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Yun DY, Bae JY, Kang YJ, Lim CU, Jang GH, Eom MO, Choe WJ. Simultaneous Analysis of 272 Pesticides in Agricultural Products by the QuEChERS Method and Gas Chromatography with Tandem Mass Spectrometry. Molecules 2024; 29:2114. [PMID: 38731605 PMCID: PMC11085925 DOI: 10.3390/molecules29092114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 04/26/2024] [Accepted: 04/30/2024] [Indexed: 05/13/2024] Open
Abstract
The aim of this study is to develop a rapid and accurate method for simultaneous analysis of multi-residue pesticides and conduct pesticide monitoring in agricultural products produced by the production and distribution stage in Korea. The representative agricultural products were selected as brown rice, soybean, potato, mandarin, and green pepper and developed using gas chromatography with tandem mass (GC-MS/MS) for the analysis of 272 pesticide residues. The experimental samples were extracted by the QuEChERS-EN method and then cleaned up by using d-SPE, including MgSO4 and primary secondary amine (PSA) sorbents. The established method was validated in accordance with Codex CAC-GL/40, and the limit of quantitation (LOQ) was determined to be 0.01 mg/kg. A total of 243 pesticides satisfied the guidelines in five samples at three levels with values of 60 to 120% (recovery) and ≤45% (coefficient of variation, CV). The remaining 29 pesticides did not satisfy the guidelines, and these pesticides are expected to be used as a screening method for the routine inspection of agricultural products. As a result of analyzing 223 agricultural products in South Korea by applying the simultaneous analysis method, none of the detected levels in the samples exceeded the standard values based on maximum residue limits (MRLs). The developed method in this study will be used to inspect residual pesticides in agricultural products, and it is anticipated to contribute to the distribution of safe agricultural products to consumers.
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Affiliation(s)
- Da-Young Yun
- Pesticides and Veterinary Drug Residues Division, National Institute of Food and Drug Safety Evaluation, Ministry of Food and Drug Safety, Cheongju 28159, Republic of Korea; (D.-Y.Y.); (J.-Y.B.); (G.-H.J.); (M.-O.E.)
| | - Ji-Yeon Bae
- Pesticides and Veterinary Drug Residues Division, National Institute of Food and Drug Safety Evaluation, Ministry of Food and Drug Safety, Cheongju 28159, Republic of Korea; (D.-Y.Y.); (J.-Y.B.); (G.-H.J.); (M.-O.E.)
| | - Yoon-Jung Kang
- Center for Food and Drug Analysis, Busan Regional Office of Food and Drug Safety, Busan 47537, Republic of Korea;
| | - Chae-Uk Lim
- Safety Analysis Division, Experiment Research Institute, National Agricultural Products Quality Management Service, Kimcheon 39660, Republic of Korea;
| | - Gui-Hyun Jang
- Pesticides and Veterinary Drug Residues Division, National Institute of Food and Drug Safety Evaluation, Ministry of Food and Drug Safety, Cheongju 28159, Republic of Korea; (D.-Y.Y.); (J.-Y.B.); (G.-H.J.); (M.-O.E.)
| | - Mi-Ok Eom
- Pesticides and Veterinary Drug Residues Division, National Institute of Food and Drug Safety Evaluation, Ministry of Food and Drug Safety, Cheongju 28159, Republic of Korea; (D.-Y.Y.); (J.-Y.B.); (G.-H.J.); (M.-O.E.)
| | - Won-Jo Choe
- Pesticides and Veterinary Drug Residues Division, National Institute of Food and Drug Safety Evaluation, Ministry of Food and Drug Safety, Cheongju 28159, Republic of Korea; (D.-Y.Y.); (J.-Y.B.); (G.-H.J.); (M.-O.E.)
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Lacaze P, Marquina C, Tiller J, Brotchie A, Kang YJ, Merritt MA, Green RC, Watts GF, Nowak KJ, Manchanda R, Canfell K, James P, Winship I, McNeil JJ, Ademi Z. Combined population genomic screening for three high-risk conditions in Australia: a modelling study. EClinicalMedicine 2023; 66:102297. [PMID: 38192593 PMCID: PMC10772163 DOI: 10.1016/j.eclinm.2023.102297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 10/12/2023] [Accepted: 10/13/2023] [Indexed: 01/10/2024] Open
Abstract
Background No previous health-economic evaluation has assessed the impact and cost-effectiveness of offering combined adult population genomic screening for mutliple high-risk conditions in a national public healthcare system. Methods This modeling study assessed the impact of offering combined genomic screening for hereditary breast and ovarian cancer, Lynch syndrome and familial hypercholesterolaemia to all young adults in Australia, compared with the current practice of clinical criteria-based testing for each condition separately. The intervention of genomic screening, assumed as an up-front single cost in the first annual model cycle, would detect pathogenic variants in seven high-risk genes. The simulated population was 18-40 year-olds (8,324,242 individuals), modelling per-sample test costs ranging AU$100-$1200 (base-case AU$200) from the year 2023 onwards with testing uptake of 50%. Interventions for identified high-risk variant carriers follow current Australian guidelines, modelling imperfect uptake and adherence. Outcome measures were morbidity and mortality due to cancer (breast, ovarian, colorectal and endometrial) and coronary heart disease (CHD) over a lifetime horizon, from healthcare-system and societal perspectives. Outcomes included quality-adjusted life years (QALYs) and incremental cost-effectiveness ratio (ICER), discounted 5% annually (with 3% discounting in scenario analysis). Findings Over the population lifetime (to age 80 years), the model estimated that genomic screening per-100,000 individuals would lead to 747 QALYs gained by preventing 63 cancers, 31 CHD cases and 97 deaths. In the total model population, this would translate to 31,094 QALYs gained by preventing 2612 cancers, 542 non-fatal CHD events and 4047 total deaths. At AU$200 per-test, genomic screening would require an investment of AU$832 million for screening of 50% of the population. Our findings suggest that this intervention would be cost-effective from a healthcare-system perspective, yielding an ICER of AU$23,926 (∼£12,050/€14,110/US$15,345) per QALY gained over the status quo. In scenario analysis with 3% discounting, an ICER of AU$4758/QALY was obtained. Sensitivity analysis for the base case indicated that combined genomic screening would be cost-effective under 70% of simulations, cost-saving under 25% and not cost-effective under 5%. Threshold analysis showed that genomic screening would be cost-effective under the AU$50,000/QALY willingness-to-pay threshold at per-test costs up to AU$325 (∼£164/€192/US$208). Interpretation Our findings suggest that offering combined genomic screening for high-risk conditions to young adults would be cost-effective in the Australian public healthcare system, at currently realistic testing costs. Other matters, including psychosocial impacts, ethical and societal issues, and implementation challenges, also need consideration. Funding Australian Government, Department of Health, Medical Research Future Fund, Genomics Health Futures Mission (APP2009024). National Heart Foundation Future Leader Fellowship (102604).
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Affiliation(s)
- Paul Lacaze
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Clara Marquina
- Health Economics and Policy Evaluation Research (HEPER) Group, Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, VIC 3052, Australia
| | - Jane Tiller
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Adam Brotchie
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Yoon-Jung Kang
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, NSW 2011, Australia
| | - Melissa A. Merritt
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, NSW 2011, Australia
| | - Robert C. Green
- Mass General Brigham, Broad Institute, Ariadne Labs and Harvard Medical School, Boston, MA, 02114, USA
| | - Gerald F. Watts
- School of Medicine, University of Western Australia, Perth, WA 6009, Australia
- Departments of Cardiology and Internal Medicine, Royal Perth Hospital, Perth, WA, 6001, Australia
| | - Kristen J. Nowak
- Public and Aboriginal Health Division, Western Australia Department of Health, East Perth, WA, 6004, Australia
- Centre for Medical Research, The University of Western Australia, Crawley, WA, 6009, Australia
| | - Ranjit Manchanda
- Wolfson Institute of Population Health, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, UK
- Department of Health Services Research, Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK
| | - Karen Canfell
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, NSW 2011, Australia
| | - Paul James
- Parkville Familial Cancer Centre, Peter McCallum Cancer Centre, Melbourne, VIC, 3000, Australia
- Department of Genomic Medicine, Royal Melbourne Hospital City Campus, Parkville, VIC, 3050, Australia
- Department of Medicine, University of Melbourne, Parkville, VIC, 3050, Australia
| | - Ingrid Winship
- Department of Genomic Medicine, Royal Melbourne Hospital City Campus, Parkville, VIC, 3050, Australia
- Department of Medicine, University of Melbourne, Parkville, VIC, 3050, Australia
| | - John J. McNeil
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Zanfina Ademi
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
- Health Economics and Policy Evaluation Research (HEPER) Group, Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, VIC 3052, Australia
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Reyes-Marcelino G, McLoughlin K, Harrison C, Watts CG, Kang YJ, Aranda S, Aitken JF, Guitera P, Cust AE. Skin cancer-related conditions managed in general practice in Australia, 2000-2016: a nationally representative, cross-sectional survey. BMJ Open 2023; 13:e067744. [PMID: 37142316 PMCID: PMC10186445 DOI: 10.1136/bmjopen-2022-067744] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 04/05/2023] [Indexed: 05/06/2023] Open
Abstract
OBJECTIVE Skin cancer is Australia's most common and costly cancer. We examined the frequency of Australian general practice consultations for skin cancer-related conditions, by patient and general practitioner (GP) characteristics and by time period. DESIGN Nationally representative, cross-sectional survey of general practice clinical activity. SETTING, PARTICIPANTS Patients aged 15 years or older having a skin cancer-related condition managed by GPs in the Bettering the Evaluation And Care of Health study between April 2000 and March 2016. PRIMARY OUTCOME MEASURES Proportions and rates per 1000 encounters. RESULTS In this period, 15 678 GPs recorded 1 370 826 patient encounters, of which skin cancer-related conditions were managed 65 411 times (rate of 47.72 per 1000 encounters, 95% CI 46.41 to 49.02). Across the whole period, 'skin conditions' managed were solar keratosis (29.87%), keratinocyte cancer (24.85%), other skin lesion (12.93%), nevi (10.98%), skin check (10.37%), benign skin neoplasm (8.76%) and melanoma (2.42%). Over time, management rates increased for keratinocyte cancers, skin checks, skin lesions, benign skin neoplasms and melanoma; but remained stable for solar keratoses and nevi. Skin cancer-related encounter rates were higher for patients aged 65-89 years, male, living in Queensland or in regional or remote areas, with lower area-based socioeconomic status, of English-speaking background, Veteran card holders and non-healthcare card holders; and for GPs who were aged 35-44 years or male. CONCLUSION These findings show the spectrum and burden of skin cancer-related conditions managed in general practice in Australia, which can guide GP education, policy and interventions to optimise skin cancer prevention and management.
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Affiliation(s)
- Gillian Reyes-Marcelino
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia
- Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia
| | - Kirstie McLoughlin
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia
| | - Christopher Harrison
- Menzies Centre for Health Policy and Economics, Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Caroline G Watts
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia
- Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia
- Kirby Institute, UNSW, Sydney, NSW, Australia
| | - Yoon-Jung Kang
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia
| | - Sanchia Aranda
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, NSW, Australia
- Department of Nursing, The University of Melbourne, Melbourne, VIC, Australia
| | - Joanne F Aitken
- Cancer Council Queensland, Brisbane, QLD, Australia
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia
| | - Pascale Guitera
- Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Anne E Cust
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia
- Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia
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Kang YJ, Caruana M, McLoughlin K, Killen J, Simms K, Taylor N, Frayling IM, Coupé VMH, Boussioutas A, Trainer AH, Ward RL, Macrae F, Canfell K. The predicted effect and cost-effectiveness of tailoring colonoscopic surveillance according to mismatch repair gene in patients with Lynch syndrome. Genet Med 2022; 24:1831-1846. [PMID: 35809086 DOI: 10.1016/j.gim.2022.05.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/30/2022] [Accepted: 05/31/2022] [Indexed: 10/17/2022] Open
Abstract
PURPOSE Lynch syndrome-related colorectal cancer (CRC) risk substantially varies by mismatch repair (MMR) gene. We evaluated the health impact and cost-effectiveness of MMR gene-tailored colonoscopic surveillance. METHODS We first estimated sex- and MMR gene-specific cumulative lifetime risk of first CRC without colonoscopic surveillance using an optimization algorithm. Next, we harnessed these risk estimates in a microsimulation model, "Policy1-Lynch," and compared 126 colonoscopic surveillance strategies against no surveillance. RESULTS The most cost-effective strategy was 3-yearly surveillance from age 25 to 70 years (pathogenic variants [path_] in MLH1 [path_MLH1], path_MSH2) with delayed surveillance for path_MSH6 (age 30-70 years) and path_PMS2 (age 35-70 years) heterozygotes (incremental cost-effectiveness ratio = Australian dollars (A) $8,833/life-year saved). This strategy averted 60 CRC deaths (153 colonoscopies per death averted) over the lifetime of 1000 confirmed patients with Lynch syndrome (vs no surveillance). This also reduced colonoscopies by 5% without substantial change in health outcomes (vs nontailored 3-yearly surveillance from 25-70 years). Generally, starting surveillance at age 25 (vs 20) years was more cost-effective with minimal effect on life-years saved and starting 5 to 10 years later for path_MSH6 and path_PMS2 heterozygotes (vs path_MLH1 and path_MSH2) further improved cost-effectiveness. Surveillance end age (70/75/80 years) had a minor effect. Three-yearly surveillance strategies were more cost-effective (vs 1 or 2-yearly) but prevented 3 fewer CRC deaths. CONCLUSION MMR gene-specific colonoscopic surveillance would be effective and cost-effective.
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Affiliation(s)
- Yoon-Jung Kang
- The Daffodil Centre, The University of Sydney, A Joint Venture With Cancer Council NSW, Sydney, New South Wales, Australia.
| | - Michael Caruana
- The Daffodil Centre, The University of Sydney, A Joint Venture With Cancer Council NSW, Sydney, New South Wales, Australia
| | - Kirstie McLoughlin
- The Daffodil Centre, The University of Sydney, A Joint Venture With Cancer Council NSW, Sydney, New South Wales, Australia
| | - James Killen
- The Daffodil Centre, The University of Sydney, A Joint Venture With Cancer Council NSW, Sydney, New South Wales, Australia
| | - Kate Simms
- The Daffodil Centre, The University of Sydney, A Joint Venture With Cancer Council NSW, Sydney, New South Wales, Australia
| | - Natalie Taylor
- The Daffodil Centre, The University of Sydney, A Joint Venture With Cancer Council NSW, Sydney, New South Wales, Australia
| | - Ian M Frayling
- Inherited Tumour Syndromes Research Group, Cardiff University, Cardiff, Wales, United Kingdom
| | - Veerle M H Coupé
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | | | | | - Robyn L Ward
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Finlay Macrae
- Colorectal Medicine & Genetics, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Karen Canfell
- The Daffodil Centre, The University of Sydney, A Joint Venture With Cancer Council NSW, Sydney, New South Wales, Australia
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Steinberg J, Chan P, Hogden E, Tiernan G, Morrow A, Kang YJ, He E, Venchiarutti R, Titterton L, Sankey L, Pearn A, Nichols C, McKay S, Hayward A, Egoroff N, Engel A, Gibbs P, Goodwin A, Harris M, Kench JG, Pachter N, Parkinson B, Pockney P, Ragunathan A, Smyth C, Solomon M, Steffens D, Toh JWT, Wallace M, Canfell K, Gill A, Macrae F, Tucker K, Taylor N. Lynch syndrome testing of colorectal cancer patients in a high-income country with universal healthcare: a retrospective study of current practice and gaps in seven australian hospitals. Hered Cancer Clin Pract 2022; 20:18. [PMID: 35509103 PMCID: PMC9066828 DOI: 10.1186/s13053-022-00225-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 04/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To inform effective genomic medicine strategies, it is important to examine current approaches and gaps in well-established applications. Lynch syndrome (LS) causes 3-5% of colorectal cancers (CRCs). While guidelines commonly recommend LS tumour testing of all CRC patients, implementation in health systems is known to be highly variable. To provide insights on the heterogeneity in practice and current bottlenecks in a high-income country with universal healthcare, we characterise the approaches and gaps in LS testing and referral in seven Australian hospitals across three states. METHODS We obtained surgery, pathology, and genetics services data for 1,624 patients who underwent CRC resections from 01/01/2017 to 31/12/2018 in the included hospitals. RESULTS Tumour testing approaches differed between hospitals, with 0-19% of patients missing mismatch repair deficiency test results (total 211/1,624 patients). Tumour tests to exclude somatic MLH1 loss were incomplete at five hospitals (42/187 patients). Of 74 patients with tumour tests completed appropriately and indicating high risk of LS, 36 (49%) were missing a record of referral to genetics services for diagnostic testing, with higher missingness for older patients (0% of patients aged ≤ 40 years, 76% of patients aged > 70 years). Of 38 patients with high-risk tumour test results and genetics services referral, diagnostic testing was carried out for 25 (89%) and identified a LS pathogenic/likely pathogenic variant for 11 patients (44% of 25; 0.7% of 1,624 patients). CONCLUSIONS Given the LS testing and referral gaps, further work is needed to identify strategies for successful integration of LS testing into clinical care, and provide a model for hereditary cancers and broader genomic medicine. Standardised reporting may help clinicians interpret tumour test results and initiate further actions.
