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Comparison of Concurrent Chemoradiotherapy Followed by Adjuvant Chemotherapy Versus Concurrent Chemoradiotherapy Alone in Locoregionally Advanced Nasopharyngeal Carcinoma: a Meta-analysis of 793 Patients from 5 Randomized Controlled Trials

  • Liang, Zhong-Guo;Zhu, Xiao-Dong;Zhou, Zhi-Rui;Qu, Song;Du, You-Qin;Jiang, Yan-Ming
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.11
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    • pp.5747-5752
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    • 2012
  • Purpose: The main objective of the present study was to evaluate the efficacy and toxicity of concurrent chemoradiotherapy followed by adjuvant chemotherapy compared with concurrent chemoradiotherapy alone in the treatment of locoregionally advanced nasopharyngeal carcinoma. Methods: The search strategy included Pubmed, Embase, the Cochrane Library, China National Knowledge Internet Web, Chinese Biomedical Database and Wanfang Database. We also searched reference lists of articles and the volumes of abstracts of scientific meetings. Randomized controlled trials (RCTs) that compared concurrent chemoradiotherapy followed by adjuvant chemotherapy with concurrent chemoradiotherapy alone in locoregionally advanced nasopharyngeal carcinoma were included. Meta-analysis was performed with RevMan 5.1.0. The Grading of Recommendations Assessment, Development, and Evaluation system (GRADE) was used to rate the level of evidence. Results: Five studies were included. Risk ratios of 1.02 (95%CI 0.89-1.15), 0.93 (95%CI 0.72-1.21), 1.07 (95%CI 0.87-1.32), 0.95 (95%CI 0.80-1.13) were observed for 3 years overall survival, 5 years failure-free survival, 5 years locoregional failure-free survival and 5 years distant metastasis failure-free survival. There were no treatment-related deaths in both groups of five studies. Hematologic and gastrointestinal toxicity were the most significant for patients during adjuvant chemotherapy. The level of evidence was low. Conclusion: Compared with concurrent chemoradiotherapy alone, concurrent chemotherapy followed by adjuvant chemotherapy did not improve prognosis. More toxicity was found during adjuvant chemotherapy.

Analysis of Esophageal Cancer Time Trends in China, 1989-2008

  • Zhao, Jun;He, Yu-Tong;Zheng, Rong-Shou;Zhang, Si-Wei;Chen, Wan-Qing
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.9
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    • pp.4613-4617
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    • 2012
  • National cancer incidence data were utilized to analyze trends in esophageal cancer incidence in China in order to provide basic information for making cancer control strategy. We retrieved and re-sorted valid esophageal cancer incidence data from National Central Cancer Registry Database over 20 years period from 1989 to 2008. Crude incidence and age-standardized incidence rates were calculated for analysis, with annual percent change estimated by Joinpoint software for long term trend analysis. The crude incidence rate of esophageal cancer was found to have remained relatively stable in both urban and rural areas over the 20 year period. Age standardized incidence rate (ASR) in cancer registration areas decreased from 39.5/100,000 in 1989 to 23.0/100,000 in 2008 in all areas (AAPC=-3.3%, 95% CI:-2.8~-3.7). The trend was no change in urban areas and 2.1% average annual decrease observed in rural aras. Before the year of 2000, esophageal cancer incidence rates significant decreased with 2.8% annually and then the rates kept stable. Over 20 years from 1989 to 2008, esophageal cancer age standardized incidence rate in cancer registration areas decreased with time. However, esophageal cancer is still a big issue and efforts for control should be continuously enhanced. Cancer registration is playing an important role in cancer control with the number of registries increasing and data quality improving in China.

Risk of Cancer Mortality according to the Metabolic Health Status and Degree of Obesity

