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Gyawali B, Poudyal BS, Carson LM, Savage C, Shilpakar R, Berry S. The differential needs and expectations from general practitioners in oncology between high-income countries and low- and-middle-income countries: results from a survey of Canadian and Nepali oncologists. Ecancermedicalscience 2024; 18:1673. [PMID: 38439813 PMCID: PMC10911672 DOI: 10.3332/ecancer.2024.1673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Indexed: 03/06/2024] Open
Abstract
Background To address the shortage of oncologists in the wake of the rapidly increasing global cancer burden, general practitioners of oncology (GPOs) have been added to cancer care teams worldwide. GPOs are family physicians with additional training in oncology and their roles differ by both country and region. In this study, we aimed to learn about the roles and expectations of GPOs from the perspective of oncologists in Canada and Nepal. Methods A survey was designed and administered to Canadian and Nepali Oncologists between February and November 2022 using Research Electronic Data Capture, a secure web-based software platform hosted at Queen's University in Kingston, Ontario, Canada. Participants were recruited through personal networks/social media in Nepal and the survey was distributed through an email list provided by the Canadian Association of Medical Oncologists. Results The survey received 48 responses from Canadian and 7 responses from Nepali oncologists. Canadian respondents indicated that in terms of educational content delivery, clinics with oncologists followed by didactic lectures by oncologists were thought to be the most effective, followed by a small group learning and online education. Nepali oncologists also indicated didactic lectures by oncologists and small group learning would be the most effective teaching techniques, followed by online education and clinics with oncologists. Critical knowledge domains and skills most relevant for GPO training identified by Canadian respondents were managing pain and other common symptoms of cancers, as well as treatment of common side effects, followed by goals of care discussion, post-treatment surveillance for recurrence, and the management of long-term complications from treatment. Respondents from Nepal, however, suggested an approach to diagnosis to patient with increased risk of cancer, and cancer staging were the most critical knowledge domains and skills. The majority of oncologists in both countries thought a training program of 6-12 months was optimal. Conclusion We found many similarities in oncologist's opinions of GPOs between the two countries, however, there were also some notable differences such as the need to provide cancer screening services in Nepal. This highlights the need to tailor GPO training programs based on local context.
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Affiliation(s)
- Bishal Gyawali
- Department of Oncology, Queen’s University, Kingston, ON K7L 3N6, Canada
- Division of Cancer Care and Epidemiology, Queen’s Cancer Research Institute, Kingston, ON K7L 3N6, Canada
- Department of Public Health Sciences, Queen’s University, Kingston, ON K7L 3N6, Canada
| | | | - Laura M Carson
- Department of Oncology, Queen’s University, Kingston, ON K7L 3N6, Canada
| | - Colleen Savage
- Department of Oncology, Queen’s University, Kingston, ON K7L 3N6, Canada
| | - Ramila Shilpakar
- Department of Clinical Oncology, National Academy of Medical Sciences, Bir Hospital, Kathmandu 44600, Nepal
| | - Scott Berry
- Department of Oncology, Queen’s University, Kingston, ON K7L 3N6, Canada
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2
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Bhardwaj PV, Dulala R, Rajappa S, Loke C. Breast Cancer in India: Screening, Detection, and Management. Hematol Oncol Clin North Am 2024; 38:123-135. [PMID: 37330342 DOI: 10.1016/j.hoc.2023.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Breast cancer is the most common cancer in urban Indian women and the second most common cancer in all Indian women. The epidemiology as well as biology of this cancer seems to be different in the Indian subcontinent when compared with the West. The lack of population-based breast cancer screening programs and delay in seeking a medical consult due to financial and social reasons, including lack of awareness and fear related to a cancer diagnosis, results in delayed diagnosis.
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Affiliation(s)
- Prarthna V Bhardwaj
- Division of Hematology-Oncology, University of Massachusetts Chan Medical School - Baystate, 759 Chestnut Street, Springfield, MA 01199, USA
| | - Renuka Dulala
- Division of Hematology-Oncology, Holyoke Medical Center, 575 Beech Street, Holyoke, MA 01040, USA
| | - Senthil Rajappa
- Department of Medical Oncology, Basavatarakam Indo-American Cancer Hospital and Research Institute, Road no. 10, Banjara Hills, Hyderabad, Telangana 500034, India
| | - Chandravathi Loke
- Division of Hematology-Oncology, University of Massachusetts Chan Medical School - Baystate, 759 Chestnut Street, Springfield, MA 01199, USA.
