Impact of Screening on Breast Cancer Incidence in Kazakhstan: Results of Component Analysis.

OBJECTIVE: The study is to conduct a component analysis of the dynamics of the incidence of BC (BC) in Kazakhstan, taking into account regions. METHODS: Primary data were for registered patients with BC (ICD 10 - C50) in the whole country during the period of 2009-2018. Evaluation of changes in BC incidence in the population of Kazakhstan was performed using component analysis according to the methodological recommendations. RESULTS: The study period, 40,199 new cases of BC were recorded. The incidence rate increased from 39.5 (2009) to 49.6 in 2018 and the overall growth was 2.8 per 100,000 population of female, including due to the age structure - ∑ΔA=+2.99, due to the risk of acquiring illness - ∑ΔR=+6.82 and their combined effect - ∑ΔRA=+0.31. The component analysis revealed that the increase in the number of patients with BC was mainly due to the growth of the population (ΔP=+31.1%), changes in its age structure (ΔA=+18.0%) and changes associated with the risk of acquiring illness (ΔR=+41.0%). The increase in the number of patients in the regions of the republic is associated with the influence of demographic factors and with risk factors for getting sick, including mammographic screening. CONCLUSION: Thus, as a result of the component analysis, the role of the influence of demographic factors and the risk of acquiring illness on the formation of the number of patients and the incidence of BC was evaluated, while geographical variability was established. This research was the first epidemiological study of the dynamics of BC in the regional context by the method of component analysis in the population of Kazakhstan. The implementation of the results of this study is recommended in management of anticancer activities for BC.

Assessing Breast Cancer Awareness in Thai Women: Validation of the Breast Cancer Awareness Scale (B-CAS)

Background: Raising breast cancer awareness is a well-established first line strategy to reduce breast cancer mortality. A properly validated instrument is needed to gain a better understanding of breast cancer awareness. Objective: The objective of this study was to develop and validate an instrument to assess breast cancer awareness in Thai women. Methods: In this study, we develop and evaluate the validity of the Breast Cancer Awareness Scale (B-CAS). Construct validity was evaluated by using exploratory factor analysis and confirmatory factor analysis, and criterion validity was investigated using ROC curves to examine the associations between B-CAS subscales and breast self-examination. Internal consistency and test-retest reliability were also investigated. This validation process employed two independent samples of Thai women aged 20-64 years collected from communities in southern Thailand. Results: In total, 660 Thai women (mean age 41 years) participated in this study. Confirmatory factor analysis demonstrated the construct validity of B-CAS (CFI =0.91; NNFI=0.90; GFI=0.95; AGFI= 0.95; RMSEA=0.044, 95%CI 0.041 to 0.047; P< 0.05). Several of the B-CAS subscales demonstrated strong utility in discriminating between women who do and do not regularly conduct breast self-examination. B-CAS also demonstrated strong internal consistency (Cronbach's α=0.86) and test-retest reliability. The final version of B-CAS contains 35 items across five domains: knowledge of risk factors, knowledge of signs and symptoms, attitude to breast cancer prevention, barriers of breast screening, and health behaviour related to breast cancer awareness. Conclusion: The breast cancer awareness scale (B-CAS) was shown to have good psychometric properties in Thai women, and is likely to prove useful in studying the epidemiology of breast cancer awareness in Thai women, and evaluating breast cancer prevention programs for raising awareness.

Clinical, Histopathological and Molecular Characteristics of Metastatic Breast Cancer in North-Eastern Kazakhstan: a 10 Year Retrospective Study

Background: Breast cancer (BC) is the top cancer among women worldwide and has been the most frequent malignancy among Kazakhstan women over the past few decades. Information on clinical and histopathological features of metastatic breast cancer (MBC), as well as the distribution of molecular subtypes is limited for Kazakh people. Materials and Methods: The present observational retrospective study was carried out at Regional Oncologic Dispensaries in the North-East Region of Kazakhstan (in Semey and Pavlodar cities). Сlinical and histopathological data were obtained for a total of 570 MBC patients in the 10 year period from 2004-2013, for whom data on molecular subtype were available for 253. Data from hospital charts were entered into SPSS 20 for analysis by one-way ANOVA analysis of associations of different variables with 1-5 year survival. Pearson correlation and linear regression models were used to examine the relation between parameters with a p-value < 0.05 considered statistically significant. Results: No significant relationships were evident between molecular subtype and survival, site of metastases, stage or ethnicity. Young females below the age of 44 were slightly more likely to have triple negative lesions. While the ductal type greatly predomonated, luminal A and B cases had a higher percentage with lobular morphology. Conclusions: In this select group of metastatice brease cancer, no links were noted for survival with molecular subtype, in contrast to much of the literature.

