• Asian Pacific Journal of Cancer Prevention
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• 제17권9호
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• pp.4323-4326
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• 2016

Background: The cancer mortality-to-incidence ratio (MIR) has been established as an important measure of health disparities in local and global circumstances. Past work has corroborated a linkage between the colorectal cancer MIR and the World Health Organization (WHO) Health System ranking. The literature further documents many Asian countries having incomplete cancer registries and a lack of comprehensive colorectal cancer screening guidelines. Materials and Methods: The colorectal cancer MIR values for 23 Asian countries were calculated from data obtained from the 2012 GLOBOCAN database. The 2000 World Health Organization (WHO) Health System rankings were used as a proxy for health system infrastructure and responsiveness. A regression equation was calculated with the MIR as the dependent variable and the WHO Health System ranking as the independent variable. Predicted MIR values were next calculated based on the regression results. Actual MIR values that exceeded 0.20 from the predicted MIR were removed as 'divergent' points. The regression equation was then re-plotted. Goodness-of-fit for both regressions was assessed by the R-squared test. Results: Asian countries have a relatively wide colorectal cancer MIR range, from a minimum of 0.24 to a maximum of 0.86. For the full dataset, the adjusted R-squared value for this regression was 0.53. The equation was then used to calculate a predicted MIR, whereby two data points were identified as 'divergent' and removed. The adjusted R-squared for the edited dataset increased to 0.66. Conclusions: Asian countries have a marked range in their colorectal cancer MIR values and there is a strong correlationwith the WHO Health System ranking. These results corroborate the contribution of the MIR as a potentially robust tool in monitoring changes in colorectal cancer care for Asian nations.

• Asian Pacific Journal of Cancer Prevention
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• 제15권6호
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• pp.2727-2732
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• 2014

Objectives: The aim of this study was to describe and analyze the incidence and mortality of female breast cancer in Jiangsu Province of China. Methods: Incidence and mortality data for female breast cancer and corresponding population statistics from eligible cancer registries in Jiangsu from 2006 to 2010 were collected and analyzed. Crude rates, age-specific rates and age-standardized rates of incidence and mortality were calculated, and annual present changes (APCs) were estimated to describe the time trends. Results: From 2006 to 2010, 11,013 new cases and 3,068 deaths of female breast cancer were identified in selected cancer registry areas of Jiangsu. The annual average crude incidence and age-standardized incidence by world population (ASW) were 25.2/ and 17.9/100,000 respectively. The annual average crude and ASW for mortality rates were 7.03/ and 4.81/100,000. The incidence was higher in urban areas than that in rural areas, and this was consistent in all age groups. No significant difference was observed in mortality between urban and rural areas. Two peaks were observed when looking at age-specific rates, one at 50-59 years and another at over 85 years. During the 5 years, incidence and mortality increased with APCs of 4.47% and 6.89%, respectively. Compared to the national level, Jiangsu is an area with relatively low risk of female breast cancer. Conclusion: Breast cancer has become a main public health problem among Chinese females. More prevention and control activities should be conducted to reduce the burden of this disease, even in relatively low risk areas like Jiangsu.

• 대한두경부종양학회지
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• 제23권2호
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• pp.147-152
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• 2007

Objectives and Background : Aims of this studies are to collect and analyze the lawful restriction against cancer registration and to suggest the model promoting the cancer registry. Materials and Methods : Total 16 countries, the members of OECD, including the U.S. are evaluated. the status of cancer registration of the evaluated countries are analyzed. The legislated laws, protect the individual's information, of the evaluated countries are analyzed. The cases any registries were impaired with the law to protect privacy are searched and analyzed. Results : All of the evaluated countries have some kinds of privacy protecting laws. For cancer registration, 11 of 16 countries implement some lawful authorities. Some of countries have experienced restriction of registration by the law of protecting individual's health data. All countries have performed cancer registry and 6 of 16 countries have nearly 100% population-based cancer registration. Conclusions : The cancer registry has to be the national effort. The informed consent of the data subjects and the permission of any special institutes are the difference to perform the registration. So, it is necessary to legislate any law supporting the cancer registration and establish any independent institutes to protect the individual's health data and support the cancer registry.

