• Asian Pacific Journal of Cancer Prevention
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• 제17권8호
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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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• 제14권3호
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• pp.2119-2125
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• 2013

Background: The aim of the study was to determine risk factors for cervical cancer for women in Izmir. Methods: This cross-sectional, descriptive field covered a population of 4319 women of reproductive age (15-49) (household registration in the Mukhtar's office-2007). A total of 1,637 women were included in the sample given a four-part questionnaire through face-to-face interview by visiting the women in their homes in order to determine socio-demographic factors, obstetric history, genital hygiene and the use of family planning methods. In addition, during the data collection process, the women were given group training in order to raise awareness of cervical cancer. The number and percentage distributions of the data were calculated. Results: While the average age of the women was $31.9{\pm}9.77$ (Min: 15.00-Max: 49.00), education level of 43.4% of them was elementary school only. It was determined that 70.3% of the women experienced at least one pregnancy, 71.0% had vaginal delivery and 75.9% used a contraceptive method. In the study it was determined that among the cervical cancer related risks vaginal delivery, vaginal lavage and having three or more pregnancies had the highest rates, while having sexual intercourse before 16 years of age and having more than one sexual partner constituted lower rates. The rate of the women who stated not having a smear in the last three years was 82.4%. Conclusions: Considering the case in terms of having Pap smear test, women's awareness on the risk factors and early diagnosis of cervical cancer was found to be low. Due to this reason, awareness of women has to be raised through education.

• Asian Pacific Journal of Cancer Prevention
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• 제15권8호
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• pp.3753-3756
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• 2014

Background: Cervical cancer is relatively common in Thai women, but the proportion of females receiving Pap smear screening is still low. Objective: The purpose of this cross-sectional study was to study factors related to cervical cancer screening uptake by Hmong hilltribe women in Lomkao District, Phetchabun Province. Materials and Methods: Interview data were collected from 547 of these women aged 30-60 years living in the study area and analyzed using multiple logistic regression. Results: The results showed that 64.9% of the study sample had received screening, and that 47.2% had attended due to a cervical screening campaign. The most common reason given for not receiving screening was lack of time (21.4%). The factors found to be positively associated with uptake (p value <0.05) were as follows: number of years of school attendance (OR=1.56, 95%CI:1.02-2.38), animistic religious beliefs (OR=0.55, 95%CI:0.33-0.91), a previous pregnancy (OR=6.20, 95%CI:1.36-28.35), receipt of information about cervical cancer screening (OR=2.25, 95%CI:1.35-3.76), and perceived risk of developing cervical cancer (OR=1.83, 95%CI:1.25-2.67). Conclusions: To promote the uptake of cervical screening, Hmong hilltribe women need to know more about cervical cancer and cervical cancer screening, and access to screening services should be provided in conjunction with existing everyday services, such as family planning and routine blood pressure monitoring or diabetes services.

• Asian Pacific Journal of Cancer Prevention
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• 제16권2호
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• pp.731-736
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• 2015

Background: Little is known about the news coverage of cancer risk factors in Korea. This study aimed to examine how the news media encompasses a wide array of content regarding cancer risk factors and related cancer sites, and investigate whether news coverage of cancer risk factors is congruent with the actual prevalence of the disease. Materials and Methods: A content analysis was conducted on 1,138 news stories covered during a 5-year period between 2008 and 2012. The news stories were selected from nationally representative media in Korea. Information was collected about cancer risk factors and cancer sites. Results: Of various cancer risk factors, occupational and environmental exposures appeared most frequently in the news. Breast cancer was mentioned the most in relation to cancer sites. Breast, cervical, prostate, and skin cancer were overrepresented in the media in comparison to incidence and mortality cases, whereas lung, thyroid, liver, and stomach cancer were underrepresented. Conclusions: To our knowledge, this research is the first investigation dealing with news coverage about cancer risk factors in Korea. The study findings show occupational and environmental exposures are emphasized more than personal lifestyle factors; further, more prevalent cancers in developed countries have greater media coverage, not reflecting the realities of the disease. The findings may help health journalists and other health storytellers to develop effective ways to communicate cancer risk factors.

