bluuebunny/crossref_metadata_2025 huggingface dataset:
Variation in 'Fast-Track' Referrals for Suspected Cancer by Patient Characteristic and Cancer Diagnosis: Evidence From 670,000 Patients With Cancers of 35 Different Sites
Authors: Zhou Y. , Mendonca S. , Abel G. , Hamilton W. , Walter F. , Johnson S. , Shelton J. , Elliss-Brookes L. , McPhail S. , Lyratzopoulos G.
Published: September 2018

Background: In England, 'fast-track' (also known as 'two-week wait') general practitioner referrals for suspected cancer in symptomatic patients are used to shorten diagnostic intervals and are supported by clinical guidelines. However, the use of the fast-track pathway may vary for different patient groups. Methods:  We examined data from 669,220 patients with 35 cancers diagnosed 2006-2010 following either fast-track or nonfast track primary-to-secondary care referrals using a bespoke English dataset, the 'Routes to Diagnosis' data. We estimated the proportion of fast-track referrals by sociodemographic characteristics and cancer diagnosis and used logistic regression to estimate respective crude and adjusted odds ratios. We additionally explored whether sociodemographic associations varied by cancer. Results:  There were large variations in the odds of fast-track referral by cancer ( P < 0.001). Patients with testicular and breast cancer were most likely to have been diagnosed after a fast-track referral (adjusted odds ratios 2.73 and 2.35 respectively, using rectal cancer as reference); while patients with brain cancer and leukemias least likely (adjusted odds ratios 0.05 and 0.09 respectively for brain cancer and acute myeloid leukemia). There were sex, age and deprivation differences in the odds of fast-track referral ( P < 0.013), which varied in their size and direction for patients with different cancers ( P < 0.001). For example, fast-track referrals were least likely in younger women with endometrial cancer and in older men with testicular cancer. Conclusion: Fast-track referrals are less likely for cancers characterized by nonspecific presenting symptoms and patients belonging to low incidence demographic strata. Interventions beyond clinical guidelines for “alarm” symptoms are needed to improve diagnostic timeliness.
Missed Breast Cancer: What We Can Do!
Authors: Waheed K.B. , Ahmad S.F. , Al Bassam M.
Published: September 2018

Background: Breast cancer is a major health concern all over the world, and also in the Kingdom of Saudi Arabia. Despite availability of modern facilities in diagnosis and improvements in healthcare systems, still many of the breast cancers are missed. Careful understanding of situation may help to minimize and even stop such unfortunate outcomes. Aim: To highlight various aspects of missed breast cancers on mammography based on their cause and course of disease. Methods: We retrospectively reviewed clinical information, imaging data and outcomes of mammography in patients who presented for both screening and diagnostic mammography in our hospital. Although we found less number of patients having diagnosed or developed breast cancer (on follow-up mammography and biopsy results) with initial negative mammogram studies. Careful analysis of clinical and imaging findings were made and interviews with the patients conducted to sort out cause of such unfortunate outcome (of missed breast cancer). Results: We found important aspects of missed breast cancers because of patient factors (lack of awareness for importance of regular check-up, social factors, inertia for access to care and late check-up), imaging related (suboptimal acquisition of mammogram views), physician related (unfamiliarity with rad-reports and BIRADS classification, late referral) and natural causes (rapid course of disease). Conclusion: Causes of missed breast cancers may be simple to understand but sometimes overlooked by anyone in the chain of process (from technician, patient, radiologist and physician). Careful analysis, creating awareness and implementing standardized practice may help to overcome such unwanted events.
Cohort Profile: The Chongqing Cancer Cohort Study (CCCS) of the Urban Population in Southwest China
Authors: Chen Y. , Lei H. , Zou X. , Zheng T. , Qiu H. , Chen Y. , He M. , Du J. , Zhou Q. , Wu Y. , Zhao P.
Published: September 2018

Purpose: Urbanization is causing an increasingly negative effect on public health in China. This study was established to examine the associations between socio-economic and environmental exposures and the potential impact of gene-environment interactions and cancer risk of urban population in Chongqing, China. Participants: The cohort was established in Beibei District of Chongqing in southwest China. Between March 2016 and December 2016, we enrolled 57,332 adults who were 40-69 years of age, and collected baseline data on demographic information, socio-economic status, lifestyle, family and personal disease histories through face-to-face interviews using a standardized questionnaire. Regular follow-up including face-to-face interviews will take place every 5 years. Findings to date: Ninety-nine percent (56658/57332) of the participants completed the baseline assessment. The eligible participants had a mean age of 54.8 years, and 51.42% were females. Nearly three-fifths of participants having a normal BMI (18.5 to 23.9 kg/m2) and one-third being overweight (24.0 to 27.9 kg/m2). Among males, 29.58% were smokers and 21.08% were alcohol users. Among females, 1.49% were smokers and 1.66% were alcohol users. Among all participants, 7.03% of males and 9.08% of females reported their family history of cancer. Future plans: The relationships of modifiable risk factors with the cancer risk will be analyzed. Meanwhile, participants will be closely tracked to minimize loss to follow-up. We plan to construct a risk prediction model on cancer and verify the prediction model by genome-wide association studies (GWAS). The successful completion of this cohort study will allow for better targeting of cancer screening to those at highest risk in urban population of China and provide clinicians and policymakers with a practical predication rule.
Is the Quality of Life in Breast Cancer Survivors the Same as Healthy Women? A Case Control Study Among Women in Klang Valley, Malaysia
Authors: Hashim H.S. Mohd , Lim C. , Junazli N.I. , Choo S.L. , Low K.Y. , Munisamy M.
Published: September 2018

