• Asian Pacific Journal of Cancer Prevention
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• 제17권sup3호
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• pp.191-195
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• 2016

Breast cancer is the most frequent cancer in females. Its incidence is higher in developed countries than in developing ones partly due to variation in risk exposure and partly due to better detection methods. Scattered evidence in Basrah, Iraq, suggests that breast cancer has been increasing at a significant pace in recent years. This study aimed to measure the current level of risk of breast cancer among females in Basrah and to describe the time trend over almost a decade of years. Data on breast cancer cases from all sources of cancer registration in Basrah governorate were compiled for the years 2005-2012. The data for each year were first checked separately for duplicate reporting of cases among various sources. Then the eight files were pooled together and checked again for any duplicate cases among years of registration. The final set of data contained 2,284 cases of breast cancer (2,213 female cases and 71 male cases). All patients were inhabitants of Basrah governorate at the time of diagnosis. Figures on the Basrah population were obtained from various sources including the Ministry of Health, Ministry of Planning and Developmental Collaboration and local household surveys. It was possible to have total population estimates for each year and by age and sex. The data were imported into SPSS (version 17) software. Age specific and year specific incidence rates were calculated. The age standardized incidence rate was also calculated using world population as the standard population to be 34.9 per 100,000 females. Age-wise, no case was reported among children aged less than 15 years and the incidence increased with advancing age reaching a peak of 123.8/100,000 females at the age range of 50-54 years. The time trend of the crude incidence rate showed only modest increased risk with passage of years and no age shift could be documented in this study. Breast cancer in females in Basrah is a significant health problem. The current incidence rate (crude, 23.7/100,000, age-standardized, 34.9/100,000) is high and justifies intensive efforts to improve early detection of cases, provide better treatment amenities and introduce long term preventive measures. Using the age standardized incidence rate as reported in this paper, it is possible to put the risk in Basrah within a regional and international context.

• Asian Pacific Journal of Cancer Prevention
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• 제14권7호
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• pp.4379-4386
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• 2013

Projection of cancer incidence is essential for planning cancer control actions, health care and allocation of resources. Here we project the cancer burden at the National and State level to understand the magnitude of cancer problem for the various calendar years from 2011 to 2026 at 5-yearly intervals. The age, sex and site-wise cancer incidence data along with populations covered by the registries were obtained from the report of National Cancer Registry Programme published by Indian Council of Medical Research for the period 2001-2004. Pooled age sex specific cancer incidence rates were obtained by taking weighted averages of these seventeen registries with respective registry populations as weights. The pooled incidence rates were assumed to represent the country's incidence rates. Populations of the country according to age and sex exposed to the risk of development of cancer in different calendar years were obtained from the report of Registrar General of India providing population projections for the country for the years from 2001 to 2026. Population forecasts were combined with the pooled incidence rates to estimate the projected number of cancer cases by age, sex and site of cancer at various 5-yearly periods Viz. 2011, 2016, 2021 and 2026. The projections were carried out for the various leading sites as well as for 'all sites' of cancer. In India, in 2011, nearly 1,193,000 new cancer cases were estimated; a higher load among females (603,500) than males (589,800) was noted. It is estimated that the total number of new cases in males will increased from 0.589 million in 2011 to 0.934 million by the year 2026. In females the new cases of cancer increased from 0.603 to 0.935 million. Three top most occurring cancers namely those of tobacco related cancers in both sexes, breast and cervical cancers in women account for over 50 to 60 percent of all cancers. When adjustments for increasing tobacco habits and increasing trends in many cancers are made, the estimates may further increase. The leading sites of cancers in males are lung, oesophagus, larynx, mouth, tongue and in females breast and cervix uteri. The main factors contributing to high burden of cancer over the years are increase in the population size as well as increase in proportion of elderly population, urbanization, and globalization. The cancer incidence results show an urgent need for strengthening and augmenting the existing diagnostic/treatment facilities, which are inadequate even to tackle the present load.

