• Journal of the Korean Data and Information Science Society
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• 제28권2호
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• pp.349-359
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• 2017

본 논문에서는 미국 국립암연구소의 SEER 프로그램에서 제공하는 우측 대장암 3기 자료에 Cox 비례위험모형을 적합하여 생존분석을 하였다. 우측 대장암 3기 환자의 사망률에 유의한 영향을 미치는 공변량들을 파악하고, 관심있는 공변량들을 가진 환자의 생존율을 추정하였다. Schoenfeld 잔차를 기반한 검정과 Schoenfeld 잔차 도표, $log[-log\{{\hat{S}}(t)\}]$ 도표를 이용하여 분석에 사용된 공변량들이 비례위험 가정을 만족함을 확인하였다. 적합된 Cox 비례위험모형의 타당성을 검증하기 위해 10-fold 교차 검증을 이용하여 calibration 도표와 시간에 의존하는 ROC 곡선 아래 면적을 계산하였다. 이를 통해 적합된 Cox 비례위험모형의 타당성을 확인하였다.

• Journal of Preventive Medicine and Public Health
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• 제52권4호
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• pp.224-233
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• 2019

Objectives: In women, breast cancer is the most common cancer and the leading cause of cancer death. Screening tests are the basis for early diagnosis. In Iranian women, the mortality rate of breast cancer is high due to insufficient screening examinations and delayed visits for care. Therefore, this study aimed to determine the factors affecting breast self-examinations among Iranian women employed in medical careers. Methods: This cross-sectional study included 501 women working in the medical professions at Hamadan University of Medical Sciences in western Iran in 2018. The subjects were selected by stratified random sampling. Data were collected using a researcher-developed, self-report questionnaire that contained demographic information and questions based on protection motivation theory and social support theory. Descriptive data analysis was conducted using SPSS version 23 and model fitting with PLS version 2. Results: The mean age of the participants was $37.1{\pm}8.3years$, and most of the women (80.4%) were married. Most women had a bachelor's degree (67.5%). The findings of this study showed that the coping appraisal construct was a predictor of protection motivation (${\beta}=0.380$, p<0.05), and protection motivation (${\beta}=0.604$, p<0.05) was a predictor of breast self-examination behavior. Additionally, social support theory (${\beta}=0.202$, p<0.05) had a significant positive effect on breast self-examination behavior. Conclusions: The frequency of practicing self-examinations among women employees in the medical sector was low; considering the influence of social support as a factor promoting screening, it is necessary to pay attention to influential people in women's lives when designing educational interventions.

• Asian Pacific Journal of Cancer Prevention
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• 제15권9호
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• pp.3915-3920
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• 2014

Background: Hepatocellular carcinoma (HCC) is a dismal tumor with a high incidence, prevalence and poor prognosis and survival. Management of HCC necessitates multidisciplinary clinics due to the wide heterogeneity in its presentation, different therapeutic options, variable biologic behavior and background presence of chronic liver disease. We studied the different prognostic factors that affected survival of our patients to improve future HCC management and patient survival. Materials and Methods: This study is performed in a specialized multidisciplinary clinic for HCC in Kasr El Eini Hospital, Cairo University, Egypt. We retrospectively analyzed the different patient and tumor characteristics and the primary mode of management applied to our patients. Further analysis was performed using univariate and multivariate statistics. Results: During the period February 2009 till February 2013, 290 HCC patients presented to our multidisciplinary clinic. They were predominantly males and the mean age was $56.5{\pm}7.7years$. All cases developed HCC on top of cirrhosis that was mainly due to HCV (71%). Most of our patients were Child-Pugh A (50%) or B (36.9%) and commonly presented with small single lesions. Transarterial chemoembolization was the most common line of treatment used (32.4%). The overall survival was 79.9% at 6 months, 54.5% at 1 year and 22.4% at 2 years. Serum bilirubin, site of the tumor and type of treatment were the significant independent prognostic factors for survival. Conclusions: Our main prognostic variables are the bilirubin level, the bilobar hepatic affection and the application of specific treatment (either curative or palliative). Multidisciplinary clinics enhance better HCC management.