Background: One of the positive outcomes of improvements in cancer care is the increasing number of people who survive the disease. Worldwide, the number of cancer survivors will continue to increase, with a threefold increase predicted from 25 million in 2008 to 75 million in 2030. Breast cancer survivors have the highest survival rates compared other types of cancer. Following a diagnosis of breast cancer, issues that women often worry about include the possibility of cancer recurrence, challenges with reacclimatizing to daily life posttreatment completion and numerous other emotional and physical challenges. It is unknown whether over time the coping skills of these survivors enable them to have a similar quality of life (QOL) as other normal women. This study aimed to assess and compare the quality of life (QOL) among breast cancer survivors and nonbreast cancer survivors in the Klang Valley, Malaysia. Methods: This case-control study used the European Organization for Research and Treatment of Cancer - Quality of Life Questionnaire (EORTC-QLQ) to ascertain QOL within breast cancer survivors and nonbreast cancer survivors. Simple random sampling was used to identify i) participants from the case arm -from four cancer-related NGOs in the Klang Valley; and ii) participants from the control arm - from women attending Kuala Lumpur Hospital. 176 number of participants were involved in this study with a 1:1 ratio. Result: There was no significant difference in quality of life (QOL) between breast cancer survivors and nonbreast cancer survivors in the Klang Valley, Malaysia. The longer the period of survival (5 years and above), the higher the QOL levels in breast cancer survivors. Conclusion: In conclusion, women with breast cancer especially those who had survived more than 5 years, had similar quality of life (QOL) levels as women who did not suffer from the disease. Women with breast cancer may have developed additional coping skills which could be taught to other patients living with cancer or even those with other chronic illnesses.
Communicating Scientific Findings to Communities With High Risk and Best Ways to Do That is a Challenge
Authors: Somdyala N.I.M. , Sithole N. , Bradshaw D. , Mbuzi N. , Fikeni N.E.
Published: September 2018

Background: A national cytology cervical cancer screening program was introduced in South Africa as part of cancer control program policy more than a decade ago. Policy guidelines state that women attending the public sector services are entitled to three free Pap smears per lifetime starting at the age of 30 years or older, with a 10 year interval between each smear. However, the frequency in which women come for Pap smears is very low, with some getting diagnosed when the disease is at its advance stage. Consequently, cervical cancer incidence rates are very high with low survival rates. Fragmented evaluation of this program done in different provinces revealed that women lacked knowledge about cervical cancer. Women are also uninformed about the free national cytology cervical cancer screening. Furthermore, there is scarcity or no free public screening services especially in rural populations. In 2014, the National Health Ministry started HPV vaccination to girls at ages 11 years in schools. The expectation was that providing vaccines to young girls will reduce cervical cancer and its associated mortality in the next two to three decades. However, commitment to reduce the burden of cervical cancer should continue. Furthermore, it is important to intensely introduce health-seeking behavior to the population at high risk through community engagement and education around cervical cancer. This will reinforce early detection and prevention initiative thus reducing premature deaths due to this cancer and improving quality life. Aim: In 2017 a partnership between Committee of Health Programs under rural development and scientists of the South African Medical Research Council was initiated. This committee's mandate is managed by the Provincial House of Traditional Leaders in the Eastern Cape. Specific objectives include forming partnership with traditional leaders as key role players in reducing cervical cancer morbidity and mortality. As well as, to reduce high incidence of cervical cancer in the rural high-risk population. Methods: Eight villages were identified for intervention. Primary health clinic nurses working in identified villages were included to work as part of the team that will deliver the interventions. Intervention activities will include providing education about cervical cancer which will be done through awareness campaigns twice a year for the next 5 years. Another component of the intervention will be voluntary cytology screening for cervical cancer for all enrolled participants. Voluntary participants will form a cohort for follow-up. After five years the intervention will be evaluated. Conclusion: It is envisaged that this intervention initiative will be expanded to other provinces in South Africa.
Patient Characteristics and Predictors of Advanced Breast Cancer Stage at a Public Referral Hospital in a Middle-Income Sub-Saharan African Country
Authors: Tau B.M.
Published: September 2018

