• Title/Summary/Keyword: biostatistics

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Epidemiology and Survival of Hepatocellular Carcinoma in North-east Peninsular Malaysia

  • Norsa'adah, Bachok;Nurhazalini-Zayani, Che Ghazali Che
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.11
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    • pp.6955-6959
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    • 2013
  • The incidence of hepatocellular carcinoma (HCC) is relatively high in Southeast Asia. Globally, HCC has a high fatality rate and short survival. The objectives of this retrospective cohort study were to review the epidemiology and survival of HCC patients at a tertiary centre in north-east of Peninsular Malaysia. Subjects were adult HCC patients diagnosed by histopathology or radio-imaging. Secondary liver carcinoma was excluded. Kaplan Meier and multiple Cox proportional hazard survival analyses were used. Only 210 HCC cases from years 1987-2008, were included in the final analysis. The number of cases was increasing annually. The mean age was 55.0 (SD 13.9) years with male:female ratio of 3.7:1. Approximately 57.6% had positive hepatitis B virus, 2.4% hepatitis C virus, 20% liver cirrhosis and 8.1% chronic liver disease. Only 2.9% had family history and 9.0% had frequently consumed alcohol. Most patients presented with abdominal pain or discomfort and had hepatomegaly, 47.9% had an elevated ${\alpha}$-fetoprotein level of 800 IU/ml or more, 51.9% had multiple tumors and 44.8% involved multiple liver lobes. Approximately 63.3% were in stage 3 and 23.4% in stage 4, and 82.9% did not receive any treatment. The overall median survival time was 1.9 months (95% confidence interval (CI): 1.5, 2.3). The 1-month, 6-month, 1-year and 2-year survival rates were 71.8%, 23.3%, 13.0% and 7.3% respectively. Significant prognostic factors were Malay ethnicity [Adjusted hazard ratio (AHR) 1.6; 95%CI: 1.0, 2.5; p=0.030], no chemotherapy [AHR 1.7; 95%CI: 1.1, 2.5; p=0.017] and Child-Pugh class C [AHR 2.6; 95%CI: 1.4, 4.9; p=0.002]. HCC in our study affected a wide age range, mostly male, in advanced stage of disease, with no treatment and very low survival rates. Primary prevention should be advocated in view of late presentation and difficulty of treatment. Vaccination of hepatitis virus and avoidance of liver toxins are to be encouraged.

Incidence and Mortality of Testicular Cancer and Relationships with Development in Asia

  • Sadeghi, Mostafa;Ghoncheh, Mahshid;Mohammadian-Hafshejani, Abdollah;Gandomani, Hamidreza Sadeghi;Rafiemanesh, Hosein;Salehiniya, Hamid
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.9
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    • pp.4251-4257
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    • 2016
  • Background: Testicular cancer is one of the most common cancers among young men between ages 20-34 in countries with high or very high levels of the Human Development Index (HDI). This study investigated the incidence and mortality of prostate cancer and the relationship with the HDI and its dimensions in Asia in 2012. Materials and Methods: The study was conducted based on data from the world data of cancer and the World Bank (including the HDI and its components). Standardized incidence and mortality rates of testicular cancer were calculated for Asian countries. Correlations between incidence and/ormortality rates, and the HDI and its components were assessed with the use of the correlation test, using SPSS software. Results: There was a total of 14902 incidences and 5832 death were recorded in Asian countries in 2012. Among the Asian countries, the five countries with the highest standardized incidence rates of testicular cancer were Israel, Georgia, Turkey, Lebanon and Kazakhstan and the five countries with the highest standardized mortality rates were Turkey, Georgia, Jordan, Cambodia and the Syrian Arab Republic. A positive correlation of 0.382 was observed between the standardized incidence rates of testicular cancer and the HDI (p=0.009). Also a negative correlation of 0.298 between the standardized mortality rate of testicular cancer and the Human Development Index was noted although this relation was statistically non-significant (p=0.052). Conclusions: There is a positive correlation between HDI and the standardized incidence rate of testicular cancer and negative correlation with standardized mortality rate.

