scholarly journals Pattern and distribution of cancers in areas of Iraq exposed to Depleted Uranium

2020 ◽  
Author(s):  
Esraa Aldujaily ◽  
Ali Duabil ◽  
Kussay M. Abbas Zwain ◽  
Hayder K. Fatlawi ◽  
Ali Al-Behadili ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Survival Data ◽  
Statistical Tests ◽  
Statistical Significance ◽  
Cancer Control ◽  
Depleted Uranium ◽  
Entire Study ◽  
Future Studies ◽  
Control Programs ◽  
Major Interest

AbstractIntroductionCancer is one of the major causes of death worldwide. Health systems whether in developed or in developing countries like Iraq are burdened with different programs to control cancer. Our study is intended to provide information about cancer in the region of Middle Euphrates Area (MEA) of Iraq, which is one of the major areas in Iraq that exposed to the depleted Uranium (DU) at different time periods. Therefore, we are aiming to explore more information about the behavior of cancers in this region of Iraq (pattern and distribution).Aim: our study aims to describe the landscape of cancer with wide focus on the clinicopathological behavior of different types of cancers in MEA of Iraq to determine whether any differences have cropped up over time in Iraqi patients’ presentations.Patients and methodsThis study is a retrospective descriptive study design. Data were collected from a single tertiary cancer care oncology centre for three consecutive years from 2016 up to 2018. This Database covers nearly the entire Middle Euphrates area of Iraq. All statistical tests performed at a 95% level of significance with a two-sided p-value of 0.05 indicating statistical significance.Results and conclusionAccording to this study, the three most common cancers among the entire population were breast, lung, and brain cancers. Females constituted 57.0% of the entire study. Most cancers including breast cancer presented with aggressive clinicopathological behavior. Middle age groups of both sexes are more at risk of developing different cancers. Such findings are important and pave the way for future scientific cancer control programs in Iraq especially for breast cancer. The cancer appears to be flourishing in Iraq, which could be due to multiple factors. Finding a new strategy to predict the treatment response, recurrence or aggressiveness of cancers in Iraq is crucial.Summary (Strengths and limitations of this study)Whats new in this study is the wide focus of studying the clinicopathological behavior of all cancers in middle Euphrates area of Iraq to establish a solid base for further future studies that aims at developing the health system and cancer control programs in Iraq and middle east. The area of middle and south of Iraq which is named the middle Euphrates area is an area of major interest for researchers and clinicians as the cancer is flourishing in this area. previous studies excuse this increase of cancer incidence to the exposure to cancerous agents like depleted uranium. This fact inspired us to explore more information about the behavior of cancer in Iraq. The limitations of this study are the lack of therapy and survival data that we hope to include them in future studies.

scholarly journals The role of dissemination and implementation science in global breast cancer control programs: Frameworks, methods, and examples

Cancer ◽  
2020 ◽  
Vol 126 (S10) ◽  
pp. 2394-2404 ◽  
Author(s):  
Anne F. Rositch ◽  
Karla Unger‐Saldaña ◽  
Rebecca J. DeBoer ◽  
Anne Ng’ang’a ◽  
Bryan J. Weiner
Keyword(s):  
Breast Cancer ◽  
Implementation Science ◽  
Cancer Control ◽  
Dissemination And Implementation ◽  
Control Programs ◽  
Dissemination And Implementation Science ◽  
Breast Cancer Control

scholarly journals Promoting Evidence-Based Practices for Breast Cancer Care Through Web-Based Collaborative Learning

2020 ◽  
Vol 6 (Supplement_1) ◽  
pp. 54-54
Author(s):  
Mishka K. Cira ◽  
Allison Dvaladze ◽  
Robel Tesfay ◽  
Jo Anne Zujewski ◽  
Kalina Duncan
Keyword(s):  
Breast Cancer ◽  
Collaborative Learning ◽  
Cancer Control ◽  
Project Teams ◽  
Global Network ◽  
Evidence Based ◽  
Web Based ◽  
Control Programs ◽  
End Point ◽  
Breast Cancer Control

