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Quattrocchi A, Demetriou CA, Cory OA, Saad B, Constantinou C, Marcou Y, Demetriou A, Scoutellas V, Kolokotroni O. Breast cancer trends in women in Cyprus: a population-based study between 2004-2017. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac131.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
In Cyprus, breast cancer (BC) is the first in incidence and second in mortality cancer in women. A national screening programme (NSP), targeting women 50-69 years, was introduced in 2007. The aim of this study is to provide a better understanding of cancer trends.
Methods
Data from the national population-based Cyprus Cancer Registry on adult women diagnosed with BC between 2004-2017 with follow-up until 2019 were analysed as follows: Joinpoint regression for age-adjusted (overall and by tumor stage at diagnosis - TSD) and age-specific rates (<50, 50-59, 60-69, 70-79, ≥ 80) incidence and mortality rates; 5-year age-adjusted Net Survival (NS) rates, overall and by TSD. TSD was categorised as localised, regional, and distant.
Results
Age-adjusted incidence rate increased from 135.3 (2004) to 153.2 (2017) per 100,000, with an annual percentage change (APC) of 1.1% (95%CI: 0.4-1.9). The greatest increase was in the age groups ≥70 years. A positive time trend was found for localized cancers between 2006-2017, while for all other stages nonsignificant trends were detected. Age-adjusted mortality rate increased from 37.0 (2004) to 50.0 (2019) per 100,000 (APC: 2.7%; 95%CI: 1.9-9.4). Significant increases in mortality rates were detected in the age groups ≥70 years. By TSD, increased rates were found at localised and regional stages, however smaller increases were detected since 2007. NS rates for the most recent period (2014-2017) was 93% for localized, 81% for regional, and 32% for distant and did not significantly improve compared to the previous years.
Conclusions
Trends in BC incidence continues to increase, especially in the older age groups and for early-stage cancers. As expected, since the introduction of the NSP, the incidence of localised cancers increased whilst the incidence of advanced stage cancer decreased, albeit non-significantly. Survival trends did not change but mortality rates for localised and regional cancers increased at a slower pace.
Key messages
• The introduction of the national screening programme may have played an important role in the increasing BC incidence trends.
• Despite survival rates not improving since the introduction of the national screening programme, mortality rates for early-stage cancers show a less steep increase.
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Affiliation(s)
- A Quattrocchi
- Primary Care and Population Health, University of Nicosia Medical School , Nicosia, Cyprus
| | - CA Demetriou
- Primary Care and Population Health, University of Nicosia Medical School , Nicosia, Cyprus
| | - OA Cory
- University of Nicosia Medical School , Nicosia, Cyprus
| | - B Saad
- University of Nicosia Medical School , Nicosia, Cyprus
| | - C Constantinou
- Basic and Clinical Sciences, University of Nicosia Medical School , Nicosia, Cyprus
| | - Y Marcou
- Bank of Cyprus Oncology Center , Nicosia, Cyprus
| | - A Demetriou
- Health Monitoring Unit, Ministry of Health , Nicosia, Cyprus
| | - V Scoutellas
- Health Monitoring Unit, Ministry of Health , Nicosia, Cyprus
| | - O Kolokotroni
- School of Health Sciences, Cyprus University of Technology , Limassol, Cyprus
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Demetriou CA, Quattrocchi A, Heraclides A, Constantinou C, Marcou Y, Demetriou A, Scoutellas V, Kolokotroni O. Geographical inequalities in breast cancer incidence, mortality and late stage at diagnosis in Cyprus. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.1259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
A national breast cancer (BC) screening programme, targeting women 50-69 years old, was introduced in Cyprus in 2007. This study aims to assess rural/urban differences in BC incidence, tumour stage at diagnosis (TSD) and mortality, since 2004 and since the introduction of the screening programme.
Methods
Data were obtained for 6589 new cases of BC (diagnosis 2004-2016) from a national population-based cancer registry (1998-today) in Cyprus. TSD was recorded according to the Surveillance, Epidemiology, and End Results categories. We defined late TSD as regional or distant stage. Unknown stages were excluded. We linked cases to the population census data and place of residence (rural/urban) and calculated incidence and mortality rate ratios (RR) by place of residence. We conducted logistic regression to measure the association between place of residence and TSD or mortality, adjusting for sex, age, ethnicity, smoking and marital status. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) are reported.