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Affiliation(s)
- Julia Steinberg
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, 153 Dowling St, NSW, 2011, Woolloomooloo, Australia.
| | - Priscilla Chan
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, 153 Dowling St, NSW, 2011, Woolloomooloo, Australia
| | - Emily Hogden
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, 153 Dowling St, NSW, 2011, Woolloomooloo, Australia
| | - Gabriella Tiernan
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, 153 Dowling St, NSW, 2011, Woolloomooloo, Australia
| | - April Morrow
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, 153 Dowling St, NSW, 2011, Woolloomooloo, Australia
| | - Yoon-Jung Kang
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, 153 Dowling St, NSW, 2011, Woolloomooloo, Australia
| | - Emily He
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, 153 Dowling St, NSW, 2011, Woolloomooloo, Australia
| | - Rebecca Venchiarutti
- Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Leanna Titterton
- NSW Health, Western Sydney Local Health District, Westmead, NSW, Australia
| | | | - Amy Pearn
- Cancer Council NSW, Sydney, NSW, Australia
| | - Cassandra Nichols
- Genetic Services of Western Australia, King Edward Memorial Hospital, Perth, Western Australia, Australia
| | - Skye McKay
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, 153 Dowling St, NSW, 2011, Woolloomooloo, Australia
| | - Anne Hayward
- The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Natasha Egoroff
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | - Alexander Engel
- The University of Sydney, Northern Clinical School Royal North Shore Hospital, Sydney, NSW, Australia
| | - Peter Gibbs
- Personalised Oncology Division, Walter and Eliza Hall Institute, Melbourne, Victoria, Australia
| | - Annabel Goodwin
- Cancer Genetics Department, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | | | - James G Kench
- Department of Tissue Pathology & Diagnostic Oncology, NSW Health Pathology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Nicholas Pachter
- Genetic Services of Western Australia, King Edward Memorial Hospital, Perth, Western Australia, Australia
- School of Medicine and Pharmacology, University of Western Australia, Perth, Western, Australia
| | - Bonny Parkinson
- Centre for the Health Economy, Macquarie University, Sydney, NSW, Australia
| | - Peter Pockney
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | - Abiramy Ragunathan
- Westmead Familial Cancer Services, The Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, NSW, Australia
| | | | - Michael Solomon
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Department of Colorectal Surgery, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Daniel Steffens
- Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Camperdown, NSW, Australia
- Department of Colorectal Surgery, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - James Wei Tatt Toh
- Department of Colorectal Surgery, The University of Sydney, Westmead Hospital, Westmead, NSW, Australia
| | - Marina Wallace
- Fiona Stanley Hospital, South Metropolitan Health Service, Murdoch, Western Australia, Australia
| | - Karen Canfell
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, 153 Dowling St, NSW, 2011, Woolloomooloo, Australia
| | - Anthony Gill
- Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Finlay Macrae
- Colorectal Medicine and Genetics, Department of Medicine, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Kathy Tucker
- Hereditary Cancer Clinic, Prince of Wales Hospital, Sydney, NSW, Australia
- Prince of Wales Clinical School, UNSW, Sydney, NSW, Australia
| | - Natalie Taylor
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, 153 Dowling St, NSW, 2011, Woolloomooloo, Australia
- School of Population Health, Faculty of Medicine, UNSW, Sydney, NSW, Australia
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Sang CM, Shi QL, Kang YJ, Cui LM, Ding K, Liu XQ, Zhao SP. [Pregnancy outcomes in patients with adenomyosis with fertility requirements: retrospective analysis of clinical data from real world]. Zhonghua Fu Chan Ke Za Zhi 2022; 57:265-270. [PMID: 35484658 DOI: 10.3760/cma.j.cn112141-20210830-00475] [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: 06/14/2023]
Abstract
Objective: To retrospectively analyze the pregnancy outcomes of patients with adenomyosis requiring fertility in a single center under real world condition. Methods: From June 2015 to May 2020, 231 cases of pregnancy complicated with adenomyosis diagnosed by ultrasound with fertility requirements were treated in the Women's and Children's Hospital Affiliated to Qingdao University with complete clinical data. And they were divided into three groups according to the treatment of adenomyosis before pregnancy: expectation group, drug group and operation group. The relevant data before pregnancy of the three groups were analyzed, and the pregnancy outcomes of the patients were summarized. According to whether the early pregnancy was treated with medication, the patients who were naturally conceived without symptoms of threatened abortion were divided into observation group and fetus protection group, and the pregnancy outcomes of the two groups were compared. Results: (1) Compared with the expectation group, the ages of patients in the drug group and the operation group were larger [(31.5±1.8) vs (34.1±3.7) vs (36.9±3.6) years old], and the difference was statistically significant (P<0.05). Only 9 patients (11.5%, 9/78) had clinical symptoms in the expectation group, while the patients in the drug group and the operation group had a higher proportion of dysmenorrhea and increased menstrual volume. The uterine volume of the drug group and the operation group were larger than that of the expectation group [(151±46) vs (166±27) vs (97±18) cm3], the difference was statistically significant (P<0.05). 78.6% (33/42) of the operation group were focal adenomyosis. The proportion of natural pregnancy in the expectation group was 97.4% (76/78), and in vitro fertilization and embryo transfer was mainly used in the drug group and the operation group. (2) The abortion rates of the three groups were 48.7% (26/111), 4/17, 67.5% (27/78) respectively. Compared with the drug group and the operation group, the preterm birth rate was lower [55.9% (33/111) vs 11/17 vs 12.5% (5/78)] and the natural delivery rate was higher [44.1% (26/111) vs 4/17 vs 67.5% (27/78)] in the expectation group. (3) There were 89 cases of spontaneous pregnancy without threatened abortion symptoms, including 31 cases in the observation group and 58 cases in the fetus protection group. Compared with the observation group, the abortion rate of patients in the fetus protection group was lower [41.9% (13/31) vs 34.5% (20/58)], and the difference was statistically significant (P<0.05). Conclusions: Patients with adenomyosis who have fertility requirements should be comprehensively evaluated and individualized treatment plans should be given. Pregnancy patients with adenomyosis have a high rate of miscarriage, and they should be included in the management of high-risk pregnant women. Active fetal protection treatment during early pregnancy might improve pregnancy outcomes.
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Affiliation(s)
- C M Sang
- Center for Gynecology, Women's and Children's Hospital Affiliated to Qingdao University, Qingdao 266011, China
| | - Q L Shi
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing 400016, China
| | - Y J Kang
- Center for Gynecology, Women's and Children's Hospital Affiliated to Qingdao University, Qingdao 266011, China
| | - L M Cui
- Department of Gynecology, Qingzhou Hospital Affiliated to Shandong First Medical University, Weifang 262500, China
| | - K Ding
- Center for Gynecology, Women's and Children's Hospital Affiliated to Qingdao University, Qingdao 266011, China
| | - X Q Liu
- Center for Reproduction, Women's and Children's Hospital Affiliated to Qingdao University, Qingdao 266011, China
| | - S P Zhao
- Center for Gynecology, Women's and Children's Hospital Affiliated to Qingdao University, Qingdao 266011, China
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Byun D, Lee SG, Kim H, You Y, Jung J, Jang JH, Lee MS, Kim CN, Cho BS, Kang YJ. Prognostic value of preoperative protein-induced vitamin K absence or antagonist II after liver resection for hepatitis B-related hepatocellular carcinoma: a nationwide multicenter study. Ann Surg Treat Res 2022; 103:271-279. [DOI: 10.4174/astr.2022.103.5.271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 08/18/2022] [Accepted: 09/01/2022] [Indexed: 11/12/2022] Open
Affiliation(s)
- Dahn Byun
- Department of Surgery, Daejeon Eulji Medical Center, Eulji University College of Medicine, Daejeon, Korea
| | - Seul Gi Lee
- Department of Surgery, Daejeon Eulji Medical Center, Eulji University College of Medicine, Daejeon, Korea
| | - Hyeyoung Kim
- Department of Surgery, Daejeon Eulji Medical Center, Eulji University College of Medicine, Daejeon, Korea
| | - Yunghun You
- Department of Surgery, Daejeon Eulji Medical Center, Eulji University College of Medicine, Daejeon, Korea
| | - Jaehag Jung
- Department of Surgery, Daejeon Eulji Medical Center, Eulji University College of Medicine, Daejeon, Korea
| | - Je Ho Jang
- Department of Surgery, Daejeon Eulji Medical Center, Eulji University College of Medicine, Daejeon, Korea
| | - Moon-Soo Lee
- Department of Surgery, Daejeon Eulji Medical Center, Eulji University College of Medicine, Daejeon, Korea
| | - Chang-Nam Kim
- Department of Surgery, Daejeon Eulji Medical Center, Eulji University College of Medicine, Daejeon, Korea
| | - Byung Sun Cho
- Department of Surgery, Daejeon Eulji Medical Center, Eulji University College of Medicine, Daejeon, Korea
| | - Yoon-Jung Kang
- Department of Surgery, Daejeon Eulji Medical Center, Eulji University College of Medicine, Daejeon, Korea
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8
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Abstract
The main purpose of this paper is the preparation of transmission electron microscopy (TEM) samples from the microsized powders of lithium-ion secondary batteries. To avoid artefacts during TEM sample preparation, the use of ion slicer milling for thinning and maintaining the intrinsic structure is described. Argon-ion milling techniques have been widely examined to make optimal specimens, thereby making TEM analysis more reliable. In the past few years, the correction of spherical aberration (Cs) in scanning transmission electron microscopy (STEM) has been developing rapidly, which results in direct observation at an atomic level resolution not only at a high acceleration voltage but also at a deaccelerated voltage. In particular, low-kV application has markedly increased, which requires a sufficiently transparent specimen without structural distortion during the sample preparation process. In this study, sample preparation for high-resolution STEM observation is accomplished, and investigations on the crystal integrity are carried out by Cs-corrected STEM.
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Affiliation(s)
- Jung Sik Park
- Product Application Support, JEOL Korea, Seoul, 05355, South Korea.
| | - Yoon-Jung Kang
- Industry University Cooperation Foundation, Hanyang University, Seoul, 04763, South Korea
| | - Sun Eui Choi
- Korea Electronics Technology Institute, Gyeonggi-do, 13509, South Korea
| | - Yong Nam Jo
- Korea Electronics Technology Institute, Gyeonggi-do, 13509, South Korea
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9
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Tiernan G, Freeman V, Morrow A, Hogden E, Canfell K, Kang YJ, Taylor N. What would I do? Perspectives on the factors underlying Lynch syndrome genetic testing and results sharing decisions for high-risk colorectal cancer patients. Psychooncology 2021; 31:587-596. [PMID: 34698409 PMCID: PMC9298871 DOI: 10.1002/pon.5840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 10/06/2021] [Accepted: 10/13/2021] [Indexed: 11/17/2022]
Abstract
Objective Universal tumour testing for Lynch syndrome (LS) in all incident colorectal cancers (CRCs) and sequential diagnostic genetic testing is cost‐effective in Australia. Because of this, our study aimed to understand factors underlying possible decisions faced by tumour test‐positive CRC patients and their at‐risk relatives throughout the LS diagnosis pathway. Methods Semi‐structured telephone interviews were conducted with 23 participants, using four hypothetical scenarios. Vignette‐guided closed‐ and open‐ended questions asked about LS genetic testing uptake, discussing diagnosis with at‐risk relatives, and risk‐reducing interventions. Personal perspectives on genetic testing were collected pre‐post vignette discussion. Inductive thematic analysis was performed on open‐ended questions. Decisional pathway diagrams were developed to convey factors influencing complex decision‐making processes. Results Participant responses incorporated unfolding scenario information, resulting in three decision themes: (1) wanting to know one's LS status; (2) informing family about LS; (3) navigating risk‐reducing interventions. Across all themes, ‘knowledge’ emerged as a facilitator, and ‘negative emotional experience’ as a barrier. Personal supportive views toward genetic testing increased post‐interview. Conclusions When communicating with tumour test‐positive CRC patients or their relatives about LS genetic testing, providing guidance/resources to inform decisions around risk‐reducing interventions and informing family members is critical. Scenario‐driven interviews provide insight into what individuals might do when facing complex healthcare decisions and could aid informed decision‐making. This approach may be applicable in other conditions, particularly with mainstreaming being increasingly introduced into the genetic context.
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Affiliation(s)
- Gabriella Tiernan
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Victoria Freeman
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - April Morrow
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Emily Hogden
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Karen Canfell
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia.,Prince of Wales Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - Yoon-Jung Kang
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Natalie Taylor
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia.,Prince of Wales Clinical School, University of New South Wales, Sydney, New South Wales, Australia.,School of Population Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
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10
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Reyes-Marcelino G, Tabbakh T, Espinoza D, Sinclair C, Kang YJ, McLoughlin K, Caruana M, Fernández-Peñas P, Guitera P, Aitken JF, Canfell K, Dobbinson S, Cust AE. Prevalence of skin examination behaviours among Australians over time. Cancer Epidemiol 2020; 70:101874. [PMID: 33341599 DOI: 10.1016/j.canep.2020.101874] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 11/26/2020] [Accepted: 11/29/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND We aimed to examine the prevalence and correlates of opportunistic skin check behaviours among Australians and whether changes over time might explain increasing underlying rates of melanoma in situ. METHODS The National Sun Protection Survey involved periodic telephone-based cross-sectional surveys during summer since 2003. Skin checks by a doctor in the past 12 months was asked in four summers over 2006-2017, and responses from 23,374 Australians aged 12-69 years were analysed. Prevalence estimates were weighted to be representative of the Australian population. Chi-square tests compared the prevalence over time and by characteristics. RESULTS The overall proportion reporting whole-body skin checks in the past 12 months was 20 % in 2006-07 and 2010-11, 21 % in 2013-14, and 22 % in 2016-17; but increased from 29 % in 2006-07 to 37 % in 2016-17 for those aged 45-69 years (p < 0.0001). In 2016-17, 5% reported a skin check of part-body and 9% for a specific mole or spot. The proportion reporting no skin checks increased from 61 % to 64 % over time (p < 0.0001). Whole-body skin checks were more common among older respondents, females, and also varied by residence location, skin sensitivity, skin colour, risk perception, and socio-economic index (all p < 0.001). CONCLUSION Approximately one third of Australians had their skin checked by a doctor within a 12-month period, but this varied across population sub-groups. Skin check behaviours were relatively stable over time, with modest increases in the prevalence of skin checks for those aged 45-69 years. These findings do not explain underlying large increases in rates of melanoma in situ.
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Affiliation(s)
- Gillian Reyes-Marcelino
- Sydney School of Public Health, Building A27, The University of Sydney, NSW 2006, Australia.
| | - Tamara Tabbakh
- Cancer Council Victoria, 615St Kilda Rd, Melbourne, VIC 3004, Australia.
| | - David Espinoza
- NHMRC Clinical Trials Centre, The University of Sydney, NSW 2006, Australia.
| | - Craig Sinclair
- Cancer Council Victoria, 615St Kilda Rd, Melbourne, VIC 3004, Australia.
| | - Yoon-Jung Kang
- Cancer Council New South Wales, 153 Dowling Street, Woolloomooloo, NSW 2011, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia.
| | - Kirstie McLoughlin
- Cancer Council New South Wales, 153 Dowling Street, Woolloomooloo, NSW 2011, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia.
| | - Michael Caruana
- Cancer Council New South Wales, 153 Dowling Street, Woolloomooloo, NSW 2011, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia.
| | - Pablo Fernández-Peñas
- Department of Dermatology, Westmead Clinical School, The University of Sydney, NSW 2006, Australia.
| | - Pascale Guitera
- Melanoma Institute Australia, The University of Sydney, 40 Rocklands Rd, Wollstonecraft, NSW 2065, Australia; Department of Dermatology, Central Clinical School, The University of Sydney, NSW 2006, Australia; Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital, NSW 2050, Australia.
| | - Joanne F Aitken
- Cancer Council Queensland, 553 Gregory Terrace, Fortitude Valley, QLD 4006, Australia.
| | - Karen Canfell
- Cancer Council New South Wales, 153 Dowling Street, Woolloomooloo, NSW 2011, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia; Prince of Wales Clinical School, University of New South Wales, Sydney, NSW 2052, Australia.
| | - Suzanne Dobbinson
- Cancer Council Victoria, 615St Kilda Rd, Melbourne, VIC 3004, Australia.
| | - Anne E Cust
- Sydney School of Public Health, Building A27, The University of Sydney, NSW 2006, Australia; Melanoma Institute Australia, The University of Sydney, 40 Rocklands Rd, Wollstonecraft, NSW 2065, Australia.
