• Asian Pacific Journal of Cancer Prevention
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• v.14 no.2
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• pp.853-857
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• 2013

Objectives: Breast cancer is a leading cause of morbidity and mortality in women worldwide. Breast screening in normal and/or asymptomatic women is essential to reduce the burden of breast malignancies. Our study aimed to identify possible risk- and/or co-factors associated with breast screening in North Indian women. Methods: A public health research survey was conducted among 100 women of North Indian ethnicity during clinic visits in a 6-month timeline (April-October 2012). Demographic and clinical data, including mammography screening, were recorded in the questionnaire-based proforma after conducting a 10 minute interview. Written informed consent was taken from all the participants. Results: The mean age of the participants was $32.2{\pm}9.9$ years. Out of 100 women, 6% had family history of breast disease. Breast-related complaints/malignancy, including galactorrhoea, mastitis, axillary lump, fibrocystic disease, fibroadenosis and adenocarcinoma were observed in 41% participants; age stratification revealed that 82.9% of this group (n=41) were <30 years, while 9.7% and 7.3% were >30 years and 30 years of age, respectively. 32% participants underwent mammography screening and 8% had breast ultrasound imaging. Age stratification in the mammography screening group demonstrated that 24 women were <40 years, while 7 women were >40 years. Conclusions: Our pilot study identified possible co-factors affecting breast screening in North Indian women. These findings may be beneficial in early detection of breast abnormalities, including malignancies in women susceptible to breast cancer, and thus aid in future design of cost-effective screening strategies to reduce the increasing burden of breast carcinoma in women worldwide.

• 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.16 no.18
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• pp.8659-8663
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• 2016

In Nepal, while no population based cancer registry program exists to assess the incidence, prevalence, morbidity and mortality of cancer, at the national level a number of hospital based cancer registries are cooperating to provide relevant data. Seven major cancer diagnosis and treatment hospitals are involved, including the BP Koirala Memorial Cancer hospital, supported by WHO-Nepal since 2003. The present retrospective analysis of cancer patients of all age groups was conducted to assess the frequencies of different types of cancer presenting from January 1st to December 31st 2012. A total of 7,212 cancer cases were registered, the mean age of the patients being 51.9 years. The most prevalent age group in males was 60-64 yrs (13.6%), while in females it was 50-54 yrs (12.8%). The commonest forms of cancer in males were bronchus and lung (17.6%) followed by stomach (7.3%), larynx (5.2%) and non Hodgkins lymphoma (4.5%). In females, cervix uteri (19.1%) and breast (16.3%), were the top ranking cancer sites followed by bronchus and lung (10.2%), ovary (6.1%) and stomach (3.8%). The present data provide an update of the cancer burden in Nepal and highlight the relatively young age of breast and cervical cancer patients.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.17
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• pp.7029-7035
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• 2014

Certain types of human papillomaviruses (HPVs) are undoubtedly involved in genesis of human malignancies. HPV plays an etiological role in cervical cancer, but also in many vaginal, vulvar, anal and penile cancers, as well as head and neck cancers. In addition, a number of non-malignant diseases such as genital warts and recurrent respiratory papillomatosis are attributable to HPV. Moreover, HPV forms have detected in several other cancers including esophageal squamous cell carcinoma, lung, prostate, ovarian, breast, skin, colorectal and urinary tract cancers, but associations with etiology in these cases is controversial. The aim of this systematic assessment was to estimate the prevalence of HPV infection and HPV types in HPV-associated cancers, HPV-related non-malignant diseases and in cancers that may be associated with HPV in Iran. The present investiagtion covered 61 studies on a variety of cancers in Iranian populations. HPV prevalence was 77.5 % and 32.4% in cervical cancer and head and neck cancers, respectively. HPV was detected in 23.1%, 22.2%, 10.4%, 30.9%, 14% and 25.2% of esophageal squamous cell, lung, prostate, urinary tract cancers, breast and skin cancers, respectively. HPV16 and 18 were the most frequent HPV types in all cancers. The findings of present study imply that current HPV vaccines for cervical cancer may decrease the burden of other cancers if they are really related to HPV.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.12
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• pp.6333-6336
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• 2012

