1
|
Van Christ Manirakiza A, Pfaendler KS. Breast, Ovarian, Uterine, Vaginal, and Vulvar Cancer Care in Low- and Middle-Income Countries. Obstet Gynecol Clin North Am 2022; 49:783-793. [DOI: 10.1016/j.ogc.2022.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
2
|
Zhao S, Huang L, Basu P, Domingo EJ, Supakarapongkul W, Ling WY, Ocviyanti D, Rezhake R, Qiao Y, Tay EH, Zhao F. Cervical cancer burden, status of implementation and challenges of cervical cancer screening in Association of Southeast Asian Nations (ASEAN) countries. Cancer Lett 2022; 525:22-32. [PMID: 34728309 DOI: 10.1016/j.canlet.2021.10.036] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 10/11/2021] [Accepted: 10/25/2021] [Indexed: 12/12/2022]
Abstract
Multiple barriers impede the transformation of evidence-based research into implementation of cervical cancer screening in ASEAN countries. This review is the first of its kind to show the disease burden of cervical cancer, progress till date to implement screening and corresponding challenges, and propose tailored solutions to promote cervical cancer prevention in ASEAN. In 2020, approximately 69 000 cervical cancer cases and 38 000 deaths happened in ASEAN, and more than 44% and 63% increases on new cases and deaths are expected in 2040. Only four countries have initiated population-based cervical cancer screening programs, but the participation rate is less than 50% in some countries and even lower than 10% in Myanmar and Indonesia. Inequity and unavailability in service delivery, lack of knowledge and awareness, limited follow-up and treatment capacity, and funding sustainability affect successful scale-up of cervical cancer screening most in ASEAN. Implementing HPV detection-based primary screening, appropriate management of screen-positives, enhancing health education, integrating health services can accelerate reduction of cervical cancer burden in ASEAN. Achieving high screening coverage and high treatment compliance will help ASEAN countries remain aligned to cervical cancer elimination strategies.
Collapse
Affiliation(s)
- Shuang Zhao
- Department of Epidemiology, National Cancer Center/ National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Liuye Huang
- Department of Epidemiology, National Cancer Center/ National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Partha Basu
- Early Detection, Prevention & Infections Branch, International Agency for Research on Cancer, Lyon, France
| | - Efren Javier Domingo
- Department of Obstetrics and Gynecology, University of the Philippines College of Medicine-Philippine General Hospital, Manila, Philippines
| | | | - Woo Yin Ling
- Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Dwiana Ocviyanti
- Department of Obstetrics and Gynecology, Faculty of Medicine Universitas Indonesia/ Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Remila Rezhake
- The 3rd Affiliated Teaching Hospital of Xinjiang Medical University (Affiliated Cancer Hospital), Xinjiang, China
| | - Youlin Qiao
- Department of Epidemiology, National Cancer Center/ National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | | | - Fanghui Zhao
- Department of Epidemiology, National Cancer Center/ National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| |
Collapse
|
3
|
The Modernization of Radiation Therapy Services in Cambodia: A Model of International Collaboration. Int J Radiat Oncol Biol Phys 2021; 111:14-22. [PMID: 34348108 DOI: 10.1016/j.ijrobp.2021.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 04/08/2021] [Indexed: 11/22/2022]
Abstract
