• Asian Pacific Journal of Cancer Prevention
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• v.15 no.14
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• pp.5523-5528
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• 2014

Objective: To evaluate the implementation of screening colonoscopy amongst first-degree relatives (FDRs) of patients with colorectal cancer (CRC) in Turkey. Materials and Methods: A total of 400 first-degree relatives (mean(SD)age: 42.5(12.7) years, 55.5% were male) of 136 CRC patients were included in this cross-sectional questionnaire based survey. Data on demographic characteristics, relationship to patient and family history for malignancy other than the index case were evaluated in the FDRs of patients as were the data on knowledge about and characteristics related to the implementation of screening colonoscopy using a standardized questionnaire form. Results: The mean(SD) age at diagnosis of CRC in the index patients was 60.0(14.0) years, while mean(SD) age of first degree relatives was 42.5(12.7) years. Overall 36.3% of relatives were determined to have knowledge about colonoscopy. Physicians (66.9%) were the major source of information. Screening colonoscopy was recommended to 19.5% (n=78) of patient relatives, while 48.7% (n=38) of individuals participated in colonoscopy procedures, mostly (57.9%) one year after the index diagnosis. Screening colonoscopy revealed normal findings in 25 of 38 (65.8%) cases, while precancerous lesions were detected in 26.3% of screened individuals. In 19.0% of FDRs of patients, there was a detected risk for Lynch syndrome related cancer. Conclusions: In conclusion, our findings revealed that less than 20% of FDRs of patients had received a screening colonoscopy recommendation; only 48.7% participated in the procedure with detection of precancerous lesions in 26.3%. Rise of awareness about screening colonoscopy amongst patients with CRC and first degree relatives of patients and motivation of physicians for targeted screening would improve the participation rate in screening colonoscopy by FDRs of patients with CRC in Turkey.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.20
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• pp.8801-8807
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• 2014

Purpose: The aim of the study was to evaluate knowledge, attitudes and behaviors of Turkish women over 20 years old on cervix cancer. Materials and Methods: This descriptive study was performed at a primary care center covering 246 women using a questionnaire composed of 3 sections and 38 questions. The data were analyzed using descriptive statistics, chi-square test in univariate analysis and multivariate hierarchical logistic regression analysis. Results: Of the 93.7% women who knew about cervical cancer, 68.0% of them had heard pap smear test and 46.1% had actually undergone a Pap smear once or more throughout their lives. According to the results of the hierarchical logistic regression analysis about factors affecting the Pap smear test; in Model 1, increase in age and education levels, in Model 2 and Model 3 increase in age and cervical cancer information points were determined. The most important information source for cervical cancer was TV-radio/media (59.9%) and health care workers (62.8%) for pap smear test. Conclusions: Although most women have heard of cervical cancer, knowledge about cervical cancer and also Pap smear screening rate are significantly lower. Having Pap smear test for women was affected by age and knowledge level about cervical cancer. Informing women about cervical cancer would be an important intervention.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.5
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• pp.3029-3035
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• 2013

Background: Most developing countries have been unable to implement well-organized health care systems, especially comprehensive Pap smear screening-based programs. One of the reasons for this is regional differences in medical services, and a low-cost portable cervical screening system is necessary. To improve regional discrepancies in cervical screening systems, we investigated the usefulness and acceptability of cervical selfsampling by liquid-based cytology (LBC) for 290 volunteers in the Lao PDR. Materials and Methods: Following health education with comprehensive documents, cervical self-sampling kits by LBC were distributed in three provincial, district, and village areas to a total of 290 volunteers, who were asked to take cytology samples by themselves. Subsequently, the acceptability of self-sampling was evaluated using a questionnaire. Results: The documents were well understood in all three regions. Regarding the acceptability of self-sampling, the selections for subsequent screening were 62% self-sampling, 36% gynecologist-sampling, 1% either method, and 1% other methods. The acceptability rates were higher in the district and the village than in the province. For the relationship between acceptability and pregnancy, the self-sampling selection rate was higher in the pregnancy-experienced group (75%) than in the pregnancy-inexperienced group (60%). For the relationship between selection of self-sampling and experience of screening, the self-sampling selection rate was higher in the screening-inexperienced group (62%) than in the screening-experienced group (52%). Conclusions: Our data show that this new way forward, involving a combination of self-sampling and LBC, is highly acceptable regardless of age, educational background, and residence in rural areas in a developing country.

