bluuebunny/crossref_metadata_2025 huggingface dataset:
A Case-Case Comparison of Molecular Subtype for Breast Cancer, Younger and Older Age at Diagnosis, in Puerto Rico, 2010-2019
Authors: Velazquez Eugenia Torres , Rosario-Rosado Rosa V. , García-Berdecía Rafael , Climent Consuelo , Freudenheim Jo L.
Published: July 2024

PURPOSE

Breast cancer (BC) accounted for 28.9% of cancer cases and 18.9% of cancer deaths, an average of 437 deaths per year, among women in Puerto Rico (PR) between 2014 and 2018. Prognosis differs by molecular subtype; little is known about the distribution of these subtypes in the population in PR and whether there are differences in distribution by age. We described the distribution of breast cancer molecular subtypes and compared them for younger and older age at diagnosis among women in PR.

METHODS

This case-case study used data from the PR Central Cancer Registry (PRCCR). Included were women aged ≥21 with primary invasive BC, and information available on estrogen (ER) and progesterone receptor (PR) and HER2 status, with diagnosis between January 1, 2010 and December 31, 2019. Those with either ER+ or PR+ were classified as HR+, those with both ER- and PR- as HR-. BC subtypes were classified as: HR+/HER2-, HR+/HER2+, HR-/HER2-, and HR-/HER2+. Five categories of age were examined: ≤39, 40-49, 50-59, 60-69 and ≥70 years. We compared the distribution of BC subtypes by age at diagnosis with polytomous logistic regression, utilizing HR+/HER2- subtype and the ≤39 age cases as the reference, adjusting for year of diagnosis and tumor stage.

RESULTS

Among 13,525 eligible cases, there were 674 aged ≥39 [5.0%], 1,988 aged 40-49 [14.7%], 3,108 aged 50-59 [23.0%], 3,884 aged 60-69 [28.7], and 3,871 aged ≥70 [28.6%]). Of the total, 9,634 (71.2%) cases were HR+/HER2-, 1,761 (13.0%) were HR-/HER2-, 1,456 (10.8%) were HR+/HER2+, and 674 (5.0%) were HR-/HER2+. Compared to cases ≤39, cases ≥70 years were less likely to have HR+/HER2+ tumors (adjusted OR: 0.31; 95% CI: 0.25, 0.40), HR-/HER2- (adjusted OR: 0.45;95% CI: 0.36, 0.56) and HER2-enriched (adjusted OR: 0.40;95% CI: 0.28, 0.57).

CONCLUSION

In this population-based study of women in PR, younger women had a higher likelihood of more aggressive BC molecular subtypes as compared to their older counterparts.
Stakeholders in Cancer Surveillance: Addressing Gaps in Data Sources
Authors: Ndlovu Babongile , Muchengeti Mazvita
Published: July 2024

PURPOSE

Having accurate cancer incidence estimations is essential in informing decision making, driving policy and supporting intervention and evaluation programs. In South Africa (SA), cancer is a reportable medical condition that every healthcare worker is obliged to report to the National Cancer Registry (NCR) as per Regulation No 380 of the National Health Act (Act 61 of 2003). Regulation 380 also mandates the NCR to establish population-based cancer registries (PBCRs) across SA. This reports aims to describe the cancer surveillance status in SA and identify gaps in cancer surveillance.

METHODS

The NCR conducts pathology-based cancer registration at national level and PBCRs at sentinel sites. The national pathology registry uses passive surveillance methods and miss cases that are diagnosed elsewhere. In order for SA to be able to produce accurate cancer incidence data, there needs to be four population-based cancer registries (PBCRs). The pioneering PBCR was established in 2017 from Ekurhuleni district. In PBCRs, all cancer data sources are explored, such as medical files, pathology reports, pharmacy prescription, cancer screening, hospital admission, hospice, private practitioner's consultation, radiology, discharge, mortuary and outpatient registers. International Classification of Diseases for Oncology-3 guidelines are used for coding the site and morphology of each case. An annual cancer incidence report is released within a 2-3-year lag period.

RESULTS

There is currently no existing accurate incidence estimation for cancers in SA. The pathology registry, due to its nature is incomplete and in addition not all pathology groups comply to reporting. In PBCRs, a significant number of data sources are inaccessible due to non-compliance and fear of sharing confidential patient medical records. PBCRs are costly to run and there is no funding permanently allocated to it and its operations rely on grant funding. Stakeholders are not well-informed of their roles in cancer surveillance.

CONCLUSION

All healthcare providers need to adhere to Regulation 380 and report cancers to NCR.
Successful Establishment of a National Cancer Control Program (NCCP) and Cancer Registry in Eswatini: Lessons to Inform NCCPs in Low- and Mid-Income Countries
Authors: Dlamini Xolisile , Nhlengetfwa Velephi
Published: July 2024

PURPOSE

Eswatini's 2017 baseline assessment revealed severe cancer service gaps in infrastructure, personnel, training, research, number served locally. We present the Ministry of Health’s (MOH) success in establishing the national cancer control unit (NCCU) and national cancer registry (NCR).