PURPOSE The objective of the Project ECHO (Extension for Community Healthcare Outcomes) for Knowledge Summaries for Comprehensive Breast Cancer Control (KSBC) was to strengthen the capacity to plan and implement evidence-based, resource-appropriate breast cancer control programs using virtual case-based learning within a global network of experts and peers. METHODS The KSBC ECHO was a collaboration between the US National Cancer Institute Center for Global Health, Women’s Empowerment Cancer Advocacy Network, and Breast Health Global Initiative in alignment with the Breast Cancer Initiative 2.5 campaign to reduce disparities in breast cancer outcomes. Using the ECHO model, we developed a 6-month Web-based program to support the development of locally relevant, resource-appropriate cancer control programs through mentorship and use of KSBCs. The course was advertised via existing networks, conferences, and social media. Breast cancer control project teams from around the world applied and were accepted to participate in the KSBC ECHO. Fourteen biweekly ECHO sessions were held via Zoom and included case presentations, didactic presentations, and discussion. Projects spanned the care continuum and sessions addressed preplanning, assessing need/barriers, setting objectives/priorities, and implementing/evaluating. Baseline and end point surveys were used to evaluate the ECHO program. Participants identified a mentor, completed worksheets, and presented on the project status. RESULTS Fifteen project teams from 11 countries—64 participants: advocates, clinicians, policymakers, and researchers—were enrolled. Twenty-eight participants (57%) completed the baseline and end point surveys. Analysis of the data using a paired t-test indicates that the knowledge increase was statistically significant: The average knowledge gain was 0.76 ± 0.89 (95% CI, 0.44 to 1.08; P < .0001). Additional feedback on the Web-based collaborative learning model will be presented. CONCLUSION The ECHO model encouraged interaction between policymakers, clinicians, advocates, and technical experts while using evidence-based tools to develop locally relevant, resource-appropriate implementation strategies and policy recommendations.

The role of HER2/neu, estrogen, and progesterone receptor status in the risk and survival of breast cancer leptomeningeal metastasis

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 11512-11512 ◽  
Author(s):  
J. Grewal ◽  
M. D. Groves ◽  
B. N. Bekele ◽  
W. A. Yung
Keyword(s):  
Breast Cancer ◽  
Retrospective Analysis ◽  
Survival Data ◽  
Statistical Significance ◽  
Leptomeningeal Metastasis ◽  
Rank Test ◽  
Fisher Exact Test ◽  
P Values ◽  
Receptor Status

11512 Background: Leptomeningeal metastasis (LM) is a dreaded complication of breast cancer with a median survival of approximately 4 months from the time of LM diagnosis. HER2/neu (HER2), estrogen (ER), and progesterone (PR) receptor status are routinely used to determine prognosis and guide treatment. There is emerging data regarding the influence of these receptors on the risk and prognosis of parenchymal brain metastasis. However, the role of these receptors in LM is unknown. We performed a retrospective analysis of 61 patients with breast cancer to determine the risk and survival of LM as a function of receptor status. Methods: Of patients with breast cancer evaluated in our department for possible LM between 2003 and 2006, those requiring CSF analysis were included in this study. Of these 61 patients, 27 were diagnosed with LM and 34 were found to be negative for LM, based on analysis of CSF and MRI. Information regarding HER2 receptor status was unavailable in 3 patients (1 with LM) due to technical issues with the assay. ER, PR, and survival data were available for all patients. Odds ratio of developing LM was calculated based on each receptor status. The Fisher exact test was used to determine significance. For the 27 patients with LM, receptor status was used to stratify survival from the time of LM diagnosis using Kaplan-Meyer analysis; significance was evaluated using the log-rank test. Results: The odds ratios of developing LM in patients with positive HER2, ER, and PR were 1.89, 0.32, and 0. 825, respectively. P values were 0.378, 0.056, and 0.799. In the 27 patients with LM, survival from the time of LM diagnosis was not significantly different when stratified by receptor status; p values were 0.983, 0.317, and 0.625 respectively. Conclusions: Our retrospective analysis suggests that HER2/neu-positive and ER-negative breast cancer may be associated with a higher risk of LM, although this approached statistical significance only for ER. For patients with confirmed LM, there were no significant differences in survival based on receptor status, although there was a trend favoring ER-positive disease. Larger studies are needed to clarify the role of these receptors in the risk and prognosis of breast cancer LM. No significant financial relationships to disclose.

