• Asian Pacific Journal of Cancer Prevention
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• 제13권1호
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• pp.147-155
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• 2012

Aboriginal and Torres Strait Islander people comprise about 2.5% of the Australian population. Cancer registry data indicate that their breast cancer survivals are lower than for other women but the completeness and accuracy of Indigenous descriptors on registries are uncertain. We followed women receiving mammography screening in BreastScreen to determine differences in screening experiences and survivals from breast cancer by Aboriginal and Torres Strait Islander status, as recorded by BreastScreen. This status is self-reported and used in BreastScreen accreditation, and is considered to be more accurate. The study included breast cancers diagnosed during the period of screening and after leaving the screening program. Design: Least square regression models were used to compare screening experiences and outcomes adjusted for age, geographic remoteness, socio-economic disadvantage, screening period and round during 1996-2005. Survival of breast cancer patients from all causes and from breast cancer specifically was compared for the 1991-2006 diagnostic period using linked cancer-registry data. Cox proportional hazards regression was used to adjust for socio-demographic differences, screening period, and where available, tumour size, nodal status and proximity of diagnosis to time of screen. Results: After adjustment for socio-demographic differences and screening period, Aboriginal and Torres Strait Islander women participated less frequently than other women in screening and re-screening although this difference appeared to be diminishing; were less likely to attend post-screening assessment within the recommended 28 days if recalled for assessment; had an elevated ductal carcinoma in situ but not invasive cancer detection rate; had larger breast cancers; and were more likely than other women to be treated by mastectomy than complete local excision. Linked cancer registry data indicated that five-year year survivals of breast cancer cases from all causes of death were 81% for Aboriginal and Torres Strait Islander women, compared with 90% for other women, and that the former had larger breast cancers that were more likely to have nodal spread at diagnosis. After adjusting for socio-demographic factors, tumour size, nodal spread and time from last screen to diagnosis, Aboriginal and Torres Strait Islander women had approximately twice the risk of death from breast cancer as other women. Conclusions: Aboriginal and Torres Strait Islander women have less favourable screening experiences and those diagnosed with breast cancer (either during the screening period or after leaving the screening program) have lower survivals that persist after adjustment for socio-demographic differences, tumour size and nodal status.

• Asian Pacific Journal of Cancer Prevention
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• 제13권9호
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• pp.4623-4626
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• 2012

Background: The risk of treatment-related death (TRD) and febrile neutropaenia (FN) with adjuvant taxane-based chemotherapy for early breast cancer is unknown in Malaysia despite its widespread usage in recent years. This study aims to determine these rates in patients treated in University Malaya Medical Centre (UMMC). Patients and Methods: Patients who were treated with adjuvant taxane-based chemotherapy for early breast cancer stages I, II or III from 2007-2011 in UMMC were identified from our UMMC Breast Cancer Registry. The TRD and FN rates were then determined retrospectively from medical records. TRD was defined as death occurring during or within 30 days of completing chemotherapy as a consequence of the chemotherapy treatment. FN was defined as an oral temperature > $38.5^{\circ}C$ or two consecutive readings of > $38.0^{\circ}C$ for 2 hours and an absolute neutrophil count < $0.5{\times}10^9/L$, or expected to fall below $0.5{\times}10^9/L$. Results: A total of 622 patients received adjuvant chemotherapy during this period. Of these patients 209 (33.6%) received taxane-based chemotherapy. 4 taxane-based regimens were used namely the FEC-D, TC, TAC and AC-PCX regimens. The commonest regimen employed was the FEC-D regimen accounting for 79.9% of the patients. The FN rate was 10% and there was no TRD. Conclusion: Adjuvant taxane-based chemotherapy in UMMC for early breast cancer has a FN rate of 10%. Primary prophylactic G-CSF should be considered for patients with any additional risk factor for FN.