METHODS

MOH led the development of the 2019-2023 national cancer control strategic plan (NCCSP) and established the NCCU in 2019. The NCCU, staffed with a manager and 3 personnel implemented the NCCSP prioritizing cancer prevention (health promotion and screening), diagnosis, treatment, palliative care and survivorship programs. Inter-government, public-private, local and international partnerships led to widespread stakeholder engagement, community advocacy procurement of cancer screening and diagnosis equipment, staff training, and establishment of oncology services such chemotherapy. A NCR was introduced. Cancer prevention and palliative care interventions were integrated into NCCU activities. We report key progress indicators between 2019-2022.

RESULTS

Between 2019-2022, 2930 cancers were captured in the NCR. Cervical (59.2%), prostate (30.4%) and breast (19.5%) cancers were commonest, and 4% of cancers were among children. There was a 31-fold increase in the number of cancer patients receiving chemotherapy locally: from 52 to 1631 patients. International referrals for cancer management declined 7-fold from 217 to 30. Patient navigators/escorts were introduced in 2021, and by 2022 had supported linkage of 1,509 patients to cancer services. Nationally, 1141 health workers have been trained to provide palliative care and 1447 patients were receiving palliative care services in 2022. National rollout of adolescent HPV vaccination is ongoing. The NCCU is currently engaged in 15 research protocols, of which 9 are utilizing NCR data for student MPH/PHD programs.

CONCLUSION

Establishment of the NCCU and implementation of the NCCSP has led to coordinated efforts in cancer prevention, diagnosis and management, and more cancer-care needs met locally.
Surgical Demand and Migratory Patterns: A 10-Year Forecast for Hepatectomy in Oncology in the Northern Region of Brazil
Authors: Da Silva Vieira Laynara Vitória , da Silva Meneses Beatriz , Dornelas Luana Baptistele , Eduarda de Aguiar Tavares Marcella
Published: July 2024

PURPOSE

This article aims to forecast the 10-year demand for hepatectomy among liver cancer patients in Northern Brazil and assess the potential need for inter-regional collaboration based on migration patterns.

METHODS

An observational study following the STROBE checklist. Annual estimates of surgical procedures carried out by region were obtained from data from the Department of Informatics of the Unified Health System of Brazil (DataSus). Patient's identities are preserved, and the conduction of any research with data from DATASUS is ethically approved. All hepatectomy procedures in oncology (Code: 0416040101) were considered based on the PICO principle: People with liver cancer in Brazil from November 2013 to November 2023 (Population);hepatectomy in oncology and total costs for the surgical procedure according to the patient's place of residence and according to the patient's place of hospitalization (Interest);Brazilian North Region (Context). Forecasting models using historical surgical volume data to predict annual oncology hepatectomy surgeries for the next ten years (2024 - 2033). Total expenditure figures by patient place of residence and by place of hospitalization were also calculated using ARIMA (R programming 4.0).

RESULTS

The ARIMA forecast predicts an average annual demand of 45 (95% CI: 21.37-68.63) hepatectomy procedures for oncology patients residing in the northern region. Conversely, the forecast for in-region hospitalizations is 40 (95% CI: 17.19-62.81) patients per year. By 2033, an estimated 3.2 (95% CI: -0.35-6.75) patients from the Northern Region are expected to migrate annually to other Brazilian regions for hepatectomy procedures. The total estimated expenditure in 2033 for patients in the northern region is R$194,680.1 (95% CI: R$110,723.103 - R$278,637.1). However, the estimate of expenses for hospitalizations in the north region based on data from the following 10-years (2024 to 2033) indicates a value of R$166,798 (95% CI: R$86,991.96 - R$246,605.0), indicating that there may be a trend toward underfunding for inpatients in the northern region over the next 10-years.

CONCLUSION

Migratory trends in liver neoplasm surgery might endure in northern Brazil for the next decade. To ensure safe, affordable, and timely cancer surgery nationwide, inter-regional collaboration is essential for delivering impactful liver neoplasm surgical treatment.
The Impact of Honey on Chemotherapy and Radiation-induced Oral Mucositis
Authors: Chu Kevin
Published: July 2024

PURPOSE

Integrative nursing framework and Faye Abdellah’s 21 Nursing Problems theory guided this review focusing on holistic care including cost efficient complementary therapies such as honey addressing social problems, such as poverty. These theories are based on meta-theoretical perspectives consistent with nursing values, beliefs, and theoretical perspectives. Chemotherapy and radiation-induced mucositis, the inflammation and ulceration of the oral mucosa, affects 40% of chemotherapy patients and 90% of head and neck cancer patients receiving the addition of radiotherapy. Honey has been reported as an effective supportive care for reducing mucositis. The purpose of this literature review was to determine if honey can be used as adjuvant therapy to reduce the frequency and severity of OM in adult oncology patients undergoing chemotherapy and/or radiation.

METHODS

A literature review was performed using PubMed, CINAHL, and OVID Medline databases limited to primary studies from the past 5 years using the search terms, “honey AND mucositis,” “honey AND oncology,” “honey AND chemotherapy,” and “honey AND radiation.” After an initial review of 41 articles, results included 5 studies who met the criteria three randomized control trials (RCT), a single-blinded RCT study and a double-blinded RCT trial.

RESULTS

Honey products demonstrated statistically significant results (p < .05) in lower grades of OM and delayed weight loss. Several of the studies showed that the honey intervention groups maintained a mild mucositis score of 2 or less. One randomized control trial (N = 72) using a thyme honey oral rinse showed a better quality of life throughout the intervention and at 6 months follow-up.

