bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of Tobacco Use and Cancer Among Malayali Tribes, Yelagiri Hills, Tamil Nadu, India
Authors: Francis D.L.
Published: September 2018

Background: Health is a state of complete wellbeing free from any discomfort and pain. Despite remarkable world-wide progress in the field of diagnostic, curative and preventive medicine, still there are large populations of people living in isolation in natural and unpolluted surroundings far away from civilization, maintaining their traditional values, customs, beliefs and myths. India has the second largest tribal population of the world next to the African countries. About half of the world's autochthonous people live in India, thus making India home to many tribes which have an interesting and varied history of origins, customs and social practices. Aim: The current study was conducted to assess the tobacco use, awareness and its effect on health among Malayali tribes, Yelagiri Hills, Tamil nadu, India. Methods: The inhabitants of the 14 villages of the Yelagiri hills, who have completed 18 years and residing for more than 15 years present on the day of examination and who were willing to participate in the study were included. Data were collected from a cross-sectional survey, using a survey proforma, clinical examination and a pretested questionnaire which included demographic data, tobacco habits. An intraoral examination was carried out by a single examiner to assess the oral health status using WHO Oral Health Surveys - Basic Methods Proforma (1997). SPSS version 15 was used for statistical analysis. Results: Results showed that among 660 study population, 381 (57.7%) had no formal education. Among the study population 75% had the habit of alcohol consumption. Of those who had the habit of smoking, 26% smoked beedi, 10.9% smoked cigarette, 65% chewed raw tobacco, 18% chewed Hans and 28% had a combination of smoking and smokeless tobacco usage. The reason for practicing these habits were as a measure to combat the cold, relieving stress and body pain after work, and the lack of awareness of the hazards of the materials used. Prevalence of oral mucosal lesions in the study population was due to tobacco usage and alcohol consumption and lack of awareness regarding the deleterious effects of the products used. Conclusion: From the results of this study it may be concluded that the Malayali tribes were characterized by a lack of awareness about oral health, deep rooted dental beliefs, high prevalence of tobacco use and limited access to health services.
Prostate Cancer and Prostate Cancer Screening: Knowledge and Attitude Among a Semiurban Population of Nigerian Men
Authors: Igbokwe M.C. , Salako A.A. , Badmus T. , David R.A. , Laoye A. , Akinbola I.A. , Babalola C.I. Onyeze
Published: September 2018

Background and context: Prostate cancer (PCa) is the most common malignancy among men in Nigeria. Despite the high prevalence, there seems to be poor awareness on PCa and PCa screening among Nigerian men. Deficient knowledge and ignorance on PCa may account for late presentation with resultant worse outcomes in Nigerian men. Aim: To assess the knowledge and attitude of a cohort of Nigerian men toward PCa and PCa screening. Strategy/Tactics: A prospective cross-sectional analysis was conducted on cohorts of men in the Ile-Ife community of southwestern Nigeria between August 2016 and February 2017. Men across all spheres were targeted (university lecturers, artisans, religious leaders, etc.) to have representative data from men in the community. Semistructured questionnaires were used to gather information on their knowledge about PCa, as well as their attitude toward PCa screening. Health talks on PCa were given to all the respondents immediately after filling the questionnaires. Analysis of completed questionnaires was done using SPSS version 20. Program/Policy process: Prostate Cancer Screening Advocacy Program in Nigeria. Outcomes: Four hundred and fifty (450) men above 40 years of age were administered the questionnaires, out of which 428 (95.1%) questionnaires were analyzed. The mean age of the respondents was 58.5 ± SD 9.3 years. One hundred and eighteen (27.6%) of them were either university lecturers or men with tertiary education while 310 (72.4%) had lower level of education. Among the lecturers, 86 (72.9%) showed good awareness of PCa while only 26 (8.5%) men among the less educated group were as aware of PCa. Only 57 (13%) men older than 50 years had presented to the hospital for prostate specific antigen (PSA) check. Three hundred and seventy men (86.5%) were oblivious to the role of PSA in the diagnosis and treatment of prostate cancer and were unwilling to have routine digital rectal examination (DRE). Respondents with superior knowledge of prostate cancer stated that they were more likely to routinely go for prostate cancer screening. What was learned: There is still limited knowledge of PCa and poor attitude toward PCa screening among men in our community. Health education is therefore critical as this may encourage early detection and possibly decrease disease-related mortality.
Clinical Impact of Delaying Surgery in Patients Undergoing Neoadjuvant Chemotherapy on Breast Cancer Recurrence and Survival
Authors: Lin J. , Anna L.
Published: September 2018