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3
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Taneepanichskul S, Chuemchit M, Wongsasuluk P, Sirichokchatchawan W, Hounnaklang N, Zongram O, Sematong S, Viwattanakulvanid P, Herman B. Practice, confidence and continuity of breast self-examination among women in Thailand during COVID-19 pandemic: a cross-sectional study. BMJ Open 2023; 13:e071306. [PMID: 37527895 PMCID: PMC10394538 DOI: 10.1136/bmjopen-2022-071306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/03/2023] Open
Abstract
OBJECTIVE Breast self-examination (BSE) is the most feasible screening tool compared with clinical breast examination and mammography. It is crucial to address the associated factors of practising BSE to develop a targeted BSE promotion programme and improve the BSE quality in Thai women, particularly during the COVID-19 pandemic. DESIGN AND SETTING We conducted a cross-sectional study in Thailand's north and northeast region from March 2020 to November 2022. PARTICIPANTS This study involved 405 women aged 30-70 years old. VARIABLES AND OUTCOMES Demographic information, health status and BSE were collected using a modified questionnaire based on the Champion Health Belief Model. The outcomes were ever-practising BSE, BSE practice within the last 6 months, continuity of BSE and confidence in doing BSE. Logistic regression and decision tree analysis identified the associated factors. RESULTS 75.55% of participants ever performed BSE. Around 74.18% did BSE within the last 6 months. Diploma graduates (adjusted OR (aOR) 25.48, 95% CI 2.04 to 318.07), 21-40 reproductive years (aOR 4.29, 95% CI 1.22 to 15.08), ever pregnant (aOR 3.31, 95% CI 1.05 to 10.49), not drinking alcohol (aOR 2.1, 95% CI 1.04 to 4.55), not receiving hormone replacement (aOR 5.51, 95% CI 2.04 to 14.89), higher knowledge (aOR 1.29, 95% CI 1.09 to 1.52), attitude (aOR 1.15, 95% CI 1.05 to 1.26) and practice/cues of action towards BSE were associated with ever-practising BSE. Frequent high-fat diet, high awareness of breast cancer, lower knowledge of BSE and lower attitude toward BSE were associated with not practising BSE within 6 months and BSE discontinuation. Only high knowledge of BSE was associated with absolute confidence in BSE (p<0.05). CONCLUSION Despite having a higher percentage than other studies in different countries prior to the pandemic, it is still crucial to improve knowledge of BSE to encourage BSE practice, confidence and continuity of BSE in Thai women. Moreover, the BSE campaign should target women with prolonged exposure to oestrogen and sedentary lifestyle.
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Affiliation(s)
| | - Montakarn Chuemchit
- College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Pokkate Wongsasuluk
- College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand
| | | | | | - Onuma Zongram
- College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Saowanee Sematong
- College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand
| | | | - Bumi Herman
- College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand
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4
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Ainembabazi P, Abila DB, Manyangwa G, Anguzu G, Musaazi J, Mutyaba I, Osingada CP, Mwaka AD. Perceived risk and risk reduction behaviours of female first-degree relatives of breast cancer patients attending care at Uganda cancer institute. Psychooncology 2023; 32:34-41. [PMID: 35584282 DOI: 10.1002/pon.5963] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 05/04/2022] [Accepted: 05/08/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVE The objective of this study was to assess the perceived risk of breast cancer (BC) and adoption of risk reduction behaviours among female first-degree relatives (FDRs) of BC patients attending care at the Uganda Cancer Institute (UCI). METHODS A cross-sectional study was performed using a questionnaire to collect data between March to October 2019. Adult female FDRs of patients attending care at UCI were recruited consecutively. Breast cancer perceived risk was assessed using a verbal measure; 'My chances of getting BC are great' on a Likert scale with 5 response alternatives. Chi square tests and modified Poisson regression using generalised estimating equations model were used to determine associations and examine factors associated with perceived risk of BC. RESULTS We enrolled 296 FDRs from 186 female BC patients. Few participants 118/296 (40%) had high perceived risk of BC. Majority 165/296 (56%), had ever practiced breast self-examination. At the multivariable modified Poisson GEE model, women aged 36-45 years were more likely to perceive themselves to be at high risk of developing BC compared to women aged 18-25 years (adjusted prevalence ratio: 1.174; 95% confidence interval [95%CI] = 1.05-2.88; p value = 0.030) after adjusting for age, religion, educational level and residence. CONCLUSION Few FDRs of BC patients perceived themselves to be at high risk of developing BC and do not seek risk reduction measures including screening and early diagnosis approaches. Breast cancer health education especially targeting younger women should emphasize the increased risk of BC in FDRs.