The burden of cancer is growing globally and is one of the top leading causes of death. Information on cancer patterns are essential for effective planning of cancer control interventions. There is limited published information available on pattern of cancer for the state of Odisha, India. The present study was an attempt to explore the pattern and trend of cancer in Odisha. To fulfill the objectives retrospective data available from 2001-2011 at Acharya Harihar Regional Cancer Center (AHRCC), Cuttack, Odisha, were analyzed. Medical records of cancer patients were reviewed and relevant information on diagnosis, primary site and demographic data were retrieved. Data were entered and analyzed using SPSS 16.0 (SPSS Inc.). A total of 74,861 cancer inpatients were registered at AHRCC for the years 2001-2011. The proportion of females outnumbered males with female:male ratio 1.1:1. The number of female cases increased four folds and that of males three fold over the period studied. Malignancies such as oral cancer (16.93%), acute lymphocytic leukemia/non Hodgkins lymphoma (14.09%) and cancer of gastrointestinal tract (21.07%) are leading cancers among males and carcinomas of breast (28.94%), cervix (23.66%) and ovary (16.11%) were leading among females. Findings from this study indicate an overall increase in cancer reporting which could be regarded as proxy measure for overall cancer situation in Odisha. There is scope and need for integrating other government hospitals, existing private health service providers and research institutions across the state for better planning of cancer control program.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.14
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• pp.5741-5747
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• 2015

Purpose: To understand the epidemiology of different upper gastrointestinal (UGI) tract related abnormalities through endoscopic data analysis. Materials and Methods: A retrospective study of three years from January 2009 to December 2011 was conducted with data from endoscopic surveillance of upper GI tract problems, collected from the Gastroenterology Unit, Osmania General Hospital, Hyderabad. MS excel and Medcalc software (comparison of proportions) were used for data analysis. Results: A total of 10,029 (6,468 in males and 3,561 in females) endoscopies were performed during this three-year period. The male to female ratio was 1.8:1. Overall, ~30% of endoscopies evaluated showed patients with acid peptic disorders, 13.6% with vascular-related abnormalities, 10.6% showed structural abnormalities, followed by 6.3% with malignancies. Burden of malignancies was mostly observed in the older age group (60-69 years). Esophageal cancer cases decreased (p=0.0001) whereas stomach cancers increased over this period (p=0.0345). We also observed an increased incidence of acid peptic disease (APD) (p=0.0036) and gastroesophageal reflux disease (GERD) (p=0.0002) cases during this period. Conclusions: Endoscopic diagnosis is useful for early detection of UGI anomalies and helpful for physicians to manage and treat varied kinds of UGI disorders. Analysis of data revealed changing trends in the incidence of various pathologies of the UGI tract. Functional dyspepsia and GERD definitely reduce the quality of life of the individual. The role of our diverse dietary habits and lifestyle associated with these problems have not yet been established, though there have been reports on the effect of coffee, spicy food, wheat-based diet, screening of UGI pathologies along with collection of complete personal and medical history details, can h elp in correlating the patients' condition with various aspects of lifestyle and diet.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.8
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• pp.3587-3592
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• 2014

Burden of cancer is progressively increasing in developing countries like India which has also led to a steep rise in toxicity due to anti-cancer therapy. A cross-sectional analysis was here conducted for patients with different malignancies (except leukaemia) who while undergoing radical anti-cancer therapy were admitted to our oncology ward from January-July 2013. In a total of 280 patients, the total number of toxicity events was 473. Nine patients expired over this time period. Among the events, grade 2 anaemia the most common (n=189) while the most common grades of neutropenia and thrombocytopenia were grade 4 (n=114) and grade 2 (n=48), respectively. Among the tracable microbial etiologies, gram negative bacteria were the most commonly found pathogens. Treatment interruptions took place in 240 patients (median duration=8.8 days). Prolonged hospital admission, intensive care and artificial ventilation support was needed to be given in 48, 7 and 13 patients respectively. Advanced NSCLC, KPS <70, pancytopenia and artificial ventilation requirement were found to have a significant impact on death. Such studies show the prevailing practice from institutes of our country and may guide us formulating a guideline for managing such toxicities for this part of the world.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.6
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• pp.3465-3467
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• 2013