Background: For patients with breast cancer, the optimal time of surgery after completion of neoadjuvant chemotherapy (NAC) is unknown. Aim: We evaluated the association between time to surgery after NAC completion and disease free survival (DFS) and overall survival (OS). Methods: Women diagnosed with breast cancer stages I to III between 2013-2016 who received NAC at our institution were included. Patients were categorized into two groups according to time to surgery after completion of NAC ≤ 60 days, and > 60 days. Survival outcomes were estimated and compared according to time to surgery after NAC completion. Statistical analysis was done using the Kaplan-Meier estimate. Groups were then compared by log rank. Results: In total, 58 patients treated with NAC were included in the study. The median interval to surgery after completion of NAC was 29 days. Five-year DFS was 82% for patients with surgery < 60 days and 63% for patients with surgery > 60 days after NAC completion (log rank z=2.32, P = 0.02). A surgery date of > 60 days after NAC completion was associated with shorter DFS. Five-year OS was 89% for patients with surgery < 60 days and 90% for patients > 60 days after NAC completion (log rank z=0.14, P = 0.89). A surgery date of > 60 days after NAC completion was not associated with a poorer overall survival. Conclusion: Time to surgery after completion of NAC influenced recurrence outcomes but not overall survival in our study cohort. Our findings suggest that the timing of surgery after completion of NAC is crucial for recurrence, but not survival, for patients undergoing NAC.
Clinical Features of Women Diagnosed With Invasive Cervical Cancer in Ghana
Authors: Nartey Y. , Hill P. , Amo-Antwi K. , Nyarko K. , Yarney J. , Cox B.
Published: September 2018

Background: The incidence of cervical cancer continues to increase in many low- and middle-income countries. It remains the commonest cancer affecting females in Ghana. However, comprehensive information on the clinical characteristics of women diagnosed with invasive cervical cancer is scarce. Aim: To characterize the clinical features of women with invasive cervical cancer in Ghana. Methods: We conducted a retrospective study in two large referral hospitals in Ghana: the Korle Bu teaching hospital, Accra and Komfo Anokye teaching hospital, Kumasi. Through the review of paper-based, electronic, and pathology medical records, information on women diagnosed with invasive cervical cancer from 1st January 2010 to 31st December 2013 was collected. The information was entered onto a standardized data abstraction sheet and included demographics, comorbid conditions, treatment and follow-up. All analyses were conducted in STATA and described the distribution of key clinical features by the stage at diagnosis. Results: A total of 1,725 women with invasive cervical cancer were included in the analysis. Few had cervical screening before their cervical cancer diagnosis (1.1%). Women who were resident in a metropolitan area ( P = 0.034), or who had any comorbidity ( P < 0.001) were at an increased risk of FIGO stage III-IV disease. The majority of women had at least two diagnostic investigations (75%) with cervical biopsy performed for 95.5% of women. More than half received radiotherapy (55.4%) and only 22.4% receiving chemotherapy. Clinical follow-up after the first consultation was performed for 61%, with 73% of women with clinical follow-up having at least one follow-up investigation. Conclusion: Improvements in access to early diagnosis and optimal treatment of cervical cancer, such as an increased use of chemoradiation would reduce the burden of the disease in Ghana.
Human Papillomavirus (HPV) Infection As an Emerging Risk Factor in Prostate Cancer
Authors: Singh N. , Josefsson A. , Hussain S. , Hugosson J.
Published: September 2018

Background: Epidemiologic investigations confirm that prostate tissue is prone to sexually transmitted infection and human papilloma virus (HPV) is the most common sexually transmitted infection. Owing to the controversy on the role of HPV infection in prostate carcinogenesis, it is appropriate to determine and validate the prevalence of HPV infection in a controlled prospective study, and its role in prostate carcinogenesis. It is crucial to investigate the prognostic impact of HPV infection in prostate cancer from a clinical point of view. Aim: The overall aim of our research is to address the possibility of using therapeutic interventions against HPV infection in young boys to prevent the development of prostate cancer in their older age. Establishment of clinical importance of HPV infection in prostate cancer and its prognostic impact for overall survival. Methods: The prostate cancer tissue specimens were obtained from Sahlgrenska University Hospital, Sahlgrenska Academy (SA), Gothenburg, Sweden. The exclusion criteria included patients undergoing any preoperative radiation or chemotherapy. Only histopathologically confirmed cases were processed for DNA, protein and RNA extraction. Histopathological grades and clinical staging was evaluated by pathologists using the Gleason scoring system for prostate cancer. The study is approved by the ethics committee of the institute. High molecular-weight genomic DNA was isolated from tumor/control tissue samples and were subjected to PCR genotyping for detection of the viral DNA. Cases and controls was compared using univariate methods. An independent t-test was performed for the comparison of clinicopathological parameters. Results: The pilot study identified HPV infection in advanced grade of prostate cancer cases in Sweden. HPV infection was identified in 57% of the prostate cancer cases with advanced pathologic grade in Swedish men compared with 11% in the normal controls. The investigation comprised of detailed analysis of the correlation between the clinical parameters and HPV genotyping. Conclusion: The research investigation substantiates the clinical significance of HPV infection in prostate carcinogenesis that has been underestimated till date. The research investigation was funded by Swedish Research Council (Vetenskaprådet) Grant no. 2015-06705.
Colecta Pública 2017 (Public Collection)
Authors: Saavedra D. Milla
Published: September 2018

