bluuebunny/crossref_metadata_2025 huggingface dataset:
Continuous Medical Education in Pediatric Oncology As Successful Approach for Improvement of Early Diagnostics and Treatment
Authors: Serik G. , Kirgizov K. , Muftakhova G. , Kogan S. , Varfolomeeva S.
Published: September 2018

Background and context: Continuous medical education (CME) is very important in improvement of knowledge in all field of pediatrics. CME in pediatric oncology could be aimed both for oncologists and pediatricians. Aim: We aimed to organize CME system in the field of pediatric oncology for oncologists and pediatricians. Strategy/Tactics: Continuous education for improvement of knowledge for all pediatric oncologists and pediatricians based on Russian CME system. This system was organized by the Ministry of Health and National Medical Chamber and based on continuous work of professional medical societies. Each society could propose their educational activities and receive accreditation (participants receiving educational credits). Specialist required receiving education in pediatric oncology participating this system, obtaining credits and getting new knowledge. Program/Policy process: The National Society of Pediatric Hematologists and Oncologists (NSPHO) organized a system of educational seminars in pediatric oncology with CME status and approved credits in different regions of the Russian Federation. NSPHO organizing one seminar per month, 12 seminars per year. Each seminar has three major components: organization (meetings with governments of regions), education (lectures and discussions) and workshops. These seminars are free of charge for all regions and organized with the help of resources of NSPHO. A special report with recommendations for improvement of pediatric cancer care prepared after each seminar and transferred to the Government and Ministry of Health. NSPHO organized also online CME courses with accreditation. To estimate the effectiveness of seminars we are doing surveys and estimation of quality of cancer treatment. Outcomes: All 86 centers and departments of pediatric hematology/oncology in Russia participating this system. All members of NSPHO (about 1200 participants) are studied within the single educational program including governmental certification and Russian CME educational meetings/seminars as well as online CME seminars. CME education in pediatric hematology/oncology and immunology for pediatricians allowed studying more than 1000 specialists during 2017. Estimation by surveys and quality control showed high effectiveness of seminars in early diagnostics and treatment. What was learned: CME platform for online and off-line education in Russia developing rapidly. Nowadays we involved all Russian regions to this work. Results showed high effectiveness of this approach.
Public-Private Partnership in Oncology: An Approach to Address Shortage of Oncologists in Clinical Trials in Malaysia
Authors: Radi N. Mat , Audrey O.
Published: September 2018

Globally, the pipeline of oncology drugs in clinical development has seen a robust growth over the past decade. Oncology clinical trials remain the top 3 industry-sponsored trials in Malaysia for the last five years. To be successful in the development of new cancer therapies, sponsors and contract research organizations (CROs) need access to sufficient numbers of trained and interested investigators, besides highly trained staff and resources to offer those trials to patients. Unfortunately, in Malaysia, the number of oncologists stands between 105 and 110. About half of all oncologists are GCP certified, and from this, even a lesser number are found active in industry-sponsored research (ISR). A public–private partnership in oncology was initiated by the Ministry of Health, Malaysia, to address the shortage of oncologists at the public sector where most oncologists are saturated with clinical work and unable to take up oncology trials. At the same time, despite the majority of oncologists working in the private sector, their willingness to conduct clinical trials are hampered by difficulties in access to patients due to the fact that the pool of cancer patients is mostly concentrated in public hospitals. This paper describes the development and implementation of a public–private partnership in oncology to address the lack of uptake of industry-sponsored oncology clinical trials in the country by allowing oncologist from the private sector to tap into the patient pool of public hospitals. As part of this policy, a pilot project was initiated at three public hospitals to allow clinical specialists (e.g., hematologists, surgeons, gynae-oncologists) to collaborate with oncologists from the private sector in industry sponsored research.
Kick Out Cancer Campaign
Authors: Mohammed S. , Bagudu Z. , Aliyu A.
Published: September 2018

Amount raised: N17,307,000 Background and context: The power of games for social change is well documented. Football, the world's most popular game is a common passion shared by most Nigerians across all divides. It defies all barriers and unites people globally. Beyond the potential for cancer awareness creation using football games, it can also be used to raise funds for cancer course. Aim: The aim was to increase cancer awareness via community participation and involvement as well as raise funds for cancer patients. To encourage the population to engage in healthy lifestyles and physical activities in lowering the risks of cancer. Strategy/Tactics: We partnered with the League Management Company- Nigeria Professional Football League and the Nigerian Football Federation (NFF) for technical support to portray a tone of professionalism in our novelty football tournament. We worked a long side with expert active, retired, Nigerian and international professional footballers as well as artists to bring out in mass fans and the community at large toward achieving our goals. Radio and television jingles were made to ensure maximum reach out to the masses. Social media hype was done where some selected players called on to their fans to get involved. An awareness 5-km walk was organized where kits (T-shirts, face caps, wrist bands) were sold in addition to the tickets for the tournament. Footballers signed on various T-shirts which were auctioned during the tournament as well as arts and jewelry. Program process: Active and retired footballers were engaged as well as prominent local artist to bring out crowd in mass crowd that benefitted in this campaign. All transactions made were through the foundation's account for credibility. Costs and returns: Costs: media and logistics - N1,000,000, walk kits and jerseys - N1,500,000, food and refreshments - N1,300,000, security - N200,000, event planners - N300,000, kids corner - N500,000. Total N4,800,000 Returns: tickets and coupon sales - N1,057,000, walk kits sold - N 3,050,000, players registration - N200,000, teams registration - N4,000,000, stands sold - N250,000, auctioned art - 1,000,000, auctioned jerseys - N1,500,000, auctioned jewelry - 250,000, donations received - N10,800,000. Total N22,107,000 What was learned: A lot can be achieved collectively as a community in reducing the burden of costs in the treatment of cancer.
Epidemiology of Female Breast Cancer in West Jakarta, Indonesia
Authors: Agustina J. , Sinulingga D. , Suzanna E. , Andinata B. , Ramadhan R. , Kadir A.
Published: September 2018

