Cancer trends and incidence and mortality patterns in Turkey

Incidence Trends of Melanoma and Nonmelanoma Skin Cancers in Jordan From 2000 to 2016

PURPOSE

Skin cancers are among the commonest cancers worldwide, and the incidence of melanoma and non-melanoma skin cancer (NMSC) continues to rise worldwide. However, there are no comprehensive reports on skin cancer incidence in Jordan during the past two decades. This report investigates the incidence of skin cancers in Jordan, in particular their time trends for the period 2000-2016.

MATERIALS AND METHODS

Data on malignant melanomas (MMs), squamous cells carcinomas (SCCs), and basal cell carcinomas (BCCs) were extracted from the Jordan Cancer Registry for the period between 2000 and 2016. Age-specific and overall age-standardized incidence rates (ASIRs) were computed.

RESULTS

Two thousand seventy patients were diagnosed with at least one BCC, 1,364 with SCC, and 258 with MM. ASIRs were 28, 19, and 4 per 100,000 person-years for BCC, SCC, and MM, respectively. The BCC:SCC incidence ratio was 1.47:1. The risk of men developing SCCs was significantly higher than women (relative risks [RRs], 1.311; 95% CI, 1.197 to 1.436), but significantly lower for BCCs (RR, 0.929; 95% CI, 0.877 to 0.984) or melanomas (RR, 0.465; 95% CI, 0.366 to 0.591). Persons older than 60 years were at a significantly higher risk of developing SCCs (RR, 1.225; 95% CI, 1.119 to 1.340) or melanomas (RR, 2.445; 95% CI, 1.925 to 3.104), but at a significantly lower risk of developing BCCs (RR, 0.885; 95% CI, 0.832 to 0.941). The overall incidence rates of SCCs, BCCs, and melanomas increased over the 16-year study period, but this was not statistically significant.

CONCLUSION

To our knowledge, this is the largest epidemiologic study regarding skin cancers in Jordan and in the Arab world. Despite low incidence rates in this study, rates are higher than reported regional figures. This is likely due to standardized, centralized, and mandatory reporting of skin cancers, including NMSC.

Clustering Trend Changes of Lung Cancer Incidence in Europe via the Growth Mixture Model during 1990-2016

Background

Lung cancer accounts for half of all deaths from cancer in Europe and has the highest incidence in Southern Europe. The current study aimed to cluster trend changes of lung cancer incidence in Europe via the growth mixture model.

Methods

The dataset included incidence rates of female and male lung cancer per 100,000 for 42 European countries during 1990–2016 compiled from the Gapminder database. The growth mixture model was implemented to recognize different longitudinal patterns and estimate the linear trend of each pattern in Mplus 7.4 software.

Results

The observed overall trend of incidence for female and male lung cancer was raising and falling, respectively, and Iceland was the only country with higher incidence of female versus male lung cancer in 2016. The growth mixture model suggests 3 main patterns for the trend of lung cancer incidence both for males and females. In male lung cancer, a sharp decreasing pattern was detected for 6 countries including Belarus, Estonia, Russia, Slovenia, Ukraine, and the United Kingdom; also, a moderately decreasing pattern was observed among the other countries. In female lung cancer, a moderate increasing trend was observed for 8 countries including the United Kingdom, Denmark, Hungary, Iceland, Ireland, Montenegro, Netherlands, and Norway; the other patterns were categorized into two clusters with slow increasing trends.

Conclusion

Given the raising patterns in the incidence of lung cancer among European females, especially in the United Kingdom, Denmark, Hungary, Iceland, Ireland, Montenegro, Netherlands, and Norway, urgent effective measures are recommended to be taken.

Immunoreactivity of ICAM-1, MMP-2, and Nesfatin-1 in lens epithelial cells of patients with diabetes mellitus with or without diabetic retinopathy

PURPOSE

The aim of this study was to evaluate the immunoreactivity of matrix metalloproteinases-2 (MMP-2), intercellular adhesion molecule-1 (ICAM-1), and nesfatin-1 in cataract lens epithelial cells (LECs) of patients with diabetes mellitus (DM) and to investigate the relationship of these markers with DM cataract and diabetic retinopathy (DR).

MATERIALS AND METHODS

Ninety patients were included in the study. The patients were divided into three groups (n = 30): Group 1 (control; patients without DM or DR); Group 2 (patients with DM only), and Group 3 (patients with both DM and DR). Lens capsule samples were collected during intraoperative cataract surgery. Samples were immunohistochemically stained for MMP-2, ICAM-1, and nesfatin-1 and their immunoreactivity was evaluated. The number of immunoreactive cells was determined with a microscope at ×400 magnification.

