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Kulothungan V, Ramamoorthy T, Sathishkumar K, Mohan R, Tomy N, Miller GJ, Mathur P. Burden of female breast cancer in India: estimates of YLDs, YLLs, and DALYs at national and subnational levels based on the national cancer registry programme. Breast Cancer Res Treat 2024; 205:323-332. [PMID: 38433127 PMCID: PMC11101532 DOI: 10.1007/s10549-024-07264-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 01/19/2024] [Indexed: 03/05/2024]
Abstract
PURPOSE Female breast cancer (BC) is the leading cause of cancer incidence and mortality in India, and accounted for 13.5% of new cancer cases and 10% of cancer-related deaths in 2020. This study aims to estimate and report the female BC burden in India at state level from 2012 to 2016 in terms of years of life lost, years lived with disability, and disability-adjusted life years (DALYs), and to project the burden for the year 2025. METHODS The cancer incidence and mortality data from 28 population-based cancer registries were analysed. The mean mortality to incidence ratio was estimated, and mortality figures were adjusted for underreporting. The burden of female BC was estimated at national and subnational levels using Census data, World Health Organisation's lifetables, disability weights, and the DisMod-II tool. A negative binomial regression is employed to project burden for 2025. RESULTS The burden of BC among Indian women in 2016 was estimated to be 515.4 DALYs per 100,000 women after age standardization. The burden metrics at state level exhibited substantial heterogeneity. Notably, Tamil Nadu, Telangana, Karnataka, and Delhi had a higher burden of BC than states in the eastern and north-eastern regions. The projection for 2025 indicates to a substantial increase, reaching 5.6 million DALYs. CONCLUSION The female BC burden in India was significantly high in 2016 and is expected to substantially increase. Undertaking a multidisciplinary, context-specific approach for its prevention and control can address this rising burden.
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Affiliation(s)
- Vaitheeswaran Kulothungan
- Indian Council of Medical Research (ICMR) - National Centre for Disease Informatics and Research (NCDIR), Nirmal Bhawan - ICMR Complex (II Floor), Poojanahalli, Kannamangala Post, Bengaluru, Karnataka, 562 110, India
| | - Thilagavathi Ramamoorthy
- Indian Council of Medical Research (ICMR) - National Centre for Disease Informatics and Research (NCDIR), Nirmal Bhawan - ICMR Complex (II Floor), Poojanahalli, Kannamangala Post, Bengaluru, Karnataka, 562 110, India
| | - Krishnan Sathishkumar
- Indian Council of Medical Research (ICMR) - National Centre for Disease Informatics and Research (NCDIR), Nirmal Bhawan - ICMR Complex (II Floor), Poojanahalli, Kannamangala Post, Bengaluru, Karnataka, 562 110, India
| | - Rohith Mohan
- Indian Council of Medical Research (ICMR) - National Centre for Disease Informatics and Research (NCDIR), Nirmal Bhawan - ICMR Complex (II Floor), Poojanahalli, Kannamangala Post, Bengaluru, Karnataka, 562 110, India
| | - Nifty Tomy
- Indian Council of Medical Research (ICMR) - National Centre for Disease Informatics and Research (NCDIR), Nirmal Bhawan - ICMR Complex (II Floor), Poojanahalli, Kannamangala Post, Bengaluru, Karnataka, 562 110, India
| | - G J Miller
- Indian Council of Medical Research (ICMR) - National Centre for Disease Informatics and Research (NCDIR), Nirmal Bhawan - ICMR Complex (II Floor), Poojanahalli, Kannamangala Post, Bengaluru, Karnataka, 562 110, India
| | - Prashant Mathur
- Indian Council of Medical Research (ICMR) - National Centre for Disease Informatics and Research (NCDIR), Nirmal Bhawan - ICMR Complex (II Floor), Poojanahalli, Kannamangala Post, Bengaluru, Karnataka, 562 110, India.
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Dixit J, Gupta N, Kataki A, Roy P, Mehra N, Kumar L, Singh A, Malhotra P, Gupta D, Goyal A, Rajsekar K, Krishnamurthy MN, Gupta S, Prinja S. Health-related quality of life and its determinants among cancer patients: evidence from 12,148 patients of Indian database. Health Qual Life Outcomes 2024; 22:26. [PMID: 38481231 PMCID: PMC10938809 DOI: 10.1186/s12955-024-02227-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 01/02/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Cancer survivors experience a decrement in health-related quality of life (HRQoL) resulting from the disease as well as adverse effects of therapy. We evaluated the HRQoL of cancer patients, stratified by primary cancer site, stage, treatment response and associated adverse events, along with its determinants. METHODS Data were collected from 12,148 patients, sampled from seven purposively chosen leading cancer hospitals in India, to elicit HRQoL using the EuroQol questionnaire comprising of 5-dimensions and 5-levels (EQ-5D-5L). Multiple linear regression was used to determine the association between HRQoL and various socio-demographic as well as clinical characteristics. RESULTS Majority outpatients (78.4%) and inpatients (81.2%) had solid cancers. The disease was found to be more prevalent among outpatients (37.5%) and inpatients (40.5%) aged 45-60 years and females (49.3-58.3%). Most patients were found to be in stage III (40-40.6%) or stage IV (29.4-37.3%) at the time of recruitment. The mean EQ-5D-5 L utility score was significantly higher among outpatients [0.630 (95% CI: 0.623, 0.637)] as compared to inpatients [0.553 (95% CI: 0.539, 0.567)]. The HRQoL decreased with advancing cancer stage among both inpatients and outpatients, respectively [stage IV: (0.516 & 0.557); stage III (0.609 & 0.689); stage II (0.677 & 0.713); stage I (0.638 & 0.748), p value < 0.001]. The outpatients on hormone therapy (B = 0.076) showed significantly better HRQoL in comparison to patients on chemotherapy. However, palliative care (B=-0.137) and surgery (B=-0.110) were found to be associated with significantly with poorer HRQoL paralleled to chemotherapy. The utility scores among outpatients ranged from 0.305 (bone cancer) to 0.782 (Leukemia). Among hospitalized cases, the utility score was lowest for multiple myeloma (0.255) and highest for testicular cancer (0.771). CONCLUSION Older age, lower educational status, chemotherapy, palliative care and surgery, advanced cancer stage and progressive disease were associated with poor HRQoL. Our study findings will be useful in optimising patient care, formulating individualized treatment plan, improving compliance and follow-up.
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Affiliation(s)
- Jyoti Dixit
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Nidhi Gupta
- Department of Radiation Oncology, Government Medical College and Hospital, Chandigarh, India
| | - Amal Kataki
- Dr. B. Booroah Cancer Institute, Guwahati, Assam, India
| | - Partha Roy
- Dr. B. Booroah Cancer Institute, Guwahati, Assam, India
| | - Nikita Mehra
- Department of Medical Oncology, Adyar Cancer Institute, Chennai, Tamil Nadu, India
| | - Lalit Kumar
- Department of Medical Oncology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Ashish Singh
- Department of Medical Oncology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Pankaj Malhotra
- Department of Clinical Haematology and Medical Oncology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Dharna Gupta
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Aarti Goyal
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Kavitha Rajsekar
- Department of Health Research, Ministry of Health and Family Welfare, New Delhi, India
| | | | - Sudeep Gupta
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Shankar Prinja
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
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Chintapally N, Nuwayhid M, Arroju V, Muddu VK, Gao P, Reddy BY, Sunkavalli C. State of cancer care in India and opportunities for innovation. Future Oncol 2023; 19:2593-2606. [PMID: 37675499 DOI: 10.2217/fon-2023-0047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/08/2023] Open
Abstract
Cancer is one of the leading causes of morbidity and mortality in India. Despite recent medical and technological advances, the cancer burden in India remains high and continues to rise. Moreover, substantial regional disparities in cancer incidence and access to essential medical resources exist throughout the country. While innovative and effective cancer therapies hold promise for improving patient outcomes, several barriers hinder their development and utilization in India. Here we provide an overview of these barriers, including challenges related to patient awareness, inadequate infrastructure, scarcity of trained oncology professionals, and the high cost of cancer care. Furthermore, we discuss the limited availability of cancer clinical trials in the country, along with an examination of potential avenues to enhance cancer care in India. By confronting these hurdles head-on and implementing innovative, pragmatic solutions, we take an indispensable step toward a future where every cancer patient in the country can access quality care.
