016

Background: This study was carried out to examine breast cancer risk and its fertility predictors in women aged ${\geq}35$. Materials and Methods: This cross-sectional study was conducted on 560 healthy women referred to health centers of Tabriz-Iran, 2013-2014. Five-year and lifetime risk of developing breast cancer were determined using the Gail model. General linear modeling was applied to determine breast cancer predictors. Results: The mean age of the subjects was 42.7 (SD: 7.7) years. Mean 5-year and lifetime risks of developing breast cancer were determined to be 0.6% (SD: 0.2%) and 8.9% (SD: 2.5%), respectively. Variables of family history of breast cancer, age, age at menarche, parity, age at first childbirth, breastfeeding history, frequency of breastfeeding, method of contraception, marital status and education were all found to be predictors of breast cancer risk. Conclusions: According to the results of this study, screening programs based on the Gail model should be implemented for Iranian people who have a high risk for breast cancer in order to facilitate early detection and better plan for possible malignancies.

• Asian Pacific Journal of Cancer Prevention
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• 제13권1호
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• pp.111-115
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• 2012

Variants of X-ray repair cross-complementing group 1 (XRCC1) are involved in the development of cancer, but studies investigating the association of XRCC1-77T>C polymorphism with cancer risk have reported conflicting results. To clarify the effect of the XRCC1 -77T>C polymorphism on cancer risk, we performed a meta-analysis by conducting searches of the published literature in PubMed, Embase and CBM databases. Finally, 13 studies were included into our meta-analysis, involving a total of 11, 678 individuals. Subgroup analyses were performed by ethnicity and cancer type. The results of this meta-analysis showed that there was significant association between the C variant of XRCC1-77T>C polymorphism and cancer risk in all four genetic comparison models (ORC vs. T =1.19, 95%CI 1.07-1.31, P = 0.001; OR homozygote model =1.28, 95%CI 1.07-1.52, P = 0.007; OR recessive genetic model =1.22, 95%CI 1.04-1.44, P = 0.015; OR dominant model =1.21, 95% CI 1.07-1.35, P = 0.001). In the subgroup analyses based on ethnicity, the association was still significant in the Asian population (all p values<0.001), but not in the Caucasian population (all p values > 0.05). Thus, the XRCC1 -77T>C polymorphism is associated with cancer risk, and individuals with XRCC1 -77C variant have a significantly higher cancer risk, particularly in the Asian population.

• Asian Pacific Journal of Cancer Prevention
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• 제16권5호
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• pp.1759-1764
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• 2015

Purpose: To establish the concept of lung cancer hazard assessment theoretical models, evaluating the degree of lung cancer risk of Beijing for regional population lung cancer hazard assessment to provide a basis for technical support. Materials and Methods: ISO standards were used to classify stratified analysis for the entire population, life cycle, processes and socioeconomic management. Associated risk factors were evaluated as lung cancer hazard risk assessment first class indicators. Study design: Using the above materials, indicators were given the weight coefficients, building lung cancer risk assessment theoretical models. Regional data for Beijing were entered into the theoretical model to calculate the parameters of each indicator and evaluate the degree of local lung cancer risk. Results: Adopting the concept of lung cancer hazard assessment and theoretical models for regional populations, we established a lung cancer hazard risk assessment system, including 2 first indicators, 8 secondary indicators and 18 third indicators. All indicators were given weight coefficients and used as information sources. Score of hazard for lung cancer was 84.4 in Beijing. Conclusions: Comprehensively and systematically building a lung cancer risk assessment theoretical model for regional populations in conceivable, evaluating the degree of lung cancer risk of Beijing, providing technical support and scientific basis for interventions for prevention.

• Journal of Preventive Medicine and Public Health
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• 제46권2호
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• pp.74-81
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• 2013

Objectives: The objective of this study was to evaluate the performance of risk-adjusted mortality models for colorectal cancer surgery. Methods: We investigated patients (n=652) who had undergone colorectal cancer surgery (colectomy, colectomy of the rectum and sigmoid colon, total colectomy, total proctectomy) at five teaching hospitals during 2008. Mortality was defined as 30-day or in-hospital surgical mortality. Risk-adjusted mortality models were constructed using claims data (basic model) with the addition of TNM staging (TNM model), physiological data (physiological model), surgical data (surgical model), or all clinical data (composite model). Multiple logistic regression analysis was performed to develop the risk-adjustment models. To compare the performance of the models, both c-statistics using Hanley-McNeil pair-wise testing and the ratio of the observed to the expected mortality within quartiles of mortality risk were evaluated to assess the abilities of discrimination and calibration. Results: The physiological model (c=0.92), surgical model (c=0.92), and composite model (c=0.93) displayed a similar improvement in discrimination, whereas the TNM model (c=0.87) displayed little improvement over the basic model (c=0.86). The discriminatory power of the models did not differ by the Hanley-McNeil test (p>0.05). Within each quartile of mortality, the composite and surgical models displayed an expected mortality ratio close to 1. Conclusions: The addition of clinical data to claims data efficiently enhances the performance of the risk-adjusted postoperative mortality models in colorectal cancer surgery. We recommended that the performance of models should be evaluated through both discrimination and calibration.

