BC5500血细胞分析仪显微镜复检规则的初步建立

目的制定适合本实验室全血细胞分析显微镜复检规则。方法利用BC5500自动血细胞分析仪自身的报警系统,参考国内"XE-2100复检协作组"制定的"XE-2100复检规则23条"结合本实验室实际情况制定暂定复检规则。按临床标本的检测流程和方法对890份住院标本进行全血细胞分析检测和推片染色,并进行镜检,对各条暂定规则和仪器提示细胞数量异常和形态异常的报警分别进行统计学评估。结果各暂定规则中出现假阳性、假阴性最多的复检规则是仪器出现未成熟细胞、核左移和异型或异常淋巴细胞报警。镜检评估结果为真阳性占标本总数的9.11%,假阳性占5.22%,真阴性占80.84%,假阴性占4.83%。该规则的临床应用镜检率为14.33%。结论制定出的复检规则适合笔者所在实验室的临床工作需求,对于使用五分类自动全血细胞分析仪的临床血液实验室,能够减轻复检工作量,降低漏检率,提高工作效率。     

磁共振成像技术用于妇科恶性肿瘤诊断价值的研究进展

妇科恶性肿瘤是一类起源于女性生殖系统的恶性肿瘤,约占女性恶性肿瘤总数的20%,严重危害女性健康、造成了极大疾病和经济、社会、家庭负担。而超声、CT、磁共振成像（MRI）等影像学技术在妇科恶性肿瘤筛查和临床诊断中广泛应用,为术前评估、治疗方案制定等提供了重要参考。本文主要就MRI在子宫内膜癌、宫颈癌、外阴癌、卵巢癌等常见妇科恶性肿瘤诊断中的研究进展作一综述。     

Estimating the future cancer management costs attributable to modifiable risk factors in Canada

ObjectivesAn estimated 33–37% of incident cancers in Canada are attributable to modifiable risk factors. Interventions targeting these risk factors would minimize the substantial health and economic burdens Canadians face due to cancer. We estimate the future health and economic burden of cancer in Canada by incorporating data from the Canadian Population Attributable Risk of Cancer (ComPARe) study into OncoSim, a web-based microsimulation tool.MethodsUsing the integrated OncoSim population attributable risk and population impact measures, we evaluated risk factor-targeted intervention scenarios implemented in 2020, assuming the targeted risk factor prevalence reduction would be achieved by 2032 with a 12-year latency period.ResultsWe estimate that smoking will be the largest contributor to cancer-related costs, with a cost of CAD $44.4 billion between 2032 and 2044. An estimated CAD $3.3 billion of the cost could be avoided with a 30% reduction in smoking prevalence by 2022. Following smoking, the next highest cancer management costs are associated with inadequate physical activity and excess body weight, accounting for CAD $10.7 billion ($2.7 billion avoidable) and CAD $9.8 billion ($3.2 billion avoidable), respectively. Avoidable costs for other risk factors range from CAD $90 million to CAD $2.5 billion.ConclusionInterventions targeting modifiable cancer risk factors could prevent a substantial number of incident cancer cases and billions of dollars in cancer management costs. With limited budgets and rising costs in cancer care in Canada, these simulation models and results are valuable for researchers and policymakers to inform decisions and prioritize and evaluate intervention programs.Supplementary InformationThe online version contains supplementary material available at 10.17269/s41997-021-00502-x.     

Rural and urban South African women's awareness of cancers of the breast and cervix

Objective : The investigation sought to establish the awareness of breast and cervical cancers among women of African descent, in both rural and urban areas, especially considering the oppression and deprivation experienced by this group. Design : Two groups of randomly selected women in a rural ( n = 70) and urban ( n = 70) area were interviewed using a structured questionnaire assessing their knowledge and attitudes regarding breast and cervical cancer and screening options. Results : The age range of the sample was 21-59 years with a mean of 35.23 years. Almost one-fifth of the women had not heard of these cancers, and almost half were unaware of the breast self-examination technique. Over one-third did not know about tests for breast cancer and more than half were unaware of tests for cervical cancer. Generally lower awareness levels were found in older and rural women who were also significantly more inclined to consult traditional healers (than doctors) about lumps in their breast or abnormal cervical bleeding. Conclusion : The findings are of great concern and represent a significant challenge in post-apartheid South Africa. The need for vigorous health promotion programmes cannot be sufficiently emphasised, especially in view of the benefits of early detection and treatment. There also needs to be particular focus on rural women, considering the inadequate health care resources in their communities and the socio-economic hardships facing them. Women in these communities must be empowered with knowledge about their health and illness prevention options.     

Parallelism in the mortality clustering of the most frequent cancer sites in Italy and in the Marche region

Clusters of selected cancer sites mortality, regarding Italy and the Marche region, were compared. Very similar associations were found both in males and in females, in particular between the alcohol-tobacco-related sites. Many clusters agree with the international literature, while others could constitute a starting point for formulating new hypotheses.     