• Korean Journal of Radiology
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• v.24 no.4
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• pp.274-283
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• 2023

Objective: To compare the outcomes of digital breast tomosynthesis (DBT) screening combined with ultrasound (US) with those of digital mammography (DM) combined with US in women with dense breasts. Materials and Methods: A retrospective database search identified consecutive asymptomatic women with dense breasts who underwent breast cancer screening with DBT or DM and whole-breast US simultaneously between June 2016 and July 2019. Women who underwent DBT + US (DBT cohort) and DM + US (DM cohort) were matched using 1:2 ratio according to mammographic density, age, menopausal status, hormone replacement therapy, and a family history of breast cancer. The cancer detection rate (CDR) per 1000 screening examinations, abnormal interpretation rate (AIR), sensitivity, and specificity were compared. Results: A total of 863 women in the DBT cohort were matched with 1726 women in the DM cohort (median age, 53 years; interquartile range, 40-78 years) and 26 breast cancers (9 in the DBT cohort and 17 in the DM cohort) were identified. The DBT and DM cohorts showed comparable CDR (10.4 [9 of 863; 95% confidence interval {CI}: 4.8-19.7] vs. 9.8 [17 of 1726; 95% CI: 5.7-15.7] per 1000 examinations, respectively; P = 0.889). DBT cohort showed a higher AIR than the DM cohort (31.6% [273 of 863; 95% CI: 28.5%-34.9%] vs. 22.4% [387 of 1726; 95% CI: 20.5%-24.5%]; P < 0.001). The sensitivity for both cohorts was 100%. In women with negative findings on DBT or DM, supplemental US yielded similar CDRs in both DBT and DM cohorts (4.0 vs. 3.3 per 1000 examinations, respectively; P = 0.803) and higher AIR in the DBT cohort (24.8% [188 of 758; 95% CI: 21.8%-28.0%] vs. 16.9% [257 of 1516; 95% CI: 15.1%-18.9%; P < 0.001). Conclusion: DBT screening combined with US showed comparable CDR but lower specificity than DM screening combined with US in women with dense breasts.

• Korean Journal of Health Education and Promotion
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• v.30 no.4
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• pp.99-110
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• 2013

Objectives: This study aimed to investigate factors related to prostate disease and follow-up procedure on health examination program in Gangwon-do. Methods: The studied population was 16,501 male aged 40 or more, who underwent screening tests for prostatic disease in 2011 health examination program designed for the low income residents in Gangwon-do. The screening tests included prostate specific antigen (PSA), international symptom score (IPSS), and maximal flow rate (Qmax). We conducted chi-square test for trend, two independent samples t-test, and binary logistic regression to find out the relationship between prostate cancer or benign prostatic hyperplasia and risk factors such as age, PSA level, and IPSS. Results: The number of subjects who turned out positive for PSA level (> 3.8ng/ml) was 971 men accounting for 5.9%. The result of post survey on them showed that 511 subjects (52.6%) got the urology check-up: 156 (30.5%) were diagnosed as normal, 286 (56.0%) as benign prostatic hyperplasia, and 69 (13.5%) as prostate cancer. The detection rate for prostate cancer was 8.8% when PSA level was between 3.81 and 9.99g/ml, and was 30.6% when PSA level was more than 10.00ng/ml. The rates of further testing varied depending on the communities from 26.7% to 68.2%, which was mainly affected by the role of local health center. Conclusions: Our findings indicate that enhanced quality control of local health center and empowerment of screening agency would increase the effort of coupled institutions between public and private sectors.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.14
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• pp.5627-5631
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• 2014

