Purpose: 1) to construct cohorts according to risk scores calculated with the Gail Breast Cancer Risk Assessment Tool (Gail et al., 1989) (Gail) and the Breast Cancer Risk Appraisal (Lee et al,. 2003) (Lee) 2) to identify the distribution of risk factors and preventive behavior stages between the cohorts 3) to identify abnormal breast conditions in risk cohort. Method: Using convenience sampling, 775 rural women were selected. Risk appraisal was scored using Gail and Lee. Preventive behavior stages for BSE (Breast self examination) and mammography were measured using 4 stages of the Transtheoretical Model (Prochaska & DiClemente, 1983). Results: 1) The risk cohort according to Gail was 12.3% (n=95), and Lee, 3.1% (n=24). 2) There were significant differences in the distribution of risk factors (age, family history, age at 1st live birth, age at menarche, number of breast biopsy, history of breast disease, and breast-feeding) between cohorts. 3) There was a significant difference in the distribution of the stage of BSE according to Lee. 4) Six women in the risk group detected masses or nodules and physician consultation and ultrasonography were recommended. Conclusion: On the basis of the constructed cohorts, further longitudinal studies of cohorts are recommended with interventions according to characteristics of cohorts.
Objectives : To examine the screening rate of cervical cancer in women and to find out the predictive factors for participation in cervical cancer screening programs within their life-time and within the last two years. Methods : The data was based on self-reported questionnaires from 1,613 women whose ages ranged from 26 to 60 years; this survey was peformed between December 1999 and January 2000. This study analyzed the predictive factors for participation in cervical cancer screening programs within their life-time and within the last two years. A logistic regression analysis was performed in order to derive the significant variables from the predisposing factors(demographic factor, health promotion behavior, reproductive factor), intervention factors(information channel, relation with medical stan, and proximal factors(attitude, social influence, self-efficacy). All analyses were peformed by the PC-SAS 6.12. Results : Our analyses showed that the screening rate for the women who received a cervical cancer screening(Pap smear) more than once within their life-time was 56.1% while those who had received one within the last two years was 34.5%. The significant factors for participation in cervical cancer screening program within their life-time were their income, married age, health promotion score, relation with medical staffs, social influence, and self-efficacy. On the other hand, age, number of pregnancies, menarche age, relation with medical staffs, social influences, and self-efficacy were significant factors for those being screened within the last two years. The predictive power of the logit model within their life-time was 68.8% and that within the last two years was 66.6%. Conclusion : The predictive factors for participation in cervical cancer screening program within their life-time are different from those for within the last two years. and that women's relations with medical staffs and social influences were the critical factors impacting on cervical cancer screening rates.
Background: Breast cancer is the second most cause of death (1.38 million, 10.9% of all cancer) worldwide after lung cancer. In present study, we assess the knowledge, level of awareness of risk factors and screening practices especially breast self examination (BSE) among women, considering the non-feasibility of diagnostic tools such as mammography for breast screening techniques of breast cancer in the holy city Varanasi, Uttar Pradesh, India. Materials and Methods: A cross-sectional population based survey was conducted. The investigation tool adopted was self administrated questionnaire format. Data were analysed using SPSS 20 version and Chi square test to determine significant association between various education groups with awareness and knowledge, analysis of variance was applied in order to establish significance. Results: The attitude of participants in this study, among 560 women 500 (89%) responded (age group 18-65 years), 53.8% were married. The knowledge about BSE was very low (16%) and out of them 15.6% were practised BSE only once in life time. study shown that prominent age at which women achieve their parity was 20 yrs, among 500 participants 224 women have achieved their parity from age 18 to 30 yrs. Very well known awareness about risk factors of breast cancer were alcohol (64.6%), smoking (64%) and least known awareness risk factors were early menarche (17.2%) and use of red meat (23%). The recovery factors of breast cancer cases were doctors support (95%) and family support (94.5%) as most familiar responses of the holy city Varanasi. Conclusions: The study revealed that the awareness about risk factors and practised of BSE among women in Varanasi is extremely low in comparison with other cities and countries as well (Delhi, Mumbai, Himachal Pradesh, Turkey and Nigeria). However, doctors and health workers may promote the early diagnosis of breast cancer.
