• Asian Pacific Journal of Cancer Prevention
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• 제14권7호
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• pp.4387-4392
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• 2013

Projection of load of cancer mortality helps in quantifying the burden of cancer and is essential for planning cancer control activities. As per our knowledge, there have not been many attempts to project the cancer mortality burden at the country level in India mainly due to lack of data on cancer mortality at the national and state level. This is an attempt to understand the magnitude of cancer mortality problem for the various calendar years from 2011 to 2026 at 5-yearly intervals. Age, sex and site-wise specific cancer mortality 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 mortality rates were obtained by taking weighted average of these six registries with respective registry populations as weights. The pooled mortality rates were assumed to represent the country's mortality rates. Populations of the country according to age and sex exposed to the risk of cancer mortality in different calendar years were obtained from the report of Registrar General of India providing population projections for the country for the years from 2011 to 2026. Population forecasts were combined with the pooled mortality rates to estimate the projected number of cancer mortality 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 cancer-leading sites as well as for 'all sites' of cancer. The results revealed that an estimated 0.44 million died due to cancer during the year 2011, while 0.51 million and 0.60 million persons are likely to die from cancer in 2016 and 2021. In the year 2011 male mortality was estimated to be 0.23 million and female mortality to be 0.20 million. The estimated cancer mortality would increase to 0.70 million by the year 2026 as a result of change in size and composition of population. In males increase will be to 0.38 millions and in females to 0.32 millions. Among women, cancer of the breast, cervical and ovary account for 34 percent of all cancer deaths. The leading sites of cancer mortality in males are lung, oesophagus, prostrate and stomach. The above results show a need for commitment for tackling cancer by reducing risk factors and strengthening the existing screening and treatment facilities.

• 대한두경부종양학회지
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• 제11권2호
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• pp.145-152
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• 1995

A retrospective analysis was performed to ascertain the relationship between the treatment modalities and their treatment results. From July 1980 to June 1993, 115 patients with squamous cell carcinoma of the maxillary sinus were: treated at the Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University. There were 88 men and 27 women with median age of 57 years. According to AJCC TNM system of 1992. eight patients of T2, 54 patients of T3 and 53 patients of T4 were available, respectively. Cervical lymph node metastases at diagnosis was observed in 11 patients. 87 patients were treated with radiotherapy and 28 patients were treated with combination of surgery and radiotherapy. The overall 5 year survival rate was 32 %, patients that were treated with radiotherapy alone had a 5 year survival rate 24.3 % and patients who were treated with combination of surgery and radiation therapy had a 5 year survival rate of 52.8 % (p<0.05). Combination of surgery and radiotherapy resulted in a better treatment modality for squamous cell carcinoma of the maxillary sinus. Improved radiotherapy technique and development of multimodality treatment are needed to improve the local control and the survival rate in patients with advanced maxillary sinus carcinoma.

• Journal of Korean Neurosurgical Society
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• 제59권4호
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• pp.392-399
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• 2016

Objective : Brain metastases in gynecologic cancer (ovarian, endometrial, and cervical cancer) patients are rare, and the efficacy of Gamma Knife Radiosurgery (GKRS) to treat these had not been evaluated. We assessed the efficacy of GKRS and prognostic factors for tumor control and survival in brain metastasis from gynecologic cancers. Methods : This retrospective study was approved by the institutional review board. From May 1995 to October 2012, 26 women (mean age 51.3 years, range 27-70 years) with metastatic brain tumors from gynecologic cancer were treated with GKRS. We reviewed their outcomes, radiological responses, and clinical status. Results : In total 24 patients (59 lesions) were available for follow-up imaging. The median follow-up time was 9 months. The mean treated tumor volume at the time of GKRS was $8185mm^3$ (range $10-19500mm^3$), and the median dose delivered to the tumor margin was 25 Gy (range, 10-30 Gy). A local tumor control rate was 89.8% (53 of 59 tumors). The median overall survival was 9.5 months after GKRS (range, 1-102 months). Age-associated multivariate analysis indicated that the Karnofsky performance status (KPS), the recursive partitioning analysis (RPA) classification, and the number of treated lesions were significant prognostic factors for overall survival (HR=0.162, p=0.008, HR=0.107, p=0.038, and HR=2.897, p=0.045, respectively). Conclusion : GKRS is safe and effective for the management of brain metastasis from gynecologic cancers. The clinical status of the patient is important in determining the overall survival time.

