Association between Echinococcus granulosus infection and cancer risk - a pilot study in Cyprus.

BACKGROUND: Infections from microorganisms and parasites have been connected with either increased or decreased cancer risk. The objective of this study was to investigate whether infection by Echinococcus granulosus is associated with cancer risk. METHODS: We assembled a pilot retrospective cohort of patients who were diagnosed as being infected by E. granulosus in Cyprus between 1930 and 2011. Age/gender-matched non-infected family members and neighbors were selected as references. Medical history was ascertained from each study subject through in-person interview. Cox proportional hazards regression analysis was performed to assess the association of being infected by E. granulosus with cancer risk. RESULTS: Individuals with prior infection by E. granulosus (n=249) were more likely to have cancer compared to those without infection (n=753), 11.65% vs. 8.37% (p=0.0492). Survival analysis also showed that subjects with prior infection had a higher risk for developing cancer. The hazards ratio (HR) was 1.595, [95% confidence interval (CI) between 1.008 and 2.525]. The risk ratio did not change significantly (HR=1.536; 95% CI: 0.965-2.445) after adjusting for gender, year of birth, smoking status, alcohol consumption, and family history of cancer. CONCLUSIONS: Our study suggests that infection by E. granulosus may increase cancer risk. If this observation can be confirmed independently, further investigation of the mechanisms underlying the association is warranted.

i-Motif DNA: structure, stability and targeting with ligands.

i-Motifs are four-stranded DNA secondary structures which can form in sequences rich in cytosine. Stabilised by acidic conditions, they are comprised of two parallel-stranded DNA duplexes held together in an antiparallel orientation by intercalated, cytosine-cytosine(+) base pairs. By virtue of their pH dependent folding, i-motif forming DNA sequences have been used extensively as pH switches for applications in nanotechnology. Initially, i-motifs were thought to be unstable at physiological pH, which precluded substantial biological investigation. However, recent advances have shown that this is not always the case and that i-motif stability is highly dependent on factors such as sequence and environmental conditions. In this review, we discuss some of the different i-motif structures investigated to date and the factors which affect their topology, stability and dynamics. Ligands which can interact with these structures are necessary to aid investigations into the potential biological functions of i-motif DNA and herein we review the existing i-motif ligands and give our perspective on the associated challenges with targeting this structure.

Incidence patterns of colorectal cancers in four countries of the Middle East Cancer Consortium (Cyprus, Jordan, Israel, and Izmir, Turkey) compared with those in the United States Surveillance, Epidemiology, and End Results Program.

BACKGROUND/AIMS: There are wide variations in colorectal cancer (CRC) incidence across the world. Historically, the highest incidence rates have been reported historically in more developed countries; however, increasing trends have been seen in developing countries. Here, we present the CRC incidence pattern in Cyprus, Israel, Jordan, and Izmir, Turkey, which are countries of the Middle East Cancer Consortium (MECC). MATERIALS AND METHODS: We analyzed 2005-2010 CRC data from population-based registries and calculated crude and age standardized rates for CRC, colon and rectum subsites, and annual percent changes (APCs) for trends. RESULTS: The age-adjusted incidence rates (AAIRs) for CRC were the highest in Israeli Jews (IJ) (46.7 for males and 35.5 for females), which exceeded those of the USA Surveillance, Epidemiology, and End Result (SEER) program registries. In both sexes, AAIRs in Cyprus and Israeli Arabs (IA) were close to those in SEER registries. For both sexes, AAIRs in Izmir and Jordan were substantially lower than those in other registries. Statistically significant decreasing trends over time were observed in AAIRs for both sexes in the SEER program (APCs: males, -3.24% and females, -2.54%), whereas the trends varied within the MECC registries. There were decreasing AAIR trends for males in IJ and IA and for females in Cyprus and IJ; APC for females in IJ (-4.29%) was significant. Conversely, increasing trends with the significant APCs were observed in males in Izmir (2.43%) and Jordan (7.57%). CONCLUSION: MECC countries comprise both high- and low-risk populations for CRCs. However, increasing trends in low-risk populations have been alarming. Thus, the need for implementing tailored primary and secondary prevention programs in the region is essential.

Cancer burden in four countries of the Middle East Cancer Consortium (Cyprus; Jordan; Israel; Izmir (Turkey)) with comparison to the United States surveillance; epidemiology and end results program.

It is important that population-based cancer registries provide accurate and reliable data for public health purposes. These data are essential data for planning of cancer control and prevention. In this study, we examined cancer incidence rates (year 2005-2010) in four MECC registries (Cyprus, Jordan, Israel, Izmir (Turkey)) and compared with the rates in the US. The overall age-standardized incidence rates for males were highest in the US followed by Israeli Jews, Izmir (Turkey), Cyprus, Israeli Arabs, and lowest in Jordan. In women the rates of cancer of all sites were also highest in US women followed by Israeli Jews, Cyprus, Israeli Arabs, Izmir (Turkey), and lowest in Jordan. It is of interest that although site-specific cancer rates differ between the countries studied, prostate, lung and colorectal cancers are within the five most common cancers males in all countries studied. In females, breast colorectal and endometrium cancers are three of the five most common cancers in females in all countries studied. The results presented in this paper can have implications for opportunities in cancer control and prevention in these countries. Future studies on individual cancer sites with highest rates in these Countries are currently underway.