Mejri, N.;Boussen, H.;Labidi, S.;Bouzaiene, H.;Afrit, M.;Benna, F.;Rahal, K.
Asian Pacific Journal of Cancer Prevention
/
제16권3호
/
pp.1277-1280
/
2015
Aim: To report epidemiologic and anatomoclinical transitions of inflammatory breast cancer (IBC) in Tunisia. Materials and Methods: Data including clinico-pathological data for 208 cases of T4d or PEV 3 non-metastatic breast cancer diagnosed between 2005 and 2010 were collected from patient records. Chi2 and Z tests were used to compare variables with two Tunisian historical series and a series about Arab-American patients. Results: Thirty three percent of our patients had their first child before 23 years of age and 56% had their menarche before 12 years, 75% never receiving oral contraception. Obesity was observed in 42% of women and IBC occurred during pregnancy in 13% of cases. Tumor grade was II-III in 90% of cases, HR was negative in 52%, HER2 was over expressed in 31% and invasion of more than 3 axillary nodes occurred in 18% of patients. We observed a pCR rate of 19% after neoadjuvant treatment (anthracyline-taxane used in 79%, trastuzumab in 27% ). Compared to historical Tunisian series (since 1996), IBC epidemiology remained stable in terms of median age, menopausal status and obesity. However we observed a significant decrease in median clinical tumor size and number of positive axillary lymph nodes. Comparison to IBC in Arab-Americans showed a significant difference in terms of median age, menopausal status, positivity of hormonal receptors and educational level. Conclusions: Our assessment of epidemiologic transition showed a reduction of clinco-pathological stage of IBC, keeping the same characteristics as compared to Tunisian historical series over a period of 14 years. Features seem to be different in Arab-American patients, probably related to migration, "occidentalization" of life style and improvement in socio-economic level.
Serum tumor marker CA15-3 is widely used in follow-up for assessment of breast cancer prognosis. The aim of this study was to evaluate levels among healthy females and patients, to assess differences with tumor stage and grade, and to determine the relationship with estrogen and progesterone receptor expression. One hundred and thirty six Jordanian females were enrolled in this study: Forty-five were healthy females; seventy-two were diagnosed with breast cancer and nineteen diagnosed with benign breast lesions. Elevated serum CA15-3 level was significantly observed among breast cancer patients ($37.95{\pm}6.65$) compared to both healthy ($14.97{\pm}0.8$) and benign females ($12.30{\pm}1.55$), but no significant association was detected between serum CA15-3 level and age of cancer onset, menarche age, menopause age, parity and BMI. Decreased CA15-3 level was significantly associated with hormone therapy and oral contraceptive consumption among breast cancer patients. Significantly elevated CA15-3 serum levels were found among grade II, III and stage II and III breast cancer females compared to normal healthy females. Elevated CA15-3 serum levels were also found among ER+/PR+($54.242{\pm}7.89$) and ER+/PR-($37.08{\pm}8.22$) compared to healthy control females.
