• Asian Pacific Journal of Cancer Prevention
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• v.14 no.8
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• pp.4903-4906
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• 2013

Background: The purpose of this study was to determine proportional rates of cervical precancerous lesions and cancer, and associations with socio-demographic variables, HIV status, and CD4 cell count. Materials and Methods: A retrospective comparative study was conducted targeting the medical records of all women over age 18 that were diagnosed histologically through colposcopy with cervical precancerous lesions and cancer from 1 December 2011 to 30 November 2012. Results: A total of 313 patient records were used for data analysis. The average age was 39.1 (SD=2.04) years. More than a third (37.1%) of the patients had CIN III or cervical cancer. There was a significant association between age, CD4 cell count, HIV status, and cervical lesions (p<0.05). Age was found to be an influential predictor of cervical lesions (OR=0.67, 95%CI: 0.46-0.98). Conclusions: There exists an association between age and cervical lesions, with presentation of cervical precancerous lesions and cervical cancer at a younger age among HIV reactive patients. The National Guidelines should be brought in line with the National HIV Counseling and Testing Policy to offer Pap smears to all sexually active women that test HIV reactive during routine HIV Testing.

• The Journal of Korean Academic Society of Nursing Education
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• v.12 no.1
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• pp.104-114
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• 2006

Genetic knowledge for oncology nurses is important in Korea because oncologists are incorporating genetic counseling and genetic testing into their practice. The purpose of this paper is to describe our method of developing the first academic cancer genetic risk assessment and counseling course for Korean nurses. A one-week (non-credit) cancer genetics counseling program was constructed for master's level Korean oncology nurses. The course emphasized basic genetic concepts and principles the genetics of cancer; hereditary cancer syndromes; family history assessments; pedigree construction; risk calculation; surveillance recommendations and treatment options ethical, legal, social, and psychological issues inherent in genetic testing. The goals of this program are to: 1) provide a comprehensive knowledge base for nurses who are currently expanding their scope of practice into the genetic counseling role 2) introduce this knowledge to nurses who want to use it in their practice; and 3) provide cancer genetic knowledge and resources to Korean nursing faculty who plan to incorporate this knowledge into existing master's courses. This academically-based course is recognized as valuable by nurses, nursing faculty, and physicians. With this new knowledge nurses can begin toexpand their role in delivering comprehensive cancer care services.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.16
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• pp.6837-6842
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• 2014

Background: Northern Thailand is a region with a high cervical cancer incidence. Combined high-risk HPV (hrHPV) DNA testing and cytology (co-testing) has increasingly gained acceptance for cervical cancer screening. However, to our knowledge, data from a population-based screening using co-testing have not been available in this region. This study therefore aimed to evaluate the performance of cytology and hrHPV test in women in northern Thailand. Materials and Methods: Cervical samples were collected for hybrid capture 2 (HC2) testing and liquid-based cytology from women aged 30 to 60 years who were residents in 3 prefectures of Chiang Mai in northern Thailand between May and September 2011. Women with positive cytology were referred to colposcopy, while women with positive for HC2 only were followed for 2 years. Results: Of 2,752 women included in this study, 3.0% were positive in both tests, 4.1% for HC2 only, and 1.3% had positive cytology only. At baseline screening, positive HC2 was observed in 70.6% among cytology-positive women compared with 4.3% among cytology-negative women. The prevalence of positive HC2 or cytology peaked in the age group 35-39 years and was lowest in the age group 55-60 years. High-grade squamous intraepithelial lesion or worse lesions (HSIL+) were histologically detected in 23.5% of women with positive baseline cytology and in 9.8% of women with positive baseline HC2 only on follow-up. All women with histologic HSIL+ had positive baseline HC2. Conclusions: The hrHPV test is superior to cytology in the early detection of high-grade cervical epithelial lesions. In this study, the prevalence of histologic HSIL+ on follow-up of women with positive hrHPV test was rather high, and these women should be kept under careful surveillance. In northern Thailand, hrHPV testing has a potential to be used as a primary screening test for cervical cancer with cytology applied as a triage test.