• 한국광학회지
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• 제18권5호
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• pp.367-372
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• 2007

자궁경부 상피이형성증(cervical dysplasia)은 세포핵/세포질(nuclear/cytoplasmic, N/C) 면적비의 변화를 포함하는 자궁경부 상피에서의 형태학적 변화를 일으킨다. 세포핵은 중요한 산란 원인중에 하나이기 때문에 N/C 면적비의 변화는 깊이에 따른 원형 편광장도를 반영한다. 따라서 우리는 편광 민감 광결맞음 단층촬영장치(polarization-sensitive optical coherence tomography, PS-OCT)를 이용하여 산란에 의해 발생하는 편광의 변화를 측정하였다. 자궁 경부 조직 샘플은 고등급 상피내종양(high-grade squamous intraepithelial, H-SIL)을 가진 한 명의 환자와 정상인 네 명의 환자에게서 얻어졌다. 우리는 자궁경부의 깊이에 따른 원형 편광의 유지 정도(degree of circular polarization, DOCP) 평균을 구하였고, 상피층의 깊이에서 최소 제곱 1차 선형 함수(least-square linear fit)를 사용하여 기울기를 획득하였다. 획득된 기울기를 가지고 DOCP의 변화율을 정량화 하였다. 그 결과 H-SIL에서의 DOCP의 감쇄가 정상 조직에서 보다 빠르게 나타남을 확인할 수 있었다. 이는 PS-OCT를 이용하여 산란 변화에 따른 DOCP의 변화율을 측정하는 것이 자궁경부상피 이형성증의 진단을 하는데 있어서 유용한 진단법이 될 수 있음을 의미한다.

• Nuclear Medicine and Molecular Imaging
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• 제42권sup1호
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• pp.110-112
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• 2008

Endometrial carcinoma is one of the most common gynecologic malignancies and which is predominant in postmenopausal women. Clinically many patients are hospitalized in early stage due to clinical sign and symptom such as vaginal bleeding and in this case, patient's prognosis is known to be good. However, considerable number of patients with advanced and relapsed disease reveal poor prognosis. Therefore, exact staging work up is essential for proper treatment as is primary lesion detection. $^{18}F-FDG-PET$ has been widely used for the evaluation of gynecologic malignancies such as cervical carcinoma and ovarian cancer. In contrast, FDG PET application to endometrial carcinoma is limited until now and there is no sufficient data to validate the usefulness of FDG PET for this disease yet. However, several studies showed promising results that FDG PET is sensitive and specific in detection of recurrent or metastatic lesions. Therefore further active investigation in this field can facilitate the use of FDG PET for endometrial carcinoma.

• 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.

• 여성건강간호학회지
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• 제17권4호
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• pp.346-358
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• 2011

Purpose: The purpose of this study was to identify predictors of HPV (Human papillomavirus) vaccination among female university students. Methods: The participants in this study were 1,486 female university students. Data were collected using self-administered questionnaire from september 1, 2010 to June 30, 2011. Data were analysed using descriptive statistics, t-test, $x^2$-test and logistic regression. Results: The rate of HPV vaccination was 7.2%. Factors that influence HPV vaccination included residential region, smoking experience, family history of cervical cancer, experience having heard about the HPV vaccination, awareness that HPV is a sexual disease, HPV knowledge, perceived seriousness, perceived benefit and perceived barrier in health beliefs. Conclusion: The results suggest a need to increase HPV vaccination campaigns to increase awareness of HPV vaccination. University and health care facilities should provide health education emphasizing perceived seriousness and perceived benefits. Also, the national health insurance corporation should consider addressing cost issues as a barrier to HPV vaccination.

• 보건교육건강증진학회지
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• 제25권5호
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• pp.79-92
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• 2008

연구목적: 3년마다 정기적인 자궁경부암 조기검진을 받도록 권고하고 있는 수검권고안은 검진행동 유발요인으로써 자궁경부암 검진참여의 가능성을 증진시키는 주요 영향요인으로 작용하고 있다. 본 연구는 보건의료 접근성과 보건의료인의 특성이 자궁경부암 조기검진 수검권고에 미치는 영향을 살펴보고자 시도되었다. 연구방법: 본 연구에서 재분석된 한인여성 건강조사자료는 미국 캘리포니아주 알라메다와 산타클라라 카운티에 거주하는 한인여성 865명을 대상으로 2002년에 전화설문조사로 수행되었다. 수검권고안에 영향을 미치는 주요 예측인자를 살펴보기 위해 로지스틱 회귀분석을 수행하였다. 연구결과: 조사대상자 중 37.9%만이 지난 3년간 자궁경부암 조기검진 참여에 관한 수검권고를 받은 것으로 나타났다. 수검권고의 주요 예측인자는 건강보험 가입여부, 지난 1년간의 의사방문횟수, 정기적으로 방문하는 보건의료인의 특성인 것으로 나타났다. 또한 보건의료 접근성에서는 공공의료보험 또는 사보험 여부와 관계없이 건강보험에 가입한 여성들이 수검권고를 더 많이 받은 것으로 나타났다. 특히 보건의료인의 특성 중 인종과의 관련성을 살펴보면, 한인이 아닌 타 인종의 여성 의사로부터 가장 많이 검진참여에 관한 수검권고를 받았고(OR=6.21, 95% CI=2.63, 14.66), 다음으로 한인 남성 의사(OR=2.19, 95% CI=1.30, 3.68), 비한인 남성 의사로부터 수검권고를많이 받았다(OR=2.07, 95% CI=1.15, 3.71). 결론: 캘리포니아주의 2개 카운티에서 거주하는 한인여성을 대상으로 보건의료 접근성과 보건의료인의 특성이 자궁경부암 조기검진 수검권고에 미치는 영향을 분석한 결과, 한인여성들의 건강보험 가입여부 및 의사방문 수준, 보건의료인의 인종이 수검권고와 관련이 있는 것으로 나타났다. 이는 한인여성들의 자궁경부암 조기검진 수검률 향상 및 자궁경부암 이환률과 사망률을 감소시키기 위한 수행전략 개발에 중요한 기초자료로 활용될 수 있다.