Results
Since 2004, 54.7% of BC cases were diagnosed at localised stage, 40.6% at regional stage and 4.7% at distant stage. Incidence, but not mortality, rate for all BC was higher in urban than in rural areas (RRincidece=1.22;95%CI=1.51-1.28 and RRmortality=1.10;95%CI=0.97-1.24). Rural place of residence was associated with higher odds of late TSD (aOR=1.34; 95%CI=1.15-1.58) and death (aOR=1.36; 95%CI=1.11-1.68). After the introduction of the screening programme, for the targeted age group, rural place of residence was still associated with higher odds of late TSD (aOR=1.31; 95%C= 1.03-1.67), but not with death (p > 0.05).
Conclusions
Even though BC incidence is higher in urban than in rural areas, women residing in rural areas had higher odds of late TSD and death. The introduction of the national BC screening programme only slightly reduced geographical inequalities in TSD. Further studies are needed to understand and reduce the role of inequalities in TSD.
Key messages
Rural/Urban inequalities in TSD are evident among BC cases in Cyprus, diagnosed between 2004 and 2016. The introduction of the national BC screening programme reduced but did not overcome geographical inequalities in TSD.
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Affiliation(s)
- C A Demetriou
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
| | - A Quattrocchi
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
| | - A Heraclides
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
| | - C Constantinou
- Department of Basic and Clinical Sciences, University of Nicosia Medical School, Nicosia, Cyprus
| | - Y Marcou
- Bank of Cyprus Oncology Center, Nicosia, Cyprus
| | - A Demetriou
- Health Monitoring Unit, Ministry of Health, Nicosia, Cyprus
| | - V Scoutellas
- Health Monitoring Unit, Ministry of Health, Nicosia, Cyprus
| | - O Kolokotroni
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
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van der Meij L, Demetriou A, Tulin M, Méndez I, Dekker P, Pronk T. Hormones in speed-dating: The role of testosterone and cortisol in attraction. Horm Behav 2019; 116:104555. [PMID: 31348926 DOI: 10.1016/j.yhbeh.2019.07.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 06/26/2019] [Accepted: 07/12/2019] [Indexed: 12/11/2022]
Abstract
There is evidence that testosterone and cortisol levels are related to the attraction of a romantic partner; testosterone levels relate to a wide range of sexual behaviors and cortisol is a crucial component in the response to stress. To investigate this, we conducted a speed-dating study among heterosexual singles. We measured salivary testosterone and cortisol changes in men and women (n = 79) when they participated in a romantic condition (meeting opposite-sex others, i.e., potential romantic partners), as well as a control condition (meeting same-sex others, i.e., potential friends). Over the course of the romantic speed-dating event, results showed that women's but not men's testosterone levels increased and cortisol levels decreased for both men and women. These findings indicate that men's testosterone and cortisol levels were elevated in anticipation of the event, whereas for women, this appears to only be the case for cortisol. Concerning the relationship between attraction and hormonal change, four important findings can be distinguished. First, men were more popular when they arrived at the romantic speed-dating event with elevated cortisol levels. Second, in both men and women, a larger change in cortisol levels during romantic speed-dating was related to more selectivity. Third, testosterone alone was unrelated to any romantic speed-dating outcome (selectivity or popularity). However, fourth, women who arrived at the romantic speed-dating event with higher testosterone levels were more selective when their anticipatory cortisol response was low. Overall, our findings suggest that changes in the hormone cortisol may be stronger associated with the attraction of a romantic partner than testosterone.
