• Asian Pacific Journal of Cancer Prevention
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• v.14 no.10
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• pp.6103-6108
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• 2013

Objective: Excision repair cross-complementing group 6 (ERCC6) is a major component of the nucleotide excision repair pathway that plays an important role in maintaining genomic stability and integrity. Several recent studies suggested a link of ERCC6 polymorphisms with susceptibility to various cancers. However, the relation of ERCC6 polymorphism with gastric cancer (GC) risk remains elusive. In this sex- and age-matched case-control study including 402 GC cases and 804 cancer-free controls, we aimed to investigate the association between a potentially functional polymorphism (rs1917799 T>G) in the ERCC6 regulatory region and GC risk. Methods: The genotypes of rs1917799 were determined by Sequenom MassARRAY platform and the status of Helicobacter pylori infection was detected by enzyme-linked immunosorbent assay. Odd ratios (ORs) and 95% confidential interval (CI) were calculated by logistic regression analysis. Results: Compared with the common TT genotype, the ERCC6 rs1917799 GG genotype was associated with increased GC risk (adjusted OR=1.46, 95%CI: 1.03-2.08, P=0.035). When compared with (GT+TT) genotypes, the GG genotype also demonstrated a statistical association with increased GC risk (adjusted OR=1.38, 95%CI: 1.01-1.89, P=0.044). This was also observed for the male subpopulation (GG vs. TT: adjusted OR=1.71, 95%CI: 1.12-2.62, P=0.013; G allele vs. T allele: adjusted OR=1.32, 95%CI: 1.07-1.62, P=0.009). Genetic effects on increased GC risk tended to be enhanced by H. pylori infection, smoking and drinking, but their interaction effects on GC risk did not reach statistical significance. Conclusions: ERCC6 rs1917799 GG genotype might be associated with increased GC risk in Chinese, especially in males.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.5
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• pp.1857-1862
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• 2012

To assess the impact of household income and economic recession on participation in CRC screening, we estimated annual participating proportions from 2007 to 2009 for different CRC screening modalities according to household income levels. A total of 8,042 subjects were derived from the fourth Korean National Health and Nutrition Examination Survey (KNHANES IV). Multivariate logistic regression analysis was used to estimate odds ratios and 95% confidence intervals for CRC screening with household income quartiles by gender in each year. People were less likely to attend a high-cost CRC screening such as a sigmoidoscopy or colonoscopy independent of the income quartile during the economic recession. Income disparities for participating in opportunistic cancer screening appear to have existed among both males and females during the three years (2007-2009), but were most distinctive in 2009. An increase in mortality of CRC can therefore be expected due to late detection in periods of economic crisis. Accordingly, the government should expand the coverage of CRC screening to prevent excess deaths by reducing related direct and indirect costs during the economic recession.

• Korean Journal of Radiology
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• v.24 no.12
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• pp.1249-1259
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• 2023

Objective: This study aimed to evaluate the clinical outcomes and cost-effectiveness of dual-energy X-ray absorptiometry (DXA) for osteoporosis screening. Materials and Methods: Eligible patients who had and had not undergone DXA screening were identified from among those aged 50 years or older at Kaohsiung Veterans General Hospital, Taiwan. Age, sex, screening year (index year), and Charlson comorbidity index of the DXA and non-DXA groups were matched using inverse probability of treatment weighting (IPTW) for propensity score analysis. For cost-effectiveness analysis, a societal perspective, 1-year cycle length, 20-year time horizon, and discount rate of 2% per year for both effectiveness and costs were adopted in the incremental cost-effectiveness (ICER) model. Results: The outcome analysis included 10337 patients (female:male, 63.8%:36.2%) who were screened for osteoporosis in southern Taiwan between January 1, 2012, and December 31, 2021. The DXA group had significantly better outcomes than the non-DXA group in terms of fragility fractures (7.6% vs. 12.5%, P < 0.001) and mortality (0.6% vs. 4.3%, P < 0.001). The DXA screening strategy gained an ICER of US$ -2794 per quality-adjusted life year (QALY) relative to the non-DXA at the willingness-to-pay threshold of US$ 33004 (Taiwan's per capita gross domestic product). The ICER after stratifying by ages of 50-59, 60-69, 70-79, and ≥ 80 years were US$ -17815, US$ -26862, US$ -28981, and US$ -34816 per QALY, respectively. Conclusion: Using DXA to screen adults aged 50 years or older for osteoporosis resulted in a reduced incidence of fragility fractures, lower mortality rate, and reduced total costs. Screening for osteoporosis is a cost-saving strategy and its effectiveness increases with age. However, caution is needed when generalizing these cost-effectiveness results to all older populations because the study population consisted mainly of women.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.6
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• pp.2695-2698
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• 2012