• Asian Pacific Journal of Cancer Prevention
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• 제17권8호
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• pp.3759-3762
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• 2016

Background: Breast cancer risk assessment is a helpful method for estimating development of breast cancer at the population level. Materials and Methods: In this cross-sectional study, participants consisted of a group of 3,847 volunteers ($mean{\pm}SD$ age: $463{\pm}7.59$ years) in a convenience sample of women referred to health centers affiliated to Tehran University of Medical Sciences in Tehran, Iran. The risk of breast cancer was estimated by applying the National Cancer Institute's online version of the Gail Risk Assessment Tool. Results: Some 24.9% of women reported having one first-degree female relative with breast cancer, with 8.05% of them having two or more first-degree relatives with breast cancer. The mean five-year risk of breast cancer for all participants was $1.61{\pm}0.73%$, and 9.36% of them had a five-year risk of breast cancer >1.66%. The mean lifetime risk of breast cancer was $11.7{\pm}3.91%$. Conclusions: The Gail model is useful for assessing probability of breast cancer in Iranian women. Based on the their breast cancer risk, women may decide to accept further screening services.

• Asian Pacific Journal of Cancer Prevention
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• 제15권6호
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• pp.2889-2892
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• 2014

Death receptor 4 (TRAIL-R1 or DR4) polymorphisms have been associated with cancer risk, but findings have been inconsistent. To estimate the relationship in detail, a meta-analysis was here performed. A search of PubMed was conducted to investigate the association between DR4 C626G, A683C and A1322G polymorphisms and cancer risk, using odds ratios (ORs) with 95% confidence intervals. The results suggested that DR4 C626G and A683C polymorphisms were indeed associated with cancer risk (for C626G, dominant model, OR 0.991, 95%CI 0.866-1.133, p=0.015; for A683C, additive model, OR=1.140, 95%CI: 0.948-1.370, p=0.028; dominant model, OR=1.156, 95%CI: 0.950-1.406, p=0.080) in the Caucasian subgroup. However, the association was not significant between DR4 polymorphism A1322G with cancer risk in Caucasians (For A1322G, additive model: OR 1.085, 95%CI 0.931-1.289, p=0.217; dominant model: OR 1.379, 95%CI 0.934-2.035, p=0.311; recessive model: OR 1.026, 95%CI 0.831-1.268 p=0.429.). In summary, our finding suggests that DR4 polymorphism C626G and A683 rather than A1322G are associated with cancer risk in Caucasians.

• Asian Pacific Journal of Cancer Prevention
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• 제14권4호
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• pp.2337-2342
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• 2013

Meta-analyses have shown that microRNA polymorphisms have variable effects in different population. Yet, no meta-analysis investigated the association of two common polymorphisms of miRNA, mir-499 rs3746444 polymorphism and mir-149 rs2292832 polymorphism, with cancer risk in the Chinese population. We searched the PubMed, Web of Knowledge, MEDLINE, CNKI databases, as well as Cochrane library, updated on December 31, 2012 for assays regarding cancer risk association with these two common polymorphisms in the present meta-analysis. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were used to explore the strength of associations. The results showed that rs3746444 polymorphism was associated with increased cancer risk (dominant model: GG/AG vs. AA: OR = 1.43, 95% CI: 1.14-1.80; recessive model: GG vs. AG/AA: OR = 1.54, 95% CI: 1.04-2.30; homozygote model: GG vs. AA: OR = 1.69, 95% CI: 1.10-2.60; heterozygote model: AG vs. AA: OR = 1. 35, 95% CI: 1.09-1.67), and rs3746444 was associated with liver cancer in the subgroup of cancer types. For the rs2292832 polymorphism, the results showed no significant risk association in both overall pooled analysis and subgroup of cancer types, smoking status, gender and tea drinking status in the Chinese population. This meta-analysis suggested that the rs3746444 GG genotype is associated with increased cancer risk, especially liver cancer, while the rs2292832 polymorphism showed no association with cancer risk in Chinese.

• Asian Pacific Journal of Cancer Prevention
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• 제14권5호
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• pp.3281-3288
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• 2013

Background: Breast cancer is the leading cause of cancer-related deaths in women. Despite being associated with high morbidity and mortality, breast cancer is a disease that can be diagnosed and treated early. Materials and Methods: In this cross-sectional study of 321 women, data were collected by Questionnaire, Breast Cancer Risk Assessment Form and Champion's Health Belief Model Scale. Mann-Whitney U, Kruskal-Wallis, Chisquared tests and logistic regression were used in the statistical analysis. Results: It was found that only 2.2% of women have high and very high risk levels of breast cancer risk. There is a positive correlation between early diagnosis techniques and Health Belief Model Sub-Dimension scores which are sensibility, health motivation, BSE (Breast self-examination) self-efficient perception and negative correlation between mammography barrier score and BSE barrier score (p 0.05). When factors for not having BSE were examined, it was determined that the women who do not have information about breast cancer and the women who smoke have a higher risk of not having BSE. Conclusions: It is important to determine health beliefs and breast cancer risk levels of women to increase the frequency of early diagnosis. Women's health beliefs are thought to be a good guide for planning health education programs for nurses working in this area.