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Affiliation(s)
- Leander van der Meij
- Department of Industrial Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands.
| | | | - Marina Tulin
- Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, the Netherlands
| | - Ileana Méndez
- Department of Experimental and Applied Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Peter Dekker
- Department of Experimental and Applied Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Tila Pronk
- Department of Social Psychology, Tilburg University, Tilburg, the Netherlands
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Charalambous H, Demetriou A, Frangos S, Pavlou P. Increase in thyroid cancer (TC) incidence in Cyprus: Overdiagnosis or true increase of clinically relevant TC? Ann Oncol 2018. [DOI: 10.1093/annonc/mdy302.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Rosenthal DA, Demetriou A, Efklides A. A Cross-National Study of the Influence of Culture on Conflict Between Parents and Adolescents. International Journal of Behavioral Development 2016. [DOI: 10.1177/016502548901200205] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Cultural differences in the dynamics of conflict between parents and adolescents were studied in 40 working-class Australian resident families, 20 of whom were of Anglo-Celtic descent and 20 Greek-born, and 40 Greekresident families, 20 of whom were working-class and 20 professional class. Levels and seriousness of conflict were investigated as well as three aspects of conflict dynamics: behaviour during conflict, styles of resolving conflict, and beliefs about the consequences of conflict. Mothers and adolescents were more aware than fathers of conflict and its effect on family life, they had a more differentiated set of conflict behaviours and were able to accept conflict as part of life which need not have long-term serious consequences. The results suggested that although cultural variation in response to conflict was not extensive, the immigrant Greek parents responded in ways which reflected both their Greek origin and their country of residence while their adolescents appeared to have moved towards an Anglo-Australian mode of responding. Implications for a culture conflict model, a cultural differences model and an assimilation model of intergenerational conflict in immigrant families are discussed.
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Affiliation(s)
| | | | - A. Efklides
- Aristotelian University of Thessaloniki, Greece
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6
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Abstract
The competitive adsorption of boric acid and chromate from aqueous solutions by alumina has been investigated by spectrophotometry at pH 8, ionic strength = 0.0, 0.1 and 1.0 M NaClO4, T = 22 ± 3 °C and under normal atmospheric conditions. The experimental data show that addition of excess boric acid in the system leads to the increase of Cr(VI) concentration in solution, indicating the replacement of adsorbed chromate by boron on the alumina surface. Data evaluation results in the determination of the competition reaction constant and the formation constant of the Cr(VI) surface complexes, which are logKCr(VI)-B(III) = -3.5 ± 0.2 and logβ*Cr = 7.6 ± 0.3, respectively.
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Affiliation(s)
- A Demetriou
- Department of Chemistry, University of Cyprus, P.O. Box 20537, Cy-1678 Nicosia, Cyprus E-mail:
| | - I Pashalidis
- Department of Chemistry, University of Cyprus, P.O. Box 20537, Cy-1678 Nicosia, Cyprus E-mail:
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Abstract
BACKGROUND Neonatal stroke is an important cause of neurodisability in childhood and in later life. Delay in diagnosis is often inevitable due to the non-specific presentation, the lack of clinical signs, and not considering stroke early enough in the differential diagnosis. CASE We report the case of a baby who initially presented with apparent newborn "jitteriness" and abnormal movements. On the background of an unremarkable birth history and negative initial investigations, the baby subsequently developed focal seizures. The diagnosis was suspected to be neonatal stroke which was later confirmed on magnetic resonance imaging. CONCLUSION General Movements assessment is an established useful tool used in the assessment of such babies and proves helpful in evaluating whether movements are normal or pathological, in addition to prognosticating outcome. Cranial ultrasound is a commonly employed first-line investigation, however, initial normal intracranial appearances do not exclude stroke. Magnetic resonance imaging is the gold standard but may not be immediately available to all practitioners.