Amount collected: Thanks to the support of all Peruvians, the League Against Cancer managed to raise more than 2,500,000 thousand soles in a record time of 2 days, a historic figure never before achieved by institutions that fight against cancer. Background and context: The League Against Cancer carries out its national public collection every year, a charitable activity of fundraising that invokes the population to donate, during two days, so that the institution can continue carrying out actions of prevention and detection in favor of the people more vulnerable. Despite the high incidence of cancer in Peru (more than 60,000 new cases and 40,000 deaths a year), never before had a crusade unite all Peruvians, in Peru and abroad, in the fight against the disease. To do this, the League Against Cancer created the campaign “La Liga Somos Todos”, to promote the participation of all Peruvians, regardless of the place or country where they were. Aim: Raise 2,000,000 soles in 2 days, so that the institution continues carrying out prevention and cancer detection actions in the less favored population, and thus reduce the high incidence of cancer in Peru. Strategy/Tactics: We involve all media, proposing that they be the main leaders and promoters of this crusade and that each one choose its maximum leader to represent it before public opinion, an action never before done in Peru to raise funds to prevent cancer. We invite the President of the Republic and all his Cabinet of Ministers, in addition to the municipal and regional authorities of the country to join the campaign. For the campaign to transcend the world: we get the collaboration of the embassies and consulates of Peru in the world, as well as communities of Peruvians abroad, getting thousands of Peruvians from five continents to join. We convinced recognized celebrities to be spokespersons for the campaign. A virtual donation platform “The Virtual Can” was created which was inserted in the main Web pages. Costs and returns: More than 100 media nationwide joined and committed to the campaign. More than 1200 ads ran for free that represented a savings of $ 500,000. More than 1060 publications in media that represented a saving of more than US $6,805,583. More than 500 authorities, influencers, media, companies, public and private institutions, joined by spreading content in their social networks. We managed to be a global trend 4 times with the hashtag #LaLigaSomosTodos (#WeAllTheLeague). Thanks to the support of all Peruvians, the League Against Cancer managed to raise more than 2,500,000 soles in a record time of 2 days, a historic figure never before achieved by institutions that fight against cancer. We learned that a communication campaign with clear messages from the beginning, achieved the participation and collaboration of a whole country that seeks to reduce the incidence of cancer.

[Figure: see text]
Prevalence of Smoking and Impact of Pictorial Health Warning on Quit Attempts Among Youths in Bhaktapur, Nepal
Authors: Dhungel B. , Basnet K.
Published: September 2018

Background: Nepal for the first time implemented laws regarding the pictorial health warnings in April 2014 regardless of an unsuccessful challenge that was set up by the tobacco industry in 2011. Results from several studies have shown that health warnings on cigarette packages have been helpful in warning smokers as well as nonsmokers regarding the harms of cigarette smoking, encouraging smokers to quit and also preventing nonsmokers from starting to smoke. Aim: The objective of this study was to find the impact of pictorial health warning on quit attempts. Methods: An explanatory cross-sectional study was conducted among youths aged 15-24 years in Suryabinayak-5, Bhaktapur with probability systematic random sampling technique using self-administered questionnaire. Results: Half (50%) of the respondents first tried smoking at the age of 16 or older. Seventeen percent of the respondents smoked cigarettes either occasionally or regularly during the past 30 days. Most of the respondents (91%) have not tried smokeless tobacco products ever in their life. Sixty-seven percent of the respondents had noticed PHW on cigarette packages during the past 30 days. One fourth (21.8%) respondents made an quit attempt due to PHW during the past 12 months and their maximum duration of abstinence during the last quit attempt was more than a week but less than a month. From the study it is found that there is statistically significant association between noticing pictorial health warning and thought about quitting smoking or intention about not starting smoking. Conclusion: Pictorial warnings effectively increased peoples quitting intentions, attempts as well as relinquishing cigarettes. Our findings suggest that implementing 90% pictorial health warnings on cigarette packs in Nepal would discourage smoking.
Multi-Disciplinary Team (MDT) Approach in Oral Cancer Management: An Exploratory Study
Authors: Alobaidi F. , Doss J. , Abmurat N.
Published: September 2018