CONCLUSIONS

The supporting evidence identifies honey as a possible cost-efficient improvement to patient care. When compared to conventional treatments, honey performed better at preventing OM from advancing beyond grade 2. Further study is needed to explore the correlation between honey, OM grade level and weight loss prevention.
Training Non-Oncologist Healthcare Providers to Manage Oral Endocrine Therapy for Breast Cancer
Authors: Ndayishimiye Aimable , Fehr Alexandra , Rugema Vestine , Cubaka Vincent Kalumire , Niyibizi Jean Claude , Sebishyimno Francois , Umwizerwa Aline , Nsabimana Nicaise , Shyirambere Cyprien , Fadeli Temidayo
Published: July 2024

PURPOSE

Oral endocrine therapy (OETs) is a crucial component of breast cancer management. However, they have traditionally only been available at tertiary cancer centers. Recent studies at Butaro Cancer Center of Excellence (BCCOE), in Northern Rwanda revealed sub-optimal adherence to OETs. Patients reported challenges including travel-related costs to BCCOE. To alleviate these challenges, we implemented a program that decentralizes the distribution of OETs to hospitals located in other provinces.

METHODS

In July 2023, before decentralization, we conducted a 5-day training of healthcare providers to empower them with skills and knowledge on clinical breast cancer management including OET management. Trainees included 5 internists, 3 general practitioners, 3 pharmacists and 9 nurses selected from 4 participating hospitals. Training included 2 days for theory and 3 days of experiential site visits. Trainees took pre- and post-assessments (20 questions) of their knowledge to evaluate the effectiveness of the training and assess the knowledge gained. Each test was graded and given a score from 0-100;mean results were compared between the pre and post-assessments. We also surveyed trainees to obtain feedback on the details of the training and their opinions on the next steps.

RESULTS

The mean scores (standard deviation) were 62 (22) and 89 (15) for the pre-and post-assessments, respectively, with a p-value < 0.0001 (T-test). Most trainees agreed/strongly agreed that the training was well organized (100%), relevant (100%), informative (100%), and effective (95%). Majority of trainees noted high levels of commitment and confidence in applying learned skills, with mean ratings of 9.07/10 and 8.73/10, respectively. Trainees recommended expansion of OET training to more hospitals and more healthcare providers, as well as incorporating more practical exercises and mentorship.

CONCLUSION

There was an increase in scores between the pre and post-assessments. We demonstrated that an abbreviated 5-day short course including theory and experiential components could impart knowledge and skills of OET management to non-oncology clinicians. The decentralization project was rolled out with longitudinal support and mentorship. Future studies will evaluate the impact of the decentralization program and provide a basis for future broader expansion of cancer care in Rwanda.
A Novel Mechanism for Chromatin Bridge Sensing by the Abscission Checkpoint in Human Cells
Authors: Petsalaki Eleni , Balafouti Sofia , Zachos George
Published: July 2024

PURPOSE

Chromatin bridges are DNA strings that link anaphase poles or daughter nuclei and are associated with carcinogenesis. In response to chromatin bridges, mammalian cells delay abscission by activating the abscission checkpoint which delays completion of cytokinesis in order to prevent chromatin breakage or tetraploidization by furrow regression. We recently showed that in cytokinesis with chromatin bridges a biochemical pathway including MRN complex, ATM and Chk2 promotes INCENP localization to the midbody to delay abscission and prevent chromatin breakage.

METHODS

In this study we used site directed mutagenesis, RNA silencing, time lapse and confocal microscopy, FISH, BrdU labeling, TUNEL assay and differential retention assay.

RESULTS

Here, we show that spontaneous or replication stress-induced chromatin bridges derived from catenated DNA exhibit “knots” of tangled, overtwisted DNA next to the midbody. Topoisomerase IIα (Top2a), an enzyme that relaxes supercoils and untangles catenated DNA forms irreversible Top2-DNA cleavage complexes (Top2ccs) on DNA knots. Inhibition of Top2a results in diminished localization of Rad17, MRN, ATM, Chk2 and CPC complex to the DNA bridges and induces chromatin bridge breakage. Furthermore, proteolytic degradation of Top2ccs is required for localization of Rad17 to the bridge DNA. In turn, Rad17 promotes recruitment of the MRN complex to DNA knots and downstream abscission checkpoint signaling to delay abscission and prevent chromatin bridge breakage in cytokinesis. In contrast, chromatin bridges generated by dicentric chromosomes do not exhibit DNA knots or Top2ccs next to the midbody, and fail to recruit Top2a, Rad17 and other downstream proteins and are unable to induce an abscission delay.

CONCLUSION

Our results describe a novel mechanism by which the abscission checkpoint detects chromatin bridges in human cells, through generation of irreversible Top2ccs on DNA knots. Because chromosomal instability is a major cause of cancer, identifying new genes that protect genome integrity is very important for cancer research.
Utility of Colonoscopy for the Screening and Management of Cervical Cancer in Africa: A Cross-Sectional Analysis of Providers' Training and Practices
Authors: Domgue Joel Fokom , Dille Issimouha , Gnangnon Freddy , Kapambwe Sharon , Bouchard Celine , Mbatani Nomonde , Gauroy Flodie , Ambounda Nathalie , Yu Robert , Sidibe Fatoumata
Published: July 2024

PURPOSE

Cervical cancer is a public health issue in Africa with devastating socioeconomic consequences due to the lack of organized screening programs. The success of screening programs depends on the appropriate investigation and management of women who test positive for screening. Colposcopic assessment following positive screening results is a critical issue in Africa. This study aimed to assess the utilization of colposcopy by providers in the region.