Multivariate Meta-Analysis Methods of Comparing the Sensitivity and Specificity of Two Diagnostic Tests (두 진단검사의 비교에 대한 민감도와 특이도의 다변량 메타분석법)

  • Nam, Seon-Young;Song, Hae-Hiang
    • Communications for Statistical Applications and Methods
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    • v.18 no.1
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    • pp.57-69
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    • 2011
  • Researchers are continuously trying to find innovative diagnostic tests and published articles are accumulating at an enormous rate in many medical fields. Meta-analysis enables previously published study results to be reviewed and summarized; therefore, an objective assessment of diagnostic tests can be done with a meta-analysis of sensitivities and specificities. Data obtained by applying two diagnostic tests to a well-defined group of diseased patients produce a pair of sensitivity and by applying the same medical tests to a group of non-diseased subjects produce a pair of specificity. The statistical tests in the meta-analysis need to consider the correlatedness of the results from two diagnostic tests applied to the same diseased and non-diseased subjects. The associations between two diagnostic test results are often found to be unequal for the diseased and non-diseased subjects. In this paper, multivariate meta-analytic methods are studied by taking into account the different associations between correlated variables. On the basis of Monte Carlo simulations, we evaluate the performance of the multivariate meta-analysis methods proposed in this paper.

Incidence and Mortality of Breast Cancer and their Relationship to Development in Asia

  • Ghoncheh, Mahshid;Mohammadian-Hafshejani, Abdollah;Salehiniya, Hamid
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.14
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    • pp.6081-6087
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    • 2015
  • Purpose: This study aimed to investigate the incidence and mortality of breast cancer, and its relationship with human development index (HDI) and its components in Asia in 2012. Materials and Methods: This study was an ecologic study in Asia for assessment of the correlation between age-specific incidence rate (ASIR) and age-specific mortality rate (ASMR) with HDI and its details that include: life expectancy at birth, mean years of schooling and gross national income (GNI) per capita. Data about SIR and SMR for every Asian country for the year 2012 were obtained from the global cancer project. We used a bivariate method for assessment of the correlation between SIR and SMR and HDI and its individual components. Statistical significance was assumed if P<0.05. All reported P-values are two-sided. Statistical analyses were performed using SPSS (Version 15.0, SPSS Inc.). Results: In 2012, 639,824 cases of breast cancer were recorded in Asian countries. Countries with the highest standardized incidence rate (ASIR) (per 100,000) were Israel (80.5), Lebanon (78.7), Armenia (74.1) and the highest standard mortality rate (ASMR) was observed in Pakistan (25.2), Armenia (24.2), and Lebanon (24). There was a positive correlation between the ASIR of breast cancer and HDI (r = 0.556, p <0.001), whereas there was a negative correlation between the ASMR of breast cancer and HDI (r = -0.051). Conclusions: Breast cancer incidence in countries with higher development is greater, while mortality is greatest in countries with less development. There was a positive and significant relationship between the ASIR of breast cancer and HDI and its components. Also there was a negative but non significant relationship between the ASMR of breast cancer and HDI.

Spatial analysis of Relative Risks for skin cancer morbidity and mortality in Iran, 2008 - 2010

  • Zayeri, Farid;Kavousi, Amir;Najafimehr, Hadis
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.13
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    • pp.5225-5231
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    • 2015
  • Background: One of the most prevalent cancers in whole world is skin cancer and its prevalence is growing. The present research sought to estimate relative risk of morbidity and mortality due to skin cancer. Materials and Methods: In this cross-sectional study. The required data were gathered from the registered cancer reports of Cancer Control Office in the Center for Non Communicable Disease of the Iranian Ministry of Health (MOH). The data were extracted at province level in the time span of 2008-10. WINBUGS software was used to analyze the data and to identify high risk regions. ArcGIS10 was utilized to map the distribution of skin cancer and to demonstrate high risk provinces by using classic and fully Bayesian models taking into account spatial correlations of adjacent regions separately for men and women. Results: Relative risk of morbidity for women in Yazd and for men in Kurdistan and relative risk of mortality for women in Bushehr and for men in Kohgiluyeh were found to be the highest. Bayesian model due to regarding adjacent regions correlation, have precise estimation in comparing to classical model. More frequent epidemiological studies to enact skin cancer prevention programs. Conclusions: High risk regions in Iran include central and highland regions. Therefore it is suggested that health decision makers enact public education, using anti UV creams and sunglasses for those parts as a short preventing program.