Background: Treatment of oral cancer has evolved throughout the past decades which has led to the introduction of the multi-disciplinary team approach (MDT). The MDT concept has been endorsed as the main approach to ensure holistic care for oral cancer patients worldwide. In Malaysia, the MDT concept has been introduced in few hospitals throughout the country. According to the available literature, the MDT approach has improved coordination of care for oral cancer patients, communication between the different disciplines, decision making to obtain the best treatment plan, provided educational opportunities for development of the members, and improved staff and patient well-being. However, little evidence is available to support the fact that the MDT approach has improved patient survival and outcome. Aim: The aim of this study was to explore the MDT approach in the management of oral cancer patients. To our knowledge this is the first study on head and neck MDTs in Malaysia. Methods: The study was conducted at University of Malaya. A mixed-method study was commenced including both quantitative and qualitative designs. The quantitative part assessed the MDT members' attitude toward the role and use of the MDT approach in oral cancer patient management, while the qualitative part assessed the perception of the MDT members regarding the MDT approach in terms of: team structure, team process, decision making, barriers and suggestions for improvement of the MDT approach. The quantitative study was conducted through a structured self-administered questionnaire which were both content and face validated, and distributed to the members of the head and neck MDT. The qualitative study was commenced through two focus group discussions (FGDs) conducted separately. Results: The study was conducted among the head and neck MDT members at University Malaya which received a 100% response rate. The majority of the MDT members showed positive attitudes toward the MDT approach, with the seniors being more positive than the juniors. The MDT approach has improved team dynamics in terms of communication, care coordination and decision making. However, there were a few issues of miscommunication as well as long waiting lists for oncological radiotherapy machines and radiologic scanning. Conclusion: The MDT approach is certainly the preferable mode of care for oral cancer patients in University of Malaya. However, there is a need for further improvement with regards to communication between the team members, expansion of the current team composition, training of the MDT members with regards to clinical and nonclinical skills, guidelines, protocols and certain facilities. Teamwork is a fundamental perspective which is crucial for an effective MDT. As such, a better understanding of each other's roles and responsibilities within the team is essential to ensure optimum patient care and management.
Precision Oncology With Radiogenomics: Non-invasive Interrogation of Liver Cancer Genomics to Select Drug Therapy and Monitor Patient Response
Authors: Chow P. , Sarkar J. , Roy N.
Published: September 2018

Background: Significant intratumoral heterogeneity is present in hepatocellular carcinoma (HCC) and single biopsy samples severely underread the genomic profile of the tumor. This confounds drug development in HCC and makes it extremely challenging to stratify and prognosticate patients to select therapy on the basis of genomic biomarkers. Multiregion sampling of surgically resected HCC allows for these intratumoral heterogeneity to be unraveled and this is currently carried out in our prospective PLANET (Precision Medicine in Liver Cancer across an Asia-Pacific Network) program. However, multiregion sampling is not practical in unresectable HCC cases, which comprise 80% of the disease burden. Radiogenomics studies on liver, lung and head-and-neck cancers have established the capability of radiomics analysis in capturing intratumor heterogeneity with the identification of radiomics signatures that are representative of underlying gene expression patterns. Aim: On this basis, our PLANET program has adopted a radiogenomics approach to characterize the intratumoral heterogeneity in HCC. Methods: This approach will leverage on the correlation of distinctive imaging traits in CT scans against the gene expression profiles of surgically resected HCC patients. Our PLANET program and the data-science enterprise Holmusk have embarked on close collaborative efforts to develop an algorithm that characterizes intratumoral heterogeneity based on distinctive traits in the CT scans. Results and conclusion: The development of such an algorithm is potentially ground-breaking as it allows for the noninvasive interrogation of liver cancer genomics and prognostication of HCC patients. This allows the easy screening of patients for therapeutic targets in vivo and will significantly improve the selection of drug therapy and monitoring of therapeutic response in HCC.
Whispers: Change in the Parent–Child Communication From Parent–Child Camp
Authors: Cheng K.Y. , Wu C.Y. , Yen Y.S.
Published: September 2018

Background: Hope Foundation for Cancer Care has been organizing programs for parent–child camps for family suffering with cancer. Communications between parents and their minor children are expected to improve by talking about cancers and emotional management for being uncertain, worried or even scared when faced with cancers. Aim: Hope Foundation for Cancer Care strives to support families to apply the befits from the camps to their day-to-day family lives to let the family members know that communication about cancer is not a once-off experience but continuous efforts in the future. Methods: Without knowing how the camps might turn out beforehand, the research set off at a semistructured depth interview to gather information about the subjective interpretation of participants. Results: The study shows that most participants were quite impressed with the camp, which ran in a casual way, and they were satisfied with related themes in those activities. They were very willing to share their personal experiences with the camp for better mutual understanding and more intimate feelings revealed among family members. Attending the camp also offered those parents to rest and free from taking care of their children, and changed the way they used to communicate. Besides, the participants suggested to shorten the durations of each scheduled session to lessen the physical pressure of patients. Conclusion: In the end of the research, it is considered great challenge to strike a balance between recreational output and experiential output. After all, it has long been the very incentive to design an environment for cancer patients and their children to learn to relax, which seems too loose when it lacks balance. On the other hand, one of the main goals is set to open communication access to understand cancers, which may be reached by other service programs. Therefore, derivation of diverse methods and programs are now one of our priorities.
Abnormal Cervical Lesions and Its Associated Factors Using Visual Inspection With Acetic Acid (VIA) at a Referral Hospital in Ethiopia
Authors: Nigus D.M. , Mezgebu Y. , Biadglegne F. , Habteyohannes A.D.
Published: September 2018