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11
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Morrow A, Parkinson B, Kang YJ, Hogden E, Canfell K, Taylor N. The health and economic impact of implementation strategies for improving detection of hereditary cancer patients—protocol for an in-depth cost-effectiveness evaluation with microsimulation modelling. Implement Sci Commun 2020. [DOI: 10.1186/s43058-020-00058-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Patients with Lynch syndrome (an inherited cancer predisposition syndrome) remain largely underdiagnosed despite clinically and cost-effective testing strategies to detect patients. This is largely due to poor referral rates for high-risk patients for consideration of genetic testing. Targeted approaches to improve the implementation of guidelines and thus uptake rates of genetic testing require the use of limited and valuable healthcare resources. Decision makers must carefully balance the potential health impacts of implementation approaches against the associated costs, similar to when assessing the direct impact of health interventions. This protocol outlines the methods used to conduct an economic evaluation of different implementation approaches aimed at improving referral rates of high-risk patients, including estimating implementation approach costs.
Methods
A cluster randomised controlled trial (the Hide and Seek Project, HaSP) is underway to compare two different implementation approaches aimed at improving referral rates, and thus detection, of Lynch syndrome among colorectal cancer patients across eight Australian hospital networks. An in-depth process evaluation is being conducted alongside the trial and includes measures to collect comprehensive data on both implementation and intervention costs. These costs, in addition to HaSP outcome data, will be incorporated as inputs into an existing microsimulation model—Policy1-Lynch—to project the downstream economic and health impacts and determine the more cost-effective implementation approach from the Australian healthcare perspective.
Discussion
The ability to model the impact of different implementation approaches will enable the most efficient way of improving Lynch syndrome detection. The approach used in this study could also be applied to assess other implementation approaches aimed at increasing the uptake of cost-effective health interventions.
Trial registration
ANZCTR, ACTRN12618001072202. Registered on 27 June 2018.
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12
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Kang YJ, Killen J, Caruana M, Simms K, Taylor N, Frayling IM, Snowsill T, Huxley N, Coupe VM, Hughes S, Freeman V, Boussioutas A, Trainer AH, Ward RL, Mitchell G, Macrae FA, Canfell K. The predicted impact and cost-effectiveness of systematic testing of people with incident colorectal cancer for Lynch syndrome. Med J Aust 2019; 212:72-81. [PMID: 31595523 PMCID: PMC7027559 DOI: 10.5694/mja2.50356] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 06/01/2019] [Indexed: 01/13/2023]
Abstract
OBJECTIVES To evaluate the health impact and cost-effectiveness of systematic testing for Lynch syndrome (LS) in people with incident colorectal cancer (CRC) in Australia. DESIGN, SETTING, PARTICIPANTS We investigated the impact of LS testing strategies in a micro-simulation model (Policy1-Lynch), explicitly modelling the cost of testing all patients diagnosed with incident CRC during 2017, with detailed modelling of outcomes for patients identified as LS carriers (probands) and their at-risk relatives throughout their lifetimes. For people with confirmed LS, we modelled ongoing colonoscopic surveillance. MAIN OUTCOME MEASURES Cost-effectiveness of six universal tumour testing strategies (testing for DNA mismatch repair deficiencies) and of universal germline gene panel testing of patients with incident CRC; impact on cost-effectiveness of restricting testing by age at CRC diagnosis (all ages, under 50/60/70 years) and of colonoscopic surveillance interval (one, two years). RESULTS The cost-effectiveness ratio of universal tumour testing strategies (annual colonoscopic surveillance, no testing age limit) compared with no testing ranged from $28 915 to $31 904/life-year saved (LYS) (indicative willingness-to-pay threshold: $30 000-$50 000/LYS). These strategies could avert 184-189 CRC deaths with an additional 30 597-31 084 colonoscopies over the lifetimes of 1000 patients with incident CRC with LS and 1420 confirmed LS carrier relatives (164-166 additional colonoscopies/death averted). The most cost-effective strategy was immunohistochemistry and BRAF V600E testing (incremental cost-effectiveness ratio [ICER], $28 915/LYS). Universal germline gene panel testing was not cost-effective compared with universal tumour testing strategies (ICER, $2.4 million/LYS). Immunohistochemistry and BRAF V600E testing was cost-effective at all age limits when paired with 2-yearly colonoscopic surveillance (ICER, $11 525-$32 153/LYS), and required 4778-15 860 additional colonoscopies to avert 46-181 CRC deaths (88-103 additional colonoscopies/death averted). CONCLUSIONS Universal tumour testing strategies for guiding germline genetic testing of people with incident CRC for LS in Australia are likely to be cost-effective compared with no testing. Universal germline gene panel testing would not currently be cost-effective.
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Affiliation(s)
- Yoon-Jung Kang
- Cancer Research Division, Cancer Council New South Wales, Sydney, NSW
| | - James Killen
- Cancer Research Division, Cancer Council New South Wales, Sydney, NSW
| | - Michael Caruana
- Cancer Research Division, Cancer Council New South Wales, Sydney, NSW
| | - Kate Simms
- Cancer Research Division, Cancer Council New South Wales, Sydney, NSW
| | - Natalie Taylor
- Cancer Research Division, Cancer Council New South Wales, Sydney, NSW
| | - Ian M Frayling
- Institute of Medical Genetics, University Hospital of Wales, Cardiff, United Kingdom.,Institute of Cancer and Genetics, Cardiff University, Cardiff, United Kingdom
| | | | - Nicola Huxley
- Centre for Health Economics, Monash Business School, Monash University, Melbourne, VIC
| | - Veerle Mh Coupe
- Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Suzanne Hughes
- Cancer Research Division, Cancer Council New South Wales, Sydney, NSW
| | - Victoria Freeman
- Cancer Research Division, Cancer Council New South Wales, Sydney, NSW
| | - Alex Boussioutas
- University of Melbourne, Melbourne, VIC.,Royal Melbourne Hospital, Melbourne, VIC
| | - Alison H Trainer
- Parkville Familial Cancer Centre, Peter MacCallum Cancer Institute, Melbourne, VIC
| | - Robyn L Ward
- University of Sydney, Sydney, NSW.,University of New South Wales, Sydney, NSW
| | - Gillian Mitchell
- Parkville Familial Cancer Centre, Peter MacCallum Cancer Institute, Melbourne, VIC
| | | | - Karen Canfell
- Cancer Research Division, Cancer Council New South Wales, Sydney, NSW.,University of Sydney, Sydney, NSW.,University of New South Wales, Sydney, NSW
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13
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Lew JB, Feletto E, Wade S, Caruana M, Kang YJ, Nickson C, Simms KT, Procopio P, Taylor N, Worthington J, Smith D, Canfell K. Benefits, harms and cost-effectiveness of cancer screening in Australia: an overview of modelling estimates. Public Health Res Pract 2019; 29:2921913. [PMID: 31384886 DOI: 10.17061/phrp2921913] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION There are three government-funded population-based screening programs in Australia - the national breast cancer screening program (BreastScreen Australia), the National Cervical Screening Program (NCSP), and the National Bowel Cancer Screening Program (NBCSP). Options for early detection of other cancers (e.g. hepatocellular carcinoma and melanoma) are under investigation. This study provides an overview of the health benefits, harms and cost-effectiveness of population-level breast, cervical and colorectal cancer screening, targeted-risk screening for lung cancer and Lynch syndrome, and prostate specific antigen (PSA) testing in Australia. METHODS The study reviewed and, where possible, updated the estimated health benefits, harms and cost-effectiveness of screening approaches from modelling studies for four cancer types, PSA testing and Lynch syndrome testing in Australia. Costs are presented in 2018 Australian dollars. RESULTS The renewed NCSP (for women not HPV-vaccinated) and the NBCSP were estimated to be cost-effective versus no screening; the cost-effectiveness ratio (CER) was $16 632 per life-year saved (LYS) for the NCSP, and $3380/LYS for the NBCSP. BreastScreen Australia was predicted to have a CER of $40 279/LYS-$65 065/LYS. In 2017, the NCSP transitioned to 5-yearly primary HPV testing with partial genotyping for HPV types 16 and 18 for women aged 25-74 years. Alongside vaccination, this change is predicted to prevent a further 587 cervical cancer deaths in 2018-2035, and have a favourable benefit-to-harm balance versus prior practice (biennial cytology testing for women aged 18-69 years). On average, the NBCSP (biennial screening using an immunochemical faecal occult blood test for people aged 50-74 years) is estimated to prevent 2519 colorectal cancer deaths and result in 350 colonoscopy-related adverse events annually. The inaccuracy of PSA testing as a screening tool impedes the capacity to conduct meaningful cost-effectiveness analyses at a population level, based on current evidence. Three annual low-dose computed tomography screens for lung cancer using the US National Lung Screening Trial selection criteria would not be cost-effective in Australia. A comprehensive cost-effectiveness evaluation of systematic proband testing, cascade testing and subsequent surveillance for Lynch syndrome in Australia is currently underway. CONCLUSIONS Current evidence supports a favourable cost-effectiveness and benefit-to-harm balance for the NCSP and NBCSP. An updated cost-effectiveness and benefits-to-harms analysis for BreastScreen Australia is required. Carefully founded quantitative estimates of health benefits, harms and cost-effectiveness provide an important aid to policy decision making, and form the basis for developing decision aids to guide individual screening decisions. Opportunities exist for lung cancer screening, systematic Lynch syndrome testing and informed decision making about PSA testing. However, more evidence is required on risk assessment, targeting of screening tests, optimal referral pathways, managing potential harms and delivering services in a cost-effective framework.
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Affiliation(s)
| | | | | | | | | | - Carolyn Nickson
- Cancer Council NSW, Sydney, Australia; University of Melbourne, VIC, Australia
| | | | - Pietro Procopio
- Cancer Council NSW, Sydney, Australia; University of Melbourne, VIC, Australia
| | | | | | - David Smith
- Cancer Council NSW, Sydney, Australia; University of Sydney, NSW, Australia; Griffith University, Gold Coast, QLD, Australia; Monash University, Melbourne, VIC, Australia
| | - Karen Canfell
- Cancer Council NSW, Sydney, Australia; University of Sydney, NSW, Australia; UNSW Sydney, Australia
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14
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Morrow A, Hogden E, Kang YJ, Steinberg J, Canfell K, Solomon MJ, Kench JG, Gill AJ, Shaw T, Pachter N, Parkinson B, Wolfenden L, Mitchell G, Macrae F, Tucker K, Taylor N. Comparing theory and non-theory based implementation approaches to improving referral practices in cancer genetics: a cluster randomised trial protocol. Trials 2019; 20:373. [PMID: 31221211 PMCID: PMC6585019 DOI: 10.1186/s13063-019-3457-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 05/20/2019] [Indexed: 02/02/2023] Open
Abstract
Background Lynch syndrome (LS) is an inherited, cancer predisposition syndrome associated with an increased risk of colorectal, endometrial and other cancer types. Identifying individuals with LS allows access to cancer risk management strategies proven to reduce cancer incidence and improve survival. However, LS is underdiagnosed and genetic referral rates are poor. Improving LS referral is complex, and requires multisystem behaviour change. Although barriers have been identified, evidence-based strategies to facilitate behaviour change are lacking. The aim of this study is to compare the effectiveness of a theory-based implementation approach against a non-theory based approach for improving detection of LS amongst Australian patients with colorectal cancer (CRC). Methods A two-arm parallel cluster randomised trial design will be used to compare two identical, structured implementation approaches, distinguished only by the use of theory to identify barriers and design targeted intervention strategies, to improve LS referral practices in eight large Australian hospital networks. Each hospital network will be randomly allocated to a trial arm, with stratification by state. A trained healthcare professional will lead the following phases at each site: (1) undertake baseline clinical practice audits, (2) form multidisciplinary Implementation Teams, (3) identify target behaviours for practice change, (4) identify barriers to change, (5) generate intervention strategies, (6) support staff to implement interventions and (7) evaluate the effectiveness of the intervention using post-implementation clinical data. The theoretical and non-theoretical components of each trial arm will be distinguished in phases 4–5. Study outcomes include a LS referral process map for each hospital network, with evaluation of the proportion of patients with risk-appropriate completion of the LS referral pathway within 2 months of CRC resection pre and post implementation. Discussion This trial will determine the more effective approach for improving the detection of LS amongst patients with CRC, whilst also advancing understanding of the impact of theory-based implementation approaches in complex health systems and the feasibility of training healthcare professionals to use them. Insights gained will guide the development of future interventions to improve LS identification on a larger scale and across different contexts, as well as efforts to address the gap between evidence and practice in the rapidly evolving field of genomic research. Trial registration ANZCTR, ACTRN12618001072202. Registered on 27 June 2018. Electronic supplementary material The online version of this article (10.1186/s13063-019-3457-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- April Morrow
- Cancer Council NSW, Woolloomooloo, NSW, Australia
| | - Emily Hogden
- Cancer Council NSW, Woolloomooloo, NSW, Australia
| | - Yoon-Jung Kang
- Cancer Council NSW, Woolloomooloo, NSW, Australia.,University of Sydney, Sydney, NSW, Australia
| | | | - Karen Canfell
- Cancer Council NSW, Woolloomooloo, NSW, Australia.,University of Sydney, Sydney, NSW, Australia
| | - Michael J Solomon
- University of Sydney, Sydney, NSW, Australia.,Department of Colorectal Surgery, Royal Prince Alfred Hospital, Camperdown, NSW, Australia.,Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - James G Kench
- University of Sydney, Sydney, NSW, Australia.,Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Anthony J Gill
- University of Sydney, Sydney, NSW, Australia.,Cancer Diagnosis and Pathology Group, Kolling Institute of Medical Research, Royal North Shore Hospital St Leonards, St Leonards, NSW, Australia.,NSW Health Pathology Department of Anatomical Pathology, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - Tim Shaw
- University of Sydney, Sydney, NSW, Australia
| | - Nicholas Pachter
- Genetic Services of Western Australia, King Edward Memorial Hospital, Subiaco, WA, Australia
| | - Bonny Parkinson
- Macquarie University Centre for the Health Economy, Macquarie University, Macquarie Park, NSW, Australia
| | - Luke Wolfenden
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Gillian Mitchell
- Familial Cancer Research Centre, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia
| | - Finlay Macrae
- Colorectal Medicine and Genetics, and Department of Medicine, University of Melbourne, The Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Kathy Tucker
- Hereditary Cancer Clinic, Prince of Wales Hospital, Syndey, NSW, Australia.,Prince of Wales Clinical School, UNSW Sydney, Sydney, NSW, Australia
| | - Natalie Taylor
- Cancer Council NSW, Woolloomooloo, NSW, Australia. .,University of Sydney, Sydney, NSW, Australia.
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15
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Kang YJ, Kim KH, Jang SH, Lee GH, Lee YJ, Kim YS, Kim EJ. Diffusion-weighted imaging negative M232R familial Creutzfeldt-Jakob disease. J Clin Neurosci 2019; 64:47-49. [PMID: 30910549 DOI: 10.1016/j.jocn.2019.03.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Accepted: 03/11/2019] [Indexed: 02/02/2023]
Abstract
The familial Creutzfeldt-Jakob disease (fCJD) usually has similar clinical and neuroimaging features as sporadic CJD (sCJD). A 57-year-old man presented with a four-month history of rapidly progressive dementia (RPD). Laboratory tests for RPD were all normal. Brain MRI demonstrated diffuse cortical atrophy and no abnormal cortical or striatal hyperintensities on fluid-attenuated inversion recovery (FLAIR)/diffusion weighted imaging (DWI). Electroencephalography revealed intermittent slow waves in the bilateral hemispheres. Cerebrospinal fluid (CSF) examination showed elevated cell counts and protein concentrations. After 10 days of empirical treatment with antiviral agents, the patient was eventually diagnosed with fCJD with M232R mutation based on the results of positivity for 14-3-3 protein, CSF PrPsc in real-time quaking-induced conversion assay and genetic test for PRNP gene. The striatal or cortical FLAIR/DWI hyperintensities are reliable radiographic markers in the diagnosis of both sCJD and fCJD. However, this case suggests that clinical work-up for CJD including genetic test is essential to do a differential diagnosis of RPD, regardless of FLAIR/DWI findings.
