Report of AIDS-related lymphoma in South Korea

Background: The prevalence of AIDS-related lymphoma (ARL) is increasingin South Korea. The aim of this study is to identify the clinicalfeatures of ARL in South Korea. Methods: From 1998 through 2006, we retrospectively analysed a totalof 23 cases of ARL from seven institutions. Results: The patients consisted of 20 males and 3 females at a medianage of 40 (range, 20–72) on diagnosis of AIDS. ARL developedat their median age of 41 (range, 24–72). The histologicaldiagnosis was aggressive B cell lymphoma in the majority, butrare T cell and NK/T cell lymphoma were also included. Ten of23 (43.5%) was receiving highly active anti-retroviral therapy(HAART) before the diagnosis of ARL. Fifteen of twenty-threepatients were given combination chemotherapy with/without radiation,four were given radiation alone, and four did not receive anytreatment against medical advice. Of 20 patients followed-up,nine were alive in remission, two alive in disease, one diedof treatment related complication, four died of progressivelymphoma, four died of AIDS related causes. The response totreatment included CR in eight (44.4%), PR in four (22.2%) andPD in three (16.7%). The response to HARRT was evaluable in13 patients based on CD4+ cell count and HIV viral load, amongwhich nine (69.2%) responded. Estimated median survival timewas 43.9 months. Conclusions: Although the population of patients is small, this is the firstclinical data analyses of Korean ARL patients. As a substantialportion of the patients remains alive disease free, the impactof HAART on the clinical course of ARL needs further follow-upand evaluation.     

Accuracy of visual screening for cervical neoplasia: Results from an IARC multicentre study in India and Africa

Visual inspection-based screening tests, such as visual inspection with 4% acetic acid (VIA) and with Lugol's iodine (VILI), have been proposed as alternatives to cytology in mass screening programs. To date, there is only limited information on the accuracy of these tests in detecting High-grade Squamous Intraepithelial Lesions (HSIL). Eleven cross-sectional studies involving 56,939 women aged 25-65 years were conducted in Burkina Faso, Congo, Guinea, India, Mali and Niger to evaluate the accuracy of VIA and VILI performed by health workers. A common protocol and questionnaire was used. For final diagnosis, all women were investigated with colposcopy and biopsies were taken when necessary. Data from the studies were pooled to calculate sensitivity, specificity and predictive values of the tests for the detection of HSIL. Of the screened women, 16.1% and 16.4% were positive on examination using, respectively, VIA and VILI; 1,063 were diagnosed with HSIL. The pooled sensitivity, specificity, positive and negative predictive values for VIA were 76.8% (95% CI: 74.2-79.4%), 85.5% (95% CI: 85.2-85.8%), 9.4% (95% CI:8.8-10.8%) and 99.5% (95% CI:99.4-99.6%), respectively. The values were 91.7% (95% CI: 89.7-93.4%), 85.4% (95% CI: 85.1-85.7%), 10.9% (95% CI: 10.2-11.6%) and 99.8% (95% CI:99.7-99.9%), respectively for VILI. The range of sensitivity and specificity for VIA was 56.1-93.9% and 74.2-93.8%, respectively, between studies and were 76.0-97.0 % and 73.0-91.3% for VILI. VILI had a significantly higher sensitivity than VIA in detecting HSIL, but specificity was similar. VILI appears to be a more accurate visual test for use in screening and treatment programs in low-resource settings.     