Background: Ethiopia has over 29 million women aged 15 years and older who are at risk for developing cervical cancer. Aim: To provide prevalence of precancerous cervical lesions and its associated factors among women visiting gynecology department of Felege Hiwot referral Hospital (FHRH). Methods: A cross sectional study was conducted from December 2016 to June 2017 on 428 women who were seeking medical service in FHRH. Relevant sociodemographic data were collected using structured questionnaire. Clients were screened for abnormal cervical presentation by physicians and those with indicative clinical presentations were recruited for visual inspection using 5% acetic acid (VIA) as per cervical cancer prevention guideline for low-resource settings. The screening result was documented based on the national VIA screening record format as; 'No acithowhite lesion', 'Acithowhite lesion eligible for cryo', 'Acithowhite lesion non eligible for cryo' or 'Suspicious for cancer'. Data were analyzed using SPSS v23. Statistical significance was set at P value < 0.05. Results: Most of the participants, 270 (63.1%), 296 (69.2%), 379 (88.6%), 247 (57.7%) and 194 (45.3%) were from urban settings, married, fertile, used long term contraceptive and HIV-positive, respectively. Similarly, the majority, 242 (56.5%) were in the age group of 39-49 years with the median age at 35.0 years. Furthermore, 167 (39.0%) and 5 (1.2%) participants reported as they experienced STI ever and practiced tobacco smoking, respectively. The median age during first sex was at 16 years. On top of this, more than half of the participants at 268 (62.6%) exercised multiple sexual partner (i.e., two and more). Majority of the screened clients at 367 (85.7%) were negative for precancerous lesions. The rest, at 61 (14.3%) had abnormal cervical lesion of which some 23% (14/61) were suspicious for cervical cancer. Among VIA positive participants, 75.4% (46/61) were eligible for cryotherapy and got the treatment. The odds of having VIA positive result was lower by 24% among women engaged in private business than government employees [adjusted OR: 0.24, 95% CI (0.07-0.85)]. The other variables tested in the model didn't show statistical association ( P value > 0.05) with VIA positive result. Conclusion: The observed VIA screening result calls stakeholders to strengthen the primary cervical cancer prevention strategies in the studied area.
The World Could End Cervical Cancer if It Tried: Embracing the Power of Youth
Authors: Krishnan S.
Published: September 2018

Background and context: The human papillomavirus (HPV) is a ubiquitous virus that causes many cancers: cervical, oropharyngeal, anal, penile, vaginal and vulvar cancers, the most serious consequence being cervical cancer that takes the life of a woman between the ages of 35-60 every two minutes in this world. There are existing tools to prevent this cancer today: at the primary prevention level, the HPV vaccines that are up to 90%-97% preventive; at the secondary level, simple screening tests including Pap test, HPV DNA testing, and VIA; and at tertiary level, effective early treatment of precancerous conditions. Yet, cervical cancer is the second most common cancer among women in the developing world. One of the main reasons for this gap is the lack of awareness that cervical cancer is a preventable public health problem. Hence, education and innovative models are necessary for successful control of this disease. The HPV vaccines are recommended between 9-26 years in males and females. Hence, our organization, The Global Initiative Against HPV and Cervical Cancer (GIAHC), decided to empower the next generation to join the fight against HPV and cervical cancer. Aim: To empower the younger generation to play a proactive role to raise awareness and increase the uptake of HPV vaccination and cervical cancer screening through the use of arts in medicine and social media. Strategy/Tactics: An educational PowerPoint presentation was developed by medical and nursing students to present to middle and high school students and in other community settings. Program/Policy process: A 30-minute-long presentation was developed so that it could fit into a classroom period. A script for the presenter, a reference sheet, slides to highlight how HPV can affect both sexes, risk factors and effective ways to prevent it were developed. Emphasis was placed on the HPV vaccine for boys and girls. This was followed by a game, and a short inspirational and aspirational film and a few words to empower them. Outcomes: The program has met with good success: The presentation has been shown by our students in several states in the US and in other countries. Our student group has grown from 2 to 60 in one year. Middle and high school students also want to get involved to spread the message. Students are continually coming up with other creative ways through, dance, painting, poetry video clips and using social media to spread the message. Students of the American Medical Women's Association (AMWA) and Medical Women's International Association (MWIA) have now partnered with us. The Department of Education has expressed an interest to collaborate with us. What was learned: Empowering the younger generation and providing them with the tools to play a pro active role to interweave science with various creative art forms can have far-reaching and greater impact on communities and societies to raise awareness about HPV.
Knowledge on Health Effects and Current Practice Toward Arecanut Use Among Secondary School Children Living in Malé City, Maldives
Authors: Hameed A.A. , Najeeb A.
Published: September 2018