Background: Breast cancer was the most common cancer in the world. GLOBOCAN 2012 estimated the incidence of female breast cancer in Indonesia was 40.3 per 100,000 and the mortality rate was 16.6 per 100,000. In 2016, Dharmais National Cancer Center was appointed as Regional Population Based Cancer Registry in West Jakarta. West Jakarta was a municipality with 2,281,945 populations, being the 2nd largest population in DKI Jakarta Province. Aim: This study was to evaluate the quality of population based cancer registry data and to describe the epidemiology of female breast cancer in West Jakarta, Indonesia during 2008-2012 and to compare with GLOBOCAN 2012 . Methods: We used population based cancer registry data with ICD - O code C50.0-C50.9 in female who live in West Jakarta. The population based cancer registry data were collected in Dharmais National Cancer Center. We evaluated the quality of population based cancer registry data based on WHO-IARC rules for cancer registry data. Results: The quality of population based cancer registry data were microscopic verification (70%); DCO percentage (20.8%), and unknown age (0%). The trend of female breast cancer was increasing during 2008-2012. Age-standardized rate incidence was 19.3 per 100,000. The most of frequent were in 45-49 years old, not other specific location subtopography (81.5%), the histopathology type was ductal and lobular neoplasm (51.8%), in stage III (44%), and with metastases to bone (34%). The average of length of duration was 29.1 months, most of them were unknown of last status contact (84%). Conclusion: The coverage and quality data of West Jakarta population based cancer registry need to be increased and establish a follow-up system to decrease the unknown last contact status of patients.
A Decade of Cervical Cancer Screening: Trends of Incidence in Zambia (2007-2017)
Authors: Matambo J. , Manasyan A. , Kapambwe S.
Published: September 2018

Background: Cervical cancer is a highly preventable disease and the major cause of cancer related illness and deaths in Africa. Cervical cancer screening to find precancers before becoming invasive cancer is a well-proven way to prevent cervical cancer. In Zambia alone, over 2000 cervical cancer cases are diagnosed each year accounting for over 30% of new cancer cases with a mortality of above 35%. Women access screening services regardless of HIV status as long as they are sexually active. Cervical cancer screening for HIV-positive women in Zambia remains low despite the high burden of the disease among this population. Aim: We aimed to determine the trends of incidence of cervical precancer lesions among women who ever presented for screening in Lusaka. Methods: We conducted a retrospective cohort study of 95,520 women who presented for cervical cancer screening between 2007 and 2017 at 11 Lusaka district clinics that provide cervical cancer screening. Data were merged from these clinics and cleaned. Descriptive analyses and Logistic regression for data analysis was conducted. Results: The study showed that the mean age of screening among women that were HIV negative and HIV-positive was 34 years. About 12% of the women that screened had a positive VIA result from which 59% were HIV-positive. Results also showed the odds of 4 to be VIA positive when one is HIV-positive. Conclusion: We have data to show that there is an increased risk among HIV-positive women to be VIA positive in Zambia. HIV infected women should be targeted as priority for cervical cancer screening especially in the resource limited countries. Resources directed to HIV care programs in these settings should be leveraged and include cervical cancer screening.
Treatment of Tobacco Dependence Syndrome in Cancer Patients
Authors: Przepiórka I. , Cedzyńska M. , Koczkodaj P. , Mańczuk M.
Published: September 2018