• Asian Pacific Journal of Cancer Prevention
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• 제13권9호
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• pp.4369-4371
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• 2012

Aim: Metastatic tumor of bone is the most common malignancy involving bone and is an important predictor of prognosis in advanced cancers. The prognosis depends upon the primary site of origin and the extent of disease. In current study, we present the pattern and distribution of metastatic bone disease seen in the leading cancer care center of Pakistan, Shaukat Khanum Cancer Hospital & Research Center (SKMCH & RC), Lahore. Materials & Methods: All cases of bony metastatic disease were included that presented in the Pathology Department, from Jan 2005 to July 2011. Patients of all ages and both sexes were included. Primary bone tumors, lymphomas, sarcomas and other malignancies were excluded. The data were recorded and analyzed with SPSS 16.0. Results: A total of 146 cases of metastatic bone disease were included in the study. Out of the total cases, 79 were male and 67 were female. Age range 25-82 years (median 52). Hip bone was the most frequent bone involved, with femur and vertebrae as second and third in the list. The commonest bone involved in males was vertebrae with 23 cases and in females was hip bone with 22 cases. Regarding primary site, cancers of breast, prostate and gastrointestinal tract were at the top of the list with prostate and breast being the most frequent primary sites of metastasis in males and females respectively. Conclusion: Bone metastasis is an important entity to consider in the differential diagnosis whenever a bony tumor especially carcinoma present in older age. Our data are comparable with international findings and the literature available regarding the site and distribution of skeletal metastatic lesions. A slight deviation noted was more common bony metastatic lesions with ovarian primaries in females and gastrointestinal tract cancers in males in our study.

• Journal of Gastric Cancer
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• 제11권1호
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• pp.38-45
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• 2011

Purpose: Bone metastasis from stomach cancer occurs only rarely and it is known to have a very poor prognosis. This study examined the clinical characteristics and prognosis of patients who were diagnosed with stomach cancer and bone metastasis. Materials and Methods: The subjects were 19 patients who were diagnosed with stomach cancer at Hanyang University Medical Center from June 1992 to August 2010 and they also had bone metastasis. The survival rate according to many clinicopathologic factors was retrospectively analyzed. Results: 11 patients out of 18 patients (61%) who received an operation were in stage IV and the most common bone metastasis location was the spine. Bone scintigraphy was mostly used for diagnosing bone metastasis and PET-CT and magnetic resonance imaging were used singly or together. The serum alkaline phosphatase at the time of diagnosis had increased in 12 cases and there were clinical symptoms (bone pain) in 16 cases. Treatment was given to 14 cases and it was mostly radiotherapy. There were 2 cases of discovering bone metastasis at the time of diagnosing stomach cancer. The interval after operation to the time of diagnosing bone metastasis for the 18 cases that received a stomach cancer operation was on average $14.9{\pm}17.3$ months and the period until death after the diagnosis of bone metastasis was on average $3.8{\pm}2.6$ months. As a result of univariate survival rate analysis, the group that was treated for bone metastasis had a significantly better survival period when the bone metastasis was singular rather than multiple, as compared to the non-treatment group, yet both factors were not independent prognosis factors on multivariate survival analysis. Conclusions: An examination to confirm the status of bone metastasis when conducting a radio-tracer test after the initial diagnosis and also after an operation is needed for stomach cancer patients, and bone scintigraphy is the most helpfully modality. Making the diagnosis at the early stage and suitable treatments are expected to enhance the survival rate and improve the quality of life even for the patients with bone metastasis.

• Asian Pacific Journal of Cancer Prevention
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• 제14권9호
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• pp.5101-5105
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• 2013

The incidence and mortality of cervical cancer remains high in India even after sixty years of introduction of the Pap smear (cervical cytology) which is an effective means of identifying preinvasive lesions of carcinoma cervix. The morbidity and mortality due to cervical cancer has come down drastically in countries with well established screening programmes at national level. This study aims at screening women for cervical cancer opportunistically during their visit to hospital and to study various types of neoplastic and non-neoplastic lesions of the cervix by cervical smear study (Pap smear study). In the present study, a total of 350 cervical smears were studied. The age of patients ranged from 19 years to 80 years with mean age being 37.5 years. Out of 350 cases, the diagnosis of neoplasia was given in 43 cases and 258 cases were diagnosed as inflammatory smears. Forty-cases were normal and 9 cases were inadequate to evaluate. Forty-three patients who were found to have neoplastic lesions on cytology were referred for further investigations like colposcopy and biopsy to confirm the diagnosis and avail proper treatment. Limitation of the present study was small sample size as all female patients aged between 20 and 60 years visiting hospital were not included in the screening, other screening tests like VIA (visual inspection with acetic acid test) and HPV DNA (human papilloma virus) tests were not done. Until the time centrally organised screening programmes for cervical cancer are established in India, arrangements should be made for hospital based opportunistic screening for all women attending hospital. The cost effectiveness of different screening tests for cervical cancer should be evaluated.