METHODS

A cross-sectional study was conducted in 2021-2022 among healthcare providers involved in cervical cancer prevention activities in Africa. They were invited to report prior colposcopy training, whether they performed colposcopy and the indications of colposcopy in their practice.

RESULTS

Of the 130 providers from 23 African countries who responded to the survey (mean age [SD]: 39.0 years [9.4]), half were female (65 [50.0%]), and 90.7% were working in urban areas. Overall, only 12.6% of respondents indicated having received prior training on colposcopy, and 11.7% reported that they were performing colposcopy in their current practice. Among the providers who reported performing colposcopy in their practice, colposcopy was indicated for routine visual screening in 21.2% of clinicians, to visualize the transformation zone in 15.2% of respondents, to assess vascularization of cervical mucosa in 33.3% of respondents, and to determine treatment modality in 12.1% of respondents.

CONCLUSION

Providers training and utilization of colposcopy for cervical cancer screening remain suboptimal in Africa. To address this situation in the region, further training is needed to improve providers' knowledge and engagement. With the development of lower-cost and portable colposcopes, efforts to equip cervical cancer prevention programs and facilities with colposcopy should be enhanced to ensure that women can be screened and managed appropriately.
Vaginal Stenosis in Patients Treated With Radiotherapy for Cancer of the Cervix in Uganda
Authors: Nakaganda Annet , Kagwa Agnes , Nassolo Cissy , Mulumba Yusuf , Tumwiine Aggrey , Lasebikan Nwamaka , Mulamira Pius , Kanyike Daniel
Published: July 2024

PURPOSE

The occurrence of Vaginal Stenosis (VS) is likely to be underreported and never treated in resource-limited settings. This study aimed to assess the incidence, risk factors, and clinical manifestation(s) of radiation-induced VS in patients with cervical cancer in Uganda.

METHODS

A retrospective cohort study was conducted in April-July 2022 for patients diagnosed with cervical cancer and treated with radiotherapy in 2019 at the Uganda Cancer Institute (UCI). Data was abstracted on patient demographics, stage of disease, type/technique/modality of radiotherapy received, incidence, grade/severity of vaginal stenosis, and treatments administered. Descriptive and Logistic Regression was used for data analysis using Excel and Stata.

RESULTS

363 patients enrolled in the study. Overall mean age was 50.6 years. Eight percent of patients were diagnosed at stage IB, 46.3% at stage II, 38.3% at stage III, 5.5% at stage IV and 1.9% were not staged. 101(28%) patients were excluded from the analysis due to missing radiotherapy treatment chart data. VS incidence was 5.3% (N= 14); 36% with CTCAE v4.03 Grade 1 VS, 14% with Grade 2, and 50% with Grade 3 VS. However, 94.7% had no documented assessment of the presence or absence of VS in their medical records. Apart from the total dose of radiotherapy (OR=1.0, p=0.045), other known risk factors were not statistically significant in predicting VS such as: tumor extension to the vagina (OR=2.4, p=0.190), receiving both external beam radiotherapy and brachytherapy (OR=2.6, p=0.100)), age (OR=1.0, p=0.077) and hyper-fractionation (OR=10.2, p=0.065). Sexual dysfunction was the most reported (71%) manifestation and 79% of VS occurred within one year of radiation treatment.

CONCLUSION

The reported radiation-induced VS incidence was low at UCI. This may be due to significant underreporting of VS in patients records as most of the identified cases were patient-reported versus physician-reported during examination. Since, there is no uniformly adopted method or grading system for VS at UCI, underreporting of VS may be related to low physician knowledge/practice to identify/diagnose VS and lack of patient education about the possible side effects associated with radiotherapy treatment. Hence, deploying a physician VS education program and a prospective study would provide a more accurate estimate of VS incidence in Uganda and other resource-limited settings.
Women Representation on Editorial Boards in Low and Middle-Income Countries Journals: Promoting Equity and Collaboration in Oncology
Authors: Da Silva Vieira Laynara Vitória , De Araújo Franca Bárbara Nissara
Published: July 2024

PURPOSE

The analysis of gender representation within journal editorial boards is crucial to understanding its potential impact on fostering collaboration among women in the global oncology community and shaping the trajectory of their careers within oncology specialties. Significantly, there exists a gap in data about Low and Middle-Income Countries (LMICs). In this context, our study aimed to assess the presence of women on the editorial boards of cancer journals in LMICs for the year 2023.

METHODS

We carried out a cross-sectional analysis, obtaining journals through Scimago Journal (Metrics based on Scopus® data as of April 2023) and the World Bank List of Countries Categorized as LMIC (2023). Journals were considered for inclusion if they were currently active, centered on oncology/cancer themes, and publicly disclosed information regarding their editorial board staff. Names and roles of editorial board members were extracted from the respective journals' websites. Members were categorized into senior positions (e.g., editor-in-chief), academic roles (e.g., reviewer), and non-academic positions (e.g., administrative office). The prediction of women's representation was determined based on first names using Genderize.io.

