bluuebunny/crossref_metadata_2025 huggingface dataset:
Innovative Interprofessional Approach Using Service Training to Enable a Fisher Folk Community to Quit Tobacco Habits
Authors: George R.M.
Published: September 2018

Background and context: Fisher folk use tobacco products to avoid sea sickness and to stay awake during night, while working at sea. They have minimal education, low income and are unaware of harmful effects of tobacco. It has also been observed that the prevalence of oral precancerous lesions and conditions are high in this community. The present dental curriculum does not emphasize on training undergraduates on antitobacco counseling. Aim: To assess the effectiveness of interprofessional initiative using service training to enable a fisher folk community to quit tobacco habits. Strategy/Tactics: Dentists are in a strategic position to diagnose oral cancerous and precancerous lesions and facilitate tobacco cessation. As tobacco addiction is based on physical, psychological and behavioral factors, it could be managed through multisectoral approach by interprofessional collaboration. Involvement of primary health care workers and community leaders will ensure reinforcement and sustainability of the desired effects in the community. Program/Policy process: A training module was formulated by an interprofessional team consisting of psychiatrist, public health dentist and tobacco interventionists. Thirty dental interns and three primary health workers participated in training program on lifestyle of fisher folk, tobacco epidemic, harmful effects of tobacco use and tobacco cessation. The interns were also trained for role play in local language, conveying the same message which empowered them to conduct awareness programs in the community there after. A house to house survey was conducted by primary health workers in 308 houses of the community to assess knowledge and attitude of fisher folk toward tobacco use before and after tobacco intervention program by interns. Outcomes: There was highly significant increase in knowledge and skills of dental interns after training program. Thirty seven percent of current tobacco users in the community decided to quit the habit and there was 52% increase in the number of smoke free homes in the community, three months after tobacco awareness programs were conducted in the community. What was learned: The interprofessional initiative empowered interns to incorporate tobacco cessation in routine dental practice and effectively enabled fisher folk community in adopting smoke free home policy.
Relationship Between Smokeless Tobacco and Cervical Premalignant and Malignant Lesions Among the Patients Screened for Cervical Cancer in the Health Promotion Clinic, Noida
Authors: Priyanka R. , Hariprasad R. , Kumar V. , Danasekaran K. , Sharma S. , Sriram L. , Mehrotra R.
Published: September 2018

Background: Global Adult Tobacco Survey (GATS-2) India (2016-17), reported that 5.1 crore rural women and 1.4 crore urban women use tobacco in any form. Cervical cancer is the second most common cancer in India among women accounting for 22.86% of all cancer cases in women and 12% of all cancer cases in both men and women. One woman dies of cervical cancer every 8 minutes in India. The risk of cervical intraepithelial neoplasia (CIN) was found to be increased with the women who smoke but the association between smokeless tobacco (SLT) and areca nut have not been adequately reported in the literature; hence this study was contemplated to bridge the literature gap. Aim: To find the association between SLT use and cervical premalignant and malignant lesions among those women screened for cervical cancer at Health Promotion Clinic. Methods: Retrospective analysis was performed on the electronically maintained records of the individuals screened for cervical cancer from February 2014 - February 2018 at the Health Promotion Clinic at National Institute of Cancer Prevention and Research (NICPR), Noida. All married women above 30 years of age were eligible to be screened for cervical cancer using visual inspection with acetic acid (VIA) and Papanicolaou (PAP) test, if any abnormality was found colposcopy was done, if required biopsy was performed for confirmation. The premalignant lesions were treated with thermocoagulation or loop electrosurgical excision procedure (LEEP) and those diagnosed of malignancy were referred to a tertiary care center for further treatment. The participant's data on sociodemographic status, tobacco use and results cervical cancer screening are maintained in an online electronic data capture system. Results: Out of 6538 individuals attended the Health Promotion Clinic, for their oral, breast and cervical cancer screening from February 2014 - February 2018, 5431 (83.1%) were females and 1107 (16.9%) were males. All the females with eligible criteria were screened for cervical cancer 5431. Among which 126 (2.3%) reported with the habit of smoking, 595 (11%) reported of SLT use and 52 (1%) reported of both smoking and SLT use. The SLT users were at a higher risk [odds ratio (OR)] of developing cervical lesions compared with the non-SLT users diagnosed by the PAP test 1.02 (1.020-1.028). Conclusion: Women consuming SLT are at high risk of developing cervical premalignant and malignant lesions compared with the non-SLT users.
Epidemiology of Esophageal Cancer (EC) In Oromia Region, Ethiopia 2016: A 4-Year Medical Record Review
Authors: Bulcha G.G. , Leon M.E. , Gwen M. , Abnet C.C. , Sime A. , Pritchett N.R. , Dawsey S.M.
Published: September 2018