• Asian Pacific Journal of Cancer Prevention
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• 제14권2호
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• pp.1023-1026
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• 2013

Cervical cancer is the most important female gynecological cancer, the second leading cause of cancer mortality in women worldwide and the second most common cancer in Thai women. The major cause of cervical cancer is persistent infection of human papillomavirus (HPV), leading to abnormal epithelial lesions, with progression to precancerous and invasive cancer. This study was conducted to investigate the frequency and type distribution of HPV in Thai women who had abnormal cytology. HPV detection from FFPE confirmed abnormal of high grade cervical intraepithelial lesions were for SPF-10-Innogenic Line Probe Assay. HPV-positivity was detected in 320/355 cases (90.14%) and HPV-negativity in 35/355 (9.86%). HPV-positive was found 147/320 cases (41.4%) of single infection, whereas 173/320 cases (48.7%) showed the multiple HPV infection. The most common seven types were HPV-16, -52, -18, -11, -51, -31 and -33, in that order. HPV 16 and 18, the important oncogenic HPV type, were observed in 64.8% of HSIL cases. Interestingly, a high proportion of multiple infections was found in this study and more than ten types could be detected in one case. Therefore, HPV infection screening program in women is essential, particularly in Thailand. Effective primary and secondary prevention campaigns that reinforce HPV screening for HPV detection and typing may be decrease the incidence and mortality of cervical cancer in the future and may lead to significantly improve the quality of life in Thai women.

• Journal of Preventive Medicine and Public Health
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• 제42권2호
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• pp.130-134
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• 2009

Objectives : A method of estimation using 8 populationbased cancer registries databases in Korea(KRCR DB) has been introduced as another strategy for validly estimating the national cancer incidence(NCI) in Korea. The purpose of this study was to evaluate the validity of this method with using the 7 KRCR DBs, excluding Seoul covering 21% of the total population of Korea. Methods : We designed the study method(NCSE_7) as same as the estimating method with using 8 KRCR DBs (NCSE_8) in order to ensure maximal comparability. We defined the expected number of cancer cases in each registry as the number of observed cases and then we added the weighted observed cases according to gender, age and the proportion of the population covered by each registry for the population of the seven regions and the population of all areas, with excluding these seven regions. From the expected number of total cancer incidents, the estimated NCI was calculated by dividing the expected number of cancer cases by the number of the total population. The standard error(SE) of the estimated incidence was also taken from the expected number of total cancer incidents. Results : Compared with the results of the NCSE_8, the overall age-standardized rates(ASR) in men and women became over-estimated and under-estimated, respectively. Primary sites that showed statistically significant differences were the colo-rectum, prostate, breast and thyroid. The index of death certificate only(DCO)and microscopically verified(MV)% indicating levels of data quality were decreased, especially for the brain in DCO% and kidney in the MV%. Conclusions : The database of Seoul regional cancer registry has a key role for the method to estimate the valid nationwide cancer statistics in Korea with using the population-based cancer registries databases.

• Asian Pacific Journal of Cancer Prevention
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• 제15권3호
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• pp.1149-1154
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• 2014

Background: In Malaysia, data from the Malaysian Health Ministry showed colorectal cancer (CRC) to be the second most common type of cancer in 2007-2009, after breast cancer. The same was apparent after looking at males and females cases separately. In the present study, the Geographic Information System (GIS) was employed to describe the distribution of CRC cases in Kuala Lumpur (KL), Malaysia, according to socio-demographic factors (age, gender, ethnicity and district). Materials and Methods: This retrospective review concerned data for patients diagnosed with colorectal cancer in the years 1995 to 2011 collected from the Wilayah Persekutuan Health Office, taken from the cancer notification form (NCR-2), and patient medical records from the Surgical Department, Universiti Kebangsaan Malaysia Medical Centre (UKMMC). A total of 146 cases were analyzed. All the data collected were analysed using ArcGIS version 10.0 and SPSS version 19.0. Results: Patients aged 60 to 69 years accounted for the highest proportion of cases (34.2%) and males slightly predominated 76 (52.1%), Chinese had the highest number of registered cases at 108 (74.0%) and staging revealed most cases in the 3rd and 4th stages. Kernel density analysis showed more cases are concentrated up in the northern area of Petaling and Kuala Lumpur subdistricts. Spatial global pattern analysis by average nearest neighbour resulted in nearest neighbour ratio of 0.75, with Z-score of -5.59, p value of <0.01 and the z-score of -5.59. Spatial autocorrelation (Moran's I) showed clustering significant with p<0.01, Z score 3.14 and Moran's Index of 0.007. When mapping clusters with hotspot analysis (Getis-Ord Gi), hot and cold spots were identified. Hot spot areas fell on the northeast side of KL. Conclusions: This study demonstrated significant spatial patterns of cancer incidence in KL. Knowledge about these spatial patterns can provide useful information to policymakers in the planning of screening of CRC in the targeted population and improvement of healthcare facilities to provide better treatment for CRC patients.

