• Asian Pacific Journal of Cancer Prevention
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• 제13권8호
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• pp.3911-3916
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• 2012

Background: The objective of this study WAS to describe cancer incidence rates and trends among THE Hong Kong population for the period 1983-2008. Methods: Incident cases and population data from 1983 to 2008 were obtained from the Hong Kong Cancer Registry and the Census and Statistics Department, respectively. Agestandardized incidence rates (ASIR) were estimated and joinpoint regression was applied to detect significant changes in cancer morbidity. Results: For all cancers combined, the ASIR showed declining trends (1.37% in men, 0.94% in women), this also being the case for cancers of lung, liver, nasopharynx, stomach, bladder, oesophagus for both genders and cervix cancer for women. With cancer of thyroid, prostate, male colorectal, corpus uteri, ovary and female breast cancer an increase was evident throughout the period. The incidence for leukemia showed a stable trend since early 1990s, following an earlier decrease. Conclusion: Although overall cancer incidence rates and certain cancers showed declining trends, incidence trends for colorectal, thyroid and sex-related cancers continue to rise. These trends in cancer morbidity can be used as an important resource to plan and develop effective programs aimed at the control and prevention of the spread of cancer amongst the Hong Kong population. It is particularly useful in allowing projection of future burdens on the society with the increase in certain cancer incidences.

• Asian Pacific Journal of Cancer Prevention
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• 제17권sup3호
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• pp.27-32
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• 2016

Stomach cancer, the fourth most common cancer and the second leading cause of cancer-related death through the world, is very common in parts of Iran. Geographic variation in the incidence of stomach cancer is due to many different factors. The aim of this study was to assess the geographical and spatial distribution of stomach cancer in Iran using data from the cancer registry program in Iran for the year 2009. The reported incidences of stomach cancer for different provinces were standardized to the world population structure. ArcGIS software was used to analyse the data. Hot spots and high risk areas were determined using spatial analysis (Getis-Ord Gi). Hot and cold spots were determined as more than or less than 2 standard deviations from the national average, respectively. A significance level of 0.10 was used for statistical judgment. In 2009, a total of 6,886 cases of stomach cancers were reported of which 4,891 were in men and 1,995 in women (standardized incidence rates of 19.2 and 10.0, respectively, per 100,000 population). The results showed that stomach cancer was concentrated mainly in northwest of the country in both men and women. In women, northwest provinces such as Ardebil, East Azerbaijan, West Azerbaijan, Gilan, and Qazvin were identified as hot spots (p<0.1). In men, all northwest provinces, Ardabil, East Azerbaijan, Gilan, Qazvin, Zanjan and Kurdistan, the incidences were higher than the national average and these were identified as hot spots (P<0.01). As stomach cancer is clustered in the northwest of the country, further epidemiological studies are needed to identify factors contributing to this concentration.

• Asian Pacific Journal of Cancer Prevention
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• 제13권5호
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• pp.2241-2247
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• 2012

Objective: This qualitative study retrospectively examined the experience and psychological impact of contralateral prophylactic mastectomy (CPM) among Southern Chinese females with unilateral breast cancer history who underwent BRCA1/2 genetic testing. Limited knowledge is available on this topic especially among Asians; therefore, the aim of this study was to acquire insight from Chinese females' subjective perspectives. Methods: A total of 12 semi-structured in-depth interviews, with 11 female BRCA1/BRCA 2 mutated gene carriers and 1 non-carrier with a history of one-sided breast cancer and genetic testing performed by the Hong Kong Hereditary Breast Cancer Family Registry, who subsequently underwent CPM, were assessed using thematic analysis and a Stage Conceptual Model. Breast cancer history, procedures conducted, cosmetic satisfaction, pain, body image and sexuality issues, and cancer risk perception were discussed. Retrieval of medical records using a prospective database was also performed. Results: All participants opted for prophylaxis due to their reservations concerning the efficacy of surveillance and worries of recurrent breast cancer risk. Most participants were satisfied with the overall results and their decision. One-fourth expressed different extents of regrets. Psychological relief and decreased breast cancer risk were stated as major benefits. Spouses' reactions and support were crucial for post-surgery sexual satisfaction and long-term adjustment. Conclusions: Our findings indicate that thorough education on cancer risk and realistic expectations of surgery outcomes are crucial for positive adjustment after CPM. Appropriate genetic counseling and pre-and post-surgery psychological counseling were necessary. This study adds valuable contextual insights into the experiences of living with breast cancer fear and the importance of involving spouses when counseling these patients.

