• Asian Pacific Journal of Cancer Prevention
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• v.14 no.1
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• pp.21-25
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• 2013

Background: Genetic factors and environmental factors play a role in pathogenesis of esophageal squamous cell carcinoma (ESCC). Previous studies regarding the association of folate intake and Methylenetetrahydrofolate reductase C677T polymorphism with ESCC was conflicting. We conducted a meta-analysis to investigate the association of MTHFR C677T and folate intake with esophageal cancer risk. Methods: MEDLINE, EMBASE and the Chinese Biomedical Database were searched in our study. The quality of studies were evaluated by predefined scale, and The association of polymorphisms of MTHFR C677T and folate intake and ESCC risk was estimated by Odds ratio (ORs) with 95% confidence intervals (CIs). Results: 19 studies (4239 cases and 5575 controls) were included for meta-analysis. A significant association was seen between individuals with MTHFR 677 CT [OR(95%)=1.47(1.32-1.63)] and TT [OR(95%)=1.69(1.49-1.91)] genotypes and ESCC risk (p<0.05). Low intake of folate had significantly higher risk of esophageal cancer among individuals with CT/TT genotype [OR(95%)=1.65(1.1-2.49)], while high intake of folate did not find significant high risk of esophageal cancer among individuals with CT/TT genotype [OR(95%)=1.64 (0.82-3.26)]. Conclusions: Our meta-analysis indicated the folate intake and MTHFR 677CT/TT are associated with the risk of ESCC, and folate showed a significant interaction with polymorphism of MTHFR C677T.

• Journal of Preventive Medicine and Public Health
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• v.43 no.4
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• pp.283-291
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• 2010

Objectives: The purpose of this study was to develop a prediction model for future smoking intention among Korean adolescents aged 13 to 15 in order to identify the high risk group exposed to future smoking. Methods: The data was collected from a total of 5940 students who participated in a self-administrated questionnaire of a cross-sectional school-based survey, the 2004 Korea Global Youth Tobacco Survey. Chi-square tests and logistic regression analyses were carried out to identify the relevant determinants associated with intentions of adolescents’ future smoking. Receiver Operation Characteristic (ROC) assessment was applied to evaluate the explanation level of the developed prediction model. Results: 8.4% of male and 7.2% of female participants show their intentions of future smoking. Among non-smoking adolescents; who have past smoking experience [odds ratio (OR) 2.73; 95% confidence interval (CI) 1.92- 3.88]; who have intentions of smoking when close friends offer a cigarette (OR 31.47; 95% CI = 21.50 - 46.05); and who have friends that are mostly smokers (OR 5.27; 95% CI = 2.85 - 9.74) are more likely to be smokers in the future. The prediction model developed from this study consists of five determinants; past smoking experience; parents smoking status; friends smoking status; ownership of a product with a cigarette brand logo; and intentions of smoking from close friends’ cigarette offer. The area under the ROC curve was 0.8744 (95% CI=0.85 - 0.90) for current non-smokers. Conclusions: For efficiency, school-based smoking prevention programs need to be designed to target the high risk group exposed to future smoking through the prediction model developed by the study, instead of implementing the programs for all the students.

• Journal of Preventive Medicine and Public Health
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• v.51 no.1
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• pp.41-50
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• 2018

Objectives: To explore alcohol perceptions and their association hazardous alcohol use in the populations of Alberta, Canada and Queensland, Australia. Methods: Data from 2500 participants of the 2013 Alberta Survey and the 2013 Queensland Social Survey was analyzed. Regression analyses were used to explore the association between alcohol perceptions and its association with hazardous alcohol use. Results: Greater hazardous alcohol use was found in Queenslanders than Albertans (p<0.001). Overall, people with hazardous alcohol were less likely to believe that alcohol use contributes to health problems (odds ratio [OR], 0.46; 95% confidence interval [CI], 0.27 to 0.78; p<0.01) and to a higher risk of injuries (OR, 0.54; 95% CI, 0.33 to 0.90; p<0.05). Albertans with hazardous alcohol use were less likely to believe that alcohol contributes to health problems (OR, 0.48; 95% CI, 0.26 to 0.92; p<0.05) and were also less likely to choose a highly effective strategy as the best way for the government to reduce alcohol problems (OR, 0.63; 95% CI, 0.43 to 0.91; p=0.01). Queenslanders with hazardous alcohol use were less likely to believe that alcohol was a major contributor to injury (OR, 0.39; 95% CI, 0.20 to 0.77; p<0.01). Conclusions: Our results suggest that people with hazardous alcohol use tend to underestimate the negative effect of alcohol consumption on health and its contribution to injuries. In addition, Albertans with hazardous alcohol use were less in favor of strategies considered highly effective to reduce alcohol harm, probably because they perceive them as a potential threat to their own alcohol consumption. These findings represent valuable sources of information for local health authorities and policymakers when designing suitable strategies to target alcohol-related problems.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.9
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• pp.3931-3936
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• 2015