PURPOSE Cambodia is a Southeast Asian low-middle-income country with a population of >15 million. In 2020, Cambodia was estimated to have 18,375 new diagnoses of cancer and 12,638 deaths attributable to cancer. Cambodia was estimated to have a deficit of 16 megavoltage machines in 2012. Cambodia's radiation therapy services have suffered through the tumultuous events of the country's history, with intermittent services until the last decade. In recent years, Cambodia has undergone rapid economic growth and, with this, the development of its first comprehensive cancer center, the National Cancer Centre (NCC). METHODS AND MATERIALS Planning for NCC began in the early 2000s, with the aim to provide comprehensive care, including modern radiation therapy services, to the public. Funding for the center was supplied primarily by the Cambodian government, assisted by donations from partners including the International Atomic Energy Agency. Training collaborations were formed with international partners, including the Asia-Pacific Radiation Oncology Special Interest Group (APROSIG) of the Royal Australian and New Zealand College of Radiologists and the Asia-Pacific Special Interest Group (APSIG) of the Australasian College of Physical Scientists and Engineers in Medicine. RESULTS The main model of APROSIG/APSIG collaboration has been in-country training, including the posting of an Australian medical physicist and radiation therapist in Phnom Penh for a year's duration to oversee a safe and sustainable start to the radiation therapy program. The first linear accelerator patient was treated at NCC in March 2018 and the first brachytherapy patient in September 2018. Since that time, the department has treated to capacity, with very little machine downtime. NCC provides comprehensive cancer services including medical oncology, pediatric oncology, hematology, palliative care, surgical oncology, and nuclear medicine. Several challenges to expanding radiation therapy services currently exist, including human resources and cultural stigma. CONCLUSION Despite many decades of tragedy and suffering, Cambodia serves as an example of successful implementation of modern radiation therapy in a low- and middle-income country. The keys to success have included local champions, support of the Ministry of Health, and willingness to embrace collaboration. The pandemic brings yet another challenge to cancer control in Cambodia, and novel training platforms are being explored.
Collapse
|
4
|
Aumpan N, Vilaichone RK, Gamnarai P, Sanglutong L, Ratanachu-Ek T, Mahachai V, Yamaoka Y. Prevalence and Antibiotic Resistance Patterns of Helicobacter pylori Infection in Koh Kong, Cambodia. Asian Pac J Cancer Prev 2020; 21:1409-1413. [PMID: 32458649 PMCID: PMC7541852 DOI: 10.31557/apjcp.2020.21.5.1409] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Indexed: 12/22/2022] Open
Abstract
Background: Gastric cancer, which is the leading cause of cancer mortality in Cambodia, can be prevented by Helicobacter pylori (H. pylori) eradication. There is limited data about H. pylori strains in Cambodia. This study aimed to evaluate H. pylori prevalence and antibiotic resistance in Koh Kong, Cambodia. Methods: 118 Cambodian dyspeptic patients were scheduled to enter this study and 58 were enrolled between July and September 2019. All patients underwent upper GI endoscopy. 3 gastric biopsies were obtained for rapid urease test, H. pylori culture with E-test and GenoType® HelicoDr (Hain Lifescience factory, Germany). 3-mL blood sample was collected for CYP2C19 genotyping. Results: 58 subjects were enrolled (40 females, 18 males, mean age 43.8 years). Overall H. pylori prevalence was 31.0%. Antibiotic resistance rates were 78.6% for metronidazole, 50.0% for fluoroquinolones, and 27.8% for clarithromycin. There was no amoxicillin and tetracycline resistance. More than half of H. pylori strains (57.1%) were multidrug-resistant. Most (35.7%) were resistant to metronidazole and quinolone. Poor, intermediate and rapid metabolizers were 5.5%, 38.9% and 55.6%, respectively. Conclusions: H. pylori infection remains common infection in Cambodia. High prevalence of clarithromycin, metronidazole, levofloxacin and multidrug-resistant H. pylori is still major problems in Cambodia. Treatment regimens without clarithromycin and quinolone such as 14-day bismuth-based quadruple therapy might be an appropriate choice for H. pylori eradication in this particular area.
