• Asian Pacific Journal of Cancer Prevention
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• v.14 no.9
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• pp.5503-5506
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• 2013

This cross-sectional analytic study aimed to investigate any relationship between the body mass index (BMI) and an abnormal Pap smear. The subjects were 7,720 women aged 30-69 years who lived in Khon Kaen Province, Thailand, and had been recruited as participants in the Khon Kaen Cohort Study during 1990-2001. All had received Pap smear screening for cervical cancer. The data were analyzed using descriptive and inferential statistics. Multiple logistic regression was used to determine the relationship between body mass index and an abnormal Pap smear. The mean BMI was $24.53kg/m^2$ (SD=3.98), and 2.14% had abnormal Pap smears. Compared with the reference group of women with a BMI ${\leq}22.9kg/m^2$, those with a body mass index of $23.0-24.9kg/m^2$ had a reduced risk of an abnormal smear (ORadj=0.92, 95%CI: 0.57-1.47), but women with a BMI $25.0-29.9kg/m^2$ were found to have an approximately 1.24 times higher risk ($OR_{adj}=1.24$, 95%CI: 0.86-1.80), and those with a BMI ${\geq}30.0kg/m^2$ had an approximately 1.63 times higher risk ($OR_{adj}=1.63$, 95%CI: 0.98-2.69). The results indicated that the risk of Pap smear abnormalities is increased in women who have a higher than normal body mass index, but this finding was not statistically significant. Nevertheless, public health personnel should encourage women to maintain their BMI in the normal range to reduce the possible future risk of cervical cancer.

• Journal of Preventive Medicine and Public Health
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• v.32 no.2
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• pp.147-154
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• 1999

Objectives: To construct basic data to develop strategies for achieving higher Pap test coverage rate by evaluating factors associated with the use of Pap test through population-based survey. Methods: 16.4%(671) of the 4,090 women, who were eligible population for this study, in 3 Myens of Chung-ju City participated in this study voluntarily from July 21 to 26, 1997. After basic physical examination by trained doctors, they were interviewed with structured questionnaire by well-educated interviewers. Results: It shows that only 54.3% of study participants experienced Pap test. The strongest factor which is related with the use of Pap test was the history of having breast screening tests(aOR=8.71, 95% CI=4.25-17.84). Probability of ever having Pap test was also higher in married women(aOR of single=0.46, 95% CI=0.29-0.72), younger(Ptrend<0,051, more educated (Ptrend<0.001), non-smoker (aOR of smoker=0.25, 95% CI=0.12-0.55), women of ever having Hepatitis test(aOR=2.60, 95% CI=1.73-3.88) in multiple lineal logistic analysis. Conclusions : This study suggests that several factors significantly associated with the use of Pap test, and especially, high-risk population for cervical cancer such as women of older ages, less educated, living alone are less likely to have the Pap test. We should concentrate on encouraging high-risk women in the use of Pap test to improve Pap test coverage rate.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.4
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• pp.2277-2282
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• 2013

Purpose: Mammography has been confirmed as the only effective mode to improve the prognosis of patients with breast cancer in Western developed countries, but might not be a good choice in other areas of the world. One of the major challenges in China is to determine an optimal imaging modality for breast cancer screening. This study was designed to clarify the sensitivity of ultrasonography compared with that of mammography in rural China. Methods: We retrospectively studied the sensitivity of mammography and ultrasonography based on 306 breast cancer patients detected by the program of "screening for cervical cancer and breast cancer" performed in Chinese rural areas between January 2009 and December 2011, and analyzed the effects of age, breast density and volume on the sensitivity. Results: Stratified analysis showed that the sensitivity of breast ultrasonography was significantly higher than that of mammography in premenopausal patients (81.4% vs. 61.1%, p=0.02), in women ${\leq}$ 55 years of age (82.2% vs. 63.4%, p<0.01), in the high breast density group (American College of Radiology [ACR] levels 3-4) (85.9% vs. 60.6%, p<0.01) and in the small breast volume group (${\leq}$ 400 ml) (87.1% vs. 66.7%, p<0.01). Age had a significant effect on sensitivity of mammography (breast density and volume-adjusted odds ratio, 6.39; 95% confidence interval, 2.8-14.4 in age group > 55 compared to age group ${\leq}$ 45), but not that of ultrasonography. Neither breast density nor volume had significant effect on sensitivity of mammography or ultrasonography. Conclusions: Ultrasonography is more sensitive than mammography in detecting breast cancer in women under 55 year-old Chinese, especially in those with high-density and relatively small breasts.