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Affiliation(s)
- Yoon-Jung Kang
- Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Republic of Korea
| | - Kyung-Hye Kim
- Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Republic of Korea
| | - Sung-Hwan Jang
- Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Republic of Korea
| | - Gha-Hyun Lee
- Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Republic of Korea
| | - Yoon-Jung Lee
- Ilsong Institute of Life Science, Hallym University, Anyang, Republic of Korea
| | - Yong-Sun Kim
- Ilsong Institute of Life Science, Hallym University, Anyang, Republic of Korea
| | - Eun-Joo Kim
- Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Republic of Korea.
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16
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Weber MFW, Marshall H, Rankin N, Duffy S, Fong K, Dunlop K, Humphreys L, Smit A, Cust A, Taylor N, Mitchell G, Kang YJ, Tucker K, Jenkins M, Macrae F, Lockart I, Danta M, Armstrong B, Howe M. Cancer screening in Australia: future directions in melanoma, Lynch syndrome, and liver, lung and prostate cancers. Public Health Res Pract 2019; 29:2921910. [DOI: 10.17061/phrp2921910] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Abstract
BACKGROUND Previous studies have reported that anal cancer incidence has increased in individual countries; however, age-specific trends were not examined in detail. This study describes pooled and country-specific anal cancer incidence trends by sex, age (all ages, <60 and 60+ years) and histological subtype (all subtypes, squamous cell carcinoma [SCC] and adenocarcinoma [ADC]). METHODS Five-year incidence and population-at-risk data were obtained from IARC's Cancer Incidence in Five Continents for the years 1988-1992 to 2008-2012. The standardised rate ratios (SRRs) for 2008-2012 vs 1988-1992 and the 5-year average percent change (AvPC) during the period were used to assess changes in the age-standardised incidence rates. RESULTS During the study period, there were significant increases in the incidence of SCC in both men and women of all age groups with significant increasing trend, and these increases were highest in those aged <60 years (SRR = 2.34 [95% CI:2.11-2.58] in men and SRR = 2.76 [95% CI:2.54-3.00] in women). By contrast, there were significant decreases in the incidence of ADC in men and women of all ages (SRR = 0.60 [95% CI:0.54-0.67]) and (SRR = 0.63 [95% CI:0.56-0.71], respectively), with similar decreases in those aged <60 years and 60+ years. These competing trends still resulted in significant increases in the overall incidence of anal cancer in men and women of all ages groups with significant increasing trend. The SRRs in men of all ages, <60 years and 60+ years were 1.35 (95% CI:1.28-1.42), 1.77 (95% CI:1.62-1.92) and 1.08 (95% CI:1.00-1.15), respectively. The corresponding SRRs in women were 1.75 (95% CI:1.67-1.83), 2.31 (95% CI:2.14-2.48) and 1.38 (95% CI 1.31-1.46), respectively. CONCLUSION Increases in the incidence of anal SCC has driven an overall increase in anal cancer incidence; this may be associated with changing sexual behaviours and increasing levels of HPV exposure in younger cohorts. The findings further reinforce the importance of HPV vaccination.
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Affiliation(s)
- Yoon-Jung Kang
- Cancer Research Division, Cancer Council NSW, Sydney, New south Wales, Australia
| | - Megan Smith
- Cancer Research Division, Cancer Council NSW, Sydney, New south Wales, Australia
| | - Karen Canfell
- Cancer Research Division, Cancer Council NSW, Sydney, New south Wales, Australia
- School of Public Health, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
- Prince of Wales Clinical School, University of New South Wales, Sydney, New South Wales, Australia
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Kang YJ, Kuo CF, Majd S. Nanoparticle-based delivery of an anti-proliferative metal chelator to tumor cells. Annu Int Conf IEEE Eng Med Biol Soc 2018; 2017:309-312. [PMID: 29059872 DOI: 10.1109/embc.2017.8036824] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This paper describes the preparation and characterization of polymeric nanoparticles loaded with a potent anti-tumor metal chelator, Di-2-pyridylketone-4,4-dimethyl-3-thiosemicarbazone (Dp44mT) for delivery to cancer cells. Metal chelators have been increasingly studied for their anti-cancer properties that rely on the high demand of neoplastic cells for iron. Dp44mT has previously shown great antiproliferative characteristics in several cancers including breast cancer and melanoma. To further expand the application of this highly cytotoxic agent for cancer treatment and to enable its specific delivery to malignant cells, here we apply nano-scale particles (NPs) of biodegradable poly(lactic-co-glycolide) (PLGA) for encapsulation of Dp44mT and evaluate its effectiveness in vitro. The results demonstrated that Dp44mT was efficiently encapsulated in PLGA particles. Resulting NPs were uniform in size and shape and had good colloidal stability. Moreover, Dp44mT encapsulation in PLGA enhanced the water solubility of this agent. Lastly, the present formulation showed high level of cytotoxicity in glioma cells. Together, these results show the potential of PLGA NPs as a nano-carrier for Dp44mT with no apparent impact on the anti-tumor activity of this compound.
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Wang H, Jeong H, Kim NH, Kang Y, Hwang K, Lee H, Hong JH, Oh KS. Association between beverage intake and obesity in children: The Korea National Health and Nutrition Examination Survey (KNHANES) 2013-2015. Nutr Res Pract 2018; 12:307-314. [PMID: 30090168 PMCID: PMC6078862 DOI: 10.4162/nrp.2018.12.4.307] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 02/08/2018] [Accepted: 06/12/2018] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND/OBJECTIVES Numerous researches have studied the association between sugar intake and obesity of children in many countries. This study was undertaken to investigate the association between beverage intake and obesity of children by reviewing a database for total sugar contents established in all foods and presented in a nutrition survey by the Korea National Health and Nutrition Examination Survey (KNHANES). SUBJECTS/METHODS Data of 1,520 children aged 6-11 years in the 6th KNHANES (2013-2015) were analyzed for this study. A database for total sugar intake comprises the total sugar contents of all foods included in the results of a nutrition survey using the 24-hour recall method of 6th KNHANES. Beverages were categorized into carbonated beverages, fruit & vegetable drinks, other drinks, tea, and coffee. RESULTS The average daily beverage intake of all children was 131.75 g/day, and the average daily total sugar intake in beverages was 13.76 g/day. Carbonated beverages had the highest intake rate (58.85 g/day) and also ranked highest for sugar intake (6.36 g/day). After adjusting for confounding variables, the odds ratio for obesity in children with beverage intake of ≥ 200 mL/day significantly increased by 1.83 times (95% CI, 1.11-3.00) as compared to children with beverage intake of < 200 mL/day. Also, a significant increase was observed in the odds ratio for obesity in total children (2.41 times; 95% CI, 1.35-4.33) and boys (3.15 times; 95% CI, 1.53-6.49) with carbonated beverage intake of ≥ 200 mL/day when compared with children who consumed < 200 mL/day. CONCLUSION A positive association is observed between beverage intake and obesity in Korean children. In particular, an intake of carbonated beverages has a positive correlation with childhood obesity in boys. This study can therefore be used as scientific evidence for reducing sugar, and for the continuous management and research on beverages.
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Affiliation(s)
- Hyewon Wang
- Nutrition and Functional Food Research Team, National Institute of Food and Drug Safety Evaluation, Cheongju, Chungbuk 28159, Korea
| | - HaYoung Jeong
- Nutrition and Functional Food Research Team, National Institute of Food and Drug Safety Evaluation, Cheongju, Chungbuk 28159, Korea
| | - Na-Hui Kim
- Nutrition and Functional Food Research Team, National Institute of Food and Drug Safety Evaluation, Cheongju, Chungbuk 28159, Korea
| | - YoonJung Kang
- Nutrition and Functional Food Research Team, National Institute of Food and Drug Safety Evaluation, Cheongju, Chungbuk 28159, Korea
| | - Kyungmi Hwang
- Nutrition and Functional Food Research Team, National Institute of Food and Drug Safety Evaluation, Cheongju, Chungbuk 28159, Korea
| | - HwaJung Lee
- Nutrition and Functional Food Research Team, National Institute of Food and Drug Safety Evaluation, Cheongju, Chungbuk 28159, Korea
| | - Jin-Hwan Hong
- Nutrition and Functional Food Research Team, National Institute of Food and Drug Safety Evaluation, Cheongju, Chungbuk 28159, Korea
| | - Keum-Soon Oh
- Nutrition and Functional Food Research Team, National Institute of Food and Drug Safety Evaluation, Cheongju, Chungbuk 28159, Korea
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Wade S, Weber M, Caruana M, Kang YJ, Marshall H, Manser R, Vinod S, Rankin N, Fong K, Canfell K. Estimating the Cost-Effectiveness of Lung Cancer Screening with Low-Dose Computed Tomography for High-Risk Smokers in Australia. J Thorac Oncol 2018; 13:1094-1105. [PMID: 29689434 DOI: 10.1016/j.jtho.2018.04.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 03/22/2018] [Accepted: 04/09/2018] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Health economic evaluations of lung cancer screening with low-dose computed tomography (LDCT) that are underpinned by clinical outcomes are relatively few. METHODS We assessed the cost-effectiveness of LDCT lung screening in Australia by applying Australian cost and survival data to the outcomes observed in the U.S. National Lung Screening Trial (NLST), in which a 20% lung cancer mortality benefit was demonstrated for three rounds of annual screening among high-risk smokers age 55 to 74 years. Screening-related costs were estimated from Medicare Benefits Schedule reimbursement rates (2015), lung cancer diagnosis and treatment costs from a 2012 Australian hospital-based study, lung cancer survival rates from the New South Wales Cancer Registry (2005-2009), and other-cause mortality from Australian life tables weighted by smoking status. The health utility outcomes, screening participation rates, and lung cancer rates were those observed in the NLST. Incremental cost effectiveness ratios (ICER) were calculated for a 10-year time horizon. RESULTS The cost-effectiveness of LDCT lung screening was estimated at AU$138,000 (80% confidence interval: AU$84,700-AU$353,000)/life-year gained and AU$233,000 (80% confidence interval: AU$128,000-AU$1,110,000)/quality-adjusted life year (QALY) gained. The ICER was more favorable when LDCT screening impact on all-cause mortality was considered, even when the costs of incidental findings were also estimated in sensitivity analyses: AU$157,000/QALY gained. This can be compared to an indicative willingness-to-pay threshold in Australia of AU$30,000 to AU$50,000/QALY. CONCLUSIONS LDCT lung screening using NLST selection and implementation criteria is unlikely to be cost-effective in Australia. Future economic evaluations should consider alternative screening eligibility criteria, intervals, nodule management, the impact and cost of new therapies, investigations of incidental findings, and incorporation of smoking cessation interventions.
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Affiliation(s)
- Stephen Wade
- Cancer Research Division, Cancer Council New South Wales, New South Wales, Australia
| | - Marianne Weber
- Cancer Research Division, Cancer Council New South Wales, New South Wales, Australia; School of Public Health, University of Sydney, New South Wales, Australia.
| | - Michael Caruana
- Cancer Research Division, Cancer Council New South Wales, New South Wales, Australia
| | - Yoon-Jung Kang
- Cancer Research Division, Cancer Council New South Wales, New South Wales, Australia
| | - Henry Marshall
- Department of Thoracic Medicine, The Prince Charles Hospital, Queensland, Australia; University of Queensland Thoracic Research Centre at The Prince Charles Hospital, Queensland, Australia
| | - Renee Manser
- Department of Respiratory and Sleep Medicine, Royal Melbourne Hospital, Victoria, Australia; Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Victoria, Australia
| | - Shalini Vinod
- South Western Sydney Clinical School, University of New South Wales, New South Wales, Australia
| | - Nicole Rankin
- Cancer Research Division, Cancer Council New South Wales, New South Wales, Australia
| | - Kwun Fong
- Department of Thoracic Medicine, The Prince Charles Hospital, Queensland, Australia; University of Queensland Thoracic Research Centre at The Prince Charles Hospital, Queensland, Australia
| | - Karen Canfell
- Cancer Research Division, Cancer Council New South Wales, New South Wales, Australia; School of Public Health, University of Sydney, New South Wales, Australia; Prince of Wales Clinical School, University of New South Wales, New South Wales, Australia
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Kang YJ, Smith M, Barlow E, Coffey K, Hacker N, Canfell K. Vulvar cancer in high-income countries: Increasing burden of disease. Int J Cancer 2017; 141:2174-2186. [PMID: 28730615 DOI: 10.1002/ijc.30900] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 06/16/2017] [Accepted: 06/28/2017] [Indexed: 11/10/2022]
Abstract
The aim of this study was to assess trends in the age-specific incidence of vulvar cancer in 13 high-income countries satisfying a priori conditions regarding the availability of cancer registry data over a 20-year period; these were Canada, the United States, nine European countries, Australia and Japan. Five-yearly incidence and population at risk were obtained from the International Agency for Research on Cancer's Cancer Incidence in Five Continents for the years 1988-1992 (Volume 7) to 2003-2007 (Volume 10). The 5-yearly average percent change (AvPC) over the period and standardised rate ratios (SRRs) for 2003-2007 versus 1988-1992 were used to assess changes in the age-standardised incidence rates of vulvar cancer for all ages, and for <60 years and 60+ years. During the study period, the 5-yearly AvPC across the 13 countries increased by 4.6% (p = 0.005) in women of all ages, and 11.6% (p = 0.02) in those <60 years. No change was observed in women aged 60+ years (5-yearly AvPC = 0.1%, p = 0.94). The SRR for 2003-2007 versus 1988-1992 was significantly elevated in women <60 years of age (SRR = 1.38, 95% CI: 1.30-1.46), but not in women of 60+ years (SRR = 1.01, 95% CI: 0.97-1.05). The increase in incidence in women <60 years of age drove a significant increase in the overall SRR in women of all ages (SRR = 1.14, 95% CI: 1.11-1.18). Some differences in the specific findings at the individual country level were observed. The findings are consistent with changing sexual behaviours and increasing levels of exposure to human papillomavirus (HPV) in cohorts born around/after about 1950, but younger cohorts offered HPV vaccination are likely to receive some protection against developing vulvar cancer in the future.
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Affiliation(s)
- Yoon-Jung Kang
- Cancer Research Division, Cancer Council NSW, Sydney, NSW, Australia
| | - Megan Smith
- Cancer Research Division, Cancer Council NSW, Sydney, NSW, Australia
| | - Ellen Barlow
- Gynaecological Cancer Centre, Royal Hospital for Women, Randwick, Sydney, NSW, Australia
| | - Kate Coffey
- Department of Women's Health, Dunedin Hospital, Dunedin, New Zealand
| | - Neville Hacker
- Gynaecological Cancer Centre, Royal Hospital for Women, Randwick, Sydney, NSW, Australia.,Department of Womens' and Children's Health, University of New South Wales, Sydney, NSW, Australia
| | - Karen Canfell
- Cancer Research Division, Cancer Council NSW, Sydney, NSW, Australia.,School of Public Health, Sydney Medical School, University of Sydney, Sydney, NSW, Australia.,Prince of Wales Clinical School, University of New South Wales, Sydney, NSW, Australia
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Lee ES, Kim J, Yoo TK, Kim Y, Han J, Kang YJ, Choi J, Rhu J, Lee HB, Han W, Noh DY, Moon HG. Abstract P6-07-19: An alteration of hormonal receptor status throughout tumor progression related to prognosis in breast cancer patients. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p6-07-19] [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: 11/16/2022]
Abstract
Abstract
Purpose
We aimed to identify whether hormonal receptors change throughout tumor progression, because this may influence management and influence prognosis in breast cancer patients.
Patients and Methods
From the institution's database, we collected data of 963 patients who developed relapse during their follow-ups. To determine estrogen receptor(ER) and progesterone receptor (PR), we retrospectively reviewed immunohistochemical(IHC) results in both primary and relapsed tumors.
