• Analytical Science and Technology
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• v.31 no.5
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• pp.201-207
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• 2018

Blood is a commonly found body fluid at crime scenes, and plays an important role in identifying suspects and in the reconstruction of crime scenes. Although serological detection of blood has been widely used in the field of forensic science, research on the detection of old bloodstains is scarce. This work aimed to compare various methods for the detection of old bloodstains and validate the reliability of their results. Four presumptive tests-Tetramethylbenzidine, $Bluestar^{(R)}$, Leucomalachite Green, Kastle-Meyer tests-and two confirmatory tests-Fecal Occult Blood (FOB) and Rapid Stain $Identification^{(TM)}-Blood$ ($RSID^{TM}-Blood$) tests-were compared. Bloodstain samples from post-mortem cases were collected on gauzes and then stored at room temperature for periods from 7 to 30 years. All the presumptive tests were positive, even for the 30-year-old sample. However, FOB and $RSID^{TM}-Blood$ provided false negative results for some samples stored for 17 years or more (1988 to 2001). The results indicate that FOB and $RSID^{TM}-Blood$ are not reliable for the detection of old bloodstains. These findings can be useful in the selection of an appropriate detection method for serological testing of old bloodstains. In addition, the information will be useful background knowledge when applied in the field of forensic practice.

• Journal of Digestive Cancer Research
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• v.1 no.2
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• pp.95-99
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• 2013

MicroRNA (miRNA) dysregulations are associated with various types of human cancers, and miRNAs can function as tumor suppressors and oncogenes. Emerging evidence has shown that miRNA pathway is also altered during colorectal tumorigenesis. The detection of cancer-related miRNAs in stool samples may become useful diagnostic marker for colorectal cancer, because miRNAs in stool samples has high stability, and maintains a high portion of its original level. Recent studies reported that stool-based miRNAs can offer more sensitivity and specificity than currently used stool-based screening methods for CRC. In addition, unlike fecal occult blood test, sampling on consecutive dates and special dietary restrictions are not required. In this review, the authors discuss stool-based miRNA for the early diagnosis of CRC and perspectives on future application.

• Journal of Digestive Cancer Research
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• v.1 no.2
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• pp.73-77
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• 2013

Gastrointestinal (GI) cancers are top priorities for cancer control in Korea. In terms of epidemiological, population-health and economic burden, GI cancers such as stomach, liver and colorectal cancers have been top four cancers in the nation during the past decade and this trend is likely to continue in the near future. In order to reduce the great burden of GI cancer in Korea, the nation might need the following strategies: (1) to put more focus on primary prevention on infection/diet and related research; (2) to improve screening rates for colorectal and stomach cancers, and conduct more cost-effectiveness analysis of these screening programs, e.g., Fecal Occult Blood Test vs. colonoscopy; (3) to establish a more consistent and integrative cost-effectiveness analysis system for new cancer treatments and anticancer drugs; and (4) to place more emphasis on hospice and other palliative care of GI cancer, as well as on the etiology, staging and treatment of pancreas cancer with its poor survival rate.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.10
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• pp.5125-5129
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• 2012

Economic decision models are being increasingly used to assess medical interventions. Advances in this field are mainly due to enhanced processing capacity of computers, availability of specific software to perform the necessary tasks, and refined mathematical techniques. We here estimated the incremental cost-effectiveness of ten strategies for colon cancer screening, as well as no screening, incorporating quality of life, noncompliance and data on the costs and profit of chemotherapy in Iran. We used a Markov model to measure the costs and quality-adjusted life expectancy of a 50-year-old average-risk Iranian without screening and with screening by each test. In this paper, we tested the model with data from the Ministry of Health and published literature. We considered costs from the perspective of a health insurance organization, with inflation to 2011, the Iranian Rial being converted into US dollars. We focused on three tests for the 10 strategies considered currently being used for population screening in some Iranians provinces (Kerman, Golestan Mazandaran, Ardabil, and Tehran): low-sensitivity guaiac fecal occult blood test, performed annually; fecal immunochemical test, performed annually; and colonoscopy, performed every 10 years. These strategies reduced the incidence of colorectal cancer by 39%, 60% and 76%, and mortality by 50%, 69% and 78%, respectively, compared with no screening. These approaches generated ICER (incremental cost-effectiveness ratios) of $9067, $654 and $8700 per QALY (quality-adjusted life year), respectively. Sensitivity analyses were conducted to assess the influence of various scales on the economic evaluation of screening. The results were sensitive to probabilistic sensitivity analysis. Colonoscopy every ten years yielded the greatest net health value. Screening for colon cancer is economical and cost-effective over conventional levels of WTP8.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.12
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• pp.7657-7661
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• 2013