RESULTS

Increased MMP-2 and ICAM-1 immunoreactivity was detected in the LECs of patients with DM, and especially in patients with DR (p < 0.001, p < 0.001, respectively). Nesfatin-1 immunoreactivity was significantly lower in LECs of diabetic patients (p < 0.001). The mean of MMP-2 immunoreactive cells were 7.47 ± 8.18, 22.80 ± 15.70, and 34.80 ± 20.85 in Groups 1, 2, and 3, respectively. The mean of ICAM-1 immunoreactive cells were 17.10 ± 9.83, 38.50 ± 23.55, and 56.93 ± 20.94 in Groups 1, 2, and 3, respectively.

CONCLUSION

Nesfatin-1, MMP-2, and ICAM-1 and could potentially play important roles in the pathogenesis of cataracts in patients with DM.

The Role of Patient Awareness and Knowledge in Developing Secondary Lymphedema after Breast and Gynecologic Cancer Surgery

Background: This study aimed to compare the effects of awareness and knowledge on demographic and clinical factors in patients with breast cancer-related lymphedema (BCRL) and gynecologic cancer-related lymphedema (GCRL) in the oncologic rehabilitation setting. Methods and Results: A total of 506 female patients with upper or lower extremity lymphedema, were evaluated for lymphedema education in their postoperative period. Only 74 survivors (25%) with BCRL and 34 survivors (16.83%) with GCRL reported that they had received information about lymphedema by physicians/primary health care providers. In breast cancer survivors, the time of diagnostic delay for lymphedema was shorter in the informed group (p < 0.001), and there was a higher rate of cellulite attacks in uninformed patients (p = 0.021). Duration between surgery and lymphedema was longer and duration of diagnostic delay for lymphedema was shorter in the informed group than uninformed group in gynecologic cancer survivors (p = 0.019, p < 0.001). There was a higher rate of cellulite history in the uninformed patients than informed patients in gynecologic cancer survivors (p < 0.001). In gynecologic cancer survivors who were educated about lymphedema were at an earlier stage than noneducated patients (p = 0.024). Conclusion: The rate of awareness about lymphedema among patients with a history of surgery for gynecologic malignancies is lower compared with those for breast cancer. In female cancer survivors, awareness and knowledge about lymphedema may lead to a later onset of lymphedema, lower lymphedema grades, and fewer infection.

Factors affecting knowledge levels of oncology nurses about skin cancer and sun protection

OBJECTIVE

This is a descriptive, cross-sectional and observational study that determines the factors affecting the knowledge levels of oncology nurses for skin cancer and sun protection.

MATERIALS & METHODS

This study was performed on the members of the Turkish Oncology Nursing Association and oncology nurses working in hospitals in Turkey between November 2019 and March 2020. Data were collected by using the Nurse Information Form and Skin Cancer and Sun Knowledge (SCSK) scale. For data analysis, average and percentage calculations and multiple linear regression analyses were used. The significance level was set at p < .05.

RESULTS

We found those female nurses who were above 40 years of age and having darker skin tone due to excessive sun exposure, with a family history of skin cancer, and educated on skin cancer, performed better on the SCSK scale. We found a statistically significant difference between the mean scores of skin cancer and sun exposure. Using multiple regression analysis, a model was created based on the relationship between variables. In this model, the personality traits of oncology nurses are responsible for higher (91.1%) knowledge levels on skin cancer and sun exposure.

CONCLUSION

In conclusion, it is important to consider factors that will influence an individual's behaviour while developing skin cancer and sun protection programmes.

Effect of high-risk human papillomavirus in esophageal squamous cell carcinoma in Somalian and Turkish cases

This study aimed to investigate the role of high-risk human papillomavirus (Hr-HPV) in Somalian and Turkish patients with esophageal squamous cell carcinoma (ESCC). In the sections obtained from paraffin-embedded blocks, the results of invasive tumor, peripheral tumor dysplasia and normal mucosa were examined. Samples containing 45 and 47 ESCC, 46 and 42 dysplasia in Somalian (n = 52) and Turkish (n = 53) cases, respectively, were included in the study. We examined the presence of 14 types of Hr-HPV in ESCC collected from Somalia and Turkey by Aptima® Panther System. Hr-HPV types were not detected in Somalian cases. p16INK4a is positive in 5 (11.4%) tumors and 6 (13%) dysplasia. p53 is positive in 28 (62.2%) tumors and 35 (76.1%) dysplasia. HPV16-18/45 are positive only in one of the Turkish cases. p16INK4a is positive in 5 (10.6%) tumors and 4 (9.5%) dysplasia. p53 is positive in 31 (63.3%) tumors and 24 (57.1%) dysplasia. No reaction was detected in normal mucosa samples in both countries. This study is regional. Although the findings did not reflect the general population, the present study shows that the effect of HPV on carcinogenesis in Somalian and Turkish ESCC patients was not significant.