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Affiliation(s)
- M Paddock
- Academic Unit of Radiology, University of Sheffield, Royal Hallamshire Hospital, Sheffield, United Kingdom
| | - A Demetriou
- Department of Paediatrics, Imperial College Healthcare, London, United Kingdom
| | - R Nicholl
- Neonatal Unit, Northwick Park Hospital, Harrow, Middlesex, United Kingdom
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Efstathiou M, Aristarchou T, Kiliari T, Demetriou A, Pashalidis I. Seasonal variation, chemical behavior and kinetics of uranium in an unconfined groundwater system. J Radioanal Nucl Chem 2013. [DOI: 10.1007/s10967-013-2787-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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9
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Coffman KL, Sher L, Hoffman A, Rojter S, Folk P, Cramer DV, Vierling J, Villamel F, Podesta L, Demetriou A, Makowka L. Survey results of transplant patients' attitudes on xenografting. Psychosomatics 1998; 39:379-83. [PMID: 9691708 DOI: 10.1016/s0033-3182(98)71327-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
For centuries, many cultures have described mythical creatures with bodies that combined human and animal features, often the result of violating taboos. This study attempted to investigate the beliefs of transplant patients about xenografting. A survey was given to 100 patients ranging in age from 17 to 74 years old, with 65 men and 35 women, including 72 whites, 18 Hispanics, 5 African Americans, and 4 Asian Americans. The subjects included liver, heart, kidney, lung, and multi-organ transplant patients. The patients were not aware of plans for xenografting at the center under study. Eighty patients agreed with xenografting in an emergency situation. Ten subjects replied, "under no circumstances." Ninety percent believed animal research has advanced medical science. In descending order, the patients preferred human (96%), monkey (44%), mechanical (43%), pig (42%), or dog (34%) organs. Twenty-four patients thought a xenograft would change their appearance, personality, or eating or sexual habits. Twenty patients believed animals have souls. The patients also documented any ethical concerns about xenografting.
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Affiliation(s)
- K L Coffman
- Comprehensive Liver Disease and Treatment Center, St. Vincent Medical Center, Los Angeles, California 90037-1904, USA
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Coffman KL, Hoffman A, Rosenthal P, Demetriou A, Makowka L. Neurological and psychological sequelae in transplant recipients after bridging with the bioartificial liver. Gen Hosp Psychiatry 1996; 18:20S-24S. [PMID: 8937919 DOI: 10.1016/s0163-8343(96)00080-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Prior to the advent of the bioartificial liver there was little hope to offer the families of comatose patients unless an organ could be found immediately, or xenografting was attempted. The elevated intracranial pressure that develops is more life-threatening than prolonged bleeding times. Over a 2-year period, nine patients were bridged to transplantation using the BAL to keep them neurologically intact prior to surgery. The goal is to maintain the ICP less than 20 mmHg in adults and between 10 and 15 mmHg in children, so that the cerebral perfusion pressure remains above 50 mmHg. The first patients, a 35-year-old woman, arrived in stage II coma. The second patient, a 10-year-old boy in stage IV coma, had decerebrate posturing and anisocoria. The third patient, an 18-year-old girl, had an ICP of 28 mmHg with decerebrate posturing and disconjugate gaze. The fourth patient, a 34-year-old male, had an ICP of > 38 mmHg. The fifth patient, a 24-year-old male, had fixed dilated pupils. The sixth patient, a 50-year-old woman, had readings to 52 mmHg. The seventh patient, a 48-year-old male, had postoperative numbness in his fingertips that remitted. The eighth patient, a 31-year-old female, had decerebrate posturing and an ICP of 64 mmHg transiently. The ninth patient, a 52-year-old woman, had decerebrate posturing with a peak ICP of 50 mmHg. All nine patients survived.
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Affiliation(s)
- K L Coffman
- St. Vincent Medical Center, National Institute for Transplantation, Los Angeles, CA 90057, USA
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11
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Paine ML, Gibbins JR, Chew KE, Demetriou A, Kefford RF. Loss of keratin expression in anaplastic carcinoma cells due to posttranscriptional down-regulation acting in trans. Cancer Res 1992; 52:6603-11. [PMID: 1384967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Rat keratin K5 and vimentin complementary DNAs have been isolated, identified, and used to study keratin and vimentin expression as markers for cell differentiation. Isologous rat neoplastic epithelial cell lines used were based on a clonal benign epithelial line (A5P/B10) and a clonal anaplastic malignant derivative line (T952/F7). Stable cytoplasmic mRNA was detected for keratin but not vimentin in the benign cells. The anaplastic derivative cells expressed vimentin but showed a 1000-fold reduction in the keratin message, which nuclear run-on assays identified as being due to posttranscriptional down-regulation. An identical pattern of posttranscriptional down-regulation was found in independent malignant somatic cell hybrids of the benign and anaplastic cells. trans-acting regulatory mechanisms implicated in posttranscriptional (pretranslational) keratin down-regulation in these anaplastic malignant cells may play a role in the apparent loss of differentiation evident in tumor progression.
