• Asian Pacific Journal of Cancer Prevention
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• v.13 no.8
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• pp.3645-3651
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• 2012

Conventional pap smear (CPS) examination has been the mainstay for early detection of cervical cancer. However, its widespread use has not been possible due to the inherent limitations, like presence of obscuring blood and inflammation, reducing its sensitivity considerably. Automated methods in use in developed countries may not be affordable in the developing countries due to paucity of resources. On the other hand, manual liquid based cytology (MLBC) is a technique that is cost effective and improves detection of precursor lesions and specimen adequacy. Therefore the aim of the study was to compare the utility of MLBC with that of CPS in cervical cancer screening. A prospective study of 100 cases through MLBC and CPS was conducted from October 2009 to July 2010, in a Medical College in India, by two independent pathologists and correlated with histopathology (22 cases). Morphological features as seen through MLBC and CPS were compared. Subsequently, all the cases were grouped based on cytological diagnosis according to two methods into 10 groups and a subjective comparison was made. In order to compare the validity of MLBC with CPS in case of major diagnoses, sensitivity and specificity of the two methods were estimated considering histological examination as the gold standard. Increased detection rate with MLBC was 150%. The concordance rate by LBC/histopathology v/s CPS/histopathology was also improved (86% vs 77%) The percentage agreement by the two methods was 68%. MLBC was more sensitive in diagnosis of LSIL and more specific in the diagnosis of inflammation. Thus, MLBC was found to be better than CPS in diagnosis of precursor lesions. It provided better morphology with increased detection of abnormalities and preservation of specimen for cell block and ancillary studies like immunocytochemistry and HPV detection. Therefore, it can be used as alternative strategy for cervical cancer prevention in limited resource settings.

• Korean Journal of Bronchoesophagology
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• v.7 no.2
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• pp.152-160
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• 2001

The presence of HPV DNA and the expression of p53 protein and proliferating cell nuclear antigen(PCNA) in head and neck squamous cell carcinoma were determined to evaluate the relationship of these factors and their association with their pathologic stages and cervical lymph node metastasis. Among 65 patients the presence of HPV DNA was found in 12 cases(18.5%), p53 was found positive in 32 cases(49.2%) and expression of PCNA was observed in 24 cases(36.9%). The expression of PCNA was more frequent in the HPV positive cancers compared with the HPV negative ones(p =0.0018), and p53 revealed its higher rate of cooccurrence with the expression of PCNA(p =0.008), which might suggest that PCNA expression has a positive relationship with HPV and p53 mutation in head and neck cancer. There might be inverse relationship between HPV and p53 mutation(p =0.063), but 3 cases showed both HPV DNA positivity and p53 expression. HPV was detected at a higher rate in the early pathologic stages than in the advanced stages of cancer, and p53 expression was more frequently found in the advanced stages(p =0.044). These results suggests that HPV and p53 mutation might have different etiologic roles in the development of head and neck cancer, or cases with p53 mutation might have more aggressive behavior. PCNA expression showed no difference between early and late stages of cancer, and between cases with and without cervical lymph node metastasis.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.12
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• pp.4839-4841
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• 2015

We conducted a retrospectively reviewed of the literature published of patients underwent fertility-preserving treatments for cervical, endometrial and ovarian cancers using the WANFANG database in Chinese. A majority were retrospective studies and case reports. With cervical cancer, radical trachelectomy(RT) in combination with pelvic lymphadenectomy could preserve the fertility of patients with early stage IA1-IB1 cancers, Tumor size ${\leq}2cm$ should be emphasized as the indication of RT in considering of the higher recurrent rate in patients with tumor size >2cm. For endometrial cancers, there is much experience on it. Given accurate pretreatment assessment, hormonal therapy is feasible management option to preserve fertility in young patients with early stage lesions that limited to the endometrium and well differentiated. High dose progestin have been applied, oral medroxyprogesterone acetate (MPA), 250-500mg/day, megestrol acetate 160-480mg/day. Other therapies that have been used in a limited number of cases include GnRH analog, intrauterine devices (IUDS) containing progestogen, usually combination of these therapies. All patients should be followed up by ultrasound and/or MRI evaluation, and endometrial curettage at intervals of 3 months. With ovarian cancer, in China, fertilitypreserving surgery in patients with stage IA (grade G1) of epithelial ovarian tumor and patients with germ cell tumor and borderline ovarian tumor have been successfully performed.

