• Asian Pacific Journal of Cancer Prevention
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• v.16 no.18
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• pp.8163-8171
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• 2016

Background: Breast cancer is the second most cause of death (1.38 million, 10.9% of all cancer) worldwide after lung cancer. In present study, we assess the knowledge, level of awareness of risk factors and screening practices especially breast self examination (BSE) among women, considering the non-feasibility of diagnostic tools such as mammography for breast screening techniques of breast cancer in the holy city Varanasi, Uttar Pradesh, India. Materials and Methods: A cross-sectional population based survey was conducted. The investigation tool adopted was self administrated questionnaire format. Data were analysed using SPSS 20 version and Chi square test to determine significant association between various education groups with awareness and knowledge, analysis of variance was applied in order to establish significance. Results: The attitude of participants in this study, among 560 women 500 (89%) responded (age group 18-65 years), 53.8% were married. The knowledge about BSE was very low (16%) and out of them 15.6% were practised BSE only once in life time. study shown that prominent age at which women achieve their parity was 20 yrs, among 500 participants 224 women have achieved their parity from age 18 to 30 yrs. Very well known awareness about risk factors of breast cancer were alcohol (64.6%), smoking (64%) and least known awareness risk factors were early menarche (17.2%) and use of red meat (23%). The recovery factors of breast cancer cases were doctors support (95%) and family support (94.5%) as most familiar responses of the holy city Varanasi. Conclusions: The study revealed that the awareness about risk factors and practised of BSE among women in Varanasi is extremely low in comparison with other cities and countries as well (Delhi, Mumbai, Himachal Pradesh, Turkey and Nigeria). However, doctors and health workers may promote the early diagnosis of breast cancer.

• Journal of Korean Public Health Nursing
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• v.3 no.1
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• pp.5-17
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• 1989

The purpose of this study was to investigate the natural menopause age of middle-aged women in Korea and to analyse various factors affecting them. For the collection of date, 1,140 women aged between 45-54 were selected through stratified sampling technics in Seoul and at a rual area in Kyong KiProvince. They were interviewed from Nov. 1 through Dec. 31,1987 by use of questionnaires made after pilot study had been performed twice. Among them the final subjects for analysis were restricted to only those who had experienced menopause or irregular menstruation during the past one year, the number of which was total 410:206 in urban and 204 in rural area. For the analysis, menopause age was used as dependent variables while fertility variables, socio-economic variables, bio-physical varibles, and insight of life variables were classified as independent variables. Dependent variables such as menopause was tested and analysed by descriptive statistical methods(e.g., frequency, percentage, mean, $X^2-test.$ t-test, ANOVA). The relation between menopause age and independent variables was analysed by use of Pearson's correlation coefficients. For the analysis of various factors affecting menopause age, multiple stepwise regression method was used. The obtained results are summarized as follows: 1. The natural menopause age of Korean women were 47.2 mean age: it was 47.7 and 46.7 mean age in urban and rural area respectively, which revealed that the former was later then the latter by one year. And the recollective error on menopause starting age between the menopause group and the group who had experienced irregular menstruation during the past one year was 0.4-0.7 year. 2. The main factors affecting the menopause age were (1) the duration of marital life, (2) the duration of oral pill use, (3) insight of life and economic status, (4) educational background. (5) menarche, (6) usual menstruation amount, (7) electic charge. and (8) area. These factors. altogether, could explain $18.4\%$ of factors related with menopause, and they took the high percentage in the order mentioned.

• Child Health Nursing Research
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• v.6 no.2
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• pp.186-198
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• 2000

With the improvement of the nutritive conditions and the influence of overflowing informations and various cultural aspects imported from foreign countries, children develop more rapidly in the bodily and sexual growth. This study was conducted to suggest some ideas useful in planning sexual education program in elementary schools and ultimate aim is to promote sexual health. The subject of this survey consisted of 802 fourth, fifth, sixth graders from 6 schools in Seoul, Hongchon and Chunchon. Major findings are summarized as follows. 1. The degree of sexual knowledge of children showed low averaged 26.96 and the degree of sexual attitude showed usual averaged 55.70. 2. With the respect to the demographic characteristics, there were stastically significant differences in sexual knowledge, according to children's grade(F=64.031, p=. 000), father's education(t=-2.504, p=.013), experience of menarche(t=3.470, p=.001), experience of sex-related question to their parents(t=-.6054, p=.000), experience of sex-related question to the teachers (t= -3.385, p=.001), experience of sexual education(t=8.607, p=.000) and in sexual attitude, there were stastically significant differences according to children's grade (F=6.588, p=.001), experience of sex- related question to their parents(t=-5.387, p=.000), experience of sex-related question to the teachers(t=-2.845, p=.005), experience of sexual education(t=5.070, p=.000). 3. The level of sexual knowledge and sexual attitude of childrens'was correlated at significant level(r=.354, p=.000) The findings of this study indicated that variety of the systematic sexual education program suitable for the stage of children should be developed and family, society, contry's higher concern and enlightment are required.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.15
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• pp.6347-6352
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• 2015