Psychometric Testing of the Turkish Version of the Skin Cancer and Sun Knowledge Scale in Nursing Students

The present study aimed assesses the nursing students' knowledge of skin cancer and sun and their sun protection behaviors. This descriptive cross-sectional study was performed from May to June 2014 with a convenience sample of 376 undergraduate nursing students from one nursing faculty located in Izmir. Mean age of the students was 21.56 ± 1.96 years. The mean score that the females obtained from the level of knowledge and protection behaviors scales was significantly higher than that of the males. Older age group (≥22 years) obtained higher scores on the knowledge and protection behaviors scales than younger group (≤21 years). Nursing students' knowledge of, and behavior regarding, skin cancer and sun health were insufficient. Equipping them with the necessary knowledge and behaviors related to skin cancer and sun health by developing training programs and strategies on the issue is of utmost importance.

Medicinal Plants from Near East for Cancer Therapy

Background: Cancer is one of the major problems affecting public health worldwide. As other cultures, the populations of the Near East rely on medicinal herbs and their preparations to fight cancer. Methods: We compiled data derived from historical ethnopharmacological information as well as in vitro and in vivo results and clinical findings extracted from different literature databases including (PubMed, Scopus, Web of Science, and Google Scholar) during the past two decades. Results: In this survey, we analyzed the huge amount of data available on anticancer ethnopharmacological sources used in the Near East. Medicinal herbs are the most dominant ethnopharmacological formula used among cancer's patients in the Near East. The data obtained highlight for the first time the most commonly used medicinal plants in the Near East area for cancer treatment illustrating their importance as natural anticancer agents. The literature survey reveals that various Arum species, various Artemisia species, Calotropis procera, Citrullus colocynthis, Nigella sativa, Pulicaria crispa, various Urtica species, Withania somnifera, and others belong to the most frequently used plants among cancer patients in the Near East countries. Molecular modes of action that have been investigated for plant extracts and isolated compounds from Near East include cell cycle arrest and apoptosis induction with participation of major player in these processes such as p53 and p21, Bcl-2, Bax, cytochrome c release, poly (ADP-ribose) polymerase cleavage, activation of caspases, etc. Conclusion: The ethnopharmacology of the Near East was influenced by Arabic and Islamic medicine and might be promising for developing new natural and safe anticancer agents. Further research is required to elucidate their cellular and molecular mechanisms and to estimate their clinical activity.

Cross-Cultural Adaptation and Psychometric Evaluation of the Turkish Version of the Cancer Behavior Inventory-Brief Version

CONTEXT

Cancer Behavior Inventory-Brief Version (CBI-B) is a simple and non-burdensome tool used to evaluate the self-efficacy of the cancer patients.

OBJECTIVES

The aim of this study was to examine the psychometric properties of the Turkish version of the CBI-B.

METHODS

This methodologic study was conducted on 143 cancer patients who received radiotherapy at the Department of Radiation Oncology at a Training and Research Hospital in Turkey. Data were collected using Medical and Demographic Information Form, CBI-B, Satisfaction With Life Scale, and European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30). Descriptive statistics, exploratory factor analysis, and correlation coefficients were used for the analysis of data.

RESULTS

Exploratory factor analysis confirmed four-factor structure explaining 74.7% of the total variance: 1) Maintaining Independence and Positive Attitude, 2) Participating in Medical Care, 3) Coping and Stress Management, and 4) Managing Affect. The CBI-B had acceptable internal consistency (Cronbach α = 0.87) and test-retest reliability (intraclass correlation coefficient = 0.961) and concurrent validity with Satisfaction With Life Scale and EORTC QLQ-C30 scores. The measures of life satisfaction and quality of life were positively correlated with CBI-B, whereas the symptom levels and the functions (with the exception of the role function) were negatively correlated.

CONCLUSION

The CBI-B was found to be a valid and reliable inventory for assessing the self-efficacy of Turkish cancer patients. The CBI-B, is a simple and brief measure of self-efficacy for coping with cancer, could be easily used in clinical and research settings.