• Clinical and Experimental Pediatrics
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• 제57권3호
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• pp.135-139
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• 2014

Purpose: Adult Korean patients on chronic dialysis have a 9-year survival rate of 50%, with cardiovascular problems being the most significant cause of death. The 2011 annual report of the North American Pediatric Renal Trials and Collaborative Studies group reported 3-year survival rates of 93.4% and relatively poorer survival in younger patients. Methods: In this study, we have reviewed data from Korean Pediatric Chronic Kidney Disease Registry from 2002 to 2010 to assess survival rates and causes of death in Korean children on chronic dialysis. Results: The overall estimated patient survival rates were 98.4%, 94.4%, and 92.1% at 1, 3, and 5 years, respectively. No significant difference was observed in survival rates between patients on peritoneal dialysis and those on hemodialysis. Patients for whom dialysis was initiated before 2 years of age (n=40) had significantly lower survival rates than those for whom dialysis was initiated at 6-11 years of age (n=140). In all, 26 patients had died; the mortality rate was 19.9 per 1,000 patient years. The most common causes of death were infections and comorbidities such as malignancy and central nervous system (CNS) or liver diseases. Conclusion: The outcomes observed in this study were better than those observed in adults and comparable to those observed in pediatric studies in other countries. To improve the outcomes of children on chronic dialysis, it is necessary to prevent dialysis-related complications such as infection, congestive heart failure, or CNS hemorrhage and best control treatable comorbidities.

• Asian Pacific Journal of Cancer Prevention
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• 제15권14호
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• pp.5839-5843
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• 2014

Objective: The Zhejiang Provincial Cancer Prevention and Control Office collected cancer registration data during 2000 to 2009 from 6 cancer registries in Zhejiang province of China in order to analyze the cancer incidence. Methods: Descriptive analysis included cancer incidence stratified by sex, age and cancer site group. The proportions and cumulative rates of 10 common cancers in different groups were also calculated. Chinese population census in 1982 and Segi's population were used for calculating age-standardized incidence rates. The log-linear model was used for fitting to calculate the incidence trends. Results: The 6 cancer registries in Zhejiang province in China covered a total of 60,087,888 person-years during 2000 to 2009 (males 30,445,904, females 29,641,984). The total number of new cancer cases were 163,104 (males 92,982, females 70,122). The morphology verified cases accounted for 69.7%, and the new cases verified only by information from death certification accounted for 1.23%. The crude incidence rate in Zhejiang cancer registration areas was $271.5/10^5$ during 2000 to 2009 (male $305.41/10^5$, female $236.58/10^5$), age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population (ASIRW) were $147.1/10^5$ and $188.2/10^5$, the cumulative incidence rate (aged from 0 to 74) being 21.7%. The crude incidence rate was $209.6/10^5$ in 2000, and it increased to $320.20/10^5$ in 2009 (52.8%), with an annual percent change (APC) of 4.51% (95% confidence interval, 3.25%-5.79%). Age-specific incidence rate of 80-84 age group was achieved at the highest point of the incidence curve. Overall with different age groups, the cancer incidences differed, the incidence of liver cancer being highest in 15-44 age group in males; the incidence of breast cancer was the highest in 15-64 age group in females; the incidences of lung cancer were the highest in both males and females over the age of 65 years. Conclusions: Lung cancer, digestive system malignancies and breast cancer are the most common cancers in Zhejiang province in China requiring an especial focus. The incidences of thyroid cancer, prostate cancer, cervical cancer and lymphoma have increased rapidly. Prevention and control measures should be implemented for these cancers.

• Asian Pacific Journal of Cancer Prevention
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• 제15권9호
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• pp.4091-4094
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• 2014

Background: This study used the receiver operating characteristic curve (ROC) to analyze Surveillance, Epidemiology and End Results (SEER) bronchioaveolar carcinoma data to identify predictive models and potential disparity in outcomes. Materials and Methods: Socio-economic, staging and treatment factors were assessed. For the risk modeling, each factor was fitted by a Generalized Linear Model to predict cause specific survival. The area under the ROC was computed. Similar strata were combined to construct the most parsimonious models. A random sampling algorithm was used to estimate modeling errors. Risk of cause specific death was computed for the predictors for comparison. Results: There were 7,309 patients included in this study. The mean follow up time (S.D.) was 24.2 (20) months. Female patients outnumbered male ones 3:2. The mean (S.D.) age was 70.1 (10.6) years. Stage was the most predictive factor of outcome (ROC area of 0.76). After optimization, several strata were fused, with a comparable ROC area of 0.75. There was a 4% additional risk of death associated with lower county family income, African American race, rural residency and lower than 25% county college graduate. Radiotherapy had not been used in 2/3 of patients with stage III disease. Conclusions: There are socio-economic disparities in cause specific survival. Under-use of radiotherapy may have contributed to poor outcome. Improving education, access and rates of radiotherapy use may improve outcome.