Tobacco Survey Among Youth in South India

Background: Smoking of cigarettes and, particularly, of “bidis” (which consist of about 0.2-0.3 gm of tobacco ‍rolled up in the leaf of another plant (temburni) has been widespread for many decades among men in India. There ‍have, however, been no substantial studies on the prevalence of tobacco use among youth in India. Hence a Global ‍Youth Tobacco Survey was conducted in schools in Tamil Nadu as part of on-going Global Youth Tobacco survey in ‍over 150 countries in the world. ‍Methods: The two-stage cluster sample method was used to select 100 schools with standards 8, 9 and 10 in Tamil ‍Nadu. The survey used self administered questionnaires, which consisted of 88 multiple choice questions. ‍Results: A total of 4820 students participated (a response rate of 90.1%) in the 99 of 100 schools selected for the ‍survey. About 10% of students aged 13-15 in Tamil Nadu had ever used tobacco. Significantly higher percentages of ‍current tobacco users (one in three students) compared to never tobacco users thought smoking or chewing tobacco ‍makes a boy or girl more attractive. About 3 in 4 current smokers expressed a wish to stop smoking and a similar ‍proportion have already tried to quit the habit. About 80% of students considered using tobacco (smoking or chewing ‍tobacco) to be harmful to their health. Only about half of the students reported that they have been taught in school ‍the health effects of tobacco use during the year preceding the survey. Exposure to environmental tobacco smoke ‍and pro-tobacco advertisements is high. ‍Conclusions: The tobacco prevalence among girls is alarming. The results of the survey show the need to increase ‍awareness about health hazards of tobacco use among students. Tobacco control programs focusing on youth are ‍essential in order to reduce the burden of tobacco related diseases in India. Repeat surveys would help in monitoring ‍the tobacco epidemic in the school and to evaluate the efficacy of state level tobacco control programs. ‍     

Cancer mortality and farming in South Korea: an ecologic study

OBJECTIVE: The aim of this study was to examine the geographical difference of cancer mortality to determine any potential associations between cancer mortality and farming in South Korea. METHODS: We calculated standardized mortality ratios (SMRs) based on age- and gender-specific cancer mortality rates for 245 geographic areas, using the registered death data from 2000 to 2004 that were obtained from the Korea National Statistical Office. Using the data from the Agriculture Census in 1995, we obtained the farming index. Poisson regression analysis was used to evaluate the associations between cancer mortality and farming after adjustment for socioeconomic factors. RESULTS: The SMR analyses based on 62,403 annual average cancer deaths yielded regional variations for all cancers combined in men (SMR = 70-192) and women (SMR = 80-132). With increasing farming index we found significantly elevated cancer mortality of esophagus, stomach, brain, and leukemia for men, and of esophagus and stomach for women, whereas the SMR for colorectal and gall bladder cancers were inversely associated with farming. The results were similar when the analyses were repeated after the exclusion of metropolitan areas. CONCLUSIONS: Our findings suggest a possible association between farming and mortality from a few cancer sites in South Korea.     

Epidemiological Correlates of Breast Cancer in South India

Background: Breast cancer is the most frequent cancer in women globally and represents the second leadingcause of cancer death among women (after lung cancer). India is going through epidemiologic transition. It isreported that the incidence of breast cancer is rising rapidly as a result of changes in reproductive risk factors,dietary habits and increasing life expectancy, acting in concert with genetic factors. Materials and Methods:In order to understand the existing epidemiological correlates of breast cancer in South India, a systematicreview of evidence available on epidemiologic correlates of breast cancer addressing incidence, prevalence,and associated factors like age, reproductive factors, cultural and religious factors was performed with specificfocus on screening procedures in southern India. Results: An increase in breast cancer incidence due to variousmodifiable risk factors was noted, especially in women over 40 years of age, with late stage of presentation,lack of awareness about screening, costs, fear and stigma associated with the disease serving as major barriersfor early presentation. Conclusions: Educational strategies should be aimed at modifying the life style, earlyplanning of pregnancy, promoting breast feeding and physical activity. It is very important to obtain reliabledata for planning policies, decision-making and setting up the priorities.     

Relationship between Socioeconomic Status and Prevalent Prostate Cancer in the South Korea

Background: Prostate cancer prevalence recently has increased among male adults in South Korea. But, few study has evaluated the reason. Therefore, we investigated the relationship between socioeconomic status and prevalent prostate cancer. Methods: This study enrolled 16,215 males aged 40 years and over who took part in the Korean National Health and Nutrition Examination Survey 2007-2016. In addition, we obtained the 2000-2016 age-standardized incidence rate and age-standardized mortality rate of prostate cancer from the Korean Statistical Information Service. Results: After adjusting for other covariates, prevalent prostate cancer was significantly associated with monthly household income (OR 3.71, 95% confidence interval [CI] 1.48–9.30, for highest vs. lowest) and significantly associated with education level (OR 3.66, 95% CI 1.54–8.70, for ≥ 13 vs. ≤ 6). In the analysis of the age-standardized incidence rate and the age-standardized mortality rate, the age-standardized incidence rate has soared from 2000 to 2011 and then decreased gradually, but the age-standardized mortality rate did not change. Conclusion: In our results, prevalent prostate cancer increased significantly with socioeconomic status and the increase in prevalent prostate cancer may be attributable to earlier detection rather than to a real increase in prevalence.     

