• Asian Pacific Journal of Cancer Prevention
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• v.17 no.11
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• pp.5011-5017
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• 2016

Background: Cervical cancer is a major public health problem worldwide. There have been several studies indicating that risk is associated with geographic location and that the incidence of cervical cancer has changed over time. In Thailand, incidence rates have also been found to be different in each region. Methods: Participants were women living or having lived in upper Northern Thailand and subjected to cervical screening at Maharaj Nakorn Chiang Mai Hospital between January 2010 and December 2014. Generalized additive models with Loess smooth curve fitting were applied to estimate the risk of cervical cancer. For the spatial analysis, Google Maps were employed to find the geographical locations of the participants' addresses. The Quantum Geographic Information System was used to make a map of cervical cancer risk. Two univariate smooths: x equal to the residency duration was used in the temporal analysis of residency duration, and x equal to the calendar year that participants moved to upper Northern Thailand or birth year for participants already living there, were used in the temporal analysis of the earliest year. The spatial-temporal analysis was conducted in the same way as the spatial analysis except that the data were split into overlapping calendar years. Results: In the spatial analysis, the risk of cervical cancer was shown to be highest in the Eastern sector of upper Northern Thailand (p-value <0.001). In the temporal analysis of residency duration, the risk was shown to be steadily increasing (p-value =0.008), and in the temporal analysis of the earliest year, the risk was observed to be steadily decreasing (p-value=0.016). In the spatial-temporal analysis, the risk was stably higher in Chiang Rai and Nan provinces compared to Chiang Mai province. According to the display movement over time, the odds of developing cervical cancer declined in all provinces. Conclusions: The risk of cervical cancer has decreased over time but, in some areas, there is a higher risk than in the major province of Chiang Mai. Therefore, we should promote cervical cancer screening coverage in all areas, especially where access is difficult and/or to women of lower socioeconomic status.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.14
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• pp.5993-5999
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• 2015

Background: Molecular testing for human papillomavirus (HPV) is the most objective and reproducible of all cervical cancer screening tests and also less demanding in terms of training and quality assurance. However, there is an impending need for cost effective molecular HPV testing methods with sampling ease, easy storage measures and minimum turn around times suitable for a low resource setting. Objective : Our aim was to evaluate the feasibility of using a fast transfer analysis (FTA) mini elute cartridge for cervical sampling to identify high risk HPV by real time PCR and to compare molecular HPV testing and Pap cytology testing to predict histologically confirmed cervical precancer (CIN 2+ lesions) in a cervical cancer prevention program. Materials and Methods: This was conducted as a pilot study (n=200) on women sampled using FTA mini elute cartridges, genotyped by two different real time PCR assays, detecting 13 high risk HPV (HR HPV) species, including HPV16 along with its physical DNA status. Results obtained from each of the tests were compared and analysed using suitable statistical tests. Results: With FTA mini elute cartridge samples HR HPV positivity was seen in 48/200 (24%). Of these, presence of HPV 16 DNA was observed in 28/48 (58.3%) women. High risk HPV was positive in 20% (37/185) of women with benign cytology and 73.3% (11/15) of women with abnormal cytology findings. A very significant correlation (${\chi}^2=22.090$ ; p=0.000) was observed between cytology and HR HPV findings showing an increasing trend of HR HPV prevalence in 50% (1/2) of LSIL, 75% (3/4) of HSIL and 100% (3/3) of SCC. Of the CIN 2+ lesions identified by histopathology, 88.9% (8/9) had HR HPV. A significant association (${\chi}^2=11.223$ ; p=0.001) of HR HPV and histopathologically confirmed CIN 2+ lesions was found. Sensitivity of the two tests were comparable but specificity of Pap testing was better (90.7% vs 70.4%) to predict histopathologically diagnosed cervical precancers. Conclusions: The current study explored the feasibility of using a FTA mini elute cartridge for cervical sampling for the first time in India as a part of a community based cervical cancer prevention program. We suggest that FTA based sampling is suitable and feasible for real time based HPV testing. Molecular HR HPV testing can be more sensitive and useful to identify high risk women requiring Pap testing which is more specific to detect histologically confirmed cervical precancer.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.16
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• pp.7267-7270
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• 2015