Introduction: Design and implementation of screening programs in each country must be based on epidemiological data. Despite the relatively high incidence of CRC, there is no nationwide comprehensive program for screening in Iran. This study was designed to investigate national CRC data and help to determine guidelines for screening. Methods: Incidence data used in this study were obtained from Iranian annual of National Cancer Registration report. Age standardized rates (ASR)were calculated using world standard population and were categorized by age, sex, anatomic subsite and morphology of tumor. Data were analyzed using SPSS.V.13 and Open Source Epidemiologic Statistics for Public Health software (OpenEpi v.2.3.1). Results: A quarter of cases were less than 50 years of age. The majority of tumors were detected in the colon. The overall ASR in the four years period was 38.0 per 100000 and was higher for men compared women (P<0.05). Incidence rate of colorectal cancer increased with age. Conclusion: Results of present study indicated that incidence of colorectal cancer is relatively high in Iran. Incidence of CRC in people under 50 years and in rectum were reported higher than other countries that related etiologic factors should be investigate in further studies. According to the increasing of ASR after age 50 years, it seems that onset of screening at age 50 would be appropriate.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.9
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• pp.3981-3990
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• 2015

Background: Breast cancer is the most common type of cancer in Jordan. Current efforts are focused on annual campaigns aimed at increasing awareness about breast cancer and encouraging women to conduct mammogram screening. In the absence of regular systematic screening for breast cancer in Jordan, there is a need to evaluate current mammography screening uptake and its predictors, assess women's knowledge and attitudes towards breast cancer and screening mammograms and to identify barriers to this preventive service. Materials and Methods: This cross-sectional study was conducted in six governorates in Jordan through face-to-face interviews on a random sample of women aged 40 to 69 years. Results: A total of 507 participants with mean age of $46.8{\pm}7.8$ years were interviewed. There was low participation rate in early detection of breast cancer practices. Breast self-examination, doctor examination and periodic mammography screening were reported by 34.9%, 16.8% and 8.6% of study participants, respectively. Additionally 3.8% underwent breast cancer screening at least once but not periodically, while 87.6% had never undergone mammography screening. Reported reasons for conducting the screening were: perceived benefit (50%); family history of breast cancer (23.1%); perceived severity (21.2%); and advice from friend or family member (5.8%). City residents have shown higher probability of undergoing mammogram than those who live in towns or villages. Results revealed negative perceptions and limited knowledge of study participants on breast cancer and breast cancer screening. The most commonly reported barriers for women who never underwent screening were: fear of results (63.8%); no support from surrounding environment (59.7); cost of the test (53.4%); and religious belief, i.e. Qadaa Wa Qadar (51.1%). Conclusions: In the absence of regular systematic screening for breast cancer in Jordan, the uptake of this preventive service is very low. It is essential for the country of Jordan to work on applying regular systematic mammography screening for breast cancer. Additionally, there is a need for improvement in the current health promotion programmes targeting breast cancer screening. Other areas that could be targeted in future initiatives in this field include access to screening in rural areas and removal of current barriers.

• Journal of Preventive Medicine and Public Health
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• v.33 no.1
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• pp.99-108
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• 2000

Objectives : The purpose of this study was to examine the present status of cancer screening recommendations(beginning age, interval, recommended screening methods, etc.) by physicians and analyze the association between physician's characteristics and the content of their recommendations. Methods : Data were collected from March 1 to April 30 of 1997, and 373 physicians who were from different hospital settings all over Korea were interviewed by telephone about their screening recommendations for stomach, cervical and breast cancer for these who provided cancer screening services. Results : For stomach cancer screening, respondents recommended that cancer screening begin at 40 years of age(57.8%), with a 1 year interval(77.2%), and by gastrofibroscopy (86.2%). For cervical cancer screening, respondents recommended that cancer screening begin at 25 years of age(42.0%), with a 1 year interval(67.8%), and by using a Pap smear(100.0%). For breast cancer screening, respondents recommended that cancer screening begin at 35 years of age(38.7%), with a 1 year interval(57.3%), and by mammography (97.3%). Conclusions : To establish appropriate cancer screening recommendations for Korea, if may be useful to consider the above results concerning medical care providers.