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Affiliation(s)
- Neha Chintapally
- Pi Health USA, Cambridge, MA, USA
- Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | | | | | - Vamshi K Muddu
- Asian Institute of Gastroenterology (AIG) Hospitals, Hyderabad, Telangana, India
| | - Peng Gao
- Pi Health USA, Cambridge, MA, USA
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Kuriakose S, Krishnamurthy A, Vinutha RS, Ramshankar V, Sekhar S, Walia GK, Gupta R, Aggarwal A, Singh R, Rajan S, Kondal D, Grover S, Prabhakaran D, Dhillon PK, Shridhar K, Goodman M. Time intervals and patient-level factors in oral cancer diagnostic pathways: An application of the WHO framework in India. Cancer Epidemiol 2022; 81:102283. [PMID: 36335850 DOI: 10.1016/j.canep.2022.102283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/21/2022] [Accepted: 10/23/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Oral cancer, a leading cancer-site in India, is often detected at advanced stages. We evaluated the time intervals from first symptom to help-seeking and diagnosis among oral cancer patients. METHODOLOGY In this cross-sectional study, we recruited 226 consecutive oral cancer patients (mean age ( ± SD) 51.9 years ( ± 10.9); 81.9% men; 70.3% advanced stage) registered for diagnosis and treatment, between 2019 and 2021 at a cancer care centre in South India. We used WHO framework and previously standardized tools to record time intervals (appraisal, help-seeking and diagnostic) and baseline characteristics. We utilized multivariable logistic regression models to test the associations between 'prolonged (i.e., over 1 month) time intervals') and patient-level factors to estimate odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS Over a half of patients presented with prolonged appraisal (60%) and help-seeking intervals (57%), and a third (34%) reported prolonged diagnostic interval. Patients with no formal education, no routine healthcare visits, no self-reported risk factors, and those who did not perceive initial symptoms to be serious were 2-4 times more likely to have prolonged appraisal and help-seeking than the rest. High travel costs and self-decision for visiting healthcare facility prolonged help-seeking. Diagnostic interval was prolonged only among women OR= 2.7 (95% CI: 1.2-6.1)) and in patients whose first doctor's opinion was 'nothing to worry' OR (=7.3 (95% CI: 2.6-20.5)). 'Correct knowledge of cancer' shortened appraisal and help-seeking intervals and 'incorrect knowledge and negative beliefs' prolonged diagnostic interval. CONCLUSION Our findings highlight that interventions targeting sociocultural and economic determinants, symptom awareness, sensitizing persons at risk (especially women) and primary care providers might reduce overall time to diagnosis. Further, patients without any known risk factors for oral cancer might be at-risk for prolonged appraisal interval. These might help inform 'pull' strategies for cancer control in India and similar settings.
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Affiliation(s)
- Steena Kuriakose
- Centre for Chronic Disease Control, C-1/52, 2ND FL, Safdarjung Development Area, Delhi 110016, India.
| | | | - R S Vinutha
- Public Health Foundation of India, Plot 47, Sector 44, Institutional Area, Gurgaon, Haryana 122002, India.
| | - Vijayalakshmi Ramshankar
- Department of Preventive Oncology and Molecular Testing Laboratory, Cancer Institute WIA, Adyar, Chennai 600020, India.
| | | | - Gagandeep Kaur Walia
- Public Health Foundation of India, Plot 47, Sector 44, Institutional Area, Gurgaon, Haryana 122002, India.
| | - Ruby Gupta
- Centre for Chronic Disease Control, C-1/52, 2ND FL, Safdarjung Development Area, Delhi 110016, India; Public Health Foundation of India, Plot 47, Sector 44, Institutional Area, Gurgaon, Haryana 122002, India.
| | - Aastha Aggarwal
- Public Health Foundation of India, Plot 47, Sector 44, Institutional Area, Gurgaon, Haryana 122002, India.
| | - Ranjana Singh
- Public Health Foundation of India, Plot 47, Sector 44, Institutional Area, Gurgaon, Haryana 122002, India.
| | - Sheril Rajan
- Centre for Chronic Disease Control, C-1/52, 2ND FL, Safdarjung Development Area, Delhi 110016, India.
| | - Dimple Kondal
- Centre for Chronic Disease Control, C-1/52, 2ND FL, Safdarjung Development Area, Delhi 110016, India; Public Health Foundation of India, Plot 47, Sector 44, Institutional Area, Gurgaon, Haryana 122002, India.
| | - Surbhi Grover
- Hospital of the University of Pennsylvania, Department of Radiation Oncology, 3400 Civic Center Blvd., Philadelphia, PA 19104, United States.
| | - D Prabhakaran
- Centre for Chronic Disease Control, C-1/52, 2ND FL, Safdarjung Development Area, Delhi 110016, India; Public Health Foundation of India, Plot 47, Sector 44, Institutional Area, Gurgaon, Haryana 122002, India.
| | - Preet K Dhillon
- Centre for Chronic Disease Control, C-1/52, 2ND FL, Safdarjung Development Area, Delhi 110016, India; Department of Real World Data, PD Data Sciences, Genentech Inc., South San Francisco, CA, USA.
| | - Krithiga Shridhar
- Centre for Chronic Disease Control, C-1/52, 2ND FL, Safdarjung Development Area, Delhi 110016, India; Public Health Foundation of India, Plot 47, Sector 44, Institutional Area, Gurgaon, Haryana 122002, India.
| | - Michael Goodman
- Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA 30322, United States.
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Sinha P, Seshadri JG, Chidambaram P. Effect of Health Education on Awareness of HPV Vaccination and its Acceptance Among Postpartum Women. INDIAN JOURNAL OF GYNECOLOGIC ONCOLOGY 2022. [DOI: 10.1007/s40944-022-00633-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kulkarni VY, Mishra GA, Pimple SA, Shaikh HKA, Awasthi AA. Compliance for Community-Based Cervical Cancer Screening Program among Women of Age 30-65 Years Residing in Low Socioeconomic Settings of Mumbai, India. Indian J Community Med 2022; 47:414-419. [PMID: 36438507 PMCID: PMC9693944 DOI: 10.4103/ijcm.ijcm_536_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 12/09/2020] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Low participation in screening and poor follow-up are major challenges in implementing population based screening in developing countries. Determinants of participation in a community-based organized cervical cancer screening program are discussed here. OBJECTIVES The objectives were to study factors determining compliance of women for cervical cancer screening in an urban low socioeconomic setting. METHODOLOGY Community-based service program was conducted for screening uterine cervix cancers with a visual inspection of the cervix on the application of 5% acetic acid by trained primary health workers. The process involved the selection of clusters, household surveys, health education, and screening of eligible women for uterine cervix cancer. Logistic regression analysis was conducted to identify determinants of participation in cervical cancer screening. RESULTS A total of 138,383 population were surveyed, of which 21,422 eligible women were contacted and 16,424 (82.50%) complied for screening. According to the results of univariate and multivariate analysis, women belonging to the age group of 30-39 (80.69%), literate women with school level or education up to Senior College (78.97% and 80.86%) (odds ratio [OR], 1.323; P ≤ 0.001) and (OR, 1.402; P ≤ 0.001), belonging to Hindu religion (77.20%), speaking Marathi (77.07%), and with a family history of cancer (81.93%) had higher participation for screening, while women belonging to the Muslim community (73.95%) (OR, 0.743; P ≤ 0.001), speaking other than Marathi and Hindi language (73%) (OR, 0.872; P = 0.017), illiterate women (70.71%), and graduate women (70.78%) had lower participation. CONCLUSION High compliance can be achieved by providing good-quality health education and setting up of screening clinics in vicinity of participating women.