Collapse
Affiliation(s)
- Natsuda Aumpan
- Gastroenterology Unit, Department of Medicine, Faculty of Medicine, Thammasat University Hospital, Pathumthani, Thailand.,Digestive diseases Research Center (DRC), Thammasat University, Pathumthani, Thailand
| | - Ratha-Korn Vilaichone
- Gastroenterology Unit, Department of Medicine, Faculty of Medicine, Thammasat University Hospital, Pathumthani, Thailand.,Digestive diseases Research Center (DRC), Thammasat University, Pathumthani, Thailand.,Department of Medicine, Chulabhorn International College of Medicine (CICM) at Thammasat University, Pathumthani, Thailand
| | - Pornpen Gamnarai
- Digestive diseases Research Center (DRC), Thammasat University, Pathumthani, Thailand.,Department of Biochemistry, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
| | - Likhasit Sanglutong
- Gastroenterology Unit, Department of Medicine, Faculty of Medicine, Thammasat University Hospital, Pathumthani, Thailand
| | | | - Varocha Mahachai
- Digestive diseases Research Center (DRC), Thammasat University, Pathumthani, Thailand.,Gastrointestinal and Liver Center, Bangkok Medical Center, Bangkok, Thailand
| | - Yoshio Yamaoka
- Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Yufu, Japan
| |
Collapse
|
5
|
Abstract
BACKGROUND Hematological malignancies have continued to be highly prevalent among people living with HIV (PLHIV). This study assessed the occurrence of, risk factors for, and outcomes of hematological and nonhematological malignancies in PLHIV in Asia. METHODS Incidence of malignancy after cohort enrollment was evaluated. Factors associated with development of hematological and nonhematological malignancy were analyzed using competing risk regression and survival time using Kaplan-Meier. RESULTS Of 7455 patients, 107 patients (1%) developed a malignancy: 34 (0.5%) hematological [0.08 per 100 person-years (/100PY)] and 73 (1%) nonhematological (0.17/100PY). Of the hematological malignancies, non-Hodgkin lymphoma was predominant (n = 26, 76%): immunoblastic (n = 6, 18%), Burkitt (n = 5, 15%), diffuse large B-cell (n = 5, 15%), and unspecified (n = 10, 30%). Others include central nervous system lymphoma (n = 7, 21%) and myelodysplastic syndrome (n = 1, 3%). Nonhematological malignancies were mostly Kaposi sarcoma (n = 12, 16%) and cervical cancer (n = 10, 14%). Risk factors for hematological malignancy included age >50 vs. ≤30 years [subhazard ratio (SHR) = 6.48, 95% confidence interval (CI): 1.79 to 23.43] and being from a high-income vs. a lower-middle-income country (SHR = 3.97, 95% CI: 1.45 to 10.84). Risk was reduced with CD4 351-500 cells/µL (SHR = 0.20, 95% CI: 0.05 to 0.74) and CD4 >500 cells/µL (SHR = 0.14, 95% CI: 0.04 to 0.78), compared to CD4 ≤200 cells/µL. Similar risk factors were seen for nonhematological malignancy, with prior AIDS diagnosis showing a weak association. Patients diagnosed with a hematological malignancy had shorter survival time compared to patients diagnosed with a nonhematological malignancy. CONCLUSIONS Nonhematological malignancies were common but non-Hodgkin lymphoma was more predominant in our cohort. PLHIV from high-income countries were more likely to be diagnosed, indicating a potential underdiagnosis of cancer in low-income settings.