Results
Among a total of 963 patients, 280 and 683 patients experienced locoregional relapse only and distant metastasis irrespective of locoreginal relapse, respectively. ER in 650 patients and PR in 590 patients from both primary tumor and relapse were identified, revealing a change in 157 (24.2%) and 154 (26.1%) patients, respectively. In patients with distant metastasis, assessment of ER and PR showed an alteration in 86 and 56 patients, respectively. The overall survival related to the change of ER and PR status in primary tumor and relapse was significantly different (log rank, P<0.001 in both ER and PR status). In addition, women with hormone receptors negative primary tumors that changed to hormone receptors positive tumors who received anti-hormonal therapy after relapse showed a statistically significant good overall survival (p<0.001) compared with women who had constant ER-negative tumors.(cox regression, hazard ratio 2.32 ; 95% CI, 1.91 to 3.01)
Conclusion
The breast cancer showed alterations of hormone receptor status throughout tumor progression, hat were related to the strategy of treatment and significantly influences survival. Therefore, investigations of hormone receptor at relapse are essential and helpful in breast cancer patient management.
Citation Format: Lee E-S, Kim J, Yoo T-K, Kim Y, Han J, Kang YJ, Choi J, Rhu J, Lee H-B, Han W, Noh D-Y, Moon H-G. An alteration of hormonal receptor status throughout tumor progression related to prognosis in breast cancer patients [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P6-07-19.
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Affiliation(s)
- E-S Lee
- Seoul National University College of Medicine, Seoul, NU, Republic of Korea; SMG - SNU Boramae Medical Center, Seoul, NU, Republic of Korea; Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, NU, Republic of Korea
| | - J Kim
- Seoul National University College of Medicine, Seoul, NU, Republic of Korea; SMG - SNU Boramae Medical Center, Seoul, NU, Republic of Korea; Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, NU, Republic of Korea
| | - T-K Yoo
- Seoul National University College of Medicine, Seoul, NU, Republic of Korea; SMG - SNU Boramae Medical Center, Seoul, NU, Republic of Korea; Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, NU, Republic of Korea
| | - Y Kim
- Seoul National University College of Medicine, Seoul, NU, Republic of Korea; SMG - SNU Boramae Medical Center, Seoul, NU, Republic of Korea; Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, NU, Republic of Korea
| | - J Han
- Seoul National University College of Medicine, Seoul, NU, Republic of Korea; SMG - SNU Boramae Medical Center, Seoul, NU, Republic of Korea; Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, NU, Republic of Korea
| | - YJ Kang
- Seoul National University College of Medicine, Seoul, NU, Republic of Korea; SMG - SNU Boramae Medical Center, Seoul, NU, Republic of Korea; Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, NU, Republic of Korea
| | - J Choi
- Seoul National University College of Medicine, Seoul, NU, Republic of Korea; SMG - SNU Boramae Medical Center, Seoul, NU, Republic of Korea; Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, NU, Republic of Korea
| | - J Rhu
- Seoul National University College of Medicine, Seoul, NU, Republic of Korea; SMG - SNU Boramae Medical Center, Seoul, NU, Republic of Korea; Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, NU, Republic of Korea
| | - H-B Lee
- Seoul National University College of Medicine, Seoul, NU, Republic of Korea; SMG - SNU Boramae Medical Center, Seoul, NU, Republic of Korea; Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, NU, Republic of Korea
| | - W Han
- Seoul National University College of Medicine, Seoul, NU, Republic of Korea; SMG - SNU Boramae Medical Center, Seoul, NU, Republic of Korea; Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, NU, Republic of Korea
| | - D-Y Noh
- Seoul National University College of Medicine, Seoul, NU, Republic of Korea; SMG - SNU Boramae Medical Center, Seoul, NU, Republic of Korea; Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, NU, Republic of Korea
| | - H-G Moon
- Seoul National University College of Medicine, Seoul, NU, Republic of Korea; SMG - SNU Boramae Medical Center, Seoul, NU, Republic of Korea; Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, NU, Republic of Korea
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Lew JB, Simms KT, Smith MA, Hall M, Kang YJ, Xu XM, Caruana M, Velentzis LS, Bessell T, Saville M, Hammond I, Canfell K. Primary HPV testing versus cytology-based cervical screening in women in Australia vaccinated for HPV and unvaccinated: effectiveness and economic assessment for the National Cervical Screening Program. The Lancet Public Health 2017; 2:e96-e107. [DOI: 10.1016/s2468-2667(17)30007-5] [Citation(s) in RCA: 92] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 12/23/2016] [Accepted: 12/23/2016] [Indexed: 01/25/2023]
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Jang WS, Yoon CY, Kim MS, Kang DH, Kang YJ, Jeong WS, Abalajon MJ, Ham WS, Choi YD. The prognostic role of tertiary Gleason pattern 5 in a contemporary grading system for prostate cancer. Prostate Cancer Prostatic Dis 2016; 20:93-98. [DOI: 10.1038/pcan.2016.55] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 09/13/2016] [Accepted: 10/10/2016] [Indexed: 11/09/2022]
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Kim HA, Ahn SH, Nam SJ, Park S, Ro J, Im SA, Jung YS, Yoon JH, Hur MH, Choi YJ, Lee SJ, Jeong J, Cho SH, Kim SY, Lee MH, Kim LS, Moon BI, Kim TH, Park C, Kim SJ, Jung SH, Park H, Gwak GH, Kang SH, Kim JG, Kim J, Choi SY, Lim CW, Kim D, Yoo Y, Song YJ, Kang YJ, Jung SS, Shin HJ, Lee KJ, Han SH, Lee ES, Han W, Kim HJ, Noh WC. The role of the addition of ovarian suppression to tamoxifen in young women with hormone-sensitive breast cancer who remain premenopausal or regain menstruation after chemotherapy (ASTRRA): study protocol for a randomized controlled trial and progress. BMC Cancer 2016; 16:319. [PMID: 27197523 PMCID: PMC4872354 DOI: 10.1186/s12885-016-2354-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 05/11/2016] [Indexed: 01/24/2023] Open
Abstract
Background Ovarian function suppression (OFS) has been shown to be effective as adjuvant endocrine therapy in premenopausal women with hormone receptor-positive breast cancer. However, it is currently unclear if addition of OFS to standard tamoxifen therapy after completion of adjuvant chemotherapy results in a survival benefit. In 2008, the Korean Breast Cancer Society Study Group initiated the ASTRRA randomized phase III trial to evaluate the efficacy of OFS in addition to standard tamoxifen treatment in hormone receptor-positive breast cancer patients who remain or regain premenopausal status after chemotherapy. Methods Premenopausal women with estrogen receptor-positive breast cancer treated with definitive surgery were enrolled after completion of neoadjuvant or adjuvant chemotherapy. Ovarian function was assessed at the time of enrollment and every 6 months for 2 years by follicular-stimulating hormone levels and bleeding history. If ovarian function was confirmed as premenopausal status, the patient was randomized to receive 2 years of goserelin plus 5 years of tamoxifen treatment or 5 years of tamoxifen alone. The primary end point will be the comparison of the 5-year disease-free survival rates between the OFS and tamoxifen alone groups. Patient recruitment was finished on March 2014 with the inclusion of a total of 1483 patients. The interim analysis will be performed at the time of the observation of the 187th event. Discussion This study will provide evidence of the benefit of OFS plus tamoxifen compared with tamoxifen only in premenopausal patients with estrogen receptor-positive breast cancer treated with chemotherapy. Trial registration ClinicalTrials.gov Identifier NCT00912548. Registered May 31 2009. Korean Breast Cancer Society Study Group Register KBCSG005. Registered October 26 2009.
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Affiliation(s)
- Hyun-Ah Kim
- Department of Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Sei Hyun Ahn
- Department of Surgery, University of Ulsan, Asan Medical Center, Seoul, Republic of Korea
| | - Seok Jin Nam
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of medicine, Seoul, Republic of Korea
| | - Seho Park
- Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jungsil Ro
- Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea
| | - Seock-Ah Im
- Department of Internal Medicine, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yong Sik Jung
- Department of Surgery, Ajou University, School of Medicine, Suwon, Republic of Korea
| | - Jung Han Yoon
- Department of Surgery, Chonnam National University Hwasun Hospital, Gwangju, Republic of Korea
| | - Min Hee Hur
- Department of Surgery, Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine, Seoul, Republic of Korea
| | - Yoon Ji Choi
- Department of Internal Medicine, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Soo-Jung Lee
- Department of Surgery, Yeungnam University Hospital, Daegu, Republic of Korea
| | - Joon Jeong
- Department of Surgery, Gangnam Severance Hospital, Yonsei University, Seoul, Republic of Korea
| | - Se-Heon Cho
- Department of Surgery, Dong-A University Hospital, Busan, Republic of Korea
| | - Sung Yong Kim
- Department of Surgery, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan, Republic of Korea
| | - Min Hyuk Lee
- Department of Surgery, Soonchunhyang University Colleage of Medicine, Seoul, Republic of Korea
| | - Lee Su Kim
- Division of Breast & Endocrine Surgery, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang, Republic of Korea
| | - Byung-In Moon
- Department of Surgery, Mokdong Hospital, Ewha Womans University, Seoul, Republic of Korea
| | - Tae Hyun Kim
- Department of Surgery, Inje University Busan Paik Hospital, Busan, Republic of Korea
| | - Chanheun Park
- Department of Surgery, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Republic of Korea
| | - Sei Joong Kim
- Department of Surgery, Inha University Hospital, Inha University, Incheon, Republic of Korea
| | - Sung Hoo Jung
- Department of Surgery, Chonbuk National University Medical School, Jeonju, Republic of Korea
| | - Heungkyu Park
- Department of Breast Surgery, Gachon University Gil Hospital, Incheon, Republic of Korea
| | - Geum Hee Gwak
- Department of Surgery, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea
| | - Sun Hee Kang
- Department of Surgery, Keimyung University School of Medicine, Daegu, Republic of Korea
| | - Jong Gin Kim
- Departments of Surgery, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Jeryong Kim
- Department of Surgery, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Su Yun Choi
- Department of Surgery, KangDong sacred heart hospital, Hallym university, Seoul, Republic of Korea
| | - Cheol-Wan Lim
- Department of Surgery, Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon, Republic of Korea
| | - Doyil Kim
- Department of Surgery, Kangseo Mizmedi Hospital, Seoul, Republic of Korea
| | - Youngbum Yoo
- Department of Surgery, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Young-Jin Song
- Department of Surgery, Chungbuk National University College of Medicine and Medical Research Institute, Cheongju, Republic of Korea
| | - Yoon-Jung Kang
- Department of Surgery, Eulji University Hospital, Daejeon, Republic of Korea
| | - Sang Seol Jung
- Department of Surgery, Seoul St. Mary's Hospital, Medical College of The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyuk Jai Shin
- Breast and thyroid care center, Department of Surgery, Myongji Hospital, Goyang, Republic of Korea
| | - Kwan Ju Lee
- Department of Surgery, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon, Republic of Korea
| | - Se-Hwan Han
- Department of Surgery, Ajou University, School of Medicine, Suwon, Republic of Korea
| | - Eun Sook Lee
- Center for Breast Cancer, National Cancer Center, Goyang, Republic of Korea
| | - Wonshik Han
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hee-Jung Kim
- Department of Surgery, University of Ulsan, Asan Medical Center, Seoul, Republic of Korea
| | - Woo Chul Noh
- Department of Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea.
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Han JH, Kang YJ, Han W, Lee HB, Kim Y, Yoo TK, Moon HG, Noh DY. Abstract P5-08-23: Ki-67 expression is not a valuable predictive prognostic factor when progesterone receptor expression is high in estrogen receptor-positive breast cancer. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p5-08-23] [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: 11/16/2022]
Abstract
Abstract
Background
Immunohistochemistry markers are recognized as a predictive prognostic factor for women with breast cancer. Ki-67 and progesterone receptor (PgR) expression are reported to be independently associated with breast cancer prognosis. Some studies report high Ki-67 expression as a negative predictive marker. Whereas other studies report tendency of similar survival between high and low Ki67 cancers when PgR expression is high. In this study, we examined the prognostic significance of Ki-67 expression under PgR expression status.
Methods
The records of 2,366 patients were retrospectively reviewed. The patients underwent surgery for primary breast cancer from July 2009 to December 2012 at a single institution. We studied the prognostic significance of Ki-67 expression under PgR expression. We used 20% and 10% as the cut-off value for PgR and Ki-67, respectively. The end point was recurrence-free survival (RFS) evaluated by use of Kaplan-Meier analysis.
Result
Of the 2,366 analyzed patients, the median follow-up time was 43 months. During follow-up, 44 patients had recurrence, loco-regional recurrence developed in 23 patients and distant recurrence developed in 21 patients. In patients with low PgR expression, high Ki-67 expression group showed significantly worse prognosis compared to low Ki-67 expression group (p=0.005). On the other hand, no significant difference was shown between low and high Ki-67 expression group when PgR expression was high (p=0.637). Also multivariate analysis demonstrated that high Ki-67 expression was an independent prognostic factor only when PgR expression was low. (95% confidence interval [CI], 1.35-10.48; p=0.011)
Conclusion
This is the largest reported study that prognostic significance of Ki-67 expression is defined by PgR expression. Our study presents that high Ki-67 expression is inversely correlated with recurrence risk in early breast cancer patients only under low PgR expression. At high PgR expression, Ki-67 expression has no influence on breast cancer prognosis. Therefore, attention should be paid to correlation between PgR and Ki-67 expression.
Citation Format: Han JH, Kang YJ, Han W, Lee H-B, Kim Y, Yoo T-K, Moon H-G, Noh D-Y. Ki-67 expression is not a valuable predictive prognostic factor when progesterone receptor expression is high in estrogen receptor-positive breast cancer. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P5-08-23.
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Affiliation(s)
- JH Han
- Seoul National University College of Medicine, Seoul, South Korea, Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea, Korea
| | - YJ Kang
- Seoul National University College of Medicine, Seoul, South Korea, Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea, Korea
| | - W Han
- Seoul National University College of Medicine, Seoul, South Korea, Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea, Korea
| | - H-B Lee
- Seoul National University College of Medicine, Seoul, South Korea, Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea, Korea
| | - Y Kim
- Seoul National University College of Medicine, Seoul, South Korea, Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea, Korea
| | - T-K Yoo
- Seoul National University College of Medicine, Seoul, South Korea, Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea, Korea
| | - H-G Moon
- Seoul National University College of Medicine, Seoul, South Korea, Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea, Korea
| | - D-Y Noh
- Seoul National University College of Medicine, Seoul, South Korea, Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea, Korea
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Lee HB, Han W, Ko S, Kim MS, Lim S, Lee KM, Kang YJ, Han JH, Kim Y, Yoo TK, Moon HG, Noh DY, Kim S, Han W. Abstract P6-04-02: Identification of ESR1 splice variants associated with prognosis in estrogen receptor positive breast cancer. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p6-04-02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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
Abstract
Background: Splice variants play a major role in carcinogenesis and disease progression. It is well known that androgen receptor splice variants are associated with resistance to prostate cancer treatment. Estrogen receptor (ER)-positive breast cancers constitute about 70% of all breast cancers and have better prognosis compared to ER-negative cancers. However, there are ER-positive breast cancers that acquire resistance to anti-estrogen therapy, and 12-55% of those tumors were shown to possess ESR1 mutations. The aim of this study was to identify common splice variants in the ESR1 gene and investigate their association with disease outcome.
Methods: Whole transcriptome sequencing was performed on breast cancer specimens from 120 invasive breast cancer patients who underwent operation at Seoul National University Hospital (SNUH) and data from SNUH, GEO, and The Cancer Genome Atlas (TCGA) was used for normal breast tissue sequencing. Exon-exon junctions were identified on aligned RNA sequencing data and was used to construct exon graphs. Splice variant candidates were selected from exon graphs and were merged according to variant subtypes of samples. Subtypes were accessed differentially in relation to how frequent the junctions appear in tumor samples and common exon skipping types with frequent junctions were identified. TCGA RNA sequencing data was then used to search for the common exon skipping subtypes detected from SNUH RNA sequencing data.
Results: Of the 120 tumor samples, 50 were clinically ER-positive by immunohistochemistry. Among exon paths logically possible, 125 paths were not observed in normal breast tissues. Exon 4-5 junction was the most commonly observed junction in the tumor samples. In a search for exon skipping type that results in missing ligand-binding domain of ER, three exon skipping types were identified. Exon skipping with exon 5-10 junction (type 1), exon 9-12 junction (type 2), and exon 10-12 (type 3) was seen in 4 (8%), 4 (8%), and 10 (20%) ER-positive samples, respectively. Retrospective medical chart review of the 18 patients showed recurrence in 4 (100%), 2 (50%), and 4 (40%) patients with type 1, 2, and 3 exon skipping, respectively. Evaluation of TCGA RNA sequencing data of 872 ER-positive samples suggested exon 4-5 junction as the most common junction. A search for exon skipping types in TCGA revealed 1 (0.1%), 9 (1.0%), and 454 (52.1%) samples with type 1, 2, and 3 exon skipping, respectively. However, none of the patients with type 1 or 2 had metastasis or had expired. Of the 454 patients with type 3 exon skipping, 54 patients had died, constituting 61.4% of 88 mortalities in the whole ER-positive population.
