• Asian Pacific Journal of Cancer Prevention
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• v.14 no.10
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• pp.5811-5816
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• 2013

Background: Breast cancer is the most common cancer among women. Molecular subtypes are important in determining prognosis. This study evaluated five-year disease-free survival among four molecular subtypes in patients with early stages of breast cancer. Materials and Methods: In this retrospective descriptive-analytical study, information on patients with breast cancer between 2001-2010 was evaluated. Five hundred ninety two patients in the early stages of breast cancer (stages 1 and 2) were selected to undergo anthracycline-based chemotherapy. Relapse, death or absence (censor) were considered as the end of the study. Patients based on ER, PR and HER-2 expression were divided into four subtypes (luminal A, luminal B, HER-2 enriched and triple negative). Information based upon questionnaire was analysed. To show the patients survival rate, life table and Kaplan-Meyer methods were used, and for comparing mean survival among different groups, the Log-Rank test was utilized. Results: Mean age at diagnosis was $47.9{\pm}9.6$. Out of the 592 patients, 586 were female (99%) and 6 were male (1%). Considering breast cancer molecular subtypes, 361 patients were in the luminal A group (61%), 49 patients in the luminal B group (8.3%), 48 patients in the HER-2 enriched group (8.1%) and 134 in the triple negative group (22.6%). Mean disease-free survival was 53.7 months overall, 55.4 months for the luminal A group, 48.3 months for the luminal B group, 43 months for the HER-2enriched group and 54.6 months for the triple negatives. Disease free survival differed significantly among the molecular subtypes (p value=0.0001). Conclusions: The best disease-free survival rate was among the luminal A subgroup and the worst disease-free survival rate was among the HER-2 enriched subgroup. Disease free survival rate in the HER-2 positive groups (luminal B and HER-2 enriched) was worse than the HER-2 negative groups (luminal A and triple negative).

• Korean Journal of Adult Nursing
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• v.17 no.3
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• pp.452-463
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• 2005

Purpose: The purpose of the present study was to analyze and evaluate prior studies published in Korea on the cardiovascular disease-related quality of life, in order to make recommendations for further research. Methods: A total of 15 studies were selected from four databases(Digital library of Research Information Center for Health, Korea Medical Database, MedRic, and National Assembly Library). The selected studies were analyzed according to criteria, such as diagnosis/operation, used instrument, generic/specific instrument, dimension of quality of life, translation/ back-translation, sample size, reliability, validity, responsiveness, number of items, type of scale, time required, and independent variables. Results: Of the 15 cardiovascular disease-related quality of life studies, approximately half of them were conducted with hypertension or ischemic heart disease patients. All studies asserted that the concept of quality of life had multidimensional attributes. With respect to the questionnaire used for measuring the quality of life, only one study used a cardiovascular disease specific-instrument and most studies did not consider whether or not the validity of their instrument had been established. In addition, when using questionnaires developed in other languages, only one study employed a translation/back-translation technique. The types of variables tested for their influence on quality of life were quite limited. Conclusion: It is recommended to develop a reliability and validity established cardiovascular disease specific-quality of life for Korean patients and to identify associated new variables.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.4
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• pp.1677-1684
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• 2016