Background: The treatment of tobacco dependence is still not included in routine cancer care in Poland. We have developed a comprehensive program aimed at introducing tobacco dependence treatment as a standard procedure of cancer treatment. The pilot program was implemented in 2015 in two Polish cities: in Maria Sklodowska-Curie Institute - Oncology Center in Warsaw and in Oncology Centre in Bialystok. After two years we started follow-up of the program. Aim: To present the results of conducted follow-up study of the treatment of tobacco dependence pilot program in Poland. Methods: The pilot smoking cessation program was implemented in 2015. Tobacco dependent patients treated in the Maria Sklodowska-Curie Institute- Oncology Center in Warsaw and Oncology Center in Bialystok participated in course of medical and psychological counseling in smoking cessation clinic and through telephone support sessions. After two years we have conducted follow-up. We reached follow-up rate of 77%. Followed-up patients were asked about behavioral changes concerning smoking and main motivation to quit smoking. The data concerning smoking cessation were collected during telephone sessions. Based on that we analyzed indicators of treatment effectiveness. Results: In pilot program 87% of participating patients implemented a behavioral change, 70% of participating patients made a quit attempt, 55% reduced smoking, and 35% stopped smoking completely after intervention. After two years 30% of participating patients are not smoking and 40% reduced smoking. 85% of patients, who have maintained the behavioral change have used a pharmacological treatment and participated in all of available procedures (medical advices, psychological counseling sessions and telephone support sessions). As main motivation for quitting, 90% patients declared state of health (including cancer diagnosis) and pressure of family members (65%). Conclusion: High percentage of cancer patients who have reduced the number of smoked cigarettes or stopped smoking indicates that specialist support increases chance to make positive behavioral changes, or even stop smoking completely. The results of the study show that cancer diagnoses can be a very teachable moment, and it is recommended that health care providers use this opportunity and offer smoking cessation help to their patients.
Cancer Prevention and Control Through Advocacy on Tobacco Control, Cancer Control by Focusing on Primary and Secondary Prevention on Cancer
Authors: Gupta P.
Published: September 2018

Background and context: Cancer Aid Society an ISO 9001 national level social organization working since 1987 for control and prevention of cancer. I am connected with this society from nine years and helping society to reaching his goal to improve the qualities of life of peoples. We are addressing on healthy lifestyle, tobacco abuse, active and passive smoking etc. Our society is working at community level by generating awareness among masses, crowd for the prevention of cancer. As we know cancer is the second biggest killer disease after heart attack and death due to cancer are almost five times more than AIDS. Aim: “Your health is our concern” is our mission and “Quality in cancer control” is our vision. So we are going to community level school, colleges, malls, offices aware peoples for the prevention of cancer. We are also working for palliative care for improving quality of life of cancer patients. Palliative care is care for uncared. We are also covering all the factors of palliative care but mostly focuses on spirituality. Strategy/Tactics: We have eight branches all our the country at Ahmedabad, Bangalore, Chennai, Delhi, Hyderabd, Lucknow, Mumbai, Kolkata these all are the metro cities of India and in branch we have minimum three social workers who all are covering the near by states so it shows our national presence. Having offices and accommodation in these cities save cost of hotels for stay. So in this way we are covering the whole country. Program/Policy process: We allot the areas to each social worker which they have to covered in the given time. In the month mostly minimum each social worker is doing 10 workshops which is organizing free of cost without any charges from institutions. We visit the institution and taking permission from head for conducting cancer awareness workshop. Outcomes: Personally in my nine years of working I have explored more than 24 states of India in which each year I have address more than 1 lac peoples for cancer prevention. Until now I have covered more than 500 institutions in the country and conducted the workshops. And declared more than 800 institutions tobacco free zone under COTPA ACT made by government of India. What was learned: In my work the thing only I learned is serving humanity is a service to God. So I am working for prevention of cancer I feel lucky that Cancer Aid Society give me opportunity for serving society.
Cervical Cancer: What Vaccine in Senegal?
Authors: Soumboundou M. , Thiam I. , Doh K. , Woto-Gaye G.
Published: September 2018

Introduction: Cervical cancer (CC) is first cancer in terms of frequency and mortality among women in Senegal. This is a public health problem hence the urgency of preventive measures including vaccination. The choice of the vaccine cannot be made on strictly financial factors, nor on the results of the others studies, but should take into account the prevalence and distribution of HPV in the CC in Senegal. We conducted this study with the aim of determining the distribution of the genotype of the different types of HPV found in the CC in Senegal and propose a vaccine for Senegal. Methods: It was a retrospective and descriptive study carried out in cooperation with the molecular and radiobiology institute of Lyon. Sixty paraffin-embedded tissue blocks were chosen by a simple random method on 1015 blocks of CC diagnosed in pathology laboratories of public hospitals of Senegal. In Lyon, the total DNA of the tumor genome was extracted and amplified according to the multiplex PCR technique using primers MY09-MY11, GP5 + and GP6 +. β-globin was used as an internal control. Results: Of the 60 paraffin blocks examined, DNA extraction was unsatisfactory in 4 cases. HPV-HR infection was present in all other tumors. It was a monoinfection in 33 cases (59%) and a multi-infection in 23 cases (41%). In total, of the 56 validated cases, 89 HPV-HR were identified by the PCR-multiplex technique. HPV 16 and 18 accounted for about 70% of all HPV implicated in the CC in Senegal. The other HPV types found are HPV 45 (9), HPV 35 (5), HPV 58 (5), HPV 39 (3), HPV 66 (2), and one case of HPV 31, 33, 51, 59, 68. In 51 patients (91.1%), HPV 16 or 18 was at least one of the viruses involved. Conclusion: The involvement of HPV in CC was first reported by German virologist Harold Zur Hausen in 1980. Several studies have subsequently corroborated this association by finding a stronger binding of HPV to CC than that of tobacco to lung cancer. In 1996, the WHO recognized HPV-HR as the leading cause of CC. There is a variable distribution of HPV in the literature according to geographical and ethnic criteria. In Senegal, as almost everywhere else, HPV 16 and to a lesser degree HPV 18 represent the two major viruses involved in carcinogenesis of the cervix. Of twelve identified viral genotypes, HPV 16 and HPV 18 account for nearly 70% of viral infections and are involved in more than 90% of CC cases. At present, there are three types of vaccines: Cervarix (HPV 16, 18), Gardasil (HPV 6, 11, 16, 18) and Gardasil 9 (HPV 6, 11, 16, 18, 31, 33, 45, 52, 58). The authors recommend the use of Cervarix in the cancer plan of Senegal. They also advise a better sexual education to control the infection and especially the multi-infection found in 40% in the CC in Senegal. Finally, they emphasize that vaccination is not exclusive of screening but rather should accompany it.
Women's Cancers: Prospects for a World-Wide High-Resolution Study Targeted to Cancer Control
Authors: Allemani C.
Published: September 2018