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Affiliation(s)
- Vasundhara Yalguresh Kulkarni
- Department of Preventive Oncology, Centre for Cancer Epidemiology, Tata Memorial Centre, Homi Bhabha National Institute, Parel, Mumbai, Maharashtra, India
| | - Gauravi Ashish Mishra
- Department of Preventive Oncology, Centre for Cancer Epidemiology, Tata Memorial Centre, Homi Bhabha National Institute, Parel, Mumbai, Maharashtra, India
| | - Sharmila Anil Pimple
- Department of Preventive Oncology, Centre for Cancer Epidemiology, Tata Memorial Centre, Homi Bhabha National Institute, Parel, Mumbai, Maharashtra, India
| | - Heena Kauser Aslam Shaikh
- Department of Preventive Oncology, Centre for Cancer Epidemiology, Tata Memorial Centre, Homi Bhabha National Institute, Parel, Mumbai, Maharashtra, India
| | - Aanchal A Awasthi
- Laboratory of Health Data Analytics & Visualization Environment, Amity Institute of Public Health, Amity University, Noida, Uttar Pradesh, India
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Sisodia G, Kumawat P, Gupta A, Gaur K, Meena S, Jahan I. Awareness and practice of breast self-examination (BSE) with its socio-demographic associates: a cross-sectional survey in the capital of Rajasthan, India. MGM JOURNAL OF MEDICAL SCIENCES 2022. [DOI: 10.4103/mgmj.mgmj_13_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Sarkar S, Datta D, Debbarma S, Majumdar G, Mandal SS. Patterns of Cancer Incidence and Mortality in North- Eastern India: The First Report from the Population Based Cancer Registry of Tripura. Asian Pac J Cancer Prev 2020; 21:2493-2499. [PMID: 32986344 PMCID: PMC7779450 DOI: 10.31557/apjcp.2020.21.9.2493] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 09/04/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND There is, till date no population-based data regarding cancer patterns in North- Eastern India, dictating the need to understand the epidemiology of cancer in this population for its effective management. METHODS This is the first report of the Population Based Cancer Registry (PBCR) in Tripura (2010-2014). The protocol involves active collection of data on all cancer cases from Tripura through staff visit in more than 150 sources of incident and mortality registration, government and private hospitals, municipal corporation, etc. and scrutiny, corroboration with existing records. Data was analyzed statistically to understand cancer trends in terms of incidence and mortality across different sites, age groups affected and gender. RESULTS A total of 10,251 cases were registered during the period, with overall age-adjusted incidence rates of 75.7 and 54.9 per 100,000 males and females respectively. Crude Incidence Rate (CR) and Age- Adjusted Rate (AAR) was among the lowest reported in India, probably due to associated socio-economic factors. The most prevalent cancers were lung (18.1%), esophageal (8.3%) for men and cervix uteri (17.6%), breast (13.8%) for females. Gall bladder cancer in females was one of the highest in the country. Rate of cancer mortality in the population was quite high and significantly increased with time, probably accounting for dearth in early detection and feasible treatment alternatives. CONCLUSION The data suggests that high cancer incidence and mortality are prevalent in the population of Tripura, dictating the need of active tobacco control measures, early detection and awareness drives for effective cancer control.
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Affiliation(s)
- Shreya Sarkar
- Department of Epidemiology and Biostatistics, Chittaranjan National Cancer Institute, Kolkata, India.
- Dalhousie Medicine New Brunswick, Saint John, NB, Canada.
- New Brunswick Heart Centre, Saint John Regional Hospital, Saint John, NB, Canada.
| | | | | | | | - Syam Sundar Mandal
- Department of Epidemiology and Biostatistics, Chittaranjan National Cancer Institute, Kolkata, India.
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Barriers to Timely Diagnosis and Management of Breast Cancer: Observations from a Tertiary Referral Center in Resource Poor Setting. Indian J Surg Oncol 2020; 11:287-293. [PMID: 32523277 DOI: 10.1007/s13193-020-01037-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 01/03/2020] [Indexed: 12/24/2022] Open
Abstract
Breast cancer (BC) is the most common cancer among females worldwide, with over 2 million cases diagnosed every year. In India, it is the most common malignancy overall (15.4%) and accounts for about 27% female cancers. Morbidity and mortality remain high despite improvements in BC therapeutics. Conventionally, a gap of more than 3 months between noticing symptoms and commencing treatment is considered delay in BC management. Delays make BC an important public health problem and lead to poor outcomes. This study aims to identify patient perceived barriers to BC management. A self-designed structured questionnaire consisting of questions pertaining to multiple aspects of BC presentation and management was prepared. The study was conducted from October 2017 to September 2018 and results were analyzed. A delay of 3 months or more was seen in 284 of the 435 patients (65.3%), among which 179 was patient delay, 69 due to provider delay, and 36 due to a combined contribution of both factors. Provider factors were associated with prolonged delay. Misdiagnosis at first consult was the most common factor perceived by patients as a barrier, followed by delay in referral, distance from hospitals, lack of information, financial constraints, and logistic issues. A significant patient and provider delay exists in BC management which prevents effective early therapy. Effective tackling of these barriers may result in the betterment of BC management outcomes. Robust screening, education of patients and providers, and awareness promotion and infrastructure development will be useful in this regard.
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Zuwasti U, Abbey G, Pollack E, Scheel J, Chong A. Breast Imaging in Global Health: Serving the Underserved. CURRENT RADIOLOGY REPORTS 2020. [DOI: 10.1007/s40134-020-00349-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Prevalence of Cervical Cancer Screening and Awareness among Women in an Urban Community in South India-A Cross Sectional Study. Ann Glob Health 2020; 86:30. [PMID: 32211300 PMCID: PMC7082824 DOI: 10.5334/aogh.2735] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background Although the incidence of cervical cancer has declined in developed countries, cervical cancer remains a major problem in those that are developing. Past studies suggest that Indian women, who account for at least one-fourth of the global disease burden, are not routinely screened. Objectives Among the women living in our low-income urban community in South India, we sought to determine the prevalence of screening and to assess women's knowledge of cervical cancer. Methods We conducted a community-based cross-sectional survey evaluating cancer screening prevalence among women aged 25-65 living in the communities served by our clinic. We also assessed knowledge of cervical cancer, screening and the HPV vaccine in a subset of 175 women in the same age range. Findings Prevalence data was available for 1033 women. Of these,14.3% had at least one lifetime pelvic exam and 7.1% had undergone cervical cancer screening. Women who were married below the age of 18, who belonged to non-Hindu religion, and who were from a higher socioeconomic status were more likely to be screened. Women who were single did not undergo screening. With regard to knowledge of cervical cancer, 84.6% of women had poor knowledge, 10.3% had moderate knowledge, and 5.1% had good knowledge. Women aged 41 years or younger had better knowledge of the disease. Conclusions Very few women are screened for cervical cancer and few have adequate knowledge of the disease within this South Indian community. These findings suggest opportunities for a community-based education and screening campaign to reduce the prevalence of cervical cancer within this population.
