• Asian Pacific Journal of Cancer Prevention
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• v.15 no.21
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• pp.9411-9416
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• 2014

Background: Cancer registration data is used to understand the nation's cancer burden, and to provide significant baseline data for cancer control efforts, as well as, research on cancer incidence, mortality, survival, and prevalence. A system that approves, assesses, and manages the qualification of specialists, responsible for performing cancer registration, has not been developed in Korea. This study presents ways to implement a certification system designed for the qualification of tumor registrars in Korea. Materials and Methods: Requirements for implementing a certified tumor registrar qualification system were determined by reviewing the system for establishing qualifications in Korea and the American qualification system via the National Cancer Registrars Association (NCRA). Moreover, a survey was conducted on Korean medical records administrators, who had taken the U.S. Certified Tumor Registrar (CTR) examination, in order to review their opinions regarding these requirements. Results: This study verified the feasibility of a qualification examination based on the opinions of CTR specialists by determining the following: items, and the associated ratings, of the qualifications necessary to register individuals as certified tumor registrars in a private qualification system; status of human resources required for the examination or training processes; plans regarding the organization needed for management, and operation of qualifications, examination standards, subject areas, examination methods, examination qualifications, or education and training programs. Conclusions: The implementation of a certified tumor registrar qualification system will lead to enhanced job competency for specialists and a qualitative improvement of cancer registration data. It will also reliably foster human resources that will lay the groundwork needed to establish scientific and reasonable national cancer management policies.

• Journal of Preventive Medicine and Public Health
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• v.51 no.5
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• pp.242-247
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• 2018

Objectives: To examine survivorship disparities in demographic factors and risk status for non-muscle-invasive bladder cancer (NMIBC), which accounts for more than 75% of all urinary bladder cancers, but is highly curable with early identification and treatment. Methods: We used the US National Cancer Institute's Surveillance, Epidemiology, and End Results registries over a 19-year period (1988-2006) to examine survivorship disparities in age, sex, race/ethnicity, and marital status of patients and risk status classified by histologic grade, stage, size of tumor, and number of multiple primary tumors among NMIBC patients (n=29 326). We applied Kaplan-Meier (K-M) and Cox proportional hazard methods for survival analysis. Results: Among all urinary bladder cancer patients, the majority of NMIBCs were in male (74.1%), non-Latino white (86.7%), married (67.8%), and low-risk (37.6%) to intermediate-risk (44.8%) patients. The mean age was 68 years. Survivorship (in median life years) was highest for non-Latino white (5.4 years), married (5.4 years), and low-risk (5.7 years) patients (K-M analysis, p<0.001). We found significantly lower survivorship for elderly, male (female hazard ratio [HR], 0.96), Latino (HR, 1.20), and unmarried (married HR, 0.93) patients. Conclusions: Survivorship disparities were ubiquitous across age, sex, race/ethnicity, and marital status groups. Non-white, unmarried, and elderly patients had significantly shorter survivorship. The implications of these findings include the need for a heightened focus on health policy and more organized efforts to improve access to care in order to increase the chances of survival for all patients.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.17
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• pp.7743-7748
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• 2015

Background: Thyroid tumors are generally regarded as rare malignancies. Nowadays, however, their global incidence is growing continuously partially due to western life style and utilization of more sensitive methods of early detection. It is approximately three times more prevalent in females than in males. Most cases of thyroid cancer are asymptomatic nodules or just have local cervical symptoms or adenopathy in early stages. Materials and Methods: The Global Burden of Diseases report 2010 study (released 3/2013) profited from 100 collaborators worldwide and used a vast network of data on health outcomes, vital registries, and population surveys. It shared many of the Global Burden of Diseases 1990 principal databases such as all available data on injuries, diseases, risk factors, as well as comparable metrics, and used different scientific approved methods to estimate important health status data like: death rate, life expectancy, healthy adjusted life expectancy, disability-adjusted life years (DALY), years of living lost due to premature death and years of life with disabilities. Results: DALY as thyroid cancer burden per 100,000 Iranian populations had increased by about 14% during 1990 to 2010 in all ages; from 6.1 (95% UI 4.2-9.74) years in 1990 to 6.95 (95% UI 5.06-9.18) years in 2010 in both sex. The 2010 peak age-group was estimated at 45-49 years in males and 40-45 years in females.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.4
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• pp.1105-1109
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• 2012