Background: Breast cancer is the second leading cause of death in women in Botswana, a middle-income country in sub-Saharan Africa where cancer treatment is free to all citizens. While treatment is accessible, treatment outcomes may be limited by delayed diagnosis and or suboptimal treatment. Aim: As a preliminary step to understanding ways to improve early diagnosis of breast cancer in Botswana, we aimed to describe sociodemographic and clinical characteristics of breast cancer patients receiving specialized oncology care. Methods: Retrospective review of electronic data of patients enrolled in Thabatse Cancer Cohort study, including female patients diagnosed with breast cancer between October 2010 and July 2017 was conducted. Patient sociodemographic and clinical characteristics were described. We used univariate and multivariable logistic regression to explore predictors of advanced stage (III or IV) at presentation. Patients without known cancer stage were excluded. All factors significant in univariate analysis ( P < 0.05) were included in final multivariable model. Statistical analyses were performed using R on an EZR platform. Results: A total of 481 female breast cancer patients were included in our analysis, with median age of 52.4 (IQR 44.0- 64.4) years. Majority of patients were not married (61%), nearly half (48%) had primary school or less education, 54% had income of less than $50 per month, and 30% were HIV positive. Overall, 260 (54%) were diagnosed with advanced cancer stage, 144 (30%) had early-stage cancer, and 77 (16%) had unknown cancer stage. Compared with early-stage cancer; income of less than $50 per month (odds ratio [OR] 1.58, 95% CI 1.03-2.44) and not having an indoor toilet (OR 0.56, 95% CI 0.36-0.87) were significantly associated with advanced cancer. Importantly, no significant association was detected for HIV infection (OR 1.29, 95% CI 0.79-2.13), education (OR 1.19, 95% CI 0.77-1.83) and electricity at home (OR 0.97, 95% CI 0.56-1.64). In the adjusted model only income of less than $50 per month was significantly associated with advanced cancer (adjusted OR 1.85, 95% CI 1.17-2.93). Conclusion: Our findings indicate that a high proportion of breast cancer cases receiving specialized oncology care were diagnosed at an advanced stage. While patients from lower socioeconomic seem to be at higher risk, these data suggest that broad sectorial interventions are needed to reduce cancer stage at presentation rather than targeted programs focused on individual populations or barriers.
Micro-RNA Expression Profiling in Malaysian Triple-Negative Breast Cancer Patients: Impact on Recurrence Prediction
Authors: Ankathil R. , Aziz A.A. Abdul , Salleh S.
Published: September 2018

Background: Triple negative breast cancer (TNBC) is characterized by its biologic aggressiveness, worse prognosis and lack of therapeutic targets. Due to high probability of tumor recurrence and also due to lack of available targeted therapies, TNBC patients are treated with standard chemotherapy using TAC [taxane (T), adriamycin (A) and cytoxan (C)] chemotherapy regimen. However, TNBC patients present significant interindividual differences of treatment efficacy. Drug resistance and recurrence remains major clinical obstacles to successful treatment in many TNBC patients. This warrants the need for early identification of TNBC patients who are likely to be chemosensitive and those who have high recurrence risk. TNBC may have specific molecular features that could be possible targets for new biologic targeted drugs. microRNAs (miRNAs) which are aberrantly expressed in tumors, can target and modulate key genes involved in TNBC chemotherapy. Aberrant microRNA expression is strongly implicated in anticancer drug resistance phenotype and hence, miRNAs appear to be promising candidates for response and recurrence prediction. Aim: To investigate the expression profile of few candidate miRNAs (miR-21, miR-27b, miR-34a, miR-182, miR-200c and miR-451) in tumourous and nontumourous tissues in Malaysian TNBC patients and their utility as predictive markers of recurrence in TNBC patients. Methods: Malaysian TNBC patients who had undergone TAC chemotherapy regimen at Hospital Universiti Sains Malaysia were identified and the clinicopathological variables were recorded. Total RNA from cancerous and adjacent noncancerous tissues of FFPE samples from 41 patients were isolated, transcribed and preamplified. The expression of selected miRNAs (miR-21, miR-27b, miR-34a, miR-182, miR-200c and miR-451) were quantified using quantitative real-time PCR (qRT-PCR). The miRNAs expression was categorized into two groups based on upregulation and downregulation. The disease outcome of the patients were evaluated after completion of chemotherapy. Disease-free survival (DFS) analysis using Kaplan-Meier method followed by univariate and multivariate Cox's regression analysis were performed to investigate the impact of these candidate miRNAs on recurrence prediction. Results: The relative expressions of miR-27b and miR-451 were found to be significantly lower in cancerous as compared with normal adjacent tissues of TNBC patients. Multivariate Cox's regression analysis demonstrated that medullary and metaplastic tumor subtypes and positive axillary lymph nodes significantly increased the risk of recurrence in TNBC patients. Downregulated expression of miR-21 and upregulated expression of miR-182 were found to be associated with risk of recurrence in TNBC patients. Conclusion: Tumor subtypes, positive axillary lymph nodes as well as expression profiles of miR-21 and miR-182 could be useful as predictive biomarkers of recurrence in TNBC patients.
Living Report of Chinese Lymphoma Patients 2018
Authors: Zhang J.
Published: September 2018