• Asian Pacific Journal of Cancer Prevention
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• 제17권7호
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• pp.3541-3544
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• 2016

Background: As the treatment modalities for oral cancer have been relatively consistent during the last two-decades, this study was conducted to compare survivals of oral cancer patients in Khon Kaen Province before and after the universal coverage scheme (UC) was launched in Thailand. Materials and Methods: The data were retrieved from the population-based cancer registry of Khon Kaen for oral cancer patients diagnosed during 1992-2001 (pre-UC), and 2004-2012 (post-UC). To compare survival of the two cohorts, Kaplan Meier and log rank tests were employed. Results: Of 1,196 patients, 65% were females and the median age was 65 years. The most common primary sites were lip (31.0%), tongue (29.9%), and buccal mucosa (14.6%). The proportion of early stage cancer increased from 20.4 % in pre-UC to 41.3% in post-UC. The overall 5-year survival rate was 36.5% (95% CI =32.6-40.9) for pre-UC and 32.4% (95% CI = 28.8-36.4) for post-UC. The declining survival was mainly due to an increasing proportion of tongue cancer. However, no survival improvement was demonstrated on subgroup analysis of the tongue cancer patients. Conclusions: After the universal coverage scheme had been launched, early diagnosis increased, but no significant gain in survival for oral cancer patients was achieved.

• Asian Pacific Journal of Cancer Prevention
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• 제15권14호
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• pp.5639-5644
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• 2014

Objective: This study aimed to determine effects of doctor-patient communication on the quality of life among breast cancer survivors in 16 communities in southern China. Methods: Multistage random sampling was to use to recruit 260 females from the Guangzhou Cancer Registry Database who were diagnosed with breast cancer. A questionnaire provided data on the doctor-patient communication (including the doctor's attitude, the patient's participation with the medical decision and information about the disease) and QOL (quality of life), as measured using FACT-B. Univariate analysis, non-conditional logistic regression was used to evaluate the associations between the doctor-patient communication and QOL. Results: Females who received good attitudes from doctors demonstrated higher FACT-B (OR=4.65, 95% CI: 1.68-12.86), social well-being (OR=5.88, 95% CI: 2.16-16.05), emotional well-being (OR=4.77, 95% CI: 1.92-11.88), and functional well-being ((OR=5.26, 95% CI: 1.90-14.52) compared to the females who encountered worse attitudes from their doctor, adjusting for age, education, marriage, employment, family income, years since diagnosis, TNM stage, radiation therapy, chemotherapy and side effects, particularly when the TNM stage was 0-II and the patients exhibited no side effects. Regardless of the length of time after diagnosis, doctors' good attitudes resulted in higher QOL scores. Conclusions: This study demonstrated that the doctor-patient communication has a significant association with the QOL of breast cancer survivors, mainly dependent on the doctors' attitude. Effective intervention is required to develop optimal doctor-patient communication.

• Asian Pacific Journal of Cancer Prevention
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• 제13권6호
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• pp.2955-2960
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• 2012

Background: Health disparities exist among and within countries, while developing and low income countries suffer more. The aim of this study was to quantify cancer disparities with regard to socioeconomic position (SEP) in 22 districts of Tehran, Iran. Method: According to the national cancer registry, 7599 new cancer cases were recorded within 22 districts of Tehran in 2008. Based on combined data from census and a population-based health equity study (Urban HEART), socioeconomic position (SEP) was calculated for each district. Index of disparity, absolute and relative concentration indices (ACI & RCI) were used for measuring disparities in cancer incidence. Results: The overall cancer age standardised rate (ASR) was 117.2 per 100,000 individuals (120.4 for men and 113.5 for women). Maximum ASR in both genders was seen in districts 6, 3, 1 and 2. Breast, colorectal, stomach, skin and prostate were the most common cancers. Districts with higher SEP had higher ASR (r=0.9, p<0.001). Positive ACI and RCI indicated that cancer cases accumulated in districts with high SEP. Female disparity was greater than for men in all measures. Breast, colorectal, prostate and bladder ASR ascended across SEP groups. Negative ACI and RCI in cervical and skin cancers in women indicate their aggregation in lower SEP groups. Breast cancer had the highest absolute disparities measure. Conclusion: This report provides an appropriate guide and new evidence on disparities across geographical, demographic and particular SEP groups. Higher ASR in specific districts warrants further research to investigate the background predisposing factors.

• Asian Pacific Journal of Cancer Prevention
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• 제15권3호
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• pp.1459-1463
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• 2014

Background: Urological cancers represent a major public problem associated with high mortality and morbidity. The pattern of these cancers varies markedly according to era, region and ethnic groups, but increasing incidence trends overall makes focused epidemiological studies important. The aim of the present study was to assess the incidence of most prevalent urological cancers in Iran from 2003 to 2009. Materials and Methods: The data for this study were obtained from the population-based Cancer Registry Center of the Iran Ministry of Health and Medical Education. Differences of mean age and age distributions of each cancer were compared between 2003 and 2009 in men and women. Results: Bladder cancer was the most common urologic cancer in both genders. The rate difference of age standardized ratio (ASR) of bladder and renal cell carcinoma in women were 1.54 and 2.01 percent per 100,000 population from 2003 to the 2009, respectively. In men, the rate difference of age standardized ratio of prostate, testis, kidney and bladder cancer was also 2.23, 1.2, 1.8 and 1.5 percent per 100,000 population from 2003 to 2009, respectively. The mean ages of patients in all cancers in both genders did not differ significantly through time (p value>0.05) but the distribution of ages of patients with bladder and prostate cancer changed significantly from 2003 to 2009 (p value<0.001). Conclusions: The results of present study suggest the general pattern and incidence of urological cancers in Iran are changing, the observed increase pointing to a need for urological cancer screening programs.