Purpose: McCune-Albright syndrome (MAS) is caused by activating mutations in the GNAS gene, resulting in peripheral precocious puberty, caf$\acute{e}$-au-lait spots, and polyostotic fibrous dysplasia (POFD). The aim of the present study was to describe the diverse clinical and endocrine characteristics of patients with MAS. Methods: Seven patients with MAS were included in this study and medical charts were reviewed retrospectively for following parameters: patient's sex and age at diagnosis, POFD, ovarian cysts, and precocious puberty. Results: The mean age at diagnosis was $5.8{\pm}4.2$ years. One patient was male (14%) and the other six patients were female (86%). Peripheral precocious puberty was associated with 6 patients (86%). Five patients manifested premature menarche as early as 2 to 5 years of age. Letrozole was administered to 4 patients, tamoxifen to one patient and GnRH agonist to one patient. Five females developed ovarian cysts. Thyroid function tests were performed in all patients and one patient showed hyperthyroidism (14%) and has been treated with methimazole. One patient presented with pseudohypoparathyroisdism, phosphaturia, calciuria suggesting hypophosphatemic rickets. Six patients (86%) revealed POFD. One patient had symptoms of optic nerve compression and secondary esotropia and 2 patients had bone pain. Conclusion: This study described clinical characteristics and endocrine complications of patients with MAS. Careful physical examinations with history taking and serial endocrine function tests should be needed to detect complications such as endocrinologic hyperfunction and POFD.
본 연구의 목적은 국민건강영양조사 2016-2019년 자료 중 성인을 대상으로 대사증후군의 위험요인 탐색하고, 성별에 따른 위험요인의 차이를 규명하여 대사증후군 예방 및 치료에 기초자료로 제공하기 위함이다. 다양한 선행연구를 통해 대사증후군 위험요인을 수집하고, 4개의 머신러닝(Logistic Regression, Decision Tree, Naïve Bayes, Random Forest)의 방법을 이용하여 분석하였다. 남성과 여성 모두에서 Random Forest의 대사증후군 예측 정확도가 높았다. 대사증후군 유병에 영향을 주는 상위 위험요인으로는 여성과 남성 모두에서 BMI, 식이(지방, 비타민 C, 비타민 A, 단백질, 에너지 섭취), 기저질환의 개수, 연령으로 나타났다. 여성의 경우 교육수준과 초경 연령, 폐경 여부가 추가적으로 주요 위험요인으로 나타났고, 남성에 비해 연령과 기저질환의 개수에서 영향력이 큰 것으로 나타났다. 대사증후군을 예방하기 위해선 BMI, 식이, 질환의 이환, 초경 및 폐경여부를 고려하여 접근해야하며 후속 연구를 통해 다양한 중재 전략을 수립하고 검증해야 할 것이다.
To determine the relationships between soybean food intake, dietary isoflavone intake, and osteoporosis incidence, questionnaire surveys, bone mineral density measurements, and dietary surveys by food record were performed with 19 postmenopausal women ($57.6{\pm}7.3$ yrs of age) in Daejeon city. The subjects were divided into two groups: an 'osteoporosis group' (OG, n=10) and a 'normal group' (NG, n=9). Mean age, height, and body weight were similar between the two groups but BMI was higher in OG than in NG. Mean age at menarche was not different between the two groups. However, mean number of childbirths was greater in OG than in NG and mean total period of lactation was shorter in OG. Mean exercise time per week was similar between the two groups, and mean time of sunlight exposure tended to be shorter in OG. Mean daily intake of calcium was lower in OG whereas sodium intake was higher in OG. Mean daily intakes of total soybean food (OG: $203.8{\pm}84.6\;g/d$, NG: $285.0{\pm}146.3\;g/d$) and total dietary isoflavone (OG: $29.1{\pm}14.3\;mg/d$, NG: $38.3{\pm}23.1\;mg/d$) were not different between the two groups. However, greater intakes of soybean food and dietary isoflavone were associated with higher bone mineral density, respectively. The above results indicate that osteoporosis incidence tends to be influenced by BMI, maternal factors, dietary nutrient intakes, soybean food intakes, and dietary isoflavone intakes in postmenopausal women; although no significant differences in soybean food and dietary isoflavone intake were found between the two groups. This tendency implies that greater intakes of soybean food and dietary isoflavone lead to lower incidence of osteoporosis in postmenopausal women.