Breast cancer is the second most common cancer in women in India and the disease burden is increasing annually. The lack of awareness initiatives, structured screening, and affordable treatment facilities continue to result in poor survival. We present a breast cancer survival scenario, in urban population in India, where standardised care is distributed equitably and free of charge through an employees' healthcare scheme. We studied 99 patients who were treated at our hospital during the period 2005 to 2010 and our follow-up rates were 95.95%. Patients received evidence-based standardised care in line with the tertiary cancer centre in Mumbai. One-, three- and five-year survival rates were calculated using Kaplan-Meier method. Socio-demographic, reproductive and tumor factors, relevant to survival, were analysed. Mortality hazard ratios (HR) were calculated using Cox proportional hazard method. Survival in this series was compared to that in registries across India and discrepancies were discussed. Patients mean age was 56 years, mean tumor size was 3.2 cms, 85% of the tumors belonged to T1 and T2 stages, and 45% of the patients belonged to the composite stages I and IIA. Overall 5-year survival was 74.9%. Patients who presented with large-sized tumors (HR 3.06; 95% CI 0.4-9.0), higher composite stage (HR 1.91; 0.55-6.58) and undergone mastectomy (HR 2.94; 0.63-13.62) had a higher risk of mortality than women who had higher levels of education (HR 0.25; 0.05-1.16), although none of these results reached the significant statistical level. We observed 25% better survival compared to other Indian populations. Our results are comparable to those from the European Union and North America, owing to early presentation, equitable access to standardised free healthcare and complete follow-up ensured under the scheme. This emphasises that equitable and affordable delivery of standardised healthcare can translate into early presentation and better survival in India.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.9
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• pp.4323-4326
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• 2016

Background: The cancer mortality-to-incidence ratio (MIR) has been established as an important measure of health disparities in local and global circumstances. Past work has corroborated a linkage between the colorectal cancer MIR and the World Health Organization (WHO) Health System ranking. The literature further documents many Asian countries having incomplete cancer registries and a lack of comprehensive colorectal cancer screening guidelines. Materials and Methods: The colorectal cancer MIR values for 23 Asian countries were calculated from data obtained from the 2012 GLOBOCAN database. The 2000 World Health Organization (WHO) Health System rankings were used as a proxy for health system infrastructure and responsiveness. A regression equation was calculated with the MIR as the dependent variable and the WHO Health System ranking as the independent variable. Predicted MIR values were next calculated based on the regression results. Actual MIR values that exceeded 0.20 from the predicted MIR were removed as 'divergent' points. The regression equation was then re-plotted. Goodness-of-fit for both regressions was assessed by the R-squared test. Results: Asian countries have a relatively wide colorectal cancer MIR range, from a minimum of 0.24 to a maximum of 0.86. For the full dataset, the adjusted R-squared value for this regression was 0.53. The equation was then used to calculate a predicted MIR, whereby two data points were identified as 'divergent' and removed. The adjusted R-squared for the edited dataset increased to 0.66. Conclusions: Asian countries have a marked range in their colorectal cancer MIR values and there is a strong correlationwith the WHO Health System ranking. These results corroborate the contribution of the MIR as a potentially robust tool in monitoring changes in colorectal cancer care for Asian nations.

• Safety and Health at Work
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• v.10 no.4
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• pp.393-399
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• 2019

Objective: This study investigates the impact of multimorbidity on work through a literature review of longitudinal studies. Methods: A systematic review was carried out in the databases Lilacs, SciELO, PAHO, PubMed/Medline, Scopus, Web of Science, and Cochrane. There were no restrictions regarding the year of publication or language to maximize the identification of relevant literature. The quality of studies was assessed by the protocol STrengthening the Reporting of OBservational studies in Epidemiology (STROBE). Results: An initial database search identified 7522 registries, and at the end of the analysis, 7 manuscripts were included in the review. Several studies have demonstrated direct and indirect impacts of multimorbidity on the health of workers. For this, the number of missed days due to health-related issues was evaluated, as well as the reduction in work productivity of the unhealthy worker, vulnerability of the worker with multimorbidity regarding higher indices of dismissal and recruitment difficulties, and incidence of early retirement and/or receipt of benefits due to disabilities. Conclusions: Multimorbidity has a negative impact on work, with damages to quality of life and work productivity, worsening the absenteeism/presenteeism indices, enhancing the chances of temporary or permanent leaves, and lowering employability and admission of individuals with multimorbidity.