Background: Oral cancer presents with high mortality rates, and the likelihood of survival is remarkably superior when detected early. Dental professionals have an important role and responsibility in prevention and early detection of oral cancer. Purpose: The aim of this study was to assess the knowledge, practices and opinions regarding oral cancer among dentists in Yemen. Materials and Methods: A cross-sectional survey was conducted using a self-administered questionnaire involving private and public dental practitioners, working in different governorates in Yemen. Results: Of the 800 dentists surveyed, a total of 221 questionnaires were completed and returned (response rate 27.6%). A vast majority of dentists (96.38%) identified tobacco as the major risk factor for oral cancer, and 82.8% knew that squamous cell carcinoma is the most common form. While 47.1% of the dentists agreed that they were adequately trained in oral cancer screening, the majority (86%) believed that they need further training in oral cancer screening. Conclusions: These results suggest that additional training and continuing educational programs on prevention and early detection of oral cancer for dentists are to be highly recommended.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.12
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• pp.7657-7661
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• 2013

Background: This study concerns uptake and results of colorectal cancer (CRC) screening of government servant as part of the Health Screening Program that was conducted in Brunei Darussalam in 2009. Materials and Methods: Government servants above the age of 40 or with family history of CRC were screened with a single fecal occult blood test (FIT, immunohistochemistry). Among 11,576 eligible subjects, 7,360 (66.9%) returned their specimen. Subjects with positive family history of CRC (n=329) or polyps (n=135) were advised to attend clinics to arrange screening. All the subjects with positive FIT (n=142, 1.9%) were referred to the endoscopy unit for counselling for screening colonoscopy. Results: Overall only 17.7% of eligible subjects attended for screening; 54.9% (n=79/142) of positive FIT, 8.8% (n=29/329) of positive family history of CRC and none with history of polyps (n=0/135). Of these, only 54 patients (50.5%) agreed for colonoscopy, 52 (48.6%) declined as they were asymptomatic, and one was not offered (0.9%) due to his very young age. On screening colonoscopy, 12.9% (n=7) had advanced lesions including a sigmoid carcinoma in situ and six advanced polyps. The other findings included non advanced polyps (n=21), diverticular (n=11) and hemorrhoids (n=26). One patient who missed his screening colonoscopy appointment re-presented two years later and was diagnosed with advanced right sided CRC. All the advanced lesions were detected in patients with positive FIT, giving a yield of 20.5% for advanced lesions including cancers in the 5.1% FIT positive subjects. Conclusions: Our study showed screening for CRC even with a single FIT was effective. However, the uptake rate was poor with just over half of the patients agreeing to screening colonoscopy. Measures to increase public awareness are important. Since one limitation of our study was the relatively small sample size, larger studies should be conduced in future.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.11
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• pp.6227-6231
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• 2013

In the past, hepatitis B virus (HBV) infection was endemic in the general Korean population. The association of HBV infection with the occurrence of liver cancer has been well demonstrated in several epidemiologic studies. While the mortality rates of liver cancer in Korea have decreased steadily over the last decade, the presence of hepatitis B surface antigen (HBsAg) in mothers remains high at 3-4%, and 25.5% of these HBsAg positive mothers are positive for hepatitis B e antigen (HBeAg). HBV infection caused almost a quarter of hepatocellular carcinoma (HCC) cases and one-third of deaths from HCC. These aspects of HBV infection prompted the Korean government to create a vaccination program against HBV in the early 1980s. In 1995, the Communicable Disease Prevention Act (CDPA) was reformed, and the government increased the number of HBV vaccines in the National Immunization Program (NIP), driving the vaccination rate up to 95%. In 2000, the National Health Insurance Act (NHIA) was enacted, which provided increased resources for the prevention of perinatal HBV infection. Then in 2002, the Korean government, in conjunction with the Korean Medical Association (KMA), launched an HBV perinatal transmission prevention program. The prevalence of HBsAg in children had been high (4-5%) in the early 1980s, but had dropped to below 1% in 1995, and finally reached 0.2% in 2006 after the NIP had been implemented. After the success of the NIP, Korea finally obtained its first certification of achievement from the Western Pacific Regional Office of the World Health Organization (WPRO-WHO) for reaching its goal for HBV control. An age-period-cohort analysis showed a significant reduction in the liver cancer mortality rate in children and adolescents after the NIP had been implemented. In addition to its vaccination efforts, Korea launched the National Cancer Screening Program (NCSP) for 5 leading sites of cancer, including the liver, in 1999. As a consequence of this program, the 5-year liver cancer survival rate increased from 13.2% (1996-2000) to 23.3% (2003-2008). The development of both the primary and secondary prevention for liver cancer including HBV immunization and cancer screening has been of critical importance.