The Importance of Awareness and Education in Patients with Breast Cancer-Related Lymphedema

Upper extremity lymphedema occurs in one of five women after breast cancer treatment and causes significant morbidity. Women often report being uninformed regarding awareness of lymphedema and other side effects after the cancer surgery. The aim of the study was to assess the postoperative information and education about lymphedema in patients with lymphedema related to breast cancer surgery in the rehabilitation unit of a tertiary hospital. One hundred eighty patients who had admitted to lymphedema rehabilitation unit between September 2013 and February 2015 were recruited to the study. The demographic properties of women, duration, and grade of lymphedema were recorded. The patients were asked whether they had received any information about awareness of lymphedema or whether they have been educated for reducement of the risk of lymphedema after the breast cancer surgery. One hundred eighty women with a mean age of 52.9 ± 10.7 years (27-53) and with a mean lymphedema duration of 19.8 ± +39.4 months were included. Ninety-eight (54.4 %) patients had grade 1, 80 (44.4 %) patients had grade 2, and 2 (1.11 %) patients had grade 3 lymphedema. Among the participants, only 35 (19.5 %) had reported that they had received information or education about lymphedema. One hundred forty-five patients (80.5 %) were not informed or trained about the development of lymphedema. The degree and duration of lymphedema were lower in patients that had been informed or educated about lymphedema as compared to the patients who had not been informed or educated, but the difference was not statistically significant (p = 0.052). Only a minor group of patients (19 %) had received information and education about lymphedema and there is an unmet need for education or information about lymphedema after breast cancer treatment, especially in developing countries. The nonsignificant correlation between education and the degree and duration of lymphedema was thought to be related with the incongrous numbers of the subgroups. In conclusion with the growing population of breast cancer survivors, patient awareness and education about postoperative lymphedema risk after the cancer surgery is warranted.

Correlations Between Oncotype DX Recurrence Score and Classic Risk Factors in Early Breast Cancer: Results of A Prospective Multicenter Study in Turkey

OBJECTIVE

Breast cancer is the most common malignancy among Turkish women and the rate of early stage disease is increasing. The Oncotype DX 21-gene assay is predictive of distant recurrence in ER-positive, HER2-negative early breast cancer. We aimed to evaluate the correlations between Recurrence Score (RS) and routine risk factors.

MATERIALS AND METHODS

Ten academic centers across Turkey participated in this prospective trial. Consecutive patients with breast cancer who had pT1-3, pN0-N1mic, ER-positive, and HER2-negative tumors were identified at tumor conferences. Both pre- and post-RS treatment decisions and physician perceptions were recorded on questionnaire forms. Correlations between RS and classic risk factors were evaluated using univariate and multivariate analyses.

RESULTS

Ten centers enrolled a total of 165 patients. The median tumor size was 2 cm. Of the 165 patients, 57% had low RS, 35% had intermediate RS, and 8% had high RS, respectively. Multivariate analysis indicated that progesterone receptor (PR) and Ki67 scores were significantly related to RS.

CONCLUSION

Oncotype DX Recurrence Score does not seem to have a significant correlation with the majority of classic risk factors, but it may have a correlation with PR score and Ki67 score.

The nomogram conundrum: a demonstration of why a prostate cancer risk model in Turkish men underestimates prostate cancer risk in the USA

PURPOSE

The utility of a nomogram is based on the patient population it is designed for-and their inherent properties and biases. Our aim was to demonstrate the variability in predictive model accuracy and utility between different populations.

METHODS

Our model is based on 761 men who underwent initial TRUS biopsy at a single institution in Turkey. Patients were included if they had at least 10 cores on biopsy and PSA level <20 ng/ml. Multivariable logistic regression models were used to develop a new nomogram. External validity was tested with two different cohorts one from another institution in Turkey (N = 136) and cohort from USA (N = 2242).

RESULTS

Prostate cancer (PCa) and high-grade PCa was diagnosed in 249/761 (32.7 %) and 101/761 (13.3 %) patients from Ankara, Turkey, respectively. Predictors of PCa were age (p < 0.0001, OR 2.11), PSA (p = 0.044, OR 1.44), PV (p < 0.0001, OR 0.38), %fPSA (p = 0.016, OR 0.72), and abnormal DRE (p < 0.0001, OR 2.05). The predictive accuracy (c-index) of our nomogram was 73 %. C-indices of 71 and 70 % were recorded in external validation cohorts from Turkey and the USA, respectively. Virtually ideal calibration was recorded for the internal validated predictive model, and good calibration was recorded when applied to the Istanbul cohort. However, the model/nomogram underestimates PCa risk in the US cohort.

CONCLUSION

This is the first nomogram predicting the risk of PCa at initial biopsy in a Turkish population and provides a good risk estimation tool with good predictive accuracy and calibration in the Turkish populations. However, our study demonstrates the poor transferability of predictive tools to widely different populations.

Impact of Oncotype DX Recurrence Score on Treatment Decisions: Results of a Prospective Multicenter Study in Turkey

INTRODUCTION

Breast cancer is the most common malignancy among Turkish women and the rate of early stage disease is increasing. The Oncotype DX(®) 21-gene assay is predictive of distant recurrence in ER-positive, HER2-negative early breast cancer. We aimed to evaluate the impact of the Recurrence Score(®) (RS) on treatment decisions and physician perceptions in Turkey. We also studied correlations between RS and routine risk factors.