• Nutritional Sciences
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• v.7 no.1
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• pp.53-58
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• 2004

The Multiethnic Cohort Study was designed to study prospectively the relationship of diet and other lifestyle factors to the risk of cancer. The cohort was established in 1993-1996 in Hawaii and California (primarily Los Angeles) and included a representative sample of more than 215,000 men and women primarily from five different ethnic groups: Japanese, whites, Native Hawaiians, Latinos, and African- Americans. Because of the emphasis on diet, great attention was paid to developing and pre-testing a self-administered quantitative food frequency questionnaire that would adequately assess food and nutrient intakes in these groups. An extensive food composition database was also created for the study. In addition, during data collection, a calibration study was conducted that makes possible adjustment for measurement error in nutrient intakes and valid comparison of intakes across the several ethnic groups. At the present time, blood and urine specimens are being collected from cohort participants and should yield a biorepository of more than 80,000 subjects. Baseline data indicate that the cohort is well representative of the general population of Hawaii and California, so that results can be generalized. These data also show a wide range in dietary intakes and in other lifestyle variables that should facilitate the testing of etiologic hypotheses.

• Women's Health Nursing
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• v.20 no.3
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• pp.225-233
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• 2014

Purpose: This study was to assess the intention of undergoing Pap testing and to identify influencing factors of HPV knowledge and their attitude related to Pap test by sexual activity among unmarried nurses. Methods: A cross sectional survey design was employed, utilizing a self-administered questionnaire amongst 343 unmarried nurses. Descriptive statistics was utilized to analyze data and inferential statistics used an independent-t test and ${\chi}^2$ test for the differences in measurement variables, and odds ratios for factors on intention of Pap testing by sexual activity. Results: Nurses not sexually active were significantly higher in intention of Pap testing (${\chi}^2$=40.15, p<.001) and influencing factors of HPV knowledge (t=3.93, p=.048) than did nurses who were sexually active. Factors influencing intention were regularity of the breast self-examination (Adjusted Odds Ratio [AOR]=4.20, 95% Confidence Interval [CI]=1.93~9.17), HPV knowledge (AOR=2.49, 95% CI=1.36~4.56), and attitudes toward the Pap test(AOR=2.33, 95% CI=1.25~4.34) amongst nurses who never had sexual experience. Conclusion: It is necessary to minimize negative attitudes of Pap testing and to increase HPV knowledge in order to improve intention of Pap testing for women who were not sexually active. More focus would be given to sexually active women to get Pap tested as a preventive measure for cervical cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.19
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• pp.8229-8237
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• 2014

Background: Organized cervical screening has decreased the incidence of cervical cancer. However, screening strategies vary in different countries. Objectives: We performed a systematic review to evaluate the economic aspects of different screening methods. Materials and Methods: We searched databases and then data were abstracted from each study. We evaluated articles based on different types of screening tests as well as screening age and intervals, and using incremental cost effectiveness ratio via calculating quality adjusted life years (QALY), or life years gained (LYG) per cost. We compared the incremental cost-effectiveness ratio (ICER) of each study using GDP per capita. Furthermore, we compared national guidelines with recommendations of cost-effectiveness studies in different countries. Results: A total of 21 articles met our criteria, of which 19 studies showed that HPV DNA testing, 13 suggested an age of 30 years or more, and 10 papers concluded that at least a 5-year or longer interval were the most cost-effective strategies. In some countries, the national guidelines did not match the recommendations of the cost-effectiveness studies. Conclusions: HPV testing, starting at age 30 years or older and repeated at 5-year or longer intervals, is the most cost-effective strategy in any setting. Closer collaboration with health economists is required during guideline development.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.18
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• pp.7981-7984
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• 2014

Purpose: Colorectal cancer (CRC) screening with fecal occult blood testing (FOBT) has been associated with a reduction in CRC incidence and CRC-related mortality. However, a conventional FOBT requires stool collection and handling, which may be inconvenient for participants. The EZ-Detect$^{TM}$ (Siam Pharmaceutical Thailand) is a FDA-approved chromogen-substrate based FOBT which is basically a self-checked FOBT (no stool handling required). This study aimed to evaluate the accuracy of EZ-Detect for CRC detection. Methods: This prospective study was conducted in the Faculty of Medicine, Siriraj Hospital, Bangkok, Thailand between November 2013 and May 2014. Some 96 patients with histologically-proven CRC and 101 patients with normal colonoscopic findings were invited to perform self-checked FOBT according to the manufacturer's instructions. Results were compared with endoscopic and pathologic findings. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for CRC detection were calculated. Results: The present study revealed the sensitivity, specificity, PPV and NPV of this self-checked FOBT for CRC detection to be 41% (95% CI: 31-51), 97% (95% CI: 92-99), 93% (95% CI: 81-98) and 63% (95% CI: 55-70), respectively. The overall accuracy of the self-checked FOBT for identifying CRC was 70%. The sensitivity for CRC detection based on 7th AJCC staging was 29% for stage I, 32% for stage II and 50% for stage III/IV (P=0.19). The sensitivity was 33% for proximal colon and 42% for distal colon and rectal cancer (P=0.76). Notably, none of nine infiltrative lesions gave a positive FOBT. Conclusions: The self-checked FOBT had an acceptable accuracy of CRC detection except for infiltrative tumors. This home-administrated or 'DIY' do-it-yourself FOBT could be considered as one non-invasive and convenient tool for CRC screening.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.5
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• pp.2245-2249
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• 2014