RESULTS

We included 64 of 66 identified journals and analyzed 2,489 names. 64 Oncology/Cancer journals represented 12 LMICs (China, Egypt, Mexico, Ecuador, Turkey, Serbia, India, Russia, Ukraine, Thailand, Pakistan, and Iran). Women held 12,1% (302/2489) of board positions [p < 0.001;95% CI(0.09, 0.14)]. Women held fewer academic roles (10,8%, 221/2,047) compared to senior [20.4%, 62/304 (p < 0.01)] and non-academic roles [13,8%, 19/138 (p = 0.05)].

CONCLUSION

Our research examined the composition of editorial boards in Oncology/Cancer journals from Low or Middle-Income Countries, revealing a persistent underrepresentation of women. The scientific collaboration potential of the female contingent cannot be ignored. Results underscore the importance of implementing regional strategies to promote the advancement of women's careers across various oncology specialties.
Association Between Hepatic Malignant Tumors and Partial Oncological Hepatectomy in Brazil: A Time Analysis From 2021 to 2023
Authors: Lech Gabriele Eckerdt , Maboni Laura Roppa , Filipin Von Muhlen Pedro Henrique , Hass Lopes Yasmin Ricarte
Published: July 2024

PURPOSE

Hepatocellular carcinoma is the most common type of hepatic cancer, and it is an aggressive malignant tumor with high lethality. Although the only potential curative treatment for hepatocellular carcinoma is tumor resection, only a few percent of cases are manageable to operative treatment. This study aims to analyze the number of diagnoses of hepatic tumors and the variation of partial hepatectomies performed throughout 3 years among Brazilian regions.

METHODS

Data was collected from DATASUS, a Brazilian Health Ministry database, from 2021 to 2023. In this cross-sectional design, the study analyzed partial hepatectomies in oncology, in addition to the number of diagnoses, comparing the number of surgical procedures among Brazilian regions (North, Northeast, Southeast, South, and Midwest) between the years. Statistical analysis was performed using R statistical software 4.2.1, considering significant p values < 0.05.

RESULTS

In the years 2021, 2022, and 2023, a total number of 10,144 malignant hepatic tumors were diagnosed. In the same period, 3,017 partial hepatectomies in oncology were performed (p < 0.001). The lowest number of surgeries performed was 951 in the year 2021, which could have been influenced by the Pandemic of COVID-19, and the highest was 1,098, in 2023. The variance in the number of surgeries performed was analyzed with the two-way ANOVA method, which presented statistical significance in the variation between regions over the years (p < 0.001). However, concerning the years analyzed, the difference was not significant (p = 0.052). Tukey post hoc test was also performed, which showed a significant association between all the regions, except for the interaction between North and Midwest (p = 0.982). The interaction between years was not statistically significant.

CONCLUSION

Hepatic tumors are potentially curable if discovered in their initial stages. The number of partial hepatectomies in oncology performed was statistically significant compared to the number of diagnoses, confirming that only a small number of cases are managed with surgery. The variation between the regions was also significant, showing an unequal distribution of surgeries performed between Brazilian regions. Further studies are needed to understand the factors behind those numbers.
Association Between Hepatocellular Carcinoma Epidemiology and Self-Reported Ancestry in Latin America
Authors: Loon Erica , Narvaez-Barbecho Cindy , Ortiz Jhon Prieto , Balderramo Domingo , Carrera Enrique , Dias-Ferrer Javier , Arrese Marco , Mattos Angelo Z. , Boonstra Andre , Debes Jose
Published: July 2024

PURPOSE

Hepatocellular carcinoma (HCC) related to non-alcoholic fatty liver disease (NAFLD, now MASLD) is a growing health concern worldwide particularly in areas of high endemicity such as Latin America. The region has a uniquely mixed population of high ancestral diversity which has been minimally studied. We aimed to assess the role of ancestry in HCC risk factors in Latin America.

METHODS

We retrospectively evaluated data from the ESCALON network, a European-Latin American network that prospectively follows patients with HCC to assess clinical, demographic, and ancestral parameters. A total of 429 individuals with HCC from 6 countries in Latin America were studied: Argentina (34% N: 145), Chile (15% N: 66), Ecuador (15% N: 63), Peru (15% N: 66), Colombia (14% N: 60), and Brazil (7% N: 29). Self-reported ancestry was categorized as European or Non-European which included the following: Amerindian or Indigenous, African, Asian, or other. HCC was diagnosed per standard AASLD guidelines.

RESULTS

131 patients (30.5%) reported having European ancestry and 298 (69.5%) non-European ancestry. Median age in both cohorts was 68 years. 72% of patients in the European cohort were male compared to 62% in the non-European cohort. The most common etiology for HCC in the European cohort was hepatitis C virus (38%) compared to NAFLD (52%) in the non-European cohort. Alcohol use disorder was the second most common etiology in both groups (25% European, 23% Non-European). Both European and Non-European ancestry cohorts had a similar proportion of HCC diagnosed under surveillance (40% and 41%, respectively) and similar presence of extrahepatic disease (47% and 50%, respectively). Interestingly, self-reported ancestry was associated with differential proportions of certain genetic polymorphisms including STAT4 and MBOAT7, suggesting a correlation between self-reporting of ancestry and genetic expression.