• Asian Pacific Journal of Cancer Prevention
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• 제13권4호
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• pp.1105-1109
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• 2012

Breast cancer is the second most common cancer in women in India and the disease burden is increasing annually. The lack of awareness initiatives, structured screening, and affordable treatment facilities continue to result in poor survival. We present a breast cancer survival scenario, in urban population in India, where standardised care is distributed equitably and free of charge through an employees' healthcare scheme. We studied 99 patients who were treated at our hospital during the period 2005 to 2010 and our follow-up rates were 95.95%. Patients received evidence-based standardised care in line with the tertiary cancer centre in Mumbai. One-, three- and five-year survival rates were calculated using Kaplan-Meier method. Socio-demographic, reproductive and tumor factors, relevant to survival, were analysed. Mortality hazard ratios (HR) were calculated using Cox proportional hazard method. Survival in this series was compared to that in registries across India and discrepancies were discussed. Patients mean age was 56 years, mean tumor size was 3.2 cms, 85% of the tumors belonged to T1 and T2 stages, and 45% of the patients belonged to the composite stages I and IIA. Overall 5-year survival was 74.9%. Patients who presented with large-sized tumors (HR 3.06; 95% CI 0.4-9.0), higher composite stage (HR 1.91; 0.55-6.58) and undergone mastectomy (HR 2.94; 0.63-13.62) had a higher risk of mortality than women who had higher levels of education (HR 0.25; 0.05-1.16), although none of these results reached the significant statistical level. We observed 25% better survival compared to other Indian populations. Our results are comparable to those from the European Union and North America, owing to early presentation, equitable access to standardised free healthcare and complete follow-up ensured under the scheme. This emphasises that equitable and affordable delivery of standardised healthcare can translate into early presentation and better survival in India.

• Asian Pacific Journal of Cancer Prevention
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• 제17권sup3호
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• pp.93-99
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• 2016

Completeness is an important indicator of data quality in cancer registry programs. This study aimed to estimate the completeness of registered cases in a population based cancer registry program implemented in five provinces of Iran. Capture-recapture methods were used to estimate the number of cases that may have been missed and to estimate rates of completeness for different categories of age, year, and sex. The data used for this study were obtained from three sources: 1) National Pathology Database; 2) National Hospital Discharge Database; and 3) National Death Registry Database. The three sources were linked and duplicates were identified based on first name, last name, father's names, and date of birth, ICD code, and case's residency address using Microsoft Excel. Removing duplicates, the three sources reported a total of 35,643 cases from March 2008 to March 2011. Running many different multivariate models of capture-recapture and controlling for source dependencies revealed an overall under-reporting of 49% in all five registries combined. The estimated completeness differed based on age, sex, and year. The overall completeness was higher for males than females (71.2% for males and 59.9% for females). Younger age had lower rates of completeness compared to older age (38.1% for <40 years, 55.4% for 40-60 years, and 76.7 for >60 years). The results of this study indicated a moderate to severe (depending on the age, sex and year) degree of completeness in the population based cancer registration of Iran.

• Asian Pacific Journal of Cancer Prevention
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• 제16권14호
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• pp.5853-5858
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• 2015

Background: The survival rate reflecting prognosis of breast cancer patients is usually estimated based on crude survival methods such as observed and cause-specific. In situations where data are based on population-cancer registries, this method may produce biased estimations. This study therefore aimed to estimate the net survival of breast cancer based on relative survival. Materials and Methods: Data for 622 breast cancer patients diagnosed at the Iran Cancer Institute during 1990-95 and tracked till the end of 2000 were analyzed. For estimation of relative survival, Ederer's second method and SAS (9.1) and STATA (11) software were used. Results: Threeyear relative survivals of 85%, 90%, 80% and 67% were observed for age groups 15-44, 55-59, 60-74, and 75+years-old, respectively. A relative survival of approximately one was observed for two subsequent years for age-group 45-59 years-old. A value greater than one for two subsequent years of follow-up was observed in the age-group 60-74 years-old. Conclusions: Tracking the diagnosis of breast cancer, the relative survival decreases as we go to higher age-groups. It is also perceived that through follow-up, relative survival first decreased and then increased a little. The statistical cure point is acceptable for age group 45-59 years-old while for age-groups 15-44 and 60-74 years old is a sign of low quality data for some follow-up intervals.

• Asian Pacific Journal of Cancer Prevention
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• 제15권5호
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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.