Fatty liver disease (FLD) can be a precondition for other liver pathology including cholangiocarcinoma (CCA). Diabetes mellitus (DM) has been suggested in some studies to be a risk factor for FLD as well as cancers, including cholangiocellular carcinoma; however, there are currently very few studies on FLD in DM subjects, although the rate of FLD continues to increase annually. To determine the association between DM and FLD ultrasonographic data were analyzed from the Cholangiocarcinoma Screening and Care Program (CASCAP), in northeast Thailand. DM was reported by the subjects based on the CASCAP health questionnaire. Factors that were associated with FLD were determined by prevalence, odds ratio (ORs) and its 95% confidence intervals (CIs) using multiple logistic regression. There were 45,263 subjects with a mean age of 53.46 (${\pm}9.25$) years. FLD was found in 36.3% of DM subjects but only in 20.7% of non-DM subjects. The association between DM and FLD was adjusted for all other factors including gender, age, education level, relatives diagnosed with CCA, smoking, alcohol consumption, and hepatitis B and C. The risk of DM in subjects having FLD was highly significant compared with the non-DM subjects (OR 2.13; 95%CI: 1.92 to 2.35; p-value < 0.001). Thus DM is significantly associated with FLD which in turn may facilitate the development of several diseases including CCA. DM should be taken into consideration in future ultrasonic investigations of FLD and CCA.

• Journal of Preventive Medicine and Public Health
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• v.51 no.2
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• pp.71-82
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• 2018

Objectives: Areca nut is widely consumed in many parts of the world, especially in South and Southeast Asia, where cardiovascular disease (CVD) is also a huge burden. Among the forms of CVD, acute coronary syndrome (ACS) is a major cause of mortality and morbidity. Research has shown areca nut chewing to be associated with diabetes, hypertension, oropharyngeal and esophageal cancers, and CVD, but little is known about mortality and re-hospitalization secondary to ACS among areca nut users and non-users. Methods: A prospective cohort was studied to quantify the effect of areca nut chewing on patients with newly diagnosed ACS by categorizing the study population into exposed and non-exposed groups according to baseline chewing status. Cox proportional hazards models were used to examine the associations of areca nut chewing with the risk of re-hospitalization and 30-day mortality secondary to ACS. Results: Of the 384 ACS patients, 49.5% (n=190) were areca users. During 1-month of follow-up, 20.3% (n=78) deaths and 25.1% (n=96) re-hospitalizations occurred. A higher risk of re-hospitalization was found (adjusted hazard ratio [aHR], 2.05; 95% confidence interval [CI], 1.29 to 3.27; p=0.002) in areca users than in non-users. Moreover, patients with severe disease were at a significantly higher risk of 30-day mortality (aHR, 2.77; 95% CI, 1.67 to 4.59; p<0.001) and re-hospitalization (aHR, 2.72; 95% CI, 1.73 to 4.26; p<0.001). Conclusions: The 30-day re-hospitalization rate among ACS patients was found to be significantly higher in areca users and individuals with severe disease. These findings suggest that screening for a history of areca nut chewing may help to identify patients at a high risk for re-hospitalization due to secondary events.

• Korean Journal of Health Education and Promotion
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• v.27 no.1
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• pp.81-89
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• 2010

Objectives: To investigate the relationship between experience of hunger in childhood or adolescence and diabetes mellitus in old age. Methods: Stratified national samples of 421 men and 554 women aged 60-89 in South Korea were analyzed. Diabetes diagnosed by a doctor was used as the dependent variable. Experience of hunger in childhood was assessed with the question, "In your childhood, have you ever gone hungry with skipping a meal?" and "In your childhood, have you ever eaten porridge or some bran cake as main dish instead of rice because of lack of food?" Odds ratios (ORs) and 95% confidence interval (CI) were calculated by multiple logistic regressions. Results: ORs of diabetes by experience of hunger in childhood were 1.64(95% CI 0.95-2.83) for men and 1.58(95% CI 1.01-2.47) for women. Significant association of experience of hunger in childhood with prevalence of diabetes persisted in men after adjustment for adulthood and old age socioeconomic position indicators and other risk factors(OR 1.88(95% CI 1.04-3.41)). The effect of experience of hunger in 10-19 years was more prominent than that in less than 10 years in both gender. Conclusion: Experience of hunger in childhood or adolescence may increase the risk of diabetes in Korean elders.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.20
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• pp.8719-8724
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• 2014