Background: On September 15th, 2018, with the 15th World Lymphoma Day approached, the experts from House 086 and Tsinghua University School of Economics and Management (Tsinghua SEM) started the first research on the real living conditions of Chinese lymphoma patients. In the meantime, it is the first time that Chinese patients and caregivers attended the World Lymphoma Coalition´s Survey. Aim: To collect and analyze the data of Chinese lymphoma patients and caregivers living condition. What's more, contrast the Chinese lymphoma patients and caregivers related data with the world related data. Methods: By using online questionnaire survey. Based on quantitative analysis, the experts concluded the living conditions of lymphoma patients and their caregivers. Results: We collected over 1200 valid questionnaires in the World Lymphoma Patients and Caregivers´ Survey. According to the past survey in China, we will collect at least 1000 valid questionnaires in Living Report of Chinese Lymphoma Patients 2018 . Conclusion: We will get the investigation conclusion after the data research. The details will be concentrate on the follow items: - Background - Research Methods - Basic Information - Identity/age/gender - The pathologic types of lymphoma patients - Diagnose and treatment - Personal economic situation of lymphomas - Psychological conditions - What they need? - Know more about the life qualities of Chinese patients and caregivers - More knowledge about Chinese lymphoma patients living condition - Chinese data VS. the world survey data.
The Women Who Fear the Unknown: Potential Drivers of the Cervical Cancer Epidemic in Rural Nigeria
Authors: Abiodun O. , Olu-Abiodun O.
Published: September 2018

Background: Visual inspection of the cervix under acetic acid is the most cost-effective method for the control of cervical cancer in sub-Saharan Africa. The region bears about 90% of the global burden of the disease accounting for about 85% of new disease and more than 90% of the mortality. The WHO piloted a largely successful community-based cervical screening in six African countries including Nigeria between 2009 and 2012. Community-based cervical screening was subsequently adopted in Nigeria as a major strategy for preventing cervical cancer. An evaluation of the community-based cervical screening in two rural local government areas in Ogun state, Nigeria, however, revealed that more than 95% of sexually active women had never had cervical screening done despite availability of the services. A substantial number of these women would not want to have cervical screening done because of the fear of a positive cervical screening result. Aim: The current study explored the characteristics of women who are unwilling to have cervical screening because of the fear of a negative result in two rural local government areas in Nigeria. Methods: A post hoc analysis of data collected for the evaluation of community-based cervical screening in two rural LGAs in Nigeria. The analysis described the characteristics of 700 sexually active women aged 25 to 64 years who declined to have cervical screening. The socio-demographic characteristics, perception (0 to 6) and knowledge scores (0 to 36) of the participants were fitted into a multivariate logistic regression model to predict the fear of an unfavorable cervical screening result. Results: About 81% (567) of the women were unwilling to get a cervical screening due to the fear of a negative result. Age, gravidity, knowledge, and perception about cervical cancer and screening were associated with the women declining cervical screening due to the fear of a negative result. On multivariate logistic regression analysis age (OR: 0.968, P = 0.007) and knowledge score (OR: 0.914, P < 0.001) were found to predict the fear of a negative result. The adjusted outcome variable model showed fair discrimination (AUC = 0.67) and good calibration ( P = 0.416). Conclusion: Many women in rural Nigeria decline to have cervical screening mainly because of the fear of a negative result which is in turn predicted by younger age and poorer knowledge scores about cervical cancer and screening. There is a need for further qualitative research to explore the dimensions of fear as it relates to refusal to have cervical screening among rural women in Nigeria.
Building a Weight of Evidence to Prevent Cancer in Later Life
Authors: Rosenberg G. , Thomas C. , Hooper L. , Vohra J.
Published: September 2018