Background: The fourth most commonly used addictive substance in the world is arecanut and is classified as a group 1 carcinogen to human. Over 600 million people are estimated to chew arecanut. It is consumed in some form or other, often with betel quid by 10%–20% of world's population. School goers lack the knowledge and practice toward arecanut use. Many high school children are not well aware about the health hazards of arecanut consumption. Most children start arecanut use at younger age. Arecanut consumption is more prevalent among boys than girls. Arecanut was introduced for majority of the school goers by either their friends or family. Most common form of arecanut used by school goers is sweetened supari. Aim: The current study was conducted to identify the knowledge on health effects, and current practice toward arecanut use among secondary school children living in Malé City, Maldives. Methods: A cross-sectional survey using precoded questionnaire was used. A total of 1350 questionnaire was distributed to the secondary school students studying at selected schools in Malé City and 804 questionnaires were returned. The total target population was 5297. The schools were selected through cluster sampling, while the students were selected via simple random sampling. The calculated sample size consists of 674 students which are equally selected from both genders. Data analyses were executed by using Excel and SPSS 21 software. Descriptive statistics and nonparametric tests were performed. Ethical approval was obtained from Villa College as well from national health research committee at ministry of health. Results: Secondary school children in Malé City have inadequate knowledge on harmful effects of arecanut use. The knowledge varies based on their gender, grade, school, and residence, but does not vary based on their age. The knowledge on harmful effects of arecanut use is more among girls, students at grade 9, students studying at Rehendhi school, and more among those who lives in both Hulhumalé and Vilimalé than those who live in Malé. The students started arecanut use mainly at age between 11-15 years. It was introduced by either friends or family members among large number of school children. Majority of participants used supari as a main form of arecanut, and Rasily supari was the favorite brand of supari among secondary school children. Boys start its use earlier, frequency, duration, and daily consumption is higher among boys than girls. Conclusion: Secondary school children have inadequate knowledge on harmful effects of arecanut use. Supari is the main form of arecanut use and most of the students initiated the habit at a younger age, which is an alarming threat to the society, hence there is an urgent need to start school based preventive programs, community awareness programs, for school children, teachers, parents, and general public at large as stopping the starting of a habit is much easier than quitting of same habit.
E-Patients: Online Health Seeking Behaviour of Cancer Patients in South Western Nigeria
Authors: Salako O. , Okediji P. , Agaga L.A. , Bashir B.M. , Mutiu J. , Fatiregun O. , Olatunji T. , Joseph A.
Published: September 2018

Background: Cancer has been reported to be one of the top three diseases that patients research on the Internet. This is because the Internet is an evolving hub of cancer information and social support for patients. With the increasing connectivity and over 92,000,000 Internet enabled devices in Nigeria, it is expected that mobile health will proliferate and this will change the way cancer patients gather health information and resources, propagating a new age of e-patients. An e-patient is a health consumer who uses the Internet as a health resource. With over 100,000 new cancer cases diagnosed yearly in Nigeria, low doctor to patient ratio, constrained consultation time and limited access to specialist care, the need to promote patients to become e-patients could efficiently empower them to become better-educated healthcare consumers. However, there is a paucity of data on how Nigerian cancer patients use the Internet. Aim: To measure the utilization rate and patient attitudes toward the Internet. Methods: This descriptive cross-sectional study was carried out among 281 cancer patients across the department of radiotherapy in three teaching hospitals in south-western Nigeria in March 2018, using a self-administered questionnaire. The analysis was done with SPSS version 20, and the level of significance was set at < 0.05. Results: The mean age for the 281 participants was 50.8±14.2 years; with the majority between 41 and 60 years (46.6%); and females (78.3%). About 67.6% owned a smartphone ( Table 1 ); and 32% possessed a personal laptop/desktop computer, or lived in households with people with smartphones (66.9%). Majority of the respondents had consistent access to the Internet (59.1%) ( Table 2 ). They also had an e-mail and social media account (52%) in order of decreasing frequency: Facebook, 52.7%; WhatsApp, 18.1%; and Instagram, 17.1% ( Fig. 1 ). At least 43.1% had searched for cancer information online with the purpose of understanding the disease better (41.6%) ( Fig. 2 ). About 45.2% of the respondents also indicated that they would be comfortable having an online medical consultation with their oncologist; however, they had not used any health/cancer app before (71.2%). Patients aged 41-60 years, married, with tertiary level of education, and monthly incomes ≤ N50,000 (∼$140) were more likely to search for cancer information online ( P < 0.05). About 56.9% of the respondents did not use the Internet for cancer information because they preferred getting information directly from doctors (43.2%), lacked the knowledge of Internet use (33.6%), and lacked access to Internet-enabled devices (20.8%). Conclusion: With more cancer patients being connected to the Internet and an increasing trend to be e-patients, there is a need to leverage technology to provide patient education, consultation, navigation and social support services.[Table: see text]

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Culture, Communication, and Cancer Risk Behaviors Among Pacific Islanders in Hawaii
Authors: Cassel K. , Lee H.-R. , Somera L. , Badowski G.
Published: September 2018