Background: Breast malignancies are one of the leading causes of deaths in females worldwide. There are a number of risk factors associated with breast cancer but in Karachi Pakistan there are insufficient data available. Materials and Methods: A case control study was conducted on females in age group between 30-80 years. This study was accomplished by retrospective data collection in Aga Khan University Hospital Karachi, Pakistan. A total of 108 females with primary malignancy of breast were included along with 108 matched controls. Relationship of various factors with disease was studied using logistic regression to calculate odds ratios with 95 % confidence intervals. Results: A total of 14 variables were analyzed and based on and 7 were found to be risk factors: old age, family history of breast cancer, family history of other carcinomas, personal history of breast carcinoma, early age of menarche, older age of mother at first delivery and lower number of children. Five factors, parity, breast feeding, history of oral contraceptive pills intake, past history of oophorectomy and hysterectomy showed protective associations. One variable, use of hormonal replacement therapy, showed a controversial link and one other, marital status, was not significant in this study. Conclusions: It is concluded that most of the well-known risk factors for breast cancer are also associated with the disease in the female population of Karachi, Pakistan. High risk patients should be the focus with the help of this study so that screening can be more effective for early diagnosis before clinically evident breast malignancy.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.17
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• pp.7507-7512
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• 2015

Background: In the low incoming country Bangladesh, breast cancer is second most common neoplasm and is increasing at an alarming rate among females. Lack of awareness and illiteracy are contributory factors for late presentation and therefore mortality. Purpose: To examine associations of different factors with breast cancer mortality and to raise awareness among the women of society in Bangladesh. Materials and Methods: This descriptive case-control study was conducted on 160 participants from April 2011 till July 2014. Through a valid questionnaire covering personal and family history, data were collected by face to face interview. For analyzing correlations among factors with breast cancer data, binary logistic regression, Pearson's ${\chi}^2$-value, odd ratios and p-value tests were conducted with SPSS version 20. Results: The mean age of the patients was 43.0 ($SD={\pm}11.12$). In ascending order the leading significant factors were hormone therapy (p<0.0000, OR=4.897), abortion (p<0.0001, OR=3.452), early start menarche (p<0.0002, OR=3.500), family history (p<0.0022, OR=3.235), and late menopause (p<0.0093, OR=3.674) with both ${\chi}^2$ test and logistic regression analyses. Non-significant factors were cancer experience, fatty food habits, marital status and taking alcohol. Conclusions: Regarding the investigation of this study, significant and insignificant factor's correlation visualization with breast cancer will be helpful to increase awareness among Bangladeshi women as well as all over the world.

• Women's Health Nursing
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• v.8 no.2
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• pp.177-189
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• 2002

Sexual health education for the patients is an independent function as well as a professional responsibility of nurses. Education should be based on the needs of patients in order to be successful and effective. Therefore nurses must identify sexual health education needs of their patients. A sexual health education protocol for hysterectomy patients was developed by the researcher for this study and included physiosexual and psychosexual topics as well as the topic of sexual interaction. The subject pool was composed of 108 post op total hysterectomy patients who had undergone doing a hysterectomy 5 to 10 days previously at 5 hospitals located in the Seoul and Kyunggi-do area from July 23 to September 30, 2001. The questionnaire was composed of 60 items on sexual health education and used a Likert-type 4-point scale. Internal consistency of this questionnaire in this study was cronbach's $\alpha$=.9495 for sexual health educational needs. For data analysis, the study executed a t-test, ANOVA, and Duncan's Test, in accordance with the purpose of the study using SPSS/PC Win 10.0. The results were as follows: The need for education was highest in the psychosexual area (3.38 point) with education related to sexual interaction the lowest (3.20 point). Osteoporosis (3.75 point) was ranked overall as the highest area of educational need. The degree of educational need varied in correlation with other characteristics of the patients including age, status of marriage, duration of marriage, religion, academic career, monthly income, occupation, the number of children age of menarche, menstruation, other diseases except gynecological disease, previous genital organ operation experience, disease discovery method, pre-explanation for the hysterectomy, average sexual intercourse frequency, how to acquire sexual health information and previous sexual health education (p<.05). In conclusion, the degree of sexual health education needs of hysterectomy patients was very high. Therefore, sexual health educational programs planned according to characteristics of the participating women is necessary.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.8
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• pp.3635-3640
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• 2014

Aim: To determine whether induced abortion (IA) increases breast cancer (BC) risk. Materials and Methods: A population-based case-control study was performed from Dec, 2000 to November, 2004 in Shanghai, China, where IA could be verified through the family planning network and client medical records. Structured questionnaires were completed by 1,517 cases with primary invasive epithelial breast cancer and 1,573 controls frequency-matched to cases for age group. The information was supplemented and verified by the family planning records. Statistical analysis was conducted with SAS 9.0. Results: After adjusting for potential confounders, induced abortions were not found to be associated with breast cancer with OR=0.94 (95%CI= 0.79-1.11). Compared to parous women without induced abortion, parous women with 3 or more times induced abortion (OR=0.66, 95%CI=0.46 to 0.95) and women with 3 or more times induced abortion after the first live birth (OR=0.66, 95%CI =0.45 to 0.97) showed a lower risk of breast cancer, after adjustment for age, level of education, annual income per capita, age at menarche, menopause, parity times, spontaneous abortion, age at first live birth, breast-feeding, oral contraceptives, hormones drug, breast disease, BMI, drinking alcohol, drinking tea, taking vitamin/calcium tablet, physical activity, vocation, history of breast cancer, eating the bean. Conclusions: The results suggest that a history of induced abortions may not increase the risk of breast cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.10
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• pp.5589-5597
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• 2013