• Radiation Oncology Journal
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• 제15권2호
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• pp.145-151
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• 1997

목적 : 자궁경부암 환자에서 방사선치료시 방사선조사면내의 골무기물 함량변화를 정상대조군 촉 환자군의 골무기물 함량을 비교하여 방사선이 골무기물에 미치는 영향을 조사하였다. 재료 및 방법 : 120kVp와 80kVp X선을 이용하는 이중에너지 전산화단층 촬영을 이용하여 환자군과 정상대조군에서 제 3, 4 및 제 5 요추의 해면골무기물 함량을 정량적으로 측정하였다. 총인원수는 정상대조군 43명과 환자군 43명으로서 86명이며 각 연령별로는 정상대조군 40대 22명, 50대 10명, 60대 11명이었고, 환자군에서는 40대 14명, 50대 14명, 60대 15명이었다. 방사선조사 부위는 골반과 제 5 요추를 포함하여 치료하였으며 외부방사선량은 45-54Gy였으며, 강내치료는 고선량률로 300y를 조사하였다 결과 : 정상대조군과 환자군의 여성에서 골무기물 함량은 나이가 증가함에 따라 감소함을 보였으며, 환자군은 정상군에 비해 약 $13\%$에서 최대 $40\%$의 감소를 보였다. 환자군에서 방사선 조사부위에 포함되지 않은 제 3, 4 요추의 각각 골무기물 함량은 40대 $119.5\pm30.6,\;117.0\pm31.7$, 50대 $83.3\pm37.8,\;88.3\pm46.8$, 60대 $61.5\pm18.3,\;56.2\pm26.6mg/cc$로 나타났으며, 반면에 정상군은 각각 40대 $148\pm19.9,\;153.2\pm23.2$, 50대 $96.1\pm30.2,\;105.6\pm26.5$ 및 60대 $73.9\[pm27.9,\;77.2\pm27.2mg/cc$를 각각 보였다. 정상군의 요추골의 골무기물함량은 제 5요추가 각연령층에서 가장 높았으며, 제 3, 4 요추는 제 5 요추에 가까울수록 높은 값에 비해 환자군에서는 방사선조사면에 가까울수록 골무기물함량의 감소하는 경향을 보였다. 특히 방사선조사부위인 환자군의 제 5 요추는 전연령층에서 제 3 요추나 제 4 요추에 비해 낮은 골무기물함량을 보였으며, 정상군에 비해서 40대 $33\%$, 50대 $31\%$와 60대 $40\%$의 골무기물함량의 감소를 보여 방사선의 영향에 의한 감소가 현저하였다. 결론 : 환자군의 요추골의 골무기물함량은 정상군에 비해 현저한 감소를 보였으며, 정상대조군의 제 5 요추가 제 3, 4 요추에 비해 높은 골무기물 함량수치를 보인 반면, 환자군에서는 방사선 조사범위에 있는 제 5 요추의 골무기물 함량이 훨씬 낮게 나타나 방사선조사가 요추의 골무기물 함량의 감소에 상당한 영향을 끼침을 알 수 있다.

• Asian Pacific Journal of Cancer Prevention
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• 제14권6호
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• pp.3541-3547
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• 2013

Background: This cross-sectional observational study was undertaken to establish clinico-pathological characteristics of patients with gynecological malignancies, focusing mainly on symptoms, histological type and stage of the disease at presentation, in a tertiary care setting in Eastern India. Materials and Methods: In the gynecology out-patient clinic of a tertiary care hospital in Kolkata, India, the patients with suggestive symptoms of gynecological malignancies were screened. Their diagnoses were confirmed by histopathology. One hundred thirteen patients with histopathologically confirmed gynecological malignancies were interviewed. Results: The most frequently reported symptoms by the patients with histopathologically confirmed gynecological malignancies were excessive, offensive with or without blood stained vaginal discharge (69.0%), irregular, heavy or prolonged vaginal bleeding (36.3%) and postmenopausal bleeding (31.9%). The majority of the patients (61.0%) had squamous cell carcinoma on histopathological examination, followed by adenocarcinoma (30.1%). Nearly half of the patients (48.7%) were suffering from the Federation Internationale des Gynaecologistes et Obstetristes (FIGO) stage III, followed by stage II (40.7%) malignancy. Conclusions: This study highlights that most of the patients with gynecological malignancies present late at an appropriate health care facility. Ovarian cancer may often have non-specific or misleading symptomatic presentation, whereas cervical cancer often presents with some specific symptoms. These observations point to the need for increasing awareness about gynecological malignancies in the community and providing easily accessible adequate facilities for early detection and treatment of the disease by optimal use of available resources, i.e. strengthening the primary health care system.