Depression and Suicide Ideas of Cancer Patients and Influencing Factors in South Korea

Background: This study compared risk factors for depression and suicidal ideas among cancer patientsfor comparison with the general population, and identified influencing factors. Materials and Methods: Weanalyzed data from 2,472 cancer patients in the National Cancer Center and nine Regional Cancer Centersand frequency-matched data for age and sex from 2,349 members of the general population who completed theNational Health and Nutrition Examination Survey in 2008. Logistic regression analysis was used to identifyfactors affecting depression and suicidal ideas. Results: Cancer patients were not likely to have more depression(OR=0.96, 95%CI=0.79-1.18) and were less likely to have suicidal ideas (OR=0.64, 95%CI=0.53-0.79) comparedto the general population. Female sex, more stress, and lower quality of life were influencing factors. Theadditional risk factors for suicidal ideas among cancer patients included income (OR=0.62, 95%CI=0.43-0.91),smoking (OR=1.63, 95% CI=1.06-2.50), recurrence (OR=1.50, 95%CI=1.15-1.95), and chemotherapy (OR=1.66,95%CI=1.26-2.19). Conclusions: No differences appeared in depression rates between cancer patients and thegeneral population, and cancer patients were less likely to have suicidal ideas. However, cancer patients werelikely to have more risk factors than the general population, and those classified as being at high risk of suicideshould receive distress management and social economic support, from early in the treatment process.     

Clinicopathological and mycological spectrum of allergic fungal sinusitis in South India

In the present study, we describe characteristic clinicopathological and radiological features as well as fungal culture results in a series of 24 patients with allergic fungal sinusitis (AFS). Nasal obstruction and discharge with nasal polyposis was the commonest (95.8%) clinical presentation. Allergic mucin was uniformly present in all patients. Aspergillus species were the commonest fungal isolates (95.8%). One case of mixed Aspergillus and Curvularia sinusitis as well as one case of Drechslera sinusitis were also identified. Typical computerized tomography scan features of hyperdense areas interspersed with soft tissue densities in the affected sinuses were seen in all patients. Application of appropriate diagnostic criteria is essential to establish the diagnosis of AFS and distinguish it from invasive fungal sinus infections.     

Spectrum of malignancies among HIV-infected patients in South India

Introduction: The current study examines the spectrum of malignancies among HIV-infected South Indians enrolled in a clinical care program. Materials and Methods: We conducted a nested matched case-control study among 42 HIV-infected cases who developed cancer and 82 HIV-infected controls between 1998 and 2008 at a tertiary care HIV care program in South India. Results: The most common types of cancer included non-Hodgkin's lymphoma (38.1%), Hodgkin's lymphoma (16.7%), squamous cell carcinoma (14.3%), and adenocarcinoma (14.3%). The median duration of time from HIV infection to cancer diagnosis was 549 days [interquartile range (IQR): 58-2013]. The nadir CD4 cell count was significantly lower in cases compared to controls (134 cells/μl vs. 169 cells/μl; P = 0.015). Cancer patients were more likely to have a more advanced HIV disease stage at the time of cancer diagnosis compared to control patients (Stage C: 90.5% vs. 49.4%; P<0.0001). Significantly more cancer patients were receiving antiretroviral treatment relative to control patients at the time of cancer diagnosis (92.9% vs. 66.3%; P=0.001). Conclusions: HIV-infected patients who developed cancer had more advanced immunodeficiency at the time of cancer diagnosis and a lower nadir CD4 cell count. It is possible that with the continued roll-out of highly active antiretroviral therapy in India, the incidence of HIV-associated malignancies will decrease.     