Background: Breast, ovarian and cervical cancers are a major public health problem world-wide. CONCORD-3 has updated cancer survival trends to 2014 for 18 malignancies, including breast (women), cervix and ovary (15-99 years). World-wide differences in survival from these cancers are striking. Inequalities in survival also exist between and within high-income countries. Aim: The aim is to assess the extent to which variations in the patterns of care explain the world-wide inequalities in survival and the number of avoidable premature deaths. Methods: The CONCORD-3 database includes incidence and follow-up data from 322 population-based registries in 71 countries for 37,513,025 patients diagnosed with one of 18 malignancies during the 15 years 2000-2014, including 7,948,798 women diagnosed with a cancer of the breast, cervix or ovary. I propose to enhance the CONCORD database: 1) by collecting and analyzing detailed data from the medical records (e.g., stage at diagnosis, staging procedures, first course of treatment and, where available, prognostic biomarkers) of women diagnosed with breast, ovarian or cervical cancer in at least two countries per continent, in the most recent year during 2010-2014 for which data are available. 2) by estimating the number of avoidable premature deaths that are attributable to inequalities in five-year survival between and within countries. Results: I will present the protocol for data collection and analysis for discussion. This will include plans for a pilot study to assess the availability of high-resolution data world-wide. Conclusion: The UICC World Cancer Congress will be an ideal platform to discuss and refine the study design with cancer registry colleagues and experts in cancer control and public health from 150 countries. The insights from this project will contribute to the planning and implementation of cancer control strategies for women's cancers.
Tobacco Control Gateway to Public Health
Authors: Suuna P.
Published: September 2018

Background and context: There are several individuals or groups who have high public profiles and can reach out easily to different audiences. These were mobilized as champions and they helped spread the word on the TC Act hence pushing for its implementation. The main aim was to equip them with the relevant information and understanding of the TC Act. These are important because they make or influence decisions on what goes on in the respective media houses. It is important that they appreciate reasons for supporting the implementation of the TC Act. Aim: Engage media managers and TC champions to understand the TC law provisions and support efforts to publicize it. This will be through one-on-one meetings with editors, producers and talk show anchors as well as facilitating TC champion activities Strategy/Tactics: This was achieved through one on one meetings and media champions community excursions. Program/Policy process: UHCA has for the last three years has been at the forefront of engaging the media to advocate and create public awareness and support for the tobacco control agenda in Uganda and the TC Bill in particular. We have equipped and facilitated monthly interactive dialogues on TC, equipped and deployed media fellows and authored resources and tools for TC communication. We are part of the Tripartite Consortium that won the bid advertised by the World Health Organization to host the Centre for Tobacco Control in Africa (CTCA), which is championing efforts to put in place policies and laws as well as support implementation of existing legislation on tobacco control in five African countries. Outcomes: At least 20 editors, producers and media managers informed on the key provisions of the TC law through 10 one-on-one meetings At least two champions (groups or individuals) actively engaged in TC law awareness and promotion activities At least four talk-shows What was learned: Engaging the information gatekeepers (editors and producers) as well as influential persons in the public is one of the ways to make tobacco control popular among the local community.
European Code Against Cancer (ECAC): Actions Taken by Polish ECAC Youth Ambassador
Authors: Koczkodaj P.
Published: September 2018