Geographic trends of tobacco-related cancers in Cyprus.

BACKGROUND: Causal relationships have been previously established between smoking and various cancers. In Cyprus, 39 % of men and 14 % of women reported daily smoking in 2008. The objective of this study was to compare the incidence of tobacco-related cancers to all other cancers by district and rural-urban classification to understand the impact of tobacco in Cyprus. METHODS: Data on lung, urinary bladder, oral, pharyngeal, head/neck, and laryngeal cancers were obtained from the Cyprus Cancer Registry (1998-2008). There were 3,635 patients with tobacco-related cancers and 18,780 with non-tobacco cancers. Univariate analysis comparing tobacco-related cancers and all other cancers were conducted with regards to age at diagnosis, age groups, sex, smoking status, disease stage, and rural/urban status, with a p-value of 0.05 considered significant. Smoking prevalence, lung cancer, and bladder cancer rates of Cyprus were also compared to a number of other European countries. RESULTS: Patients with tobacco-related cancers were older than those with non-tobacco cancers (mean age 67.2 ± 12.4 vs. 62.4 ± 17.1, p < 0.0001). Among those with tobacco-related cancers, 80.1 % were male compared to 45.4 % males with other cancer types. The proportion of ever smokers was higher among males compared to females in urban and rural districts. Sub-districts 41 (Age Adjusted Rate (AAR) 41.9, 95 % CI: 35.7-48.1), 60 (AAR 40.3, 95 % CI: 35.2-45.3), and 50 (AAR 36.3, 95 % CI: 33.8-38.7) had the highest rates of tobacco-related cancers. The overall tobacco-related cancer rate was the highest among males in urban districts (AAR 60.8, 95 % CI: 58.2-63.5). Among tobacco-related cancers, lung cancer had the highest overall AAR (17.9 per 100,000) while head and neck cancer had the lowest overall AAR (5.3 per 100,000). Additionally, even though Cypriot males aged 65-69 years old exhibited higher smoking prevalence than other European countries, the overall lung and bladder cancer rates were lower in Cyprus. CONCLUSION: Despite the high proportion of smokers in Cyprus, cancer rates are low compared to other countries. Future in-depth measurements of relevant risk factors and smoking exposure can help understand this phenomenon and provide insights for cancer prevention.

Incidence and time trends of cancer in Cyprus over 11 years (1998-2008).

Cyprus maintains a population-based cancer registry that allows for in-depth study of cancer in a culturally and environmentally unique setting. Using 11 years of collected data (1998-2008), we present the first comprehensive analysis of cancer in Cyprus. We calculated gender-specific, world age-adjusted incidence rates and time trends for the 26 most incident cancers. This study revealed that overall world age-standardized rates among men increased from 195.4 cases per 100,000 in 1998-2002 to 239.0 cases per 100,000 in 2006-2008. For the entire 11-year period, prostate, lung, colorectal and bladder cancers were the most incident cancers among men. Among women, the overall world age-standardized rate increased from 180.6 cases per 100,000 in 1998-2002 to 217.1 cases per 100,000 in 2006-2008. Over the entire period, breast, colorectal, uterine and thyroid cancers were the most incident cancers in women. There were 16 sex-specific cancers showing statistically significantly increasing incidence trends over the study period and no types for which the rate was significantly decreasing. Thyroid cancer illustrated rapid increases in rates. Results were compared to other Mediterranean European registries using the Cancer Incidence in 5 Continents reports for 1997-2002. Overall cancer incidence in Cyprus is lower than that of many southern Mediterranean countries, and given the known environmental risk factors in Cyprus, the low rate of lung cancer is especially interesting. The epidemiologic patterns reported in this study open the door for future etiologic studies to elucidate the role of environmental and lifestyle factors in this population and highlight opportunities for cancer prevention and control.

Particulate matter concentrations during desert dust outbreaks and daily mortality in Nicosia, Cyprus.

Ambient particulate matter (PM) has been shown to have short- and long-term effects on cardiorespiratory mortality and morbidity. Most of the risk is associated with fine PM (PM(2.5)); however, recent evidence suggests that desert dust outbreaks are major contributors to coarse PM (PM(10-2.5)) and may be associated with adverse health effects. The objective of this study was to investigate the risk of total, cardiovascular and respiratory mortality associated with PM concentrations during desert dust outbreaks. We used a time-series design to investigate the effects of PM(10) on total non-trauma, cardiovascular and respiratory daily mortality in Cyprus, between 1 January 2004 and 31 December 2007. Separate PM(10) effects for non-dust and dust days were fit in generalized additive Poisson models. We found a 2.43% (95% CI: 0.53, 4.37) increase in daily cardiovascular mortality associated with each 10-µg/m(3) increase in PM(10) concentrations on dust days. Associations for total (0.13% increase, 95% CI: -1.03, 1.30) and respiratory mortality (0.79% decrease, 95% CI: -4.69, 3.28) on dust days and all PM(10) and mortality associations on non-dust days were not significant. Although further study of the exact nature of effects across different affected regions during these events is needed, this study suggests adverse cardiovascular effects associated with desert dust events.