  • Oh, Chang-Mo;Jun, Jae Kwan;Suh, Mina
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.22
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    • pp.10027-10031
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    • 2014
  • Background: We investigated the risk of cancer mortality according to obesity status and metabolic health status using sampled cohort data from the National Health Insurance system. Materials and Methods: Data on body mass index and fasting blood glucose in the sampled cohort database (n=363,881) were used to estimate risk of cancer mortality. Data were analyzed using a Cox proportional hazard model (Model 1 was adjusted for age, sex, systolic blood pressure, diastolic blood pressure, total cholesterol level and urinary protein; Model 2 was adjusted for Model 1 plus smoking status, alcohol intake and physical activity). Results: According to the obesity status, the mean hazard ratios were 0.82 [95% confidence interval (CI), 0.75-0.89] and 0.79 (95% CI, 0.72-0.85) for the overweight and obese groups, respectively, compared with the normal weight group. According to the metabolic health status, the mean hazard ratio was 1.26 (95% CI, 1.14-1.40) for the metabolically unhealthy group compared with the metabolically healthy group. The interaction between obesity status and metabolic health status on the risk of cancer mortality was not statistically significant (p=0.31). Conclusions: We found that the risk of cancer mortality decreased according to the obesity status and increased according to the metabolic health status. Given the rise in the rate of metabolic dysfunction, the mortality from cancer is also likely to rise. Treatment strategies targeting metabolic dysfunction may lead to reductions in the risk of death from cancer.

Psychosocial Factors and Health Behavior among Korean Adults: A Cross-sectional Study

  • Kye, Su-Yeon;Park, Kee-Ho
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.1
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    • pp.49-56
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    • 2012
  • Objective: This study was an attempt to identify associations between health behavior, such as smoking, alcohol consumption, healthy diet, and physical activity, and psychosocial factors. Methods: This crosssectional study was conducted among 1,500 participants aged between 30 and 69 years, selected from a population-based database in October 2009 through multiple-stratified random sampling. Information was collected about the participants' smoking and drinking habits, dietary behavior, level of physical activity, stress, coping strategies, impulsiveness, personality, social support, sense of coherence, self-efficacy, health communication, and sociodemographics. Results: Agreeableness, as a personality trait, was negatively associated with smoking and a healthy diet, while extraversion was positively associated with drinking. The tendency to consume a healthy diet decreased in individuals with perceived higher stress, whereas it increased in individuals who had access to greater social support. Self-efficacy was found to be a strong predictor of all health behaviors. Provider-patient communication and physical environment were important factors in promoting positive healthy behavior, such as consumption of a healthy diet and taking regular exercise. Conclusions: Psychosocial factors influence individuals' smoking and drinking habits, dietary intake, and exercise patterns.

Effect of Sociodemographic Factors, Cancer, Psychiatric Disorder on Suicide: Gender and Age-specific Patterns (인구사회적 요인, 암, 일부 전신질환 등이 자살에 미치는 영향: 성별, 연령별 분석)

  • Park, Jae-Young;Chae, Yoo-Mi;Jung, Sang-Hyuk;Moon, Ki-Tae
    • Journal of Preventive Medicine and Public Health
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    • v.41 no.1
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    • pp.51-60
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    • 2008
  • Objectives : We examined the effect of sociodemographic factors, cancer, and psychiatric disorders on suicide by gender and age-specific patterns in South Korea. Methods : The study is a case-control study. Claim data was obtained from the national health insurance database and national death registration database. The number of people who committed suicide was 11,523, which was matched with a control group consisting of ten times as many people at 115,230 selected from the national health insurance and medical aids beneficiaries. The medical utilization of the case group was one year before death and that of the control group was from July 1,2003 to June 30, 2004. Four variables-address, economic status, presence of a psychiatric disease, and cancer-were used in multiple logistic regression analyses. Results : Living in cities or in rural areas showed a greater risk for suicide than living in a metropolitan city. Low economic status, the presence of a psychiatric disorder, and cancer were also statistically meaningful risk factors for suicide. The three major psychiatric diseases, schizophrenia, alcohol abuse, and bipolar disorder, were meaningful in all age groups, but the scale of the odds ratio differed by the age group. Only the psychiatric disorder variable was meaningful in the adolescent group, whereas a psychiatric disorder and economic status were meaningful for the young adult group, and all variables were meaningful for the middle-aged group. A psychiatric disorder and cancer were meaningful in the elderly group, economic status was meaningful for male subjects, and address was meaningful for female subjects. Conclusions : Factors such as living in city or rural areas, low economic status, the presence of a psychiatric disorder, and cancer were statistically meaningful risk factors in suicide. These factors also differed by age group. Therefore, policymakers should establish policies for suicide prevention that are relevant for each age group.