Background: It is difficult to determine the prevalence/incidence of EC without an established functional national cancer registry, which helps to demarcate the population at-risk and monitor cancer trends over time. The review of medical records can help to identify areas in a country with high number of diagnosed EC cases and help set public health priorities. Aim: To describe EC hospital case series during a period of 4 years at the main cancer treatment center in Ethiopia and two hospitals in the EC high-risk zones in the Oromia region, concentrating on residents of Oromia region and to offer recommendations for public health officials. Methods: All EC malignancy data from the period 2013-2016 were collected by reviewing patient charts at the selected hospitals: Tikur Anbessa Teaching hospital (TATH) in Addis Ababa, Adama General and Medical Teaching Hospital (AGMTH) and Adama Referral and Medical Teaching Hospital (ARMTH). Cases with insufficient residence information and residents of other regions were excluded from the summary. The number of EC cases is presented by age, sex and site as well as method of diagnosis. Data were expressed as percentages (%). Statistical analysis was done using SPSS 20 software. Results: Over the study period, a total of 669 EC cases who resided in Oromia region were identified in the selected hospitals out of 2211 registered in the referral surgical departments of hospitals in the study, with insignificant difference by sex. A total of 457 (68%) were residents from high risk Arsi/Bale zones and the rest 212 (32%) from other zones of the region. The mean age at diagnosis was 52.4 years with the majority of cases in the age range 45-69 years. A total of 34 (5%) EC cases were younger at diagnosis (15-29 years). A total of 258 (38.5%) cases were identified at TATH, 305 (46%) from AGHMT/ARHMT and 106 (16%) cases from both TATH/AGHMT. Data were gathered from patient charts at endoscopy departments 227 (34%), endoscopy and pathology departments 246 (37%) and all other sources (ie surgical department) 196 (29%). Most patients complained dysphagia for solids 664 (99%) and weight loss 352 (53%). Cases were histopathology proven (256, 38%), identified through endoscopy investigation (385, 58%) or radiology (28, 4%). Squamous cell carcinoma was the predominant histology type with 160 cases (62.5%) of those histologically proven. Among the total of 420 cases whose risk factor history was recorded, 401 (97%) had a previous history of digestive disease, 49% reported hot beverage consumption and 34% persistent heart burn. Conclusion: Two thirds of EC incident cases came from Arsi and Bale zones with decreasing trends over the period considered. Such trends warrant in depth investigation for possible reasons and future study to investigate local based risk factors associated with the disease.
Social Marketing Plays As a Donation Box When It Comes to Fundraising
Authors: Eltaweel M.
Published: September 2018

Amount raised in 2017 Financial donation 628,111.61 USD Other donations 117,601.73 USD March 2018 Financial donation 109,844.00 USD Background and context: Qatar Cancer Society Marketing Department work hand in hand with the society when it comes to fundraising. Aim: Our aim is to bring cancer awareness into the Qatar community as well as provide cancer patients and the organization with the needed fund to either cover cancer cases who needs financial support inside Qatar. And to financial support the organization to continue its awareness activities. Strategy/Tactics: Our campaigns are based on the World Health Organization calendar, where every month we have a marketing awareness campaign for a type of cancer as per the below: January: cervical health awareness July: skin cancer awareness February: World Cancer Day (February 4) August: blood cancer March: colorectal cancer awareness September: childhood cancer awareness April: thyroid cancer awareness October: breast cancer awareness May: no tobacco and cancer November: prostate cancer June: cancer survivors December: cancer awareness We mainly use these tactics to promote each campaign: e-mail marketing, direct marketing, engaging events, social media campaign, cinema advertising, TV ads, SMS marketing, partnerships, sponsorships, and cancer patients visit. Program process: Costs and returns 2017 Marketing costs 98,096.46 USD Agreements: 18 Financial donation 628,111.61 USD Other donations 117,601.73 USD What was learned: In Qatar donation was limited to boxes only for a long time. Now marketing has proved that creative messages and inbound marketing can encourage people to donate and not only donate, it happens in a real time and remotely by donating via a link, SMS or bank transfer. Each and every sponsor support as part of their Social Corporate Responsibility which is a win-win situation for both the sponsor and the nonprofit organization. Social marketing works the same way as marketing, it is a systematic and planned process. However, the aim is to either change/enhance a behavior or to spread awareness. And for cancer, we work hardly to spread awareness and to tell people the importance of donation, early detection and how to live if you or one of your beloved one has the cause. Donation shouldn't be limited to cover cancer cases, it should also consider the importance of spreading awareness. As you can see in the statistics above, we were able to raise a fund of a huge amount this year comparing it to the previous year, and the only reason was social marketing.
Unusual Presentations of Acute Lymphoblastic Leukemia in Children: A Study of 9 Patients
Authors: Maheshwari G.
Published: September 2018