Collapse
|
6
|
Vorn R, Ryu E, Srun S, Chang S, Suh I, Kim W. Breast and cervical cancer screening for risk assessment in Cambodian women. J OBSTET GYNAECOL 2019; 40:395-400. [DOI: 10.1080/01443615.2019.1633515] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Rany Vorn
- Department of Nursing, Chung-Ang University Graduate School, Seoul, Republic of Korea
| | - Eunjung Ryu
- Department of Nursing, Chung-Ang University, Seoul, Republic of Korea
| | - Sreynet Srun
- Graduate School of Cancer Science and Policy, Goyang, Republic of Korea
| | - Soonbok Chang
- International Program of Bachelor of Nursing, University of Health Science, Phnom Penh, Cambodia
| | - Insoo Suh
- Department of Pediatrics, Hebron Medical Centers, Phnom Penh, Cambodia
| | - Woojung Kim
- Department of Pediatrics, Hebron Medical Centers, Phnom Penh, Cambodia
| |
Collapse
|
7
|
Vorn R, Touch S, Ryu E. Depression and health-related quality of life among Cambodian patients with cancer. Int J Health Plann Manage 2019; 34:e1747-e1759. [PMID: 31414509 DOI: 10.1002/hpm.2888] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 08/06/2019] [Accepted: 08/07/2019] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Symptom assessment and quality of life (QoL) are considered two of the most important factors in the overall care of cancer patients. Although cancer is one of the leading causes of death after communicable disease in Cambodia, the QoL of Cambodian cancer patients has not been examined previously. This study aimed to describe the QoL of cancer patients in Cambodia. METHODS A cross-sectional study was conducted with cancer patients who visited Khmer-Soviet Friendship Hospital in Phnom Penh. Two hundred patients participated in this study. The inventory comprised two previously validated scales: the Center for Epidemiological Studies Depression Scale-10 (CESD-10) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30. Descriptive analyses, independent samples t-tests, and Pearson's correlation analysis were performed to examine the differences and relationship between study variables. RESULTS The mean global health score was 51.62, and 58.5% of the participants had depressive symptom. The global health score was statistically significantly lower in depressive patients. The QoL was negatively correlated with depression, but positively and significant correlated with physical function, role function, emotional function, cognitive function, and social function. CONCLUSION This study is the first to describe the QoL of Cambodian cancer patients. Our findings suggest that more attention should be paid to psychological concerns and symptom management in Cambodian cancer patients. Appropriate management could be effective in improving the QoL of cancer patients.
Collapse
Affiliation(s)
- Rany Vorn
- Chung-Ang University School of Graduate, Seoul, Republic of Korea.,Chung-Ang University, Department of Nursing, Seoul, Republic of Korea
| | - Socheat Touch
- Khmer-Soviet Friendship Hospital and Clinical Lecturer at University of Health Sciences, Phnom Penh, Cambodia
| | - Eunjung Ryu
- Chung-Ang University, Department of Nursing, Seoul, Republic of Korea
| |
Collapse
|
8
|
Bui TC, Scheurer ME, Pham VTT, Tran LTH, Hor LB, Vidrine DJ, Ross MW, Markham CM. Intravaginal practices and genital human papillomavirus infection among female sex workers in Cambodia. J Med Virol 2018; 90:1765-1774. [PMID: 30016541 DOI: 10.1002/jmv.25268] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 06/17/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Intravaginal practices (IVPs) include washing, wiping, or inserting something inside the vagina. This study investigates the associations between IVPs and genital human papillomavirus (HPV) infection. METHODS We conducted a cross-sectional study of 200 female sex workers aged 18 to 35 years in Phnom Penh, Cambodia. From August to September 2014. Data on sociodemographic characteristics, IVPs, and other behaviors were collected through face-to-face interviews. Self-collected cervicovaginal specimens were tested for 37 HPV genotypes. RESULTS Multivariable Poisson regression models showed that a lower number of infecting HPV genotypes were associated with intravaginal washing in the past 3 months (incident rate ratios [IRR] = 0.65, 95% confidence interval [CI]: 0.46-0.94) and often performing intravaginal washing shortly after sex (IRR = 0.89, 95% CI: 0.81-0.99). Intravaginal washing before vaginal sex, intravaginal wiping, and intravaginal insertion were not associated with HPV infection. CONCLUSION These findings challenge the existing view that all types of vaginal cleansing are harmful. Specifically, intravaginal washing shortly after sex (mainly with water) may help prevent HPV infection in female sex workers, who have several partners and thus frequently expose to sources of HPV infection with different genotypes.