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Somanna SN, Nandagudi Srinivasa M, Chaluvarayaswamy R, Malila N. Time Interval between Self-Detection of Symptoms to Treatment of Breast Cancer. Asian Pac J Cancer Prev 2020; 21:169-174. [PMID: 31983180 PMCID: PMC7294006 DOI: 10.31557/apjcp.2020.21.1.169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Indexed: 12/24/2022] Open
Abstract
Background: In India breast cancer is the number one cancer among females with an incidence rate of 25.8 per 100,000 women and mortality of 12.7 per 100,000 women. India continues to have a low 5-year survival rate of breast cancer with only 66.1% as compared to 90% in developed countries. The major reason for low survival is that patients are diagnosed with cancer at high stage. The present study attempts to delineate the time interval between self-detection of breast cancer symptoms and seeking care and to find the main reasons for delay in seeking care. Methods: A cross sectional study was undertaken from October 2016 to March 2017 in a population based cancer registry (PBCR) and hospital based cancer registry (HBCR) located in south of India. Histologically confirmed breast cancer patients (N=181) were interviewed at hospital using a pre-tested semi structured questionnaire. Results: The median time interval between the self-detection of breast cancer symptoms and first contact with general physician was 60 [IQR 30-180] days. The median time to diagnosis from the first contact was 30 [IQR 10 - 60] days and the overall median time span from self-detection of symptoms to treatment was 150 [IQR 95-265] days. The major reason given for not seeking medical care in time was lack of awareness in identifying the cancer symptoms both among patients and primary care providers. Conclusion: There was considerable delay from self-detection of symptoms to cancer specific primary treatment of breast cancer. We found lack of awareness among patients as well as in primary care providers to be the major concern for delay. Awareness among the target population and health care professionals would have to be improved for early diagnostics and access to care.
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Affiliation(s)
| | | | - Ramesh Chaluvarayaswamy
- Department of Epidemiology and Biostatistics, Kidwai Memorial Institute of Oncology, Bangalore, India
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Thulaseedharan JV, Frie KG, Sankaranarayanan R. Challenges of health promotion and education strategies to prevent cervical cancer in India: A systematic review. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2019; 8:216. [PMID: 31867380 PMCID: PMC6905291 DOI: 10.4103/jehp.jehp_156_19] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 07/13/2019] [Indexed: 05/30/2023]
Abstract
BACKGROUND Although there is a reduction in cervical cancer incidence over the years, it keeps the second position of the most common cancers among females in India. The aim of this review is to understand the challenges of health promotion and education strategies to prevent cervical cancer in India. MATERIALS AND METHODS This review is based on 78 studies published during 1993-2017 on the topics of awareness, attitude, and acceptance toward cervical cancer, screening, and human papilloma virus vaccination among Indians. The extracted information was summarized according to different populations such as people from different social and community groups, women and men attended clinics, students (nursing/medical/nonmedical), health-care providers (doctors, nurses, and other health workers), migrated Indians, and cervical cancer patients. RESULTS The awareness about cervical cancer and its prevention was very poor among women from different communities and the majority had a negative attitude toward screening and vaccination in general. The health professionals and medical students were more aware of cervical cancer and its prevention compared to the general population. Majority of students irrespective of medical or nonmedical background had a positive attitude toward vaccination. Only a small proportion of women in the general population were ever screened. CONCLUSIONS Observations from this review indicate immediate attention of the public health authority to take appropriate actions to educate and motivate general population toward cervical cancer prevention and to improve the facilities to incorporate the much needed preventive and early detection interventions in India.
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Affiliation(s)
- Jissa Vinoda Thulaseedharan
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| | - Kirstin Grosse Frie
- Institute for Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Rengaswamy Sankaranarayanan
- Research Triangle Institute Global India Private Limited (RTI International), New Delhi, 100 037, India
- International Agency for Research on Cancer (IARC/WHO), Lyon CEDEX 08, France
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Jacob J, Palat G, Verghese N, Kumari P, Rapelli V, Kumari S, Malhotra C, Teo I, Finkelstein E, Ozdemir S. Health-related quality of life and its socio-economic and cultural predictors among advanced cancer patients: evidence from the APPROACH cross-sectional survey in Hyderabad-India. BMC Palliat Care 2019; 18:94. [PMID: 31690311 PMCID: PMC6833246 DOI: 10.1186/s12904-019-0465-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 09/12/2019] [Indexed: 12/01/2022] Open
Abstract
Background Patients with advanced cancer often experience poor health-related quality-of-life (HRQoL) due to cancer and treatment-related side-effects. With India’s palliative care landscape in its infancy, there is a concern that advanced cancer patients, especially individuals who are from disadvantaged populations experience poor HRQoL outcomes. We aim to assess HRQoL of advanced cancer patients in terms of general well-being (physical, functional, emotional, and social/family well-being), pain experiences, psychological state, and spiritual well-being, and determine the relationship between belonging to a disadvantaged group and HRQoL outcomes. We hypothesize that patients from disadvantaged or minority backgrounds, identified in this paper as financially distressed, female, lower years of education, lower social/family support, minority religions, and Non-General Castes, would be associated with worse HRQoL outcomes compared to those who are not from a disadvantaged group. Methods We administered a cross-sectional survey to 210 advanced cancer patients in a regional cancer center in India. The questionnaire included standardized instruments for general well-being (FACT-G), pain experiences (BPI), psychological state (HADS), spiritual well-being (FACT-SP); socio-economic and demographic characteristics. Results Participants reported significantly lower general well-being (mean ± SD) (FACT-G = 62.4 ± 10.0) and spiritual well-being (FACT-SP = 32.7 ± 5.5) compared to a reference population of cancer patients in the U.S. Patients reported mild to moderate pain severity (3.2 ± 1.8) and interference (4.0 ± 1.6), normal anxiety (5.6 ± 3.1) and borderline depressive symptoms (9.7 ± 3.3). Higher financial difficulty scores predicted most of the HRQoL domains (p ≤ 0.01), and being from a minority religion predicted lower physical well-being (p ≤ 0.05) and higher pain severity (p ≤ 0.05). Married women reported lower social/family well-being (p ≤ 0.05). Pain severity and interference were significant predictors of most HRQoL domains. Conclusions Advanced cancer patients, especially those with lower financial well-being and belonging to minority religions, reported low physical, functional, emotional, social/family, and spiritual well-being, and borderline depressive symptoms. Future studies should be directed at developing effective interventions supporting vulnerable groups such as those with financial distress, and those belonging to minority religions.
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Affiliation(s)
- Jean Jacob
- MNJ Institute of Oncology and Regional Cancer Center (MNJIORCC), Hyderabad, Telangana, India.,Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Gayatri Palat
- MNJ Institute of Oncology and Regional Cancer Center (MNJIORCC), Hyderabad, Telangana, India
| | - Naina Verghese
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, 169857, Singapore
| | - Priya Kumari
- MNJ Institute of Oncology and Regional Cancer Center (MNJIORCC), Hyderabad, Telangana, India
| | - Vineela Rapelli
- MNJ Institute of Oncology and Regional Cancer Center (MNJIORCC), Hyderabad, Telangana, India
| | - Sanjeeva Kumari
- MNJ Institute of Oncology and Regional Cancer Center (MNJIORCC), Hyderabad, Telangana, India
| | - Chetna Malhotra
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, 169857, Singapore
| | - Irene Teo
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, 169857, Singapore
| | - Eric Finkelstein
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, 169857, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Semra Ozdemir
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, 169857, Singapore. .,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
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15
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Shankar A, Roy S, Rath GK, Chakraborty A, Kamal VK, Biswas AS. Impact of Cancer Awareness Drive on Generating Awareness of and Improving Screening for Cervical Cancer: A Study Among Schoolteachers in India. J Glob Oncol 2019; 4:1-7. [PMID: 30241246 PMCID: PMC6223415 DOI: 10.1200/jgo.17.00074] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Purpose Cervical cancer is the second most common cancer in India. Our study assessed the level and impact of awareness programs in the adoption of safe practices in prevention and early detection. Methods This assessment was part of a Pink Chain Campaign, the mission of which is to fight cancer. During cancer awareness events from 2013 to 2015 at various women’s colleges in different parts in India, a pretest related to cervical cancer was followed by an awareness program. A post-test was conducted 6 months and 1 year later. Results A total of 872 of 985 teachers participated in the study, for a response rate of 88.5%. Mean age of the population was 42.4 years. There was a significant increase in the level of knowledge regarding cervical cancer at 6 months, which was sustained at 1 year. Regarding cervical cancer screening, knowledge and practice of the Papanicolaou (Pap) test as a screening test for cervical cancer among teachers were changed significantly at 6 months and 1 year. More than 75% of teachers were educated by physicians about the Pap test. At the time of the post-test, there was a significant change in alcohol and smoking habits. The main reasons for not undergoing a screening test were ignorance (50%), lethargic attitude (44.8%), and lack of time (34.6%). Conclusion The level of knowledge of cervical cancer was poor. A significant increase in the level of knowledge of cervical cancer among the population was found after this study. To inculcate safe lifestyle practices, awareness programs should be conducted more widely and frequently.
