• Asian Pacific Journal of Cancer Prevention
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• v.16 no.3
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• pp.927-932
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• 2015

Background: Breast and cervical cancers are the most common causes of cancer mortality among women in India, but actually they are largely preventable diseases. Although early detection is the only way to reduce morbidity and mortality, there are limited data on breast and cervical cancer knowledge, safe practices and attitudes of teachers in India. The purpose of this study is to assess the level of awareness and impact of awareness programs in adoption of safe practices in prevention and early detection. Materials and Methods: This assessment was part of a pink chain campaign on cancer awareness. During cancer awareness events in 2011 at various women colleges in different parts in India, a pre-test related to cervical cancer and breast cancer was followed by an awareness program. Post-tests using the same questionnaire were conducted at the end of the interactive session, at 6 months and 1 year. Results: A total of 156 out of 182 teachers participated in the study (overall response rate was 85.7 %). Mean age of the study population was 42.4 years (range- 28-59 yrs). There was a significant increase in level of knowledge regarding cervical and breast cancer at 6 months and this was sustained at 1 year. Adoption of breast self examination (BSE) was significantly more frequent in comparison to CBE, mammography and the Pap test. Magazines and newspapers were sources for knowledge regarding screening tests for breast cancer in more than 60% of teachers where as more than 75% were educated by doctors regarding the Pap test. Post awareness at 6 months and 1 year, there was a significant change in alcohol and smoking habits. Major reasons for not doing screening test were found to be ignorance (50%), lethargic attitude (44.8%) and lack of time (34.6%). Conclusions: Level of knowledge of breast cancer risk factors, symptoms and screening methods was high as compared to cervical cancer. There was a significant increase in level of knowledge regarding cervical and breast cancer at 6 months and this was sustained at 1 year. Adoption of BSE was significantly greater in comparison to CBE, mammography and the Pap test. To inculcate safe practices in lifestyle of people, awareness programmes such as pink chain campaign should be conducted more widely and frequently.

• Journal of Nutrition and Health
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• v.27 no.10
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• pp.1058-1069
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• 1994

This study was performed to study the effects of dietary factors on breast and cervical cancer incidence in female Koreans. The subjects were 60 breast and 109 cervical cancer patients recruited from five general hospitals in Seoul. Food intake, anthropometric measurement, and blood compositions were studied through personal interview and using medical records, from August 1991 to September 1992. Body weight, body mass index, triceps skinfold thickness and body muscle mass were at upper limit of normal value, which suggest that these patients had a tendency of overweight. The levels of hemoglobin and hematocrit of the patients were below the normal values. The values of serum protein, albumin, and calcium were in the normal range but close to the lower bound. Therefore the nutritional status assessed by blood composition seems to be marginal. The results of diet history showed that most of the nutrient intake of the subjects met with RDA. The fat intake were 22.9-36.9g/day which supplies about 15-16% of total calories. The results of this study do not agree with those reports of western societies which showed the positive correlation between calorie and fat intake and the incidence of breast and cervical cancer. Even through the calories and fat intake of the subjects were not high, it was higher than national average, especially in breast cancer patients. From this study, dietary factors does not seem to be a major risk factor in cancer incidence in Korea. However, the tendency of the increasing consumption of fat could be a contributing risk factor together with overweight.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.9
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• pp.4439-4444
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• 2016

The objective of this case-control study was to determine anthropometric and reproductive factors associated with the development of breast cancer among women. Fifty-six newly diagnosed breast cancer patients were recruited from the Oncology Clinic, Universiti Sains Malaysia (USM), and 56 healthy female hospital employees were recruited as controls. Socio-demographic and reproductive data were obtained using a standard questionnaire. Anthropometric factors (body weight, height, body fat percentage, visceral fat and waist and hip circumference) were assessed. A high waist circumference (adjusted OR= 1.04, [95% CI: 1.00, 1.09]) and being more than 30 years of age at first full-term pregnancy (adjusted OR=3.77, [95% CI: 1.10, 12.90]) were predictors of breast cancer development. The results of this study indicate that weight and reproductive health management should be emphasized for breast cancer prevention in Malaysia.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.10
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• pp.4185-4192
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• 2015