Cancer News Coverage in Korean Newspapers: An Analytic Study in Terms of Cancer Awareness

  • Min, Hye Sook;Yun, E Hwa;Park, Jinsil;Kim, Young Ae
    • Journal of Preventive Medicine and Public Health
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    • v.53 no.2
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    • pp.126-134
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    • 2020
  • Objectives: Cancer diagnoses have a tremendous impact on individuals and communities, drawing intense public concern. The objective of the current research was to examine news coverage and content related to cancer-related issues in Korean newspapers. Methods: Primarily using the database system of the Korea Press Foundation, we conducted a content analysis of 2806 articles from 9 Korean daily newspapers during a recent 3-year period from 2015 to 2017. Thematic categories, the types of articles, attitudes and tone, and the number of sources in each article were coded and classified. Results: Many news articles dealt with a diverse range of themes related to cancer, including general healthcare information, the latest research and development, specific medical institutions and personnel, and technology and products, which jointly accounted for 74.8% of all articles. Those thematic categories differed markedly in terms of article type, tone, and the number of cited sources. News articles provided extensive information about healthcare resources, and many articles seemed to contain advertising content. However, the content related to complex social issues such as National Health Insurance did not include enough information for the reader to contextualize the issues properly or present the issues systematically. Conclusions: It can be assumed that the media exert differential influence on individuals through news coverage. Within the present reporting framework, the availability and usefulness of information are likely to depend solely on individuals' capabilities, such as financial and health literacy; this dependency has a negative impact on knowledge gaps and health inequities.

Factors Associated with Performance of National Cancer Screening Program in Korea (국가 암조기검진사업 성과에 영향을 미치는 요인 - 보건소 및 사업실무자 특성을 중심으로 -)

  • Choi, Kui-Son;Yang, Jeong-Hee;Kye, Su-Yeon;Lee, Sun-Hee;Shin, Hai-Rim;Kim, Chang-Min;Park, Eun-Cheol
    • Journal of Preventive Medicine and Public Health
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    • v.37 no.3
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    • pp.246-252
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    • 2004
  • Objectives : Cancer is the leading cause of death in Korea. Therefore, a National Cancer Screening Program (NCSP) was launched in 1999. This study planned to evaluate the performance of the NCSP to identifying the influencing factors in relation to characteristic public health centers. Methods : To analyze the performance, the database of the NCSP records for 2002 was used. The performance index was measured by the goal achievement rate, which was defined by the real number of screenees against the expected number of screenees. Also, a survey was conducted by a self-administered questionnaire to identify the factors associated with the goal achievement rate. The questionnaire was divided into two sections. In the first section, the individual characteristics of the program coordinator in each public health center were measured, and second section was comprised of questions about the organizational characteristics associated with the NCSP. A total of 121 subjects from 241 public health centers completed the questionnaire. Results : Of the 121 public health centers (50.2% response rate), the average goal achievement rate was 72.8%. The results of the regression model showed that public health centers located in rural area (parameter estimates=38.2) and had great support from a head of center or province (parameter estimates=0.20) and tended to have higher goal achievement rates. However, the characteristics of the program coordinator, especially their knowledge of and attitude toward cancer screening, were not significantly related to the goal achievement rates. Conclusions : It appears that the most important associated factors to the goal achievement rate in the NSCP were the location of the public health center and the support for the NCSP from the head of the center or province.

Cervical Cancer Trends in Mexico: Incidence, Mortality and Research Output

  • Anaya-Ruiz, Maricruz;Vincent, Ana Karen;Perez-Santos, Martin
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.20
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    • pp.8689-8692
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    • 2014
  • Purpose: To evaluate the recent incidence and mortality of and scientific research trends in cervical cancer in Mexican females. Materials and Methods: Data between 2000 and 2010 from the Department of Epidemiology of the Ministry of Health, and International Agency for Research on Cancer (IARC) of World Health Organization were analyzed, and age-standardized rates (ASRs) were calculated. In addition, scientific research data were retrieved from the Web of Science database from 2003 to 2012, using different terms related to cervical cancer. Results: The incidence rate decreased during last five years, while mortality rates showed an annual decrease of 4.93%. A total of 780 articles were retrieved, and the institutions with the majority of publications were National Autonomous University of Mexico (34.87%), Social Security Mexican Institute (16.02%), and National Institute of Cancerology (15%). The main types of research were treatment, diagnosis, and prevention. Conclusions: The above results show that incidence of cervical cancer decreased over time in Mexico during last five years; similarly, the downturn observed in mortality mainly reflects improved survival as a result of earlier diagnosis and cancer treatment. Also, this article demonstrates the usefulness of bibliometrics to address key evaluation questions and to establish priorities, define future areas of research, and develop cervical cancer control strategies in Mexico.