• Asian Pacific Journal of Cancer Prevention
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• 제15권6호
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• pp.2495-2500
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• 2014

Background: Lung cancer is one of the most commonly diagnosed cancers and the most frequent cause of cancer-related death worldwide. In Iran, it ranks second and third as the cancer-causing death in men and women, respectively. We carried out this study to find out the demographic, clinical, and histological characteristics and risk factors of lung cancer in a referral tertiary center in Iran. Materials and Methods: A retrospective study was conducted on cases of primary lung cancer based on the results of registered cancer reports of cytological and pathological specimens between March 2001 and March 2012. Demographic variables, clinical manifestations, histology and location of tumors were determined based on the data found in the medical records of each patient. Definite or probable etiologic factors were identified. Data analysis was performed with SPSS version 16 and a p-value ${\leq}0.05$ was considered as significant. Results: A total of 203 patients, with a mean age of 65.7 years (SD=11.2), with primary lung cancer were identified, 81.3% being men. Of the total, 110 cases (54.2%) were living in urban areas. In 53.2% of cases, the site of tumor was on the right side and in 72.9% of cases the lesion was centrally located. The histological types of lung cancer were squamous cell carcinoma (SCC) in 107 cases (52.7%), adenocarcinoma (AC) in 30 cases (14.8%), and small cell carcinoma (SC) in 27 cases (13.3%). Significant correlations between the gender and residence, smoking, and the histological type and location (central or peripheral) of tumor were found. The percentage of smokers was 75.2% in men and 15.8% in women. Conclusions: Smoking was the most important risk factor and squamous cell carcinoma the most common histological type of lung cancer in our study. Male sex and being a smoker was associated with histological types of SCC while being nonsmoker had relationship with adenocarcinoma.

• Asian Pacific Journal of Cancer Prevention
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• 제15권20호
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• pp.8657-8660
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• 2014

Background: Yanting is one of high risk areas for esophageal cancer and the screening program was therefore initiated there. This study was aimed to investigate the dietary behaviors on the risk of esophageal squamous cell carcinoma (ESCC), among the individuals with normal and abnormal esophagus mucosa. Materials and Methods: A frequency matched case-controls study was proposed to estimate the different distribution of dietary behavior between individuals of control, esophagitis and cancer groups. Cancer cases were selected from hospitals. Esophagitis cases and controls were selected from screening population for ESCC. Health workers collected data for 1 year prior to interview, in terms of length of finishing a meal, temperature of eaten food and interval between water boiling and drinking. Chi-square, Kruskal-Wallis tests and unconditional logistic regression model were used to estimate differences and associations between groups. Results: Compared with controls, length of finishing a meal ${\geq}15mins$ was related to a reduced OR for cancer (OR=0.46, 95%CI, 0.22-0.97) and even compared with cases of esophagitis, the OR of cancer was reduced to 0.30 (95%CI, 0.13-0.72). The OR for often eating food at a high temperature was 2.48 (95%CI 1.06, 5.82) for ESCC as compared with controls. Interval between water boiling and drinking of ${\geq}10mins$ was associated with lower risk of cancer: the OR was 0.18 compared with controls and 0.49 with esophagitis cases (p<0.05). Conclusions: Length of eating food ${\geq}15mins$ and interval between water boiling and drinking ${\geq}10mins$ are potentially related to reduced risk of esophageal SCC, compared with individuals with normal and abnormal esophageal mucosa. Recommendations to Yanting residents to change their dietary behaviors should be made in order to reduce cancer risk.