Background and context: European Code Against Cancer (ECAC) is an initiative of the European Commission aims to inform citizens about actions possible to take to decrease cancer risk. Current - 4th issue - of the ECAC contains 12 recommendations which can be implemented in daily life without any specific skills or advices. It is estimated that more than 50% of all cancer deaths in Europe could be prevented if every person would follow ECAC recommendations. So as to promote ECAC recommendations, Association of European Cancer Leagues - ECL created in 2015 Youth Ambassadors Program which brought together young people (18-35 y.o.) from more than 20 European countries to support ECAC dissemination in each country represented by youth ambassadors chosen in competitive process. In Poland, actions coordinated by ECAC Youth Ambassador (YA) - Pawel Koczkodaj - has been taken since 2017. Aim: To promote recommendations of the European Code Against Cancer, and raise its visibility in Poland. Strategy/Tactics: Accordingly to ECL data, 21% of people in Poland in 2017 have heard about ECAC. In comparison with 2015, there is an increase of awareness on ECAC existence - 13% in 2015, but this result is still not rewarding. Moreover, same knowledge is not enough - to reduce cancer risk, it is crucial to convince people to modify their behaviors and attitudes. Therefore, to achieve this goal, a brochure “12 sposobow na zdrowie” (12 ways to health) with ECAC recommendations in Polish language has been developed. This brochure in a simple words describes what to do to limit cancer risk. Additionally, Polish ECAC YA has developed strategy for promotion of this publication and performed its implementation. Program/Policy process: In developed strategy a wide variety of actions have been planned and performed so far. In planning process these actions were divided into two basic groups: education (lectures, seminars, nationwide brochure shipment, conferences) and promotion (media activities - nationwide TV and radio interviews, social media). All of these activities were scheduled and performed after SWOT analyze since July 2017 (strategy is still ongoing). Outcomes: With highly limited financial resources a large-scale educational and promotional action about ECAC recommendations was successfully planned, initiated and performed. What was learned: There is a need of constant actions aiming education about primary cancer prevention in Poland, especially among teenagers and young adults. Experience from meetings with these young people show that a lot of them have insufficient knowledge or misconceptions about primary cancer prevention - for example about HPV vaccinations. ECAC YAs concept turned out as a complex, efficient tool in promoting ECAC recommendations in Poland, which could be worth to spread to other, not only European countries.
Bowel Cancer Screening Participation in Rural Tasmania: A Comparative Case Study of Four Local Government Areas
Authors: Cooper A. , Lee S. , Barnett T.
Published: September 2018

Background: Bowel cancer is a preventable condition, yet it is the second most common cancer after prostate cancer, with one in 12 Australians developing the disease by age 85. If detected early, the chances of survival are very high. One way to detect bowel cancer before it becomes a problem is through the use of a screening kit. The Australian government has distributed free kits to specific age groups since 2006, through their National Bowel Cancer Screening Program (NBCSP). Participation in the NBCSP is currently quite low (39% Australia-wide). In Tasmania, participation rates among local government areas (LGAs) range from 28% to 47%. These differences in participation are especially apparent in rural and remote areas and form the focus of this research. Aim: Our research aims to determine why there are marked differences in National Bowel Cancer Screening Program participation rates between rural LGAs in Tasmania. Secondary aims include developing future strategies for increased screening uptake in rural Tasmania. Method: A total of four LGAs, identified as having either high (n=2) or low (n=2) NBCSP participation rates, were included in the study. Face to face interviews with community members and stakeholders across the four LGAs were recorded and transcribed to obtain qualitative data. A total of 50 male and female community members aged 50-75 were recruited and interviewed regardless of whether they had used the NBCSP kit. A total of 28 health professionals including doctors, pharmacists, nurses and health promotion officers, working in each of the four LGAs were also interviewed. All interviews were recorded and transcribed. Thematic analysis was conducted to elucidate common barriers and enablers for screening, as well as suggestions for increasing NBCSP participation rates in Tasmania. Demographic data including age, gender, and educational attainment were collected from community members to further identify potential associations with screening participation. Results: All interviews have been successfully completed and transcribed, and thematic analysis has begun. Themes emerging from the data to date include the importance of community connectedness; the role of women in encouraging men to screen; health literacy; new/transient versus established/stable communities; and access to follow-up colonoscopies. Final results will be available shortly and presented in full. Conclusion: The findings from this study will highlight differences and reasons for screening participation in four rural Tasmanian LGAs. The results will have implications for the NBCSP in terms of recommendations for increasing participation in the program.
BWS Effort in Cancer Screening in Rural Communities
Authors: Lasebikan A. , Nnamani A. , Iloanusi N. , Okoye I. , Okwuosa C. , Ezeilo L. , Mba I.
Published: September 2018

Background and context: Nigeria, being the most populous African country has the highest cancer burden. Most of the population reside in rural areas where there are no functional health centers. Life in these communities is marked by profound ignorance, superstition and stigma, concerning cancers. There is no cancer control plan in place in the country. Aim: BWS aims at increasing awareness of the need for prevention and early detection of cancers. Strategy/Tactics: Three-pronged approach of education, screening and vaccination, with navigation where required. Monthly education and cancer screening in rural communities. Provision of a navigation system of medical follow-up for patients with a positive screening result; establishing treatment and support care for patients and recruiting and training volunteers and local advocates for cancer awareness campaigns. Program/Policy process: Monthly education/enlightenment activities in various rural communities in southeast Nigeria. Dissemination of information on screening activities is done via church and other community groups; town criers, WhatsApp, radio and banners at strategic locations. Outcomes: A total of 1990 participants (1388 females and 602 males) were screened from January 2016 to December 2017. 1342 women had CBE, 96 were referred for mammography. 105 out 1041 females who had VIA with colposcopy were positive and 26 of them had cryotherapy. 426 girls and young women (9-26 years) received HPV vaccination. 12 out of 204 men who had PSA tests were positive and referred to urologists. Since the launch of project Rid Nigeria of Late Cancer Detection in 2016, BWS has acquired a physical infrastructure for daily screening and continued her monthly rural screening services. What was learned: Women need to take permission from their husbands to even get screened, therefore involvement of traditional rulers, local government chairmen, opinion molders, leaders of faith-based organizations, and local cancer advocates from the community, is helping to increase awareness and reduce stigmatization. Taking the screening to the community is helping combat “late presentation syndrome”. However, financing rural awareness and screening is quite a challenge without financial support.
A Longitudinal Follow-up Study on Factors Associated With Smoking Relapse Among Adolescent Quitline Users in Korea
Authors: Thao T. Thi Phuong , Park E. , Shin S. Hwa , Lim M. Kyung
Published: September 2018

