• Asian Pacific Journal of Cancer Prevention
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• v.17 no.sup3
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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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• v.16 no.18
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• pp.8659-8663
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• 2016

In Nepal, while no population based cancer registry program exists to assess the incidence, prevalence, morbidity and mortality of cancer, at the national level a number of hospital based cancer registries are cooperating to provide relevant data. Seven major cancer diagnosis and treatment hospitals are involved, including the BP Koirala Memorial Cancer hospital, supported by WHO-Nepal since 2003. The present retrospective analysis of cancer patients of all age groups was conducted to assess the frequencies of different types of cancer presenting from January 1st to December 31st 2012. A total of 7,212 cancer cases were registered, the mean age of the patients being 51.9 years. The most prevalent age group in males was 60-64 yrs (13.6%), while in females it was 50-54 yrs (12.8%). The commonest forms of cancer in males were bronchus and lung (17.6%) followed by stomach (7.3%), larynx (5.2%) and non Hodgkins lymphoma (4.5%). In females, cervix uteri (19.1%) and breast (16.3%), were the top ranking cancer sites followed by bronchus and lung (10.2%), ovary (6.1%) and stomach (3.8%). The present data provide an update of the cancer burden in Nepal and highlight the relatively young age of breast and cervical cancer patients.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.14
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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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• v.15 no.5
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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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• v.40 no.3
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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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• v.15 no.2
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• pp.599-603
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• 2014

Background: Reproductive cancers are those that affect the human organs that are involved in producing offspring. An attempt is made in the present communication to assess the magnitude and pattern of reproductive cancers, including their treatment modalities, in India. The cancer incidence data related to reproductive cancers collected by five population-based urban registries, namely Bangalore, Bhopal, Chennai, Delhi and Mumbai, for the years 2006-08 were utilized. The reproductive cancers among females constituted around 25% of the total and around 9% among males. Among females, the three major contributors were cervix (55.5%), ovary (26.1%) and corpus uteri (12.4%). Similarly among males, the three major contributors were prostate (77.6%), penis (11.6%) and testis (10.5%). For females, the AAR of reproductive cancers varied between 30.5 in the registry of Mumbai to 37.3 in the registry of Delhi. In males, it ranged between 6.5 in the registry of Bhopal to 14.7 in the registry of Delhi. For both males and females, the individual reproductive cancer sites showed increasing trends with age. The leading treatment provided was: radio-therapy in combination with chemo-therapy for cancers of cervix (48.3%) and vagina (43.9%); surgery in combination with chemo-therapy (54.9%) for ovarian cancer; and surgery in combination with radio-therapy for the cancers of the corpus uteri (39.8%). In males, the leading treatment provided was hormone-therapy for prostate cancer (39.6%), surgery for penile cancer (81.3%) and surgery in combination with chemo-therapy for cancer of the testis (57.6%).

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.15
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• pp.6087-6094
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• 2014

Purpose: The aim of the present study was to invesitigate the impact of significant clinico-pathological prognostic factors on survival rates and to identify factors predictive of poor outcome in patients with ovarian carcinoma. Materials and Methods: A retrospective chart review of 74 women with pathologically proven ovarian carcinoma who were treated between January 2006 and April 2011 was performed. Patients were investigated with respect to survival to find the possible effects of age, gravida, parity, menstruel condition, pre-operative Ca-125, treatment period, cytologic washings, presence of ascites, tumor histology, stage and grade, maximal tumor diameter, adjuvan chemotherapy and cytoreductive success. Also 55 ovarian carcinoma patients were investigated with respect to prognostic factors for early 2-year survival. Results: The two-year survival rate was 69% and the 5-year survival rate was 25.5% for the whole study population. Significant factors for 2-year survival were preoperative CA-125 level, malignant cytology and FIGO clinical stage. Significant factors for 5-year survival were age, preoperative CA-125 level, residual tumor, lymph node metastases, histologic type of tumor, malignant cytology and FIGO clinical stage. Logistic regression revealed that independent prognostic factors of 5-year survival were patient age, lymph node metastasis and malignant cytology. Conclusions: We consider quality registries with prospectively collected data to be one important tool in monitoring treatment effects in population-based cancer research.

• Journal of Preventive Medicine and Public Health
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• v.43 no.3
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• pp.257-264
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• 2010

Objectives: An accurate estimation of cancer patients is the basis of epidemiological studies and health services. However in Korea, cancer patients visiting out-patient clinics are usually ruled out of such studies and so these studies are suspected of underestimating the cancer patient population. The purpose of this study is to construct a more complete, hospital-based cancer patient registry using multiple sources of medical information. Methods: We constructed a cancer patient detection algorithm using records from various sources that were obtained from both the in-patients and out-patients seen at Asan Medical Center (AMC) for any reason. The medical data from the potentially incident cancer patients was reviewed four months after first being detected by the algorithm to determine whether these patients actually did or did not have cancer. Results: Besides the traditional practice of reviewing the charts of in-patients upon their discharge, five more sources of information were added for this algorithm, i.e., pathology reports, the national severe disease registry, the reason for treatment, prescriptions of chemotherapeutic agents and radiation therapy reports. The constructed algorithm was observed to have a PPV of 87.04%. Compared to the results of traditional practice, 36.8% of registry failures were avoided using the AMC algorithm. Conclusions: To minimize loss in the cancer registry, various data sources should be utilized, and the AMC algorithm can be a successful model for this. Further research will be required in order to apply novel and innovative technology to the electronic medical records system in order to generate new signals from data that has not been previously used.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.4
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• pp.2595-2598
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• 2013

Background: Prostate cancer is common in elderly men, especially in western countries, and incidences are rising in low-risk populations as well. In India, the age-standardized rates vary between registries. Under these circumstances we have estimated the survival of prostate cancer patients based on age, family history, diabetes, hypertension, tobacco habit, clinical extent of disease (risk group) and treatment received. Materials and Methods: The present retrospective study was carried out at the Tata Memorial Hospital (TMH), Mumbai, India. During years 1999-2002, some 850 prostate cancer cases, including 371 new cases, treated in TMH were considered as eligible entrants for the study. Five-year survival rates using actuarial and loss-adjusted (LAR) method were estimated. Results: The patient population was distributed uniformly over the three age groups. A larger proportion of the patients were diagnosed at 'metastatic stage' and hormone treatment was most common. 20% patients had history of diabetes and 40% with hypertension. The 5-year overall survival rate was 64%. Survival was 55%, 74% and 52% for '<59 years','60-69 years' and '>70 years' respectively. Non-diabetic (70%), hypertensive (74%), with family history (80%) of cancer, with localized-disease (91%) and treated with surgery, either alone or in combination, (91%) had better survival. Conclusions: The present study showed that prostate cancer patients with localized disease at diagnosis experience a better outcome. Local treatment with either surgery or radiation achieves a reasonable outcome in prostate cancer patients. A detailed study will help in understanding the prognostic indicators for survival especially with the newer treatment technologies available now.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.4
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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.