Analysis of Mammography Screening Schedules under Varying Resource Constraints for Planning Breast Cancer Control Programs in Low- and Middle-Income Countries: A Mathematical Study

2020 ◽  
Vol 40 (3) ◽  
pp. 364-378
Author(s):  
Shifali Bansal ◽  
Vijeta Deshpande ◽  
Xinmeng Zhao ◽  
Jeremy A. Lauer ◽  
Filip Meheus ◽  
...  
Keyword(s):  
Breast Cancer ◽  
United States ◽  
Mammography Screening ◽  
Cancer Control ◽  
The United States ◽  
Middle Income ◽  
Control Programs ◽  
Middle Income Countries ◽  
Optimal Screening ◽  
Current Guidelines

Background. Low-and-middle-income countries (LMICs) have higher mortality-to-incidence ratio for breast cancer compared to high-income countries (HICs) because of late-stage diagnosis. Mammography screening is recommended for early diagnosis, however, the infrastructure capacity in LMICs are far below that needed for adopting current screening guidelines. Current guidelines are extrapolations from HICs, as limited data had restricted model development specific to LMICs, and thus, economic analysis of screening schedules specific to infrastructure capacities are unavailable. Methods. We applied a new Markov process method for developing cancer progression models and a Markov decision process model to identify optimal screening schedules under a varying number of lifetime screenings per person, a proxy for infrastructure capacity. We modeled Peru, a middle-income country, as a case study and the United States, an HIC, for validation. Results. Implementing 2, 5, 10, and 15 lifetime screens would require about 55, 135, 280, and 405 mammography machines, respectively, and would save 31, 62, 95, and 112 life-years per 1000 women, respectively. Current guidelines recommend 15 lifetime screens, but Peru has only 55 mammography machines nationally. With this capacity, the best strategy is 2 lifetime screenings at age 50 and 56 years. As infrastructure is scaled up to accommodate 5 and 10 lifetime screens, screening between the ages of 44-61 and 41-64 years, respectively, would have the best impact. Our results for the United States are consistent with other models and current guidelines. Limitations. The scope of our model is limited to analysis of national-level guidelines. We did not model heterogeneity across the country. Conclusions. Country-specific optimal screening schedules under varying infrastructure capacities can systematically guide development of cancer control programs and planning of health investments.

scholarly journals An Observational Study Framework to Assess Breast Cancer Control Policy Needs in Low- and Middle-Income Countries

2018 ◽  
Vol 4 (Supplement 3) ◽  
pp. 46s-46s
Author(s):  
Ethan Thayumanavan ◽  
Catherine Duggan ◽  
Barri M. Blauvelt
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Health Outcomes ◽  
Cancer Control ◽  
Control Policy ◽  
Middle Income ◽  
Control Programs ◽  
Middle Income Countries ◽  
Breast Cancer Control ◽  
Low And Middle Income

Purpose Women with breast cancer in low- and middle-income countries (LMICs) have worse health outcomes than their counterparts in high-income countries (HICs). Improved outcomes in HICs are attributable to more rigorous breast cancer control policies, implementation of evidence-based guidelines, and greater national investment in health care. In resource-limited settings, identifying the most effective resource-appropriate policies can be a challenge. The proposed study will provide a framework to identify unmet breast cancer policy and infrastructure needs in LMICs and will aid in the prioritization of key elements of successful breast cancer control programs. Building on previous work, we will develop a framework for policy analysis and conduct a breast cancer policy needs assessment through a comparative analysis of attitudes and preferences for breast cancer control elements in 30 countries. Methods The proposed observational survey-based study will measure and compare attitudes and preferences for breast cancer control across 24 LMICs and six reference HICs from across the six WHO regions, stratifying countries by health care spending and mortality-to-incidence ratios. This study will be a cross-sectional survey of medical, policy, and advocacy experts in breast cancer from each of the selected countries. Research will be conducted in three phases. First, we will conduct key informant interviews of international breast cancer experts. Then we will develop and pilot a survey tool. Finally, we will conduct the full survey in countries. The study will use analysis of variance, conjoint analysis, and best-worst scaling to analyze survey results. Results This study will assess current breast cancer control needs, prioritize elements of a comprehensive breast cancer control plan, and determine attitudes about the potential of emerging technologies to improve breast cancer control. Conclusion This study will facilitate the improvement of health outcomes for women with breast cancer by assessing the specific unmet breast cancer policy and infrastructure needs in LMICs and prioritizing elements to improve breast cancer control programs. The study thus provides a resource-appropriate framework to improve breast cancer control policy, reform, and implementation. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . Barri M. Blauvelt Stock or Other Ownership: AstraZeneca, Biogen, Celgene, Ecolab, Elite Pharmaceuticals Consulting or Advisory Role: Boehringer Ingelheim, Novartis