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Affiliation(s)
- Abhishek Shankar
- Abhishek Shankar and Goura Kishor Rath, Dr BR Ambedkar Institute Rotary Cancer Hospital; Abhishek Shankar, Goura Kishor Rath, and Vineet Kumar Kamal, All India Institute of Medical Sciences; Shubham Roy, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi; Abhijit Chakraborty, Netaji Subhas Chandra Bose Cancer Research Institute; and Aalekhya Sharma Biswas, Maulana Abul Kalam Azad University of Technology, Kolkata, India
| | - Shubham Roy
- Abhishek Shankar and Goura Kishor Rath, Dr BR Ambedkar Institute Rotary Cancer Hospital; Abhishek Shankar, Goura Kishor Rath, and Vineet Kumar Kamal, All India Institute of Medical Sciences; Shubham Roy, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi; Abhijit Chakraborty, Netaji Subhas Chandra Bose Cancer Research Institute; and Aalekhya Sharma Biswas, Maulana Abul Kalam Azad University of Technology, Kolkata, India
| | - Goura Kishor Rath
- Abhishek Shankar and Goura Kishor Rath, Dr BR Ambedkar Institute Rotary Cancer Hospital; Abhishek Shankar, Goura Kishor Rath, and Vineet Kumar Kamal, All India Institute of Medical Sciences; Shubham Roy, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi; Abhijit Chakraborty, Netaji Subhas Chandra Bose Cancer Research Institute; and Aalekhya Sharma Biswas, Maulana Abul Kalam Azad University of Technology, Kolkata, India
| | - Abhijit Chakraborty
- Abhishek Shankar and Goura Kishor Rath, Dr BR Ambedkar Institute Rotary Cancer Hospital; Abhishek Shankar, Goura Kishor Rath, and Vineet Kumar Kamal, All India Institute of Medical Sciences; Shubham Roy, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi; Abhijit Chakraborty, Netaji Subhas Chandra Bose Cancer Research Institute; and Aalekhya Sharma Biswas, Maulana Abul Kalam Azad University of Technology, Kolkata, India
| | - Vineet Kumar Kamal
- Abhishek Shankar and Goura Kishor Rath, Dr BR Ambedkar Institute Rotary Cancer Hospital; Abhishek Shankar, Goura Kishor Rath, and Vineet Kumar Kamal, All India Institute of Medical Sciences; Shubham Roy, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi; Abhijit Chakraborty, Netaji Subhas Chandra Bose Cancer Research Institute; and Aalekhya Sharma Biswas, Maulana Abul Kalam Azad University of Technology, Kolkata, India
| | - Aalekhya Sharma Biswas
- Abhishek Shankar and Goura Kishor Rath, Dr BR Ambedkar Institute Rotary Cancer Hospital; Abhishek Shankar, Goura Kishor Rath, and Vineet Kumar Kamal, All India Institute of Medical Sciences; Shubham Roy, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi; Abhijit Chakraborty, Netaji Subhas Chandra Bose Cancer Research Institute; and Aalekhya Sharma Biswas, Maulana Abul Kalam Azad University of Technology, Kolkata, India
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16
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Srivastava AN, Misra JS, Srivastava S, Das BC, Gupta S. Cervical cancer screening in rural India: Status & current concepts. Indian J Med Res 2019; 148:687-696. [PMID: 30778002 PMCID: PMC6396551 DOI: 10.4103/ijmr.ijmr_5_17] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Cervical carcinoma is one of the most common and dreaded diseases of women, and in India, it accounts for 16 per cent of total cervical cancer cases occurring globally. The situation is more alarming in the rural areas where the majority of women are illiterate and ignorant about the hazards of cervical cancer. Different screening strategies such as rural cancer registries and camp approach for cancer detection have been found useful in minimizing the problem of cervical cancer in the villages. Various screening techniques such as visual inspection with acetic acid, visual inspection with Lugol's iodine, visual inspection with magnification devices-magnavisualizer, Pap smear and HPV-DNA testing have been suggested and tried under low-resource settings of our country, and cervical cytology screening has been found effective in reducing incidence of the disease. In the present review, feasibility of different screening methods has been assessed to find out the most suitable mode applicable at the rural level. Single lifetime screening particularly of high-risk women along with analysis of cost-effective tumour markers such as Argyrophilic nucleolar organizer regions (AgNOR) counts to discriminate high-risk dysplasia cases appears to be an appropriate approach in fighting against cervical cancer.
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Affiliation(s)
- Anand Narain Srivastava
- Department of Pathology, Era's Lucknow Medical College & Hospital, Era University, Lucknow, India
| | - Jata Shankar Misra
- Department of Pathology, Era's Lucknow Medical College & Hospital, Era University, Lucknow, India
| | - Shruti Srivastava
- Department of Genetics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | - Bhudav C Das
- Amity Institute of Molecular Medicine & Stem Cell Research, Noida, India
| | - Shilpi Gupta
- ICMR-National Institute of Cancer and Prevention Research, Noida, India
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17
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Lohia N, Prashar M, Singh S, Bhatnagar S, Viswanath S, Anand S, Ranjan R. Epidemiological and Survival Trends in Patients of Cancer of Uterine Cervix Treated with Definitive Concurrent Chemoradiotherapy: Observations from a North Indian Hospital-Based Cancer Registry. INDIAN JOURNAL OF GYNECOLOGIC ONCOLOGY 2019. [DOI: 10.1007/s40944-019-0288-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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18
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Masood A, Masood K, Hussain M, Ali W, Riaz M, Alauddin Z, Ahmad M, Masood M, Shahid A. Thirty Years Cancer Incidence Data for Lahore, Pakistan: Trends and Patterns 1984-2014. Asian Pac J Cancer Prev 2018; 19:709-717. [PMID: 29580045 PMCID: PMC5980846 DOI: 10.22034/apjcp.2018.19.3.709] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2017] [Indexed: 12/02/2022] Open
Abstract
This research was conducted to generate trends and patterns of most common male and female cancers from 1984-2014 for the city population of Lahore Pakistan. Cancer incidence data gathered for different organs were processed through cleaning, integration, transformation, reduction and mining for ultimate representation. Risk of cancer appeared to be continuously increasing among both males and females. Overall, lymphomas and breast cancer are the most common neoplasm in males and females, respectively, in Lahore with almost the highest rates in the Asian Pacific region. The incidence of head and neck, brain, and lung cancers, as well as leukemia have rapidly increased among males, whereas, ovarian, cervix, head and neck and lymphomas have become more common among females. The present communication should be helpful for adequate strategic planning, identification of risk factors and taking appropriate prevention and control measures at the national level.