Background: A protective effect of resistant starch (RS) containing foods on carcinogenesis has been shown from several lines of experimental evidence for gastrointestinal cancers. Therefore, we aimed to investigate the association between RS contained foods and breast cancer (BC) risk in a hospital-based, age- and origin-matched, case-control study. Materials and Methods: A validated, semi-quantitative, food frequency questionnaire (FFQ) was completed by 306 women newly diagnosed with BC aged 25 to 65 years, and 309 healthy women as matched controls. Odds ratios (ORs) and 95% confidence intervals (95%CI) were estimated using conditional logistic regression models. Results: Reduced BC risk was associated with the highest tertile of whole-wheat bread and boiled potato consumption with adjusted ORs at 0.34 (95%CI: 0.19-0.59) and 0.61 (95%CI: 0.37-0.99), respectively. Among consumers of whole-wheat bread, the protective role of cereals remained relatively apparent at higher intakes level of fiber rich breads at adjusted models (OR=0.53, 95%CI: 0.28-1.01). Moreover, high intake of legumes was found out to be a significant protective dietary factor against risk of BC development with an OR of 0.01 (95%CI: 0.03-0.13). However, consumption of white bread and biscuits was positively related to BC risk. Conclusions: Our results show that certain RS containing foods, in particular whole wheat bread, legumes and boiled potato may reduce BC risk, whereas higher intake of white bread and biscuits may be related to increased BC risk.

• Korean Journal of Adult Nursing
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• v.20 no.6
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• pp.815-828
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• 2008

Purpose: This study was to develop and evaluate the clinical utility of the breast and ovarian cancer genetic counselling program specific for 20 Korean women(KBOCGP). Methods: The KBOCGP was developed using three types of approaches: an ethnography among Korean women who underwent BRCA1/2 test, designing and implementing one week clinical genetic educational course for clinical cancer nurses, educational observation visits to three American cancer genetic counselling programs. And then pre-experimental design was implicated to evaluate the change of the women's knowledge about the hereditary breast and ovarian cancer and the level of the satisfaction with genetic counselling. Results: The mean score of the knowledge has significantly increased from $7.45{\pm}3.86$ to $11.55{\pm}2.21$ (t = 5.63, p < .001). The level of the satisfaction with the counselling was very high ($27.47{\pm}1.35$). Because most of the subjects have young kids, they showed strong concerns about their kids' getting cancer. Conclusion: This new KBOCGP is the satisfactory program for the education and communication of the genetic information to the Korean women with HBOC. But it is needed more to strengthen the cultural sensitivity especially to Korean family relationships. Authors recommend that this program be provided by other nurses who are counselling women at high risk of breast cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.6
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• pp.2675-2679
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• 2012

Introduction: Annually a considerable number of people die because of breast cancer, a common disease among women also in Iran. Identifying risk factors and susceptible people can lead to prevention or at least early diagnosis. Among susceptibility risks, 5-10% of patients have a family history predisposing factor which can influence the risk of incidence among the family. Having a registry program can be a more practical way to screen high risk families for preventive planning. Method: Based on inclusion criteria, a questionnaire was prepared and after a pilot study on a small number of patients, actual data were collected on 400 patients and processed in SPSS 16.0. Results: Totally, 28.2%of the patients were younger than 40 years old and 36.8% had the included criteria for familial breast cancer (FBC). 102 patient's samples could be compared for receptor presentation. Similar to other studies, the number of triple negative breast cancers increased as the age decreased. Conclusion: The high percentage of patients with FBC among 400 cases in this study demonstrates that in order to design an infrastructural diagnostic protocol and screening of patients with FBC, a precise survey related to frequency and founder mutations of FBC is needed nationwide.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.14
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• pp.5669-5673
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• 2015