CONCLUSION

NAFLD-HCC was more common in Latin American patients of non-European descent compared to those of European descent, suggesting that ancestry may contribute to underlying liver disease, and in turn, the risk for HCC. However, larger studies including admixture analyses are needed to better understand this interaction.
Attributable Burden of Breast Cancer in a Middle-Income Asian Country: Understanding the Impact of Known Risk Factors
Authors: Ang Boon Hong , Ho Weang Kee , Teo Soo Hwang
Published: July 2024

PURPOSE

The Population Attributable Risk (PAR) is a valuable tool for gauging the influence of risk factors on the incidence of breast cancer within a population, thereby providing a better understanding of the preventable fraction of cases. Whilst developed nations use PAR from prevalence data and effect sizes from prospective studies to inform cancer control strategies, the lack of prospective studies limits PAR data availability in the majority of low- and middle-income countries. Our aim is to estimate PAR in a middle-income Asian country using population-specific distributions and literature-based estimates.

METHODS

We calculated attributable proportions to specific risk factors by incorporating population-specific prevalences from national surveys or relevant Malaysian studies. The associated relative risks were derived from literature based on prospective studies conducted in Asian countries. Utilizing Levin's formula for attributable proportions and applying the delta method for confidence intervals, we determined the impact of these factors on breast cancer risk.

RESULTS

More than 50% of breast cancer risk amongst Malaysian women is attributed to mammographic density (MD), assessed using computer-generated Breast Imaging Reporting and Data System (cBIRADS), whilst family history of breast cancer and genetics (common and rare variants) collectively account for less than 2% of the risk. The predominant contributors are MD (53%, 95% confidence interval: 52-53%), postmenopausal body mass index (BMI, 5%, 5-5%), and reproductive history (5%, 5-5%) - particularly delayed parity. Notably, attributable proportion for MD amongst pre-menopausal women (49%, 49%-50%) is higher than that of post-menopausal women (26%, 25-26%). Out of the total observed risk of 91% (88-94%), the unexplored 9%, potentially linked to other factors, including environmental exposures, remains unanalyzed due to a lack of available data.

CONCLUSION

Up to 60% of all breast cancers could be prevented if women maintained a breast density of less than 17% (classified as cBIRADS 1-2), a BMI of less than 23 kg/m2, and considered planned pregnancies at an early age. Further investigation is required to ascertain the modifiable attributable proportion of MD, considering its hereditary nature. This information directs public health interventions, aiming to alleviate the cancer burden in Malaysia and inform policies in comparable settings.
Cancer Data Systems in Africa: A Scoping Review
Authors: Nyambega Benson , Wattanga Lilac , Anyango Victor , Okama Edwin , Ndeda Laureen , Hantel Andrew , Rotimi Solomon
Published: July 2024

PURPOSE

Cancer is the third most common cause of death in Low- and Middle-Income Countries (LMICs), and rates are rising quickly. Standardized, high-quality cancer registries are essential for the research and policy needed to reduce cancer incidence and death. To date, best practices and challenges for African cancer registries are unclear, limiting our ability to optimally inform these stakeholders.

METHODS

We conducted a scoping review that evaluated challenges, use of, and opportunities for improvement of Cancer registries in Africa. The review followed the PRISMA guidelines. Databases included in the search were PubMed, Web of Science, ProQuest, Google Scholar and Scopus. Peer-reviewed studies published between January 2018 to August 2023 were included. A cross-sectional, stakeholder-informed qualitative approach was used to validate the scoping review findings and establish data needs and desired targets for data availability, analysis, and use.

RESULTS

Among the 212 peer reviewed articles initially identified, 28 were eligible for review and documented either Facility Based Cancer Registries (FBCRs) and/or Population-Based Cancer Registries (PBCRs) across 20 African countries. Major challenges identified included inadequate legislation and/or implementation, funding, office space, staffing, hardware, software, and capacity building; information contributed by limited departments; biased data collection; lack of accurate records and lack of sample archiving for research. Identified remedies, including from the African Cancer Registry Network (ACRN), were: frequent and longitudinal needs assessment, engagement of trained data registrars, continuous on-site training, alternative data sources, use of accession numbers to enhance linkage between registry data and pathologic samples, creation of an administrative structure to promote logistical success and good governance, enhanced government support, partnerships for external support, establishing jurisdiction of operation.

CONCLUSION

The challenges identified from the few countries implementing their registries can be broadly grouped under lack of legislative frameworks, inadequate finances, limited physical infrastructure, incompetent human resource, incomplete data, and inadequate data demand and use. The successes of African countries with advanced registries and the best practices proposed by ACRN provide substantial grounds for the establishment of effective FBCRs and PBCRs in LMICs.
Characterizing Baseline Prevalence and Causes of Complications of Tracheostomy and Gastrostomy Tubes Among Cancer Patients at Muhimbili National Hospital in Tanzania
Authors: Morales Leyda Marrero , Maina Ivy , Nkya Aslam , Mushi Beatrice P. , Xu Mary Jue , Dharsee Nazima , Elias Nashivai , Van Loon Katherine , Mmbaga Elia , Selekwa Msiba
Published: July 2024

PURPOSE

Tracheostomy and gastrostomy tube interventions are common procedures for patients with head and neck and esophageal cancer, which are both highly prevalent at Muhimbili National Hospital (MNH), the largest referral hospital in Tanzania. Reported complications lead to unplanned hospital readmissions and increased disease burden, negatively impacting patient outcomes. While there are described approaches to quality improvement for complications in these procedures, these have mostly been in high-income countries. We aimed to study patients at MNH in Tanzania to tailor interventions to low-middle-income country (LMIC) settings. This project is part of the pre-intervention phase of a longitudinal multifaceted implementation science study with the MNH Global Cancer Program.