Background: Acute lymphoblastic leukemia is the most common malignancy in children below 15 years of age. Bone marrow, CNS and the gonads are the three major sites of failure or relapse in acute lymphoblastic leukemia. Occasionally, leukemic cells can infiltrate the unusual sites and present with some unusual manifestations either at initial (diagnosis) presentation or during the course of disease. This study presents 9 such rare cases of unusual manifestations of acute lymphoblastic leukemia. Aim: To report the unusual presentation and management of acute lymphatic leukemia in children either at initial diagnosis or during the course of disease. Methods: Between 2000-2012, 1800 patients with acute lymphoblastic leukemia were treated at the Gujarat Cancer & Research Institute, Ahmedabad, a tertiary cancer care center and one of the largest regional cancer center of India. Among these patients a total of 317 cases were found to develop relapse at bone marrow, CNS, testicles etc. Out of these patients, a total of 9 patients were detected to have very unusual manifestations of the disease, either at initial presentation or during the course of their disease. These patients had parotid salivary gland involvement (1), maxillary sinus (2), bilateral blindness due to retinal detachment (1), bilateral facial nerve palsies (1), multiple symmetrical involvement of bones of both upper and lower extremities (1), small bone of the hand (4th metacarpal bone) (1), massive splenomegaly (1) and torsion of the testicle (1). The manifestations of such unusual clinical presentations, their evaluation, management and ultimate outcome is being presented in this presentation along with review of the literature. Results: Acute lymphoblastic leukemia can present with very unusual manifestation during initial diagnosis or later. Conclusion: ALL may occasionally present in some unusual way. Such uncommon presentation can create a diagnostic dilemma as well as difficulty in management. All such presentations require special attention from the treating consultant and team for the better outcome. We strongly recommend that all such rare presentations must be reported to enhance the understanding of the disease and enhance the literature.
Public Engagement With and Recognition of the “Be Cancer Alert Campaign” - Colorectal Cancer Awareness
Authors: Schliemann D. , Donnelly M. , Dahlui M. , Loh S.Y. , Paramasivam D. , Somasundaram S. , Tamin N.S.B. Ibrahim , Su T.T.
Published: September 2018

Background: Colorectal cancer is the most common cancers in males in Malaysia and the second most common cancer in females. Low awareness of cancer delays help-seeking and contributes to late presentation, poor detection and survival. We developed a culturally sensitive mass media campaign to increase awareness about the signs and symptoms of colorectal cancer among Malaysians, which was informed by previously successful campaigns in Northern Ireland. Aim: The aim of this study is to analyze the public engagement with the campaign on social media and to identify whether the public recognizes the campaign materials postintervention. Methods: Focus group discussions informed the cultural adaptation of the Be Cancer Alert Campaign - Colorectal Cancer (BCAC-CRC). Based on the focus discussions we developed a TV commercial and radio advertisement as well as a print advertisement campaign. In addition, we promoted the BCAC through a Web site and social media campaign. The BCAC-CRC will run from the 2nd of April for five weeks. The engagement with the Web site and the social media campaign will be analyzed on a daily basis to respond to public engagement immediately. A population-based survey postintervention including a randomly selected sample of approximately 700 participants will evaluate whether people recall the campaign key messages and have noticed the campaign materials. Results: Postintervention data collection will take place from May-July 2018. The results of the analysis will be presented at the conference. Conclusion: To our knowledge, the BCAC-CRC is the first colorectal cancer awareness campaign in Malaysia that will be evaluated for its public engagement on social media as well as public recognition of the TV, radio and print materials.
Waterpipe Tobacco Cessation
Authors: Shishani K.
Published: September 2018

Background: Waterpipe smoking contains carcinogens and toxicants such as tobacco nitrosamines and heavy metals. To date, few smoking cessation interventions targeting waterpipe tobacco smoking have been reported worldwide. The most recent Cochrane review emphasized the need for evidence on hookah tobacco use interventions since only a few trials of sufficient quality have been published. Aim: The objective of this randomized clinical trial was to examine the efficacy of contingency management (CM) for promoting initial waterpipe smoking abstinence. Methods: Thirty-nine adults completed the study. Participants were adults 18 years of age and older who smoked tobacco using a waterpipe three times or more per week for the past one year, did not smoke cigarettes, and were not planning on quitting waterpipe tobacco smoking. A two-group, repeated measures (10 study visits on Mondays and Thursdays) design was used. Participants were randomly assigned to either the contingent (n = 19) or noncontingent (n = 20) study arms. The primary study outcomes were biochemically verified prolonged abstinence and 7-day point prevalence. Results: The prolonged abstinence rate in the contingent and noncontingent groups were 42.1% and 5.0%, respectively, ( P = 0.008). The 7-day point prevalence in the contingent and noncontingent were 47.4% and 5.0%, respectively, ( P = 0.003). Conclusion: Rewards contingent on biochemically verified abstinence promote initial waterpipe tobacco cessation. This is useful information for consideration in future cessation programs for waterpipe smokers.
Dietary Trans Fatty Acid Intake in Relation to Cancer Risk: A Systematic Review
Authors: Michels N. , Van der Meulen K. , Huybrechts I.
Published: September 2018