Association between Diabetes Mellitus and Fatty Liver Based on Ultrasonography Screening in the World's Highest Cholangiocarcinoma Incidence Region, Northeast Thailand.

Fatty liver disease (FLD) can be a precondition for other liver pathology including cholangiocarcinoma (CCA). Diabetes mellitus (DM) has been suggested in some studies to be a risk factor for FLD as well as cancers, including cholangiocellular carcinoma; however, there are currently very few studies on FLD in DM subjects, although the rate of FLD continues to increase annually. To determine the association between DM and FLD ultrasonographic data were analyzed from the Cholangiocarcinoma Screening and Care Program (CASCAP), in northeast Thailand. DM was reported by the subjects based on the CASCAP health questionnaire. Factors that were associated with FLD were determined by prevalence, odds ratio (ORs) and its 95% confidence intervals (CIs) using multiple logistic regression. There were 45,263 subjects with a mean age of 53.46 (±9.25) years. FLD was found in 36.3% of DM subjects but only in 20.7% of non-DM subjects. The association between DM and FLD was adjusted for all other factors including gender, age, education level, relatives diagnosed with CCA, smoking, alcohol consumption, and hepatitis B and C. The risk of DM in subjects having FLD was highly significant compared with the non-DM subjects (OR 2.13; 95%CI: 1.92 to 2.35; p-value < 0.001). Thus DM is significantly associated with FLD which in turn may facilitate the development of several diseases including CCA. DM should be taken into consideration in future ultrasonic investigations of FLD and CCA.

Overview of cancer registration research in the Asian Pacific from 2008-2013.

Cancer registration provides a firm basis for cancer control efforts and research into changing patterns of incidence, mortality, survival and prevalence is of obvious importance. Most of the countries of Asia have already published relevant data although the level of coverage and accuracy do vary a great deal both between and within countries. The present review concerns the relevant literature for the period 2008-2013, focusing on the types of research conducted and the conclusions that can be drawn with regard to what should be done in the future to translate the information available into effective intervention efforts to reduce the burden of disease. A major emphasis has been on determining variation in incidence and mortality/survival on the basis of ethnicity and socioeconomic as well as geographical background, as well as trends over time, either for cancer in general or specific organ sites. In addition a small number of papers focused on methodological, quality and cancer control issues, very pertinent to the future development of cancer registry based research.

What and where for publications by cancer registries in the Asian Pacific? - roles for the APJCP in the future.

The absolute necessity of cancer registration for cancer control planning is well accepted. The registry at the national or local level can provide not only essential data for cancer incidence, mortality and survival but may also point to risk and protective factors and efficacy of interventions by conducting epidemiological research. Timely publication of research findings in PubMed indexed journals is of the essence, especially in examples that allow free access so that the widest dissemination of information can be achieved. The present commentary covers the scope of research in Asia or using Asian data in the period 2008-2013, nearly 40% of a total of over 300 papers being published in the APJCP. In order to reach its full potential the registry should incorporate many skills. Cooperation for this purpose, whether it be national, regional, Asia-wide or international, is a high priority and the International Agency for Research on Cancer, together with the National Cancer Institute in Thailand and the APOCP/APJCP are staging an Asian Cancer Network Forum in Bangkok in February of 2014 to allow discussion of ways forward. It is hoped that representatives from all regions of Asia will decide to attend and also contribute country reports for publication in a special supplement of the APJCP.

Epidemiological evaluation of laryngeal cancer incidence in Kazakhstan for the years 1999-2009.

The purpose was to provide a descriptive epidemiological assessment of the incidence of cancer of the larynx in Kazakhstan and spatial evaluation with gender characteristics. This retrospective study covered all new cases of laryngeal cancer in 11 years (1999-2009). The total number was 4,967 cases, 4,535 (91.3%) in males and 432 (8.7%) in women, with a ratio of 10.5:1. The higher incidence in men compared to women was evident in all age groups, the differences being statistically significant (p<0.05). At the same time revealed a unimodal growth with age, peaking at 70 years and older both sexes. In the dynamics, incidence rates of laryngeal cancer demonstrated a tendency to decrease, in women (T=-6.7%) this being more pronounced than in men (T=-3.3%). Levels were determined to produce cartograms of cancer of the larynx for male and female populations, clear geographical variation being evidenced. The data are discussed with reference to possible risk factors.

