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Fulltext The Use of M2-Pyruvate Kinase as a Stool Biomarker for Detection of Colorectal Cancer in Tertiary Teaching Hospital: A Comparative Study

Che Alhadi S, Wan Zain WZ, Zahari Z, Md Hashim MN, Syed Abd Aziz SH, Zakaria Z, et al.

Ann Coloproctol, 2020 Dec;36(6):409-414.
PMID: 32972105 DOI: 10.3393/ac.2020.08.27

PURPOSE: Guaiac fecal occult blood test (gFOBT) has been the standard for colorectal screening but it has low sensitivity and specificity. This study evaluated the use of fecal tumor M2-pyruvate kinase (M2-PK) for detection of colorectal cancer and to compare with the current surveillance tool; gFOBT in symptomatic adult subjects underwent colonoscopy.
METHODS: Stool samples were collected prospectively from symptomatic adults who had elective colonoscopy from September 2014 to January 2016 and were analyzed with the ScheBo M2-PK Quick test and laboratory detection of fecal hemoglobin.
RESULTS: The results were correlated to the colonoscopy findings and/or histopathology report. Eighty-five subjects (age of 56.8 ± 15.3 years [mean ± standard deviation]) were recruited with a total of 17 colorectal cancer (20.0%) and 10 colorectal adenoma patients (11.8%). The sensitivity of M2-PK test in colorectal cancer detection was higher than gFOBT (100% vs. 64.7%). M2-PK test had a lower specificity when compared to gFOBT (72.5% vs. 88.2%) in colorectal cancer detection. The positive and negative predictive values were 47.2% and 100% for M2-PK test and 57.9% and 90.9% for gFOBT.
CONCLUSION: Fecal M2-PK Quick test has a high sensitivity for detection of colorectal cancer when compared to gFOBT, making it the potential choice for colorectal tumor screening biomarker in the future.

Matched MeSH terms: Early Detection of Cancer
Fulltext Incidence of breast cancer attributable to breast density, modifiable and non-modifiable breast cancer risk factors in Singapore

Ho PJ, Lau HSH, Ho WK, Wong FY, Yang Q, Tan KW, et al.

Sci Rep, 2020 01 16;10(1):503.
PMID: 31949192 DOI: 10.1038/s41598-019-57341-7

Incidence of breast cancer is rising rapidly in Asia. Some breast cancer risk factors are modifiable. We examined the impact of known breast cancer risk factors, including body mass index (BMI), reproductive and hormonal risk factors, and breast density on the incidence of breast cancer, in Singapore. The study population was a population-based prospective trial of screening mammography - Singapore Breast Cancer Screening Project. Population attributable risk and absolute risks of breast cancer due to various risk factors were calculated. Among 28,130 women, 474 women (1.7%) developed breast cancer. The population attributable risk was highest for ethnicity (49.4%) and lowest for family history of breast cancer (3.8%). The proportion of breast cancers that is attributable to modifiable risk factor BMI was 16.2%. The proportion of breast cancers that is attributable to reproductive risk factors were low; 9.2% for age at menarche and 4.2% for number of live births. Up to 45.9% of all breast cancers could be avoided if all women had breast density <12% and BMI <25 kg/m2. Notably, sixty percent of women with the lowest risk based on non-modifiable risk factors will never reach the risk level recommended for mammography screening. A combination of easily assessable breast cancer risk factors can help to identify women at high risk of developing breast cancer for targeted screening. A large number of high-risk women could benefit from risk-reduction and risk stratification strategies.

Matched MeSH terms: Early Detection of Cancer
Fulltext 4-(2-(1H-Benzo[d]imidazol-2-ylthio)acetamido)-N-(substituted phenyl)benzamides: design, synthesis and biological evaluation

Tahlan S, Ramasamy K, Lim SM, Shah SAA, Mani V, Narasimhan B

BMC Chem, 2019 Dec;13(1):12.
PMID: 31384761 DOI: 10.1186/s13065-019-0533-7

Background: Dihydrofolate reductase (DHFR) is an important target for antimetabolite class of antimicrobials because it participates in purine synthesis. 2-mercaptobenzimidazole (2MBI) has similar structural features as purine nucleotides. Given that benzimidazole and similar heteroaromatics have been broadly examined for their anticancer potential, so, we hereby report the design, synthesis and biological studies (i.e. antimicrobial and anticancer studies) of 2MBI derivatives.
Methodology: The antimicrobial activity of synthesized 2MBI derivatives were evaluated against Gram positive and Gram negative bacterial species as well as fungal species by tube dilution technique whereas their anticancer activity was assessed against human colorectal carcinoma cell line (HCT116) by Sulforhodamine B (SRB) assay. They were also structurally characterized by IR, NMR, MS and elemental analyses.
Results discussion and conclusion: The antimicrobial activity findings revealed that compound N1 (MIC
bs,st,
ca
= 1.27, 2.54, 1.27 µM), N8 (MIC
ec
= 1.43 µM), N22 (MIC
kp,an
= 2.60 µM), N23 and N25 (MIC
sa
= 2.65 µM) exhibited significant antimicrobial effects against tested strains, i.e. Gram-positive, Gram-negative (bacterial) and fungal strains. The anticancer screening results demonstrated that compounds N9, N18 (IC50 = 5.85, 4.53 µM) were the most potent compounds against cancer cell line (HCT116) even more than 5-FU, the standard drug (IC50 = 9.99 µM).