Background: A western-type diet is probably the key modifiable risk factor toward cancer. Ultra-processed foods may contain trans fatty acids produced during partial oil hydrogenation. Aim: Harmful cardiovascular effects of trans fatty acids are already proven, but the link with cancer risk has not been summarized yet. Methods: The online electronic databases PubMed (n=375 articles) and Embase (n=122 articles) were used to find observational studies on the intake of trans fatty acids as predictor of neoplasms. The full-text of 78 articles was read by two independent researchers, after a first elimination based on abstract, and eventually 24 articles were included in this review. Results: In total, 7 cancer types have been researched in cohort and case-control studies investigating associations between trans fatty acid intakes and cancer risk: breast cancer (n=6), colorectal cancer (n=9), mouth/pharynx/esophagus cancer (n=3), non-Hodgkin lymphoma (NHL, n=4), ovarian cancer (n=5), pancreatic cancer (n=3) and prostate cancer (n=6). Concerning total trans fatty acid intake, the studies on NHL and oral/pharynx/esophagus cancer univocally showed a positive association, while the ones on pancreatic cancer showed no significant association and the other cancers had contradictory results. Some studied subtypes of trans fatty acids: C16:1 and C18:2 but not C18:1 were related to breast cancer; C16:1 but not C18:1 or C18:2 were related to pancreatic cancer; while results for colorectal and prostate cancer were contradictory. For C18:1, even the place of the double bound can change the relation with prostate cancer. Vulnerability factors were genetics (for prostate cancer), ethnicity (Caucasian more at risk for prostate or colorectal cancer), menopause (for breast cancer), high age (for colon and prostate cancer) and high BMI (for colon cancer). Conclusion: This systematic review suggests potential harmful effects of high consumptions of trans fatty acids through increased cancer risks, with most evidence available for NHL and oral/pharynx/esophagus cancer. Underlying pathways are not fully known, but chronic inflammation and oxidative stress possibly play a role. Future studies investigating associations between trans fat intakes and cancer risk should apply higher methodological quality (eg adjusting for confounders and using biomarkers of intake). For targeted prevention strategies, studies should examine which trans fatty acid subtypes are more carcinogenic and what populations are at highest risk.
Quality of Life of Ostomy Patients Attending BP Koirala Memorial Cancer Hospital Chitwan
Authors: Mehta R.S. , Garbuja C.K.
Published: September 2018

Background: The global scenario shows an increase trend of ostomy surgery. And, quality of life of ostomy patients has become a common concern. Understandings of factors that can have an impact on QoL should be assessed which will provide a guideline for improving QoL of ostomy patients. Aim: The aim of the study are to assess quality of life of ostomy patients and to find out the association between quality of life with selected demographic variables. Methods: A descriptive cross-sectional study was conducted to assess quality of life of ostomy patient. Ninety-four patients were selected by purposive sampling technique. COH-QOL-Ostomy questionnaire tool was used for data collection. Data were collected from descriptive and inferential statistics were used for data analysis. The P value was estimated at 95% confidence interval with 5% permissible error. Results: The study demonstrated that mean age of respondents was 51.10 ± 16.14 years. Permanent colostomy was common. The mean score for overall QoL was 6.50 ± 1.69. The physical domain (7.14 ± 2.32) had the highest score and spiritual (5.87 ± 1.56) had lowest. The major problems related to ostomy bag were leakage (68.90%), followed by itching around the stoma (52.70%), redness (32.40%), burning sensation (16.2%) and rashes (16.2%) respectively. Age, education, residence, occupation, duration of ostomy, reason and kind of ostomy, isolation of self from social gatherings and change in clothing style had significant effects on quality of life ( P < 0.05). Conclusion: The findings revealed that presence of ostomy influences QoL of ostomy patients. Hence, adequate stoma care services, health education and counseling are important for having a positive impact on patients living with ostomy.
An Analysis of the Psychosocial, Financial and Emotional Needs of Adolescent and Young Adult Cancer Survivors in Singapore Through Focus Group Discussions
Authors: Tan C.J. , Toh Y.L. , Tan I.M.J. , Yeo K.X.H. , Goh W.L. , Poon E. , Farid M. , Srilatha B. , Chan A.
Published: September 2018

Background: The adolescent and young adult (AYA) population, aged between 15-39 years, is an understudied and medically underserved community of cancer survivors in Singapore. Aim: This study was designed to elicit perspectives on various psychosocial, emotional and financial concerns that the AYA cancer survivors (CS) encountered, in their transition to survivorship. Methods: The AYA CS in the age range of 18-39 years, with at least 6 months to 2 years since diagnosis and/or completion of curative treatment were recruited for this study. Four focus group discussions, which consisted of 2-4 respondents, were conducted within the premises of National Cancer Centre Singapore. Participants were prompted by the facilitator with a series of open-ended questions on themes specific to survivorship, including treatment side-effects, sexual and reproductive health concerns, changes in work or education and survivorship support services. Participants' responses were then transcribed verbatim, and analyzed through qualitative content analysis. Results: Twelve AYA, with a mean (±SD) age of 27.1 (±5.9) years, participated in four focus group discussions. The mean (±SD) number of years since cancer diagnosis was 2.3 (±0.6) years, with majority diagnosed with non-Hodgkin's lymphoma (41.6%) and germ cell tumor (25.0%). AYA CS were greatly affected by physical side-effects such as alopecia, changes in body image, and cognitive changes. There were also emotional concerns including the fear of recurrence, infertility anxieties, poor insurance coverage and lack of career advancement opportunities. Majority expressed that they preferred consulting a specialist rather than a general practitioner for their follow-up care. Conclusion: The AYA CS suffer from a multitude of problems as they transit toward survivorship. Innovative and effective survivorship care models are required to timely address their bio-psychosocial, financial and emotional concerns.
A Strategy of Networking and Colaboration to Promote Early Diagnosis of Childhood Cancer in Rio De Janeiro
Authors: Marques R. , Pires L.D.J.A. , Santos E.K.d.
Published: September 2018