2013年青海省城市、农村、牧区不同地区特征恶性肿瘤死亡分析

目的 分析2013年青海省肿瘤登记地区恶性肿瘤死亡情况,为青海省肿瘤防治提供依据。方法 2016年青海省6个登记地区上报2013年恶性肿瘤死亡资料,根据全国肿瘤登记中心对肿瘤登记数据质量要求,对数据质量较好的3个地区（西宁市区、湟中县、海南州）的资料进行统计分析。结果 2013年纳入分析的3个肿瘤登记地区,恶性肿瘤死亡率为114.53/10 万（男性144.78/10万,女性84.21/10万）,中标率为110.44/10 万。死亡率前十位依次是胃癌、肝癌、肺癌、食管癌、结直肠癌、子宫颈癌、女性乳腺癌、胰腺癌、子宫体癌和脑瘤。结论 胃癌、肝癌、肺癌、子宫颈癌、食管癌是青海省肿瘤登记地区最多发的肿瘤,应作为防治工作的重点。     

诸城市1998～2007年恶性肿瘤发病情况回顾性分析

目的 了解中小城市恶性肿瘤发病的基本情况,为肿瘤防治工作提供基本数据和参考依据.方法 以潍坊地区诸城市二级医院经病理确诊的恶性肿瘤患者为研究对象,初步分析这一地区人群恶性肿瘤的发病趋势、发病病因.结果 10年间经病理确诊的恶性肿瘤计8490例,男女之比1.57∶ 1,排序前5位的分别是胃癌、肺癌、乳腺癌、食道癌、结肠癌.胃癌、肺癌分别占居第1位和第2位.吸烟、饮酒分别是肺癌、食道癌的主要致病因素.癌前病变与相关肿瘤发病相关.结论 中小沿海发达城市肿瘤发病情况不容乐观,政府应加大肿瘤防治工作的资金投入.     

Re-grounding the concept of liminality by foregrounding spatial aspects in experiences of cancer care

Liminality captures the passing stages in transitioning from one sociocultural status to another. As its spatial dimension remains under-examined, we analyse this in experiences of people affected by cancer. We review liminality in cancer-related literature and juxtapose this with empirical material. Analysing interview data (with eight patients) and participant-made photos highlights why places may be experienced differently throughout a period of illness and how places of diagnosis and care ‘stretch’ across locations. We conclude that exploring liminality's spatial dimension has implications for people ‘living beyond’ cancer, advances sociological understandings of (cancer) illness, and may inform healthcare facility design.     

2012年南通市居民恶性肿瘤发病和死亡情况

目的探讨南通市恶性肿瘤的流行特征,并对该地区肿瘤登记工作质量作以简要评估。方法收集南通市恶性肿瘤的发病和死亡数据,采用Canreg4软件录人,通过Excel和SPSS软件进行整理,分析该地区恶性肿瘤的发病率、死亡率,标化发病（死亡）率、年龄别发病率（死亡率）等指标。对死亡／发病比（M／I）、病理组织学诊断所占比例（MV％）、只有死亡医学证明书比例（DCO％）、未指明部位和原发部位不明的恶性肿瘤新发病例所占的百分比（O＆U％）进行评估。结果2012年南通市恶性肿瘤发病为23736人,死亡为17464人,恶性肿瘤发病率为312．84／10万,恶性肿瘤死亡率为234．00／10万,经年龄构成调整后,发病的中标率为167．03／10万,死亡的中标率为113．38／10万。前6位高发恶性肿瘤分别为肺癌、肝癌、胃癌、食管癌、结／直肠癌、乳腺癌。肺癌在男性和女性中均居发病率的首位,全人口发病率为60．66／10万。前6位高死亡率的恶性肿瘤分别为肺癌、肝癌、食管癌、胃癌、结直肠癌、胰腺癌。肿瘤登记工作质量指标,M／I为0．74、MV％为54．86％、DCO％为0．41％、0＆u％为3．70％。结论恶性肿瘤是南通市居民的第1位死因,肺癌居恶性肿瘤发病率和死亡率之首,消化系统肿瘤占比例最高。南通市肿瘤登记数据基本反映了全市恶性肿瘤的发病和死亡情况,但仍需完善。     

Cancer registry policies in the United States and geographic information systems applications in comprehensive cancer control

OBJECTIVES: Through a long history of cancer policies, public health has a foundation for cancer research and data to use in applying technological advancements for U.S. cancer control efforts. Geographic information systems (GIS) are one technology enabling the visualization of cancer risk patterns associated with incidence, mortality, and accessibility to care. METHODS: U.S. Comprehensive Cancer Control (CCC) program directors were interviewed from 49 of 50 states to assess use and function of GIS tools for mapping data related to cancer control policies and practices. Interviews were coded to obtain frequencies of response associated with content domains mapped using GIS tools and the perceived relative advantages. RESULTS: Significant relationships were found between the mapping of behavioral risk factors, health care services, transportation access, and policy advantages identified by program managers. The mapping of cancer incidence, mortality, and staging, transportation access, and multiple layers of content were found to have significant associations with perceived research advantages. CONCLUSIONS: U.S. CCC program managers recognize several important advantages relating to health policy and research for use of GIS tools in cancer control efforts. The application of GIS in U.S. cancer control efforts is employed unevenly, suggesting the need for innovative policies to support accessibility.     