Collapse
Affiliation(s)
- Thanh Cong Bui
- Department of Family and Preventive Medicine, Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Michael E Scheurer
- Department of Pediatrics, Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, Texas
| | - Vy Thi-Tuong Pham
- Department of Epidemiology, College for Public Health and Social Justice, Saint Louis University, St. Louis, Missouri
| | - Ly Thi-Hai Tran
- Department of Epidemiology, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas
| | - Leng Bun Hor
- Cambodian National AIDS Authority, Phnom Penh, Cambodia
| | - Damon J Vidrine
- Department of Family and Preventive Medicine, Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Michael W Ross
- Department of Family Medicine and Community Health, Medical School, University of Minnesota, Minneapolis, Minnesota
| | - Christine M Markham
- Department of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas
| |
Collapse
|
9
|
Chassagne F, Deharo E, Punley H, Bourdy G. Treatment and management of liver diseases by Khmer traditional healers practicing in Phnom Penh area, Cambodia. JOURNAL OF ETHNOPHARMACOLOGY 2017; 202:38-53. [PMID: 28284791 DOI: 10.1016/j.jep.2017.03.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 03/02/2017] [Accepted: 03/03/2017] [Indexed: 05/22/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Liver disorders are a major health problem in Cambodia, where some patients prefer to seek treatment from traditional healers. The aim of the study was to document the knowledge and practices of these healers in four Southern Cambodian provinces. MATERIALS AND METHODS An ethnopharmacological survey was carried out from September 2015 to January 2016 in Cambodian urban and rural areas. Thirty-three Khmer traditional healers (KTH) were interviewed using a semi-structured questionnaire including socio-demographic data, healer's formation and their professional practice conditions, perception of liver diseases (types and causes of liver disorders, diagnostic methods and symptoms of liver problems), dietary recommendations given to patients, and herbal remedies used to treat them. For each medicinal plant mentioned in herbal remedies, the local name, part of the plant, mode of preparation and administration, and their properties, according to the healers, were recorded. The plants mentioned by the traditional therapists were collected and later identified by specialists. RESULTS Different types of liver disease are identified by the healers, and diagnosis was mostly based on reading medical records, and by observing the yellow discoloration of the skin and eyes. A total of 42 herbal remedies including 83 medicinal plants belonging to 40 families were mentioned for treating liver disorders. The most predominant families were Leguminosae and Poaceae. Among the plants reported, Cananga latifolia, Andrographis paniculata, Smilax aff. glabra, Gomphrena celosioides, Passiflora foetida and Physalis minima were the most cited species. A large part of the herbal remedies used were multi-ingredient recipes, and were prepared mainly by a decoction administered orally. Plants are combined in multi-ingredient recipes, and selected on the basis of their properties (trocheak, psah, somrap mé rok, ktchol) which originate from Khmer medical concepts. Most of the plants used by healers have a wide ethnobotanical use for liver disorders, and have been studied for their hepatoprotective activity and related activities on the liver. CONCLUSION In the diagnosis and treatment of liver diseases, KTH have incorporated biomedical concepts and new practices, which suggest that they could be defined as neotraditional healers. Medicinal plants constitute the core of traditional medicine practice by these healers, and these plants play a very important role in the health care of people with liver problems in Cambodia. Therefore, more attention should be paid to the integration of healers in national health care programs for the development of combined therapies. Furthermore, two plant species (i.e. Cananga latifolia and Willughbeia edulis) were found to be widely used for treating liver disorders in our survey, and should be studied for their pharmacological potential for liver problems.