Background: Obesity is the largest preventable risk factor for cancer in the UK after smoking. Being overweight as an adult is linked to 13 types of cancer, and overweight children are more likely to become overweight adults. Routine data shows that around one in three children leave primary school in the UK (aged 12) overweight or obese, with the children from the most deprived communities twice as likely to be so. Cancer Research UK is campaigning for restrictions on the marketing of foods high in salt sugar and fat (HFSS foods) to children as part of a comprehensive population level strategy to prevent obesity-related cancers in the future. Aim: To undertake a mixed methods program of research aimed at building a body of evidence to directly inform policy to address childhood obesity. Methods: Individual studies included: a national cross-sectional survey to investigate obesity and cancer awareness in the UK adult population; a modeling study to predict future obesity-related cancer cases; and qualitative and quantitative studies to explore obesity-linked behaviors and exposure to HFSS marketing in children. A narrative synthesis of results from individual studies was conducted to identify key themes and develop recommendations for policy. Results: Cancer was not at the forefront of people's minds when thinking about obesity, with only 26% of UK adults reporting (unprompted) awareness of the link. However, results from modeling identified that the projected impact of obesity on cancer is high: if current trends continue it will lead to a further 670,000 cases in the UK over the next 20 years. Qualitative research identified a high awareness of junk food marketing in children aged 8-19. This influenced their behavior using a variety of persuasive marketing techniques, including catchy slogans and jingles, celebrity endorsements or by referencing youth culture. Logistic regression modeling associated commercial TV screen time with an increased risk of high junk food consumption (OR 1.8, P = 0.002). Furthermore, recalling one extra broadcast advert predicted a significant increase in HFSS consumption, approximately 18,000 extra calories/person/year. Conclusion: These linked studies have informed Cancer Research UK's campaign on obesity, and results have been used to inform work with the media, coalition building and influencing. Findings that HFSS food marketing influenced children's consumption behaviors were published on the charity's lobbying day in parliament where the research was discussed with almost 170 members of parliament. To achieve further HFSS marketing restrictions, research evidence is essential to making the case for policy change and this approach from a large UK cancer charity could inform similar efforts in other countries.
International Projects of The National Society of Pediatric Hematologist and Oncologists
Authors: Muftakhova G. , Kirgizov K. , Serik G. , Kogan S. , Varfolomeeva S.
Published: September 2018

Background and context: International cooperation is a key factor in the success of multicenter studies and educational projects, especially in LMICs. Aim: To describe projects of The National Society of Pediatric Hematologists and Oncologists (NSPHO) in the international collaboration. Strategy/Tactics: NSPHO international projects: optimization of care for children with cancer in Commonwealth of Independent States (CIS) and developing relationship with international organizations such as UICC, SIOP (Asian region). Unique feature is that these projects based on collaboration between healthcare professionals and governments with support of leading institutions. Program/Policy process: Program based on online and off-line meetings and courses. CIS project (in collaboration with WHO and St. Jude Children's Research Hospital) based on series of scientific and organizational meetings (online/off-line). Aim of this work is to organize a community of pediatric hematologists/oncologists of the region and prepare unique projects to improve the outcomes of treatment of pediatric cancer cases. Next meeting under the auspices if WHO will be held in Moscow in April 2018 (participants from 10 countries). The objectives of this meeting are to describe current situation of pediatric oncology care in the region, identify regional gaps in pediatric oncology care, and create collaborative project proposals to address identified gaps in care to improve pediatric cancer outcomes in the region. NSPHO working close with SIOP Asia: SIOP Asia Congress was organized in Moscow in 2016. Second project is developing of Directory of Asian Societies and Foundations in the field of pediatric hematology and oncology. Russian-Vietnamese collaborative group in pediatric hematology and oncology was formed in November 2017 in Vietnam. Second meeting of this group is planned for April 2018. Outcomes: More than 5 collaborative projects will be discussed such as CIS cancer registries, collaborative multicentre protocols, educational outreach projects, etc. As the deliverables the plan to publish a special report as well as a resolution to the Ministries of Health of CIS region. SIOP Asia Congress in Moscow was one of the most successful, attracted 1000 participants from 40 different countries attended. New relations were started. Directory of Asian Societies and Foundations in the field of pediatric hematology and oncology includes information on more than 40 organizations. Printed version will be presented at SIOP 2018 Congress in Kyoto. Several collaborative projects discussed in Russian-Vietnamese group. A “memorandum of understanding” was signed as a part of this meeting. It was decided to continue a series of scientific meetings as a part of collaboration. What was learned: Only active international collaboration supported by healthcare professionals and governments could lead to strong improvement of outcomes of pediatric cancer care in all countries worldwide.
Breast Cancer Support Group at Ocean Road Cancer Institute in Dar es Salaam
Authors: Nyagabona S. , Rubagumya F. , Longombe A. , Manirakiza A. , Maniragaba T. , Lulabuka N. , Nguma I. , Mkuchika E. , Ngoma M. , Dharsee N.
Published: September 2018