• Asian Pacific Journal of Cancer Prevention
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• 제13권11호
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• pp.5511-5515
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• 2012

Introduction: The nuclear factor ${\kappa}B$ (NF-${\kappa}B$) is a super family of transcription factors which plays important roles in development and progression of cancer. The present investigation concerns NF-${\kappa}B$ /p65 activity in human breast cancers with overexpression of ER, PR, HER-2/neu, as well as the significance of p65 expression with regard to menopausal status, stage, grade, tumor size, nodal status, and NPI of invasive ductal carcinomas in Eastern India. Materials and Methods: In this hospital based study 57 breast cancer patients attending a Breast Clinic of a reputed institute of Eastern India were assessed for p65 protein expression in breast tumor tissue samples by Western blotting. ER, PR and HER-2/neu expression was determined by immunohistochemistry. Results: NF-${\kappa}B$/p65 was significantly associated with advanced stage, large tumor size (${\geq}5$ cm), high grade, negative ER, negative PR, and positive HER-2/neu. High NF-${\kappa}B$/p65 expression was more frequent in patients with a high NPI ($NPI{\geq}5.4$, 84.6%) compared with low NPI (<5.4, 44.4%) and this association was statistically significant (p = 0.002). Conclusion: NF-${\kappa}B$/p65 overexpression was associated with advanced stage, large tumor size, high grade, and high NPI which are poor prognostic factors linked to enhanced aggressiveness of the disease. NF-${\kappa}B$/p65 expression implies aggressive biological behavior of breast cancer and this study validates significant association of NF-${\kappa}B$ /p65 overexpression with negative estrogen and progesterone receptor status and overexpression of HER-2/neu oncoprotein. In our good clinical practice, patients with NF-${\kappa}B$ positive tumors need to be treated aggressively.

• Asian Pacific Journal of Cancer Prevention
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• 제16권6호
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• pp.2531-2535
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• 2015

Background: Breast cancer diagnosed in young women may be more aggressive, with higher rates of local and distant recurrence compared to the disease in older women. Epidemiologic evidence suggests that Korean women have a lower incidence of breast cancer than women in the United States, but that they present at a younger age than their American counterparts. We sought to compare risk factors and management of young women with breast cancer in Boston, Massachusetts (US) with those in Seoul, South Korea (KR). Materials and Methods: A retrospective review was performed of consecutive patients less than 35 years old with a diagnosis of breast cancer at academic cancer centers in the US and KR from 2000-2005. Patient data were obtained by chart review. Demographic, tumor and treatment characteristics were compared utilizing Pearson's chisquare or Wilcoxon rank-sum tests where appropriate. All differences were assessed as significant at the 0.05 level. Results: 205 patients from the US and 309 from KR were analyzed. Patients in US were more likely to have hormone receptor positive breast cancer, while patients in KR had a higher rate of triple negative lesions. Patients in US had a higher mean body mass index and more often reported use of birth control pills, while those in the KR were less likely to have a sentinel node procedure performed or to receive post mastectomy radiation. Conclusions: Patients under 35 diagnosed with breast cancer in the US and KR differ with respect to demographics, tumor characteristics and management. Although rates of breast conservation and mastectomy were similar, US patients were more likely to receive post mastectomy radiation. The lower use of sentinel node biopsy is explained by the later adoption of the technique in KR. Further evaluation is necessary to evaluate recurrence rates and survival in the setting of differing disease subtypes in these patients.

• Asian Pacific Journal of Cancer Prevention
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• 제13권12호
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• pp.6491-6496
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• 2012

Background: The influence of parental socio-economic status on childhood cancer treatment outcome in low-income countries has not been sufficiently investigated. Our study examined this influence and explored parental experiences during cancer treatment of their children in an Indonesian academic hospital. Materials and Methods: Medical charts of 145 children diagnosed with cancer between 1999 and 2009 were reviewed retrospectively. From October 2011 until January 2012, 40 caretakers were interviewed using semi-structured questionnaires. Results: Of all patients, 48% abandoned treatment, 34% experienced death, 9% had progressive/relapsed disease, and 9% overall event-free survival. Prosperous patients had better treatment outcome than poor patients (P<0.0001). Odds-ratio for treatment abandonment was 3.3 (95%CI: 1.4-8.1, p=0.006) for poor versus prosperous patients. Parents often believed that their child's health was beyond doctor control and determined by luck, fate or God (55%). Causes of cancer were thought to be destiny (35%) or God's punishment (23%). Alternative treatment could (18%) or might (50%) cure cancer. Most parents (95%) would like more information about cancer and treatment. More contact with doctors was desired (98%). Income decreased during treatment (55%). Parents lost employment (48% fathers, 10% mothers), most of whom stated this loss was caused by their child's cancer (84% fathers, 100% mothers). Loss of income led to financial difficulties (63%) and debts (55%). Conclusions: Treatment abandonment was most important reason for treatment failure. Treatment outcome was determined by parental socio-economic status. Childhood cancer survival could improve if financial constraints and provision of information and guidance are better addressed.