Background: Breast cancer is the most prevalent kind of cancer among women in Iran. Regarding the importance of cancer prevention and considerable variation of breast cancer incidence in different parts of the country, it is necessary to recognize regions with high incidence of breast cancer and evaluate the role of potential risk factors by use of advanced statistical models. The present study focussed on incidence of breast cancer in Iran at the province level and also explored the impact of some prominent covariates using Bayesian models. Materials and Methods: All patients diagnosed with breast cancer in Iran from 2005 to 2008 were included in the study. Smoking, fruit and vegetable intake, physical activity, obesity and the Human Development Index (HDI), measured at the province level, were considered as potential modulating factors. Gamma-Poisson, log normal and BYM models were used to estimate the relative risk of breast cancer in this ecological investigation with and without adjustment for the covariates. Results: The unadjusted BYM model had the best fit among applied models. Without adjustment, Isfahan, Yazd, and Tehran had the highest incidences and Sistan- Baluchestan and Chaharmahal-Bakhtiari had the lowest. With the adjusted model, Khorasan-Razavi, Lorestan and Hamedan had the highest and Ardebil and Kohgiluyeh-Boyerahmad the lowest incidences. A significantly direct association was found between breast cancer incidence and HDI. Conclusions: BYM model has better fit, because it contains parameters that allow including effects from neighbors. Since HDI is a significant variable, it is also recommended that HDI should be considered in future investigations. This study showed that Yazd, Isfahan and Tehran provinces feature the highest crude incidences of breast cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.5
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• pp.1919-1924
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• 2014

Background: In India, breast cancer is the leading malignancy among women in a majority of the cancer registries. Therefore it is important to understand screening practices and its predictors, including in rural areas with high female literacy and good health indices. Materials and Methods: A cross-sectional study with multistage sampling was conducted in Vypin Block, Ernakulam district, Kerala, India. Four Panchayats (self administration units) were randomly chosen and a woman in every second household was invited to participate from the tenth ward of each. Thus a total of 809 women were interviewed. Results: The majority of the repondents (82.1%) were not aware of risk factors and about a third (37.9%) were not aware of symptoms of breast cancer. About half of the population studied (46.6%) had undergone screening. Age (35-50 years), being married, health professionals as source of information and working were significant predictors of screening. Logistic regression showed that older women (35-50 yrs) were more likely to practice screening. Out of the never screened, about a third (35%) were desirous of doing it, but had not for various reasons and 53.5% were not willing to screen. The reasons identified for not screening among those desirous of doing it were grouped into knowledge 66 (43.4%), resources 23 (15.1%) and psychosocial 32(21.1%) factors. Unmarried women were significantly more likely to express factors related to all the three domains. Conclusions: This study showed that in spite of the absence of a population-based screening program, about half of the study population had undergone some type of screening. The older women (35-50 years) in particular were significantly more likely to practice screening. At this critical juncture, a high quality breast cancer awareness and screening initiative can help to consolidate the gains and tackle knowledge, resource and psychosocial barriers.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.6
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• pp.2979-2982
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• 2016