• 대한핵의학회:학술대회논문집
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• 2002.05a
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• pp.9-13
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• 2002

Clinical application of positron emission tomography (PET) is rapidly increasing for the detection and staging of cancer at whole-body studios performed with 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FDG). Although many cancers can be detected by FDG-PET, there has been limited clinical experience with FDG-PET for the defection of gynecological cancers including malignancies in uterus and ovary. FDG-PET can show foci of metastatic disease that may not be apparent at conventional anatomic imaging and can and in the characterization of indeterminate soft-tissue masses. Most gynecological cancers need to surgical management. FDG-PET can improve the selection of patients for surgical treatment and thereby reduce the morbidity and mortality associated with inappropriate surgery. FDG-PET is also useful for the early detection of recurrence and the monitoring of therapeutic effect. In this review, I discuss the clinical feasibility and limitations of this imaging modality in patients with gynecological cancers.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.9
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• pp.3639-3644
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• 2015

Oral, cervical and breast cancers, which are either preventable and/or amenable to early detection and treatment, are the leading causes of cancer-related morbidity and mortality in India. In this paper, we describe implementation science research priorities to catalyze the prevention and control of these cancers in India. Research priorities were organized using a framework based on the implementation science literature and the World Health Organization's definition of health systems. They addressed both community-level as well as health systems-level issues. Community-level or "pull" priorities included the need to identify effective strategies to raise public awareness and understanding of cancer prevention, monitor knowledge levels, and address fear and stigma. Health systems-level or "push" and "infrastructure" priorities included dissemination of evidence-based practices, testing of point-of-care technologies for screening and diagnosis, identification of appropriate service delivery and financing models, and assessment of strategies to enhance the health workforce. Given the extent of available evidence, it is critical that cancer prevention and treatment efforts in India are accelerated. Implementation science research can generate critical insights and evidence to inform this acceleration.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.11
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• pp.6501-6505
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• 2013

To obtain a screening and early detection reference for individuals who have a family history of cancer on the paternal side, we collected and analyzed data from 240 pairs in which both fathers and their children were diagnosed with cancer. Disease categories of fathers and sons were similar to that of the general population of China, whereas daughters were different from general female population with high incidence of breast cancer and gynecological cancer. Sons were more likely than daughters to have the same type of cancer, or to have cancer in the same organ system as their fathers (P < 0.0001). Sons and daughters developed malignant diseases 11 and 16 years earlier than their fathers, respectively (P < 0.0001 for both sons and daughters). Daughters developed malignant diseases 5 years earlier than sons (P < 0.0001). Men with a family history of malignant tumors on the paternal side should be screened for malignancies from the age of 45 years, or 11 years earlier than the age of their fathers' diagnosis, and women should be screened from the age of 40 years, or 16 years earlier than the age at which their fathers were diagnosed with cancer. Lung cancer should be investigated in both men and women, whilst screening should focus on cancer of the digestive system in men and on breast and gynecological cancer (ovary, uterine and cervical cancer) in women.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.7
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• pp.3201-3205
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• 2014

The aim of this study was to investigate the frequencies of GSTT1 and GSTM1 deletion polymorphisms in newly-diagnosed patients with uterine cervical lesions from central Serbia. Polymorphisms of GST genes were genotyped in 97 patients with cervical lesions and 50 healthy women using a multiplex polymerase chain reaction (PCR). The GSTM1 null genotype was significantly more prominent among the patients than in controls (74.2% vs 56.0%), the risk associated with lesions being almost 2.3-fold increased (OR=2.26, 95%CI=1.10-4.65, p=0.03) and 3.17-fold higher in patients above >45 years old (95%CI=1.02-9.79, p=0.04). The analysis of the two genotypes demonstrated that GSTM1 null genotype significantly increased risk only for low grade squamous intraepithelial lesion-LSIL (OR=2.81, 95%CI=1.03-7.68, p=0.04). GSTT1 null genotype or different genotype combinations were not found to be risk factors, irrespective to lesion stages, age or smoking. We found that the risk of cervical lesions might be significantly related to the GSTM1 null genotype, especially in women aged above 45 years. Furthermore, the GSTM1 polymorphism might have greater role in development of early stage lesions.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.11
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• pp.6459-6463
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• 2013