Conclusion: Certain splice variants of ESR1 gene yields exon skipping subtypes commonly observed in the ER-positive breast cancer. Estrogen receptor-positive breast cancer with these exon skipping types resulting in a missing ligand-binding domain of ER may be associated with poorer disease outcome. Further investigation is warranted to validate the role of ESR1 exon skipping subtypes in the disease progression of breast cancer.
Citation Format: Lee H-B, Han W, Ko S, Kim M-S, Lim S, Lee K-M, Kang YJ, Han JH, Kim Y, Yoo T-K, Moon H-G, Noh D-Y, Kim S, Han W. Identification of ESR1 splice variants associated with prognosis in estrogen receptor positive breast cancer. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P6-04-02.
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Affiliation(s)
- H-B Lee
- Seoul National University College of Medicine, Seoul, Republic of Korea; Bioinformatics Institute, Seoul National University, Seoul, Republic of Korea; Seoul National University, Seoul, Republic of Korea; Interdisciplinary Program in Bioinformatics, Seoul National University, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Interdisciplinary Program in Bioinformatics, and Bioinformatics Institute, Seoul National University, Seoul, Republic of Korea
| | - W Han
- Seoul National University College of Medicine, Seoul, Republic of Korea; Bioinformatics Institute, Seoul National University, Seoul, Republic of Korea; Seoul National University, Seoul, Republic of Korea; Interdisciplinary Program in Bioinformatics, Seoul National University, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Interdisciplinary Program in Bioinformatics, and Bioinformatics Institute, Seoul National University, Seoul, Republic of Korea
| | - S Ko
- Seoul National University College of Medicine, Seoul, Republic of Korea; Bioinformatics Institute, Seoul National University, Seoul, Republic of Korea; Seoul National University, Seoul, Republic of Korea; Interdisciplinary Program in Bioinformatics, Seoul National University, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Interdisciplinary Program in Bioinformatics, and Bioinformatics Institute, Seoul National University, Seoul, Republic of Korea
| | - M-S Kim
- Seoul National University College of Medicine, Seoul, Republic of Korea; Bioinformatics Institute, Seoul National University, Seoul, Republic of Korea; Seoul National University, Seoul, Republic of Korea; Interdisciplinary Program in Bioinformatics, Seoul National University, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Interdisciplinary Program in Bioinformatics, and Bioinformatics Institute, Seoul National University, Seoul, Republic of Korea
| | - S Lim
- Seoul National University College of Medicine, Seoul, Republic of Korea; Bioinformatics Institute, Seoul National University, Seoul, Republic of Korea; Seoul National University, Seoul, Republic of Korea; Interdisciplinary Program in Bioinformatics, Seoul National University, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Interdisciplinary Program in Bioinformatics, and Bioinformatics Institute, Seoul National University, Seoul, Republic of Korea
| | - K-M Lee
- Seoul National University College of Medicine, Seoul, Republic of Korea; Bioinformatics Institute, Seoul National University, Seoul, Republic of Korea; Seoul National University, Seoul, Republic of Korea; Interdisciplinary Program in Bioinformatics, Seoul National University, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Interdisciplinary Program in Bioinformatics, and Bioinformatics Institute, Seoul National University, Seoul, Republic of Korea
| | - YJ Kang
- Seoul National University College of Medicine, Seoul, Republic of Korea; Bioinformatics Institute, Seoul National University, Seoul, Republic of Korea; Seoul National University, Seoul, Republic of Korea; Interdisciplinary Program in Bioinformatics, Seoul National University, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Interdisciplinary Program in Bioinformatics, and Bioinformatics Institute, Seoul National University, Seoul, Republic of Korea
| | - JH Han
- Seoul National University College of Medicine, Seoul, Republic of Korea; Bioinformatics Institute, Seoul National University, Seoul, Republic of Korea; Seoul National University, Seoul, Republic of Korea; Interdisciplinary Program in Bioinformatics, Seoul National University, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Interdisciplinary Program in Bioinformatics, and Bioinformatics Institute, Seoul National University, Seoul, Republic of Korea
| | - Y Kim
- Seoul National University College of Medicine, Seoul, Republic of Korea; Bioinformatics Institute, Seoul National University, Seoul, Republic of Korea; Seoul National University, Seoul, Republic of Korea; Interdisciplinary Program in Bioinformatics, Seoul National University, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Interdisciplinary Program in Bioinformatics, and Bioinformatics Institute, Seoul National University, Seoul, Republic of Korea
| | - T-K Yoo
- Seoul National University College of Medicine, Seoul, Republic of Korea; Bioinformatics Institute, Seoul National University, Seoul, Republic of Korea; Seoul National University, Seoul, Republic of Korea; Interdisciplinary Program in Bioinformatics, Seoul National University, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Interdisciplinary Program in Bioinformatics, and Bioinformatics Institute, Seoul National University, Seoul, Republic of Korea
| | - H-G Moon
- Seoul National University College of Medicine, Seoul, Republic of Korea; Bioinformatics Institute, Seoul National University, Seoul, Republic of Korea; Seoul National University, Seoul, Republic of Korea; Interdisciplinary Program in Bioinformatics, Seoul National University, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Interdisciplinary Program in Bioinformatics, and Bioinformatics Institute, Seoul National University, Seoul, Republic of Korea
| | - D-Y Noh
- Seoul National University College of Medicine, Seoul, Republic of Korea; Bioinformatics Institute, Seoul National University, Seoul, Republic of Korea; Seoul National University, Seoul, Republic of Korea; Interdisciplinary Program in Bioinformatics, Seoul National University, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Interdisciplinary Program in Bioinformatics, and Bioinformatics Institute, Seoul National University, Seoul, Republic of Korea
| | - S Kim
- Seoul National University College of Medicine, Seoul, Republic of Korea; Bioinformatics Institute, Seoul National University, Seoul, Republic of Korea; Seoul National University, Seoul, Republic of Korea; Interdisciplinary Program in Bioinformatics, Seoul National University, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Interdisciplinary Program in Bioinformatics, and Bioinformatics Institute, Seoul National University, Seoul, Republic of Korea
| | - W Han
- Seoul National University College of Medicine, Seoul, Republic of Korea; Bioinformatics Institute, Seoul National University, Seoul, Republic of Korea; Seoul National University, Seoul, Republic of Korea; Interdisciplinary Program in Bioinformatics, Seoul National University, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Interdisciplinary Program in Bioinformatics, and Bioinformatics Institute, Seoul National University, Seoul, Republic of Korea
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Lee HB, Jeon S, Kim BC, Jho S, Kim J, Kang YJ, Yoo TK, Han JH, Kim Y, Im SA, Moon HG, Noh DY, Han W. Abstract P2-02-15: Discovery of putative circulating tumor cells through somatic mutation profile of epithelial cell adhesion molecule positive single cells from blood of metastatic breast cancer patients. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p2-02-15] [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: 11/16/2022]
Abstract
Abstract
Background: Circulating tumor cell (CTC) enumeration provides prognostic information for chemotherapy in metastatic breast cancer. However, due to its rarity and heterogeneity, it is difficult to distinguish true CTCs from normal blood cells and perform genomic analysis on them for use in therapeutic strategies. The main application of most currently available CTC detection systems consists of an enumeration of putative CTCs without further analysis. The aim of this study was to evaluate the feasibility of single cell picking and target sequencing of epithelial cell adhesion molecule (EpCAM)-positive cells for detecting CTCs.
Methods: Whole blood sampled from metastatic breast cancer patients who were newly diagnosed with metastasis or who had disease progression during palliative treatment were used for this study. After applying IsoFlux Circulating Tumor Cell Enrichment Kit (Fluxion, South San Francisco, CA, USA), single CTC candidates were picked from a pool of EpCAM-positive cells. Genomic DNA from the picked cells was whole genome amplified and target sequencing was performed using Ion AmpliSeq™ Cancer Hotspot Panel (Life Technologies, Carlsbad, CA, USA). Target sequencing reads were mapped to human genome reference (hg19) using BWA-MEM (0.7.10). Single nucleotide variants (SNVs) were annotated using dbSNP, Variome Data 0.2, and COSMIC databases.
Results: A total of 172 EpCAM-positive cells were selected according to size and EpCAM status from whole blood of 11 patients. The remaining cells were grouped into a pooled sample for each patient. The mean read depth of the target genes was 13455×. A mean 7.82 mutations as determined by SNVs listed in the COSMIC database but not in dbSNP and Variome Data 0.2 were detected in each patient. Cells with multiple mutated genes, or those with a mutated gene repeatedly observed in another cell from the same patient were judged to be putative CTCs. At least 2 putative CTCs were detected in 7 patients while no CTCs were detected in 2 patients. Mutated genes observed in the putative CTCs were ABL1, AKT1, APC, CDH1, CDKN2A, ERBB2, FGFR3, HRAS, IDH1, JAK2, KDR, NPM1, RB1, RET, SMARCB1, STK11, and TP53.
Conclusions: Potential CTCs were successfully identified by single cell picking and target sequencing of EpCAM-positive cells from whole blood of metastatic breast cancer patients. Unique mutations not detected in other single cells and pooled samples can be used to distinguish putative CTCs from normal cells. Genomic profiling of corresponding primary tumor and metastatic site biopsy is warranted to verify the CTCs and investigate their role in disease progression.
Citation Format: Lee H-B, Jeon S, Kim BC, Jho S, Kim J, Kang YJ, Yoo T-K, Han JH, Kim Y, Im S-A, Moon H-G, Noh D-Y, Han W. Discovery of putative circulating tumor cells through somatic mutation profile of epithelial cell adhesion molecule positive single cells from blood of metastatic breast cancer patients. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P2-02-15.
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Affiliation(s)
- H-B Lee
- Seoul National University College of Medicine, Seoul, Republic of Korea; The Genomics Institute, UNIST, Ulsan, Republic of Korea; Personal Genomics Institute, Genome Research Foundation, Suwon, Republic of Korea; Borame Medical Center, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - S Jeon
- Seoul National University College of Medicine, Seoul, Republic of Korea; The Genomics Institute, UNIST, Ulsan, Republic of Korea; Personal Genomics Institute, Genome Research Foundation, Suwon, Republic of Korea; Borame Medical Center, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - BC Kim
- Seoul National University College of Medicine, Seoul, Republic of Korea; The Genomics Institute, UNIST, Ulsan, Republic of Korea; Personal Genomics Institute, Genome Research Foundation, Suwon, Republic of Korea; Borame Medical Center, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - S Jho
- Seoul National University College of Medicine, Seoul, Republic of Korea; The Genomics Institute, UNIST, Ulsan, Republic of Korea; Personal Genomics Institute, Genome Research Foundation, Suwon, Republic of Korea; Borame Medical Center, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - J Kim
- Seoul National University College of Medicine, Seoul, Republic of Korea; The Genomics Institute, UNIST, Ulsan, Republic of Korea; Personal Genomics Institute, Genome Research Foundation, Suwon, Republic of Korea; Borame Medical Center, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - YJ Kang
- Seoul National University College of Medicine, Seoul, Republic of Korea; The Genomics Institute, UNIST, Ulsan, Republic of Korea; Personal Genomics Institute, Genome Research Foundation, Suwon, Republic of Korea; Borame Medical Center, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - T-K Yoo
- Seoul National University College of Medicine, Seoul, Republic of Korea; The Genomics Institute, UNIST, Ulsan, Republic of Korea; Personal Genomics Institute, Genome Research Foundation, Suwon, Republic of Korea; Borame Medical Center, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - JH Han
- Seoul National University College of Medicine, Seoul, Republic of Korea; The Genomics Institute, UNIST, Ulsan, Republic of Korea; Personal Genomics Institute, Genome Research Foundation, Suwon, Republic of Korea; Borame Medical Center, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Y Kim
- Seoul National University College of Medicine, Seoul, Republic of Korea; The Genomics Institute, UNIST, Ulsan, Republic of Korea; Personal Genomics Institute, Genome Research Foundation, Suwon, Republic of Korea; Borame Medical Center, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - S-A Im
- Seoul National University College of Medicine, Seoul, Republic of Korea; The Genomics Institute, UNIST, Ulsan, Republic of Korea; Personal Genomics Institute, Genome Research Foundation, Suwon, Republic of Korea; Borame Medical Center, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - H-G Moon
- Seoul National University College of Medicine, Seoul, Republic of Korea; The Genomics Institute, UNIST, Ulsan, Republic of Korea; Personal Genomics Institute, Genome Research Foundation, Suwon, Republic of Korea; Borame Medical Center, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - D-Y Noh
- Seoul National University College of Medicine, Seoul, Republic of Korea; The Genomics Institute, UNIST, Ulsan, Republic of Korea; Personal Genomics Institute, Genome Research Foundation, Suwon, Republic of Korea; Borame Medical Center, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - W Han
- Seoul National University College of Medicine, Seoul, Republic of Korea; The Genomics Institute, UNIST, Ulsan, Republic of Korea; Personal Genomics Institute, Genome Research Foundation, Suwon, Republic of Korea; Borame Medical Center, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
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Kang YJ, O'Connell DL, Lotocki R, Kliewer EV, Goldsbury DE, Demers AA, Canfell K. Effect of changes in treatment practice on survival for cervical cancer: results from a population-based study in Manitoba, Canada. BMC Cancer 2015; 15:642. [PMID: 26394749 PMCID: PMC4580014 DOI: 10.1186/s12885-015-1624-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Accepted: 08/24/2015] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Results from clinical trials in the 1990s led to changes in the recommended treatment for the standard therapy for stage IIB-IVA cervical cancer from radiotherapy alone to chemo-radiotherapy. We conducted the first population-based study in Canada to investigate temporal treatment patterns for cervical cancer and long-term survival in relation to these changes in the treatment guidelines. METHODS Detailed information on stage and treatment for 1085 patients diagnosed with cervical cancer in 1984-2008 and identified from the population-based Manitoba Cancer Registry (MCR) in Canada was obtained from clinical chart review and the MCR. Factors associated with receiving guideline treatment were identified using logistic regression. All cause and cervical cancer specific survival were compared in patients who were and were not treated as recommended in the guidelines, using Cox proportional hazards models. RESULTS The median follow-up time was 6.4 years (range: 0.05-26.5 years). The proportion of women who received guideline treatment was 79 % (95 % confidence interval [CI]: 76-81 %). However, the likelihood of being treated according to the guidelines over time was modified by age (p < 0.0001) and tumour stage at diagnosis (p = 0.002). Women who were treated according to the guidelines after the change in recommended clinical practice (1999-2008) had a significantly lower risk of death from all causes and from cervical cancer. This was driven by lower mortality rates in cases with stage IIB-IVA tumours (all causes of death: hazard ratio [HR] = 0.60, 95 % CI: 0.43-0.82, p = 0.002; cervical cancer related death: HR = 0.64, 95 % CI: 0.44-0.93, p = 0.02). CONCLUSIONS The management of cervical cancer patients in Manitoba, Canada was in good agreement with treatment guidelines although reasons for departure from the guideline recommendations could not be examined further due to lack of data. Treatment of stage IIB-IVA cervical cancers with recommended concurrent chemo-radiotherapy, which is now standard practice, was associated with substantially increased survival, although the effect of changes in clinical practice including maintenance of haemoglobin levels on improved survival cannot be ruled out as a contributing factor.
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Affiliation(s)
- Yoon-Jung Kang
- Prince of Wales Clinical School, the University of New South Wales, Sydney, NSW, Australia.
- Cancer Research Division, Cancer Council NSW, 153 Dowling Street, Woolloomooloo, NSW, Australia.
| | - Dianne L O'Connell
- Cancer Research Division, Cancer Council NSW, 153 Dowling Street, Woolloomooloo, NSW, Australia.
| | - Robert Lotocki
- Division of Gynecologic Oncology, CancerCare Manitoba, Winnipeg, MB, Canada.
- Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
| | - Erich V Kliewer
- Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, MB, Canada.
- Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
| | - David E Goldsbury
- Cancer Research Division, Cancer Council NSW, 153 Dowling Street, Woolloomooloo, NSW, Australia.
| | - Alain A Demers
- Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, MB, Canada.
- Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
| | - Karen Canfell
- Prince of Wales Clinical School, the University of New South Wales, Sydney, NSW, Australia.
- Cancer Research Division, Cancer Council NSW, 153 Dowling Street, Woolloomooloo, NSW, Australia.