The purpose of this study was to get a data which can provide a basis for future direction in nutritional education and to build up right eating habit and to find the way how to improve food life and the nutritional supply by evaluating the current nutritional intake of average middle school girls through the survey study of their daily food intakes and physical status. The survey of nutritional intakes and physical status in two girls middle schools, namely Jang'hung girls middle school at Jang'hung Up and Bo'song girls middle school at Bo'song Up, were carried by teachers majoring in Home Economics and nurse-teachers from 5 July to 7 July 1983. From a total of 1080 subjects of two girls middle schools, 887 subjects were surveyed. The results obtained from survey are summarized as follow: 1) Physical Status Average height, weight and chest girth of subjects in both middle schools were much lower than the Korean average standard (p<0.005${\sim}$p<0.001) and t-score of differences between two middle school girls were not significant. Rohrer index, nutrition rate and physique rate were also lower than Korean averag standard through all the ages in both girls middle schools. Menarche appeared mainly between the age of 13 to 15 (91.55 %), with a mean age of 14 (35. 01 %) and which was experienced by the subjects of 51.52 percentage among total surveyed Iniddlf school girls. 2) Nutritional Intakes The average daily intakes of all nutrient except iron, vitamin A, thiamin, ascorbic acid and niacin was lower than Korean Recommanded Dietary Allowances (RDA) . Especially average intake of calorie and calcium were much lower than Korean RDA(p<0.001) while average intake of thiamine and ascorbic acid were much higher than Korean RDA (p<0.001). T-score of differences of iron, thiamin, riboflavin between two middle school girls were very significant (p<0.001). Generally iron and riboflavin were the highest rate of intakes through three meals and breakfast took charge of considerable amount of all nutrient intake without omitting anything (about 30 % of daily nutrient intake). The nutrients of which ratio of nutrient intake by snack was more than 16.7 % were vitamin A, thiamin, riboflavin, ascorbic acid etc. and snack foods which were intake frequently in both middle school girls commonly were fruits, milk and milk products, bread and biscuits in sequence. 3) Correlations and t-score between physical status, menarche and nutrient intakes. Average intake of calorie at Jang'hung area was positively correlated with height, weight, nutrition rate and physique rate and this correlation was very significant (p<0.005). Average intake of calorie was also correlated with chest girth and Rohrer index (P<0.05). At Bo'song area, averse intake of riboflavin was negatively correlated with all the items of physical status (p<0.05-p<0.005), vitamin A was negatively correlated with chest girth and Rohrer index (p<0.05 respectively) and thiamin was also negatively correlated with chest girth, Rohrer index and nutrition rate (p<0.05 respectively). Especially niacin showed a negative cor-relation with all the items of physical status very significantly (p<0.005).The time of menarche showed a positive correlation with iron in both middle school girls commonly P<0.05 at Jang'hung, p<0.10 at Bo'song).
Purpose: The aims of this study were to construct a hypothetical structural model which explains the premenstrual syndrome (PMS) in adolescent girls and to test the fitness with collected data. Methods: The participants were 1,087 adolescent girls from 3 high schools and 5 middle schools in B city. Data were collected from July 3 to October 15, 2012 using self-reported questionnaires and were analyzed using PASW 18.0 and AMOS 16.0 programs. Results: The overall fitness indices of hypothetical model were good (${\chi}^2$ =1555, p<.001), ${\chi}^2$/df=4.40, SRMR=.04, GFI=.91, RMSEA=.05, NFI=.90, TLI=.91, CFI=.92, AIC=1717). Out of 16 paths, 12 were statistically significant. Daily hassles had the greatest impact on PMS in the adolescent girls in this model. In addition, PMS in adolescent girls was directly affected by menarche age, Body Mass Index (BMI), amount of menstruation, test anxiety, social support, menstrual attitude and femininity but not by academic stress. This model explained 27% of the variance in PMS in adolescent girls. Conclusion: The findings from this study suggest that nursing interventions to reduce PMS in adolescent girls should address their daily hassles, test anxiety, menstrual attitude and BMI. Also, social support from their parents, friends, and teachers needs to be increased.
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