Background: A priority of the National Cancer Institute (NCI) is to acquire, aggregate and integrate cancer control data that facilitates collaborations to address health disparities and communication inequalities. To better communicate cancer research to the public, the NCI developed the Health Information National Trends Survey (HINTS). However, as with most national health surveillance systems, HINTS nationally obtained data are not sufficient to address the behaviors of unique demographic and geographic subpopulations. US Pacific Islanders are one of the fastest growing population groups in the US, and cancer is the leading cause of death in this group. Limited knowledge about the cancer communication practices and risk behaviors of US Pacific Islanders drive the poor implementation of effective cancer prevention interventions. Aim: This study aims to document the prevalence and differences in the cancer relevant knowledge, attitudes, and information seeking practices of Pacific Islander populations residing in Hawaii. Specifically, we aim to expand HINTS assessment to native Hawaiians and recent migrant Marshallese and Chuukese populations in Hawaii. Methods: We conducted surveys with 352 native Hawaiians, 282 Chuukese, and 129 Marshallese residing in HI. We used Respondent Driven Sampling method (RDS) to recruit these geographically diffuse populations in HI. The survey included questions about basic knowledge, attitude and behavior about various cancers, detailed communication behaviors about health information, and cultural beliefs and practices. Results: Data show there are clear differences among the three ethnic groups across a variety of cancer-related attitudes, knowledge, behaviors and risk factors. For example, a larger proportion of Chuukese have BMIs that can be described as obese or morbidly obese compared with native Hawaiians. On the other hand, native Hawaiians are significantly more likely to smoke than Marshallese and Chuukese. These groups also differ significantly regarding the level of acculturation, religiosity, fatalism about cancer, and trust in medical professionals. Regarding communication, cell phone use was common with 75% of native Hawaiians, 80% of Marshallese and 88% of Chuukese having cell phones. This use of cellphone technology was in stark contrast to Internet use with only 45% of native Hawaiians, 49% of Marshallese and 27% of Chuukese reporting access to the Web. Conclusion: There is a need for cancer prevention programs for Pacific Islanders in Hawaii. An effective health program has to address their unique cultural beliefs and practices, and fit their unique communication ecology. This study provides new knowledge concerning the use of nonprobability based study sampling methods, and the role of culture in cancer-related communications in influencing cancer risk behaviors that may be generalizable to the growing number of migrant Pacific Islander populations living in the US.
A Descriptive Review of the Community-Based Cervical Cancer Screening Programme at the Singapore Cancer Society
Authors: Srilatha B. , Huang Q. , Hafidza M.S. , Asarpota N.K.
Published: September 2018

Background: Cervical cancer is the fourth common malignancy in women worldwide and clinical Papanicolaou (Pap) smear test is a relatively inexpensive yet efficacious screening method for the detection of precancerous or cancerous lesions. Aim: Herein, we sought to quantify the incidence and prevalence of abnormal cervical cytology in asymptomatic women who underwent routine Papanicolaou test screening at the community-based clinical setting of our Singapore Cancer Society's Multi-Service Centre. Methods: This retrospective study reviewed a total of 15,195 reports of cervical Pap smears performed from January 2015 to December 2017 to delineate epithelial abnormalities. Additionally, a descriptive cross-sectional analysis was carried out on the corroborative demographic and clinical data retrieved from the relevant case notes. Results: The mean age of women recruited for screening in this period was 49.0 ± 11.1 years. A total of 623 (4.1%) were identified with abnormal Papanicolaou test results viz., i. atypical squamous/glandular cells of undetermined significance (n=592; 3.9%), ii. low/high grade squamous intraepithelial lesions (n=28; 0.18%) and iii. high grade squamous intraepithelial lesion, suspicious of squamous cell carcinoma/adenocarcinoma (n=3; 0.02%). Clinical history in the latter two cohorts (n=31; 0.2%) revealed first sexual encounter at age ≤ 20 years (54.8%), ≥ 2 sexual partners (38.7%) or abnormal vaginal discharge (29.0%). An 80.6% and 6.5% had undergone Papanicolaou test or HPV - human papillomavirus - vaccination in the past. History of smoking, long-term contraceptive use and treatment of STI(s) were reported by 22.6%, 3.2% and 6.5% respectively. Conclusion: Cervical cancer originates in the transformation zone of the uterine cervix and screening for abnormal cytology is the cornerstone in early detection. The low percentage of epithelial cell abnormality identified in this large population sampling over three years confirms that routine Papanicolaou test testing would suffice as a cost-effective screening approach to detect precancerous cervical lesions. Where imperative, necessary follow-up on unsatisfactory Papanicolaou test result(s), HPV genotyping and/or due referral procedures would significantly aid in reducing the cervical cancer burden for women in the susceptible age range.
The Homogeneous and Heterogeneous Risk Factors for the Morbidity and Prognosis of Bone Metastasis in Patients With Prostate Cancer
Authors: Chao Z. , Guo X. , Xu Y. , Han X. , Wang X. , Wang G.
Published: September 2018