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Affiliation(s)
- Provia Ainembabazi
- Department of Nursing, School of Health Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Derrick Bary Abila
- Department of Pathology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | | | - Godwin Anguzu
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda.,Duke University, Durham, North Caroline, USA
| | - Joseph Musaazi
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | | | - Charles Peter Osingada
- Department of Nursing, School of Health Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Amos Deogratius Mwaka
- Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.,Department of Medicine, Faculty of Medicine, Gulu University, Kampala, Uganda
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5
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Ngan TT, Jenkins C, Minh HV, Donnelly M, O’Neill C. Breast cancer screening practices among Vietnamese women and factors associated with clinical breast examination uptake. PLoS One 2022; 17:e0269228. [PMID: 35622840 PMCID: PMC9140272 DOI: 10.1371/journal.pone.0269228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 05/17/2022] [Indexed: 11/18/2022] Open
Abstract
Background
This study examined current breast cancer (BC) screening practices among Vietnamese women and the factors associated with the uptake of clinical breast examination (CBE).
Methods
A total of 508 women aged 30–74 years in Hanoi completed a knowledge-attitude-practice (KAP) survey in 2019 including validated measures of breast cancer awareness (Breast-CAM) and health beliefs (Champion’s Health Belief Model Scale). Descriptive statistics, χ2, and ANOVA tests were used to analyse KAP responses across groups with different sociodemographic characteristics. A logistic regression model assessed the associations of knowledge, beliefs, and sociodemographic characteristics with CBE uptake.
Results
Only 18% of respondents were aware of BC signs, risk factors, and screening modalities although 63% had previously received BC screening. CBE was the most common screening modality with an uptake of 51%. A significantly higher proportion of urban residents compared with rural residents (32% vs 18%, Chi-square test, p = 0.04) received mammography. Unlike mammography, CBE uptake was not associated with sociodemographic characteristics (i.e., residence area/education level/occupation/household monthly income/possession of health insurance). CBE uptake was associated with BC knowledge (OR = 2.44, 95%CI: 1.37–4.32), perceived susceptibility to BC (OR = 1.15, 95%CI: 1.05–1.25), and perceived barriers to accessing CBE (OR = 0.88, 95%CI: 0.84–0.92).
Conclusion
The study points to the need for public health education and promotion interventions to address low levels of awareness about BC and to increase uptake of BC screening in Vietnam in advance of screening programme planning and implementation. It also suggests that screening programmes using CBE are promising given current engagement and the absence of socio-demographic disparities.
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Affiliation(s)
- Tran Thu Ngan
- Centre for Public Health, Queen’s University Belfast, Belfast, United Kingdom
- Centre for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam
- * E-mail:
| | - Chris Jenkins
- Centre for Public Health, Queen’s University Belfast, Belfast, United Kingdom
| | - Hoang Van Minh
- Centre for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam
| | - Michael Donnelly
- Centre for Public Health, Queen’s University Belfast, Belfast, United Kingdom
| | - Ciaran O’Neill
- Centre for Public Health, Queen’s University Belfast, Belfast, United Kingdom
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6
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Newman LA. Breast cancer screening in low and middle-income countries. Best Pract Res Clin Obstet Gynaecol 2022; 83:15-23. [PMID: 35589536 DOI: 10.1016/j.bpobgyn.2022.03.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 03/27/2022] [Accepted: 03/28/2022] [Indexed: 12/09/2022]
Abstract
Breast cancer incidence rates are rising in low and middle-income countries (LMIC), and these populations have reduced access to advanced multidisciplinary treatment. Screening and early detection are therefore critical in these regions but must be affordable and sustainable. Mammography screening programs are well established in more affluent countries, but alternative strategies to reduce the breast cancer burden of LMIC (such as clinical breast examination, general breast health awareness, and addressing modifiable lifestyle factors including obesity) are likely to be more realistic at the present time.