Addressing Taiwan's high incidence of cervical cancer: factors associated with the Nation's low compliance with Papanicolaou screening in Taiwan

BACKGROUND: Despite cervical cancer being the leading female cancer, women in Taiwan have received fewer screening examinations for this disease than populations in Western countries. METHODS: Randomly selected telephone questionnaire interviews with women aged 20 years and over were conducted to investigate the factors associated with the subject's cancer screening practices. RESULTS: Among 1021 respondents, 51.6% self-reported no Papanicolaou (Pap) examination received within their lifetime. The multivariate logistic regression analysis revealed that, in addition to marital status, cancer knowledge was the most significant factor associated with screening practice compliance. Compared with women with correct answers for 22-28 cancer knowledge questions, the odds ratios (OR) for non-compliance were 1.4 (95% confidence interval (CI)=1.0-2.0) for women with 17-21 correct answers and 2.3 (95% CI=1.6-3.4) for women with less than 17 correct answers. Women aged 40-49 years had the best cancer knowledge scores. Unmarried women were at an elevated risk for no Pap examination (OR=7.6, 95% CI=5.2-11.3). CONCLUSIONS: Women in Taiwan should be targeted for intervention to promote cancer knowledge and screening compliance.     

Nutrition and Microbiome Interactions in Human Cancer

Individual physiologic responses to changes in dietary patterns can vary widely to affect cancer risk, which is driven by multiple host-specific factors (eg, genetics, epigenetics, inflammatory and metabolic states, and the colonizing microbiome). Emerging evidence indicates that diet-induced microbiota alterations are key modulators of several host functions important to tumor etiology, progression, and response to cancer therapy. Thus, diet may potentially be used to target alterations of the microbiota as an effective means to improve outcomes across the cancer continuum (from cancer prevention to tumor development and progression, to effects on treatment and survivorship). This review will focus on recent examples of functional interactions between dietary components (nutrients and non-nutrients) and the gastrointestinal microbiome, which are 2 critical and malleable environmental variables in cancer risk that affect host immune, metabolic, and cell signaling functions and may provide insights for novel cancer therapeutic and preventive strategies.     

陕西省三县90年代与70年代恶性肿瘤死亡率比较

自1995年1月至1996年1月我们对陕西省宝鸡地区的凤县、眉县及岐山县80余万人进行了1992～1994年恶性肿瘤发病及死亡调查。共查出30种恶性肿瘤1291例病人。结果与70年代全国恶性肿瘤普查资料比较可见，恶性肿瘤平均死亡年龄乳腺癌明显下降，恶性淋巴瘤、白血病上升。性别比鼻咽癌和脑瘤明显上升。粗死亡率和标化死亡率除肺癌以外均有不同程度的下降，以食道癌最著。死亡位次，肝癌由原来的第3位上升为第1位，食道癌则由原来的第1位下降为第4位。前5位依次是肝、胃、肺、食道、肠癌。消化系癌（肝、胃、食道、肠、胆囊、胰腺癌）死亡占所有癌症总死亡的64．27％，为该地区爆死亡的主要原因。     

A Validation Study of the Dutch Version of the Quality of Life – Cancer Survivor (QOL-CS) Questionnaire in a Group of Prostate Cancer Survivors

The primary objective of this study was to validate the Dutch version of the Quality of Life – Cancer Survivor (QOL-CS) questionnaire using a group of Dutch prostate cancer survivors. The QOL-CS was specifically designed to measure the quality of life of long-term cancer survivors. We performed a population-based, cohort study of 784 prostate cancer survivors who were diagnosed with prostate cancer between 1994 and 1998. To determine the test–retest reliability, second questionnaires were sent to 109 participants, of whom 103 (94%) returned the forms. The quality of life in Dutch long-term prostate cancer survivors was adequately measured by the physical, psychological and social well-being subscale and can be used in order to measure the specific aspects of quality of life important to cancer survivors. However, as the subscale spiritual well-being showed a low internal consistency, which could be related to cultural background, it seems to be appropriate to evaluate the validity and reliability of the QOL-CS in other cultural settings.     