Association of Breast Cancer with Sleep Pattern - A Pilot Case Control Study in a Regional Cancer Centre in South Asia

  • Datta, Karabi;Roy, Asoke;Nanda, Durgaprasad;Das, Ila;Guha, Subhas;Ghosh, Dipanwita;Sikdar, Samar;Biswas, Jaydip
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.20
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    • pp.8641-8645
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    • 2014
  • The rising trend of breast cancer both in developed and developing countries is a real threat challenging all efforts to screening, prevention and treatment aspects to reduce its impact. In spite of modern preventive strategies, the upward trend of breast cancer has become a matter of great concern in both developed and developing countries. Chittaranjan National Cancer Institute is a premier regional cancer institute in eastern region of India catering to a large number of cancer patients every year. A pilot case control study of fifty breast cancer patients and 100 matched controls was conducted during 2013 to evaluate the effects of habitual factors like working in night shift, not having adequate sleep, and not sleeping in total darkness on breast cancer of women. The study revealed that not sleeping in total darkness was associated with higher odds of outcome of breast cancer of women. This positive correlation can play a vital role in formulation of preventive strategies through life style modification.

Evaluation of BreastLight as a Tool for Early Detection of Breast Lesions among Females Attending National Cancer Institute, Cairo University

  • Labib, Nargis Albert;Ghobashi, Maha Mohamed;Moneer, Manar Mohamed;Helal, Maha Hesien;Abdalgaleel, Shaimaa Abdalaleem
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.8
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    • pp.4647-4650
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    • 2013
  • Background: Breast illumination was suggested as a simple method for breast cancer screening. BreastLight is a simple apparatus for this purpose. Objective: To evaluate the diagnostic performance of BreastLight as a screening tool of breast cancer in comparison to mammography and histopathology. Materials and Methods: This hospital-based cross sectional study was conducted in the mammography unit of the radiodiagnosis department at National Cancer Institute, Cairo University. All participants were subjected to breast examination with the BreastLight tool, mammography and ultrasonography. Suspicious cases were biopsied for histopathological examination which is considered as a gold standard. Results: The mean age of the participants was $46.3{\pm}12.4$ years. Breast illumination method had sensitivity, specificity, positive predictive value, negative predictive value and total accuracy of 93.0%, 73.7%, 91.4%, 77.8% and 88.2%, respectively in detection of breast cancer. Conclusions: Breast illumination method with BreastLight apparatus is a promising easy-to-use tool to screen for breast cancer suitable for primary health care physician or at-home use. It needs further evaluation especially in asymptomatic women.

Estimating the Completeness of Lung Cancer Registry in Ardabil, Iran with a Three-Source Capture-Recapture Method

  • Khodadost, Mahmoud;Mosavi-Jarrahi, Alireza;Hashemian, Seyed Sepehr;Sarvi, Fatemeh;Maajani, Khadije;Moradpour, Farhad;Khatibi, Seyed Reza;Amini, Hossein
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.sup3
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    • pp.225-229
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    • 2016
  • Cancer registration is an important component of a comprehensive cancer control program, providing timely data and information for research and administrative use. Capture-recapture methods have been used as tools to investigate completeness of cancer registry data. This study aimed to estimate the completeness of lung cancer cases registered in Ardabil Population Based Cancer Registry (APBCR) with a three-source capture-recapture method. Data for all new cases of lung cancer reported by three sources (pathology reports, death certificates, and medical records) to APBCR for 2006 and 2008 were obtained. Duplicate cases shared among the three sources were identified based on similarity of first name, last name and father's names. A log-linear model was used to estimate number of missed cases and to control for dependency among sources. A total of 218 new cases of lung cancer was reported by three sources after removing duplicates. The estimated completeness calculated by log-linear method was 26.4 for 2006 and 27.1 for 2008. The completeness differed according to gender. In men, the completeness was 26.0% for 2006 and 28.1 for 2008. In women, the completeness was 36.5% for 2006 and 46.9 for 2008. In conclusion, none of the three sources can be considered as a reliable source for accurate cancer incidence estimation.