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Kang YJ, Lewis H, Smith MA, Simonella L, Neal H, Bromhead C, Canfell K. Pre-vaccination type-specific HPV prevalence in confirmed cervical high grade lesions in the Māori and non-Māori populations in New Zealand. BMC Infect Dis 2015; 15:365. [PMID: 26297490 PMCID: PMC4546322 DOI: 10.1186/s12879-015-1034-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 07/16/2015] [Indexed: 11/17/2022] Open
Abstract
Background New Zealand initiated HPV vaccination in 2008, and has attained 3-dose coverage of ~50 % in 12–13 year old girls. Due to the success of program initiatives in Māori girls, higher coverage rates of ~60 % have been achieved in this group. We have previously reported a benchmark overall pre-vaccination prevalence of oncogenic HPV infection in high grade cervical lesions in New Zealand. The current extended analysis provides separate pre-vaccination benchmark prevalence for Māori and non-Māori women. Methods The National Cervical Screening Programme Register (NCSP-R) was used to identify any woman aged 20–69 years of age with an index high grade cytology report from 2009–2011. Extended recruitment was performed until 2012 in clinics with a high proportion of Māori women. Ethnicity status was based on self-reported information by participating women through phone contact supplemented by recordings on the study questionnaire (the NCSP-R was not used to extract ethnicity status). A total of 730 women consented to participate and had a valid HPV test result; 418 of these had histologically-confirmed cervical intraepithelial neoplasia (CIN) 2/3 lesions (149 Māori, 269 non-Māori). The prevalence of any cervical oncogenic HPV infection, HPV16, and HPV18 was calculated in women with CIN2/3. Results In confirmed CIN2/3, the prevalence of any oncogenic HPV, HPV16 and HPV18 was 96 % (95 % CI:91–99 %), 54 % (95 % CI:46–63 %), 11 % (95 % CI:7–18 %) in Māori and 96 % (95 % CI:93–98 %), 54 % (95 % CI:48–60 %), 11 % (95 % CI:7–15 %) in non-Māori women, respectively. Age-specific patterns of infection for HPV16/18 in confirmed CIN2/3 differed between the two groups (Pinteraction = 0.02), with a lower prevalence in younger vs. older Māori women (57 % in 20–29 years vs 75 % in 40–69 years) but a higher prevalence in younger vs. older non-Māori women (70 % in 20–29 years vs 49 % in 40–69 years); the difference in the age-specific patterns of infection for HPV16/18 was not significant either when considering confirmed CIN2 alone (p = 0.09) or CIN3 alone (p = 0.22). Conclusions The overall prevalence of vaccine-included types in CIN2/3 was similar in Māori and non-Māori women, implying that the long-term effects of vaccination will be similar in the two groups. Electronic supplementary material The online version of this article (doi:10.1186/s12879-015-1034-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yoon-Jung Kang
- Prince of Wales Clinical School, UNSW, Sydney, NSW, 2052, Australia. .,Cancer Research Division, Cancer Council NSW, 153 Dowling Street, Woolloomooloo, NSW, 2011, Australia.
| | - Hazel Lewis
- National Cervical Screening Programme, Ministry of Health, Wellington, New Zealand. .,, Current address: 59 Normandale Rd, Lower Hutt, New Zealand.
| | - Megan A Smith
- Prince of Wales Clinical School, UNSW, Sydney, NSW, 2052, Australia. .,Cancer Research Division, Cancer Council NSW, 153 Dowling Street, Woolloomooloo, NSW, 2011, Australia.
| | - Leonardo Simonella
- Cancer Research Division, Cancer Council NSW, 153 Dowling Street, Woolloomooloo, NSW, 2011, Australia. .,Current address: MORSE (modelling outcomes research, statistics and epidemiology) group, Roche, Basel, Switzerland.
| | - Harold Neal
- National Cervical Screening Programme, Ministry of Health, Wellington, New Zealand.
| | - Collette Bromhead
- Molecular Biology, Aotea Pathology, CMC Building 89 Courtenay Place, Wellington, New Zealand. .,Current address: Institute of Food and Nutrition, College of Health, Massey University Wellington, Wellington, New Zealand.
| | - Karen Canfell
- Prince of Wales Clinical School, UNSW, Sydney, NSW, 2052, Australia. .,Cancer Research Division, Cancer Council NSW, 153 Dowling Street, Woolloomooloo, NSW, 2011, Australia.
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Zhang JP, Liu Z, Zhang B, Yin XY, Wang L, Shi HN, Kang YJ. Genetic diversity and taxonomic status of Gymnocypris chilianensis based on the mitochondrial DNA cytochrome b gene. Genet Mol Res 2015; 14:9253-60. [PMID: 26345858 DOI: 10.4238/2015.august.10.5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
In order to study the genetic diversity and taxonomic status of Gymnocypris chilianensis on a molecular level, the mitochondrial DNA cytochrome b gene was sequenced for 74 individuals of G. chilianensis from two locations (Heihe River and Shule River) and 42 individuals of its affinis species Gymnocypris przewalskii. Analyses of genetic diversity and sequence differences were conducted for these samples, combined with the analysis of 30 homologous sequences of another affinis species Gymnocypris eckloni, which were downloaded from GenBank. The results showed that both the haplotype diversity (h = 0.9820) and nucleotide diversity (π= 0.0039) of the Shule River G. chilianensis were lower than the other populations, thus, the Shule River G. chilianensis should be prioritized for protection because of its lower genetic diversity level. The results of sequence analysis showed that the genetic distance between the Heihe River G. chilianensis population and the Shule River G. chilianensis population was 0.0064, and the genetic distance between these two populations and the G. przewalskii population was 0.0838 and 0.0810, respectively. The genetic distance between the two G. chilianensis populations and the G. eckloni population was 0.0805 and 0.0778, respectively. Analysis of sequence differences indicates that G. chilianensis is sufficiently diverged from G. przewalskii and G. eckloni to the extent that it has reached species level, thus, G. chilianensis can be considered an independent species of Gymnocypris.
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Affiliation(s)
- J P Zhang
- College of Animal Science and Technology, Gansu Agricultural University, Lanzhou, China
| | - Z Liu
- College of Animal Science and Technology, Gansu Agricultural University, Lanzhou, China
| | - B Zhang
- The Fisheries Bureau of Jiuquan City in Gansu, Jiuquan, China
| | - X Y Yin
- The Fisheries Bureau of Jiuquan City in Gansu, Jiuquan, China
| | - L Wang
- Gansu Agro-Ecological Environment Protection Agency, Lanzhou, China
| | - H N Shi
- College of Animal Science and Technology, Gansu Agricultural University, Lanzhou, China
| | - Y J Kang
- College of Animal Science and Technology, Gansu Agricultural University, Lanzhou, China
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Kang YJ, O’Connell DL, Tan J, Lew JB, Demers A, Lotocki R, Kliewer EV, Hacker NF, Jackson M, Delaney GP, Barton M, Canfell K. Optimal uptake rates for initial treatments for cervical cancer in concordance with guidelines in Australia and Canada: Results from two large cancer facilities. Cancer Epidemiol 2015; 39:600-11. [DOI: 10.1016/j.canep.2015.04.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Revised: 04/16/2015] [Accepted: 04/17/2015] [Indexed: 11/25/2022]
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Kang HY, Suh HS, Kim HS, Kang YJ, Lee H. Economic Evaluation of Catheter-Based Renal Denervation for Patients with Resistant Hypertension in Korea. Value Health 2014; 17:A762. [PMID: 27202790 DOI: 10.1016/j.jval.2014.08.265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- H Y Kang
- College of Pharmacy, Yonsei Institute of Pharmaceutical Sciences, Yonsei University, Incheon, South Korea
| | - H S Suh
- College of Pharmacy, Yonsei Institute of Pharmaceutical Sciences, Yonsei University, Incheon, South Korea
| | - H S Kim
- Jongno-gu Public Health Center, Seoul, South Korea
| | - Y J Kang
- The Korean Research-based Pharmaceutical Industry Association, Seoul, South Korea
| | - H Lee
- College of Pharmacy, Yonsei Institute of Pharmaceutical Sciences, Yonsei University, Incheon, South Korea
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Cho JH, Lee JH, Park GY, Lim JH, Kim JS, Kang YJ, Kwon O, Choi JY, Park SH, Kim YL, Kim HK, Huh S, Kim CD. Successful treatment of recurrent focal segmental glomerulosclerosis with a low dose rituximab in a kidney transplant recipient. Ren Fail 2014; 36:623-6. [PMID: 24502587 DOI: 10.3109/0886022x.2014.882238] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Recurrence of focal segmental glomerulosclerosis (FSGS) is a major therapeutic challenge in kidney transplantation (KT). Although intensive plasmapheresis and high-dose rituximab have been introduced to treat recurrent FSGS, the most effective dosage and regimen of rituximab have not been determined. Herein we reported the first case of successful treatment of recurrent FSGS with a low-dose rituximab. The patient showed marked proteinuria (3.5 g/d) and oliguria 2 d after KT. Two courses of plasmapheresis and immunoglobulin were applied to the patient, however, nephrotic range proteinuria persisted and creatinine level increased to 3.56 mg/dL. Five months post-transplant, the patient received injection with only one dose of rituximab 100 mg, without further plasmapheresis, which resulted in immediate reduction of serum creatinine and full remission of proteinuria during the following 18 months. This case suggested that recurrent FSGS, which frequently relapses after plasmapheresis, could be treated successfully with a low-dose rituximab even without plasmapheresis.
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Affiliation(s)
- Jang-Hee Cho
- Department of Internal Medicine, Kyungpook National University School of Medicine , Daegu , Korea
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Lew JB, Howard K, Gertig D, Smith M, Clements M, Nickson C, Shi JF, Dyer S, Lord S, Creighton P, Kang YJ, Tan J, Canfell K. Expenditure and resource utilisation for cervical screening in Australia. BMC Health Serv Res 2012; 12:446. [PMID: 23216968 PMCID: PMC3548768 DOI: 10.1186/1472-6963-12-446] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2012] [Accepted: 11/21/2012] [Indexed: 11/13/2022] Open
Abstract
Background The National Cervical Screening Program in Australia currently recommends that women aged 18–69 years are screened with conventional cytology every 2 years. Publicly funded HPV vaccination was introduced in 2007, and partly as a consequence, a renewal of the screening program that includes a review of screening recommendations has recently been announced. This study aimed to provide a baseline for such a review by quantifying screening program resource utilisation and costs in 2010. Methods A detailed model of current cervical screening practice in Australia was constructed and we used data from the Victorian Cervical Cytology Registry to model age-specific compliance with screening and follow-up. We applied model-derived rate estimates to the 2010 Australian female population to calculate costs and numbers of colposcopies, biopsies, treatments for precancer and cervical cancers in that year, assuming that the numbers of these procedures were not yet substantially impacted by vaccination. Results The total cost of the screening program in 2010 (excluding administrative program overheads) was estimated to be A$194.8M. We estimated that a total of 1.7 million primary screening smears costing $96.7M were conducted, a further 188,900 smears costing $10.9M were conducted to follow-up low grade abnormalities, 70,900 colposcopy and 34,100 histological evaluations together costing $21.2M were conducted, and about 18,900 treatments for precancerous lesions were performed (including retreatments), associated with a cost of $45.5M for treatment and post-treatment follow-up. We also estimated that $20.5M was spent on work-up and treatment for approximately 761 women diagnosed with invasive cervical cancer. Overall, an estimated $23 was spent in 2010 for each adult woman in Australia on cervical screening program-related activities. Conclusions Approximately half of the total cost of the screening program is spent on delivery of primary screening tests; but the introduction of HPV vaccination, new technologies, increasing the interval and changing the age range of screening is expected to have a substantial impact on this expenditure, as well as having some impact on follow-up and management costs. These estimates provide a benchmark for future assessment of the impact of changes to screening program recommendations to the costs of cervical screening in Australia.
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Affiliation(s)
- Jie-Bin Lew
- Cancer Research Division, Cancer Council NSW, 153 Dowling Street, Woolloomooloo, Sydney, NSW 2011, Australia
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Hong KD, Kwon O, Cho JH, Yu CH, Park GY, Kim JS, Kang YJ, Choi JY, Kim CD, Kim YL, Park SH. Encapsulating Peritoneal Sclerosis: An Experience From A Single Korean University Center. Kidney Res Clin Pract 2012. [DOI: 10.1016/j.krcp.2012.04.403] [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: 11/16/2022] Open
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Kwon O, Cho JH, Yu CH, Park GY, Kim JS, Kang YJ, Choi JY, Jung TD, Kim CD, Kim YL, Park SH. THE ASSOCIATION OF PREALBUMIN WITH NUTRITIONAL MARKERS AND INFLAMMATION IN INCIDENT PERITONEAL DIALYSIS PATIENTS. Kidney Res Clin Pract 2012. [DOI: 10.1016/j.krcp.2012.04.447] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Kim JH, Kang YJ, Kim DS, Lee CH, Jeon YS, Lee NK, Oh MH. The relationship between mast cell density and tumour grade in transitional cell carcinoma of the bladder. J Int Med Res 2012; 39:1675-81. [PMID: 22117967 DOI: 10.1177/147323001103900509] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [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] Open
Abstract
This study investigated the relationship between mast cell numbers and the grade of bladder transitional cell carcinoma (TCC). Bladder TCC biopsies were obtained via transurethral resection and 45 stage T1 specimens were included in the study. Specimens were sorted into two groups, low grade (grade I) and high grade (grades II and III). Samples were stained using haematoxylin and eosin, toluidine blue and immunohistochemical staining for tryptase. Mast cells were examined by light microscopy and cell density was recorded. Mast cell density was significantly higher in high-grade TCC than low-grade TCC. There was also a significant relationship between the number of mast cells identified using toluidine blue staining or immunohistochemical staining for tryptase. Detailed studies of mast cell function will enable the development of more effective antitumour therapies via mast cell manipulation.
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Affiliation(s)
- J H Kim
- Department of Urology, Korea University Hospital, Korea University College of Medicine, Ansan, Republic of Korea
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Kim HJ, Kwon YM, Kim YI, Lee IH, Jin BR, Han YS, Cheon HM, Kang YJ, Seo SJ. Molecular cloning and characterization of the STAT gene in Hyphantria cunea haemocytes. Insect Mol Biol 2011; 20:723-732. [PMID: 21958414 DOI: 10.1111/j.1365-2583.2011.01102.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
A new insect member of the signal transducer and activator of transcription (STAT) family of transcription factors, Hyphantria cunea STAT (HcSTAT), was cloned from the lepidopteran H. cunea. The domain involved in DNA interaction and the Src homology 2 (SH2) domain were well conserved. During all developmental stages, the gene was expressed at a low level in the haemocytes, fat body cells, midgut, epidermis and Malpighian tubules. The haemocytes and Malpighian tubules showed transcriptional activation of HcSTAT upon Gram-negative and Gram-positive bacterial challenges. These challenges increased the induction and nuclear translocation of the HcSTAT protein that recognizes a STAT target site in H. cunea haemocytes. In vivo treatment with sodium orthovanadate translocated HcSTAT to the haemocyte nucleus. This study shows the involvement of the haemocyte Janus kinase/STAT pathway after microbial infection in lepidopteran insects.
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Affiliation(s)
- H J Kim
- Division of Applied Life Science (BK21 program), Gyeongsang National University, Jinju, Korea
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Shi JF, Canfell K, Lew JB, Zhao FH, Legood R, Ning Y, Simonella L, Ma L, Kang YJ, Zhang YZ, Smith MA, Chen JF, Feng XX, Qiao YL. Evaluation of primary HPV-DNA testing in relation to visual inspection methods for cervical cancer screening in rural China: an epidemiologic and cost-effectiveness modelling study. BMC Cancer 2011; 11:239. [PMID: 21668946 PMCID: PMC3141766 DOI: 10.1186/1471-2407-11-239] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2010] [Accepted: 06/13/2011] [Indexed: 12/11/2022] Open
Abstract
Background A new lower-cost rapid-throughput human papillomavirus (HPV) test (careHPV, Qiagen, Gaithersburg, USA) has been shown to have high sensitivity for the detection of high grade cervical intraepithelial neoplasia. Methods We assessed the outcomes and cost-effectiveness of careHPV screening in rural China, compared to visual inspection with acetic acid, when used alone (VIA) or in combination with Lugol's iodine (VIA/VILI). Using data on sexual behaviour, test accuracy, diagnostic practices and costs from studies performed in rural China, we estimated the cost-effectiveness ratio (CER) and associated lifetime outcomes for once-lifetime and twice-lifetime screening strategies, and for routine screening at 5-yearly, 10-yearly and IARC-recommended intervals. The optimal age range for once-lifetime screening was also assessed. Results For all strategies, the relative ordering of test technologies in reducing cervical cancer incidence and mortality was VIA (least effective); VIA/VILI; careHPV@1.0 pg/ml and careHPV@0.5 pg/ml (most effective). For once-lifetime strategies, maximum effectiveness was achieved if screening occurred between 35-50 years. Assuming a participation rate of ~70%, once-lifetime screening at age 35 years would reduce cancer mortality by 8% (for VIA) to 12% (for careHPV@0.5) over the long term, with a CER of US$557 (for VIA) to $959 (for careHPV@1.0) per life year saved (LYS) compared to no intervention; referenced to a 2008 GDP per capita in Shanxi Province of $2,975. Correspondingly, regular screening with an age-standardised participation rate of 62% (which has been shown to be achievable in this setting) would reduce cervical cancer mortality by 19-28% (for 10-yearly screening) to 43-54% (using IARC-recommended intervals), with corresponding CERs ranging from $665 (for 10-yearly VIA) to $2,269 (for IARC-recommended intervals using careHPV@1.0) per LYS. Conclusions This modelled analysis suggests that primary careHPV screening compares favourably to visual inspection screening methodologies in rural China, particularly if used as part of a regular screening program.
