Ovarian cancer screening practices of obstetricians and gynecologists in puerto rico

Polymer-Based Terbium Complex as a Fluorescent Probe for Cancer Antigen 125 Detection: A Promising Tool for Early Diagnosis of Ovarian Cancer

A novel photoprobe, Tb-acetylacetone (Tb-ACAC) doped within a modified epoxy cellulose polymer immobilized with CA-125 monoclonal antibody, offers an accurate and highly selective method for early ovarian cancer (OC) diagnosis by detecting cancer antigen 125 (CA-125) in serum samples. This approach leverages quenching of the Tb-ACAC luminescence upon binding to CA-125. Characterization of the photoprobe film through UV-vis and fluorescence measurements confirmed the presence of Tb-ACAC within the polymer matrix. In aqueous solution (pH 6.8, λex = 365 nm), the characteristic emission band of Tb-ACAC at λem = 546.2 nm exhibited significant quenching upon CA-125 binding. This quenching effect enabled the sensitive and specific detection of CA-125 in diverse serum samples from OC patients, demonstrating the applicability, simplicity, and effectiveness of this novel approach.

Prevalence of breast and ovarian cancer subtypes in Hispanic populations from Puerto Rico

Background

Previous epidemiological studies aimed at describing characteristics of breast (BC) and ovarian cancer (OC) patients tend to examine Hispanic populations using a mix of individuals that come from ethnically different Hispanic backgrounds. Since most USA cancer statistics do not include cancer data from Puerto Rico (PR), there is a lack of historical and descriptive data analysis for Hispanic women in the island that suffer from these diseases. Therefore, the aim of our study is to provide a comprehensive clinicopathological characterization of BC and OC cases in PR.

Methods

Our study consisted of a longitudinal retrospective review of archived pathology reports at Southern Pathology Services (SPS), which mostly serves southwestern PR, from years 2000–2015. After filtering SPS records with pre-established criteria, tumor samples from 3451 BC and 170 OC cases were used for descriptive statistics and analysis using R program.

Results

In our cohort, the mean age of diagnosis for BC was 60.5 years and 60.3 years for OC. Available data for subtype characterization from BC cases, exhibited an expected subtype distribution that remained stable over time (Luminal A = 68.8%, Luminal B = 9.7%, HER-2 = 6.1% and Triple negative = 15.4%). Additionally, tumor grades distribution varied within different BC subtypes in which the majority of Luminal A tumors were G2 and most Triple negative tumors were G3. For OC cases, available subtype and tumor grade information identified serous histology in 64.71% of all cases and G3 as being the most prevalent tumor grade. Pathology reports revealed that 39.42% of all OC cases were described as late stage, while 50.5% as early stage (by pathological staging).

Conclusion

Our data suggests that OC and BC subtypes distribution in Hispanic populations from PR are in-line with national averages. In a significant number of BC cases, subtype could not be determined due to study limitations, health insurance coverage, or other reasons described here and may constitute a health disparity. Altogether, and despite these gaps, this study represents one of the most complete reviews of BC and OC in PR and provides an opportunity to further study this population separate from other US Hispanic populations.

Electronic supplementary material

The online version of this article (10.1186/s12885-018-5077-z) contains supplementary material, which is available to authorized users.

Transnational Mortality Comparisons Between Archipelago and Mainland Puerto Ricans

Puerto Ricans in the US experience higher deaths from diabetes and other causes compared to non-Hispanic Whites and other Hispanic groups. We compared mortality in Puerto Rico to that of Puerto Ricans in the US as a first step to investigate if similar or worse mortality patterns originate from the sending country (Puerto Rico). Age-adjusted death rates were generated using national vital statistics databases in the US and territories for all-cause and the top ten causes of death among Hispanics in 2009. Mortality ratios in the archipelago of Puerto Rico (APR) were compared to mainland US Puerto Ricans (MPR). Rates for other ethnic/racial groups (Mexican Americans, Cubans, and non-Hispanic Whites, Blacks, American Indians, and Asians) were calculated to provide a context. APR had significantly higher all-cause mortality and death rates for diabetes, nephritis, pneumonia/influenza, and homicide/assault compared to MPR (APR/MPR ratio for all-cause: 1.08, diabetes: 2.04, nephritis: 1.84, pneumonia/influenza: 1.33, homicide/assault: 3.15). Death rates for diabetes and homicide/assault (particularly among men) were higher among APR compared to any other racial/ethnic groups in the US. In contrast, deaths from heart disease, cancer, and chronic liver disease were significantly lower for APR compared to MPR (MPR/APR ratio 0.72, 0.91, 0.41, respectively). Among APR women, death rates for these causes were also lower compared to any other group in the US. Substantial mortality variability exists between Puerto Ricans in Puerto Rico and those in the US, re-emphasizing the need to study of how socio-environmental determinants of health differ in sending and receiving countries. Explanations for disparate rates include access to and availability of healthcare and unique factors related to the migration experience of this group.

Public perception of risk-reducing salpingectomy for preventing ovarian cancer

OBJECTIVE

The fallopian tube is considered as the site of origin of serous ovarian cancer, and risk-reducing salpingectomy (RRS) has been proposed as a new and safe strategy for preventing ovarian cancer. However, little is known about the public perception of RRS.

METHODS

We performed a questionnaire survey of 100 healthy female volunteers in November 2014. Questionnaire for this survey included questions on demographics, medical history, knowledge of and belief about RRS, and barrier to its application.

RESULTS

Among 100 respondents, 71% did not realize the seriousness of ovarian cancer, 79% were unaware of the fact that salpinx was the origin of ovarian cancer, and 87% stated that they had never heard of RRS as a preventive method for ovarian cancer. Also, 98% of respondents replied that they had the right to be informed about RRS and the choice given. The respondents' fears about RRS included increased risk of surgical complications (68%), no benefit (8%), and increased surgical costs (3%).

CONCLUSION

Most general women were unaware of RRS as a method for preventing ovarian cancer in women at average risk. Therefore, physicians should discuss RRS with patients and consider this procedure at the time of abdominal or pelvic surgery.