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Affiliation(s)
- Lisa A Newman
- Department of Surgery, International Center for the Study of Breast Cancer Subtypes, Weill Cornell Medicine, 420 East 70th Street, New York, 10021, USA
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7
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Addressing breast cancer mortality in low-income and middle-income countries: if you can't measure it, it doesn't exist. Lancet Oncol 2021; 22:1493-1494. [PMID: 34653371 DOI: 10.1016/s1470-2045(21)00519-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 08/31/2021] [Indexed: 12/29/2022]
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8
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Subedi R, Dhimal M, Budukh A, Chapagain S, Gyawali P, Gyawali B, Dahal U, Dikshit R, Jha AK. Epidemiologic Pattern of Cancer in Kathmandu Valley, Nepal: Findings of Population-Based Cancer Registry, 2018. JCO Glob Oncol 2021; 7:443-452. [PMID: 33788597 PMCID: PMC8081507 DOI: 10.1200/go.20.00574] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Although cancer is an important and growing public health issue in Nepal, the country lacked any population-based cancer registry (PBCR) until 2018. In this study, we describe the establishment of the PBCR for the first time in Nepal and use the registry data to understand incidence, mortality, and patterns of cancer in the Kathmandu Valley (consisting of Kathmandu, Lalitpur, and Bhaktapur districts), which comprises 10.5% of the estimated 29 million population of Nepal in 2018. MATERIALS AND METHODS The PBCR collects information from facilities and communities through the active process. The facilities include cancer or general hospitals, pathology laboratories, hospice, and Ayurvedic centers. In the communities, the field enumerators or female community health volunteers collected the data from the households. In addition, the Social Security and Nursing Division under the Department of Health Services, which provides subsidy for cancer treatment of underprivileged patients, was another major source of data. The collected data were verified for residence, accuracy, and completeness and then entered and analyzed using CanReg5 software. RESULTS In the Kathmandu Valley, the PBCR registered 2,156 new cancer cases with overall age-adjusted incidence rate for all cancers of 95.7 per 100,000 population (95.3 for males and 98.1 for females). The age-adjusted mortality rate for males was 36.3 (n = 365) and for females 27.0 (n = 305) per 100,000 population. We found that the commonest cancers in males were lung and stomach, whereas in females, they were breast and lung cancer. Gallbladder cancer was among the top five common cancers in both sex. CONCLUSION These findings provide a milestone to understand the cancer burden in the country for the first time using the PBCR and will be helpful to develop and prioritize cancer control strategies.
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Affiliation(s)
- Ranjeeta Subedi
- Nepal Health Research Council, Ramshahpath, Kathmandu, Nepal
| | - Meghnath Dhimal
- Environmental Health Sciences, Nepal Health Research Council, Ramshahpath, Kathmandu, Nepal
| | - Atul Budukh
- Epidemiology, Homi Bhabha National Institute, Tata Memorial Centre, Mumbai, India
| | - Sandhya Chapagain
- Radiation Oncology, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal
| | - Pradeep Gyawali
- Clinical Pharmacology, Nepal Health Research Council, Ramshahpath, Kathmandu, Nepal
| | - Bishal Gyawali
- Departments of Oncology and Public Health Sciences, Division of Cancer Care and Epidemiology, Queen's University, Kingston, Canada
| | - Uma Dahal
- Nepal Health Research Council, Ramshahpath, Kathmandu, Nepal
| | - Rajesh Dikshit
- Homi Bhabha National Institute, Tata Memorial Centre, Mumbai, India
| | - Anjani Kumar Jha
- Radiation Oncology, Nepal Health Research Council (NHRC), Ramshahpath, Kathmandu, Nepal
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9
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AlWaheidi S, McPherson K, Chalmers I, Sullivan R, Davies EA. Mammographic Screening in the Occupied Palestinian Territory: A Critical Analysis of Its Promotion, Claimed Benefits, and Safety in Palestinian Health Research. JCO Glob Oncol 2021; 6:1772-1790. [PMID: 33206549 PMCID: PMC7713523 DOI: 10.1200/jgo.19.00383] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
PURPOSE To critically review the evidence and opinions expressed about mammographic screening (MS) in research reports on breast cancer in the occupied Palestinian territory (oPt) and to assess whether benefits and harms in MS are presented in a balanced way. METHODS Searches of PubMed, Cochrane, MEDLINE, EMBASE, CINAHL, and gray literature identified 14 eligible research reports relating to the oPt. We reviewed these documents and then used a thematic analysis to describe and analyze the evidence and the opinions about MS expressed in them. RESULTS All 14 research reports mentioned that MS would improve survival rates in the oPt. Only three gave information on major harmful effects, and only two emphasized that MS must be accompanied by effective treatment to have any beneficial effects on population mortality. There was no consistency in the recommended frequency of MS. CONCLUSION Most information presented by Palestinian health researchers was selective and failed to address the important established harms of MS. Thus, calls to support MS in the oPt are not based on a measured discussion of the risks and benefits for women or grounded in the systemic readiness of health care necessary for its effectiveness. As long as diagnostic and treatment facilities remain deficient, screening cannot lead to reduced mortality from breast cancer.