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Affiliation(s)
- Ju-Fang Shi
- Department of Cancer Epidemiology, Cancer Institute, Chinese Academy of Medical Sciences, Peking Union Medical College, 17, South Panjiayuan LN, PO Box 2258, Beijing 100021, China
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Cho BS, Lee MS, Lee MK, Choi YJ, Kim CN, Kang YJ, Park JS, Ahn HY. Treatment guidelines for isolated dissection of the superior mesenteric artery based on follow-up CT findings. Eur J Vasc Endovasc Surg 2011; 41:780-5. [PMID: 21333559 DOI: 10.1016/j.ejvs.2010.12.022] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2010] [Accepted: 12/20/2010] [Indexed: 12/28/2022]
Abstract
OBJECTIVES The treatment guidelines for isolated superior mesenteric artery dissection (SMAD) are not well established. The purpose of this study was to report a single-centre series of SMAD and propose treatment guidelines. MATERIALS AND METHODS Between November 2004 and December 2009, 30 patients were diagnosed with SMAD. We retrospectively reviewed their medical records. RESULTS The subjects included 26 men and four women, with a mean age of 55.1 years. The chief complaint was abdominal pain in 17 patients, whereas 13 patients were asymptomatic. The mean follow-up was 38.3 months. The radiographic findings included intimal flap with a false lumen in 20 patients and intramural haematoma in 10 patients. The treatments included observation in 18 patients, anticoagulation in five patients, stenting in six patients and surgery in one patient. During follow-up (mean 15.6 months), there was no change in the computed tomography scans of seven patients, improvement was observed in four patients and complete resolution was observed in four patients. All patients, including the symptomatic patients, remained asymptomatic during follow-up. CONCLUSIONS Most patients with SMAD can be successfully managed with conservative treatment. Surgical treatment or percutaneous intervention can be reserved for patients with severe mesenteric ischaemia and those for whom the initial conservative treatment fails.
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Affiliation(s)
- B S Cho
- Department of Surgery, Eulji University School of Medicine and Eulji University Hospital, 1306 Dunsan-dong, Seo-gu, Daejeon, South Korea.
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Kang YJ, Cheng J, Mei LJ, Hu J, Piao Z, Yin SX. Multiple copies of 16s rRNA gene affect the restriction patterns and DGGE profile as revealed by analysis of genome database. Mikrobiologiia 2010; 79:664-671. [PMID: 21090508] [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: 05/30/2023]
Abstract
The use of 16S rRNA gene has been a "golden" method to determine the diversity of microbial communities in environmental samples, phylogenetic relationships of prokaryotes and taxonomic position of newly isolated organisms. However due to the presence of multiple heterogeneous 16S rRNA gene copies in many strains, the interpretation of microbial ecology via 16S rRNA sequences is complicated. Purpose of present paper is to demonstrate the extent to which the multiple heterogeneous 16S rRNA gene copies affect RFLP patterns and DGG E profiles by using the genome database. In present genome database, there are 782 bacterial strains in total whose genomes have been completely sequenced and annotated. Among the total strains, 639 strains (82%) possess multiple 16S rRNA gene copies, 415 strains (53%) whose multiple copies are heterogeneous in sequences as revealed by alignment, 236 strains (30%) whose multiple copies show different restrict patterns by CSP61 + Hinfl, MspI + Rsal or HhaI as analyzed in silico. Polymorphisms of the multiple copies in certain strains were further characterized by G + C% and phylogentic distances based on the sequences of V3 region, which are linked to DGGE patters. Polymorphisms of a few strains were shown as examples. Using artificial communities, it is demonstrated that the presence of multiple heterogeneous 16S rRNA gene copies potentially leads to over-estimation of the diversity of a community. It is suggested that care must be taken when interpreting 16S rRNA-based RFLP and DGGE data and profiling an environmental community.
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Affiliation(s)
- Y J Kang
- Agricultural College, Yangzhou University, Yangzhou, China
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Park KH, Kang YJ. Factors correlated with the advanced life support simulation performance of senior medical students. Crit Care 2010. [PMCID: PMC2934180 DOI: 10.1186/cc8545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- KH Park
- Jeju National University Hospital, Jeju-si, Republic of Korea
| | - YJ Kang
- Jeju National University Hospital, Jeju-si, Republic of Korea
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Shan TL, Cui L, Dai XQ, Guo W, Shang XG, Yu Y, Zhang W, Kang YJ, Shen Q, Yang ZB, Zhu JG, Hua XG. Sequence analysis of an isolate of minute virus of canines in China reveals the closed association with bocavirus. Mol Biol Rep 2009; 37:2817-20. [PMID: 19760094 DOI: 10.1007/s11033-009-9831-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2009] [Accepted: 09/04/2009] [Indexed: 10/20/2022]
Abstract
In the present study, we have cloned and sequenced the nearly-full-length genome of minute virus of canines (MVC), SH26, in China. The genome of MVC, 5,132 nucleotides (nts) in length, contains three open reading frames (ORFs), which are 2,325-bp of NS1, 561-bp of NP1 and 2,112-bp of VP1/VP2 encoding three proteins of 774, 186 and 703 residues, respectively. Predicted amino acids sequence of NS1 of MVC has 44% identity with human bocavirus (HBoV) and human boacvirus 2 (HBoV2), NP1 has 48 and 45% identity with HBoV and HBoV2, VP1/VP2 has 45 and 46% identity with HBoV and HBoV2, respectively. Phylogenetic analysis showed that the present Chinese MVC strain was also closely clustered with the previous American and Japanese MVC isolates, and MVCs formed a different branch together with bovine parvovirus and HBoVs from other parvoviruses classified into Parvovirinae.
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Affiliation(s)
- T L Shan
- Zoonosis and Comparative Medicine Group, School of Agriculture and Biology, Shanghai Jiaotong University, Shanghai, People's Republic of China.
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Bae SU, Kim CN, Kim KH, Hwang IT, Choi YJ, Lee MK, Cho BS, Kang YJ, Park JS. Laparoscopic Treatment of Early Retroperitoneal Abdominal Pregnancy Implanted on Inferior Vena Cava. Surg Laparosc Endosc Percutan Tech 2009; 19:e156-8. [DOI: 10.1097/sle.0b013e3181ab91b0] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kwon YM, Kim HJ, Kim YI, Kang YJ, Lee IH, Jin BR, Han YS, Cheon HM, Ha NG, Seo SJ. Comparative analysis of two attacin genes from Hyphantria cunea. Comp Biochem Physiol B Biochem Mol Biol 2008; 151:213-20. [PMID: 18682300 DOI: 10.1016/j.cbpb.2008.07.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2008] [Revised: 06/30/2008] [Accepted: 07/08/2008] [Indexed: 10/21/2022]
Abstract
A full-length clone corresponding to attacin was isolated from a cDNA library made from fat body of immunized Hyphantria cunea larvae. This newly isolated attacin B shows characteristics different from those previously reported for attacin A. The two attacin cDNAs encode precursor proteins of 233 and 248 amino acid residues, respectively. The two attacins show 45.9% identity at the amino acid level, and 35.2% identity at the nucleotide level. Attacins A and B of H. cunea show significant identities with the attacins of Lepidoptera. Attacin B is a typical glycine-rich protein, while attacin A is leucine-rich. Attacin B is expressed from last instar larvae to adult, while attacin A showed stage-specific expression during the prepupal and pupal stages. Attacins A and B are predicted to have different secondary structure in that attacin A has no tendency to form helices but attacin B contains a substantial number of helices. Attacin A is induced at a trace level in infected larvae, while attacin B is strongly induced against Gram-positive and negative bacteria, fungi, and viruses. The attacin B transcripts were detected in fat body, epidermis and hemocytes after injection with Escherichia coli, Citrobacter freundii, or Candida albicans, but not in the midgut and Malpighian tubule. Recombinant attacin A showed no antibacterial activity, while recombinant attacin B showed strong antibacterial activity in proportion to the amount of the protein injected.
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Affiliation(s)
- Y M Kwon
- Division of Applied Life Science, Gyeongsang National University, Jinju, Republic of Korea
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Jung UJ, Baek NI, Chung HG, Bang MH, Yoo JS, Jeong TS, Lee KT, Kang YJ, Lee MK, Kim HJ, Yeo JY, Choi MS. The anti-diabetic effects of ethanol extract from two variants of Artemisia princeps Pampanini in C57BL/KsJ-db/db mice. Food Chem Toxicol 2007; 45:2022-9. [PMID: 17574717 DOI: 10.1016/j.fct.2007.04.021] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2006] [Revised: 03/05/2007] [Accepted: 04/26/2007] [Indexed: 10/23/2022]
Abstract
The anti-diabetic effects of two variants of Artemisia princeps Pampanini, sajabalssuk (SB) and sajuarissuk (SS), were investigated in type 2 diabetic animal using their ethanol extracts. Male C57BL/KsJ-db/db (db/db) mice were divided into control, SB ethanol extract (SBE), SS ethanol extract (SSE), or rosiglitazone (RG) groups and their age-matched littermates (db/+) were used. Supplementation of the SBE (0.171 g/100g diet), SSE (0.154 g/100g diet), and RG (0.005 g/100g diet) improved glucose and insulin tolerance and significantly lowered blood glycosylated hemoglobin levels, as compared to the control group. Plasma insulin, C-peptide and glucagon levels in db/db mice were higher in the db/+ mice, however these values were significantly lowered by SBE, SSE or RG-supplement. Hepatic GK activity was significantly lower in the db/db mice than in the db/+ mice, while hepatic G6Pase activity was vice versa. Supplementation of SBE, SSE and RG reversed these hepatic glucose-regulating enzyme activities. In addition, SBE and SSE markedly increased the hepatic glycogen content and muscle ratio as compared to the control group, but they did not alter the food intake, body weight and plasma leptin level. The RG group, however, showed a significant increase in the food intake, body weight and plasma leptin. These results suggest that SBE and SSE exert an anti-diabetic effect in type 2 diabetic mice.
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Affiliation(s)
- U J Jung
- Institute of Human Nutrition, College of Physicians and Surgeons, Columbia University, New York, NY 10032, United States
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Abstract
Diabetes is a serious public health problem. Improvements in the treatment of noncardiac complications from diabetes have resulted in heart disease becoming a leading cause of death in diabetic patients. Several cardiovascular pathological consequences of diabetes such as hypertension affect the heart to varying degrees. However, hyperglycemia, as an independent risk factor, directly causes cardiac damage and leads to diabetic cardiomyopathy. Diabetic cardiomyopathy can occur independent of vascular disease, although the mechanisms are largely unknown. Previous studies have paid little attention to the direct effects of hyperglycemia on cardiac myocytes, and most studies, especially in vitro, have mainly focused on the molecular mechanisms underlying pathogenic alterations in vascular smooth-muscle cells and endothelial cells. Thus, a comprehensive understanding of the mechanisms of diabetic cardiomyopathy is urgently needed to develop approaches for the prevention and treatment of diabetic cardiac complications. This review provides a survey of current understanding of diabetic cardiomyopathy. Current consensus is that hyperglycemia results in the production of reactive oxygen and nitrogen species, which leads to oxidative myocardial injury. Alterations in myocardial structure and function occur in the late stage of diabetes. These chronic alterations are believed to result from acute cardiac responses to suddenly increased glucose levels at the early stage of diabetes. Oxidative stress, induced by reactive oxygen and nitrogen species derived from hyperglycemia, causes abnormal gene expression, altered signal transduction, and the activation of pathways leading to programmed myocardial cell deaths. The resulting myocardial cell loss thus plays a critical role in the development of diabetic cardiomyopathy. Advances in the application of various strategies for targeting the prevention of hyperglycemia-induced oxidative myocardial injury may be fruitful.
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Affiliation(s)
- L Cai
- Department of Medicine, University of Louisville, Louisville, KY 40202, USA
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Abstract
Zinc is proposed to be antiapoptotic for it has been shown to inhibit late events of apoptotic pathways such as Ca(2+)/Mg(2+)-dependent endonuclease cleavage of chromatin DNA, poly-ADP ribose polymerase cleavage, and caspase-3 activity. Because caspase-3 is a critical executioner caspase in apoptosis, this study was undertaken to examine specifically a correlation between zinc inhibition of caspase-3 activation and apoptosis in HeLa cells. Cultured HeLa cells were exposed to 100 microM ZnCl(2) for 1 h prior to 12 h treatment with 1.0 microM doxorubicin (DOX), an important anticancer agent that causes apoptosis in a wide variety of tumor cells. Western blot analysis of HeLa cells treated with DOX for 12 h revealed that DOX caused proteolytic activation of caspase-3 and zinc inhibited this activation. Interestingly, zinc did not inhibit DOX-induced apoptosis as measured by a terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling assay. Furthermore, a microculture tetrazolium assay confirmed that cell death occurred in the presence of zinc. These results demonstrate that zinc specifically inhibits DOX-induced activation of caspase-3 in HeLa cells, but does not suppress DOX-induced apoptosis or otherwise cell death, thus suggesting DOX-induced caspase-3 activation may not play a major role in overall cell death and/or non-caspase-3 pathways are involved in DOX-induced apoptosis in HeLa cells.
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Affiliation(s)
- J C Lambert
- Department of Pharmacology and Toxicology, University of Louisville School of Medicine, Louisville, Kentucky 40202, USA
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Wang GW, Klein JB, Kang YJ. Metallothionein inhibits doxorubicin-induced mitochondrial cytochrome c release and caspase-3 activation in cardiomyocytes. J Pharmacol Exp Ther 2001; 298:461-8. [PMID: 11454906] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023] Open
Abstract
Previous studies using transgenic mice in which metallothionein (MT) was overexpressed only in the heart have demonstrated that MT protects from oxidative cardiac injury induced by doxorubicin (DOX), an important anticancer agent. MT cardioprotection is associated with its antiapoptotic effect. The present study was undertaken to test the hypothesis that MT suppresses DOX-induced apoptosis through inhibition of mitochondrial cytochrome c release and caspase-3 activation. Primary cultures of cardiomyocytes isolated from the hearts of transgenic neonatal mice and nontransgenic controls were treated with DOX at a clinically relevant concentration (1.0 microM) for varying time periods. Apoptosis was detected in nontransgenic cardiomyocyte cultures by terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling and Annexin V-fluorescein isothiocyanate binding. This apoptotic effect was significantly suppressed in the MT-overexpressing transgenic cardiomyocytes. Western blot analysis revealed that DOX caused mitochondrial cytochrome c release. Furthermore, caspase-3 activation was observed. The activation of this apoptotic pathway by DOX was dramatically inhibited in the MT-overexpressing cardiomyocytes. To elucidate the role of reactive oxygen species (ROS) in the activation of the cytochrome c-mediated caspase-3 activation pathway, the intracellular levels of ROS and their localization were detected by fluorescent confocal microscopy. Mitochondrial ROS concentrations were dramatically elevated by DOX in nontransgenic cardiomyocytes. This elevation was completely inhibited almost in the MT-overexpressing cardiomyocytes. Thus, these results demonstrate that MT suppresses DOX-induced apoptosis in cardiomyocytes through, at least in part, inhibition of the cytochrome c-mediated apoptotic pathway.
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Affiliation(s)
- G W Wang
- Department of Medicine, University of Louisville, Louisville, Kentucky 40202, USA
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