Background and context: It is known the chances of healing in developed countries might be of 90%, depending on the type of tumor and, especially, its early diagnosis. In Brazil, cancer is the leading cause of death by disease among ages from 1 to 19, and because it is rare, health professionals have difficulties in diagnosing and referring cases to treatment. Aim: The “Unidos pela Cura” aims to promote early diagnosis of childhood cancer in Rio de Janeiro in a coresponsible and integrated way to the principles of Brazilian Unified Health System (universalization, equity and integrality). Strategy/Tactics: This initiative included the Desiderata Institute as the leader of civil society organization, having as its bases: i) Mobilization of managers from the government, heads and professionals of the pediatric oncology services, health practitioners (primary care) and social organization to identify the main problem with pediatric oncology in the public system and to collectively think solutions. The identified problem was related to the early diagnosis; ii) Knowledge about the identified problem, with studies: one pointed out the main epidemiologic trends of childhood cancer in the state of Rio de Janeiro ( Koiffman, 2004 ); and another showed the system problems by revealing that suspicions of childhood cancer took an average of 60 days to be investigated when they arrived from primary care ( Brito, 2005 ); iii) Advocacy: the collective construction of coresponsibilities and priorities regarding childhood cancer in a term of commitment, and marked the definition of the initiative as public policy; and iv) Communication: bulletins with the results of the Unidos pela Cura are to be annually produced and sent to managers and health professionals to monitor cases and disseminate the results. Program/Policy process: Unidos pela Cura is a collective and coresponsible initiative to promote the early diagnosis of childhood cancer, created in 2005 and organized into three axes: i) Education - training health professionals in the family health strategy for cancer suspicion; ii) Flow - organization of referral flow and referral of suspected cases of childhood cancer from primary care to specialized hospitals to start the diagnostic investigation within 72 hours; and iii) Information - online system for monitoring suspected cases referred by primary care until diagnostic confirmation, with annual results disclosure. Outcomes: As results, the Unidos pela Cura has been included in the State Cancer Care Plan (2018-2021) and the Municipal Health Plan (2009-2012); 535 doctors and 3038 professionals from the family health strategy; 1311 children and adolescents were referred and 127 confirmed cases of cancer; 37 meetings of the managing group of Unidos pela Cura, among others. What was learned: Collaborative actions between society and governments can contribute to better outcomes and chances of cure.
Frequency of BRCA1 and BRCA2 Germline Variants in Women With Ovarian Cancer in Malaysia
Authors: Lim J. , Lau S.Y. , Bashah N.S. Ahmad , Lai K.N. , Wen W.X. , Hasan S.N. , Park D.J. , Pope B.J. , Nguyen-Dumont T. , Southey M.C. , Rahman N. , Woo Y.L. , Thong M.K. , Ch'ng G.S. , Teo S.H. , Yoon S.Y. ,   MaGiC Investigators
Published: September 2018

Background: Germline BRCA1 or BRCA2 pathogenic variants in ovarian cancer patients may be informative in risk management and treatment, with the advent of poly(ADP-ribose) polymerase inhibitors. In the era of precision medicine, companion diagnostics for BRCA1 and BRCA2 genes have been featured as a strategy in the Malaysia National Strategic Plan for Cancer Control Program (2016-2020). To facilitate this strategy, frequency data from Malaysia's understudied multiethnic population will be required. Aim: To determine the prevalence of BRCA1 and BRCA2 germline variants in a population-based cohort of ovarian cancer patients in Malaysia. Methods: From August 2016, women with nonmucinous epithelial ovarian, peritoneal or fallopian tube carcinoma are prospectively recruited to the Malaysia-wide population-based MaGiC Observational Study. DNA were tested using a Hi-Plex next generation sequencing method and multiplex ligation-dependent probe amplification to detect < 10 bp alterations and exon deletions or duplications in the BRCA1 and BRCA2 genes. Results: Interim results from 325 patients tested until March 2018 have identified BRCA1 and BRCA2 pathogenic variants in 9.8% (32/325) and 3.1% (10/325) patients, respectively. Variants of uncertain significance were detected in 13.2% (43/325) patients and no pathogenic variants were detected in 73.8% (240/325) patients. Taken together, the frequency of BRCA1/2 pathogenic variants in ovarian cancer patients is approximately 12.9% (42/325). Conclusion: The identification of BRCA1 or BRCA2 carriers across the country have enabled the concentration of efforts from limited genetic counseling resources to high risk families. Results arising from the completion of this study will supplement cancer control programs and genetic services in Malaysia.
Overcoming Overdiagnosis: Women´s Preferences for Improving Breast Cancer Screening
Authors: Bromley H.L. , Roberts T.E. , Petrie D. , Mann B.G. , Rea D. , Nickson C.
Published: September 2018

