• Asian Pacific Journal of Cancer Prevention
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• v.14 no.8
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• pp.4759-4763
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• 2013

Background: Prognostic factors of postoperative early and late recurrence in patients with hepatocellular carcinoma (HCC) undergoing curative resection remain to be clarified. The aim of this study was to identify risk factors for postoperative early (${\leq}$ 2 year) and late (> 2 year) intrahepatic recurrences in patients with single HCCs without macrovascular invasion. Methods: A total of 280 patients from December 2004 to December 2007 were retrospectively included in this study. Intrahepatic recurrence was classified into early (${\leq}$ 2 year) and late (> 2 year) and the Chi-Square test or Fisher's exact test and multivariate logistic regression analysis were performed to determine significant risk factors. Results: During the follow-up, 124 patients had intrahepatic recurrence, early and late in 82 and 42 patients, respectively. Multivariate logistic regression analysis showed that microvascular invasion (p=0.006, HR: 2.397, 95% CI: 1.290-4.451) was the only independent risk factor for early recurrence, while being female (p = 0.031, HR: 0.326, 95% CI: 0.118-0.901), and having a high degree of cirrhosis (P=0.001, HR: 2.483, 95% CI: 1.417-4.349) were independent risk factors for late recurrence. Conclusions: Early and late recurrence of HCC is linked to different risk factors in patients with single HCC without macrovascular invasion. This results suggested different emphases of strategies for prevent of recurrence after curative resection, more active intervention including adjuvant therapy, anti-cirrhosis drugs and careful follow-up being necessary for patients with relevant risk factors.

• Journal of Preventive Medicine and Public Health
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• v.49 no.6
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• pp.367-375
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• 2016

Objectives: The established theory that breast density is an independent predictor of breast cancer risk is based on studies targeting white women in the West. More Asian women than Western women have dense breasts, but the incidence of breast cancer is lower among Asian women. This meta-analysis investigated the association between breast density in mammography and breast cancer risk in Asian women. Methods: PubMed and Scopus were searched, and the final date of publication was set as December 31, 2015. The effect size in each article was calculated using the interval-collapse method. Summary effect sizes (sESs) and 95% confidence intervals (CIs) were calculated by conducting a meta-analysis applying a random effect model. To investigate the dose-response relationship, random effect dose-response meta-regression (RE-DRMR) was conducted. Results: Six analytical epidemiology studies in total were selected, including one cohort study and five case-control studies. A total of 17 datasets were constructed by type of breast density index and menopausal status. In analyzing the subgroups of premenopausal vs. postmenopausal women, the percent density (PD) index was confirmed to be associated with a significantly elevated risk for breast cancer (sES, 2.21; 95% CI, 1.52 to 3.21; $I^2=50.0%$). The RE-DRMR results showed that the risk of breast cancer increased 1.73 times for each 25% increase in PD in postmenopausal women (95% CI, 1.20 to 2.47). Conclusions: In Asian women, breast cancer risk increased with breast density measured using the PD index, regardless of menopausal status. We propose the further development of a breast cancer risk prediction model based on the application of PD in Asian women.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.7
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• pp.2857-2870
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• 2015

Although the incidence of breast cancer in Asia remains lower than in North America, Western Europe, and Oceania, rates have been increasing rapidly during the past few decades, and Asian countries now account for 40% of breast cancer cases diagnosed worldwide. Breast cancer mortality has also increased among Asian women, in contrast to decreased mortality in Northern America, Western Europe, and Oceania. These increased rates are associated with higher prevalence of breast cancer risk factors (e.g., reduced parity, delayed childbirth, increased obesity) that have accompanied economic development throughout the region. However, Asian regions (western, south-central, south-eastern, and eastern) and countries differ in the types and magnitude of changes in breast cancer risk factors, and cannot be viewed as a single homogeneous group. The objective of this paper was to contrast the heterogeneous epidemiology of breast cancer by Asian regions and countries, and to suggest potential avenues for future research.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.2
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• pp.861-865
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• 2014

Background: High risk HPV (HR-HPV) testing has been recommended as an effective tool along with cytology screening in identification of cervical intraepithelial lesions (CINs) and prevention of their progress towards invasive cervical cancer. The aim of this study was to assess the HR-HPV DNA status by Hybrid Capture 2 (HC2) assay in healthy asymptomatic women of North-East India. Materials and Methods: This study examined cervical cell samples of forty three (n=43) healthy women by HC2 assay. A High Risk HPV DNA kit (Qiagen) was used which can detect 13 high risk HPV types: 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59 and 68. Results: The mean relative light units (RLU) for samples was in the range of 141-5, 94, 619. HR-HPV DNA was confirmed in 16% (7/43) of participant women samples. Among demographic and clinical parameters, menstrual irregularity (p=0.039) and infection history (p=0.028) has shown statistically significant differences between the HR-HPV-positive and negative groups. In the HR-HPV positive group, two women were confirmed for CINs after colposcopy and histopathologic examination. Conclusions: We suggest that there may be an association between irregular menstruation and infection history of the urogenital tract with HR-HPV DNA prevalence in North-East Indian asymptomatic women. HC2 assay can be a valuable tool for HR-HPV screening.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.7
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• pp.2981-2986
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• 2015