Background: Smoking among adolescent is one of the biggest alarming issues in tobacco control. Although smoking cessation interventions for adolescents have been implemented, 92% would be relapsed within one year. However, the information on factors associated with smoking relapse is insufficient among adolescents, although it looks necessary for understanding smoking behaviors of adolescents and applying more effective intervention program for them. Korea is one of the country having the highest adolescent smoking prevalence (9.6% in boys and 2.7% in girls aged 19 years or less) and in lack of information on smoking behaviors and factors associated with relapse or successful quit. Telephone-based cessation service (hereafter Quitline) has been available since 2006 regarding the confidentiality and accessibility of adolescent smokers and it has followed-up abstinence of users with intensive counseling for 1 year. Therefore, analysis on the adolescent smokers who used Quitline might be meaningful to understand adolescents' cessation behaviors and factors associated with. Aim: To identify the factors associated with smoking relapse among adolescent Quitline users in Korea. Methods: 2141 (1370 boys and 394 girls) adolescent smokers who registered at Quitline in Korea from January 2007 to December 2017 and attempted quit were included in the current study. The baseline information on sociodemographic characteristics, smoking and other health behaviors, nicotine dependency, and motivational factors for quit were collected. Cessation outcome and reason of relapse were identified during the 1 year follow-up of each individual. Multivariate logistic regression was performed to identify associated factors of smoking relapse. Results: The analysis on the data are undergoing and the result would be suggested in the conference with the further analysis. Conclusion: It will be suggested in the conference.
Educational Preparation and Perceived Proficiency of Nurses Working in Oncology Units at the University College Hospital, Ibadan, Nigeria
Authors: Oluwatosin O.A. , Fadodun O. , Brown V. , Aluko J.
Published: September 2018

Background: Cancer is a malignant pathologic disorder, which poses a global threat to the health and survival of an individual, both young and old. Globally, nurses are considered very vital in all aspects of cancer control due to their impact on the quality of care outcomes which is greatly influenced by specialized training in oncology nursing. However, in Nigeria and some parts of Africa, there is dearth of information and documentation on the nurses' educational preparation and proficiency of nurses in delivery of oncology care. Aim: This study assessed educational preparation and perceived proficiency of nurses working in oncology units at University College Hospital, Ibadan to provide information oncology nursing training of these nurses as well as their perceived proficiency. Methods: The study used a descriptive cross-sectional design. Permission and clearance were obtained from the Joint University of Ibadan/UCH ethical review committee and subsequently head nurses in each unit and the nurses that participated. A purposive sampling method was used for selection of participants and a structured questionnaire with reliability coefficient value of 0.94 was used for data collection. Data were entered using SPSS version 20 and data analysis was done using descriptive and inferential statistics. Results: A total of 104 nurses working in oncology units fully participated in the study. For age, mean ± SD was 35 years ± 6. 54.4% of respondents had diploma professional training in general nursing as their highest level of education. Most of the respondents 88.5% did not have certification in oncology nursing, 77.9% had no form of specialized training in oncology care. The only exposure to oncology nursing training for most of the participants was during their basic training in nursing and midwifery schools but duration of exposure could not be ascertained. Most 64.4% of respondents felt their exposure to oncology nursing care wasn't adequate. 62.7% affirmed there was no educational institution that caters for specialized oncology training in their locality. However, 55.8% of the respondents considered themselves as highly proficient in giving oncology care. There was no statistically significant association between years of experience in oncology care and perceived proficiency χ2 value χ2 = 3.05, pv = 0.11. Conclusion: This findings revealed the training in oncology nursing among nurses is not adequate as the only oncology nursing training exposure was at the basic nursing schools. Hence the need to establish oncology nursing training programs for nurses in cancer care in Nigeria. This will go a long way to influence cancer control.
An Evidence-Based National Cancer Control Program (NCCP) Quality Assessment Checklist
Authors: Yap M.L. , Oar A. , Moraes F.Y. , Ilbawi A.
Published: September 2018