METHODS

Two patient surveys aimed to study indications for, and complications of tracheostomy and gastrostomy tubes were created. The surveys, created in English but translated to the local language Swahili, inform on the patient's social drivers of health, clinical characteristics, caregiver support, complication and readmission rates, and quality of life. Survey administration was piloted and optimized for data entry to REDCap while minimizing clinical burden in a resource-constrained healthcare system. An automated study tracker was also created to facilitate follow-up for the enrolled patients.

RESULTS

The surveys enable the collection of important patient data that will ultimately determine the direction of the multifaceted intervention to address complication rates with tracheostomy and gastrostomy tube care at MNH in Tanzania. These surveys, the REDCap database, and the study tracker were all created in a context-appropriate manner to promote independent sustainability of data collection and maintenance for the team at MNH. Additionally, stakeholder meetings were held with the General Surgery and Otolaryngology Departments to ensure partnership with the healthcare teams at MNH. These highlighted important areas to refine the proposed interventions to fit the local context. Data collection has begun and is expected to continue in the coming months.

CONCLUSION

This project, to our knowledge, will be the first to apply an implementation science framework to adopt quality improvement strategies for tracheostomy and gastrostomy tube care in an LMIC setting. The tools developed and this multifaceted approach can be adopted regionally and by other LMICs.
Collaborative Action for Public Health: The Esophageal Cancer Consortium's Approach to Policy Influence and Capturing Policy Makers' Attention in Ethiopia
Authors: Deressa Biniyam Tefera , Deybasso Haji Aman , Megerso Abebe , Adem Jibril Bashir , Tekeba Dagim , Mama Mohammedaman , Batu Didha , Bude Bonso , Agero Gebi , Hinika Gudeta , Tura Ismael , Kabeto Mohammed , Abdo Abdella Amano , Fikadu Desalegn , Lencho Abashamo , Tiba Melik
Published: July 2024

PURPOSE

Esophageal cancer disproportionately affects specific regions in Ethiopia, particularly the Arsi Bale areas. 1 , 2 Studies reveal that more than 50% of esophageal cancer cases in Ethiopia originate from Arsi-Bale region. 3 Collaborative efforts by individuals and institutions from this region-initiated actions to elevate esophageal cancer as a national concern. This abstract illustrates the collaborative process and the formation of the Esophageal Cancer Consortium in Ethiopia.

METHODS

The method encompasses collaborative discussions, real-time documentation during detailed dialogues, and iterative reviews aimed at capturing the program's evolution and key achievements. Experts from clinical and public health fields, actively involved throughout the program's lifecycle, contributed insights from its inception to its current state.

RESULTS

Initiatives to prioritize esophageal cancer as a public health concern in Arsi-Bale regions were spearheaded by individuals and diasporas from these regions. These efforts led to the first conference at Arsi University in 2022, involving clinicians, researchers, public figures, and community leaders, along with four educational institutions, namely Arsi University, Madda Wallabu University, Adama Hospital Medical College, and Arsi Negelle General Hospital and Medical College, and International Oromo Health Professional Association (IOHPA). This conference resulted in forming the Southeast Esophageal Cancer Task Force (SEECTF). Progressive efforts, including regular weekly meetings under the structured SEECTF, led to the implementation of a first-of-its-kind endoscopy curriculum in Ethiopia, initiation of endoscopy diagnosis in previously unequipped hospitals, and the development of the first Esophageal cancer treatment guidelines and training manuals in Ethiopia. Community education pamphlets in local languages and community education through mass media were implemented. During the second national esophageal cancer conference in 2023, which led to national recognition, MOUs were signed with the Ministry of Health, Oromia Regional Health Bureau, the four educational institutions, and IOHPA. This conference resulted in the formation of a centralized consortium involving these institutions under one umbrella, working on research, advocacy, and capacity building, channeling esophageal cancer actions nationally.

CONCLUSION

Collaborative efforts by individuals and institutions are crucial in influencing policymakers, addressing public health concerns, and garnering national attention and action to reduce the burden of esophageal cancer and enhance patients' quality of life in Ethiopia.
Comparison of Gene Expression Differences in Gastrointestinal Cancer Between Developing and Developed Countries
Authors: Zheng Andrew , Li Bin , Chen Wenqiang
Published: July 2024

PURPOSE

Gastric cancer is the third most lethal malignancy, but its incidence varies widely in different countries. Currently, most of the cancer treatment options used in most countries come from a few developed countries in Europe and North America. However, with the continuous development of cancer targeting and immunotherapy, do different countries need to develop specific treatments based on the tumor gene expression characteristics of their patients? We hypothesized that there are significant differences in differentially expressed genes (DEGs) and related signaling pathways in gastric cancer tissues from different countries.

METHODS

To test this hypothesis, this study used data from the Gene Expression Omnibus (GEO) database to compare DEGs and associated metabolic pathways in tumor samples from different countries, including developing and developed countries.

RESULTS

The results showed that only a very small number of DEGs were shared in tumor tissues from cases from different countries, and accordingly, there were also very few metabolic pathways that were altered in cancer tissues shared by cases from various countries. This strongly supports our hypothesis that patients from different countries have very different tumorigenesis pathways and, presumably, different therapeutic targets.