Introduction: Kelantan is one of the states in Malaysia which has a high prevalence of type 2 diabetes (DM2). Other than with endometrial carcinoma, the association of DM2 with particular female cancers is not known. Objective: To determine the proportion of breast, cervical, ovarian and endometrial cancers among females with DM2 diagnosed in Hospital Universiti Sains Malaysia (HUSM) over an 11 year period. Materials and Methods: All histologically confirmed cases of breast, endometrial, cervical and ovarian carcinomas admitted to the Hospital were included in the study. The patient diabetic status was traced from the hospital medical records. Results: There was a total of 860 cases of breast, cervical, ovarian and endometrial carcinomas over this period. Breast carcinoma was the commonest, accounting for 437/860 (50.8%) followed by cervix, 159/860 (18.5%), ovarian, 143/860 (16.6%) and endometrial carcinomas, 121/860 (14.1%). Out of these, 228/860 (26.5%) were confirmed diabetics. Endometrial carcinoma patients showed the highest proportion being diabetics, 42.1% (51/121), followed by ovarian cancer, 25.9% (37/143), breast carcinoma, 23.6% (103/437) and cervical cancer 23.3% (37/159). Conclusions: There is a significant proportion of DM2 among women with these four cancers, endometrial carcinoma being the highest followed by ovarian, breast and cervical carcinoma. The rising trend of these four cancers is in tandem with an increasing trend of DM2 in the community. In populations where diabetes is prevalent, screening for epithelial cancers should be rigourous. Diabetic clinics should include screening for these cancers among their female patients and gynecology clinics should screen the women they treat for their diabetes status.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.19
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• pp.8209-8213
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• 2014

Background: Cervical cancer is a common, preventable and manageable disease in women worldwide. Objectives: This study was conducted to determine the cost of follow-up for suspicious precancerous cervical lesions within a screening program using Pap smear or HPV DNA test through the decision tree. Materials and Methods: Patient follow-up processes were determined using standard guidelines and consultation with specialists to design a decision tree model. Costs of treatment in both public and private sectors were identified according to the national tariffs in 2010 and determined based on decision tree and provided services (visits to specialists, colposcopy, and conization) with two modalities: Pap smear and HPV DNA test. The number of patients and the mean cost of treatment in each sector were calculated. The prevalence of lesions and HPV were obtained from literature to estimate the cost of treatment for each woman in the population. Results: Follow-up costs were determined using seven processes for Pap smear and 11 processes for HPV DNA test. The total cost of using Pap smear and HPV DNA process for each woman in the population was 36.1$ and 174$ respectively. Conclusions: The follow-up process for patients with suspicious cervical lesions needs to be included in the existing screening program. HPV DNA test is currently more expensive than Pap smear, it is suggested that we manage precancerous cervical lesions with this latter test.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.12
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• pp.7483-7487
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• 2013

Purpose: Human papillomavirus (HPV) infection plays an important role in the development of cervical cancer, but the prevalence of HPV infection in women of Shenzhen city remains unclear. The present study was performed to describe the change of cervical HPV infection in females who participated in voluntary cervical cancer screening from 2006 to 2010 in Shenzhen city, China. Methods: A total of 4, 413 women were recruited. HPV infections were genotyped by polymerase chain reaction (PCR) and reversed dot blot hybridization in Shenzhen Maternity and Child Health Hospital. Results: The prevalence of HPV infection was 13.8%. The five most commonly found HPV types were HPV16 (3.47%), HPV58 (1.68%), HPV33 (1.38%), HPV43 (1.36%) and HPV18 (1.27%). The secular trends of major HPV type-specific were diverse. Among of them, the prevalence of HPV18 increased sharply while others increased slowly or even decreased in the period. The change of total HPV, single HPV and multiple HPV infection were similar during the five years. Conclusions: Our findings suggested that HPV infection is common with HPV16 and HPV 58 as the primary subtypes in women in Shenzhen city.The prevalence of HPV 18 infection is increasing faster than any others, which will lead it to be one of the main subtypes in this city in the future.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.8
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• pp.4163-4167
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• 2016

Background: Cervical cancer is the second most common in Thailand, but the mortality rate may be rising yearly. It is a cancer that can be prevented by early screening for precancerous lesions, several methods being available. Objective: To identify the prevalence of abnormal Papanicolaou (Pap) smears and lesions with visual inspection with acetic acid (VIA) in pregnant women and assess risk factors for this group. Materials and Methods: This prospective study was performed at Prapokklao Hospital, Thailand during April-July 2016. All pregnant women of gestational age between 12-36 weeks who attended an antenatal clinic were recruited. All participants were screened for cervical cancer by Pap smear and VIA. If results of one or both were abnormal, colposcopic examination was evaluated by gynecologic oncologist. Results: A total of 414 pregnant women were recruited. Prevalence of abnormal Pap smear and VIA were 6.0 and 6.7 percent, respectively. The most common abnormal Pap smear was low grade intraepithelial lesion (LSIL, 44%). Factors associated with abnormal Pap smear in pregnant women were low BMI, multiple partners and being a government officer. In pregnancy, Pap smear had higher sensitivity and specificity than VIA for detection of precancerous cervical lesion. Patients with young coitarche or more than 25 years of active sexual activity were high risk groups. Conclusions: Prevalence of abnormal Pap smear and VIA in pregnant women was 6.0 and 6.7 percent, respectively. Factors associated with abnormal Pap smear were coitarche, years of sexual activity, low BMI, multiple partners and being a government officer.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.1
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• pp.311-314
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• 2016