scholarly journals Cancer Incidence in Nigeria and Border Countries

2018 ◽  
Vol 5 (1) ◽  
pp. 7-12
Author(s):  
Isa Abdullahi Baba ◽  
Evren Hincal
Keyword(s):  
Breast Cancer ◽  
Cancer Incidence ◽  
Cancer Control ◽  
Kaposi Sarcoma ◽  
Cervix Uteri ◽  
Control Programs ◽  
Non Hodgkin Lymphoma ◽  
Common Cancer ◽  
Cancer Larynx ◽  
Males And Females

Many inequalities in cancer incidence exist between Nigeria and border countries. This information is absent or largely unavailable. Benin, Cameroun, Chad, Niger, and Nigeria cover a population of more than 224,922,000. Globocan data base supplied incidence for 132,939cases of cancer for these countries. The prevalence of Bladder, Colorectum, Kaposi sarcoma, Larynx, Leukaemia, Lip, oral cavity, Liver, Lungwas estimated for the year 2012.The prevalence of Nasopharynx, Non – Hodgkin, Lymphoma, Pancrease, Prostrate, Stomach combined was also estimated for the same year. The most common male cancer found in Nigeria and border countries is Prostate cancer, seconded by Liver. In this study also we found Breast cancer to be the most common in females, followed by Cervical Cancer. Larynx and Kaposi sarcoma are found to be the least common cancer for both males and females in the population. In conclusion, the findings of this study gave lights to some guidelines to aid the design of cancer control programs in Nigeria and border countries.  The spectrum of the cancers is dominated by the breast & Cervix uteri for females, while Prostate & Liver for males.  

scholarly journals Commonly Studied Single-Nucleotide Polymorphisms and Breast Cancer: Results From the Breast Cancer Association Consortium

2006 ◽  
Vol 98 (19) ◽  
pp. 1382-1396 ◽  
Author(s):  
Keyword(s):  
Breast Cancer ◽  
Single Nucleotide Polymorphisms ◽  
Association Studies ◽  
Statistical Tests ◽  
Statistical Significance ◽  
Genome Wide Association Studies ◽  
Nucleotide Polymorphisms ◽  
Odds Ratios ◽  
Single Nucleotide ◽  
Breast Cancer Association Consortium

Abstract Background: The Breast Cancer Association Consortium (BCAC) is an international collaboration that was established to provide large sample sizes for examining genetic associations. We conducted combined analyses on all single-nucleotide polymorphisms (SNPs) whose associations with breast cancer have been investigated by at least three participating groups. Methods: Data from up to 12 studies were pooled for each SNP ( ADH1C I350V, AURKA F31I, BRCA2 N372H, CASP8 D302H, ERCC2 D312N, IGFBP3 −202 c > a , LIG4 D501D, PGR V660L, SOD2 V16A, TGFB1 L10P, TP53 R72P, XRCC1 R399Q, XRCC2 R188H, XRCC3 T241M, XRCC3 5′ UTR, and XRCC3 IVS7-14). Genotype frequencies in case and control subjects were compared, and genotype-specific odds ratios for the risk of breast cancer in heterozygotes and homozygotes for the rare allele compared with homozygotes for the common allele were estimated with logistic regression. Statistical tests were two-sided. Results: The total number of subjects for analysis of each SNP ranged from 12 013 to 31 595. For five SNPs— CASP8 D302H, IGFBP3 −202 c > a , PGR V660L, SOD2 V16A, and TGFB1 L10P—the associations with breast cancer were of borderline statistical significance ( P = .016, .060, .047, .056, and .0088 respectively). The remaining 11 SNPs were not associated with breast cancer risk; genotype-specific odds ratios were close to unity. There was some evidence for between-study heterogeneity ( P <.05) for four of the 11 SNPs ( ADH1C I350V, ERCC2 D312N, XRCC1 R399Q, and XRCC3 IVS5-14). Conclusion: Pooling data within a large consortium has helped to clarify associations of SNPs with breast cancer. In the future, consortia such as the BCAC will be important in the analysis of rare polymorphisms and gene × gene or gene × environment interactions, for which individual studies have low power to identify associations, and in the validation of associations identified from genome-wide association studies.