Adherence to Health-Related Lifestyle Behavior Recommendations and Association with Quality of Life among Cancer Survivors and Age-Matched Controls in Koreaaa

  • Moon, Sae Hoon;Lee, Dae Taek;Son, Younsun
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.5
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    • pp.2949-2954
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    • 2013
  • Background: This study was conducted to determine the relationship between lifestyle behavior and quality of life (QoL) among cancer survivors in Korea. Materials and Methods: Data for a total of 471 (173 men, 298 women) cancer survivors (CS) over 40 years old were obtained from the database of the $4^{th}$ Korean National Health and Nutrition Examination Survey (KNHANES IV). An identical number of subjects of the same age, sex, and education who had no restrictions in physical activity were randomly selected from the database and represented the control group (CG). Drinking, smoking, and exercise behavior were assessed. Results: The number of heavy drinkers was lower in CS (9.4%) than in CG (15.8%) (p<0.01); similarly, there were fewer smokers in CS (9.1%) than in CG (14.0%) (p<0.05). The percentage of individuals engaging in vigorous, moderate, and low-intensity exercise did not differ between CS (13.6%, 14.7%, and 50.0%) and CG (14.3%, 13.4%, and 49.7%, respectively). No differences in Euro QoL Questionnaire 5-Dimensional Classification (EQ-5D) scores on both drinking and smoking behaviors were noted. Compared to the non-exercisers, the low-intensity exercisers in CG ($0.91{\pm}0.10$ vs. $0.94{\pm}0.09$), vigorous-intensity exercisers in CS ($0.84{\pm}0.62$ vs. $0.91{\pm}0.11$), and low-intensity exercisers in CS ($0.82{\pm}0.22$ vs. $0.88{\pm}0.13$) scored higher on the EQ-5D. Conclusions: Although cancer survivors practiced more conscious health behavior in drinking and smoking, their engagement in exercise did not differ from that of non-cancer survivors. Since exercise engagement increases QoL in general, implementation of an educational program that promotes exercise engagement in cancer survivors may be required.

Colorectal Cancer Incidence and Mortality in China, 2010

  • Zheng, Zhao-Xu;Zheng, Rong-Shou;Zhang, Si-Wei;Chen, Wan-Qing
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.19
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    • pp.8455-8460
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    • 2014
  • Background: The National Central Cancer Registry of China (NCCR) affiliated to the Bureau of Disease Control, National Health and Family Planning Commission of China is responsible for cancer surveillance in the entire country. Cancer registration data from each local registry located in each province are collected by NCCR annually to be analyzed and published to provide useful information for policy makers and cancer researchers. Materials and Methods: Until 1st June, 2013, 219 population-based cancer registries submitted data of 2010 to the National Central Cancer Registry of China covering about 207,229,403 population, and 145 cancer registries were selected after quality evaluation for this study. Colorectal cancer cases were selected from the database according to ICD-10 coded as "C18-C20". We calculated the crude incidence and mortality rates by sex, age groups and location (urban/rural). The China population in 2000 and Segi's population were used as standardized populations for the calculation of age-standardized rates. The 6th National Population Census data of China was used to combined with the cancer registries' data to estimate the colorectal cancer burden in China in 2010. Results: Colorectal cancer was the sixth most common cancer in China. It was estimated that there were 274,841 new cases diagnosed in 2010 (157,355 in males and 117,486 in females), with the crude incidence rate of 20.1/100,000, highest in males in urban areas. Age-standardized rates by China standard population of 2000 (ASRcn) and World standard population (Segi's population, ASRwld) for incidence were 16.1/100,000 and 15.9/100,000 respectively. There were 132,110 cases estimated to have died from colorectal cancer in China in 2010 (76,646 men and 55,464 women) with the crude mortality rate of 10.1/100,000. The ASRcn and ASRwld for mortality were 7.55/100,000 and 7.44/100,000 respectively, higher in males and urban areas than in females and rural areas. The incidence and mortality rates increased with age, reaching peaksin the 80-84 year old, and oldest age groups, respectively. Conclusions: Colorectal cancer is one of the most common incident cancers and cause of cancer death in China. Primary and secondary prevention, with attention to a health lifestyle, physical activity and screening should be enhanced in the general population.