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Gohari K, Saberi S, Esmaieli M, Tashakoripour M, Hosseini ME, Nahvijou A, Mohagheghi MA, Kazemnejad A, Mohammadi M. Development of a gastric cancer risk calculator for questionnaire-based surveillance of Iranian dyspeptic patients. BMC Gastroenterol 2024; 24:39. [PMID: 38238682 PMCID: PMC10797901 DOI: 10.1186/s12876-024-03123-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 01/02/2024] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Gastric cancer (GC) is considered a silent killer, taking more than three quarters of a million lives annually. Therefore, prior to further costly and invasive diagnostic approaches, an initial GC risk screening is desperately in demand. METHODS In order to develop a simple risk scoring system, the demographic and lifestyle indices from 858 GC and 1132 non-ulcer dyspeptic (NUD) patients were analysed. We applied a multivariate logistic regression approach to identify the association between our target predictors and GC versus NUD. The model performance in classification was assessed by receiver operating characteristic (ROC) analysis. Our questionnaire covering 64 predictors, included known risk factors, such as demographic features, dietary habits, self-reported medical status, narcotics use, and SES indicators. RESULTS Our model segregated GC from NUD patients with the sensitivity, specificity, and accuracy rates of 85.89, 63.9, and 73.03%, respectively, which was confirmed in the development dataset (AUC equal to 86.37%, P < 0.0001). Predictors which contributed most to our GC risk calculator, based on risk scores (RS) and shared percentages (SP), included: 1) older age group [> 70 (RS:+ 241, SP:7.23), 60-70 (RS:+ 221, SP:6.60), 50-60 (RS:+ 134, SP:4.02), 2) history of gastrointestinal cancers (RS:+ 173, SP:5.19), 3) male gender (RS:+ 119, SP:3.55), 4) non-Fars ethnicity (RS:+ 89, SP:2.66), 5) illiteracy of both parents (RS:+ 78, SP:2.38), 6) rural residence (RS:+ 77, SP:2.3), and modifiable dietary behaviors (RS:+ 32 to + 53, SP:0.96 to 1.58). CONCLUSION Our developed risk calculator provides a primary screening step, prior to the subsequent costly and invasive measures. Furthermore, public awareness regarding modifiable risk predictors may encourage and promote lifestyle adjustments and healthy behaviours.
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Affiliation(s)
- Kimiya Gohari
- HPGC Research Group, Department of Medical Biotechnology, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran
- Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Samaneh Saberi
- HPGC Research Group, Department of Medical Biotechnology, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran
| | - Maryam Esmaieli
- HPGC Research Group, Department of Medical Biotechnology, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran
| | - Mohammad Tashakoripour
- Gastroenterology Department, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahmoud Eshagh Hosseini
- Gastroenterology Department, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Azin Nahvijou
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Mohagheghi
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Anoshirvan Kazemnejad
- Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
| | - Marjan Mohammadi
- HPGC Research Group, Department of Medical Biotechnology, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran.
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Wee HL, Canfell K, Chiu HM, Choi KS, Cox B, Bhoo-Pathy N, Simms KT, Hamashima C, Shen Q, Chua B, Siwaporn N, Toes-Zoutendijk E. Cancer screening programs in South-east Asia and Western Pacific. BMC Health Serv Res 2024; 24:102. [PMID: 38238704 PMCID: PMC10797973 DOI: 10.1186/s12913-023-10327-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 11/14/2023] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND The burden of cancer can be altered by screening. The field of cancer screening is constantly evolving; from the initiation of program for new cancer types as well as exploring innovative screening strategies (e.g. new screening tests). The aim of this study was to perform a landscape analysis of existing cancer screening programs in South-East Asia and the Western Pacific. METHODS We conducted an overview of cancer screening in the region with the goal of summarizing current designs of cancer screening programs. First, a selective narrative literature review was used as an exploration to identify countries with organized screening programs. Second, representatives of each country with an organized program were approached and asked to provide relevant information on the organizations of their national or regional cancer screening program. RESULTS There was wide variation in the screening strategies offered in the considered region with only eight programs identified as having an organized design. The majority of these programs did not meet all the essential criteria for being organized screening. The greatest variation was observed in the starting and stopping ages. CONCLUSIONS Essential criteria of organized screening are missed. Improving organization is crucial to ensure that the beneficial effects of screening are achieved in the long-term. It is strongly recommended to consider a regional cancer screening network.