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Affiliation(s)
- Andleeb Masood
- Cancer Incidence Statistical Analysis Group, Department of Physics, Government College University, Lahore, Pakistan
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19
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Khanduri S, Chaudhary M, Sabharwal T, Usmani T, Goyal A, Khanduri S, Bhagat S, Huda F, Yadav S, Katyal G. A Low-Cost, Low-Skill Model for Efficient Breast Cancer Screening in Low Resource Rural Settings of a Developing Country. Cureus 2017; 9:e1571. [PMID: 29057183 PMCID: PMC5642813 DOI: 10.7759/cureus.1571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Objective To suggest a low-cost, easily-operable, non-invasive imaging modality for cancer detection in rural settings. Method A total of 212 cases with palpable breast masses aged 18 - 65 years were enrolled and underwent thorough clinical, mammographic, and ultrasonographic (USG) evaluation. Imaging findings were reported using the American College of Radiology (ACR) Breast Imaging Reporting and Data System (BI-RADS®) criteria. The findings were confirmed histopathologically. Data were analyzed using the Chi-square test. Results The malignancy rate was 35.8% (n = 76). On mammography, lesions size, margins, shape, calcification, and distorted arch/skin thickening were significantly associated with malignancy. On USG, the number of nodules, shape, margins, echotexture, posterior wall echo, through transmission changes, distorted arch/skin thickening, microlobulation, duct extension, and height/width ratio were significantly associated with malignancy. Independently, mammography and USG had a sensitivity of 78.1% and 80.3%, respectively, and a specificity of 83.3% and 89.0%, respectively. Using a positive result of either study as the criteria, the sensitivity was 97.4% and the specificity was 80.1%. Conclusion The combined use of mammography and USG provides high sensitivity and specificity, thus showing that a combination of two can be used as a screening tool for use in low resource rural settings.
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Affiliation(s)
| | | | | | - Tarim Usmani
- Radiodiagnosis, Era's Lucknow Medical College and Hospital
| | - Aakshit Goyal
- Radiodiagnosis, Era's Lucknow Medical College and Hospital
| | | | - Saurav Bhagat
- Radiodiagnosis, Era's Lucknow Medical College and Hospital
| | - Fahimul Huda
- Radiodiagnosis, Era's Lucknow Medical College and Hospital
| | - Santosh Yadav
- Radiodiagnosis, Era's Lucknow Medical College and Hospital
| | - Gaurav Katyal
- Radiodiagnosis, Era's Lucknow Medical College and Hospital
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20
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Parsa P, Sharifi F, Shobeiri F, Karami M. Effects of Group Counseling Based on Health Belief Model on Cervical Cancer Screening Beliefs and Performance of Rural Women in Kaboudrahang, Iran. Asian Pac J Cancer Prev 2017; 18:1525-1530. [PMID: 28669162 PMCID: PMC6373803 DOI: 10.22034/apjcp.2017.18.6.1525] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Objective: Pap smear test is an appropriate screening method for early diagnosis of cervical cancer and reduction of mortality. This study targeted effects of group counseling based on the Health Belief Model on cervical cancer screening practices of Iranian rural women. Method: This quasi-experimental study was conducted on 80 rural women under coverage of the health care centers in rural areas in the city of Kabudrahang, Iran, in 2015. The data collection tool was a researcher-made questionnaire covering demographic information, Health Belief Model (HBM) constructs and screening performance. Data were collected using a multi-stage sampling method. Group counseling was conducted based on the Health Belief Model and the GATHER steps in three sessions for the intervention group. Counseling included an introduction to cervical cancer, disease symptoms, warning signs and prevention approaches. Pap smear testing in both intervention and control groups was evaluated two months after the group counseling. Results: Before the intervention, there was no significant difference between both groups in the HBM constructs and performance. After the intervention, a significant difference was seen in the perceived susceptibility (P<0.001), severity (P=006), benefits (P=012), barriers (P<0.001), and self-efficacy (P=002). Two months after the intervention, 17 patients (42.5%) in the intervention group, and 4 patients (10%) in the control group had undergone a Pap smear test (P<0.001). Conclusion: Design and implementation of counseling programs based on the HBM can modify the beliefs of rural women regarding cervical cancer screening and increase their performance.
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Affiliation(s)
- Parisa Parsa
- Chronic Disease (Home Care) Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.
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21
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Rakkapao N, Promthet S, Moore MA, Solikhah S, Hurst C. Assessing Breast Cancer Awareness in Thai Women: Validation of the Breast Cancer Awareness Scale (B-CAS). Asian Pac J Cancer Prev 2017; 18:995-1005. [PMID: 28545198 PMCID: PMC5494250 DOI: 10.22034/apjcp.2017.18.4.995] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
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.
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Affiliation(s)
- Nitchamon Rakkapao
- Faculty of Public Health, Thammasat University Lampang Center, Thailand.
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22
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Chen PL, Zhao T, Feng R, Chai J, Tong GX, Wang DB. Patterns and trends with cancer incidence and mortality rates reported by the China National Cancer Registry. Asian Pac J Cancer Prev 2017; 15:6327-32. [PMID: 25124619 DOI: 10.7314/apjcp.2014.15.15.6327] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
National cancer registration reports provide a huge potential for identifying patterns and trends of important policy, research, prevention and treatment significance. As summary reports written on an annual basis, the China Cancer Registry Annual Reports (CCRARs) fall short from fully addressing their potential. This paper attempts to explore part of the patterns and trends hidden behind published CCRARs. It extracted data for cancer incidence rates (IRs) and mortality rates (MRs) for 2004, 2006 and 2009 from relevant CCRARs and portrayed 4 kinds of indicators in line graphs. The study showed that: a) all of the line graphs of age-specific IRs and MRs characterized typical "growth curves or histogram"; b) graphs of IRs and MRs for males and urban areas had higher peaks than that for females and rural regions; c) most of the line graphs of IR/MR ratios comprised a starting peak, a secondary peak and a decreasing tail and the secondary peaks for females and urban areas were higher than those for males and rural areas; d) most of the urban versus rural IR ratios valued above one, but most the urban versus rural MR ratios, below one; e) the accumulative IRs and MRs showed a stable increasing trend from 2004 to 2009 for urban areas, but mixed for rural regions.
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Affiliation(s)
- Peng-Lai Chen
- School of Health Services Management, Anhui Medical University, Hefei, China E-mail :
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23
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Rakkapao N, Promthet S, Moore MA, Hurst CP. Development of a Breast Cancer Awareness Scale for Thai Women: Moving towards a Validated Measure. Asian Pac J Cancer Prev 2017; 17:851-6. [PMID: 26925691 DOI: 10.7314/apjcp.2016.17.2.851] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Breast cancer is a major health problem among women around the world. Recent developments in screening and treatment have greatly improved the prognosis of patients with breast cancer in developed countries. However, in developing countries breast cancer mortality remains high.Breast cancer awareness is a first and important step in reducing breast cancer mortality. The development of a validated instrument to measure breast cancer awareness is crucial for the understanding and implementation of suitable health education programs to facilitate early deletion and minimize mortality. OBJECTIVE The objective of this study was to develop an instrument for the assessment of breast cancer awareness in Thai women. MATERIALS AND METHODS This methodological study was conducted in two stages: (1) literature searches and semi-structured interviews were conducted to generate items of the breast cancer awareness scale (B-CAS) which were subsequently examined for content and face validity, and (2) an exploration of the factor structure of the resulting instrument and an examination of its reliability. Data were collected using a self-administered questionnaire in Thai women aged 20-64 in August, 2015. RESULTS A total of 219 women (response rate 97.4 %) participated in this validation study. The B-CAS contains five domains with 53 items on breast cancer awareness: 1) knowledge of risk factors, 2) knowledge of signs and symptoms, 3) attitude to breast cancer prevention, 4) barriers of breast screening, and 5) health behavior related to breast cancer awareness. Items with a content validity index <0.80 were excluded, and factor structure for the remaining items reflected the hypothesized five factor model. The scales based on all retained items was shown to have strongly internal consistency reliability (Cronbach's α=0.86). CONCLUSIONS The B-CAS provides good psychometric properties to assess breast cancer awareness in women. It can be used to examine breast cancer awareness in Thai women and it could lead to the development and evaluation of suitable educational interventions for raising breast cancer awareness. Future research should focus on further validating the B-CAS including an assessment of construct and criterion-based validity.