• Journal of Korean Academy of Nursing
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• v.30 no.1
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• pp.160-170
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• 2000

The purpose of this study was to develop an explanatory model to predict factors related to continuous participation in the Pap smear screening among Korean women. A hypothetical model was constructed on the basis of Health Belief Model and extensive review of literature on the Pap smear screening. Exogeneous variables included in this model were knowledge, perceived sensitivity, perceived severity, negative and positive emotional responses and professional support from physicians and nurses. Endogeneous variables were threat to cervical cancer, perceived benefit of the Pap smear screening, perceived barrier, and the final outcome variable was continuous participation in the Pap smear screening. The hypothetical model was tested with an empirical study. The data was collected from 623 married women whose age range was 24 - 83 using a self-reported survey questionnaire which was developed by the researcher. It's Cronbach's alpha score ranged from .6478 to .9118. Data was collected at different locations in Seoul; a university hospital, a local health center, and apartment complexes. Data analysis was done using SPSS 7.5 WIN Program for descriptive statistics and LISREL 8.12a WIN Program for covariance structural analysis. In conclusion, threat, perceived benefit, perceived barrier, positive emotion and professional support had a significant direct effect on continuous participation in the Pap smear screening among Korean women. The results of this study also showed that perceived barrier had the most significant direct effect on continuous participation in the Pap smear screening while negative emotional response had the most significant direct effect on perceived barrier. It can be suggested that decreasing perceived barrier by reducing negative emotional responses may be the most effective strategies for increasing continuous participation in the Pap smear screening among married Korean women.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.18
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• pp.8473-8477
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• 2016

Background: High risk human papilloma virus (HPV) types 16 and 18 have been proven as central causes of cervical cancer and safety and immunogenicity of HPV vaccines are sufficiently established. Knowledge and practices of HPV vaccination among medical and paramedical students is vital as these may strongly determine intention to recommend vaccination to others in the future. The present study was therefore undertaken to assess the knowledge, attitude and practices regarding cervical cancer screening and HPV vaccination among medical and paramedical students and to analyze factors influencing them. Materials and Methods: The present cross sectional study, conducted in a tertiary care teaching hospital in south India, included undergraduate students aged 18 years and above, belonging to medical, dental and nursing streams, after informed written consent. Results: Out of 957 participants, only 430 (44.9%) displayed good knowledge and only 65 (6.8%) had received HPV vaccination. Among the unvaccinated, 433 (48.54%), were not willing to take the vaccine. Concerns regarding the efficacy (30.5%), safety (26.1%) and cost of the vaccine (21.7%) were responsible for this. Age, gender, family history of malignancy and mother's education had no influence on knowledge. Compared to medical students, nursing students had better knowledge (OR-1.49, 95% CI 0.96 to 2.3, p = 0.072) and students of dentistry had poor knowledge (OR-0.50 95% CI 0.36 to 0.70, p<0.001). Conclusions: The knowledge and uptake of HPV vaccination among medical and paramedical students in India is poor. Targeted health education interventions may have huge positive impact not only on the acceptance of vaccination among them, but also on their intention to recommend the vaccine in future.

• Journal of Preventive Medicine and Public Health
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• v.38 no.1
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• pp.82-92
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• 2005

Objective : To evaluate the relationships among sociodemographic characteristics, health behaviors, levels of pros and cons and stages of change in Pap testing for uterine cervical cancer. Methods : A questionnaire survey was performed on 560 randomly sampled people who were assigned to participate in a Pap testing program by the National Cancer Screening Project in 2003' between 25 September and 10 October in Gyeonggi, Korea. Data about the behaviors and intentions of Pap testing, sociodemographic characteristics, health behaviors, and levels of acknowledged benefit (pros) and barrier (cons) for Pap testing was collected. The stages of change were grouped according to behaviors and intentions of Pap testing as passive, active, and relapse. Results : Logistic analysis between the passive and active groups showed that city dwellers, 'high' and 'middle' groups in terms of the individual s health belief, those who had undergone a health examination within the past 2 years, and those who had undergone hormone replacement therapy had a higher odds ratios to be in the active group. As the 'benefit' scores increased and the 'Unnecessity' scores decreased, the probabilities to be in the active group increased. According to the logistic analysis results between the active and relapse groups, those who were 60 years or older, members of the National Heath Insurance, and those who had not undergone a health examination within the past 2 years had a higher odds ratio to be in the relapse group. The 'Benefit' scores were not significant in this relationship. The probabilities of being in the relapse group increased as the Unnecessity and 'Shamefulness' scores increased. Conclusions : In conclusion, health planners should inform women in the passive group of the benefits and necessity of Pap testing. It would be better to reduce the barriers to the active group of undergoing Pap smear. This study might be a useful guide for future planning of Pap testing program.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.14
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• pp.5843-5846
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• 2015