Background: Breast cancer incidence is increasing among South Asian migrants to the United States (US). However, their utilization of cancer screening services is poor. This study characterizes attitudes of South Asians towards breast health and screening in a community sample. Materials and Methods: A cross-sectional survey based on the Health Belief Model (HBM) was conducted among South Asians (n=124) in New Jersey and Chicago. The following beliefs and attitudes towards breast cancer screening were assessed-health motivation, breast self-examination confidence, breast cancer susceptibility and fear, and mammogram benefits and barriers. Descriptive statistics and Spearman rank correlation coefficients were computed for HBM subscales. Findings: Mean age of participants was 36 years with an average 10 years stay in the US. Most women strived to care for their health ($3.82{\pm}1.18$) and perceived high benefits of screening mammography ($3.94{\pm}0.95$). However, they perceived lower susceptibility to breast cancer in the future ($2.30{\pm}0.94$). Conclusions: Increasing awareness of breast cancer risk for South Asian women may have a beneficial effect on cancer incidence because of their positive attitudes towards health and breast cancer screening. This is especially relevant because South Asians now constitute one of the largest minority populations in the US and their incidence of breast cancer is steadily increasing.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.3
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• pp.909-913
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• 2015

Background: A systematic review and meta-analysis of observational studies evaluated the association of intake of vitamin B2 with the incidence of colorectal cancer. Materials and Methods: Relevant studies were identified in MEDLINE via PubMed (published up to April 2014). We extracted data from articles on vitamin B2 and used multivariable-adjusted odds ratio (OR) and a random-effects model for analysis. Results: We found 8 articles meeting the inclusion criteria (4 of cohort studies and 4 of case-control studies) and a total of 7,750 colorectal cancer cases were included in this meta-analysis. The multivariable-adjusted OR for pooled studies for the association of the highest versus lowest vitamin B2 intake and the risk of colorectal cancer was 0.83 (95% confidence interval [95%CI]:0.75,0.91). We performed a sensitivity analysis for vitamin B2. If we omitted the study by Vecchia et al., the pooled OR was 0.86 (95%CI, 0.77,0.96). Conclusions: This is the first meta-analysis to study links between vitamin B2 and colorectal cancer. We found vitamin B2 intake was inversely associated with risk of colorectal cancer. However, further research and large sample studies need to be conducted to better validate the result.

• The Korean Journal of Health Service Management
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• v.10 no.4
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• pp.109-121
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• 2016

Objectives : This study was conducted to investigate the need of medical supporting service (MSS) as a part of community-based hospice palliative care from the view point of beneficiaries and providers. Methods : This study adopted a methodological triangulation design. A questionnaire regarding intention to use MSS was completed by 175 patients under home-based cancer patient management program. And three focus groups consisted of hospice nurses, public health physicians, and public officials were interviewed to obtain the perceived needs, obstacles, and solutions of MSS. Results : Mean age of home-based cancer patient was 70.18 year old, 48.0% of them were living alone. Only 53.7% of them were treated pain and 93.7% intend to take pain medication prescribed by public health physician. All participants of focus group interviews agreed necessity and importance of MSS. Physicians' lack of confidence and unwillingness to prescribe opioid to terminal patients was the biggest obstacle to provide MSS in the public health center. Conclusions : The necessity and demand of MSS for community-dwelling cancer patients were verified. MSS is urgent issue to meet their needs.

• Korean Journal of Health Education and Promotion
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• v.25 no.1
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• pp.25-38
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• 2008

Objectives: This study identified the factors associated with successful smoking cessation for 6 months at a smoking-cessation clinic of a public health center in an urban area. Methods: The subjects of this study were 670 visitors to the smoking cessation clinic of Dongjak-Gu public health center in Seoul, from September 6, 2005 to March 24, 2006. The 274 visitors of them responded to the questionnaire with registration, which contained the information related to the study except that of registered card for the clinic. A dependent variable was success or failure in smoking cessation during the 6 month-smoking cessation program, measured the status of smoking cessation in each week by self-report. Independent variable included demographic information, the characteristics in using the clinic, health status and smoking related behaviour, exposure to other smokers in daily life and motivation. Multiple logistic regression model was used to find the factors associated with success of smoking cessation. Results: The success rate in smoking cessation for 6 months was 33.6%. Five pretreatment characteristics were identified as univariate predictors of continuous abstinence. Finally, age, job, and practice oriented motivation were associated significantly with the success of smoking cessation for 6 months from a multiple logistic regression analysis. The lower socio-economic smokers such as people having lower literacy level, lower income people, unskilled workers, and recipients by Medical Assistant Program were more likely to fail in continuous abstinence for 6 months. Conclusions: In order to increase the success rate in smoking cessation clinics of public centers, counselors should activate self confidence and practice oriented motivation of participants for smoking cessation.