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Affiliation(s)
- Hwee-Lin Wee
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Karen Canfell
- The Daffodil Centre, A Joint Venture with Cancer Council NSW and the University of Sydney, Sydney, NSW, Australia
| | - Han-Mo Chiu
- Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Kui Son Choi
- Graduate School of Cancer Science and Policy, National Cancer Center, Ilsandonggu, Goyang, Republic of Korea
| | - Brian Cox
- Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Nirmala Bhoo-Pathy
- Centre for Epidemiology and Evidence-Based Practice, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Kate T Simms
- The Daffodil Centre, A Joint Venture with Cancer Council NSW and the University of Sydney, Sydney, NSW, Australia
| | - Chisato Hamashima
- Division of Cancer Screening Assessment and Management, Institute of Cancer Control, National Cancer Center, Tokyo, Japan
- Teikyo University, Tokyo, Japan
| | - Qianyu Shen
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Brandon Chua
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Niyomsri Siwaporn
- Department of Medical Services, Ministry of Public Health, National Cancer Institute of Thailand, Bangkok, Thailand
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Esther Toes-Zoutendijk
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
- Department of Public Health, Erasmus MC University Medical Center, P.O. Box 2014, Rotterdam, CA, 3000, the Netherlands.
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Mishra GA, Shaikh HA, Pimple SA, Awasthi AA, Kulkarni VY. Determinants of Compliance to Population-Based Oral Cancer Screening Program among low Socioeconomic Women in Mumbai, India. Indian J Community Med 2021; 46:210-215. [PMID: 34321728 PMCID: PMC8281837 DOI: 10.4103/ijcm.ijcm_190_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 11/24/2020] [Indexed: 12/24/2022] Open
Abstract
Background The use of tobacco, especially smokeless variety, is common and culturally accepted among Indian women. Hence, oral cavity cancers rank as the fourth most common cancers among Indian women. Objectives The objectives of this study were to study factors determining compliance of women for oral cancer screening in a population-based program in Mumbai and to create awareness among women regarding ill effects of tobacco and importance of oral cancer screening. Materials and Methods This is a community-based organized service program for awareness and screening of oral cavity cancers among women residing in low socioeconomic areas of Mumbai, India. Screening was conducted by oral visual inspection by trained primary health workers (PHWs). Univariate and multivariate logistic regression analyses were conducted to identify predictors of participation in oral cancer screening. Results 138,383 population was surveyed, out of which 13,492 eligible women were enlisted for oral cancer screening. Among these, 12,495 were contacted and 11,895 (95.12%) women participated in a cancer awareness program and 11,768 (94.18%) participated in oral cancer screening. According to results of multivariate logistic regression analysis, women belonging to Hindu religion 94.57%, with mother tongue Marathi 94.76%, and with family history of cancer 95.84% complied significantly higher to oral cancer screening as compared to other women. Conclusion This program has assisted in identifying predictors of compliance to oral cavity screening. Furthermore, it demonstrates that good compliance can be achieved through multiple household visits, personal invitation during camps, organizing well-planned Health Education Program, and the use of simple, low-cost visual inspection test performed by trained PHWs.
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Affiliation(s)
- Gauravi A Mishra
- Department of Preventive Oncology, Centre for Cancer Epidemiology, Tata Memorial Centre, Homi Bhabha National Institute (HBNI) Parel, Mumbai, Maharashtra, India
| | - Heenakauser A Shaikh
- Department of Preventive Oncology, Centre for Cancer Epidemiology, Tata Memorial Centre, Homi Bhabha National Institute (HBNI) Parel, Mumbai, Maharashtra, India
| | - Sharmila A Pimple
- Department of Preventive Oncology, Centre for Cancer Epidemiology, Tata Memorial Centre, Homi Bhabha National Institute (HBNI) Parel, Mumbai, Maharashtra, India
| | - Aanchal A Awasthi
- Department of Clinical Research Secretariat, Tata Memorial Hospital, Tata Memorial Centre, Homi Bhabha National Institute (HBNI) Parel, Mumbai, Maharashtra, India
| | - Vasundhara Y Kulkarni
- Department of Preventive Oncology, Centre for Cancer Epidemiology, Tata Memorial Centre, Homi Bhabha National Institute (HBNI) Parel, Mumbai, Maharashtra, India
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Mahalakshmi S, Suresh S. Barriers to Cancer Screening Uptake in Women: A Qualitative Study from Tamil Nadu, India. Asian Pac J Cancer Prev 2020; 21:1081-1087. [PMID: 32334474 PMCID: PMC7445965 DOI: 10.31557/apjcp.2020.21.4.1081] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The uptake for cancer screening has been consistently poor in India despite the efforts of nation-wide screening programs. Understanding the barriers and enablers among community women would aid in increasing the proportion of cancer screening uptake. METHODS Nineteen key informants including community women, service providers and a cancer survivor were interviewed using a semi-structured interview guide. Interviews were recorded and transcribed by the interviewers. Manual descriptive thematic analysis was conducted using deductive approach. Codes were given and extracted into categories which were later grouped to form themes. RESULTS The mean age of participants was 38 years. Among the participants, 38.9% and 16.7% underwent breast and cervical cancer screening respectively. The psychosocial factors were the major barriers for screening uptake such as fear of screening procedure and fear of being diagnosed with cancer. The other factors include lack of awareness, cultural beliefs, in addition to financial difficulties and health care system-related factors. Change in government policies to conduct mandatory screening programs, incentivization and creating awareness were reported as enablers for increasing the screening uptake among women. CONCLUSION Psychosocial factors, the major barriers for screening uptake in women have remained unchanged over the years. Increasing awareness campaigns, usage of decision-making aids and changes in government policies are crucial for improving the rate of uptake and successful implementation of national screening programs.