Background: High dose ionizing radiation can induce ovarian cancer, but the effect of low dose radiation on the development of ovarian cancer has not been extensively studied. We evaluated the effect of low dose radiation and total background radiation, and the radiation delivered to the ovaries during the treatment of rectosigmoid cancer and breast cancer on ovarian cancer incidence. Materials and Methods: Background radiation measurements are from Assessment of Variations in Radiation Exposure in the United States, 2011. Ovarian cancer incidence data are from the Centers for Disease Control and Prevention. Standardized incidence ratios (SIR) of ovarian cancer following breast cancer and rectosigmoid cancer are from Surveillance, Epidemiology, and End Results (SEER) data. Obesity data by US state are from the Centers for Disease Control and Prevention. Mean ages of US state populations are from the United States Census Bureau. Results: We calculated standardized incidence ratios (SIR) from Surveillance, Epidemiology, and End Results (SEER) data, which reveal that in 194,042 cases of breast cancer treated with beam radiation, there were 796 cases of ovarian cancer by 120+ months of treatment (0.41%); in 283, 875 cases of breast cancer not treated with radiation, there were 1,531 cases of ovarian cancer by 120+ months (0.54%). The difference in ovarian cancer incidence in the two groups was significant (p < 0.001, two tailed Fisher exact test). The small dose of scattered ovarian radiation (about 3.09 cGy) from beam radiation to the breast appears to have reduced the risk of ovarian cancer by 24%. In 13,099 cases of rectal or rectosigmoid junction cancer treated with beam radiation in the SEER data, there were 20 cases of ovarian cancer by 120+ months of treatment (0.15%). In 33,305 cases of rectal or rectosigmoid junction cancer not treated with radiation, there were 91 cases of ovarian cancer by 120+ months (0.27%). The difference in ovarian cancer incidence in the two groups was significant (p = 0.017, two tailed Fisher exact test). In other words, the beam radiation to rectum and rectosigmoid that also reached the ovaries reduced the risk of ovarian cancer by 44%. In addition, there was a significant inverse relationship between ovarian cancer in white women and radon background radiation (r = - 0.465. p = 0.002) and total background radiation (r = -0.456, p = 0.002). Because increasing age and obesity are risk factors for ovarian cancer, multivariate linear regression was performed. The inverse relationship between ovarian cancer incidence and radon background was significant (${\beta}=-0.463$, p = 0.002) but unrelated to age (${\beta}=-0.080$, p = 0.570) or obesity (${\beta}=-0.180$, p = 0.208). Conclusions: The reduction of ovarian cancer risk following low dose radiation may be the result of radiation hormesis. Hormesis is a favorable biological response to low toxin exposure. A pollutant or toxin demonstrating hormesis has the opposite effect in small doses as in large doses. In the case of radiation, large doses are carcinogenic. However, lower overall cancer rates are found in U.S. states with high impact radiation. Moreover, there is reduced lung cancer incidence in high radiation background US states where nuclear weapons testing was done. Women at increased risk of ovarian cancer have two choices. They may be closely followed (surveillance) or undergo immediate prophylactic bilateral salpingo-oophorectomy. However, the efficacy of surveillance is questionable. Bilateral salpingo-oophorectomy is considered preferable, although it carries the risk of surgical complications. The data analysis above suggests that low-dose pelvic irradiation might be a good third choice to reduce ovarian cancer risk. Further studies would be worthwhile to establish the lowest optimum radiation dose.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.6
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• pp.2953-2957
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• 2016

Background: Breast Cancer (BCa) is the most common malignant tumour in Mexican women. In BCa, several studies have linked ${\beta}2-adrenergic$ receptor activation with increased tumour growth and progression as related with Epinephrine-NorEpinephrine (E-NE) stimulation. The aim of this study was to describe Beta-Blocker (BB) treatment related with reduction of the risk of metastasis in Mexican patients with BCa. Materials and Methods: We collected data of 120 patients seen at the High-Specialty Naval General Hospital in Mexico City (HOSGENAES), all of these with a histopathological diagnosis of BCa. Four groups of patients were divided as follows: without Systemic Arterial Hypertension (SAH); with SAH treatment with non-selective BB; with SAH treatment with selective BB, and with SAH treatment with other antihypertensive drugs. Chi-square, Mantel-Haenszel, Student t, and ANOVA tests were performed for data analysis. Results: On average, patients were $54.8{\pm}11.8$ years of age. Risk factors such as smoking and consuming alcohol exhibited a frequency of 33 and 36.5% respectively. Clinical stages III- IV were found in 50% of patients, while, 30% of patients had arterial hypertension (n=29 and N=96, respectively) and 17.5% used BB. One hundred percent of patients with arterial hypertension treated with BB for ${\beta}1$ - and ${\beta}2$ -adrenergic-receptors did not present metastasis globally, but patients treated with ${\beta}1$ BB presented 30% of metastasis while patients treated with no BB or without SAH had around 70% of metastasis. Conclusions: In Mexican patients with BCa and SAH treated with non-selective (${\beta}1$- and ${\beta}2-adrenergic$ receptors) BB, a decrease in the risk for metastasis was observed at the time of diagnosis.