Collapse
Affiliation(s)
| | - Eric Deharo
- UMR 152 Pharmadev, Université de Toulouse, IRD, UPS, France.
| | - Hieng Punley
- Faculty of Medicine, University of Health Sciences, Phnom Penh, Cambodia.
| | | |
Collapse
|
10
|
Chong VH, Telisinghe PU, Lim E, Tan J, Chong CF. Cancers among South-East Asian Nationals in Brunei Darussalam. Asian Pac J Cancer Prev 2017; 17:845-9. [PMID: 26925690 DOI: 10.7314/apjcp.2016.17.2.845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Worldwide, the incidence of cancers is increasing and is becoming a major public health issue, including those in the Asia Pacific region. South-East Asia is a region with diverse populations with different disease spectra. This study looked at the spectrum of cancers among South-East Asians working in Brunei Darussalam. MATERIALS AND METHODS The cancer registry from 1994 to 2012 maintained by the State Laboratory was retrospectively reviewed. Crude incidence rates were calculated based on the population census of 2010. RESULTS Altogether, there was a total of 418 cancer cases diagnosed among South-East Asians, giving an incidence of 5.1% (n=418/8,253). The affected nationals in decreasing frequency were Malaysians (53.1%), followed by Filipinos (25.8%), Indonesians (15.3%), Thais (3.8%), Myanmese (1.7%) and Vietnamese (0.2%) with no recorded cases for Singapore and the People's Republic of Laos. The overall mean age of diagnosis was 46.1±4.2 years old, with an increasing trend over the years (p<0.05 ANOVA). The overall gender ratio was 42.3:57.7 (male:female), more females among the Filipinos and Indonesians, more males among the Thais, and equal representation among the Malaysians and the Myanmese. The most common were cancers of the digestive system (19.9%), followed by female reproductive/gynecologic system (16.0%), breast (15.6%), hematological/lymphatic (12.0%) and head/neck (8.1%). There were differences in the prevalence of cancers among the various nationalities with highest crude incidence rate among the Myanmese (141.2/100,000), followed by the Malaysian (88.5/100,000), and the Filipinos (40.6/100,000) and the lowest among the Thais (18.4/100,000), Indonesians (10.5/100,000) and the Vietnamese (6.3/100,000). CONCLUSIONS Cancers among South-East Asian residing in Brunei Darussalam accounted for 5.1% of all cancers. The most common cancers were cancers of the digestive, gynecologic/female reproductive system and breast with certain types slowly increasing in proportions. There mean age of diagnoses was increasing.
Collapse
Affiliation(s)
- Vui Heng Chong
- Department of Medicine, RIPAS Hospital, Bandar Seri Begawan BA, Brunei Darussalam E-mail :
| | | | | | | | | |
Collapse
|
11
|
Chassagne F, Rojas Rojas T, Bertani S, Bourdy G, Eav S, Ruiz E, Pineau P, Deharo E. A 13-Year Retrospective Study on Primary Liver Cancer in Cambodia: A Strikingly High Hepatitis C Occurrence among Hepatocellular Carcinoma Cases. Oncology 2016; 91:106-16. [PMID: 27250992 DOI: 10.1159/000446398] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 04/19/2016] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Hepatocellular carcinoma (HCC) is the main type of primary liver cancer (PLC) worldwide, but cholangiocarcinoma (CCA) may be predominant in some specific regions of Southeast Asia. The aim of the present study was to delineate a pattern of Cambodian PLC patients attending the Calmette Hospital in the Cambodian capital Phnom Penh. MATERIALS AND METHODS A total of 553 medical charts diagnosing PLCs from January 2003 to May 2015 were obtained from both the Oncology and Hepato-Gastroenterology Departments of the Calmette Hospital. RESULTS HCC was the predominant type of PLC recorded, with 511 cases (92.4%), whereas CCA represented merely 7.6% (42 cases) of the overall series. Hepatitis B virus (HBV; 44.3%) and hepatitis C virus (HCV; 43%) infection rates were similar among the HCC patients, while small subsets of CCA patients were infected with HBV (15.4%) or HCV (11.5%). Most HCC (84%) and CCA (73.8%) patients received palliative treatment only. CONCLUSION The present study indicates that HCC is the main form of primary hepatic neoplasm among PLC patients attending a hospital in Cambodia. HBV and HCV infections represented equivalent burdens and major contributing factors to HCC. Therefore, the implementation of prevention programs for these infectious agents should become a priority for health policy makers in the country.