Background: Breast cancer screening is effective in reducing breast cancer mortality, but there is increasing concern that it may also lead to overdiagnosis; the detection and treatment of a cancer that would never have presented symptomatically during the woman's lifetime. Conservative management of low-risk breast cancer may reduce the harm of overdiagnosis resulting from mammographic screening programs, yet little is known about how such strategies might impact upon quality of life. Aim: To quantify women's preferences for managing low risk breast cancers identified by breast cancer screening. Methods: Utilities (measures of preference) were obtained from women with and without a history of breast cancer for seven health states reflecting low risk screen detected ductal carcinoma in situ (DCIS) using standard gambles. Demographics and a history of prior screening participation or breast cancer diagnosis were examined as predictors of screening and treatment pathway preferences. Results: Utilities were lower for breast cancers treated with mastectomy or invasive adjuvant treatment. The impact of active monitoring on quality of life was comparable to breast conserving surgery, although women in both patient and general population groups rated active monitoring more favorably as the risk of disease spread was decreased. There was some variation in ratings across patients suggesting that individual risk aversion does affect preferences for the type of conservative management valued. Conclusion: Overdiagnosis remains a challenge for improving the current breast cancer screening program. Active monitoring of low risk ductal carcinoma in situ may provide an acceptable solution for reducing the impact of overdiagnosis and overtreatment resulting from breast cancer screening on quality of life.
Super Healthy: A Healthy Diet Card Game
Authors: Fonseca C.
Published: September 2018

Background and context: The Portuguese League Against Cancer works with schools in cancer prevention for 30 years and since the very beginning tried to offer attractive strategies to get children engagement. Knowing that card games are again on the top strategies for children we develop the Super Healthy Card Game. Aim: To promote health habits in children (6-10 years old), namely in what concerns their lunch and snacks options. Strategy/Tactics: We have created a card game in which each card represents a healthy and important food (e.g., carrot, broccoli, milk, beans, fish) with specific powers like resistance or defense, for instance. There are 15 cards in total; children get the first 5 for free in the beginning of the program and then, to get the other 10, they have to eat the food defined by the card, either at lunch (school canteens have them available on predated days) or at midmorning and midafternoon snacks (children and their parents have to prepare it at home). Program/Policy process: To have success we have articulated with three main institutions on a national and governmental levels: General Health Committee; General Education Committee and National Nutrionists Association. Then, we have publicized the game in schools and asked for their registrations for the materials. Thousands of games were send to schools free of charge. The program has involved all school community because the school canteens have to cook the meals, parents have to prepare healthier snacks, teachers have to monitor the entire process and children have to play the card game. Outcomes: With this methodology many children tasted for the first time some foods and parents reflected on the importance of healthy snacks. Besides that, after getting the cards, children played with it and learned a little bit more about what they eat and its effects on their health. What was learned: This kind of strategy is very challenging because it implies the coordination of various partners. Also, nutrition is a transversal theme and different institutions stress unique aspects so it was important to assure that all partners feel their message is respected. Nevertheless, we find this strategy to be empowering and really successful.
How Cancer Patients Reported Their Quality of Life? Findings From a Nationwide Cross-Sectional Survey in Korea
Authors: Shin M. , Xuan M. Tran Thi , Lee S. , Chang Y. , Cho H.
Published: September 2018