• Korean Journal of Head & Neck Oncology
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• v.23 no.2
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• pp.147-152
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• 2007

Objectives and Background : Aims of this studies are to collect and analyze the lawful restriction against cancer registration and to suggest the model promoting the cancer registry. Materials and Methods : Total 16 countries, the members of OECD, including the U.S. are evaluated. the status of cancer registration of the evaluated countries are analyzed. The legislated laws, protect the individual's information, of the evaluated countries are analyzed. The cases any registries were impaired with the law to protect privacy are searched and analyzed. Results : All of the evaluated countries have some kinds of privacy protecting laws. For cancer registration, 11 of 16 countries implement some lawful authorities. Some of countries have experienced restriction of registration by the law of protecting individual's health data. All countries have performed cancer registry and 6 of 16 countries have nearly 100% population-based cancer registration. Conclusions : The cancer registry has to be the national effort. The informed consent of the data subjects and the permission of any special institutes are the difference to perform the registration. So, it is necessary to legislate any law supporting the cancer registration and establish any independent institutes to protect the individual's health data and support the cancer registry.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.14
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• pp.5853-5858
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• 2015

Background: The survival rate reflecting prognosis of breast cancer patients is usually estimated based on crude survival methods such as observed and cause-specific. In situations where data are based on population-cancer registries, this method may produce biased estimations. This study therefore aimed to estimate the net survival of breast cancer based on relative survival. Materials and Methods: Data for 622 breast cancer patients diagnosed at the Iran Cancer Institute during 1990-95 and tracked till the end of 2000 were analyzed. For estimation of relative survival, Ederer's second method and SAS (9.1) and STATA (11) software were used. Results: Threeyear relative survivals of 85%, 90%, 80% and 67% were observed for age groups 15-44, 55-59, 60-74, and 75+years-old, respectively. A relative survival of approximately one was observed for two subsequent years for age-group 45-59 years-old. A value greater than one for two subsequent years of follow-up was observed in the age-group 60-74 years-old. Conclusions: Tracking the diagnosis of breast cancer, the relative survival decreases as we go to higher age-groups. It is also perceived that through follow-up, relative survival first decreased and then increased a little. The statistical cure point is acceptable for age group 45-59 years-old while for age-groups 15-44 and 60-74 years old is a sign of low quality data for some follow-up intervals.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.7
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• pp.3149-3152
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• 2012

Objective: The prognostic significance of perineural invasion (PNI) in gastric cancer has been previously investigated but not clearly clarified. The objective of our study was to investigate the role of PNI as prognostic factor in patients undergoing curative surgical resection and without distant metastasis in comparison with other clinicopathological factors. Methods: Between 2001 and 2010, 287 cases of gastric adenocarcinoma underwent radical gastrectomy recorded in hospital based registries. PNI was assessed as positive when cancer cells were seen in the perinerium or neural fascicles intramurally. Categorical and continuous variables were summarized using descriptive statistics and compared using chi-square and Mann-Whitney U tests, respectively. Cancer related survival rates were estimated by the Kaplan-Meier method. Results: PNI was positive in 211 of 287 cancers (73%), with a positive relation to lymph node metastases and advanced stage (p=0.0001, p=0.0001, respectively), mural invasion, and lymphatic and blood vessel invasion (p=0.0001, p=0.0001, respectively). The median survival of the PNI positive patients was significantly shorter than that of their PNI negative counterparts (24.1 versus 38.2 months, p=0.008). In the multivariate analysis, we detected PNI was an independent prognostic factor (p=0.025, HR=1.21, 95% CL 1.08-2.3) along with classical clinicopathological variables such as lymph node involvement (p=0.001), pT stage (p=0.03), and LVI (p=0.017), but not age, gender, tumour localization, stage, histologic type, and surgery procedure. Conclusions: PNI positivity in gastric cancers was related mural invasion, lymph node involvement, advanced stage and lymphatic and venous blood vessels. The presence of PNI appeared as an independent prognostic factor on survival on multivariate analysis, not influenced by tumor stage, lymph node metastases and other classical factors.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.15
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• pp.6087-6094
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• 2014

Purpose: The aim of the present study was to invesitigate the impact of significant clinico-pathological prognostic factors on survival rates and to identify factors predictive of poor outcome in patients with ovarian carcinoma. Materials and Methods: A retrospective chart review of 74 women with pathologically proven ovarian carcinoma who were treated between January 2006 and April 2011 was performed. Patients were investigated with respect to survival to find the possible effects of age, gravida, parity, menstruel condition, pre-operative Ca-125, treatment period, cytologic washings, presence of ascites, tumor histology, stage and grade, maximal tumor diameter, adjuvan chemotherapy and cytoreductive success. Also 55 ovarian carcinoma patients were investigated with respect to prognostic factors for early 2-year survival. Results: The two-year survival rate was 69% and the 5-year survival rate was 25.5% for the whole study population. Significant factors for 2-year survival were preoperative CA-125 level, malignant cytology and FIGO clinical stage. Significant factors for 5-year survival were age, preoperative CA-125 level, residual tumor, lymph node metastases, histologic type of tumor, malignant cytology and FIGO clinical stage. Logistic regression revealed that independent prognostic factors of 5-year survival were patient age, lymph node metastasis and malignant cytology. Conclusions: We consider quality registries with prospectively collected data to be one important tool in monitoring treatment effects in population-based cancer research.