Collapse
Affiliation(s)
- François Chassagne
- IRD, UPS, UMR 152 PHARMA-DEV, Facultx00E9; des Sciences Pharmaceutiques, Universitx00E9; de Toulouse, Toulouse, France
| | | | | | | | | | | | | | | |
Collapse
|
12
|
Kamanzi JB, Adeduntan R, Antoni D, Musafiri S, Noël G. Implementing radiotherapy in Africa: Focus on the needs in Rwanda. Cancer Radiother 2016; 20:231-5. [DOI: 10.1016/j.canrad.2016.01.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 11/29/2015] [Accepted: 01/13/2016] [Indexed: 11/16/2022]
|
13
|
Rodin D, Grover S, Xu MJ, Hanna TP, Olson R, Schreiner LJ, Munshi A, Mornex F, Palma D, Gaspar LE. Radiotherapeutic Management of Non–Small Cell Lung Cancer in the Minimal Resource Setting. J Thorac Oncol 2016; 11:21-9. [DOI: 10.1016/j.jtho.2015.09.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 09/22/2015] [Accepted: 09/30/2015] [Indexed: 01/22/2023]
|
14
|
Narin P, Hamajima N, Kouy S, Hirosawa T, Eav S. Characteristics of liver cancer at Khmer-soviet Friendship Hospital in Phnom Penh, Cambodia. Asian Pac J Cancer Prev 2015; 16:35-9. [PMID: 25640378 DOI: 10.7314/apjcp.2015.16.1.35] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hepatocellular carcinoma (HCC) is one of the most frequent cancers in South East Asian countries including Cambodia, where prevalence of chronic carriers of hepatitis B and C virus (HBV and HCV) is reported to be very high. We reviewed HCC cases admitted to a cancer hospital in Phnom Penh, which is the only one hospital for cancer treatment and care in Cambodia during the study period. MATERIALS AND METHODS Information was collected from medical records of 281 cases (210 males and 71 females) diagnosed as primary HCC from 2006 to 2011. RESULTS The subjects were 7-81 years old with a median age of 53 years. Hypochondriac pain was the most common complained symptom (74%). One third of the cases presented with jaundice. Nearly half had ascites at their first visit. One third had liver cirrhosis. Nearly three fourths of the cases presented with tumor sized more than 50 mm in diameter, and in almost all cases (97.4%) the size was more than 20 mm. Among 209 subjects tested, hepatitis virus carriers were 75.6%; 46.4% for HBV only, 21.5% for HCV only, and 7.7% for both viral infections. Median age of patients with HBV was about ten years younger than those with HCV. CONCLUSIONS This study revealed the characteristics of HCC cases in Cambodia, although there were several limitations. Most HCC cases were infected with HBV and/or HCV, and diagnosed at late stages with complications. This implicated that public health intervention to prevent HBV and HCV infection is of high priority.