PATIENTS AND METHODS

Ten academic centers across Turkey participated in this prospective trial. Consecutive breast cancer patients with pT1-3, pN0-N1mic, ER-positive, and HER2-negative tumors were identified at multidisciplinary tumor conferences. The initial treatment decision was recorded before tumor blocks were sent to the central laboratory. Each case was brought back to tumor conference after receiving the RS result. Both pre- and post-RS treatment decisions and physician perceptions were recorded on questionnaire forms. Correlations between RS and classical risk factors were evaluated using univariate and multivariate analyses.

RESULTS

Ten centers enrolled a total of 165 patients. The median tumor size was 2 cm. Of 165 patients, 57% had low RS, 35% had intermediate RS, and 8% had high RS, respectively. The overall rate of change in treatment decision was 33%. Initially, chemotherapy followed by hormonal therapy (CT+HT) was recommended to 92 (56%) of all patients, which decreased to 61 (37%) patients post-RS assay (p<0.001). Multivariate analysis indicated that progesterone receptor (PR) and Ki-67 scores were significantly related to RS.

CONCLUSION

Oncotype DX testing may provide meaningful additional information in carefully selected patients.

Increased colorectal cancer incidence in Iran: a systematic review and meta-analysis

BACKGROUND

Colorectal cancer is the third most common cancer in Iran. The increasing trend of colorectal cancer incidence in Iran and the close relationship with the geographical location are the underlying reasons for this study.

METHODS

DATA SOURCE

Eleven databases, including MEDLINE, EMBASE, SCOPUS, and four other databases, for articles in Persian were searched from April 2014 to October 2014. Additional data were obtained from an online survey of the Central Library of Tabriz Faculty of Medicine.

STUDY ELIGIBILITY CRITERIA

In this systematic review and meta-analysis, we included studies reporting different measures of incidence, age-standardized incidence rates, and crude incidence rates. All rates (per 100,000 person-years) were standardized to the world standard population.

STUDY APPRAISAL AND SYNTHESIS METHODS

A preliminary review of the title and abstracts of these articles was used to exclude any that were clearly irrelevant. The full text review determined whether the article was relevant to our topic. All the potentially relevant manuscripts were reviewed by two other investigators (S.D., M.G.). A total of 39 studies (10 Persian and 29 English articles) from different provinces and diverse areas of Iran, were analyzed in this study using comprehensive meta-analysis software. For accuracy studies, we used estimated rates for males and females with 95 % confidence intervals.

RESULTS

Age-standardized incidence rates were obtained based on the random effects model and were 8.16 (95 % CI: 6.64 to 9.68) and 6.17 (95 % CI: 5.01 to 7.32) for males and females, respectively. The random crude rates were 5.58 (95 % CI: 4.22 to 6.94) for males and 4.01 (95 % CI: 3.06 to 4.97) for females.

CONCLUSIONS

Colorectal cancer incidence rates rise due to individual and environmental risk factors as well as improvement in the registry system and increase in access to health services. A more executed organized and structured system for collecting cancer data, in all cities and rural areas of the country, is an essential priority.

Cancer mortality in Brazil: Temporal Trends and Predictions for the Year 2030

Cancer is currently in the spotlight due to their heavy responsibility as main cause of death in both developed and developing countries. Analysis of the epidemiological situation is required as a support tool for the planning of public health measures for the most vulnerable groups. We analyzed cancer mortality trends in Brazil and geographic regions in the period 1996 to 2010 and calculate mortality predictions for the period 2011 to 2030.This is an epidemiological, demographic-based study that utilized information from the Mortality Information System on all deaths due to cancer in Brazil. Mortality trends were analyzed by the Joinpoint regression, and Nordpred was utilized for the calculation of predictions.Stability was verified for the female (annual percentage change [APC] = 0.4%) and male (APC = 0.5%) sexes. The North and Northeast regions present significant increasing trends for mortality in both sexes. Until 2030, female mortality trends will not present considerable variations, but there will be a decrease in mortality trends for the male sex. There will be increases in mortality rates until 2030 for the North and Northeast regions, whereas reductions will be verified for the remaining geographic regions. This variation will be explained by the demographic structure of regions until 2030.There are pronounced regional and sex differences in cancer mortality in Brazil, and these discrepancies will continue to increase until the year 2030, when the Northeast region will present the highest cancer mortality rates in Brazil.