Background and context: Breast cancer is a common type of cancer among women worldwide, with about 2 million new cases diagnosed in the yearly. It is the second common cancer and leading cause of cancer mortality among women in Tanzania, after cervical cancer. More than 70% of breast cancer patients in developed countries are diagnosed at early stages, whereas in low and middle-income countries, only 20%–60% of patients are diagnosed early. Physician in developed countries consults on average 15-20 breast cancer patients daily, while in developing countries the number triples. This high load does not allow a treating physician to spend ample time with patients explaining hence leaving patients not informed about their diagnosis, side effects of treatments and even living with the physical, emotional and psychological challenges of their disease. Residents at the Ocean Road Cancer Institute (ORCI), initiated a patient support group targeting breast cancer patients for feasibility. Aim: Provide forum for patients with same diagnosis to share common challenges Provide peer emotional, psychosocial support and cancer education Organize activities that will help to spread awareness to the community Initiate projects to improve socioeconomic status of breast cancer survivors in Tanzania Strategy/Tactics: Involved the ORCI administration from the beginning Involved the academic and research unit of ORCI Residents prepared session curriculum and teaching materials Sessions took place once a month Sessions were two hours long divided into three components, where the first is introduction of participants, then survivors led discussions or lectures prepared by an expert in the topic and lastly closing remarks by a physician Breakfast was provided Program/Policy process: Open membership for all breast cancer patients Physician lead face to face peer discussions Institutional acknowledgment of the support group Provision of primary registry of patients for follow-up Provision of a link to other social organizations Outcomes: Increase knowledge of cancer in general and breast cancer in particular A total of seven sessions were held to date For each session, participation ranged from 30-50 breast cancer survivors, and on average attendance was 4 sessions out of 7 Topics covered over a period of seven months included Coping with a cancer diagnosis and treatment Living with cancer and its changes to daily life Exercise Nutrition Breast cancer general knowledge Collaboration with other stake holders including IST secondary school students who initiated breast prosthesis knitting club What was learned: A need to reach out and give psycho-social support to ORCI patients Through education we can improve treatment adherence Possible partners are available if we reach out Exist a need to address misconceptions in the community so as to avoid stigma to patients.
The Symptom Experience of Jordanian Patients With Cancer
Authors: Omran S.
Published: September 2018

Background: An individual's symptom experience and ability to function in everyday life are increasingly being acknowledged as important health outcomes for individuals with cancer. Unrelieved symptoms continue to be prevalent and persistent among patients with cancer. Aim: The purpose of the study is to describe the symptom experience of Jordanian patients with cancer. Methods: A descriptive cross-sectional design and self-administered questionnaires was used to guide data collection from a convenience sample of Jordanian patients attending two hospitals for treatment of cancer or cancer symptoms. Jordanian adults with any cancer diagnosis documented in their medical record, being informed about her/his diagnosis, currently receiving cancer or supportive therapy will be enrolled in this study. Data were collected using the demographic and clinical characteristics data sheet, the Cancer Symptom Scale, and the Multidimensional Quality of Life Scale-Cancer. Demographic data will be analyzed using descriptive statistics. Results: The research questions will be analyzed using means, SDs, frequencies, and percentages. Analysis of results in progress. Conclusion: Knowing which symptoms are causing the most distress for patients will assist nurses in prioritizing their care and providing the much needed support and education for patients with cancer. Continued attention on treating these symptoms should be the focus of ongoing research as well as nursing education both in service areas and in schools of nursing.
Using Mass Media Communications to Promote Smoking Cessation in Turkey and Post-test Measurement
Authors: Durgut M.P.T.
Published: September 2018

Background and context: In 2017 March, Turkey has launched a public campaign to promote smoking cessation among adults. The purpose of the campaign is to create awareness about the risks and health effects of cigarette smoking and to promote behavioral change, based on health behavior model (HBM.) Aim: To encourage behavioral change by decreasing perceived benefits of smoking and increasing perception of threat related to smoking among the target audience. decreasing perception of barrier related to behavioral change and increase sense of self-efficacy among the target audience Strategy/Tactics: · Three television advertisements aiming to increase perceived threat of smoking and to increase perceived benefits of quitting · Two radio advertisements aiming to increase self-efficacy to quit, · Web portal ( birakabilirsin.org ) aiming to increase self-efficacy to quit Outcomes: After the ad campaign, a quantitative survey was carried out aiming to measure the attitude about the key messages of the campaign and intention to quit smoking. The survey was conducted in October-November 2017 and used the in-person household survey method to reach samples of current cigarette smokers, ex-smokers and nonsmokers in Turkey aged 18 years and above (planned sample size is 1700). According to the results of the postcampaign evaluation, the messages of the campaign were retained with a high 85.5% Nearly half of those saying they quit after the campaign started declared that the campaign was effective in helping them quit smoking. 48% of those quit said that the campaign helped them to not restart smoking. 80% of those who never smoked stated that the campaign decreased their desire to try smoking. Half of the survey participants heard of the campaign Web site 7% of the people who heard of the Web site visited it. 68% of the participants who visited the Web site believed that the Web site would help in quitting smoking. What was learned: The results of the postcampaign evaluation show that the campaign was successful in establishing perceived risk of smoking, changing perception and attitudes and developing the intention of quitting smoking among the target population. The campaign also helped people to actually quit smoking. The mandated free publication of antitobacco PSAs in all local and national channels according to the Turkish Tobacco Control Laws positively affected the public access of the campaign.
Saving Women's Lives From Cervical Cancer: Promoting a Cost-Effective Cervical Cancer Screening Tool in Rural Albania
Authors: Hylviu B. , Cekodhima G. , Rista M. , Shehu B. , Vandewiele M. , Huang Y.
Published: September 2018