Background: Breast cancer is the most frequent malignant disease amongst young women. If we review local data in Pakistan then breast cancer represents approximately a third of all cancers in females. The age standardized incidence rate (ASR) world per 100,000 is 53.8 and crude incidence rate is 30.9. We have observed during our surgical pathology practice and it is also reported by other Asian studies that breast carcinoma is amongst the leading malignancies in the region and the patients are at least a decade younger than counterparts in developed nations. Age is an important issue in effective screening, diagnosis and management of breast cancer, especially in this geographical region where late presentation and poor prognosis are a hallmark of the disease. Objective: The aim of this study is to determine the frequency of malignant breast lesions in symptomatic young females presenting with breast lumps. Materials and Methods: This is a retrospective study conducted at the Pathology Department, Liaquat National Hospital and Medical College, Karachi. Descriptive and pathology data of malignant breast tumors 1st January 2004 to 31st December 2009 were reviewed, using the departmental archived data. It included both male and female patients up to the age of 25 years. Results: A total of 714 surgical specimens from/of symptomatic breast lesions were received at the pathology department of Liaquat National Medical, in the five years study period, in young females. There were 575 (80%) benign, 119 (16%) inflammatory and 20 (2.8%) malignant lumps. Conclusions: The obtained data for females only up to 25 years of age suggest a massive burden which requires urgent attention. Early assessment of lesions is essential in order to avoid mortality from malignancies.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.15
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• pp.6451-6455
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• 2015

Background: Primary bone neoplasms are rare, contributing only 0.2% of the global burden of all human malignancies. Osteosarcoma (OS) and chondrosarcoma (CS) are the most common malignancies of bone. The giant cell tumor of bone (GCTb) is a benign tumor with behavior characterized by osteolytic bone destruction. The OS, CS and GCTb affect both sexes, all races and generally have incidence peaks regarding the age of the patient which vary according to the tumor type. We analyzed the incidences of OS, CS and GCTb and their relations with gender and age in patients treated in the National Rehabilitation Institute (INR, for its acronym in Spanish) over a period of nine years. Materials and Methods: In the study period, clinic pathological data for 384 patients were obtained with clinical, radiological and histopathological diagnosis for OS, GCTb and CS. Data analysis was performed using the chi-square and Fisher's exact tests. Results: From 2006 to 2014 were recorded 384 cases of bone malignancies in the database of INR. The GCTb had the highest incidence (53.1%), followed by OS (31.3%) and finally the CS (15.6%). The overall average age was $33.6{\pm}15.8$ years and the overall frequency of gender had a ratio of 1/1.03 male/female. The states with the highest incidence were Distrito Federal and Estado de Mexico with 29.2% and 25.3% respectively. Malignant neoplasms of bone assessed in the course of nine years show three significant increases in 2008, 2011 and 2014 (p=0.14). We found association between sex and tumor type (p=0.03), GCTb and CS predominated in females (54.9% and 56.6% respectively), while for the OS males were most affected (59.1%). Age was different in relation with tumor type (p=0.0001), average age was $24.3{\pm}11.2$ years for OS, $34.5{\pm}13$ years for GCTb and $49.2{\pm}18.5$ years for CS. Furthermore, associations of tumor type with topographic location of the primary tumor (P=0.0001) were found. Conclusions: In this study we can see that incidence of musculoskeletal tumor in our population is continuously increasing and in nine years an approximately 200% increase of musculoskeletal tumor cases was observed.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.6
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• pp.3007-3013
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• 2016

Background: Gastrointestinal cancers are common malignancies associated with high mortality rates. Healthcare systems are always faced with high costs of treatment of gastrointestinal cancers including stomach cancer. Identification and prioritization of these costs can help determine economic burden and then improve of health planning by policy-makers. This study was performed in 2015 in Kerman City aimed at estimating the direct hospital costs for patients with gastric cancer. Materials and Methods: In this cross-sectional study, the medical records of 160 patients with stomach cancer admitted from 2011 to 2014 to Shafa Hospital were examined, the current stage of the disease and the patients' health status were identified, and the direct costs related to the type of treatment in the public and private sectors were calculated. SPSS-19 was used for statistical analysis of the data. Results: Of the patients studied, 103 (65%) were men and 57 (35%) were women. The mean age of patients was 65 years. Distribution into four stages of the disease was 5%, 20%, 30%, and 45%, respectively. Direct costs in four stages of the disease were calculated as 2191.07, 2642.93, 2877, and 2674.07 USD (63,045,879, 76,047,934, 82,783,019, and 76,943,800 IRR), respectively. The highest percentage of costs was related to surgery in Stage I and to medication in Stages II, III, and IV. According to the results of direct costs of treatment for stomach cancer in Kerman, the mean total cost of treating a patient in the public sector was estimated at 74,705,158 IRR, of which averages of 60,141,384 IRR and 14,563,774 IRR were the shares of insurance and patients, respectively. Conclusions: The high prevalence and diagnosis of disease in old age and at advanced stages of disease impose great costs on the patients and the health system. Early diagnosis through screening and selecting an appropriate treatment method might largely ameliorate the economic burden of the disease.