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Affiliation(s)
- Selvam Mahalakshmi
- Department of Applied Psychology, Rajiv Gandhi National Institute for Youth Development, Sriperumpudur, Kanchipuram, Tamil Nadu, India
| | - Sundaram Suresh
- Department of Applied Psychology, Rajiv Gandhi National Institute for Youth Development, Sriperumpudur, Kanchipuram, Tamil Nadu, India
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Philip PM, Nayak P, Philip S, Parambil NA, Duraisamy K, Balasubramanian S. Population-based cancer screening through community participation: Outcome of a district wide oral cancer screening program from rural Kannur, Kerala, India. South Asian J Cancer 2018; 7:244-248. [PMID: 30430093 PMCID: PMC6190395 DOI: 10.4103/sajc.sajc_104_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background: Oral cancer is a major public health challenge, and about one-fifth of all oral cancer cases reported globally are from India. In spite of the potential for early detection by simple visual examination, the majority of patients report in later stages of the disease, especially in low and middle-income countries. We report the results from a district level population-based oral cancer screening program. Methods: A cross-sectional survey was carried out among people aged >15 years in 48 panchayats of Kannur district in Kerala, India. This comprehensive multi-stakeholder district-wide screening was carried out in six stages including planning, sensitization, recruiting of community volunteers and training, survey, organization of specialist camps and referring to cases to cancer center. The descriptive statistical analysis was performed using EpiData analysis software (Version 2.2.2.180). Results: Among the 1,061,088 people in 265,272 houses surveyed, 2507 of them attended the screening camps, and 13 oral cancers and 174 oral precancers were detected. Majority of the oral cancer patients were male (69%), with primary education or illiterate (62%) and low socioeconomic status (61%). Five of the patients diagnosed with early-stage cancer are alive and have good oral health-related quality of life. Conclusion: Detection of precancerous and early-stage cancers should be a priority of oral cancer screening programs. The possible key for addressing cancer screening needs of the rural population is to equip the primary health centers in cancer screening activities with available human resources while adapting to local context.
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Affiliation(s)
| | - Priyakanta Nayak
- PATH, Department of International Development, India Country Programme, New Delhi, India
| | - Sairu Philip
- Department of Community Medicine, Government T. D. Medical College, Alappuzha, Kerala, India
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Verdial FC, Etzioni R, Duggan C, Anderson BO. Demographic changes in breast cancer incidence, stage at diagnosis and age associated with population-based mammographic screening. J Surg Oncol 2017; 115:517-522. [PMID: 28194807 DOI: 10.1002/jso.24579] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 01/24/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Breast cancer incidence and mortality are influenced by early-detection methods, including mammographic screening. Demographic changes in US statistics serve as a model for changes that can be anticipated in countries where mammographic screening has not been implemented. METHODS SEER statistics (1973-2013) for breast cancer mortality, incidence, stage at diagnosis, and age at diagnosis were examined. Temporal associations between screening changes and breast cancer demographics in the US were documented. FINDINGS Before 1982 (pre-screening), breast cancer incidence in the US remained stable, with similar incidence of localized and regional cancers, and with in-situ disease comprising <2% of diagnosed disease.1 During the transitional phase of mammographic screening, breast cancer incidence increased. In 1991, breast cancer age-adjusted mortality rates began decreasing and have continued to decrease. In the post-screening phase, stage distribution stabilized, but now with localized and in-situ disease representing the majority of diagnosed cases. The median age at diagnosis has increased to 61 years. DISCUSSION Mammographic screening increases breast cancer incidence, shifts the stage distribution toward earlier stage disease, and in high-income countries, is associated with improved survival. Whether similar improvement in breast cancer survival can be achieved in the absence of mammographic screening has yet to be conclusively demonstrated.
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Affiliation(s)
- Francys C Verdial
- Department of Surgery, University of Washington School of Medicine, Seattle, Washington
| | - Ruth Etzioni
- Program in Epidemiology, Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Catherine Duggan
- Program in Epidemiology, Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Benjamin O Anderson
- Department of Surgery, University of Washington School of Medicine, Seattle, Washington.,Breast Health Global Initiative, Fred Hutchinson Cancer Research Center, Seattle, Washington.,Department of Global Health-Medicine, University of Washington School of Medicine, Seattle, Washington
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