• Journal of Preventive Medicine and Public Health
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• 제40권3호
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• pp.213-217
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• 2007

Objectives : This study aimed to calculate the survival rates of cancer patients in Jeju Island residents from 2000 to 2001, based on their major primary sites of occurrence. Methods : Data were extracted from the database of the Jejudo Cancer Registry (JCR). The eligible population comprised 2,382 cancer cases, whose cancers were diagnosed from 1 January 2000 through 31 December 2001. Of the eligible population, 1,438 patients with 5 major cancers defined by the level of incidence rates were selected as the study participants. The period of survival for each case was calculated from the date of first diagnosis to the date of death, or the end of follow-up, i.e., 31 December 2003. The observed survival rates (OSR) and relative survival rates (RSR) were calculated according to sex, age-group, and primary sites of occurrence. Results : The 3-year OSR and RSR in 5 major cancers were higher in women than in men except 75 year-old over group. The 3-year RSR of stomach, colorectum, liver, and lung in both sexes were 61.0%, 62.6%, 24.7%, and 22.8%, respectively. The respective rates in JCR showed some statistically significant differences from those in the Korea Central Cancer Registry (KCCR). Conclusions : These results would suggest some clues about prognostic factors of major cancers in Korean, and could apply to planning and evaluating of cancer control strategies in Jeju Island.

• Asian Pacific Journal of Cancer Prevention
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• 제13권7호
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• pp.3149-3152
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• 2012

Objective: The prognostic significance of perineural invasion (PNI) in gastric cancer has been previously investigated but not clearly clarified. The objective of our study was to investigate the role of PNI as prognostic factor in patients undergoing curative surgical resection and without distant metastasis in comparison with other clinicopathological factors. Methods: Between 2001 and 2010, 287 cases of gastric adenocarcinoma underwent radical gastrectomy recorded in hospital based registries. PNI was assessed as positive when cancer cells were seen in the perinerium or neural fascicles intramurally. Categorical and continuous variables were summarized using descriptive statistics and compared using chi-square and Mann-Whitney U tests, respectively. Cancer related survival rates were estimated by the Kaplan-Meier method. Results: PNI was positive in 211 of 287 cancers (73%), with a positive relation to lymph node metastases and advanced stage (p=0.0001, p=0.0001, respectively), mural invasion, and lymphatic and blood vessel invasion (p=0.0001, p=0.0001, respectively). The median survival of the PNI positive patients was significantly shorter than that of their PNI negative counterparts (24.1 versus 38.2 months, p=0.008). In the multivariate analysis, we detected PNI was an independent prognostic factor (p=0.025, HR=1.21, 95% CL 1.08-2.3) along with classical clinicopathological variables such as lymph node involvement (p=0.001), pT stage (p=0.03), and LVI (p=0.017), but not age, gender, tumour localization, stage, histologic type, and surgery procedure. Conclusions: PNI positivity in gastric cancers was related mural invasion, lymph node involvement, advanced stage and lymphatic and venous blood vessels. The presence of PNI appeared as an independent prognostic factor on survival on multivariate analysis, not influenced by tumor stage, lymph node metastases and other classical factors.

• Asian Pacific Journal of Cancer Prevention
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• 제17권4호
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• pp.1745-1754
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• 2016

Background: The prime output of Hospital Based Cancer Registries is stage and treatment based survival to evaluate patient care, but because of challenges of obtaining follow-up details a separate study on Patterns of Care and Survival for selected sites was initiated under the National Cancer Registry Programme of India. The results of stage and treatment based survival for head and neck cancers by individual organ sites are presented. Materials and Methods: A standardized Patient Information Form recorded the details and entered on-line at www.hbccrindia.org to a central repository - National Centre for Disease Informatics and Research. Cases from 12 institutions diagnosed between 1 January 2006 and 31 December 2008 comprised the study subjects. The patterns of treatment were examined for 14053 and survival for 4773 patients from five institutions who reported at least 70% follow-up as of 31 December 2012. Results: Surgical treatment with radiation for cancer tongue and mouth showed five year cumulative survival (FCS) of 67.5% and 60.4% respectively for locally advanced stage. Chemo-radiation compared to radiation alone showed better survival benefit of around 15% in both oro and hypo-pharyngeal cancers and their FCS was 40.0%; Hazard Ratio (HR):1.5;CI=1.2-1.9) and 38.7%; (HR):1.7; CI=1.3-2.2). Conclusions: The awareness about the requirement of concurrent chemo-radiation in specifically cancers of the oro and hypopharynx has to be promoted in developing countries. The annual (2014) estimate number of new Head and Neck cancers with locally advanced disease in India is around 140,000 and 91,000 (65%) patients do not receive the benefit of optimal treatment with ensuing poorer survival.