scholarly journals Sleep Duration and Breast Cancer Phenotype

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Ali Khawaja ◽  
Santosh Rao ◽  
Li Li ◽  
Cheryl L. Thompson
Keyword(s):  
Breast Cancer ◽  
Sleep Duration ◽  
Statistical Significance ◽  
Hormone Replacement ◽  
Breast Cancer Patients ◽  
Her2 Receptor ◽  
Entire Study ◽  
Increased Risk ◽  
Post Menopausal ◽  
Risk Of Cancer

Emerging evidence suggests that short sleep is associated with an increased risk of cancer; however, little has been done to study the role of sleep on tumor characteristics. In this study, we evaluated the relationship between sleep duration and tumor phenotype in 972 breast cancer patients. Sleep duration was inversely associated with tumor grade (univariateP=0.032), particularly in postmenopausal women (univariateP=0.018). This association did not reach statistical significance after adjustments for age, race, body mass index, hormone replacement therapy use, alcohol consumption, smoking, and physical activity in the entire study sample (P=0.052), but it remained statistically significant (P=0.049) among post-menopausal patients. We did not observe a statistically significant association between sleep duration and stage at diagnosis, ER, or HER2 receptor status. These results present a modest association between short duration of sleep and higher grade breast cancer in post-menopausal women. Further work needs to be done to validate these findings.

Comparative study of Clinical Characteristics in Patients with Mild and Severe Reflux Esophagitis

2020 ◽  
Vol 66 (1) ◽  
pp. 19-22
Author(s):  
Melania Macarie ◽  
Simona Maria Bataga ◽  
Monica Pantea ◽  
Razvan Opaschi ◽  
Simona Mocan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Sex Ratio ◽  
Hiatal Hernia ◽  
Statistical Significance ◽  
Erosive Esophagitis ◽  
Male Gender ◽  
Consecutive Series ◽  
Study Group ◽  
Entire Study ◽  
Significant Difference

AbstractObjective: This study aims to determine the correlation between risk factors and erosive esophagitis development.Methods: We conducted a retrospective observational study on a consecutive series of 19.672 patients who underwent upper gastrointestinal endoscopy between 01.01.2011-31.12.2017. A total of 3005 patients, diagnosed with erosive esophagitis, were included in the present study and stratified according to Los Angeles classification.Results: During the studied period we found 3005 patients with erosive esophagitis, sex ratio male to female was 1.3/1, the most common forms of esophagitis being grade A and B: 74.54% patients with esophagitis grade A, 14.80% patients with grade B; 5.29% patients were with grade C and 5.35% patients with esophagitis grade D. In severe esophagitis the male predominance was more prevalent (249 males, 71 female), with a sex ratio 3.50/1. The correlation of male gender with severe esophagitis was highly statistically significant (p < 0.0001, OR 2.97; 95% CI 2.25-3.91). Hiatal hernia was diagnosed in 1171 patients, the presence of large hiatal hernias, being an important predictor, with statistical significance (p < 0.0001, OR 3.41; 95% CI 2.22-5.21), for severe esophagitis development. Incidence of Helicobacter pylori infection was 11.51%, in the entire study group, with no statistical significant difference between patients with mild or severe esophagitis (12.02% vs 7.18%).Conclusion: Erosive esophagitis is a frequent disease, the most common forms being grade A and B. Male gender and the presence of hiatal hernia are the most important risk factors for erosive esophagitis development, in our study group.

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