• Journal of Digestive Cancer Research
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• 제11권2호
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• pp.85-92
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• 2023

Colorectal cancer (CRC) is one of the most prevalent cancers and is the leading cause of cancer-related mortality worldwide. Based on the current screening guidelines by the American Cancer Society and Korean multi-society expert committee, CRC screening is recommended in asymptomatic adults starting at the age of 45 years. Fecal immunochemical test-based screening programs reduce the development of CRC and related mortality in the general population. However, this most popular CRC screening strategy demonstrates a crucial limitation due to modest diagnostic accuracy. Colonoscopy may be considered as an alternative primary method for CRC screening; however, its implementation can still be challenging due to concerns regarding invasiveness, low adherence, cost-effectiveness, and quality assurance. To overcome the limitations of current screening tests, innovative noninvasive tests for CRC screening have been developed with advances in molecular biology, genetics, epigenetics, and microbiomics for detecting CRC, which may enhance the approach to CRC screening and diagnosis in clinical practice in the near future. This review explores the emerging screening methods and discusses their potential for integration into current practice.

• Asian Pacific Journal of Cancer Prevention
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• 제15권22호
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• pp.9773-9779
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• 2014

Background: Colorectal cancer (CRC) is one of the prime causes of mortality around the globe, with a significantly rising incidence in the Middle East region in recent decades. Since detection of CRC in the early stages is an important issue, and also since to date there are no comprehensive epidemiologic studies depicting the Middle East region with special attention to the average risk group, further investigation is of significant necessity in this regard. Aim: Our aim was to investigate the prevalence of preneoplastic and neoplastic lesions of the colon in an average risk population. Materials and Methods: A total of 1,208 eligible asymptomatic, average- risk adults older than 40 years of age, referred to Firuzgar Hospotal in the years 2008-2012, were enrolled. They underwent colonoscopy screening and all polypoid lesions were removed and examined by an expert gastrointestinal pathologist. The lesions were classified by size, location, numbers and pathologic findings. Size of lesions was measured objectively by endoscopists. Results: The mean age of participants was $56.5{\pm}9.59$ and 51.6% were male. The overall polyp detection rate was 199/1208 (16.5 %), 26 subjects having non-neoplastic polyps, including hyperplastic lesions, and 173/1208 (14.3%) having neoplastic polyps, of which 26 (2.15%) were advanced neoplasms. The prevalence of colorectal neoplasia was more common among the 50-59 age group. Advanced adenoma was more frequent among the 60-69 age group. The majority of adenomas were detected in the distal colon, but a quarter of advanced adenomas were found in the proximal colon; advance age and male gender was associated with the presence of adenoma. Conclusions: It seems that CRC screening among average-risk population might be recommended in countries such as Iran. However, sigmioidoscopy alone would miss many colorectal adenomas. Furthermore, the 50-59 age group could be considered as an appropriate target population for this purpose in Iran.

• Asian Pacific Journal of Cancer Prevention
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• 제16권17호
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• pp.7831-7836
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• 2015

Background: Colorectal cancer (CRC) is one of the most common malignancies of the gastrointestinal tract. The aim of this study was to assess the general knowledge of CRC in individuals living in Rasht, Iran, using a population-based cross-sectional telephone survey. Materials and Methods: A total of 1557 participants between 18 and 80 years of age were interviewed using random sampling from the telephone directory. Knowledge of risk factors, symptoms, diagnosis, and prevention of CRC was assessed using a validated questionnaire. Results: The mean knowledge level of the 1,557 respondents (average age 46 y) was $13.5{\pm}4.29$ (maximum possible score = 26), and 46.4% (722/1,557) of the subjects achieved grades lower than the mean score. The mean scores for knowledge of symptoms and risk factors were $3.97{\pm}1.83$ (range: 0-7) and $5.17{\pm}1.65$ (range: 0-9), respectively. Older age, higher education, and employment were significantly associated with better scores for recognition of risk factors and warning symptoms. The majority of subjects correctly identified weight loss (70.2%; 1,093/1,557) and rectal bleeding (63.3%; 986/1,557) as symptoms of CRC, and that smoking (85.9%; 1,337/1,557) and a low-fiber diet (73.4%; 1,143/1,557) were risk factors. Approximately half of the subjects noted increasing age, genetic background and fried food as other risk factors. A considerable number (54.8%; 853/1,557) identified colonoscopy as a screening method for detecting CRC in asymptomatic patients. However, a third of the subjects in the target group for screening (${\geq}50y$) were not interested in undergoing screening, primarily due to a lack of symptoms. Conclusions: Our results suggest that the knowledge of CRC is poor among the public, and therefore greater attempts should be made to increase awareness. Public education emphasizing the risk factors and symptoms of CRC, as well as the importance of regular screening regardless of the presence of symptoms, may help to reduce CRC morbidity and mortality.