We investigated the cancer screening rates for five types of cancer (stomach, liver, colorectal, breast, and cervix uteri) using data from the Korean National Cancer Screening Survey (KNCSS), which is a nationwide, annual cross-sectional survey. The eligible study population included cancer-free men 40 years of age and older and women 30 years of age and older. The lifetime screening rate and screening rate with recommendation were calculated. The lifetime screening rates for gastric, liver, colorectal, breast, and cervical cancers were 77.9%, 69.9%, 65.8%, 82.9%, and 77.1%, respectively. The screening rates with recommendation were 70.9%, 21.5%, 44.7%, 70.9%, and 67.9%, respectively. The most common reason for all types of cancer was "no symptoms", followed by "lack of time" and "fear of the examination procedure". Efforts to facilitate participation in liver and colorectal cancer screening among Korean men and women are needed.

• Journal of Preventive Medicine and Public Health
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• v.29 no.2 s.53
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• pp.159-172
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• 1996

A hospital-based case-control study was carried out to investigate the risk factors of uterine cervical cancer in Korea. Information on a wide-range of life-styles, which might be related with uterine cervix cancer, has been routinely collected through a dual application of the self-administered questionnaire and the direct interview by a well-trained nurse at the Department of Gynecology, Seoul National University Hosiptal since 1992. The number of cervical cancer cases, histologically confirmed at the hospital, were 284. Included were 939 women as controls, who were free of past history of any malignancies. Adjusted odds ratio and 95% confidence limits were based on the unconditional logistic regression model. The multivariate logistic model was constructed under the consideration of biologic characteristics on the natural history of the malignancy. In the multivariate results, the uterine cervical cancer risk was higher in women of shorter height$(P_{trend}<0.05)$, less educated spouse$(P_{trend}<0.001)$(0.001), multiple marriages(adjusted OR=2,70, 95% C.I. $1.64\sim4.47$), ever had a family history (adjusted OR=2.14., 95% C.I. $1.18\sim3.89$), multiparity$(P_{trend}<0.001)$, and early age at first $(P_{trend}<0.001)$. These results strongly suggest that the uterine cervix cancer might be related to the reproductive factors, and probably with sexual behaviour of both women and men in Korea.

• Journal of Preventive Medicine and Public Health
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• v.24 no.3 s.35
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• pp.428-440
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• 1991

This study was conducted to estimate the prevalence rate of cervical cancer and to investigate its risk factors. 5,417 asymptomatic married women were screened from March, 1984 to December, 1990 in Taegu city. Of 5,417 examinees, 3,817 (70.46%) were normal, 1,542 (28.7%) showed inflammatory change, 51 (0.94%) were dysplasia and 7 (0.13%) were carcinoma in situ or invasive carcinomas. The prevalence of abnormal finding (dysplasia, carcinoma in situ or invasive carcinoma) was 1,070 per 100,000 population. The prevalence of dysplasia was 940 per 100,000 and that of carcinoma in situ or invasive carcinoma was 130 per 100,000. Age-adjusted prevalence rate for abnormal finding adjusted with standard population of Taegu city was estimated to be 850 per 100,000. The prevalence of cervical cancer was significantly increased with age (P<0.05). The prevalence of cervical cancer was significantly decreased with age at marriage and educational level (P<0.05). The history of induced abortion and the number of pregnancies were significantly associated with the prevalence of cervical cancer (p<0.05), whereas, the number of parity was not. Age at marriage was significantly associated with the prevalence of cervical cancer after stratification by age (p<0.05). However, the level of education, parity, induced abortion, number of pregnancies were not significant. Inflammation and human papiloma virus infection were associated with cervical cancer with odds ratio of 13.48 (95% confidence interval $7.80{\sim}23.40$) and 474.29 (95% confidence interval $196.80{\sim}1143.10$), respectively. In conclusion, for early detection of cervical cancer it should be recommended to perform mass cytological screening. In particular, regular and periodic cytologic screening, starting at age 25, for cervical cancer should be recommended for those women who have frequent cervical inflammation and for those women married before age of 20.