Background: Despite many epidemiological studies on the effects of dietary antioxidant micronutrients on risk of cervical cancer, the findings remain uncertain and little evidence is available for serum nutrient markers. The present study aimed to examine the relationship between serum carotenoid, retinol and tocopherol concentrations and risk of cervical cancer among Chinese women. Materials and Methods: We conducted a hospital-based case-control study in which 358 adults (158 incident cases and 200 controls) were recruited from Xinjiang, China. Serum levels of carotenoids (${\alpha}$-carotene, ${\beta}$-carotene, ${\beta}$-cryptoxanthin, lycopene and lutein/zeaxanthin), retinol, and tocopherols (${\alpha}$-tocopherol and ${\gamma}$-tocopherol) were assessed by reverse-phase high-performance liquid chromatography. Results: We found inverse associations between serum carotenoid (${\alpha}$-carotene, ${\beta}$-carotene, and lutein/zeaxanthin) and tocopherol (${\alpha}$-tocopherol) concentrations and the risk of cervical cancer after adjusting for potential confounders, but a null association for retinol. The ORs for 1-SD increase were 0.71 (95 % CI: 0.56-0.92; p=0.003) for total carotenoids and 0.75 (95 % CI: 0.60-0.94; p=0.008) for total tocopherols. Conclusions: These results show that higher serum concentrations of some carotenoids and tocopherols are associated with a lower risk of cervical cancer among Chinese women.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.7
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• pp.3431-3436
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• 2012

Objective: X-ray cross-complementing group 4 (XRCC4) is a major repair gene for DNA double-strand breaks (DSB) in the non-homologous end-joining (NHEJ) pathway. Several potentially functional polymorphisms of the XRCC4 gene have been implicated in breast cancer risk, but individually published studies showed inconclusive results. The aim of this meta-analysis was to investigate the association between XRCC4 polymorphisms and the risk of breast cancer. Methods: The MEDLINE, EMBASE, Web of science and CBM databases were searched for all relevant articles published up to June 20, 2012. Potential associations were assessed with comparisons of the total mutation rate (TMR), complete mutation rate (CMR) and partial mutation rate (PMR) in cases and controls. Statistical analyses were performed using RevMan 5.1.6 and STATA 12.0 software. Results: Five studies were included with a total of 5,165 breast cancer cases and 4,839 healthy controls. Meta-analysis results showed that mutations of rs2075686 (C>T) and rs6869366 (G>T) in the XRCC4 gene were associated with increased risk of breast cancer, while rs2075685 (G>T) and rs10057194 (A>G) might decrease the risk of breast cancer. However, rs1805377 (A>G), rs1056503 (G>T), rs28360317 (ins>del) and rs3734091 (A>G) polymorphisms of XRCC4 gene did not appear to have an influence on breast cancer susceptibility. Conclusion: Results from the current meta-analysis suggest that the rs2075685 (G>T) and rs6869366 (G>T) polymorphisms of the XRCC4 gene might increase the risk of breast cancer, whereas rs2075685 (G>T) and rs10057194 (A>G) might be protective factors.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.14
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• pp.5787-5791
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• 2014

Background: With increasing survival periods and diversification of treatment methods, treatment of critically ill cancer patients has become an important factor influencing patient prognosis. Patients with cancer are at high risk of infections and subsequent complications. This study investigated the incidence and factors contributing to the development of ventilator-associated pneumonia (VAP). Materials and Methods: This retrospective study investigated the incidence of VAP and factors leading to infection in patients admitted to the intensive care unit (ICU) of a cancer center from January 1, 2012 to December 31, 2013. Results: The incidence of VAP was 2.13 cases per 1,000 days of intubation, and 13 of 288 patients (4.5%) developed VAP. Lung cancer was the most common cancer associated with VAP (N=7, 53.9%), and longer hospital stays and intubation were associated with increased VAP incidence. In the group using a "ventilator bundle," the incidence was 1.14 cases per 1,000 days compared to 2.89 cases per 1,000 days without its use; however, this difference was not statistically significant (p=0.158). Age (${\geq}65$, OR=5.56, 95% confidence interval [CI]=1.29-23.95), surgery (OR=3.78, 95%CI=1.05-13.78), and tracheotomy (OR=4.46, 95%CI=1.00-19.85) were significant VAP risk factors. The most common causative organisms were methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa (N=4, 30.8% each), followed by Acinetobacter baumannii and Candida albicans (N=2, 15.4% each). Conclusions: The incidence of pneumonia among critically ill cancer patients is highest in those with lung cancer, but lower than among non-cancer patients. The length of hospital stay and time on mechanical ventilation are important risk factors for development of VAP. Although not statistically significant, "ventilator bundle" care is an effective intervention that delays or reduces incidence of VAP. Major risk factors for VAP include age (${\geq}65$ years), surgery, and tracheostomy, while fungi, gram-negative bacteria, and multidrug-resistant organisms were identified as the major causative pathogens of VAP in this study.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.18
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• pp.8163-8171
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• 2016