Downregulation of ABCE1 via siRNA affects the sensitivity of A549 cells against chemotherapeutic agents

ATP-binding cassette E1 (ABCE1) is involved in several biological functions in cancer cells such as tumor proliferation, antiapoptotic pathway and chemoresistance mechanism. This work aimed to investigate the alterations in chemosensitivity of A549 lung cancer cells for 5-Fluorouracil (5-FU) and irinotecan by silencing ABCE1 using specific small interfering RNAs (siRNA). The cells were treated with low doses of drugs, alone and also their combinations with ABCE1 siRNA. Cytotoxicity, cell proliferation and apoptosis/necrosis evaluations were performed in order to examine the effects of the combined treatment. Reverse transcriptase polymerase chain reaction (RT-PCR) was used to confirm the downregulation of ABCE1. We also investigated the levels of B cell lymphoma 2 (Bcl-2) and mammalian target of rapamycin (mTOR) after the treatments by RT-PCR. Downregulation of ABCE1 improved the anticancer effects of 5-FU in inducing cell viability/proliferation inhibition and apoptosis/necrosis, whereas interestingly, almost did not change or slightly reduced the anticancer effects of irinotecan. ABCE1 expression significantly decreased by transfecting the cells with ABCE1 siRNA. Moreover, Bcl-2 and mTOR levels changed after the single or combined therapy in parallel with the apoptotic and antiproliferation effect. In conclusion, the simultaneous treatment of lung cancer cells with ABCE1 siRNA and 5-FU exhibited synergistic or additive effects; however, ABCE1 siRNA and irinotecan had unexpected antagonistic effects. Our findings demonstrate that the strategy of downregulation of ABCE1 may be included in conventional 5-FU chemotherapy for lung cancer, minimizing the usage of 5-FU at high dosages.

Age-related changes in rat prostate tissue; perspective of protein oxidation

BACKGROUND

Increased systemic oxidative stress is considered as an important risk factor for prostate cancer occurrence; however, the relationship between impaired redox homeostasis of prostate tissue and aging remains unclear.

OBJECTIVE

In our study, we hypothesized that age-related deterioration of redox homeostasis in prostate tissue may be considered as a predisposing factor for prostate cancer occurrence.

METHODS

Sprague-Dawley rats were divided into two groups as young control (5 months) and naturally aged (24 months). We investigated the levels of oxidant and antioxidant parameters in prostate tissue.

RESULTS

Advanced oxidation protein products, protein carbonyl, non-protein thiol and lipid hydroperoxides levels of aged rats were significantly higher than in the young control rats (p < 0.01, p < 0.05, p < 0.001, p < 0.05, respectively). Additionally, antioxidant activity of Cu-Zn-superoxide dismutase in elderly group was significantly lower than young controls (p < 0.05).

CONCLUSIONS

We suggest that increased non-protein thiol levels found in aged rats may prevent further dissemination of oxidative protein damage. We also propose that the increased levels of oxidative protein damage markers and decreased Cu-Zn superoxide dismutase activity in aged prostate may be considered as a predisposing factor for prostate cancer. Further studies are warranted to clarify all these oxidative changes as initiation factors for prostate cancer in the association of aging with prostate cancer.

Validation of the Turkish version of the Liverpool Oral Rehabilitation Questionnaire version 3 (LORQv3) in prosthetically rehabilitated patients with head and neck cancer

BACKGROUND

The Liverpool Oral Rehabilitation Questionnaire version 3 (LORQv3) is a measure assessing the impact of oral rehabilitation on patients' health-related quality of life (HRQOL).The aims of the study were to adapt culturally the LORQv3 for Turkish-speaking head and neck cancer patients who had undergone prosthetic rehabilitation and to undertake an initial investigation of its psychometric properties.

METHODS

The Turkish version of the LORQv3 was translated and culturally adapted into Turkish, and tested on a sample of 46 head and neck cancer patients who had undergone prosthetic rehabilitation at a university clinic. Patients were categorized into three groups: Patients with maxillary obturator prostheses treated by surgery alone (n = 15); Patients with maxillary obturator prostheses treated by surgery plus radiotherapy, with or without chemotherapy (n = 23); and, Nasopharyngeal cancer patients without maxillary defects wearing conventional dental prostheses who had been treated by radiotherapy with or without chemotherapy (n = 8). Data were collected through clinical examinations and self-reported questionnaires, including socio-demographic characteristics, the LORQv3, and the University of Washington Quality of Life questionnaire version 4 (UW-QOLv4). The psychometric evaluation included validity (content, face, construct, and criterion) and reliability (internal consistency and test-retest).

RESULTS

All sections of the LORQv3 showed satisfactory internal consistency, with Cronbach's alpha between 0.71 to 0.82. Kappa statistics showed moderate to perfect test-retest reliability for the 33 LORQv3 items. We found significant negative correlations between the LORQv3 and the UW-QOL v4 for some related items. The LORQv3 also identified differences in responses among patient groups, supporting its construct and criterion validity.