• The Korean Journal of Nuclear Medicine
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• 제18권1호
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• pp.1-8
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• 1984

To evaluate the clinical significance of serum tissue polypeptide antigen (TPA) levels in patients with malignancy, serum TP A levels were measured by radioimmunoassay in 49 normal controls, 9 patients of postoperative colon cancer without recurrence and 68 patients with various untreated malignancy, who visited Seoul National University Hospital from February, 1983 to September, 1983. The results were as follows; 1) Serum TPA levels in 49 normal controls were in the range of 22-135 U/L $(74{\pm}28U/L,\;mean{\pm}S.D.)$. There was no sex or age difference. Normal upper limit of serum TPA was defined as 130 U/L (mean+2S.D.). 2) Serum TPA levels in 68 patients with various untreated malignancy (stomach cancer 33 cases, colon cancer 11 cases, lung cancer 10 cases, primary liver cancer 9 cases and metastatic cancer of unknown primary site 5 cases) were in the range of 10-800 U/L $(189{\pm}170U/L,\;mean{\pm}S.D.)$ and significantly elevated, compared with those of normal controls (p<0.005). 3) The sensitivities of serum TPA in various untreated malignancy were 39% in stomach cancer, 55% in colon cancer, 50% in lung cancer, 67% in primary liver cancer and 80% in metastatic cancer of unknown primary site respectively. 4) The sensitivities of serum TPA related to resectability in stomach and colon cancer were 32% in resectable stomach cancer, 50% in unresectable stomach cancer, 29% in resectable colon cancer and 100% in unresectable colon cancer respectively. 5) The mean value of serum TPA levels in 9 patients of postoperative colon cancer without recurrence was $70{\pm}39U/L$ and significantly decreased, compared with that of untreated colon cancer, $180{\pm}150U/L$ U/L (p<0.05). 6) In patients with stomach or colon cancer, there was no significant correlation between serum TP A and serum CEA levels, but simultaneous measurement of serum TPA and serum CEA levels increased sensitivities. From above results, we concluded that serum TPA level is a useful indicator reflecting tumor activity and responses to anticancer treatment in patients with malignancy.

• Asian Pacific Journal of Cancer Prevention
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• 제13권4호
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• pp.1413-1418
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• 2012

Background: Previous studies generally indicate that synchronous bilateral breast cancers (SBBC) have an equivalent or moderately poorer survival compared with unilateral cases. The prognostic characteristics of SBBC would be relevant when planning adjuvant therapies and follow-up medical surveillance. The frequency of SBBC among early breast cancers in clinical settings in Australia and New Zealand was investigated, plus their prognostic significance, using the Breast Cancer Audit Database of the Society of Breast Surgeons of Australia and New Zealand, which covered an estimated 60% of early invasive lesions in those countries. Design: Rate ratios (95% confidence limits) of SBBC were investigated among 35,370 female breast cancer cases by age of woman, histology type, grade, tumour diameter, nodal status, lymphatic/vascular invasion and oestrogen receptor status. Univariate and multivariable disease-specific survival analyses were undertaken. Results: 2.3% of cases were found to be SBBC (i.e., diagnoses occurring within 3 months). The figure increased from 1.4% in women less than 40 years to 4.1% in those aged 80 years or more. Disease-specific survivals did not vary by SBBC status (p=0.206). After adjusting for age, histology type, diameter, grade, nodal status, lymphatic/vascular invasion, and oestrogen receptor status, the relative risk of breast cancer death for SBBC was 1.17 (95% CL: 0.91, 1.51). After adjusting for favourable prognostic factors more common in SBBC cases (i.e., histology type, grade, lymphatic/vascular invasion, and oestrogen receptor status), the relative risk of breast cancer death for SBBC was 1.42 (95% CL: 1.10, 1.82). After adjusting for unfavourable prognostic factors more common in SBBC cases (i.e., older age and large tumour diameter), the relative risk of breast cancer death for SBBC was 0.98 (95% CL: 0.76, 1.26). Conclusions: Results confirm previous findings of an equivalent or moderately poorer survival for SBBC but indicate that SBBC status is likely to be an important prognostic indicator for some cases.