• Asian Pacific Journal of Cancer Prevention
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• 제13권4호
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• pp.1407-1412
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• 2012

Background & Objectives: Gastric cancer is a leading cause of cancer-related deaths in both sexes in Iran. This study was designed to assess upper GI endoscopic findings among people > 50 years targeted in a mass screening program in a hot-point region. Methods: Based on the pilot results in Guilan Cancer Registry study (GCRS), one of the high point regions for GC-Lashtenesha- was selected. The target population was called mainly using two methods: in rural regions, by house-house direct referral and in urban areas using public media. Upper GI endoscopy was performed by trained endoscopists. All participants underwent biopsies for rapid urea test (RUT) from the antrum and also further biopsies from five defined points of stomach for detection of precancerous lesions. In cases of visible gross lesions, more diagnostic biopsies were taken and submitted for histopathologic evaluation. Results: Of 1,394 initial participants, finally 1,382 persons (702 women, 680 men) with a mean age of $61.7{\pm}9.0$ years (range: 50-87 years) underwent upper GI endoscopy. H. pylori infection based on the RUT was positive in 66.6%. Gastric adenocarcinoma and squamous cell carcinoma of esophagus were detected in seven (0.5%) and one (0.07%) persons, respectively. A remarkable proportion of studied participants were found to have esophageal hiatal hernia (38.4%). Asymptomatic gastric masses found in 1.1% (15) of cases which were mostly located in antrum (33.3%), cardia (20.0%) and prepyloric area (20.0%). Gastric and duodenal ulcers were found in 5.9% (82) and 6.9% (96) of the screened population. Conclusion: Upper endoscopy screening is an effective technique for early detection of GC especially in high risk populations. Further studies are required to evaluate cost effectiveness, cost benefit and mortality and morbidity of this method among high and moderate risk population before recommending this method for the GC surveillance program at the national level.

• Journal of Gastric Cancer
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• 제13권1호
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• pp.3-18
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• 2013

Gastrointestinal stromal tumor is the most common mesenchymal tumor in the gastrointestinal tract and is most frequently developed in the stomach in the form of submucosal tumor. The incidence of gastric gastrointestinal stromal tumor is estimated to be as high as 25% of the population when all small and asymptomatic tumors are included. Because gastric gastrointestinal stromal tumor is not completely distinguished from other submucosal tumors, a surgical excisional biopsy is recommended for tumors >2 cm. The surgical principles of gastrointestinal stromal tumor are composed of an R0 resection with a normal mucosa margin, no systemic lymph node dissection, and avoidance of perforation, which results in peritoneal seeding even in cases with otherwise low risk profiles. Laparoscopic surgery has been indicated for gastrointestinal stromal tumors <5 cm, and the indication for laparoscopic surgery is expanded to larger tumors if the above mentioned surgical principles can be maintained. A simple exogastric resection and various transgastric resection techniques are used for gastrointestinal stromal tumors in favorable locations (the fundus, body, greater curvature side). For a lesion at the gastroesophageal junction in the posterior wall of the stomach, enucleation techniques have been tried preserve the organ's function. Those methods have a theoretical risk of seeding a ruptured tumor, but this risk has not been evaluated by well-designed clinical trials. While some clinical trials are still on-going, neoadjuvant imatinib is suggested when marginally unresectable or multiorgan resection is anticipated to reduce the extent of surgery and the chance of incomplete resection, rupture or bleeding.