• Asian Pacific Journal of Cancer Prevention
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• 제15권15호
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• pp.6353-6356
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• 2014

Background: The purpose of this study was to investigate and evaluate risk factors for lymph node metastases (LNM) in cases of endometrial cancer (EC). Materials and Methods: A retrospective single institution analysis of patients surgically staged for EC at Ankara Oncology Education and Research Hospital from 1996 to 2010 was performed. Roles of prognostic factors, such as age, histological type, grade, depth of myometrial invasion, cervical involvement, peritoneal cytology, and tumor size, in the prediction of LNM were evaluated. Fisher's exact test and logistic regression analysis were used to assess the effects of various factors on LNM. Results: LNM was observed in 22 out of 247 patients (8.9%) and was significantly more common in the presence of tumors of higher grade, deep myometrial invasion (DMI), cervical involvement, size >2cm, and with positive peritoneal cytology. Logistic regression analysis revealed that DMI remained the only independent risk factor for LNM. NPV, PPV, sensitivity, and specificity for satisfying LNM risk were 98.0, 19.5, 86.3, and 65.3%, respectively for DMI. Conclusions: The incidence of LNM is influenced independently by DMI. If data support a conclusion of DMI, LND should be seriously considered.

• Asian Pacific Journal of Cancer Prevention
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• 제16권14호
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• pp.5733-5739
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• 2015

The primary objective of this study was to assess the knowledge of medical students and determine variation between different cultural groups. A secondary aim was to find out the willingness to pay for cervical cancer vaccination and the relationships between knowledge and attitudes towards Human Papillomavirus vaccination. A cross-sectional survey was conducted in a private medical university between June 2014 and November 2014 using a convenient sampling method. A total of 305 respondents were recruited and interviewed with standard questionnaires for assessment of knowledge, attitudes and practice towards human papilloma virus and their willingness to pay for HPV vaccination. Knowledge regarding human papilloma virus, human papilloma virus vaccination, cervical cancer screening and cervical cancer risk factors was good. Across the sample, a majority (90%) of the pupils demonstrated a high degree of knowledge about cervical cancer and its vaccination. There were no significant differences between ethnicity and the participants' overall knowledge of HPV infection, Pap smear and cervical cancer vaccination. Some 88% of participants answered that HPV vaccine can prevent cervical cancer, while 81.5% of medical students said they would recommend HPV vaccination to the public although fewer expressed an intention to receive vaccination for themselves.

• Asian Pacific Journal of Cancer Prevention
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• 제17권9호
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• pp.4301-4306
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• 2016

Background: Cancer is a burden on humanity and ranks as a leading cause of morbidity and mortality in China. Shanxi province has its unique cancer patterns and the burden is increasing. In this study, we aimed to assess the pattern of dietary habits and life-style in Shanxi, a high-risk area for upper gastrointestinal cancers in China and further evaluate the trends in cancer incidence and mortality based on registered data. Materials and Methods: Data on lifestyle, diet, physical activity were obtained from the household health survey at Zhongyang from 2013 to 2015. Cancer diagnoses were reported to Shanxi Center for Disease Control and Prevention (SCDCP). Population-based cancer incidence data and mortality data of 2012 were collected from the SCDCP. All incidence and death rates were expressed per 100,000 populations. Univariate analysis was performed using the Chi-squared test or Fisher's exact test. Results: Overall, deficiencies in fresh fruits and vegetable food, and intake of hot food, salted food, or pickled food are serious problems in Shanxi, especially in rural areas. Upper gastrointestinal cancers were the most commonly diagnosed cancers, and the incidence in rural areas is higher than those in urban areas. Cervical cancer is the most common cancer for females. Moreover, the agespecific incidence exhibited an increased trend before 40 years old. Consistent with the previous literature, our epidemiological investigation results suggest that lifestyle, nutrition deficient, and infections were major risk factors for upper gastrointestinal cancers or cervical cancer in Shanxi. Facing a serious situation, we further explored defensible recommendations for the general public in order to promote changes in environments that support healthful eating and physical activity habits, to reduce cancer risk. Conclusions: Our results present the current cancer trends in Shanxi and its related etiologic risk factors and provide a theoretical basis to guide public health efforts to prevent and control cancers in the province.