Background: The 2017 World Health Assembly resolution on cancer (WHA70.12) defined a key action for governments to be the implementation of a national cancer control plan (NCCP) with a focus on equity and access. A survey of member states performed in 2015 by WHO found that 87% of countries have NCCPs but only 68% are operational. There are limited data analyzing the quality of NCCPs and an evidence-based 'best practice' appraisal tool is lacking. Aim: We formulated an evidence-based comprehensive checklist for the critical appraisal of an NCCP, for potential application for countries across all continents and income classifications. Methods: An extensive literature review was performed to identify previous publications used to advise on or assess NCCPs. Each article was reviewed by three investigators and potential quality items were created to form the preliminary checklist. Items were ranked according to the frequency of appearance in the identified publications, then further refined by an expert panel of global cancer partners including NCCP researchers, civil society, NGOs and technical content experts. Checklist items were categorized to ensure comprehensiveness across both the cancer continuum and health systems building blocks. Multiple choice answers for checklist items were created to allow ease of use and reproducibility. Concordance between multiple reviewers was assessed to confirm precision of the appraisal. Results: Twelve publications/documents which advise on NCCP design were identified in the literature. From these, 65 checklist items were identified and included in the tool; each item was present in a median of 2 publications (range 1-8). An additional 13 items which were absent from the twelve documents were added, as the authors and the expert panel viewed these to be important in appraising an NCCP. This gave a total of 78 check list items for quality assessment, grouped in the following categories: (1) General overview; (2) Prevention; (3) Diagnosis, staging and screening; (4) Treatment (5) Service delivery (6) Governance; (7) Health workforce; (8) Health information systems; (9) Research; (10) Finance and (11) Overall summary. The checklist was refined for clarification of language and content after trialing the draft tool for current NCCPs from ten countries. A final validation was performed on six additional countries that demonstrated strong concordance between reviewers, no further changes were made. The final checklist also allows for non-communicable disease (NCD) plans to be appraised as part of cancer policy review in each country. Conclusion: We have developed a comprehensive tool for the quality assessment of NCCPs. An appraisal of all available NCCPs globally is currently underway using this recently-formed check-list. This tool can also potentially be used by governments, policy makers and stakeholders as a 'best practice' guide when formulating and/or updating their country's NCCP.
Motivations for Current E-Cigarette Use Among Adult Smokers in Malaysia
Authors: Ruzlin A.N. Mat , Omar M. , Yong H.-H. , Tangiisuran B. , Rani N.A. Abdul , Samin A.S. Mohd , Quah A.C. , Baharom N. , Driezen P.
Published: September 2018

Background: Recommendations from WHO regarding the comprehensive ban on tobacco advertisements, promotions and scholarships (TAPS) have recently caused tobacco companies in shifting their market strategies to focus on promoting unregulated devices such as electronic cigarettes (ECs) and vapes. Aim: This study aims to explore the motivations of EC use among dual users and its associations with sociodemographic factors and smoking related characteristics under different regulatory environments in Malaysia. Methods: A total of 5823 dual users was collected using a multistage sampling study design. Data collection was conducted through intercept face-to-face interviews within 3 waves; wave 1 (May-September 2016), wave 2 (December 2016 - April 2017) and wave 3 (May-August 2017). The samples were drawn from 5 streets randomly (two in hotspot and three in nonhotspot locations) within stratified urban and rural areas in 14 states of Malaysia. Every fifth person passing an interview station in each street was approached. All statistical tests were conducted using PASW 18. Results: The top four self-reported motivations of using EC by dual users included “tasted better than conventional cigarettes” (85.1%), “to reduce the number of cigarettes smoked” (72.9%), “to quit smoking” (63.5%) and “increase price of cigarette taxes” (62.9%). Based on a multivariate analysis, respondents from states that have no current restrictions toward the sale and usage of ECs and who use ECs less than weekly (Adj.OR=2.54; 95% CI=1.93-3.34), weekly (Adj.OR=2.22; 95% CI=1.72-2.85) and daily users (Adj.OR= 1.77; 95% CI=1.36-2.31) were more likely to use ECs due to its better taste as compared with those who use ECs less than once a month. In states that have banned the sales and usage of ECs, there was a significant association between daily users of ECs and the four primary motivations. It was found that an increasing amount of cigarettes smoked per day (Adj.OR=2.46; 95% CI=1.59-3.81) had significantly influenced smokers in these states to more likely use ECs due to the increase price of cigarette tax. Conclusion: This study was conducted to show associations between smoking characteristics, EC use and self-reported motivations under different regulatory environments in Malaysia. Frequency of EC use was significantly associated with these self-reported motivations. Further research should be conducted to monitor EC use by Malaysians as well as to contribute to the formulation of EC policy in Malaysia.
Clinicopathological Criteria and Prognostic Factors in Gastric Adenocarcinoma in Kuwait
Authors: Al-Saleh K. , El-Sherify M. , Bedair A. , Nazmy N. , Elbasmi A. , Hussein A. , Shete J. , Omar M. , Mostafa A.
Published: September 2018