CONCLUSIONS

This study provides initial evidence in support of the validity and reliability of the Turkish version of LORQv3 in prosthetically rehabilitated patients with head and neck cancer; it could be used in clinical practice in Turkey.

Positron emission tomography/computerized tomography in lung cancer

Positron emission tomography (PET) using 2-(18F)-flouro-2-deoxy-D-glucose (FDG) has emerged as a useful tool in the clinical work-up of lung cancer. This review article provides an overview of applications of PET in diagnosis, staging, treatment response evaluation, radiotherapy planning, recurrence assessment and prognostication of lung cancer.

Cancer awareness among university students in Turkey

BACKGROUND

One of the most important reasons for the high mortality rates of cancer is the low level of awareness, which can lead to a late diagnosis and treatments starting too late. Therefore, it is necessary for individuals, especially at younger age, to gain awareness and integrate taking the necessary precautions into their lifestyle in order to prevent cancer and ensure early diagnosis. The aim of this study was to assess the levels of awareness of factors for major cancers among students studying in two different campuses of a university in the Western Black Sea Region.

MATERIALS AND METHODS

This descriptive/cross-sectional study was performed between January-March 2014. Students studying in the 2013-2014 academic year in a university in the Western Black Sea Region in two separate campuses were the subjects.

RESULTS

The mean age was 21.01 ± 3.63. While female students (51.2%) were the majority in the health sciences campus (74.8%), male students (48.8% ) were the majority in the social sciences campus (76.5%). Some 9.6% of the students from the health sciences campus and 12.4% of the students from the social sciences campus thought that cancer was communicable, while most of the students from both campuses knew that smoking caused cancer. It can also be seen that the rate of answering questions regarding cancer correctly was higher among students studying in the health sciences campus.

CONCLUSIONS

It was determined that students who do not study at the health sciences campus have insufficient information on cancer, cancer symptoms, and the possibility of breast cancer in males and approximately half of them regarded obesity as a risk factor for cancer.

Prevalence of aging population in the Middle East and its implications on cancer incidence and care

The Middle Eastern population is aging rapidly, and as aging is the main risk factor for cancer, the incidence and prevalence of that disease are increasing among all the populations in the region. These developments represent huge challenges to national and community-based health services. At the current state of affairs, most Middle Eastern countries require the cooperation of international agencies in order to cope with such new challenges to their health systems. The focus and emphasis in facing these changing circumstances lie in the education and training of professionals, mainly physicians and nurses, at the primary, secondary and tertiary levels of health services. It is imperative that these training initiatives include clinical practice, with priority given to the creation of multidisciplinary teams both at the cancer centers and for home-based services.

The effects of p38 gene silencing on breast cancer cells

p38 mitogen-activated protein kinases (MAPK) are members of the MAPK family that are activated by inflammatory cytokines and a variety of environmental stresses. It mediates various biological processes. p38 MAPK activity play important roles in tumour progression. Excessive p38 expression is observed in invasive breast cancers. The aim of the present study was to investigate whether the p38 siRNA transfection of breast cancer cells is a putative preventive treatment for human breast cancer. p38 siRNA was used at a concentration of 15, 30, and 100 nM in human breast cancer cell lines (MCF-7) and normal fibroblast cell lines (NIH 3T3). After 48 and 72 h of transfection, the reduction in p38 expression was measured using quantitative real-time PCR. The activation of p38 signalling was measured by ELISA. XTT cell proliferation assay was performed to determine the effect of p38 silencing on MCF-7 and NIH 3T3 cell lines. The results demonstrated that approximately 96% gene silencing occurred by the selected siRNA targeting p38 mRNA. The most effective silencing was observed at 72 h post-transfection using 30 nM p38 siRNA. The results of ELISA showed that the expression of p38 protein was inhibited by p38 siRNA at 30 nM siRNA and 100 nM at 72 h post transfection. XTT results showed that cells stimulated by 30 nM siRNA at 72 h post transfection were the lowest in proliferation. p38 siRNA can interfere with the expression of p38 at protein level in MCF-7 cells, result in inhibition of cell proliferation. p38 siRNA may be a critical regulator to promote the proliferation and protein expression in MCF-7 cells. In this study, we demonstrate that p38 silencing is a preventive maintenance for treating breast cancer.

Relationship between primary lesion metabolic parameters and clinical stage in lung cancer

OBJECTIVES

The relation of PET-derived parameters as maximum standardized uptake value (SUVmax), total lesion glycolysis (TLG), metabolic tumor volume (MTV) with clinical stage in lung cancer and correlation of SUVmax of primary tumor and that of metastatic lesion was studied in lung cancer patients.