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Affiliation(s)
- Shaymaa AlWaheidi
- Cancer Epidemiology, Population and Global Health, King's College London, London, United Kingdom
| | - Klim McPherson
- Public Health Epidemiology, Nuffield Department of Primary Health Care Research and New College, University of Oxford, Oxford, United Kingdom
| | - Iain Chalmers
- Centre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Richard Sullivan
- Institute of Cancer Policy, Kings Health Partners Comprehensive Cancer Centre, King's College London, London, United Kingdom
| | - Elizabeth A Davies
- Cancer Epidemiology, Population and Global Health, King's College London, London, United Kingdom
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10
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Ngan TT, Nguyen NTQ, Van Minh H, Donnelly M, O'Neill C. Effectiveness of clinical breast examination as a 'stand-alone' screening modality: an overview of systematic reviews. BMC Cancer 2020; 20:1070. [PMID: 33167942 PMCID: PMC7653771 DOI: 10.1186/s12885-020-07521-w] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 10/13/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND There is uncertainty about the effectiveness of clinical breast examination (CBE) and conflicting recommendations regarding its usefulness as a screening tool for breast cancer. This paper provides an overview of systematic reviews that assessed the effectiveness of CBE as a 'stand-alone' screening modality for breast cancer compared to no screening and focused on its value in low- and middle-income countries (LMICs). METHODS We searched MEDLINE, EMBASE, Scopus, Web of Science, and the Cochrane Database of Systematic Reviews for systematic reviews reporting the effectiveness of CBE published prior to October 29, 2019. The main outcomes assessed were mortality and down staging. The AMSTAR 2 checklist was used to assess the methodological quality of the reviews including risk of bias. RESULTS Eleven systematic reviews published between 1993 and 2019 were identified. There was no direct evidence that CBE reduced breast cancer mortality. Indirect evidence suggested that a well-performed CBE achieved the same effect as mammography regarding mortality despite its apparently lower sensitivity (40-69% for CBE vs 77-95% for mammography). Greater sensitivity was recorded among younger and Asian women. Moreover, CBE contributed between 17 and 47% of the shift from advanced to early stage cancer. CONCLUSIONS CBE merits attention from health system and service planners in LMICs where a national screening programme based on mammography would be prohibitively expensive. In particular, it is likely that considerable value would be gained from conducting implementation scientific research in countries with large numbers of Asian women and/or where younger women are at higher risk. REGISTRATION PROSPERO, registration number CRD42019126798 .
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Affiliation(s)
- Tran Thu Ngan
- Centre for Public Health, Queen's University Belfast, Belfast, UK.
- Centre for Population Health Sciences, Hanoi University of Public Health, Hanoi, Viet Nam.