• Parasites, Hosts and Diseases
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• 제54권1호
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• pp.93-96
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• 2016

Toxoplasmosis, a neglected tropical disease caused by the protozoan parasite Toxoplasma gondii, occurs throughout the world. Human T. gondii infection is asymptomatic in 80% of the population; however, the infection is life-threatening and causes substantial neurologic damage in immunocompromised patients such as HIV-infected persons. The major purpose of this study was to investigate the seroprevalence of T. gondii infection in subjects infected with HIV/AIDS in eastern China. Our findings showed 9.7% prevalence of anti-T. gondii IgG antibody in HIV/AIDS patients, which was higher than in intravenous drug users (2.2%) and healthy controls (4.7%), while no significant difference was observed in the seroprevalence of anti-Toxoplasma IgM antibody among all participants (P>0.05). Among all HIV/AIDS patients, 15 men (7.7%) and 10 women (15.9%) were positive for anti-T. gondii IgG antibody; however, no significant difference was detected in the seroprevalence of anti-Toxoplasma IgG antibody between males and females. The frequency of anti-Toxoplasma IgG antibody was 8.0%, 13.2%, 5.5%, and 0% in patients with normal immune function ($CD4^+$ T-lymphocyte count ${\geq}500cells/ml$), immunocompromised patients (cell count ${\geq}200$ and <500 cells/ml), severely immunocompromised patients (cell count ${\geq}50$ and <200 cells/ml), and advanced AIDS patients, respectively (cell count <50 cells/ml), while only 3 immunocompromised patients were positive for anti-T. gondii IgM antibody. The results indicate a high seroprevalence of T. gondii infection in HIV/AIDS patients in eastern China, and a preventive therapy for toxoplasmosis may be given to HIV/AIDS patients based on $CD4^+$ T lymphocyte count.

• 대한임상검사과학회지
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• 제37권2호
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• pp.88-95
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• 2005

Even though the echocardiograph has been recognized as the method of choice among various diagnostic tools to detect congestive heart failure (CHF), there were some limitations in relation to the consumption of time, labor and process. We analyzed results of N-terminal probrain-type natriuretic peptide (NT-proBNP) and various parameters of the echocardiographic findings to clarify the diagnostic usefulness of NT-proBNP in detecting patients with CHF. We analyzed the sera from total of 242 cases from in-patients and out-patients, which were requested from the cardiovascular section of department of Internal Medicine at Chungnam National University Hospital from March 2003 to May 2004. The procedures were performed in order as shown below; sampling, NT-proBNP analysis, data acquisition and data analysis. All data including personal information and echocardiographic findings ware acquired by medical record review. When classifying the study population into six groups according to the degree of left ventricular ejection fraction (LVEF), the serum level of NT-proBNP was higher in the group with 51-60% of LVEF (P=0.023). There were low correlation between the serum level of NT-proBNP and various parameters of the echocardiographic findings with LVESD (r=0.1513), LVEDD (r=0.0831), LVEF (r=0.2035), IVST (r=0.03) and LVPWT (r=0.0728), respectively. When comparing NT-proBNP with atrial and/or ventricular enlargement, the patient group with both left atrial and left ventricular enlargement (p=0.186) or only left atrial (p=0.105) or only left ventricular enlargement (p=0.256) showed higher level of NT-proBNP without statistical significance than patient group with no enlargement. Searching the optimal cutoff of the serum level of NT-proBNP, the sensitivity (98.9%) and the specificity (100%) was highest at the cutoff of 300 pg/mL than any other cutoffs. These findings suggested that the analysis of NT-proBNP in serum might detect the patients with CHF earlier than with the echocardiograph, especially in patients with asymptomatic or mild symptomatic CHF. In conclusion, NT-proBNP test was proved to be clinically useful to diagnose CHF patients.