New APJCP impact factor for 2012 is 1.271--time to make a major effort to break through the 2.0 barrier.

The APJCP Impact Factor for 2012 is 1.271, returning from 0.659 for 2011 (1.240 for 2010 and 1.108 for 2009). For an Asian Pacific journal publishing over 100 papers a month from countries with very varied resources it is heartening and we thank all those who continued to submit papers and cite references in the APJCP through our difficult period. However, we still have very much room for improvement. As Chief Editors it is our shared responsibility to act for the benefit of the cancer control research community who utilize the journal in our region of over four billion people and provide a prestigious forum for publication of research findings which can be freely shared by all. The motivation for the APOCP/APJCP has never been financial profit but a firm financial base is nevertheless essential. Although we have kind support from the Korean National Cancer Center for our Managing Editor and the website, our ability to maintain our Chinese and Thai offices is totally dependent on the processing charges paid by the authors. In order to expand our staff to cope with increased submissions and provide greater assistance in ensuring comprehensive reference coverage and dissemination of findings published in the APJCP to the worldwide research community, a joint decision has been made to increase formatting charges by 50% from July. We ask for author understanding. In addition, we appeal to scientists to positively consider our requests to make their reference lists as comprehensive as possible, including papers from the APJCP where appropriate. The future of the journal and the APOCP is largely in your own hands.

Laryngeal cancer in Kazakhstan - ethnic, age and gender differences over time.

The purpose of the present study was to provide an assessment of the incidence of cancer of the larynx in Kazakhstan with especial attention to ethnicity and gender, as well as age. The retrospective design covered all new cases of laryngeal cancer in 11 years (1999-2009). The total number was 4,967 cases, 4,535 (91.3%) in males and 432 (8.7%) in women, with a gender ratio of 10.5:1. Patients of Kazakh (31.2%) and Russian (51.4%) ethnicity accounted for the vast majority (82.6%), with Russians predominating in both sexes, but particularly in females. Age peak in Kazakhs was 70 years and older (14.6 ± 0.70/0000), and in Russians was 60-69 years (21.6 ± 1.30/0000). In the dynamics, the rates had the tendency to decrease more markedly in Russian than Kazakh men, especially in the younger groups, while increase was noted in the youngest females of both ethnicities, but again greater in Russians, presumably reflecting change in underlying lifestyle factors.

Health behavior after a multiprofessional intervention and training for ongoing volunteer-based community health programme intervention in the North-East of Thailand: what changed and what not?

This qualitative research within the project entitled "Multiprofessional Intervention and training for Ongoing Volunteer-based Community Health Programs in the Northeast of Thailand (MITV-NET) " was aimed at explaining changes of health behavior of community people in the Northeast after the intervention. The participants comprised 15 community volunteers and 27 villagers. Data were collected by indepth interview, focus group discussion, participation and non-participation observation, and note taking. Analyses were conducted in parallel with data collection, through content and comparative analysis. It was found that the health behavior fell into 2 categories: easy-to-change and difficult-to-change. The former involved fun activities joined by community people that improved their health or made them recover from illnesses after a short period without becoming addicted. These activities could be done by themselves, for example, exercising and cooking. The difficult-to- change health behavior is habitual, for example, chewing betel nuts or eating uncooked food. The following factors were found affecting behavioral changes: 1) underlying disease; 2) enjoyment in doing activities; 3) habitual behaviour; 4) improved health in a short period; 5) ability of community leaders and volunteers; and 6) community health-supporting resources. It is suggested that improving people's health requires cooperation of community people through fun activities and some initial external support. People who persist in bad habits should be encouraged to stop by showing them health deteriorating effects.

Evaluation of health education in the Multi-professional Intervention and Training for Ongoing Volunteer-based Community Health Programme in the north-east of Thailand.

This was a survey research conducted in Northestern Thailand during 2009-2010 and designed to evaluate the success of a health education program by comparing levels of health knowledge in the community before and after the launching of a Multi-professional Intervention and Training for Ongoing Volunteer-based Community Health Programme. The survey questionnaire included items about demographic characteristics and health knowledge. The participants were 1,015 members of various communities, who were randomly selected to be included in the survey before launching the intervention, and 1,030 members of the same communities randomly selected to be included in the survey after the intervention was completed. The demographic characteristics of both groups were similar. Overall knowledge and knowledge of all the diseases, except lung and cervical cancer, were significantly higher after the intervention. In conclusion, a Volunteer-based Community Health Programme has advantages for areas where the numbers of health personnel are limited. The use of trained community health volunteers may be one of the best sustainable alternative means for the transfer of health knowledge.