| | - Nga T Q Nguyen
- Centre for Public Health, Queen's University Belfast, Belfast, UK
- Department of Pharmaceutical Administration, Faculty of Pharmacy, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet Nam
| | - Hoang Van Minh
- Centre for Population Health Sciences, Hanoi University of Public Health, Hanoi, Viet Nam
| | - Michael Donnelly
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Ciaran O'Neill
- Centre for Public Health, Queen's University Belfast, Belfast, UK
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11
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Pereira AAC, Destro JR, Picinin Bernuci M, Garcia LF, Rodrigues Lucena TF. Effects of a WhatsApp-Delivered Education Intervention to Enhance Breast Cancer Knowledge in Women: Mixed-Methods Study. JMIR Mhealth Uhealth 2020; 8:e17430. [PMID: 32706726 PMCID: PMC7404019 DOI: 10.2196/17430] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 03/28/2020] [Accepted: 04/03/2020] [Indexed: 12/18/2022] Open
Abstract
Background Breast cancer is the leading cause of cancer-related death in the female population. Health education interventions based on the use of mobile technologies enable the development of health self-care skills and have emerged as alternative strategies for the control of breast cancer. In previous studies, WhatsApp has stood out as a useful tool in health education strategies; however, it has not yet been applied for breast cancer education. Objective This study aimed to analyze the potential of WhatsApp as a health education tool used to improve women's knowledge on the risk reduction of breast cancer. It also aimed to understand how women feel sensitized within the WhatsApp group throughout the intervention and how they incorporate information posted to improve knowledge about early detection and risk reduction methods. Methods The study involved a pre-post health educational intervention with 35 women (aged 45-69 years) included in a WhatsApp group to share information (audio, video, text, and images) over 3 weeks on the early detection and risk reduction of breast cancer. Data were collected through questionnaires on topics related to risk reduction, as well as qualitative content analysis of group interactions. Effectiveness and feasibility were analyzed through conversations and the comparison of the scores obtained in the questionnaires before and after the intervention. Results A total of 293 messages were exchanged (moderator 120 and users 173). The average scores of the participants were 11.21 and 13.68 points before and after the educational intervention, respectively, with sufficient sample evidence that the difference was significant (P<.001). The intervention enabled women to improve their knowledge on all topics addressed, especially “myths and truths,” “incidence,” “clinical manifestations,” and “protective factors.” Some themes emerged from the interactions in the group, including group dynamics, general doubts, personal narratives, religious messages, daily news, and events. Conclusions The use of groups for women in WhatsApp for health education purposes seems to be a viable alternative in strategies on breast cancer control, especially as it provides a space for the exchange of experiences and disinhibition. However, the need for a moderator to answer the questions and the constant distractions by members of the group represent important limitations that should be considered when improving this strategy.
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Affiliation(s)
| | | | - Marcelo Picinin Bernuci
- Universidade Cesumar, Maringá, Brazil.,ICETI-Cesumar Institute of Science, Technology, and Innovation, Maringá, Brazil
| | - Lucas França Garcia
- Universidade Cesumar, Maringá, Brazil.,ICETI-Cesumar Institute of Science, Technology, and Innovation, Maringá, Brazil
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12
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Autier P, Sullivan R. Population Screening for Cancer in High-Income Settings: Lessons for Low- and Middle-Income Economies. J Glob Oncol 2020; 5:1-5. [PMID: 30715958 PMCID: PMC6426516 DOI: 10.1200/jgo.18.00235] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Affiliation(s)
- Philippe Autier
- University of Strathclyde Institute of Global Public Health at International Prevention Research Institute, Ecully, Lyon, France.,International Prevention Research Institute, Lyon, France
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13
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Yang Q, Zhao J, Zhang W, Chen D, Wang Y. Aberrant alternative splicing in breast cancer. J Mol Cell Biol 2019; 11:920-929. [PMID: 31065692 PMCID: PMC6884705 DOI: 10.1093/jmcb/mjz033] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 02/19/2019] [Accepted: 03/03/2019] [Indexed: 12/11/2022] Open
Abstract
Alternative splicing is critical for human gene expression regulation, which plays a determined role in expanding the diversity of functional proteins. Importantly, alternative splicing is a hallmark of cancer and a potential target for cancer therapeutics. Based on the statistical data, breast cancer is one of the top leading causes of cancer-related deaths in women worldwide. Strikingly, alternative splicing is closely associated with breast cancer development. Here, we seek to provide a general review of the relationship between alternative splicing and breast cancer. We introduce the process of alternative splicing and its regulatory role in cancers. In addition, we highlight the functions of aberrant alternative splicing and mutations of splicing factors in breast cancer progression. Moreover, we discuss the role of alternative splicing in cancer drug resistance and the potential of being targets for cancer therapeutics.