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Affiliation(s)
- Nitchamon Rakkapao
- Doctor of Public Health Program, Khon Kaen University, Thailand E-mail :
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So WKW, Chan RJ, Truant T, Trevatt P, Bialous SA, Barton-Burke M. Global Perspectives on Cancer Health Disparities: Impact, Utility, and Implications for Cancer Nursing. Asia Pac J Oncol Nurs 2016; 3:316-323. [PMID: 28083548 PMCID: PMC5214864 DOI: 10.4103/2347-5625.195885] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 10/29/2016] [Indexed: 12/31/2022] Open
Abstract
This paper examines cancer health disparities and contributing factors at national, regional, and international levels. The authors all live in different countries and regions with different health-care systems and practices. Despite the shared cancer nursing perspective, each country or global region approaches cancer disparities differently. With globalization the world is becoming smaller, and in turn becoming interconnected and interdependent. This article focuses on cancer health disparities and global cancer nursing, exemplifying these concepts about the impact and implications of person-centered care.
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Affiliation(s)
- Winnie K. W. So
- Asian Oncology Nursing Society, The Chinese University of Hong Kong, Hong Kong, China
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China
| | - Raymond Javan Chan
- Cancer Nurses Society of Australia, Queensland University of Technology, Brisbane, Australia
- Royal Brisbane and Women's Hospital, Queensland University of Technology, Brisbane, Australia
| | | | | | - Stella Aguinaga Bialous
- International Society of Nurses in Cancer Care, University of California, San Francisco, CA, USA
- School of Nursing, University of California, San Francisco, CA, USA
| | - Margaret Barton-Burke
- Oncology Nursing Society, New York, NY, USA
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- College of Nursing, University of Missouri, St. Louis, MO, USA
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Masood K, Masood A, Zafar J, Shahid A, Kamran M, Murad S, Masood M, Alluddin Z, Riaz M, Akhter N, Ahmad M, Ahmad F, Akhtar J, Naeem M. Trends and Analysis of Cancer Incidence for Common Male and Female Cancers in the Population of Punjab Province of Pakistan during 1984 to 2014. Asian Pac J Cancer Prev 2016. [PMID: 26225669 DOI: 10.7314/apjcp.2015.16.13.5297] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Pakistan Atomic Energy Commission Cancer Registry (PAECCR) program has made availability of a common cancer incidence database possible in Pakistan. The cancer incidence data from nuclear medicine and oncology institutes were gathered and presented. MATERIALS AND METHODS The cancer incidence data for the last 30 years (1984-2014) are included to describe a data set of male and female patients. The data analysis concerning occurrence, trends of common cancers in male and female patients, stage-wise distribution, and mortality/follow-up cases is also incorporated for the last 10 years (2004-2014). RESULTS The total population of provincial capital Lahore is 9,800,000. The total number of cancer cases was 80,390 (males 32,156, females 48,134). The crude incidence rates in PAECCR areas were 580.8/105 during 2010 to 885.4/105 in 2014 (males 354.1/105, females 530.1/105). The cancer incidence rates for head and neck (15.70%), brain tumors (10.5%), and non-Hodgkin lymphoma (NHL, 9.53%) were found to be the highest in male patients, whereas breast cancer (46.7%), ovary tumors (6.80%), and cervix (6.31%) cancer incidence rates were observed to be the most common in female patients. The age range distribution of diagnosed and treated patients in conjunction with the percentage contribution of cancer patients from 15 different cities of Punjab province treated at the Institute of Nuclear Medicine and Oncology, Lahore are also included. Leukemia was found to be the most common cancer for the age group of 1-12 years. It has been identified that the maximum number of diagnosed cases were found in the age range of 51-60 years for males and 41-50 years for female cancer patients. CONCLUSIONS Overall cancer incidence of the thirty years demonstrated that head and neck and breast cancers in males and in females respectively are the most common cancers in Punjab province in Pakistan, at rates almost the highest in Asia, requiring especial attention. The incidence of brain, NHL, and prostate cancers among males and ovarian and cervix cancers among females have increased rapidly. These data from a major population of Punjab province should be helpful for implementation of appropriate planning, prevention and cancer control measures and for determination of risk factors within the country.
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Affiliation(s)
- Khalid Masood
- Cancer Prevention and Control Research Group, Department of Medical Physics, Institute of Nuclear Medicine and Oncology Lahore, Lahore, Pakistan E-mail :
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Kadam YR, Quraishi SR, Dhoble RV, Sawant MR, Gore AD. Barriers for Early Detection of Cancer Amongst Urban Indian Women: A Cross Sectional Study. IRANIAN JOURNAL OF CANCER PREVENTION 2016; 9:e3900. [PMID: 27366310 PMCID: PMC4922203 DOI: 10.17795/ijcp.3900] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Revised: 10/05/2015] [Accepted: 01/17/2016] [Indexed: 11/25/2022]
Abstract
Background: Cancer is a leading cause of death globally. Every year, millions of cancer patients could be saved from premature death and and suffering if they had timely access to early detection and treatment. There are two main components of early detection: early diagnosis and screening. In India, cancers of cervix, breast, mouth/oropharynx are the most frequent cancers in women. These cancers are amenable to early detection. More than two third of the cancer patients are already in an advanced and incurable stage at the time of diagnosis. Objectives: This study was designed with the aim to know the reasons for non availment of cancer screening procedures and early diagnostic facilities. Materials and Methods: This cross-sectional study was planned in Sangli, Miraj and Kupwad Corporation area during October 2013 - March 2014 by a pretested questionnaire. Women of 25 years and above were study subjects selected randomly from a cluster sample of ward with estimated sample size of 559 women. Statistical analysis was done with the help of IBM SPSS 22. Results: Nearly 74% of women said that cancer is curable. For awareness about signs and symptoms, risk factors and screening test 82.3% women scored less than 50% of total score. Only 17.7% women had awareness score more than 50%. But their attitude score was > 50% in 85.2% of women. For practice score, 24.4% women scored > 50%. Significant association was found between awareness, attitude and practice scores and education, occupation and history of cancer in family, friends and neighborhood of respondents. Conclusions: Low awareness is the main barrier for undergoing cancer screening and early detection. There is a need of effective health education programme.
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Affiliation(s)
- Yugantara R Kadam
- Department of Community Medicine, Bharati Vidyapeeth Deemed University Medical College, Sangli, India
| | - Sanjay R Quraishi
- Department of Community Medicine, Bharati Vidyapeeth Deemed University Medical College, Sangli, India
| | - Randheer V Dhoble
- Department of Community Medicine, Bharati Vidyapeeth Deemed University Medical College, Sangli, India
| | - Minaxi R Sawant
- Department of Community Medicine, Bharati Vidyapeeth Deemed University Medical College, Sangli, India
| | - Alka D Gore
- Department of Community Medicine, Bharati Vidyapeeth Deemed University Medical College, Sangli, India
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Chong VH, Lim AG, Baharudin HN, Tan J, Chong CF. Poor knowledge of colorectal cancer in Brunei Darussalam. Asian Pac J Cancer Prev 2016; 16:3927-30. [PMID: 25987062 DOI: 10.7314/apjcp.2015.16.9.3927] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Colorectal cancer (CRC) is the most common gastrointestinal cancer and the incidence is increasing in many developing countries. While it can be detected early and even prevented through screening and removal of premalignant lesions, there are barriers to screening which include low level of knowledge and awareness of CRC. This study assessed the level of knowledge of CRC in Brunei Darussalam. MATERIALS AND METHODS A total of 431 (262 male and 161 female) subjects participated in this questionnaire study. Subjects were scored on their knowledge of signs/symptoms (maximum 10 correct answers) and known risk factors for CRC (maximum 10 correct answers) and were categorised into poor (0-2), moderate (3-4) and satisfactory (5-10). Comparisons were made between the various patient factors. RESULTS Overall, 54.1% could not name any CRC signs/symptoms or associated risk factors. Most were not aware of any screening modalities. The overall scores for CRC signs/symptoms and risk factors were 1.3±1.39 (range 0-6) and 0.6±1.05 (range 0-5) respectively. Overall, the breakdown of scores was: poor (78.1%), moderate (20.3%) and satisfactory (6.2%) for signs/symptoms and poor (93.2%), moderate (6.2%) and satisfactory (0.7%) for risk factors. Higher level of education, female gender and non-Malay race were associated with higher scores for both signs/symptoms and knowledge of screening modality; however the overall scores were low. CONCLUSIONS Our study showed that the general knowledge of CRC in Brunei Darussalam is poor. Being female, with higher levels of education and non-Malay race were associated with higher scores, but they were still generally poor. More needs to be done to increase the public knowledge and awareness of CRC.