• Asian Pacific Journal of Cancer Prevention
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• 제15권14호
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• pp.5781-5785
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• 2014

Background: As in other developing countries, cervical cancer is the most frequent gynecologic malignancy in Indonesia. Persistent high risk genotypes of human papillomavirus (HPV) that infect the cervical tissue have been established as the etiology of cervical cancer. This study aimed to explore the profile of cervical cancer patients and the infected HPV genotypes at Dr. Hasan Sadikin General Hospital-Bandung. Materials and Methods: During the year 2010, 554 cervical cancer patients were registered. In a subset of the patients during July - November 2010, 40 randomized fresh biopsies were tested for HPV genotype after obtained informed consent. The distribution of HPV genotypes and the association to risk factors were analysed. Results: The result showed that 62.5% of the tested biopsies were infected by multiple HPV infections, with HPV-16 found in most of the cervical cancer patients (90%). Marriage at age younger than 16 years old was statistically significant in relation to multiple HPV infection (p=0.003), but not parity more than three times (p=0.59). Conclusions: Although high paritiy in our study was not associated with multiple HPV infection, good family planning programs and reproductive health education need to be emphasized in Indonesia as high parity and marriage at young age might increase the chance of cervical cancer development.

• Asian Pacific Journal of Cancer Prevention
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• 제17권7호
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• pp.3147-3153
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• 2016

Background: Many strategies are required for cervical cancer reduction e.g. provision of education cautious sexual behavior, HPV vaccination, and early detection of pre-invasive cervical lesions and invasive cancer. Basic health data for cervical cytology/ HPV DNA and associated factors are important to make an appropriate policy to fight against cervical cancer. Aims: To assess the prevalence of abnormal cervical cytology and/or HPV DNA and associated factors, including sexual behavior, among Bangkok Metropolitan women. Materials and Methods: Thai women, aged 25-to-65 years old, had lived in Bangkok for ${\geq}5$ years were invited into the study. Liquid-based cervical cytology and HPV DNA tests were performed. Personal data were collected. Main Outcomes Measures: Rates of abnormal cytology and/ or high-risk HPV (HR-HPV) and factors associated with abnormal test (s) were studied. Results: Abnormal cytology and positive HR-HPV were found in 6.3% (279/4442 women) and 6.7% (295/4428), respectively. The most common abnormal cytology was ASC-US (3.5%) while the most common HR-HPV genotype was HPV 16 (1.4%) followed by HPV 52 (1.0%), HPV 58 (0.9%), and HPV 18 and HPV 51 at equal frequency (0.7%). Both tests were abnormal in 1.6% (71/4428 women). Rates of HR-HPV detection were directly associated with severity of abnormal cytology: 5.4% among normal cytology and 13.0%, 30.8%, 40.0%, 39.5%, 56.3% and 100.0% among ASC-US, ASC-H, AGC-NOS, LSIL, HSIL, and SCC, respectively. Some 5% of women who had no HR-HPV had abnormal cytology, in which 0.3% had ${\geq}$ HSIL. Factors associated with abnormal cytology or HR-HPV were: age ${\leq}40$ years, education lower than (for cytology) or higher than bachelor for HR-HPV), history of sexual intercourse, and sexual partners ${\geq}2$. Conclusions: Rates for abnormal cytology and HR-HPV detection were 6.3% and 6.7% HR-HPV detection was directly associated with severity of abnormal cytology. Significant associated factors were age ${\leq}40$ years, lower education, history of sexual intercourse, and sexual partners ${\geq}2$.

• Asian Pacific Journal of Cancer Prevention
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• 제14권11호
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• pp.6389-6392
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• 2013

Background: Cervical cancer is one of the ten most frequent cancers in Turkey. We here examined knowledge about cervical cancer in relation to Papanicolaou (Pap) testing among female primary health care workers in Hatay, a city is located in the south of Turkey. Materials and Methods: The study was completed on 261 women healthcare workers who were or had been sexually active and who accepted to participate to the study. The participants gave verbal informed consent and thereafter questionnaires prepared by the investigators were administered by personal interview. Results: Only 30.3% (n=79) of the participants regularly had a gynecologic examination. While 87.4% (n=228) of the participants reported that they had already heard about the Pap smear test, only 45.2% (n=118) had undergone this test. It was determined that had undergone an average of $1.66{\pm}0.89$ times (1-4) within the last five years. Some 56.0% (n=117) of the participants were well informed about the Pap smear test (p<0,001) and 81.1% (n=63) of the participants who regularly had gynecological examinations (p<0,001) had this test. Conclusions: For the early diagnosis of the cervical cancer, regularly having a Pap smear test is crucial. Healthcare workers should also demonstrate sensitivity about this issue. We think that the importance of the issue should be re-highlighted by organizing in-service training for female primary healthcare workers. Studies are warranted to determine the psychosociological factors that cause individuals to not have the test.