• Asian Pacific Journal of Cancer Prevention
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• 제14권3호
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• pp.1669-1676
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• 2013

Background: Variation in cancer incidence in geographical locations is due to different lifestyles and risk factors. Diet and socio-economic position (SEP) have been identified as important for the etiology of cancer but patterns are changing and inconsistent. The aim of this study was to investigate correlations of the incidence of common cancers with food groups, total energy, smoking, and SEP. Materials and Methods: In an ecological study, disaggregated cancer data through the National Cancer Registry in Iran (2008) and dietary intake, smoking habits and SEP obtained through a population based survey within the Urban Health Equity Assessment (Urban-HEART) project were correlated across 22 districts of Tehran. Results: Consumption of fruit, meat and dairy products adjusted for energy were positively correlated with bladder, colorectal, prostate and breast and total cancers in men and women, while these cancers were adversely correlated with bread and fat intake. Also prostate, breast, colorectal, bladder and ovarian cancers had a positive correlation with SEP; there was no correlation between SEP and skin cancer in both genders and stomach cancer in men. Conclusions: The incidence of cancer was higher in some regions of Tehran which appeared to be mainly determined by SEP rather than dietary intake. Further individual data are required to investigate reasons of cancer clustering.

• Asian Pacific Journal of Cancer Prevention
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• 제15권8호
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• pp.3383-3389
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• 2014

Background: Prostate cancer is rapidly increasing in Korea and professional societies have requested adding prostate specific antigen (PSA) testing to the National Cancer Screening Program (NCSP), but this started a controversy in Korea and neutral evidence on this issue is required more than ever. The purpose of this study was to provide economic evidence to the decision makers of the NCSP. Materials and Methods: A cost-utility analysis was performed on the adoption of PSA screening program among men aged 50-74-years in Korea from the healthcare system perspective. Several data sources were used for the cost-utility analysis, including general health screening data, the Korea Central Cancer Registry, national insurance claims data, and cause of mortality from the National Statistical Office. To solicit the utility index of prostate cancer, a face-to-face interview for typical men aged 40 to 69 was conducted using a Time-Trade Off method. Results: As a result, the increase of effectiveness was estimated to be very low, when adopting PSA screening, and the incremental cost effectiveness ratio (ICER) was analyzed as about 94 million KRW. Sensitivity analyses were performed on the incidence rate, screening rate, cancer stage distribution, utility index, and treatment costs but the results were consistent with the base analysis. Conclusions: Under Korean circumstances with a relatively low incidence rate of prostate cancer, PSA screening is not cost-effective. Therefore, we conclude that adopting national prostate cancer screening would not be beneficial until further evidence is provided in the future.

• Asian Pacific Journal of Cancer Prevention
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• 제17권4호
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• pp.2125-2129
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• 2016

Background: Stomach cancer is an aggressive malignancy that is difficult to detect at an early stage and therefore is characterized by poor survival rates. Over the last two decades, there has been no report of gastric cancer survival in Khon Kaen province, Thailand. The aim of this retrospective cohort study was to provide up-to-date information about the survival of gastric cancer patients in this province. Materials and Methods: Data from Khon Kaen population-based cancer registry, Faculty of Medicine, Khon Kaen University were newly obtained on 650 patients who were diagnosed with stomach cancer during the period 1 January, 2000 to 31 December, 2012. These were then followed up until death or the end of the study (31 December 2014). We calculated the observed survival with the actuarial life table method, and relative survival, defined as the ratio of observed survival in the group of the stomach cancer patients to the expected survival in the entire Thai population from the estimated generation life tables for Thailand of five-year birth cohorts from 1900 - 2000. Results: The 5 year observed and 5 year relative survival rates were 17.2 % (95% CI: 13.54-21.14) and 18.2 % (95% CI: 14.3-22.4), respectively. The highest 5 year relative survival rates were demonstrated among patients aged 45-65, with stage I or II lesions, with adenocarcinomas, with a body of stomach location, well differentiated and receiving surgery and/or chemotherapy. Conclusions: The observed and relative survival rates were close to each other. Our findings provide basic information beneficial to development of an effective treatment system and appropriately improved population-based cancer registration.