Spatial Analysis of Stomach Cancer Incidence in Iran

  • Pakzad, Reza;Khani, Yousef;Pakzad, Iraj;Momenimovahed, Zohre;Mohammadian-Hashejani, Abdollah;Salehiniya, Hamid;Towhidi, Farhad;Makhsosi, Behnam Reza
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.sup3
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    • pp.27-32
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    • 2016
  • Stomach cancer, the fourth most common cancer and the second leading cause of cancer-related death through the world, is very common in parts of Iran. Geographic variation in the incidence of stomach cancer is due to many different factors. The aim of this study was to assess the geographical and spatial distribution of stomach cancer in Iran using data from the cancer registry program in Iran for the year 2009. The reported incidences of stomach cancer for different provinces were standardized to the world population structure. ArcGIS software was used to analyse the data. Hot spots and high risk areas were determined using spatial analysis (Getis-Ord Gi). Hot and cold spots were determined as more than or less than 2 standard deviations from the national average, respectively. A significance level of 0.10 was used for statistical judgment. In 2009, a total of 6,886 cases of stomach cancers were reported of which 4,891 were in men and 1,995 in women (standardized incidence rates of 19.2 and 10.0, respectively, per 100,000 population). The results showed that stomach cancer was concentrated mainly in northwest of the country in both men and women. In women, northwest provinces such as Ardebil, East Azerbaijan, West Azerbaijan, Gilan, and Qazvin were identified as hot spots (p<0.1). In men, all northwest provinces, Ardabil, East Azerbaijan, Gilan, Qazvin, Zanjan and Kurdistan, the incidences were higher than the national average and these were identified as hot spots (P<0.01). As stomach cancer is clustered in the northwest of the country, further epidemiological studies are needed to identify factors contributing to this concentration.

Lack of Association between an XRCC1 Gene Polymorphism and Colorectal Cancer Survival in Thailand

  • Siewchaisakul, Pallop;Suwanrungruang, Krittika;Poomphakwaen, Kirati;Wiangnon, Surapon;Promthet, Supannee
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.2055-2060
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    • 2016
  • Background: Colorectal cancer (CRC) is one of the most common causes of death worldwide and in Thailand. The X-ray repair cross-complementary protein 1 (XRCC1) is required for efficient DNA repair. The effects of this gene on survival in colorectal cancer remain controversial and have not been reported in Thailand. The aim of this study was to investigate the association of the XRCC1 gene with survival of colorectal cancer patients in a Thai population. Materials and Methods: Data and blood samples were collected from 255 newly diagnosed and pathologically confirmed CRC patients who were recruited during the period 2002 to 2006 and whose vital status was followed up until 31 October, 2014. Real-time PCR-HRM was used for genotype identification. The Kaplan-Meier method, the log-rank test, and Cox proportional hazard regression were used to estimate cumulative survival curves and compare various survival distributions and adjusted hazard ratios. Results: Most of the cases were males, and the median age was 55 years. The median survival time was 2.43 years. The cumulative 1-, 3-, 5-, 7-, and 10 year survival rates were 76.70%, 39.25%, 26.50%, 16.60% and 3.56%, respectively. After adjustment, female gender, ages 50-59 and ${\geq}60years$, tumour stage III+IV, a signet-ring cell carcinoma, and poor differentiation had significant associations with increased risk of CRC death. While the XRCC1 Arg/Arg homozygote appeared to be a risk factor for CRC death, the association was not significant. Conclusions: The genetic variant in the XRCC1 may not be associated with the survival of CRC patients in Thailand. Further studies are needed to verify our findings.