• 보건교육건강증진학회지
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• 제31권4호
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• pp.51-62
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• 2014

Objectives: The objective of study was to calculate the municipal level environmental burden of disease (EBD) due to heat wave. Methods: The data used were Korea National Health Insurance 2011 claim data and 2011 death registry. Heatwave related diseases included hypertensive heart diseases, ischemic heart diseases, cerebrovascular disease, and heat related illness. According to the method that WHO proposed, the study computed population-attributable fraction with relative risk which come from previous study and proportion of exposure which the study calculated with historical meteorology data. Results: The Average of 251 municipal EBD was 2.11 per thousand persons. The value of years lost due to disability was 11 times higher than that of years of life lost. On average EBD of county and southern geographical areas tended to be higher than those of District or city areas. The relationship between municipal deprivation index (composite deprivation index) and EBD showed the positive association, which means that the worse deprived municipal is, the higher EBD takes. Conclusions: Climate change is getting one of the major risk factors of cardio-cerebrovascular disease, which is the second leading cause of death. The study results suggested the urgent policy planning and reaction of climate change adaptation.

• Asian Pacific Journal of Cancer Prevention
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• 제17권1호
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• pp.353-356
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• 2016

Background: This study used receiver operating characteristic curve to analyze Surveillance, Epidemiology and End Results (SEER) for glassy cell carcinoma data to identify predictive models and potential disparities in outcome. Materials and Methods: This study analyzed socio-economic, staging and treatment factors. For risk modeling, each factor was fitted by a generalized linear model to predict the cause specific survival. Area under the receiver operating characteristic curves (ROCs) were computed. Similar strata were combined to construct the most parsimonious models. A random sampling algorithm was used to estimate modeling errors. Risk of glassy cell carcinoma death was computed for the predictors for comparison. Results: There were 79 patients included in this study. The mean follow up time (S.D.) was 37 (32.8) months. Female patients outnumbered males 4:1. The mean (S.D.) age was 54.4 (19.8) years. SEER stage was the most predictive factor of outcome (ROC area of 0.69). The risks of cause specific death were, respectively, 9.4% for localized, 16.7% for regional, 35% for the un-staged/others category, and 60% for distant disease. After optimization, separation between the regional and unstaged/others category was removed with a higher ROC area of 0.72. Several socio-economic factors had small but measurable effects on outcome. Radiotherapy had not been used in 90% of patients with regional disease. Conclusions: Optimized SEER stage was predictive and useful in treatment selection. Underuse of radiotherapy may have contributed to poor outcome.

• 대한한방종양학회지
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• 제9권1호
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• pp.39-46
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• 2003

Objectives : The former study of Oriental Medicine on cancer has been mostly focused on lab studies with herbal medicine. Among this atmosphere, the aim of this study is to investigate the suitability of Oriental Medicine institutions to participate in cancer registry programme in R.O.K by investigating the type of treatments used for cancer patients in Oriental Medicine institutes. Methods : To investigate the actual conditions of cancer patients who visited Oriental Medicine institutes, a survey was done based on clinical charts of 258 patients of cancer. Results : The order for the percentage of the original tumor organ of the patients, the number of patients who recognized the outbreak on the year of the first visit was the biggest, and the number gradually decreased while the years passed. For the type of treatment, herbal medicine was the most for 92.6%, acupuncture 52.6%, moxibustion 16.7%, cupping 14.7%. It can be seen that multiple treatment was preferred to single treatment. Among the periods for herbal medication, 10 days was the most for 34.1%, 29.8% for within 50 days and 10.5% for within 100 days. The percentage of patients who took treatment of western medicine at the same time and those who took treatment of Oriental medicine only was 47.4% and 43.8% respectively. By surveying categories such as the symptoms, diagnosis of syndrome, principle of treatment from the chart by a free description, there was 841 names of symptoms, 207 diagnoses of syndromes and 206 principles of treatment. But no relation or connection between these could be found statistically. At there were even occasions which the doctor didn't record the cancer itself, precise investigatio for the actual condition of cancer patients in Oriental Medicine institutions appeared to be very difficult. Conclusions : It seems impossible to enroll cancer patients of Oriental Medicine institutions to the cancer registry programme in R.O.K as far as the patients are recorded only under the paradigm of Oriental Medicine. However, if the Oriental Medicine doctors keep a consistency in classifying categories such as cause of death, syndrome diagnosis, principle of treatment and prescriptions, and limit the choices, for each category, a pilot study for cancer registry programme in R.O.K. in Oriental Medicine could be carried out.