Background: Globally, prostate cancer is the second most common malignancy in males and fifth leading cancer-related cause of death. To build a reliable predictive system for screening performance, the study looking into the risk factors of BM in prostate cancer patients is warranted. Aim: Using the Surveillance, Epidemiology, and End Results database (SEER) to assess the incidence, and risk factors of morbidity and prognosis for bone metastases in initial metastatic prostate cancer. Methods: A total of 249,331 prostate cancer patients who were diagnosed between 2010 and 2014 in SEER database were obtained to investigate the risk factors for developing bone metastasis, and 9925 of them who registered before 2013 were retrieved (with at least 1 year follow-up) to explore the prognostic factors for bone metastasis. Multivariate logistic and Cox regression were used to identify risk factors and prognostic factors for bone metastases, respectively. Results: Totally, 12,794 patients (5.1%) were diagnosed with bone metastases at the initial diagnosis. Older age, unmarried status, higher tumor stage, lymph node metastasis, metastases at lung brain and liver were the homogeneous risk factors for the morbidity and prognosis of bone metastasis in prostate cancer. Race and histologic differentiation grade were the heterogeneities associated factors. Black race was positively associated with bone metastasis morbidity; however, it has no significant effect on the prognosis. Poor differentiated grade may be the risk factors for developing bone metastasis; however, grade II was negatively associated with prognosis of bone metastasis. Conclusion: The survival of prostate cancer was poor with the bone metastasis approximate 5%. The prostate cancer has homogeneous and heterogeneities risk factors for incidence and prognosis of bone metastasis, which may provide potential guideline for the screening and preventive treatment of the bone metastasis of prostate cancer.
Use of Mixed Method Approach on the Norms and Beliefs Related to Cervical Cancer Screening Among Women Aged 25-49 in Botswana: A Pilot Study
Authors: Ntsayagae E. , Koyabe B. , Major T. , Molwane O. , Monare B.
Published: September 2018

Background: A low cervical cancer screening uptake has been reported among women in low middle income countries (Idowu et al, 2016; Ndejjo et al, 2016), including Botswana. An important first step in increasing any health related behavior is to identify factors that affect that behavior. Identifying the norms and beliefs could influence cancer screening among women and would therefore influence the development of interventions to encourage women to screen. Aim: The aim of this exploratory pilot study was to investigate the norms and beliefs related to cancer screening among women aged 25-49 years in Botswana. Methods: The study employs a descriptive cross-sectional mixed-methods design in two purposively selected districts in Botswana. In the first qualitative phase focus group discussions were conducted. Information learned was used to construct a semistructured interview guide for individual interviews. Mixed method allows for triangulation of data as the qualitative data would be mapped with quantitative data to explore emerging norms and beliefs among Batswana women. This research approach was informed by theory of reasoned action, theory of planned behavior and social cognitive theory. Results: Qualitative results revealed that lack of knowledge about cervical cancer, behavioral beliefs, normative beliefs and control beliefs held by Batswana women contributed to their failure to go for cervical cancer screening. Quantitative data are yet to be analyzed. Conclusion: The results will yield information to design and evaluate a series of interventions to maximize the number of women going for cervical screening hence reduce the burden of cervical cancer in Botswana.
MetaPink Program: Simplifying the Breast Cancer Journey for Patients With Advanced Stage Breast Cancer in Nigeria
Authors: Nwankwo E.
Published: September 2018

Background and context: Breast cancer is the number one diagnosed cancer in Nigeria. 75% of these breast cancer diagnosis are at stage 3 and 4. This is due in part to lack of awareness of the signs and symptoms, inadequate screening and diagnostic facilities, insufficient policies and guidelines, and fear. Metastatic breast cancer patients do not have the time nor the strength to deal with the stress, delay, and confusion of trying to find adequate care. Run For a Cure Africa (RFCA) wishes to establish a program that helps navigate metastatic breast cancer patients in Lagos state, and surrounding states in Nigeria toward breast cancer care and resources. Aim: The MetaPink program empowers and educates patients with advanced stage breast cancer by providing them with timely and relevant information and resources on their disease and how they, the patient, can improve their quality of life and overall prognosis. Additionally, RFCA creates greater awareness of metastatic breast cancer in the community and the necessity for regular screenings. Strategy/Tactics: This project is being implemented by RFCA. RFCA is working work with the health care professionals (HCP) in the oncology and community health department at the Lagos University Teaching Hospital (LUTH) in addition to their organization mentors, The Rose Foundation in Houston, Texas. RFCA is also working with community associations, drama troupes, and groups to create sensitization in hard to access areas. Patients and participants of the MetaPink program have a support team, through the monthly support group, with whom they fellowship, ask advice, gain insight, and just off load any looming concerns. Program/Policy process: RFCA enrolls metastatic patients through our supported clinics, call ins, and our screening outreaches. Each patient enrolled in the program gets a starter pack. RFCA hosts monthly support groups and Q&A sessions anchored by medical professionals, RFCA also hosts community outreach events via the radio, market drama skits, and musical awareness presentations. Periodically we follow-up and communicate with MetaPink program participants via MetaPink WhatsApp, telephone, in-person meetings/visits, and support group meetings. Outcomes: The objective of the MetaPink program is to simplify the breast cancer journey for metastatic breast cancer patients in Nigeria and give them the emotional support and confidence to understand and navigate through their personal breast cancer journey. RFCA also creates larger community awareness of advanced stage breast cancer in a method that is culturally appealing and resonates with the environment. What was learned: As the program progresses, RFCA will learn how to effectively navigate patients in this resource-poor environment. This will contribute to their quality of life and improved breast cancer management in Nigeria.

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