Background: Among the factors reported to determine the quality of life of breast cancer patients are socio-demographic background, clinical stage, type of treatment received, and the duration since diagnosis. Objective: The objective of this study was to determine the quality of life (QOL) scores among breast cancer patients at a Malaysian public hospital. Materials and Methods: This cross-sectional study of breast cancer patients was conducted between March to June 2013. QOL scores were determined using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and its breast cancer supplementary measure (QLQ-BR23). Both the QLQ-C30 and QLQ-BR23 assess items from functional and symptom scales. The QLQ-C30 in addition also measures the Global Health Status (GHS). Systematic random sampling was used to recruit patients. Results: 223 breast cancer patients were recruited with a response rate of 92.1%. The mean age of the patients was 52.4 years (95% CI = 51.0, 53.7, SD=10.3). Majority of respondents are Malays (60.5%), followed by Chinese (19.3%), Indians (18.4%), and others (1.8%). More than 50% of respondents are at stage III and stage IV of malignancy. The mean Global Health Status was 65.7 (SD = 21.4). From the QLQ-C30, the mean score in the functioning scale was highest for 'cognitive functioning' (84.1, SD=18.0), while the mean score in the symptom scale was highest for 'financial difficulties' (40.1, SD=31.6). From the QLQ-BR23, the mean score for functioning scale was highest for 'body image' (80.0, SD=24.6) while the mean score in the symptom scale was highest for 'upset by hair loss' (36.2, SD=29.4). Two significant predictors for Global Health Status were age and employment. The predictors explained 10.6% of the variation of global health status ($R^2=0.106$). Conclusions: Age and employment were found to be significant predictors for Global Health Status (GHS). The Quality of Life among breast cancer patients reflected by the GHS improves as age and employment increases.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.4
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• pp.1961-1966
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• 2016

Background: To investigate the prevalence of premature ejaculation (PE) and erectile dysfunction (ED) in a sample of patients with prostate cancer and to determine the utility of the previously suggested cutoffs of the Premature Ejaculation Diagnostic Tool (PEDT) for the diagnosis of PE and that of International Index of Erectile Function (IIEF-5) for ED. Materials and Methods: A total of 1,202 men with prostate cancer were invited from urology clinics at the universities of Iran, Tehran, Qazvin, Ahvaz, Guilan and Tabriz. Clinical characteristics were collected through medical records. PE and ED diagnoses were made by trained urologists. In addition to the clinical diagnoses, PE and ED were measured through self-report using the PEDT and the IIEF-5. Questionnaire cutoff scores were determined using receiver operating characteristic (ROC) curves and confirmed by predictive ability using logistic regression. Results: The prevalence of PE was 63.7% and that of ED was 66.2%. Prevalences of PE decreased and that of ED increased with advanced TNM stages. According to ROC, the suggested cutoff for the PEDT to diagnose a PE was ${\geq}11$ (sensitivity=0.988, 1-specificity=0.084, and predictive ability=0.914) and ${\leq}17$ for the IIEF-5 (sensitivity=0.966, 1-specificity=0.031, and predictive ability=0.967). Conclusions: Prevalence of sexual problems was high in prostate cancer patients in Iran, therefore oncologists should take into account these potential problems when deciding on treatment modalities.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.3
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• pp.979-984
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• 2015

Breast cancer is the leading cause of morbidity and mortality globally but has an even more significant impact in developing countries. Pakistan has the highest prevalence among Asian countries. A general lack of public awareness regarding the disease often results in late diagnosis and poor treatment outcomes. The literacy rate of the Southern Punjab (Pakistan) is low compared to its Northern part. It is therefore vital that university students and especially medical students develop a sound knowledge about the disease so that they can spread awareness to others who may be less educated. This study therefore considers current knowledge and understanding about the early signs of breast cancer amongst a study group of medical and non-medical university students of the Southern Punjab, Pakistan. A cross-sectional descriptive analysis of the university students was carried out using a self-administered questionnaire to assess their awareness of breast cancer from March to May 2014. A total of 566 students participated in this study, out of which 326 were non-medical and 240 were from a medical discipline. Statistical analysis was carried out using Graph Pad Prism Version 5 with a significance level set at p<0.05. The mean age of the non medical and medical participants was 23 (SD 2.1) and 22 (SD 1.3) years, respectively. Less than 35% students were aware of the early warning signs of the breast cancer development. Knowledge of medical students about risk factors was significantly better than the non medical ones, but on the whole was insufficient. Our study indicated that knowledge regarding breast cancer was generally insufficient amongst the majority of the university students (75% non-medical and 55% medical) of Southern Punjab, Pakistan. This study highlights the need to formulate an awareness campaign and to organize conferences to promote breast cancer awareness among students in this region.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.3
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• pp.957-962
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• 2012