Background and context: The WHO has presented that more than 90% of deaths from cervical cancer happened in low and middle-income countries. Albania is one of them. Albania has a national cervical cancer screening program. However, the program is not well-promoted and the service is not always available at the primary public health care level. The situation worsens when it comes to rural areas. In 2016, to bridge the gap and achieve health equity the Albanian Center for Population and Development (ACPD) initiated a series of activities to promote the utilization of visual inspection with acetic acid (VIA) and cryotherapy for the first time as a pilot study in rural Albania. ACPD sees this as a health priority to strengthen the existing national screening program through advocacy with the Ministry of Health and Social Protection (MoHSP). Aim: To enable VIA and cryotherapy provision in rural Albania to expand cervical cancer screening by advocating for its integration into the national cervical cancer screening program. Strategy/Tactics: The strategy applies a client-centered and bottom-up approach. The changes are driven through four sections, namely: context understanding, providers' engagement, partnership strengthening, and sustainability development (Fig 1). Program/Policy process: Following the proposed strategy, four main approaches were developed. · Demand generation: ACPD promoted relevant cervical cancer prevention and treatment information as well as redressed misconceptions through developing education materials and carrying out education sessions. · Provide services in rural settings: ACPD engaged different health providers into the VIA and cryotherapy training and institutional protocol development. · Collaborate with key stakeholders: ACPD worked closely with stakeholders, such as civil society organizations (CSOs), media, and health facilities. · Provide medical evidence to affect national policy-making processes: ACPD provided strong evidence to support the integration of VIA and cryotherapy into the existing cervical cancer screening program. Outcomes: In line with aforementioned process, the project succeeded to establish an effective model improve national cervical cancer screening program. All achievements and outcomes are summarized in Table 1. What was learned: The proposed strategy enabled VIA and cryotherapy in rural Albania. From clients' perspectives, this cost-effective cervical cancer screening tool is well-accepted, and most women were thrilled by the idea that the precancerous lesions could be screened and eliminated at the same visit. It is evident that ACPD distributed this desired service in rural Albania through collaborating with key stakeholders, including media, CSOs and public health facilities. ACPD still works on integrating VIA and cryotherapy into the national cancer screening program to reduce cervical cancer deaths.

[Figure: see text][Table: see text]
Effectiveness of the 'Oral Rub And Rinse Technique' As a Tool for Oral Cancer Screening in South Indian Population
Authors: D'Cruz A.
Published: September 2018

Background: Oral cancer is a public health problem and causing huge economic and a social burden. Early detection of oral potentially malignant disorders and oral cancers is very important in reducing the morbidity and mortality rates. Aim: To assess the effectiveness of the 'Oral Rub and Rinse Technique' as a tool for oral cancer screening among South Indian population. Methods: A population based, high risk targeted oral cancer screening was conducted in 2 districts of Karnataka, South India. About 523 subjects participated in the study. Data were collected regarding the sociodemographic details, history of tobacco use and knowledge regarding oral cancer. The participants were then screened for presence of oral premalignant/malignant lesions or conditions. Exfoliative cytology was done using traditional method and the 'Oral Rub and Rinse Technique' if red/white lesions were present. Smears were stained with Papanicolaou (PAP) stain and were evaluated by 2 cytopathologists independently. The data were tabulated and subjected to statistical analysis. Results: Of the 523 subjects, 112 had red/white lesions. Of these, 23% were Class I smears, 24% Class II smears, 31% Class III and 16% Class IV smears and 6% were unsatisfactory using the conventional technique whereas the Oral Rub and Rinse Technique showed 19% Class I smears, 28% Class II smears, 32% Class III smears, 17% Class IV smears and 4% unsatisfactory. The cellular quantity and quality in terms of clarity and dispersion was better with the smears prepared by the Oral Rub and Rinse Technique than the conventional technique. Conclusion: Oral Rub and Rinse Technique can be a reliable tool for population screening of oral cancer.
Breast Cancer Risk Perception of First Degree Female Relatives of Breast Cancer Patients Influences Their Risk Reduction Behaviors: A Pre-Study Assessment
Authors: Bary A. Derrick
Published: September 2018