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Affiliation(s)
- Quan Yang
- Institute of Cancer Stem Cell, Dalian Medical University, Dalian 116044, China
| | - Jinyao Zhao
- Institute of Cancer Stem Cell, Dalian Medical University, Dalian 116044, China
| | - Wenjing Zhang
- Institute of Cancer Stem Cell, Dalian Medical University, Dalian 116044, China
| | - Dan Chen
- Department of Pathology, First Affiliated Hospital, Dalian Medical University, Dalian 116044, China
| | - Yang Wang
- Institute of Cancer Stem Cell, Dalian Medical University, Dalian 116044, China
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14
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Kikuchi K, Ayer R, Okawa S, Nishikitani M, Yokota F, Jimba M, Nakashima N. Interventions integrating non-communicable disease prevention and reproductive, maternal, newborn, and child health: A systematic review. Biosci Trends 2018; 12:116-125. [PMID: 29760355 DOI: 10.5582/bst.2018.01070] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Reproductive, maternal, newborn, and child health (RMNCH) care services could be critical entry points for preventing non-communicable diseases in women and children. In high-income countries, non-communicable diseases screening has been integrated into both the medical and public health systems. To integrate these services in low- and middle-income countries, it is necessary to closely examine its effectiveness and feasibility. In this systematic review, we evaluated the effectiveness of integrating gestational and non-gestational non-communicable diseases interventions and RMNCH care among women and children in low- and middle-income countries. This systematic review included randomized and quasi-randomized controlled trials published from 2000 to 2015. Participants included reproductive-age women, children < 5 years old, and RMNCH care providers. The included interventions comprised packaged care/services that integrated RMNCH services with non-communicable disease care. The outcomes were maternal and/or infant mortality and complications, as well as health care service coverage. We analyzed six studies from 7,949 retrieved articles. Yoga exercise (p < 0.01) and nutritional improvements (p < 0.05) were effective in reducing gestational hypertension and diabetes. Additionally, integrating cervical cancer and RMNCH services was useful for identifying potential cervical cancer cases. Interventions that integrate non-communicable disease care/screening and RMNCH care may positively impact the health of women and children in low- and middle-income countries. However, as primary evidence is scarce, further research on the effectiveness of integrating non-communicable disease prevention and RMNCH care is warranted. (Review Registration: PROSPERO International prospective register of systematic reviews (CRD42015023425).).
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Affiliation(s)
- Kimiyo Kikuchi
- Institute of Decision Science for a Sustainable Society, Kyushu University
| | - Rakesh Ayer
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo
| | - Sumiyo Okawa
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo
| | - Mariko Nishikitani
- Institute of Decision Science for a Sustainable Society, Kyushu University
| | - Fumihiko Yokota
- Institute of Decision Science for a Sustainable Society, Kyushu University
| | - Masamine Jimba
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo
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Affiliation(s)
- Bishal Gyawali
- Bishal Gyawali, Anticancer Fund, Belgium, and Civil Service Hospital, Kathmandu, Nepal; and Gilberto Lopes, University of Miami, Miami, FL
| | - Gilberto Lopes
- Bishal Gyawali, Anticancer Fund, Belgium, and Civil Service Hospital, Kathmandu, Nepal; and Gilberto Lopes, University of Miami, Miami, FL
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Alternative Splicing in Breast Cancer and the Potential Development of Therapeutic Tools. Genes (Basel) 2017; 8:genes8100217. [PMID: 28981467 PMCID: PMC5664086 DOI: 10.3390/genes8100217] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 08/22/2017] [Accepted: 08/22/2017] [Indexed: 12/19/2022] Open
Abstract
Alternative splicing is a key molecular mechanism now considered as a hallmark of cancer that has been associated with the expression of distinct isoforms during the onset and progression of the disease. The leading cause of cancer-related deaths in women worldwide is breast cancer, and even when the role of alternative splicing in this type of cancer has been established, the function of this mechanism in breast cancer biology is not completely decoded. In order to gain a comprehensive view of the role of alternative splicing in breast cancer biology and development, we summarize here recent findings regarding alternative splicing events that have been well documented for breast cancer evolution, considering its prognostic and therapeutic value. Moreover, we analyze how the response to endocrine and chemical therapies could be affected due to alternative splicing and differential expression of variant isoforms. With all this knowledge, it becomes clear that targeting alternative splicing represents an innovative approach for breast cancer therapeutics and the information derived from current studies could guide clinical decisions with a direct impact in the clinical advances for breast cancer patients nowadays.
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