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Affiliation(s)
- Vui Heng Chong
- Division of Gastroenterology, Department of Medicine, RIPAS Hospital, Brunei Darussalam E-mail :
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Kwok C, Ogunsiji O, Lee CF. Validation of the Breast Cancer Screening Beliefs Questionnaire among African Australian women. BMC Public Health 2016; 16:117. [PMID: 26846341 PMCID: PMC4743245 DOI: 10.1186/s12889-016-2793-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 01/27/2016] [Indexed: 11/11/2022] Open
Abstract
Background The Breast Cancer Screening Beliefs Questionnaire (BCSBQ) has been designed as a culturally appropriate instrument for assessing women’s beliefs, knowledge and attitudes to breast cancer and breast cancer screening practices. While it has proved to be a reliable instrument when applied to women of Chinese, Arabic and Korean origin living in Australia, its psychometric properties among women from African backgrounds have not been tested. The aim of this study is to examine the psychometric properties of the BCSBQ among African Australian women. Methods The BCSBQ was administered to 284 African Australian women who were recruited from a number of African community organizations and churches. Factor analysis was conducted to study the factor structure. Construct validity was examined using Cuzick’s non-parametric test while Cronbach alpha was used to assess internal consistency reliability. Results Exploratory factor analysis results demonstrated that the African-Australian BCSBQ can be conceptualized as a 4-factor model. The third factor, viz. “barriers to mammography”, was split into two separate factors namely, “psychological” and “practical” barriers. The results indicated that the African-Australian BCSBQ had both satisfactory validity and internal consistency. The Cronbach’s alpha of the three subscales ranged between 0.84-0.92. The frequency of breast cancer screening practices (breast awareness, clinical breast-examination and mammography) were significantly associated with attitudes towards general health check-ups and perceived barriers to mammographic screening. Conclusions Our study provided evidence to support the psychometric properties of the BCSBQ.in African Australian women. The study moreover demonstrated that the use of the instrument can help health professionals to understand the beliefs, knowledge and attitudes to breast cancer among African Australian women and also the factors that impact on their breast cancer screening practices.
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Affiliation(s)
- Cannas Kwok
- School of Nursing and Midwifery, Western Sydney University, Sydney, New South Wales, Australia.
| | - Olayide Ogunsiji
- School of Nursing and Midwifery, Western Sydney University, Sydney, New South Wales, Australia.
| | - Chun Fan Lee
- Department of Biostatistics, Singapore Clinical Research Institute, Singapore, Singapore.
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Shankar A, Rath G, Roy S, Malik A, Bhandari R, Kishor K, Barnwal K, Upadyaya S, Srivastava V, Singh R. Level of awareness of cervical and breast cancer risk factors and safe practices among college teachers of different states in india: do awareness programmes have an impact on adoption of safe practices? Asian Pac J Cancer Prev 2015; 16:927-32. [PMID: 25735384 DOI: 10.7314/apjcp.2015.16.3.927] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Breast and cervical cancers are the most common causes of cancer mortality among women in India, but actually they are largely preventable diseases. Although early detection is the only way to reduce morbidity and mortality, there are limited data on breast and cervical cancer knowledge, safe practices and attitudes of teachers in India. The purpose of this study is to assess the level of awareness and impact of awareness programs in adoption of safe practices in prevention and early detection. MATERIALS AND METHODS This assessment was part of a pink chain campaign on cancer awareness. During cancer awareness events in 2011 at various women colleges in different parts in India, a pre-test related to cervical cancer and breast cancer was followed by an awareness program. Post-tests using the same questionnaire were conducted at the end of the interactive session, at 6 months and 1 year. RESULTS A total of 156 out of 182 teachers participated in the study (overall response rate was 85.7 %). Mean age of the study population was 42.4 years (range- 28-59 yrs). There was a significant increase in level of knowledge regarding cervical and breast cancer at 6 months and this was sustained at 1 year. Adoption of breast self examination (BSE) was significantly more frequent in comparison to CBE, mammography and the Pap test. Magazines and newspapers were sources for knowledge regarding screening tests for breast cancer in more than 60% of teachers where as more than 75% were educated by doctors regarding the Pap test. Post awareness at 6 months and 1 year, there was a significant change in alcohol and smoking habits. Major reasons for not doing screening test were found to be ignorance (50%), lethargic attitude (44.8%) and lack of time (34.6%). CONCLUSIONS Level of knowledge of breast cancer risk factors, symptoms and screening methods was high as compared to cervical cancer. There was a significant increase in level of knowledge regarding cervical and breast cancer at 6 months and this was sustained at 1 year. Adoption of BSE was significantly greater in comparison to CBE, mammography and the Pap test. To inculcate safe practices in lifestyle of people, awareness programmes such as pink chain campaign should be conducted more widely and frequently.
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Affiliation(s)
- Abhishek Shankar
- Department of Radiation Oncology, Dr. B.R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Delhi, India E-mail :
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Baishya N, Das AK, Krishnatreya M, Das A, Das K, Kataki AC, Nandy P. A Pilot Study on Factors Associated with Presentation Delay in Patients Affected with Head and Neck Cancers. Asian Pac J Cancer Prev 2015; 16:4715-8. [DOI: 10.7314/apjcp.2015.16.11.4715] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Breast cancer knowledge, attitudes and screening behaviors among Indian-Australian women. Eur J Oncol Nurs 2015; 19:701-6. [PMID: 26051075 DOI: 10.1016/j.ejon.2015.05.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 05/05/2015] [Accepted: 05/06/2015] [Indexed: 11/23/2022]
Abstract
PURPOSE OF RESEARCH The aims of the study were to report breast cancer screening practices among Indian-Australian women and to examine the relationship between demographic characteristics, cultural beliefs and women's breast cancer screening (BCS) behaviors. METHOD A descriptive and cross-sectional method was used. Two hundred and forty two Indian-Australian women were recruited from several Indian organizations. English versions of the Breast Cancer Screening Beliefs Questionnaire (BCSBQ) were administered. The main research variables are BCS practices, demographic characteristics and total scores on each of the BCSBQ subscales. RESULT The majority of participants (72.7%-81.4%) had heard of breast awareness, clinical breast examination (CBE) and mammograms. Only 28.9% performed a BSE monthly and although 60% had practiced CBE, only 27.3% of women within the targeted age group had annual CBE. Only 23.6% of women within the targeted age group reported they had a mammogram biennial. Marital status and length of stay in Australia were positively associated with women's screening behaviors. In terms of BCSBQ score, women who had the three screening practices regularly as recommended obtained significantly higher scores on the "attitude towards general health check-ups" and "barriers to mammographic screening" subscales. There was a significant difference in the mean score of the "knowledge and perceptions about breast cancer" between women who did and who did not engage in breast awareness. CONCLUSIONS Our study reveals that attitudes toward health check-ups and perceived barriers to mammographic screening were influential in determining compliance with breast cancer screening practices among Indian-Australian women.
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