Collapse
Affiliation(s)
- Piseth Narin
- Department of International Cooperation, Ministry of Health, Phnom Penh, Cambodia E-mail :
| | | | | | | | | |
Collapse
|
15
|
Grover S, Xu MJ, Yeager A, Rosman L, Groen RS, Chackungal S, Rodin D, Mangaali M, Nurkic S, Fernandes A, Lin LL, Thomas G, Tergas AI. A systematic review of radiotherapy capacity in low- and middle-income countries. Front Oncol 2015; 4:380. [PMID: 25657930 PMCID: PMC4302829 DOI: 10.3389/fonc.2014.00380] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 12/18/2014] [Indexed: 11/13/2022] Open
Abstract
Objectives: The cancer burden in low- and middle-income countries (LMIC) is substantial. The purpose of this study was to identify and describe country and region-specific patterns of radiotherapy (RT) facilities in LMIC. Methods: A systematic review of the literature was undertaken. A search strategy was developed to include articles on radiation capacity in LMIC from the following databases: PubMed, Embase, CINAHL Plus, Global Health, and the Latin American and Caribbean System on Health Sciences Information. Searches included all literature up to April 2013. Results: A total of 49 articles were included in the review. Studies reviewed were divided into one of four regions: Africa, Asia, Eastern Europe, and South America. The African continent has the least amount of resources for RT. Furthermore, a wide disparity exists, as 60% of all machines on the continent are concentrated in Egypt and South Africa while 29 countries in Africa are still lacking any RT resource. A significant heterogeneity also exists across Southeast Asia despite a threefold increase in megavoltage teletherapy machines from 1976 to 1999, which corresponds with a rise in economic status. In LMIC of the Americas, only Uruguay met the International Atomic Energy Agency recommendations of 4 MV/million population, whereas Bolivia and Venezuela had the most radiation oncologists (>1 per 1000 new cancer cases). The main concern with the review of RT resources in Eastern Europe was the lack of data. Conclusion: There is a dearth of publications on RT therapy infrastructure in LMIC. However, based on limited published data, availability of RT resources reflects the countries’ economic status. The challenges to delivering radiation in the discussed regions are multidimensional and include lack of physical resources, lack of human personnel, and lack of data. Furthermore, access to existing RT and affordability of care remains a large problem.
Collapse
Affiliation(s)
- Surbhi Grover
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA , USA
| | - Melody J Xu
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA , USA
| | - Alyssa Yeager
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA , USA
| | - Lori Rosman
- Johns Hopkins School of Public Health , Baltimore, MD , USA
| | - Reinou S Groen
- Department of Gynecology and Obstetrics, Johns Hopkins Hospital , Baltimore, MD , USA
| | - Smita Chackungal
- Department of Surgery, University of Western Ontario , London, ON , Canada
| | - Danielle Rodin
- Department of Radiation Oncology, University of Toronto , Toronto, ON , Canada
| | - Margaret Mangaali
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA , USA
| | - Sommer Nurkic
- Johns Hopkins School of Public Health , Baltimore, MD , USA
| | - Annemarie Fernandes
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA , USA
| | - Lilie L Lin
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA , USA
| | - Gillian Thomas
- Department of Radiation Oncology, University of Toronto , Toronto, ON , Canada
| | - Ana I Tergas
- Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons , New York, NY , USA
| |
Collapse
|
16
|
Karakoyun-Celik O, Altun M, Olmezoglu A, Büyükpolat MY, Ozkok S, Akmansu M, Cengiz M, Onal C, Dizman A, Esassolak M. Practice Patterns for Oropharyngeal Cancer in Radiation Oncology Centers of Turkey. TUMORI JOURNAL 2014. [DOI: 10.1177/1578.17204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Omur Karakoyun-Celik
- Celal Bayar University Faculty of Medicine, Department of Radiation Oncology, Manisa
| | - Musa Altun
- Istanbul University, Oncology Institute, Department of Radiation Oncology, Istanbul
| | - Ali Olmezoglu
- Ataturk Training and Research Hospital, Department of Radiation Oncology, Izmir
| | | | | | - Muge Akmansu
- Gazi University Faculty of Medicine, Department of Radiation Oncology, Ankara
| | - Mustafa Cengiz
- Hacettepe University Faculty of Medicine, Department of Radiation Oncology, Ankara
| | - Cem Onal
- Baskent University Faculty of Medicine, Department of Radiation Oncology, Adana
| | - Aysen Dizman
- Ankara Oncology Hospital Department of Radiation Oncology, Ankara
| | - Mustafa Esassolak
- Ege University Faculty of Medicine, Department of Radiation Oncology, Izmir, Turkey
| |
Collapse
|