• Asian Pacific Journal of Cancer Prevention
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• 제17권sup3호
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• pp.191-195
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• 2016

Breast cancer is the most frequent cancer in females. Its incidence is higher in developed countries than in developing ones partly due to variation in risk exposure and partly due to better detection methods. Scattered evidence in Basrah, Iraq, suggests that breast cancer has been increasing at a significant pace in recent years. This study aimed to measure the current level of risk of breast cancer among females in Basrah and to describe the time trend over almost a decade of years. Data on breast cancer cases from all sources of cancer registration in Basrah governorate were compiled for the years 2005-2012. The data for each year were first checked separately for duplicate reporting of cases among various sources. Then the eight files were pooled together and checked again for any duplicate cases among years of registration. The final set of data contained 2,284 cases of breast cancer (2,213 female cases and 71 male cases). All patients were inhabitants of Basrah governorate at the time of diagnosis. Figures on the Basrah population were obtained from various sources including the Ministry of Health, Ministry of Planning and Developmental Collaboration and local household surveys. It was possible to have total population estimates for each year and by age and sex. The data were imported into SPSS (version 17) software. Age specific and year specific incidence rates were calculated. The age standardized incidence rate was also calculated using world population as the standard population to be 34.9 per 100,000 females. Age-wise, no case was reported among children aged less than 15 years and the incidence increased with advancing age reaching a peak of 123.8/100,000 females at the age range of 50-54 years. The time trend of the crude incidence rate showed only modest increased risk with passage of years and no age shift could be documented in this study. Breast cancer in females in Basrah is a significant health problem. The current incidence rate (crude, 23.7/100,000, age-standardized, 34.9/100,000) is high and justifies intensive efforts to improve early detection of cases, provide better treatment amenities and introduce long term preventive measures. Using the age standardized incidence rate as reported in this paper, it is possible to put the risk in Basrah within a regional and international context.

• 지역사회간호학회지
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• 제33권2호
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• pp.237-246
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• 2022

Purpose: The aim of this study was to investigate the relationship between the 5-year survival rate, socioeconomic status, and SEER (Surveillance Epidemiology and End Results) stage of stomach, colorectal, breast and cervical cancer patients. Methods: A total of 11,770 cases of four target cancers, which were diagnosed during 2005-2007, were extracted from the database of Gwangju-Jeonnam Regional Cancer Registry. The subjects of the study were 11,770 including stomach (n=5,479), colorectal (n=3,565), breast (n=1,516) and cervical cancers (n=710). Cox's proportional hazards model was used to obtain the hazards ratio (HR) according to the SEER stage and socioeconomic status. Results: Stomach cancer had a significantly higher HR in the medical aid recipients (HR=1.39), and the group below 20% (HR=1.20) compared to the group with the highest income level. Colorectal cancer had a significantly higher HR in the medical aid recipients (HR=1.26) than in the group with the highest income level. In addition, stomach, colorectal, breast and cervical cancers had a significantly higher HR according to the SEER stage in regional direct (stomach=4.10, colorectal=1.76, breast=12.90, cervical=3.10), regional lymph only(stomach=2.58, colorectal=2.33, breast=4.32, cervical=4.43), regional both (stomach=6.74 colorectal=3.04, breast=15.57 cervical=6.50), and regional NOS (Not Otherwise Specified)/distant (stomach=17.53, colorectal=11.53, breast=25.34, cervical=26.51) than in situ and localized only. Conclusion: In order to increase the cancer survival rate, a support system for early detection and early treatment of cancer should be established for groups with low individual income levels, and regular health checkups and management measures should be actively implemented through the National Cancer Screening Program.