Background: Breast cancer is the second most common cancer affecting women worldwide. There is an increased risk of breast cancer among the first degree relatives. Perceived risk relates to an individual's belief about the probability or likelihood of developing some specified illness. Cancer fatalism is the belief that cancer is predetermined, beyond individual control, and necessarily fatal. Aim: To assess the self-perceived risk of breast cancer and screening and risk reduction behaviors among the first degree female relatives of breast cancer patients. Findings from this study can inform interventions to increase uptake of breast cancer screening services among relatives of breast cancer patients in low- and middle-income countries (LMICs). The results formed a baseline for designing a study on risk perception and risk reduction practices among first degree female relatives of patients diagnosed with breast cancer at Uganda Cancer Institute, Kampala, Uganda. Methods: Review of literature on risk perception and risk reduction practices of first degree relatives of breast cancer patients. We searched through various literature published in PubMed and oncology journals in HINARI published in English. All the studies were conducted among female relatives of breast cancer patients from world. All eligible papers were included in the review. The papers were carefully appraised to identify key outcomes of the studies. Results: Women were engaged in risk reduction behaviors like smoking cessation, reduction in alcohol intake, physical activity and screening for breast cancer. Women aged 54 years and below had a higher perceived lifetime risk of breast cancer (39.5%) compared with those aged ≥ 55 years (30.6%) who perceived themselves at lower risk. Levels of education have also been found key in determining an individual's perceived risk. Being unrealistically optimistic was significantly associated with high level of educational attainment while women who did not know their risk were less educated. Socioeconomic status has also been seen to influence breast cancer perceived risk. Unrealistic pessimism was frequent among women with a higher income status although a greater proportion of women who accurately perceived their 5-year risk of breast had a higher annual income. There was a significant association of the stage of breast cancer, time since diagnosis and perceived breast cancer risk among the relatives. Fatalistic beliefs about cancer prevention influenced prevention behaviors by promoting a sense of external locus of control changing beliefs about the value of specific behaviors, or reducing self-efficacy and motivation to perform prevention behaviors. Conclusion: High risk perception is associated with increase need to engage in risk reduction behaviors. Fatalism among women was the primary reason not to engage in breast cancer screening.
Contribution and Influence of the Civil Society for the New Health Warning Label of Tobacco Products in Brazil
Authors: Marques de Pinho M. Coutinho , Perez C. Abreu , Vianna C. Galhardo Ferreira
Published: September 2018

Background and context: In April 2017, National Agency for Health Surveillance (Anvisa) launched a public consultation for the revision of Resolution Number 335/2003, on health warning labels. Aim: A group of representatives from civil society and tobacco control advocates in Brazil met in person and virtually to make contributions to the Anvisa´s proposal for new health warning label for tobacco products packages, considering the civil rights for participation and collaboration to Brazilian policies provided by public consultation. Strategy/Tactics: The advocates and researches consulted the Framework Convention on Tobacco Control of the World Health Organization and its Guideline for Article 11 (Packaging and Labeling of Tobacco Products) implementation adopted in 2008 based on scientific studies and successful experiences in other countries. In addition, international researchers and representatives of international institutions were also consulted to collect successful examples of health warnings in the world. Program/Policy process: In October 2017, the Anvisa Board of Directors at a public ordinary meeting approved the new health warnings and in December of the same year, published the new resolution about it. Outcomes: In a comparative analysis, even if all the recommendations made in the CP have not been complied with, the influence of the contributions of the group of tobacco control advocates to the final version of the warnings is evident. The main contributions considered by Anvisa were: 1) to increase the effectiveness of the health warnings using colored images instead of black and white images, 2) the use of yellow in the upper and lower tiers was also one of the points suggested by the group, and 3) the concept proposed by the group for side warnings was fully complied. What was learned: Civil society participation for the agency´s public policy implementation process is essential and has been possible through the regulatory agenda, public consultations and regular public meetings. However, as is expected, the regulated sector has been quite active. The group recognizes the importance of the Anvisa measure in proposing new health warnings, however, significant recommendations have not been adopted and it may interfere with the goals of the measure. Anvisa´s strategy of allowing the social participation is essential, in accordance with Universal Health System principles and must be maintained. Regarding to the next health warnings and messages on packages of tobacco products, it would be greater to consider higher frequency of updating the images and recover the scientific process of development of the 3rd round of health warnings labels coordinated by the National Institute of Cancer in 2007/2008.