• Research in Community and Public Health Nursing
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• v.33 no.2
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• pp.237-246
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• 2022

Purpose: The aim of this study was to investigate the relationship between the 5-year survival rate, socioeconomic status, and SEER (Surveillance Epidemiology and End Results) stage of stomach, colorectal, breast and cervical cancer patients. Methods: A total of 11,770 cases of four target cancers, which were diagnosed during 2005-2007, were extracted from the database of Gwangju-Jeonnam Regional Cancer Registry. The subjects of the study were 11,770 including stomach (n=5,479), colorectal (n=3,565), breast (n=1,516) and cervical cancers (n=710). Cox's proportional hazards model was used to obtain the hazards ratio (HR) according to the SEER stage and socioeconomic status. Results: Stomach cancer had a significantly higher HR in the medical aid recipients (HR=1.39), and the group below 20% (HR=1.20) compared to the group with the highest income level. Colorectal cancer had a significantly higher HR in the medical aid recipients (HR=1.26) than in the group with the highest income level. In addition, stomach, colorectal, breast and cervical cancers had a significantly higher HR according to the SEER stage in regional direct (stomach=4.10, colorectal=1.76, breast=12.90, cervical=3.10), regional lymph only(stomach=2.58, colorectal=2.33, breast=4.32, cervical=4.43), regional both (stomach=6.74 colorectal=3.04, breast=15.57 cervical=6.50), and regional NOS (Not Otherwise Specified)/distant (stomach=17.53, colorectal=11.53, breast=25.34, cervical=26.51) than in situ and localized only. Conclusion: In order to increase the cancer survival rate, a support system for early detection and early treatment of cancer should be established for groups with low individual income levels, and regular health checkups and management measures should be actively implemented through the National Cancer Screening Program.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.1
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• pp.215-220
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• 2014

Objective: To determine the expression of E-cadherin, ${\beta}$-catenin, and transcription factor 4 (TCF4) proteins in gastric diseases with relation to Helicobacter pylori infection. Methods: A total of 309 patients including 60 with superficial gastritis (SG), 57 with atrophic gastritis (AG) and 192 with gastric cancer (GC), were enrolled. The expression of E-cadherin, ${\beta}$-catenin, TCF4 proteins in the gastric mucosa was detected by immunohistochemistry and H. pylori infection by immunohistochemistry and PCR. Results: The expression rates of E-cadherin were significantly higher in SG and AG than in GC (P<0.01), while those of ${\beta}$-catenin in the nucleus were significantly lower in SG and AG than in GC (P<0.05). In GC cases, the expression rates of E-cadherin, ${\beta}$-catenin and TCF4 were significantly higher in the intestinal type than in the diffuse type (P<0.05). In GC patients, the expression rate of E-cadherin was significantly higher in the presence of H. pylori than in the absence of infection (P=0.011). Moreover, the expression level of TCF4 and ${\beta}$-catenin protein was significantly higher in the nucleus and cytoplasm in H. pylori positive than in H. pylori negative GC patients, especially in those with the intestinal type (all P < 0.05). Conclusion: The expression of E-cadherin and ${\beta}$-catenin progressively decreases during the process of GC tumorigenesis, while overexpression of TCF4 occurs. H. pylori infection is associated with a significant increase in the expression of E-cadherin and ${\beta}$-catenin in the cytoplasm and nucleus in GC patients, especially those with the intestinal type.