Objective: Rapidly increasing colorectal cancer (CRC) incidence in Malaysia and the introduction of cutting edge new treatments, which prolong survival, mean that treatment outcome measures meed to be evaluated, including consideration of patient's quality of life (QoL) assessment. There are limited data on QoL in CRC patients, especially in Malaysia. Therefore, this study was performed focusing on cancer stages and age groups. Methods: The cross sectional study was conducted from June to September 2011 at three public tertiary hospitals with the EORTC QLQ C-30 questionnaire in addition to face to face interview and review of medical records of 100 respondents. Results: The mean age was 57.3 (SD 11.9) years with 56.0% are males and 44.0% females, 62% of Malay ethnicity, 30% Chinese, 7% Indian and 1% Sikh. Majority were educated up to secondary level (42%) and 90% respondents had CRC stages III and IV. Mean global health status (GHS) score was 79.1 (SD 21.4). Mean scores for functional status (physical, emotional, role, cognitive, social) rangeds between 79.5 (SD 26.6) to 92.2 (SD 13.7). Mean symptom scores (fatigue, pain, nausea/vomiting, constipation, diarrhea, insomnia, dyspnoea, loss of appetite) ranged between 4.00 (SD 8.58) to 20.7 (SD 30.6). Respondents role function significantly deteriorates with increasing stage of the disease (p=0.044). Females had worse symptoms of pain (p=0.022), fatigue (p=0.031) and dyspnoea (p=0.031). Mean insomnia (p=0.006) and diarrhea (p=0.024) demonstrated significant differences between age groups. Conclusion: QOL in CRC patients in this study was comparable to that in other studies done in developed countries. Pain, fatigue and dyspnoea are worse among female CRC patients. Given that functions deteriorates with advanced stage of the disease at diagnosis, a systematic screening programme to detect cases as early as possible is essential nationwide.

• Clinical and Experimental Pediatrics
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• v.59 no.5
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• pp.218-225
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• 2016

Purpose: The recent increase in the prevalence of allergic diseases is hypothetically attributed to immune dysregulation in turn caused by a reduction in exposure to sunlight. We explored relationships between birth season, sunlight exposure, exercise duration, and an allergic disease. Methods: We performed a questionnaire-based survey on allergic diseases among elementary school students. Birth time was categorized according to the season (summer and winter). Results: The prevalence of atopic dermatitis (AD) "symptoms ever" was higher in the children born in winter than in those born in summer (adjusted odds ratio [aOR], 1.24; 95% confidence interval [CI], 1.03-1.49; P=0.024). Birth in winter was associated with an increase in the "symptoms in the past 12 months" prevalence of food allergy (FA) (aOR, 1.56; 95% CI, 1.09-2.24; P=0.015). The lifetime prevalence of allergic diseases except FA was higher in the children whose parents considered their sunlight exposure prior to 24 months of ageas inadequate than those who considered their exposure as adequate ("diagnosis ever" asthma: aOR, 1.4; 95% CI, 1.17-1.67; P<0.001; allergic rhinitis [AR]: aOR, 1.4; 95% CI, 1.17-1.67; P<0.001; AD: aOR, 1.26; 95% CI, 1.06-1.51; P=0.01). Neither recent sunlight exposure nor exercise duration was associated with the prevalence of an allergic disease. Conclusion: Birth in winter may be associated with development of AD and FA. Inadequate sunlight exposure before the age of 24 months might possibly increase the risks of development of asthma, AR, and AD.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.2
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• pp.1141-1145
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• 2013