• Asian Pacific Journal of Cancer Prevention
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• 제13권11호
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• pp.5759-5762
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• 2012

The objective of the study was to evaluate the efficacy of a health check-up program among Thai people at the National Cancer Institute in the years 2008-2009. The program included history taking, physical examination, chest X-ray, EKG, and laboratory tests. A total of 28,240 women and 9,665 men were included in the study, with mean ages of 44.5 and 46.9 years, respectively. The study showed that obesity, as assessed by a BMI over 25.0 kg/m2, in men and women was present in 41.4% and 30%, respectively. Biochemical study revealed that anemia was prevalent in 21.6% of men and 20.1% of women. High plasma glucose level (>115 mg/dL), cholesterol level (>200 mg/dL), triglyceride level (>190 mg/dL) in men was 13.8%, 63.8%, 22.6% and 7.7%, 61.1%, 8.9% in women. Hepatitis B virus infection was found 7.5% in men and 4.1% in women. In this study, 177 new cancer cases were detected, of which 35 were breast, 19 were cervical and 26 were colorectal, most of these cancers being detected at early stage. In addition, precancerous states was also found including 718 cases of benign and 99 cases of adenoma in situ. In conclusion, an annual check up may detect abnormalities that have no obvious clinical symptoms of disease. Early detection of asymptomatic neoplasms and precursor lesions should contribute to a prompt provision of treatment and further decline of death from cancer.

• 대한임상검사과학회지
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• 제44권1호
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• pp.1-6
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• 2012

Hepatitis A virus (HAV) is an epidemiologically important virus with a worldwide distribution. It causes acute hepatitis in humans. HAV infection is often subclinical or asymptomatic in children; however, symptomatic acute infections become more common with age. In this study, we investigated the prevalence of anti-HAV among hospital workers in Jeonbuk province. 447 (127 males, 320 females) persons were included in the study from January to June, 2011. Anti-HAV (total and IgM) in the sample serum was measured by VIDAS Hepatitis A (bioMerieux, France), and IgM positive samples were tested in terms of their serum alanine aminotransferase (ALT) levels by a HITACHI 7600-010 automatic analyzer (HITACHI, Japan). The overall prevalence of total anti-HAV was 45.9% (205/447), and rate for males (60.6%) was higher than that for females (40%). According to the age group, the prevalence rates of total anti-HAV were 20% (1/5) in those under 20 years old, 11.3% (18/160) in those 20-29 years, 49.7% (71/143) in those 30-39 years, 86.5% (83/96) in those 40-49 years, 92.9% (26/28) in those 50-59 years, and 40% (6/15) in those over 60 years old. The total prevalence of anti-HAV IgM was 0.8% (4/447), and rate for males (1.6%) was higher than that for females (0.6%). Through this study, we determined the prevalence of anti-HAV among hospital workers in Jeonbuk province. The prevalence of the HAV antibody overall was low in hospital workers under 40 years old and in those over 60 years old. Therefore, an improvement in sanitary conditions and hygiene and vaccinations against HAV in this population are recommended.

• 대한후두음성언어의학회지
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• 제11권2호
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• pp.161-166
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• 2000

Background and Objectives : Vocal fold hemorrhage occur by blood accumulation in Reinke's space by vocal trauma. It is mostly asymptomatic, but in some cases it may cause severe dysphonia. It is often seen in patients who use their voice professionally. However, recent changes of life style affected the phonation in general population. We studied to know what are the causes and what are the major factors to affect the vocal fold hemorrhages. Materials and Methods : 19 subjects were evaluated by using of questionaire and laryngoscopic examinations. We evaluated the factors to lead the change in voice directly, underlying causes, occupations and laryngeal findings. Results : The direct causes of the vocal fold hemorrhages were clearing throat, talking, coughing and singing. Reflux laryngitis and upper respiratory infection were the underlying diseases. Vocal fold hemorrhages were developed during the menstruation in 5 patients. Accompanying functional voice disorders were seen in 13 patients, such as, vocal fold nodule, nodule with varix, vocal polyp, Reinke's edema. Patients with reflux laryngitis had the habits of clearing throat as the direct cause of the vocal fold hemorrhages and had hyperkinetic functional voice disorders. Voice abuse was the direct cause of the vocal fold hemorrhages in patients who was in the period of the menstruation. The most common site of the hemorrhage was at the membranous portion of the vocal folds. Conclusions : Authors thought the forceful laryngeal activity was the cause of the vocal fold hemorrhages. And reflux laryngitis and menstruation was the risk factors of the vocal fold hemorrhages.