Background: This study concerns uptake and results of colorectal cancer (CRC) screening of government servant as part of the Health Screening Program that was conducted in Brunei Darussalam in 2009. Materials and Methods: Government servants above the age of 40 or with family history of CRC were screened with a single fecal occult blood test (FIT, immunohistochemistry). Among 11,576 eligible subjects, 7,360 (66.9%) returned their specimen. Subjects with positive family history of CRC (n=329) or polyps (n=135) were advised to attend clinics to arrange screening. All the subjects with positive FIT (n=142, 1.9%) were referred to the endoscopy unit for counselling for screening colonoscopy. Results: Overall only 17.7% of eligible subjects attended for screening; 54.9% (n=79/142) of positive FIT, 8.8% (n=29/329) of positive family history of CRC and none with history of polyps (n=0/135). Of these, only 54 patients (50.5%) agreed for colonoscopy, 52 (48.6%) declined as they were asymptomatic, and one was not offered (0.9%) due to his very young age. On screening colonoscopy, 12.9% (n=7) had advanced lesions including a sigmoid carcinoma in situ and six advanced polyps. The other findings included non advanced polyps (n=21), diverticular (n=11) and hemorrhoids (n=26). One patient who missed his screening colonoscopy appointment re-presented two years later and was diagnosed with advanced right sided CRC. All the advanced lesions were detected in patients with positive FIT, giving a yield of 20.5% for advanced lesions including cancers in the 5.1% FIT positive subjects. Conclusions: Our study showed screening for CRC even with a single FIT was effective. However, the uptake rate was poor with just over half of the patients agreeing to screening colonoscopy. Measures to increase public awareness are important. Since one limitation of our study was the relatively small sample size, larger studies should be conduced in future.

• Journal of Korean Academy of Nursing
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• v.45 no.1
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• pp.129-138
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• 2015

Purpose: The purpose of this study was to report the instrument modification and validation processes to make existing health belief model scales culturally appropriate for Korean Americans (KAs) regarding colorectal cancer (CRC) screening utilization. Methods: Instrument translation, individual interviews using cognitive interviewing, and expert reviews were conducted during the instrument modification phase, and a pilot test and a cross-sectional survey were conducted during the instrument validation phase. Data analyses of the cross-sectional survey included internal consistency and construct validity using exploratory and confirmatory factor analysis. Results: The main issues identified during the instrument modification phase were (a) cultural and linguistic translation issues and (b) newly developed items reflecting Korean cultural barriers. Cross-sectional survey analyses during the instrument validation phase revealed that all scales demonstrate good internal consistency reliability (Cronbach's alpha=.72~.88). Exploratory factor analysis showed that susceptibility and severity loaded on the same factor, which may indicate a threat variable. Items with low factor loadings in the confirmatory factor analysis may relate to (a) lack of knowledge about fecal occult blood testing and (b) multiple dimensions of the subscales. Conclusion: Methodological, sequential processes of instrument modification and validation, including translation, individual interviews, expert reviews, pilot testing and a cross-sectional survey, were provided in this study. The findings indicate that existing instruments need to be examined for CRC screening research involving KAs.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.9
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• pp.5157-5163
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• 2013

The aim of the study was to evaluate of the knowledge, behavior and health beliefs of individuals over 50 regarding colorectal cancer screening, with a descriptive and cross-sectional design at Karabuk Life and Health Center in Turkey. A total of 160 people meeting set criteria were included in the study. The questionnaire consisted of two parts. The first part was composed of questions on characteristics of participants and the second part of questions derived from the Champion's Health Belief Model Scale. Only 15.0% of participants (n=24) had undergone a fecal occult blood test (FOBT), 11.3% (n=18) had had colonoscopy and 4.4% (n=7) had had sigmoidoscopy. Some 90.6% of the participants had low levels of risk awareness about the colorectal cancer. It was found that the average point of severity subscale of participants over 65 is higher than that of participants under 65 (p<0.05). In conclusion, because of the many barriers and health beliefs for the colorectal cancer screening program, the rate of participation in screening programs is not sufficient. Healthcare providers have important responsibilities for increasing rate of attendance in colorectal cancer screening programs.