Background: Cancer treatments have negative physical and socio-emotional consequences. Understanding which problems cancer patients are suffering and their quality of life (QOL) status is therefore important. Aim: This study aimed to describe how cancer patients reported their QOL and factors associated therewith. Methods: A total of 689 cancer patients aged ≥ 19 were selected from the Korea National and Nutrition Examination Survey (KNHANES), 2007-2015. HRQOL was measured using the five dimensions and summary index (ranges from 0 to 1) of the EuroQOL-5 (EQ-5D). Higher index score and less problems reported in dimensions indicates better QOL status. Logistic regression was performed to analyze the probability of cancer patient reporting problem in QOL dimensions. Statistical analyses were adjusted for sample weights. Result: Of 689 participants, mean age was 57.7 ± 0.67, 47.9% were male, 80.4% lived in urban area. 29.3% had hypertension and 15.3% had arthritis as comorbidity. Mean EQ-5D index score was 0.898 ± 0.007; higher score was noted in 19-65 age group (0.932 ± 0.007), living in urban area (0.906 ± 0.008), living in apartment (0.926 ± 0.008), male gender (0.912 ± 0.011), higher income, higher education level and more comorbidities ( P < 0.05). Participants reported more problems in pain or discomfort (34.09%), followed by mobility (24.91%) and usual activities (19.72%). Less problems were recorded in depression (17.37%) and self-care (8.04%). Patients with two or more comorbidities experienced higher chance of reporting problems in mobility, usual activity and self-care (aOR 4.01, 3.11 and 2.82 respectively, P < 0.05). Older age group was associated with higher chance of reporting problems in all QOL dimensions. Female cancer patients experienced higher chance of reporting problems in pain/discomfort and depression/anxiety (aOR 2.11 and 2.18 respectively, P < 0.05). Conclusion: More than one third of Korean adult cancer patients reported moderate or severe level of pain and discomfort. Older age, female gender and having two or more comorbidities were factors associated with lower QOL.
Cancer-Related Stigma in South Africa: Exploring Beliefs and Experiences Among Cancer Patients and the General Public
Authors: Wallace M. , Bos A. , Noble C.
Published: September 2018

Background: Stigma refers to a distinctive, discrediting characteristic, rendering its bearer tainted or inferior by others. Definitions of stigma acknowledge the recognition of difference; and devaluation. Evidence, largely from high-income countries suggests that cancer is a stigmatized disease. Cancer-related stigma is not well-documented in South Africa, and little is known about how it impacts health-seeking behavior, treatment adherence, quality of life and psychosocial well-being in cancer patients. Limited research has explored perceptions and cultural representations of cancer but an in-depth focus on this is lacking. This context-specific information is essential for relevant, effective intervention. Aim: This study aims to increase understanding of cancer-related stigma in South Africa and the role of cultural beliefs in contributing to this. Findings will be used to inform a larger study and ultimately, interventions to address cancer-related stigma in communities in which the Cancer Association of South Africa (CANSA) is working. Methods: This qualitative study was conducted in two provinces of South Africa, KwaZulu Natal and the Western Cape and included participants from a range of cultural and racial groups. Cancer patients over 18 years were recruited through CANSA's Service Delivery teams to participate in focus groups or one to one in depth interviews. Six focus groups and 40 in depth interviews were conducted with cancer patients. Data collection focused on understanding patient experiences of cancer stigma; cognitive, emotional and behavioral responses to this; and inputs on interventions to address this. Six focus groups were also conducted with noncancer patients recruited from local communities to explore cultural perceptions of cancer and reasons for stigmatization. Audio recordings were transcribed and translated; coded using NVivo 11; and analyzed by the authors using thematic analysis. Results: Results indicated very poor knowledge of cancer both in patients and nonpatients. Overwhelmingly, findings highlight the perception of cancer as a “death sentence”, influencing patients' experiences and responses of others in numerous ways. The influence of cultural beliefs was relevant, exacerbating stigma in some cases. The location of the cancer also played a role in determining level of stigmatization. Certain body parts (associated with masculine and feminine roles) as well as more visible cancers/side-effects were more stigmatised. Conclusion: Results indicate that stigmatization is a significant factor for cancer patients in South Africa, increasing social isolation and negatively impacting quality of life. The implications of the findings for intervention development will be discussed. Education is needed but requires a different focus for different cultural groups.
The Approach of Faith-Based Organizations for Awareness
Authors: Hervé A.
Published: September 2018

Background and context: Breast and cervical cancers are the most deadly cancers in Côte d´Ivoire. According to the Abidjan cancer registry, breast and cervical cancers account for 32.6% of cancers diagnosed in Côte d´Ivoire. To curb the spread of this disease, a real policy of awareness and early detection of cases must be implemented. This policy will have to involve all layers of society. The NGO Hope Life for this, initiated an action with the Shunamite Women´s Apostolate of the Catholic Church in 2017, this action led to a campaign against breast and cervical cancer on Saturday October 14, 2017 at the Abidjan Classic High School. Aim: The objective is to demonstrate how religious leaders can contribute to the popularization of information on cervical and breast cancer in Côte d´Ivoire. Program/Policy process:The methodology for the realization of the project to consist of: •Meeting the leaders of the Shunamite Women´s Apostolate, •Train leaders on how to prevent breast and cervical cancer, •To raise awareness during the moments of encounter of the apostolate. Through projections of cancer images, video on self-examination and distribution of flyers, we sensitized women on the risk factors, the warning signs and the modes of prevention of these cancers. Outcomes: The Shunamite women of the Catholic Service of Evangelization have joined the project. They participated in awareness-raising activities. They also initiated a campaign against breast and cervical cancer on October 14, 2017 at the Lycée Classique in Abidjan. This activity saw the participation of more than 500 women who were sensitized on breast and cervical cancers. These women practiced sports and 300 of them were screened for free breast and cervical cancer. There were no positive cases in the cervix but there were eight (8) cases of breast abnormalities. On Saturday, October 21, 2017, she organized a Gala Dinner during which she collected more than ten million francs (10,000000 F) CFA. This allowed to take care of eight (8) women who had anomalies at the level of the breasts. What was learned: At the end of this project, we realized that the religious community has a big role to play in the fight against cancer. Shunamite women have made their fight against breast and cervical cancer their fight and made the commitment to organize every year in October activities for the fight against cancer. These activities will include awareness raising, screening and fundraising for the fight against cancer.
New Approaches on Cervical Cancer Prevention Campaign For the Young Women
Authors: Ma I.-G. , Wang C.-A. , Chen C.-H.
Published: September 2018