Background: Breast cancer is the second most cause of death (1.38 million, 10.9% of all cancer) worldwide after lung cancer. In present study, we assess the knowledge, level of awareness of risk factors and screening practices especially breast self examination (BSE) among women, considering the non-feasibility of diagnostic tools such as mammography for breast screening techniques of breast cancer in the holy city Varanasi, Uttar Pradesh, India. Materials and Methods: A cross-sectional population based survey was conducted. The investigation tool adopted was self administrated questionnaire format. Data were analysed using SPSS 20 version and Chi square test to determine significant association between various education groups with awareness and knowledge, analysis of variance was applied in order to establish significance. Results: The attitude of participants in this study, among 560 women 500 (89%) responded (age group 18-65 years), 53.8% were married. The knowledge about BSE was very low (16%) and out of them 15.6% were practised BSE only once in life time. study shown that prominent age at which women achieve their parity was 20 yrs, among 500 participants 224 women have achieved their parity from age 18 to 30 yrs. Very well known awareness about risk factors of breast cancer were alcohol (64.6%), smoking (64%) and least known awareness risk factors were early menarche (17.2%) and use of red meat (23%). The recovery factors of breast cancer cases were doctors support (95%) and family support (94.5%) as most familiar responses of the holy city Varanasi. Conclusions: The study revealed that the awareness about risk factors and practised of BSE among women in Varanasi is extremely low in comparison with other cities and countries as well (Delhi, Mumbai, Himachal Pradesh, Turkey and Nigeria). However, doctors and health workers may promote the early diagnosis of breast cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.23
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• pp.10335-10337
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• 2015

Background: Gastric cancer is considered as the second most prevalent cancer in Iran. The present research sought to identify high risk clusters of gastric cancer with mapping using space-time scan statistics. Materials and Methods: The present research is of descriptive type. The required data were gathered from the registered cancer reports of Cancer Control Office in the Center for Non Communicable Disease of the Ministry of Health (MOH). The data were extracted at province level in the time span of 2004-9. Sat-Scan software was used to analyse the data and to identify high risk clusters. ArcGIS10 was utilized to map the distribution of gastric cancer and to demonstrate high risk clusters. Results: The most likely clusters were found in Ardabil, Gilan, Zanjan, East-Azerbaijan, Qazvin, West-Azerbaijan, Kurdistan, Hamadan, Tehran and Mazandaran between 2007 and 2009. It was statistically significant at the p-value below 0.05. Conclusions: High risk regions included Northern, West-North and central provinces, particularly Ardabil, Kurdistan, Mazandaran and Gilan. More screening tests are suggested to be conducted in high risk regions along with more frequent epidemiological studies to enact gastric cancer prevention programs.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.1
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• pp.57-64
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• 2016

Background: Tobacco smoking is considered a risk factor for cervical cancer development due to the presence of tobacco based carcinogenic metabolites in cervical cells of female smokers. In this study, we investigated the role of the T3801C (MspI) polymorphism of CYP1A1, a gene encoding an enzyme necessary for the initiation of tobacco based carcinogen metabolism, on cervical cancer risk. The T to C substitution may alter CYP1A1 activities, potentially elevating cervical cancer risk. Since results of gene-disease association studies vary according to the study population, the multi-ethnic population of Malaysia provides an excellent representative cohort for identifying and comparing the cervical cancer risk among the 3 major ethnics in Southeast Asia in relation to CYP1A1 MspI polymorphism. Materials and Methods: A total of 195 Thin Prep Pap smear samples from HPV negative and cancer free females were randomly selected as controls while 106 formalin fixed paraffin embedded samples from females with invasive cervical cancer were randomly selected for the cases group. The polymorphisms were identified using restriction fragment length polymorphism (RFLP) PCR. Results: We found no significant associations between CYP1A1 MspI polymorphism and cervical cancer in the general Malaysian female population. However, upon ethnic stratification, the variant C/C genotype was significantly associated with a 4.66-fold increase in cervical cancer risk in Malay females (95% CI= 1.21-17.9; p=0.03). No significant association was observed in the Chinese and Indian females. Additionally, there were no significant associations in the dominant model and allele frequency model analysis in both the general and ethnically stratified female population of Malaysia. Conclusions: Our findings suggest that the C/C genotype of CYP1A1 MspI polymorphism is associated with the development of cervical carcinoma in the Malay females of Malaysia.