• Journal of Cancer Prevention
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• v.23 no.4
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• pp.176-182
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• 2018

Background: Family physicians (FPs) play an important role in cancer control. The aim of this study was to understand the functions of FPs in cancer control and to explore FPs' perceptions of their own roles and the difficulties they face in cancer control in Karabuk province, Turkey. Methods: The study consisted of two methodological parts. The qualitative part included a descriptive study in which data were collected from 87.5% (n=56) out of all FPs in Karabuk using a questionnaire. In the quantitative part, in-depth interviews with 15 FPs were conducted and analyzed through content analysis. Results: Half of the FPs (50.0%) provided cancer prevention information for their registered people, focusing on especially smoking cessation. In the last three months, the proportion of FPs who had not invited anyone to screenings was 37.5% for the pap test, 26.8% for the mammography, 19.0% for the fecal occult blood test and 34.5% for the colonoscopy. Only 16.1% of them reported that they made home visits for cancer patients. In the qualitative part of study, the following themes were highlighted: the perceived responsibilities of FPs regarding cancer control; the effect of geographically undefined working area of FPs; the issues with coordination between FPs and specialists; the effect of the number of primary care team members. Conclusions: Cancer control services provided by FPs have significant problems in terms of the FPs' approach to the services and their content, continuity and coordination.

• Asian Oncology Nursing
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• v.12 no.2
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• pp.166-174
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• 2012

Purpose: Even though the incidence of colorectal cancer (CRC) has increased in Korea, the colorectal cancer screening (CRCS) is lower than that of other cancer screenings. The purpose of this study was to identify CRCS rate and to predict factors in blue-color workers. Methods: A descriptive survey design was employed. Data were collected with 327 workers, recruited from 32 companies, aged 40 and over using questionnaire from August 2010 to January 2011. Collected information included CRCS, demographic characteristics, job characteristics, health behaviors, and interpersonal relationship. The definition of CRCS included fecal occult blood test (FOBT), colonoscopy, or double contrast barium enema (DCBE). Results: Among 94 workers receiving CRCS, workers having FOBT were 37, colonoscopy were 28, and DCBE was 6 in the past. Workers who aged over 50 (OR=2.30, 95% CI=1.11-4.77), middle school educated (OR=0.30, 95% CI=0.14-0.65), less working hours (OR=0.98, 95% CI=0.96- 0.99), and had family members who carried out regular cancer screening (OR=1.89, 95% CI=1.01-3.55) were more likely to perform CRCS. Conclusion: The findings suggest that the information and notice about CRCS to increase screening uptake, providing the accessible screening method, and involving company administrators or health managers might be useful to increase the CRCS rate in workers.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.2
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• pp.569-573
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• 2016

Background: A colorectal cancer screening program was piloted in two districts of Kedah in 2013. There is scarcity of information on colorectal cancer screening in Malaysia. Objective: Thus, this research was conducted to evaluate the colorectal cancer screening program in the districts to provide insights intop its efficacy. Materials and Methods: A cross sectional study was conducted using data on the colorectal cancer screening program in 2013 involving Kota Setar and Kuala Muda districts in Malaysia. We determined the response rate of immunochemical fecal occult blood test (iFOBT), colonoscopy compliance, and detection rates of neoplasia and carcinoma. We also compared the response of FOBT by demographic background. Results: The response rate of FOBT for first iFOBT screening was 94.7% while the second iFOBT screening was 90.7%. Participants from Kuala Muda district were 27 times more likely to default while Indians had a 3 times higher risk of default compared to Malays. The colonoscopy compliance was suboptimal among those with positive iFOBT. The most common finding from colonoscopy was hemorrhoids, followed by tubular adenoma. Detection rate of carcinoma and neoplasia for our program was 1.2%. Conclusions: In summary, the response rate of iFOBT was encouraging but the colonoscopy compliance was suboptimal which led to a considerably low detection rate.