白洋淀上游蓄污工程沿岸地下水污染状况及对居民健康影响的调查

白洋淀污染一直是国家和河北省所关注的问题，对白洋淀上游蓄污工程沿岸小环境调查表明；饮用深层地下水受到城市工业废水的污染，主要污染物为有机物。污染区儿童贫血率、白细胞计数、舒张压高于非污染区，白细胞吞噬率低于非污染区，居民恶性肿瘤标化死亡比高于非污染区，肝癌标化死亡比明显上升。     

奉贤县消化道恶性肿瘤死亡率分析

目的了解奉贤县消化道恶性肿瘤的死亡率情况。方法对奉贤县１９９２～１９９７年消化道恶性肿瘤死亡２８３１例进行分析。结果６年中消化道恶性肿瘤年平均死亡率为９０．７１／１０万,标化死亡率为８６．５７／１０万,死亡率有缓慢上升趋势。死亡总数中肝癌（死亡率为３１．８２／１０万,标化死亡率为２９．９７／１０万）死亡９９３例,占总死亡数的３５．０８％,居首位;其次为胃癌（死亡率为２８．８０／１０万,标化死亡率为２７．９５／１０万）死亡８９９例,占总死亡数的３１．７６％;肠癌（死亡率１３．０１／１０万,标化死亡率为１２．１１／１０万）死亡４０６例,占总死亡数的１４．３４％,其余依次为食道癌、胰腺癌和胆囊癌。男性消化道恶性肿瘤年平均死亡率为１２０．６９／１０万,女性年平均死亡率为６１．８９／１０万,男性消化道恶性肿瘤死亡率高于女性。死亡率随年龄增长而上升,特别是４５岁以上死亡率上升幅度较大。结论消化道恶性肿瘤严重威胁中老年人群健康。     

上海市部分社区癌症患者生活质量影响因素的研究

目的探讨社区癌症患者生活质量的主要影响因素。方法应用癌症患者功能量表（FACT—G）及癌症患者疾病和社会信息的一般状况登记表对上海市社区癌症患者进行抽样问卷调查。调查方法包括自评和访谈，统计学方法采用单因素方差分析和线性模型等分析。结果共收回有效问卷7580份，对上海市社区癌症患者的生活质量（QOL）各维度均有显著影响的因素有家庭收入、本人受教育程度、职业状况、知情状况、体育活动状况、医疗费来源和疼痛状况（P〈0．01）。而患者年龄、婚姻状况、肿瘤类型、肿瘤分期等因素对上述癌症患者QOL部分维度评分有非常显著影响。KPS评分与FACT—G各维度评分具有显著相关性（P〈0．000）。结论年龄大、肿瘤分期晚、伴有疼痛、受教育水平低、收入低、离异或丧偶、不参加体育锻炼以及医疗费用来源为合作医疗者，QOL相应较差。[编者按]     

MRI检查在宫颈癌诊断分期中的应用价值

目的 探讨提高宫颈癌临床分期诊断准确性的方法。方法 比较临床分期、MRI扫描与病理诊断分期的符合率。结果 MRI对IB期宫颈癌的分期准确性明显高于临床分期(χ²=4.16,P < 0.05);MRI对该组病例总的诊断分期的准确率显著高于临床分期(χ²=4.16,P < 0.01)。结论 MRI检查对宫颈癌的诊断分期具有重要意义,有利于选择最恰当的治疗方法,提高治疗效果。MRI扫描显示宫颈外膜毛糙或模糊时选择手术治疗应慎重。     

癌症防治中硒用量的探讨

硒的特点是生理需要量和毒性之间范围极端狭窄，但是预防或治疗癌症则需要超营养水平的硒，故硒在癌症防治中的用量便成为人们关注的热点．     

The role of education in the uptake of preventative health care: the case of cervical screening in Britain

This paper reports findings on the relationship between education and the take-up of screening for cervical cancer, as an example of preventative health-care activity. Theoretically, education can enhance the demand for preventative health services by raising awareness of the importance of undertaking regular health check-ups and may also improve the ways in which individuals understand information regarding periodical tests, communicate with the health practitioner, and interpret results. Furthermore, education enhances the inclusion of individuals in society, improving self-efficacy and confidence. All these factors may increase service uptake. The empirical analysis uses data from the British Household Panel Survey (BHPS) and applies techniques for discrete panel data to estimate the parameters of the model. Results show that adult learning leading to qualifications is statistically associated with an increase in the uptake of screening. The marginal effect indicates that participation in courses leading to qualifications increases the probability of having a smear test between 4.3 and 4.4 percentage points. This estimate is strongly robust to time-invariant selectivity bias in education and the inclusion of income, class, occupation, and parental socio-economic status. These findings enrich existing evidence on the socio-economic determinants of screening for cervical cancer and enable policy makers to better understand barriers to service uptake.