Background: Detection of cervical high grade lesions in patients with atypical squamous cells of undetermined significance (ASCUS) is still a challenge. Our study tested the efficacy of the paired boxed gene 1 (PAX1) methylation analysis by methylation-sensitive high-resolution melting (MS-HRM) in the detection of high grade lesions in ASCUS and compared performance with the hybrid capture 2 (HC2) human papillomavirus (HPV) test. Materials and Methods: A total of 463 consecutive ASCUS women from primary screening were selected. Their cervical scrapings were collected and assessed by PAX1 methylation analysis (MS-HRM) and high-risk HPV-DNA test (HC2). All patients with ASCUS were admitted to colposcopy and cervical biopsies. The Chisquare test was used to test the differences of PAX1 methylation or HPV infection between groups. Results: The specificity, sensitivity, and accuracy for detecting CIN2 + lesions were: 95.6%, 82.4%, and 94.6%, respectively, for the PAX1 MS-HRM test; and 59.7%, 64.7%, and 60.0% for the HC2 HPV test. Conclusions: The PAX1 methylation analysis by MS-HRM demonstrated a better performance than the high-risk HPV-DNA test for the detection of high grade lesions (CIN2 +) in ASCUS cases. This approach could screen out the majority of low grade cases of ASCUS, and thus reduce the referral rate to colposcopy.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.4
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• pp.2355-2359
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• 2013

Vulva cancer is rare among all gynecological cancer worldwide, including Thailand, and mainly affects older women. Persistent high risk type infection of human papillomavirus (HPV) is the one important factor for developing cancer. In this study, we focused on HPV DNA investigation and type-specific distribution of HPV in 25 formalin-fixed paraffin-embedded (FFPE) samples collected from Thai women with vulva cancer histologically confirmed by the National Cancer Institute, Thailand, during 2003-2011. HPV DNA detection and genotyping were undertaken with polymerase-chain reaction and enzyme-immunoassay using GP5+/bio6+ consensus specific primers and digoxigenin-labeled specific oligoprobes, respectively. Human ${\beta}$-globin genes was used as the internal control. Our results showed that 44% (11/25) of all vulva cancer samples were HPV-positive. All of them are high risk HPV type infection, detected as single (63.64%, 7/11) and/or double infections (4/11, 36.36%). HPV 16 was the most common type identified in vulva cancer, followed by HPV 35, 33, 18 and 58. In conclusion, this study presented that HPV-16 is observed at the highest frequency in this cancer, similar to cervical cancer, with HPV 18 being less frequent. Although the sample size was small and could not represent overall incidence and prevalence in Thai women, these preliminary data for vulva cancer are of interest since they reinforce the necessity for HPV screening or vaccination in Thailand.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.17
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• pp.7929-7933
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• 2015

Background: The incidence of breast cancer in India is on the rise and is rapidly becoming the number one cancer in females, pushing the cervical cancer to the second position. Most of the predisposition to hereditary breast and ovarian cancer has been attributed to inherited defects in two tumor suppressor genes BRCA1 and BRCA2. Alterations in these genes have been reported in different populations, some of which are population-specific mutations showing founder effects. Two specific mutations in the BRCA1 (185delAG) and BRCA2 (6174delT) genes have been reported to be of high prevalence in different populations. The aim of this study was to estimate the carrier frequency of 185delAG and 6174delT mutations in eastern Indian breast cancer patients. Materials and Methods: We selected 231 histologically confirmed breast cancer patients from our tertiary cancer care center in eastern India. Family history was obtained by interview or a self-reported questionnaire. The presence of the mutation was investigated by allele specific duplex/multiplex-PCR on genomic DNA extracted from peripheral blood. Results: A total of 231 patients (age range: 26-77 years), 130 with a family history and 101 without were screened. The two founder mutations 185delAG in BRCA1 and 6174delT in BRCA2 were not found in any of the subjects. This was confirmed by molecular analysis. Conclusions: Our findings suggest that these BRCA mutations may not have a strong recurrent effect on breast cancer among the eastern Indian population. The contribution of these founder mutations to breast cancer incidence is probably low and could be limited to specific subgroups. This may be particularly useful in establishing further pre-screening strategies.

• Journal of the Korea Convergence Society
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• v.13 no.1
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• pp.119-129
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• 2022

Cervical cytology has been widely used as a screening tool for cervical cancer. However, Human papillomavirus (HPV) detection and subtype testing are suggested to overcome the high false-negative rate associated with cytology. We aimed to investigate the clinical usefulness and infection rate in the HPV polymerase chain reaction (PCR) test performed in hospitals. HPV PCR data from 217 patients were analyzed. Analysis of variance revealed a significant difference in the infection rate among different age groups (P=0.015). The biopsy results showed that epithelial cell abnormalities and high HPV-positivity rate was observed in 1 (100%) subject aged <29 years, in 4 out of 5 (80%) patients in their 30s, and in 3 out of 4 (75%) patients aged ≥70 years. The prevalence of HPV infection was very high (46.1%). The highest prevalence (87.5%) was observed among patients in their <29, followed by those in their 30s (67.7%) and those in their 40s (31.9%).A high rate of epithelial cell abnormalities (≥ cervical intraepithelial neoplasia type 1, mild dysplasia) was observed in HPV-infected women aged<30 years. Therefore, extensive research and prevention activities are needed in this age group. HPV PCR testing is recommended to complement cervical cytology