Background: Human papillomavirus is a well-established cause of the development of a variety of epithelial lesions in the cervix. However, as yet, incorporation of HPV testing into cervical cancer screening either as an adjunct or stand alone test is limited due to its cost. We therefore here ascertained the presence and type specificity of human papilloma virus (HPV) DNA in routine cervical scrapings. Materials and Methods: Cervical scrapings were collected from women attending clinics for routine Pap smear screening. HPV-DNA was detected by PCR using MY09/11 and GP5+/GP6+ primer sets and genotyping was accomplished by cycle-sequencing. Results: A total of 635 women were recruited into the study with $mean{\pm}SD$ age of $43{\pm}10.5$ years. Of these 92.6% (588/635) were reported as within normal limits (WNL) on cytology. The presence of HPV infection detected by nested MY/GP+-PCR was 4.4% (28/635). The overall prevalence of high-risk HPV (HR-HPV) in abnormal Pap smears was 53.8% (7/13). HPVs were also seen in 3.1% (18/588) of smears reported as WNL by cytology and 5.9% (2/34) in smears unsatisfactory for evaluation. Conclusions: The overall percentage of HPV positivity in routine cervical screening samples is comparable with abnormal findings in cytology. Conventional Pap smear 'missed' a few samples. Since HPV testing is expensive, our results may provide valuable information for strategising implementation of effective cervical cancer screening in a country with limited resources like Malaysia. If Pap smear coverage could be improved, HPV testing could be used as an adjunct method on cases with ambiguous diagnoses.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.17
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• pp.7437-7441
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• 2014

Background: Acceptability of self-sampling HPV testing is confirmed worldwide. However, some cultural differences may affect this question. Therefore, this study was conducted to evaluate the acceptability of self-sampling HPV testing in Thai women. Materials and Methods: One hundred women aged 30-65 years with an intact cervix were included in this study. The participants were asked to do the Pap test by physicians and then brush type self-sampling instruments were assigned for self-collection and finally completed a questionnaire for acceptability evaluation. The questionnaire contains 2 parts. Part one covered general information of the participants and part two is the acceptability questions. Results: Mean age was 40.6 years. The incidence of high risk HPV detection in this study was 16%. The most common reason for doing Pap smear was for annual checkup. On the topic of ease of use, 85 % of the subjects agreed. Most of the participants (82%) reported that they felt less pain. However, reliability of the result was not satisfactory because 37% of the participants hesitated to rely on the results of the test. According to the price, if the price is less than 1,000 Baht (32.59 Baht = 1USD), 82% of the subjects would use it for their next screening. Conclusions: The acceptability of self-sampling device in this study is quite good but the reliability of the test was questioned by some of the participants. Moreover, the price of the test in Thailand may also influence the acceptability of the test.

• Journal of Digestive Cancer Research
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• v.2 no.1
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• pp.5-7
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• 2014

Screening and early diagnosis of cancer is important. Screening lead to detect disease earlier, and earlier treatment of disease cause to yield a better outcome than treatment at the onset of symptoms. Some studies suggest that gastric cancer screening may be associated with a reduced risk of mortality from gastric cancer, although there are no definitive data from large controlled trials. Regular colorectal cancer screening or testing is one of the most powerful weapons for preventing colorectal cancer, because some polyps, or growths can be found and removed before they have the chance to turn into cancer. Screening can also result in finding colorectal cancer early, when it is highly curable. In conclusion, to increase utilization of screening is important to decrease gastric and colorectal cancer morbidity and mortality.