Gastric cancer surgery in South Korea: Past,present, and future

Gastric cancer remains a significant global health concern and its surgical management approaches have undergone significant changes in South Korea and worldwide. Subtotal or total gastrectomy with D2 lymph node dissection is well established as a standard surgical procedure for gastric cancer. With the active implementation of cancer screening in South Korea, the proportion of early gastric cancer cases has significantly increased over the past few decades, leading to a steady increase in the s...     

Diet and stomach cancer: a case-control study in South India.

A prospective case-control study was conducted in Trivandrum, India, to evaluate the dietary risk factors for stomach cancer. One hundred and ninety-four patients with stomach cancer registered at the Regional Cancer Centre (RCC), Trivandrum, Kerala, India, during the period 1988-1991 were considered as cases. A minimum of one control (n = 305), matched for age (+/- 5 years), sex, religion and residential area was selected from the visitors to RCC during the same period. Interviews were carried out using a predetermined structured food frequency questionnaire. The information collected also included socio-demographic/economic background, tobacco chewing, tobacco smoking and alcohol habits. Data were analysed using a multiple logistic regression model. Odds ratios for all dietary variables were estimated. Increased risks were observed with higher consumption of rice (OR 3.9; 95% CI 1.6-10.0). Risk was high for those consuming spicy food (OR 2.3; 95% CI 1.1-5.0), high consumption of chilli (OR 7.4; 95% CI 4.0-13.5) and consumption of high-temperature food (OR 7.0; 95% CI 3.7-12.9). On multivariate analysis, high consumption of rice, high consumption of chilli and consumption of high-temperature food were found to be independent risk factors.     

Cancer incidence patterns in Koreans in the US and in Kangwha,South Korea

Objective: In the US, Koreans are a rapidly growing group and comprised 10.5% of the total Asian population as of 2000. However, little has been published regarding cancer patterns in this subpopulation. Methods: Using data from the Surveillance, Epidemiology, and End Results program, the California Cancer Registry, and the International Association for Research on Cancer, we compared age-adjusted and age-specific incidence rates for cancers of the prostate, breast, cervix, lung, colon, rectum, stomach, liver, and esophagus in US Koreans with rates of these cancers in residents of Kangwha, South Korea, and in US whites as a reference. Results: While the most frequently diagnosed cancer was lung among US Korean males and breast among US Korean females, it was stomach cancer for both sexes in Kangwha. Rates of prostate, breast, and colon cancer were considerably higher for Koreans in the US than in Kangwha, but were not as high as in whites. Cervical and stomach cancers showed the opposite racial/ethnic pattern, with rates highest in Kangwha, intermediate among US Koreans, and lowest among whites. Rates of rectal cancer in females and esophageal cancer in males were two-times higher in Kangwha than in US Koreans but esophageal cancer rates were similar between US Koreans and whites. Liver cancer rates were similar between Kangwha residents and US Koreans, but nearly 10-times lower among whites. Conclusions: Although these comparisons may have methodologic limitations, including data quality and racial/ethnic misclassification, the differences seen in migrant and native Koreans for some cancers warrant further investigation in this growing subpopulation.     

Cancer Control and the Communication Innovation in South Korea: Implications for Cancer Disparities

Over the last 10 years, the number of cancer survivors in South Korea has reached nearly one million with asurvival rate of 49.4%. However, integrated supportive care for cancer survivors is lagging. One area in which thecurrent cancer control policy needs updating is in the utilization of information and communication technology(ICT). The remarkable progress in the field of ICT over the past 10 years presents exciting new opportunitiesfor health promotion. Recent communication innovations are conducive to the exchange of meta-information,giving rise to a new service area and transforming patients into active medical consumers. Consequently, suchinnovations encourage active participation in the mutual utilization and sharing of high-quality information.However, these benefits from new ICTs will almost certainly not be equally available to all, leading to so-calledcommunication inequalities where cancer survivors from lower socioeconomic classes will likely have morelimited access to the best means of making use of the health information. Therefore, most essentially, emphasismust be placed on helping cancer survivors and their caregivers utilize such advances in ICT to create a moreefficient flow of health information, thereby reducing communication inequalities and expanding social support.Once we enhance access to health information and better manage the quality of information, as a matter of fact,we can expect an alleviation of the health inequalities faced by cancer survivors.