• The Korean Journal of Nuclear Medicine Technology
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• v.13 no.3
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• pp.185-188
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• 2009

Purpose: Standard of retests were discrepant and inconsistent due to inaccuracy and lack of standardization within normal range limit of tumor marker test. To enhance the standardization of retests set standard value below normal range and the Order Communication System Quality Control (OCS QC) program was put in place. This program enables managing the results within lower limit of normal range which were used for tumor marker test in Health Center. Materials and Methods: At present the tumor marker study for AFP, CEA, CA19-9, CA125, and PSA included outpatients in Asan Medical Center from February to March, 2009. The standard value was obtained by using the percentage of CV of Inter Assay according to the normal range of each tumor test. The results were confirmed by using the OCS QC program via formatted assessment of screening test such as test items, standard value and medical department. The number of out-of-range results within plus and minus 30 percents regarding the five primary items of tumor marker test was assessed. The next step was to obtain the number of AFP, CEA, and CA125 according to the ratio of comparison between prior and post test result, 60%, 50%, and 40% within normal range, respectively. In addition, set standard value below normal range. Results: The first screening test with percentage of sample number was resulted between 30%-40% and the second one was AFP 26.1%, CEA 18.9%, CA19-9 17.3%, CA125 18.7%, and PSA 21.0% obtained screening percentage of average 20 percents. The limited value of retest was AFP less than 5.0 and more than 10.0, CEA less than 1.0 and more than 3.0, CA19-9 less than 10.0 and more than 30.0, and PSA less than 1.0 and more than 2.0 to set and the number of retest was obtained by applying to the limited value of retest to screening percentage of average 20 percents For two months, the number of retest was AFP 0, CEA 15, CA19-9 3, CA125 2, and PSA 5. Conclusions: Through using the OCS QC program in establishing the standard of retest systemically, there appeared to be reduced discrepancy among the examiners and to be expected improvement in relation to the error of results.

• Bulletin of the Korean Chemical Society
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• v.32 no.11
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• pp.4086-4088
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• 2011

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.6
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• pp.2901-2904
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• 2014

The incidence of colorectal cancer has been increasing in many Asian countries including Malaysia during the past few decades. A physician recommendation has been shown to be a major factor that motivates patients to undergo screening. The present study objectives were to describe the practice of colorectal cancer screening by primary care providers in Malaysia and to determine the barriers for not following recommendations. In this cross sectional study involving 132 primary care providers from 44 Primary Care clinics in West Malaysia, self-administered questionnaires which consisted of demographic data, qualification, background on the primary care clinic, practices on colorectal cancer screening and barriers to colorectal cancer screening were distributed. A total of 116 primary care providers responded making a response rate of 87.9%. About 21% recommended faecal occult blood test (FOBT) in more than 50% of their patients who were eligible. The most common barrier was "unavailability of the test". The two most common patient factors are "patient in a hurry" and "poor patient awareness". This study indicates that colorectal cancer preventive activities among primary care providers are still poor in Malaysia. This may be related to the low availability of the test in the primary care setting and poor awareness and understanding of the importance of colorectal cancer screening among patients. More awareness programmes are required for the public. In addition, primary care providers should be kept abreast with the latest recommendations and policy makers need to improve colorectal cancer screening services in health clinics.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.17
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• pp.7485-7489
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• 2015

Background: Breast cancer is the most common type of cancer in women throughout the world. However, in comparison with Western women, it presents relatively early in women of Asian ethnicity. Early menarche, late menopause, use of OCP's, family history of benign or malignant breast disease, exposure to radiation and BMI in the under-weight range are well known risk factors for the development of breast cancer in premenopausal women. Early detection with the use of breast self-examination (BSE) and breast cancer screening programs can lead to a reduction in the mortality rates due to breast cancer. The aim of our study was to assess the risk factors for breast cancer among young women and to emphasize the importance of early screening among them. Materials and Methods: We conducted a cross-sectional study among women aged 18 to 25 using a self-administered questionnaire. Data was collected over a period of 6 months from June to December, 2014. A total of 300 young women selected randomly from Dow Medical College and various departments of Karachi University successfully completed the survey. Results: Respondents were 18-25 years of age (mean age=21.5). Out of the 300 young females, 90 (30%) had at least one risk factor, 90 (30%) had two, 40 (13%) had three, 8 (2.7%) had four, 2 (0.7%) had five while one female was found to have six positive risk factors for breast cancer. Some 66 women (22%) experienced symptoms of breast cancer such as non-cyclical pain and lumps. While 222 women (74%) had never performed breast self-examination, 22 (7.3%) had had a breast examination done by a health professional while 32 (10.7%) had participated in breast screening programs. A total of 223 (74.3%) women considered breast cancer screening important for young women. Conclusions: The percentage of young women with risk factors for breast cancer was found to be alarmingly high. Therefore, screening for breast cancer should start at an early age especially in high risk groups. Awareness about breast self-examination should be emphasized. Moreover, screening programs should be started to ensure early detection and reduction of mortality rates caused by breast cancer also in young Pakistani females.