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Affiliation(s)
- M L Paine
- Department of Medical Oncology, University of Sydney, Westmead Centre, New South Wales, Australia
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Abstract
This study determined the pathological effects of niacin/tryptophan deficiency on the esophagus. Nine patients with severe clinical pellagra and 31 age- and sex-matched controls were assessed. All pellagrins had an esophagitis varying from severe to mild. The esophagitis improved in five patients following six to seven days of vitamin therapy. The relationship between vitamin deficiencies and esophageal cancer is discussed.
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Affiliation(s)
- I Segal
- Gastroenterology Unit, Baragwanath Hospital, Johannesburg, South Africa
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13
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Demetriou A, Efklides A. The person's conception of the structures of developing intellect: early adolescence to middle age. Genet Soc Gen Psychol Monogr 1989; 115:371-423. [PMID: 2792743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
According to experiential structuralism, thought abilities have six capacity spheres: experimental, propositional, quantitative, imaginal, qualitative, and metacognitive. The first five are applied to the environment. The metacognitive capacity is applied to the others, serving as the interface between reality and the cognitive system or between any of the other capacities. To test this postulate, 648 subjects aged 12 to 40 years, solved eight tasks that were addressed, in pairs, to the first four capacity spheres. One of the tasks in each pair tapped the first and the other the third formal level of the sphere. Having solved the tasks, the subjects were required to rate each pair of tasks in terms of similarity of operations, difficulty, and success of solution. Factor analysis of difficulty and success evaluation scores revealed the same capacity-specific factors as the analysis of performance scores. Factor analysis of similarity scores differentiated between same- and different-sphere pairs. Analysis of variance showed that difficulty and success evaluation scores preserved performance differences between the first and the third formal tasks. Cognitive level, age, socioeconomic status, and sex were related to the metacognitive measures in ways similar to their relations to performance measures. These findings were integrated into a model aimed at capturing real-time metacognitive functioning.
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Affiliation(s)
- A Demetriou
- Division of Psychology, Aristotelian University of Thessaloniki, Greece
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Abstract
Twenty (44%) of 45 patients with cutaneous pellagra had diarrhoea. Inflammation was seen on sigmoidoscopy in 42 and was severe in 5 (11%), moderate in 4 (9%) and mild in 33 (73%). Six patients (13%) had perianal excoriation. Rectal biopsies taken in all cases showed extensive ulceration in 1 case, moderate to severe inflammation in 16 (36%) and mild inflammation in 18 (40%). Minimal oedema of the lamina propria was seen in 11 (24%) patients. At 5 to 7 days after starting vitamin treatment in nine cases histological changes had returned to normal in 4, improved in 3 and had not changed in 2. Diarrhoea stopped within a week in all cases.
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Demetriou A. Points: Vocational training for general practice. West J Med 1980. [DOI: 10.1136/bmj.281.6243.813-d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Demetriou A, Thorpe M, Forrest T. A secure isolation unit in Manchester. Nurs Times 1979; 75:274-6. [PMID: 253322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Abstract
A 2 1/2-year-old girl recently arrived from eastern Nigeria presented with a soft tissue swelling of the infraclavicular region. Subsequent investigation revealed a cavity in the left lung associated with a small pleural effusion and leucocytosis with pronounced eosinophilia. Clinical and serological findings were compatible with the diagnosis of paragonimiasis. After a course of Bitin-S the chest x-ray returned to normal, the soft tissue changes disappeared, and the eosinophil count fell.
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Rettura G, Schittek A, Hardy M, Levenson SM, Demetriou A, Seifter E. Antitumor action of vitamin A in mice inoculated with adenocarcinoma cells. J Natl Cancer Inst 1975; 54:1489-91. [PMID: 1133855 DOI: 10.1093/jnci/54.6.1489] [Citation(s) in RCA: 44] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Vitamin A palmitate was incorporated into a laboratory chow (150,000 IU/kg diet) and fed ad libitum to C3H/HeJ female mice inoculated with 1 times 10-6 C3HBA tumor cells, beginning the day of inoculation. Control female mice of the same strain similarly inoculated were fed the laboratory chow alone. Vitamin A did not affect rate for the first 19 days, after which growth rates were independent of treatment. Vitamin A-treated mice survived for significantly longer times than did control mice.
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