• Asian Pacific Journal of Cancer Prevention
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• 제16권3호
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• pp.1069-1072
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• 2015

Background: Colorectal cancer (CRC) is an important cause of mortality and morbidity in many communities worldwide. This population based study was conducted to assess determinants of colorectal mortality in Iranian patients. Materials and Methods: A cohort of 1,127 cases of confirmed colorectal cancer registered in a population based registry covering 10 referral hospital in Tehran, Iran, were followed for five years. Information about tumor characteristics, smoking status and family history were collected at base line and survival status were followed every six months by contacting patient or next of kin (if patients died during the follow-up). The cause of death for each case was validated by verbal autopsy and referring to patient medical records at the time of death. The data were analyzed by Stata software using univariate and multivariate analysis (Cox regression). In building the model a p value of less than 5% was considered as significant. Results: The age at diagnosis was $53.5{\pm}14$ years. Sixty one percent were male. Colorectal mortality among the patients was 96.9 person-years among men and 83 person-years among women. Seventy five percent of patients lived for 2.72 years, 50% for 5.83, and 25% for 13 years after the diagnosis of colorectal cancer. The age at diagnosis was significantly different between men and women (p<0.03). Higher tumor grade predicted higher death rate; the adjusted hazard ratios were 1.79 (95%CI, 0.88-3.61), 2.16 (95%CI, 1.07-4.37), and 3.1 (95%CI, 1.51-6.34) for grades II, III, and IV respectively when they were compared with grade I as reference. Ethnicity, marital status, family history of cancer, and smoking were related to survival with different degrees of magnitude. Conclusions: Among many factors related to survival among the colorectal patients, tumor grade and smoking showed the highest magnitudes of association.

• Korean Circulation Journal
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• 제48권11호
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• pp.989-999
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• 2018

Background and Objectives: We aimed to compare outcomes of complete revascularization (CR) versus culprit-only revascularization for ST-segment elevation myocardial infarction (STEMI) and multivessel disease (MVD) in the $2^{nd}$ generation drug-eluting stent (DES) era. Methods: From 2009 to 2014, patients with STEMI and MVD, who underwent primary percutaneous coronary intervention (PCI) using a $2^{nd}$ generation DES for culprit lesions were enrolled. CR was defined as PCI for a non-infarct-related artery during the index admission. Major adverse cardiovascular event (MACE) was defined as cardiovascular (CV) death, non-fatal myocardial infarction, target lesion revascularization, or heart failure during the follow-up year. Results: In total, 705 MVD patients were suitable for the analysis, of whom 286 (41%) underwent culprit-only PCI and 419 (59%) underwent CR during the index admission. The incidence of MACE was 11.5% in the CR group versus 18.5% in the culprit-only group (hazard ratio [HR], 0.56; 95% confidence interval [CI], 0.37-0.86; p<0.01; adjusted HR, 0.64; 95% CI, 0.40-0.99; p=0.04). The CR group revealed a significantly lower incidence of CV death (7.2% vs. 12.9%; HR, 0.51; 95% CI, 0.31-0.86; p=0.01 and adjusted HR, 0.57; 95% CI; 0.32-0.97; p=0.03, respectively). Conclusions: CR was associated with better outcomes including reductions in MACE and CV death at 1 year of follow-up compared with culprit-only PCI in the $2^{nd}$ generation DES era.