CONCLUSION

It is proposed that for the treatment of gastric cancer, different countries should develop treatment protocols suitable for the tissue characteristics of gastric cancer patients in their own countries. Simply applying treatment options from developed countries may have limited effect. Analysis of the genome, transcriptome, and proteome of cancer tissues will greatly advance the development of cancer treatments.
Development of miRNA-Based Therapeutics for Liver Cancer Using Bioinformatics Approaches
Authors: Pritam Manisha , Dutta Somenath
Published: July 2024

PURPOSE

Hepatitis B virus (HBV) can cause chronic infection and can induce high risk of liver cancer. Hepatocellular carcinoma is a predominant form of all liver cancers. Despite the availability of an effective HBV vaccine, all people are not vaccinated. Previously, it was reported that human miRNA can inhibit the HBV replication and can be used as biomarker or therapeutics.

METHODS

In our present study, we have used the CDS region of capsid protein, protein X, and small S protein of HBV. We used miRNAProtPred tool for prediction of potential human miRNAs. Tertiary structure prediction and miRNA-RNA docking was performed using RNA composer and HNADOCK server, respectively. We have used PyMol and GROMACs for molecular docking analysis and MD simulation, respectively.

RESULTS

We have identified a total of 120 human miRNA against the HBV CDS region. However, only 31 human miRNAs were identified as potential human miRNA that can inhibit the protein expression of HBV and can be used as potential therapeutics or biomarkers. Interestingly, some of the identified miRNAs were experimentally validated by other research groups such as hsa-miR-199a-3p, hsa-miR-15a and others. However, experimental validation is required for the remaining miRNAs.

CONCLUSION

The current approach will facilitate the research of development of miRNA-based therapeutics and biomarkers against liver cancer and/or HBV infection. The current approach is rapid and cost effective. The identified human miRNA can be used as therapeutics against HBV after experimental validation.
Discovering Novel and Unique Saliva and Serum miRNA and mRNA Signatures for Oral Cancer Detection Using Whole Transcriptome and Small Non-Coding RNA Sequencing: Prediction of Their Association With the PI3K/AKT Pathway
Authors: Vageli Dimitra , Doukas Panagiotis , Judson Benjamin
Published: July 2024

PURPOSE

Identification of molecular biomarkers in the saliva and serum of oral cavity cancer patients represents a first step in the development of essential and efficient clinical tools for early detection and post-treatment monitoring. Molecular analyses of paired saliva and serum samples from an individual patient will likely yield better results than analyses of either serum or saliva alone.

METHODS

We performed whole-transcriptome and small non-coding RNA sequencing analyses on sixteen paired saliva and serum samples from patients with oral squamous cell carcinoma (OSCC) and healthy controls (HC).

RESULTS

We identified twelve novel saliva and serum miRNAs and a panel of unique miRNA and mRNA signatures, significantly differentially expressed in saliva and serum of OSCC patients versus HC (log2foldchange: 2.6–26.8 DE 0.02–0.000001). We utilized a panel of the 10 top-deregulated miRNA and mRNA markers, hsa-miR-7704, hsa-miR-3648-5p, TNC, MMP10, TP63 in saliva and hsa-miR-23a-5p, hsa-miR-499a-5p, hsa-miR-556-5p, RELA(p65), and TCAIM in serum, and evaluated its putative diagnostic potential (>87% sensitivity 100% specificity). Based on this preliminary analysis, we recommended a set of 10 biomarkers for further validation as a biomarker panel for the detection of oral cancer. Functional and pathway analyses based on the discovered miRNAs and mRNAs and their targets indicated interactions with canonical pathways, including PI3K/AKT signaling.

CONCLUSION

We have identified a panel of miRNA and mRNA markers exhibiting promise as non-invasive biomarkers for oral cavity cancer and recommend further clinical testing.
Efficacy Review of Flavonoid-Rich Nutraceuticals in Cancer Prevention and Treatment
Authors: Devi Metta
Published: July 2024

PURPOSE

Cancer, a leading cause of mortality globally, is characterized by the uncontrolled proliferation of malignant cells, often influenced by genetic predispositions and unhealthy lifestyle choices. This has led to a surge in the consumption of dietary supplements, particularly flavonoid-rich nutraceuticals, as individuals seek to adopt healthier lifestyles. Over the years, plant-derived flavonoids have garnered attention for their potential as chemopreventive and chemotherapeutic agents, attributed to their antioxidant, anti-inflammatory, and anti-carcinogenic properties. This review aims to critically assess existing literature on the health claims of specific flavonoids and their potential impact on cancer, as well as to examine the efficacy of flavonoid-rich dietary supplements in cancer prevention and treatment.

METHODS

The review synthesizes and critically evaluates available evidence from previous studies on the health claims of flavonoids and their impact on cancer. It also examines the efficacy of flavonoid-rich dietary supplements in cancer prevention and treatment.

RESULTS

The analysis suggests that flavonoid-rich dietary supplements, when consumed as nutraceuticals, may offer significant medical benefits with minimal toxicity, potentially aiding in cancer prevention and treatment by disrupting key cellular pathways involved in cancer progression.

CONCLUSION

This review provides a comprehensive understanding of the potential role of flavonoids in cancer management and highlights the need for further research in this area.