Delay in seeking treatment for breast cancer is a barrier to the early diagnosis and management of the disease, resulting in a poorer prognosis. We here estimated the prevalence of delayed presentation for breast cancer and identified possible influential sociodemographic factors in a cross-sectional study of 250 patients diagnosed with primary breast cancer at the Radiotherapy and Oncology Clinic in Kuala Lumpur Hospital. Data were collected by face-to-face interview using a structured questionnaire and from medical records. We examined associations between delayed presentation (presenting to a physician more than 3 months after self-discovery of a symptom) and sociodemographic characteristics, practice of breast self examination (BSE), history of benign breast disease, family history of breast cancer and type of symptom, symptom disclosure and advice from others to seek treatment using multiple logistic regression. Time from self-discovery of symptom to presentation ranged from tghe same day to 5 years. Prevalence of delayed presentation was 33.1% (95%CI: 27.4, 39.3). A significantly higher proportion of delayers presented with late stages (stage III/IV) (58.3% vs. 26.9%, p<0.001). Divorced or widowed women (OR: 2.23, 95% CI: 1.11, 4.47) had a higher risk of delayed presentation than married women and women who never performed breast self examination were more likely to delay presentation compared to those who regularly performed BSE (OR: 2.74, 95% CI: 1.33, 5.64). Our findings indicate that delayed presentation for breast cancer symptoms among Malaysian women is high and that marital status and breast self examination play major roles in treatment-seeking for breast cancer symptoms.

• Nutrition Research and Practice
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• v.10 no.3
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• pp.305-312
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• 2016

BACKGROUND/OBJECTIVES: As the prevalence of chronic diseases has risen, the need for straightforward diagnostic tools for monitoring nutrition status to improve nutrition counseling and disease prevention has likewise increased. This study developed an easily usable dietary behavior pattern diagnosis checklist and investigated its correlation with dietary quality index. SUBJECTS/METHODS: A draft dietary pattern evaluation tool was generated by analyzing previous studies. The draft questionnaire comprised 61 questions for assessing dietary habits. A survey was administered to 320 adults (19 to 64 years old) using the dietary pattern evaluation tool and 24-hour-recall method between March and May of 2014 in Jeonbuk province and the metropolitan area. Principal component analysis with varimax rotation was performed to identify dietary behavior patterns. Nutritional analysis was conducted using CAN-Pro 4.0, and the Diet Quality Index-International (DQI-I) was calculated to assess dietary quality. The correlation between dietary pattern scores and DQI-I scores was also analyzed. RESULTS: The factor analysis resulted in a total of 34 questions mapped to four main dietary behavior patterns: "high fat and calorie" pattern (12 questions), "overeating/binge" pattern (nine questions), "dietary impulse" pattern (eight questions), and "unbalanced food intake" pattern (five questions). The four dietary behavior patterns were negatively correlated with DQI-I adequacy and total scores (P < 0.01). CONCLUSIONS: The dietary pattern evaluation tool developed in this study can be used to diagnose a client's dietary behavior problems and is available as a nutrition counseling tool in the field.

• Journal of Community Nutrition
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• v.8 no.4
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• pp.185-192
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• 2006

This study was performed to investigate factors affecting sensitivity and preference for salty tastes of Korean adult females. Sensitivity and preference for salty tastes were determined as detection threshold concentration of NaCl solution and the optimally-preferred NaCl concentration of the bean sprout soup, respectively. A self-administered questionnaire was used to obtain the information regarding general characteristics, self diagnosis of stress, health-related lifestyle practices, dietary habits and food preferences. Dietary intake using 24-hours recall and blood pressure were measured. Salty taste detection thresholds and optimally-preferred NaCl concentrations were 0.0197% and 0.357%, respectively. There was a significant positive correlation between the optimally-preferred salt concentration and age, despite no significant correlation between either sensitivity or preference for salty taste and sodium intake, which was 3,605mg/day. Those who had bread or cereal with milk as breakfast instead of a traditional Korean meal and those who preferred jjigae to soup had significantly higher NaCl preferences for bean sprout soup. Going to bed after midnight and skipping meals (${\geq}3/week$) decreased salty taste sensitivity without reaching statistical significance. Self awareness of one's own health, recent weight changes, family history of hypertension, sleep quality, getting-up time, rate of eating and other food preferences did not affect either perception. Stress level, TV watching, BMI and sodium intake did not have significant correlation to sensitivity or preference. Further research including a large number of well-controlled subjects and more accurate measurement of sodium intake should be directed to find other factors affecting salt preference and sensitivity in order to decrease Na intake and related diseases.