Background: Nurses play an important role in preventive medicine because they represent the largest sector of health professionals. This role is very crucial in developing countries, which are going through rapid societal and economic changes, associated with a rising burden of cancers due to different risk factors. The current study aimed to compare health awareness between nurses and healthy women regarding preventive gynecological examinations and to answer the question - can nurses make a difference in women's health? Materials and Methods: This cross sectional research included a total of 150 women, 70 nurses and 80 healthy women, randomly selected. Data were collected in 2014 in Vlora city through a self-administered questionnaire that assessed different variables about preventive gynecological examinations. Results: Cervical screening rates were 20.3% and 41.8%, respectively, for nurses and healthy women, despite the former having a statistical significant greater knowledge of risk factors and symptoms. Conclusions: Even if the health awareness of nurse participants can be considered good, they need themselves to increase participation rates in cervical screening if they are to provide role models for health education/promotion addressing misconceptions and barriers.

• Journal of Korean Traditional Oncology
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• v.21 no.1
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• pp.1-14
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• 2016

The incidence rate of cervical cancer in Korea is still higher than in other developed countries, notwithstanding the national mass screening program. Cervical cancer prognosis is good due to an effective treatment such as surgery or radiation therapy, concurrent chemotherapy in the early stage. However, it is still a poor prognosis when advanced stage or recurrent. Some studies said that combined oriental and western medicine can improve the survival, quality of life, immune function, and decrease side effects in cervical cancer. In the western medical part, clinical practice guideline was published in 2006, 2007 and 2010 in Korea. In China, oriental medicine clinical practice guideline have been published in 2014. But there is no Korean medicine clinical practice guideline. This study will introduce the methods of diagnosis and the medical therapeutics which is commonly utilized for cervical cancer in Korea, and existing Korean medicine clinical practice guideline for Disease Analysis and Treatment (辨證論治). This study will be a meaningful study to establish clinical practice guidelines of Korean Medicine for cervical cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.5
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• pp.1719-1724
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• 2015

Background: Breast and cervical cancers are the most common types of cancer in women worldwide. Previous studies in Asia have shown that related knowledge and awareness is low among female university students. The goal of this study was to assess breast and cervical cancer knowledge, practices, and awareness among female university students in Samsun,Turkey. Materials and Methods: This research was a cross-sectional survey of female university students using a self-administered. questionnaire to investigate participant awareness and knowledge of breast and cervical cancer. A total of 301 female university students participated. Descriptive statistics and chi square tests were used for data analysis. Results: The mean age of the participants in this study was $22.0{\pm}5.91$ years. Regarding family history, 89.7 % of the students had no known familial history of breast cancer. Students (65.4%) had knowledge about breast self examination and 52.2 % of them had performed breast self examinationm while 55.1% of them had knowledge about prevention of cervical cancer. Conclusions: Although the results are preliminary, the study points to an insufficient knowledge of university students in Samsun about breast and cervical cancer.

• Imaging Science in Dentistry
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• v.30 no.4
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• pp.259-263
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• 2000

Purpose: Upper cervical vertebrae are commonly imaged together with the jaw bones in panoramic radiography. There have been many studies investigating the possible role of mandible as an indicator of osteoporosis. But the result doesn't show unanimity. This study measured bone densities of mandible and second and third cervical vertebrae to find out any relationship between these two areas. These results may contribute in panorama being used as a screening method in detecting possible osteoporotic patient. Materials and Methods: Randomly selected 226 digitized panoramic images with cervical vertebrae shadows from 156 dental patients between 5 to 80 years of age were used. And the bone densities of second and third cervical vertebrae, apical areas of first and second mandibular molars and interdental areas were measured. The bone density measurements were restricted to the cancellous bone and the average and standard deviations and paired t-tests were done to each measurements. Results: All the measurements were statistically significantly related. The best relationship was found between the third cervical vertebrae and first and second mandibular apical areas. The average and standard deviations of the measured bone density ratios of these areas were 1.20±0.45 and 1.34±0.48 each. Conclusion: Patients whose panoramic bone density of the third cervical vertebrae are much below those of mandibular first or second molar apical areas may have osteoporosis.