Background and context: Approximate 4000 new cases of cervical cancer, including carcinoma in situ, are found in Taiwan each year. More than 20% of that are in precancerous status, the age ranges from 20 to 34, equivalent to 1 out of 5 cases is young women. To deliver the message to young women to advocate cervical cancer prevention through vaccination + Papanicolaou test screening, new promotional approaches have been executed with innovative technology. Aim: 1. To elevate the understanding of the risk of HPV infection to young women between age 20 to 34 with new technology approaches. 2. Raise the awareness of cervical cancer prevention among young women. 3. Drive young women to take active role on cervical cancer prevention, particularly on HPV vaccination. 4. Encourage young women to visit gynecology clinic (OB/GYN) willingly to have regular Papanicolaou test screening. Strategy/Tactics: 1. Use humorous video + social media to attract the attention of young women, by male celebrities to remind female about HPV vaccination, and encourage them to prevent the disease with peers. 2. Invite key opinion leader (KOL) and social media influencers to resolve the passiveness, by celebrities + KOL to call on people to take action. 3. Use innovative technology/social media channels to spread and extend the meaning of this campaign. 4. Use location based service (LBS) provided by mobile service companies + GPS service to encourage young women to visit nearby OB/GYN. Program/Policy process: 1. Video of HPV and cervical cancer reminder from male KOL celebrity; in addition, HPV awareness ambassadors encourage young women to participate “vaccination + Pap smear screening”. 2. Resolve passive action by celebrities + KOL calling people to take part on the cervical cancer prevention, by sharing cervical cancer prevention messages on Facebook to influence fans to carry out the event spontaneously. 3. To encourage young women to visit nearby OB/GYN by LBS mobile text message service, and search for the nearby OB/GYN with GPS system on the map of the campaign Web site. Outcomes: The significant views from social media events: promotional video, Facebook activity, and mental quiz game have totally reached 4,889,276 views, from August 11 to November 1, 2017, the completion of promotion. Moreover, the page view of the campaign Web site had reached nearly 125,000 views and accessed 45,000 new target audience. LBS messages were read by 52,464 women, 8114 of them visited OB/GYN, which means 15.5% of young women were successfully encouraged to visit OB/GYN. What was learned: By using new technology and social media approaches to promote cervical cancer prevention to young women, we found that KOLs played significant role on influencing our target audience. By utilizing a variety of channels to communicate with the young women in new technology approaches will be the mainstream of promotion.
Evaluation of Breast Cancer Awareness Campaign, Screening Drivers
Authors: Ammar K. , Alsater S.
Published: September 2018

Background: King Hussein Cancer Foundation and Center (KHCF & KHCC) lead Breast Cancer (BC) awareness in Jordan through the Jordan Breast Cancer Program. The program aims to reduce morbidity and mortality from BC, and shift the current state of diagnosis from late stages to earlier ones, where the disease is curable, survival rates are higher, and treatment costs are lower. In October, the international BC awareness month, many activities are organized to encourage Jordanian women to undergo screening. Aim: To find out predictors of screening visits at KHCC early detection clinic in October 2015 to evaluate echo of the campaign. In addition, we aim to find the screening rate among women at KHCC early detection clinic. Methods: This is a cross sectional study, using a self-administered questionnaire, carried out in October 2015 and follow-up was completed on August 2016. Results: 291 women responded to the questionnaire, they were categorized into two groups; screening and diagnostic. Screening rate was 57.8% (N=166). In women above 40 years old, 69.3% (N=113) were in the screening group and 30.7% (N= 50) in the diagnostic group. There was no statistically significant difference in the average ages between two groups (49.49 year, 47.82 year, P = 0.218). Positive family history of BC in a first-degree relative was found to be a strong predictor for mammogram screening in comparison with screening group (65.4% vs 16%, P = 0.05); other screening behaviors like commitment to self-breast exam, clinical breast exam and attending educational lecture about BC did not significantly affect screening rates. In addition, screened women were more likely to complete their investigations and follow-up procedures. In this sample, five women were diagnosed with BC; two in advanced stages among the diagnostic group 4%, (N=50) with mean age 54.5 year, and three in early stage among screened group 2.7%, (N=113) with a mean age of 50 year. Conclusion: First-degree family history of BC is a strong predictor of BC screening. Awareness activities might lead to higher screening rates among women in general. Further studies need to be conducted on larger scale to confirm the results of this study.