The aim of this review article was to evaluate the relationship and the possible etiological mechanisms between endometriosis, leiomyoma (LM) and adenomyosis and gynecological cancers, such as ovarian and endometrial cancer and leiomyosarcoma (LMS). MEDLINE was searched for all articles written in the English literature from July 1966 to May 2013. Reports were collected systematically and all the references were also reviewed. Malignant transformation of gynecologic benign diseases such as endometriosis, adenomyosis and LM to ovarian and endometrial cancer remains unclear. Hormonal factors, inflammation, familial predisposition, genetic alterations, growth factors, diet, altered immune system, environmental factors and oxidative stress may be causative factors in carcinogenesis. Early menarche, low parity, late menopause and infertility have also been implicated in the pathogenesis of these cancers. Ovarian cancers and endometriosis have been shown to have common genetic alterations such as loss of heterozygosity (LOH), PTEN, p53, ARID1A mutations. MicroRNAs have also been implicated in malignant transformation. Inflammation releases proinflammatory cytokines, and activates tumor associated macrophages (TAMS) and nuclear factor kappa b (NF-KB) signaling pathways that promote genetic mutations and carcinogenesis. MED12 mutations in LM and smooth muscle tumors of undetermined malignant potential (STUMP) may contribute to malignant transformation to LMS. A hyperestrogenic state may be shared in common with pathogenesis of adenomyosis, LM and endometrial cancer. However, the effect of these benign gynecologic diseases on endometrial cancer should be studied in detail. This review study indicates that endometriosis, LM, adenomyosis may be associated with increased risk of gynecological cancers such as endometrial and ovarian cancers. The patients who have these gynecological benign diseases should be counseled about the future risks of developing cancer. Further studies are needed to investigate the relationship between STUMPs, LMS and LM and characteristics and outcome endometrial carcinoma in adenomyotic patients.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.3
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• pp.1277-1280
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• 2015

Aim: To report epidemiologic and anatomoclinical transitions of inflammatory breast cancer (IBC) in Tunisia. Materials and Methods: Data including clinico-pathological data for 208 cases of T4d or PEV 3 non-metastatic breast cancer diagnosed between 2005 and 2010 were collected from patient records. Chi2 and Z tests were used to compare variables with two Tunisian historical series and a series about Arab-American patients. Results: Thirty three percent of our patients had their first child before 23 years of age and 56% had their menarche before 12 years, 75% never receiving oral contraception. Obesity was observed in 42% of women and IBC occurred during pregnancy in 13% of cases. Tumor grade was II-III in 90% of cases, HR was negative in 52%, HER2 was over expressed in 31% and invasion of more than 3 axillary nodes occurred in 18% of patients. We observed a pCR rate of 19% after neoadjuvant treatment (anthracyline-taxane used in 79%, trastuzumab in 27% ). Compared to historical Tunisian series (since 1996), IBC epidemiology remained stable in terms of median age, menopausal status and obesity. However we observed a significant decrease in median clinical tumor size and number of positive axillary lymph nodes. Comparison to IBC in Arab-Americans showed a significant difference in terms of median age, menopausal status, positivity of hormonal receptors and educational level. Conclusions: Our assessment of epidemiologic transition showed a reduction of clinco-pathological stage of IBC, keeping the same characteristics as compared to Tunisian historical series over a period of 14 years. Features seem to be different in Arab-American patients, probably related to migration, "occidentalization" of life style and improvement in socio-economic level.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.3
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• pp.857-860
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• 2012

Serum tumor marker CA15-3 is widely used in follow-up for assessment of breast cancer prognosis. The aim of this study was to evaluate levels among healthy females and patients, to assess differences with tumor stage and grade, and to determine the relationship with estrogen and progesterone receptor expression. One hundred and thirty six Jordanian females were enrolled in this study: Forty-five were healthy females; seventy-two were diagnosed with breast cancer and nineteen diagnosed with benign breast lesions. Elevated serum CA15-3 level was significantly observed among breast cancer patients ($37.95{\pm}6.65$) compared to both healthy ($14.97{\pm}0.8$) and benign females ($12.30{\pm}1.55$), but no significant association was detected between serum CA15-3 level and age of cancer onset, menarche age, menopause age, parity and BMI. Decreased CA15-3 level was significantly associated with hormone therapy and oral contraceptive consumption among breast cancer patients. Significantly elevated CA15-3 serum levels were found among grade II, III and stage II and III breast cancer females compared to normal healthy females. Elevated CA15-3 serum levels were also found among ER+/PR+($54.242{\pm}7.89$) and ER+/PR-($37.08{\pm}8.22$) compared to healthy control females.