Background: Gastric cancer is the 5th most common cancer in the world and 2nd leading cause of cancer deaths. It has marked geographic incidence variation. Most common in Japan, China, other East Asian countries, Eastern Europe and South America. There is sharp decrease in incidence in western countries over the past 60 years but incidence of GE junction and proximal gastric tumors is increasing. In state of Kuwait in 2012 ASR was 2.6/100,000 population (similar to other Gulf countries; apart from Oman). There are many known risk factors including eating smoked and salted food and H. pylori infection. Aim: The aim of this study is to analyze gastric cancer diagnosed cases from 2009 to 2015 in Kuwait and to analyze clinicopathological criteria and prognostic factors. Methods: A total of 145 adult patients with newly diagnosed gastric cancers were treated and followed-up at Kuwait Cancer Control Center (KCCC) between 2009-2015. Patients' data were examined retrospectively. In all cases: age, performance status, sex, ethnicity, smoking and dietary habit, tumor site, pathology, staging and type of treatment were identified. Survival analysis was done using Kaplan-Meier, and comparison was done using long-rank test. Results: The median age at diagnosis was 54 (29-94). Men represented 63.5%. 75.2% had adenocarcinoma, 14.5% gastric lymphoma, 6.2% GIST, 3.4% carcinoid and 1 case squamous cell carcinoma. For gastric adenocarcinoma, 22 were metastatic (20.2%). In spite of composing almost 25% of country population and expected high incidence in their home countries, only 19.5% of patients were Asian with known habit of spicy food intake. 31% of patients were smokers. Performance at diagnosis was ECOG 0-1 in majority. Median follow-up was 45 months (1-89) and median overall survival was 34 months (0.5-89). Almost half of tumors were poorly differentiated with signet-ring feature in 36.8%. 12.6% presented with clinically advanced tumor but after surgery the number upstaged to be 25.9% (Stage III). Tumor epicenter localization was almost equivalent with 43 (49.4%) localized proximally and 44 (50.6%) distally. Surgery was the main treatment in majority (85.1%) while radiation was used in 58.6% and chemotherapy in 74.4% (adjuvant, neoadjuvant or concomitant). 22 patients failed; 7 locoregionally, 15 had distant metastasis while 2 patients failed both locally and distantly. Close surgical margins, and proximal localization were poor prognostic factors. Age and ethnicity had no impact on outcomes in our cohort. Conclusion: Gastric adenocarcinoma in Kuwait has similar profile to that documented worldwide and regionally (apart from Oman). Proximal tumors represent a challenge and has poorer prognosis that may need more intensification of treatment. Current (neo)adjuvant treatment seem to be effective in our population. Molecular profiling and studies are needed for further understanding of this potentially curable disease.
Combination of Cytopathology and DNA Ploidy Increases the Performance of Oral Epithelial Dysplasia Prediction in Oral Potentially Malignant Disorders
Authors: Karim Z.B.A. , Kallarakkal T.G. , Amtha R. , Guledgud M.V. , Telang A. , Ramanathan A. , Zaini Z. , Gunardi I. , Telang L.A. , Yang Y.H. , Patil K. , Doddawad V.G. , Kamaraj L. , Saikrishna D. , Warnakulasuriya S. , Zain R.B.
Published: September 2018

Background: Grading of oral epithelial dysplasia (OED) by a pathologist is currently the key guide used for treatment planning of oral potentially malignant disorders (OPMDs). Conventional oral examination (COE) clinically detects OPMDs but may not predict their risk status to transform to cancer. Therefore, there is a need for a reliable test to predict OED in OPMDs. Aim: This study was conducted to evaluate COE, liquid based cytology (Cytopath) and DNA image cytometry (Ploidy) in predicting OED in OPMDs. Methods: A total of 179 patients from Malaysia, India and Indonesia underwent COE followed by brush biopsies and scalpel biopsies. Brush-biopsy samples were analyzed for cytopathology and DNA ploidy at Dental Faculty, University of Malaya. Histopathological findings of presence/absence of OED were used as the reference standard. Calculations for sensitivity (Sn), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV) and accuracy (A) were done for individual tools and in combinations. The Youden index (Sn+Sp-1) was used as a measure of overall performance. The relevant medical ethics committees of the different research locations approved the study. Results: For COE, the sensitivity (Sn) was high (100%) and the specificity (Sp) was low (5.9%), while both Cytopath and Ploidy showed a low sensitivity (Sn) (28.6% and 22.2%) and high specificity (Sp) (94.3% and 82.3%). All 3 tools individually have high negative predictive value (NPV) for predicting presence of OED (COE-100%, Cytopath-66.7%, Ploidy-78.5%). When combining outcomes from all 3 tools, the best performance indicated by Youden index (42.1) is which defines a positive case when both COE and Cytopath show abnormal. In general, using results from at least 2 tools had better Youden indices than using these tools individually. Conclusion: COE as a screening tool by virtue of its high Sn would be a suitable first level diagnostic test, while the Cytopath and the Ploidy individually with high Sp may be used as a second level test to predict presence of OED. Combining the COE with cytopathology would be the best combination for a high performance of the tools. Cytopathology (when performed by a trained cytologist) would allow for most of the false positives from the first level test to be correctly identified as true negative at the second level. Longitudinal data are needed to assess which of these may correctly identify the malignant potential of OPMDs. Acknowledgment: Grant: High Impact Research - Ministry of Higher Education (HIR-MOHE UM000025/C3)