MATERIALS AND METHODS

Patients with lung cancer who were referred for FDG PET/CT were included in the study.

RESULTS

PET/CT scans and pathology reports of 168 patients were assessed. A total of 146 (86.9%) of these patients had a diagnosis of non-small cell lung cancer (NSCLC) and 22 (13.1%) had small cell lung cancer (SCLC). Metabolic parameters such as SUVmax, TLG and MTV showed significant differences in all the stages in NSCLC patients (p<0.001). However, after tumors sizes <25 mm were excluded, no significant differences in SUVmax between stages were observed. No significant differences were found between these metabolic parameters and limited or extended disease SCLC. Tumor diameter correlated with primary tumor SUVmax and significant correlations between primary lesion SUVmax and metastatic lesion SUVmax were found.

CONCLUSIONS

Although differences were found regarding indices between stages of NSCLC cases, SUVmax differences between stages seem to be caused by underestimation of SUVmax in small lesions. Other glucose metabolism indexes such as MTV and TLG show promising results in terms of prognostic stratification. Future studies are needed for better understanding of their contribution to clinical cases.

Association between gene polymorphism of manganese superoxide dismutase and prostate cancer risk

Manganese superoxide dismutase (MnSOD) is the most effective antioxidant enzyme in mitochondria and protects cells from reactive oxygen species-induced oxidative damage. The aim of this study was to investigate the association between MnSOD Ala-9 Val gene polymorphism and prostate cancer (PCa) risk in Turkish men with prostate cancer. 33 patients with PCa and 81 control individuals were included in the study. We observed an association between MnSOD Ala/Ala frequency and a higher PCa risk. In addition, we found that the increased risk of early-onset PCa (under age of 65) in the men homozygous for Ala allele was higher than the men homozygous for Val allele. However, we determined that MnSOD Ala-9 Val genotype was not associated with the aggressiveness of the disease. The results of our study suggest that MnSOD Ala/Ala genotype may influence on early-onset of PCa patients, but no effect on subsequent development of the disease in Turkish men. However, our study has a limitation that is small numbers of individuals for cases and controls. Therefore, the presented study limited our statistical power to fully investigate the gene polymorphism on cancer risk.

Cancer registries in four provinces in Turkey: a case study

Background

The burden of cancer affects all countries; while high-income countries have the capacity and resources to establish comprehensive cancer control programs, low and middle-income countries have limited resources to develop such programs. This paper examines factors associated with the development of cancer registries in four provinces in Turkey. It looks at the progress made by these registries, the challenges they faced, and the lessons learned. Other countries with similar resources can benefit from the lessons identified in this case study.

Methods

A mix of qualitative case study methods including key informant interviews, document review and questionnaires was used.

Results

This case study showed that surveillance systems that accurately report current cancer-related data are essential components of a country’s comprehensive cancer control program. At the initial stages, Turkey established one cancer registry with international support, which was used as a model for other registries. The Ministry of Health recognized the value of the registry data and its contribution to the country’s cancer control program and is supporting sustainability of these registries as a result.

Conclusions

This study demonstrates how Turkey was able to use resources from multiple sources to enhance its population based cancer registry system in four provinces. With renewed international interest in non-communicable diseases and cancer following the 2011 UN high-level meeting on NCDs, low- and middle- income countries can benefit from Turkey’s experience. Other countries can utilize lessons learned from Turkey as they address cancer burden and establish their own registries.

Systematic review of breast cancer biology in developing countries (part 1): Africa, the middle East, eastern europe, Mexico, the Caribbean and South america

There has been no systematic appraisal of ethnicity-based variations in breast cancer (BC) biology amongst women from developing countries. A qualitative systematic review was conducted of breast cancer size, stage, grade, histological type, extra-mammary involvement, hormone receptor status as well as patient demographics. This review includes patients from Africa, the Middle East, Eastern Europe, Mexico, the Caribbean and South America. BC in these regions present at an earlier age with large aggressive tumours. Distant metastases are frequently present at the time of diagnosis. African women have a higher frequency of triple negative tumours. Over half of Middle Eastern women have lymph node involvement at the time of diagnosis. Despite experiencing a lower incidence compared to the Ashkenazi Jewish population, Palestinian women have poorer five-year survival outcomes. The majority of women from Mexico and South America have stage two or three disease whilst over sixty percent of women from Eastern Europe have either stage one or stage two disease. The biological characteristics of BC in the Caribbean cannot be fully assessed due to a paucity of data from the region. BC amongst the developing world is characterised by an early peak age of onset with aggressive biological characteristics. Strategies that improve breast cancer awareness, address amenable risk factors and improve early detection are essential.