Matched MeSH terms: Early Detection of Cancer
Fulltext Analysis of octamer-binding transcription factor-4 expression in oral leukoplakia

Tegginamani AS, Shivakumar VH, Kallarakkal TG, Ismail SM, Abraham MT, Bin Zamzuri AT

J Oral Maxillofac Pathol, 2020 09 09;24(2):400.
PMID: 33456258 DOI: 10.4103/jomfp.JOMFP_272_19

Background: Oral potentially malignant disorders have a risk for malignant transformation but are difficult to reliably identify and predict which patients are at the risk for malignant transformation. OCT4 has been hypothesized to play a key oncogenic driver in a variety of solid tumors. A deeper understanding of the aberrant molecular pathways which lead to carcinogenesis needs to be identified by the potential markers.
Aims: To assess the OCT4 stemness factor in oral leukoplakia for its potential risk to malignant transformation.
Settings and Design: 20 cases of oral leukoplakia were obtained from archives at Oral Cancer Research & Coordinating center (OCRCC) Malaysia Subjects and Methods: 20 cases of oral leukoplakia were assessed by OCT4 immunohistochemically. Oral squamous cell carcinoma was used as a control.
Result: no expression of OCT 4 was observed in any cases of oral leukoplakia.
Conclusion: The molecular mechanisms of Oct4 regulation and in particular of its switch on and off in tissues depends upon its microenvironment, which makes it challenging in fundamental and applied research fields of regenerative medicine and cancer therapy. It's better that patients should undergo multiple biopsies for the early detection of malignant transformation with close follow-up during the first two to three years, a large amount of work remains to be done with multi-marker panel investigation, as cure rates have remained constant over three decades.

Matched MeSH terms: Early Detection of Cancer
Fulltext Health system strengthening: Integration of breast cancer care for improved outcomes

Horton S, Camacho Rodriguez R, Anderson BO, Aung S, Awuah B, Delgado Pebé L, et al.

Cancer, 2020 05 15;126 Suppl 10:2353-2364.
PMID: 32348567 DOI: 10.1002/cncr.32871

The adoption of the goal of universal health coverage and the growing burden of cancer in low- and middle-income countries makes it important to consider how to provide cancer care. Specific interventions can strengthen health systems while providing cancer care within a resource-stratified perspective (similar to the World Health Organization-tiered approach). Four specific topics are discussed: essential medicines/essential diagnostics lists; national cancer plans; provision of affordable essential public services (either at no cost to users or through national health insurance); and finally, how a nascent breast cancer program can build on existing programs. A case study of Zambia (a country with a core level of resources for cancer care, using the Breast Health Global Initiative typology) shows how a breast cancer program was built on a cervical cancer program, which in turn had evolved from the HIV/AIDS program. A case study of Brazil (which has enhanced resources for cancer care) describes how access to breast cancer care evolved as universal health coverage expanded. A case study of Uruguay shows how breast cancer outcomes improved as the country shifted from a largely private system to a single-payer national health insurance system in the transition to becoming a country with maximal resources for cancer care. The final case study describes an exciting initiative, the City Cancer Challenge, and how that may lead to improved cancer services.

Matched MeSH terms: Early Detection of Cancer
Fulltext Association between breast self-examination knowledge level and practice among the Chinese female students of a private university in Kajang

Raadshini Vejayakumar, Jagjit Kaur Najar Singh, Thavamalar Paramasivam, Lim Pek Hong, Fong Ka Ling, Mohammed Abdul Razzaq Jabbar

Malaysian Journal of Medicine and Health Sciences, 2020;16(105):25-0.
MyJurnal

Introduction: The incidence of breast cancer is high among Malaysian females especially those aged 25-59 years old and from Chinese ethnic background.Breast Self-Examination (BSE) is a traditional, cost-free screening method to identify breast abnormalities likegrowth and cancer. If performed correctly and consistently, it can facilitate early detection, early treatment and better prognosis. Despite having high risk, there is insufficient evidence about the BSE knowledge level and practiceamong Malaysian Chinese females. This research determines the association between BSE knowledge level, practice and selected socio-demographic variables among the Chinese female students of a private university in Kajang. Methods: Quantitative, correlation study was conducted among 192 Chinese female students in a private university. Purposive sampling method was utilized to recruit participants. Data were collected using self-administered questionnaire and analysed in terms of frequency and percentage. Chi-Square test was used for inferential analysis with significance level, p, set at

Matched MeSH terms: Early Detection of Cancer
Fulltext Provider cost of treating oral potentially malignant disorders and oral cancer in Malaysian public hospitals

Raman S, Shafie AA, Abraham MT, Shim CK, Maling TH, Rajendran S, et al.

PLoS One, 2021;16(5):e0251760.
PMID: 33984051 DOI: 10.1371/journal.pone.0251760

Oral cancer has been recognized as a significant challenge to healthcare. In Malaysia, numerous patients frequently present with later stages of cancers to the highly subsidized public healthcare facilities. Such a trend contributes to a substantial social and economic burden. This study aims to determine the cost of treating oral potentially malignant disorders (OPMD) and oral cancer from a public healthcare provider's perspective. Medical records from two tertiary public hospitals were systematically abstracted to identify events and resources consumed retrospectively from August 2019 to January 2020. The cost accrued was used to estimate annual initial and maintenance costs via two different methods- inverse probability weighting (IPW) and unweighted average. A total of 86 OPMD and 148 oral cancer cases were included. The initial phase mean unadjusted cost was USD 2,861 (SD = 2,548) in OPMD and USD 38,762 (SD = 12,770) for the treatment of cancer. Further annual estimate of initial phase cost based on IPW method for OPMD, early and late-stage cancer was USD 3,561 (SD = 4,154), USD 32,530 (SD = 12,658) and USD 44,304 (SD = 16,240) respectively. Overall cost of late-stage cancer was significantly higher than early-stage by USD 11,740; 95% CI [6,853 to 16,695]; p< 0.001. Higher surgical care and personnel cost predominantly contributed to the larger expenditure. In contrast, no significant difference was identified between both cancer stages in the maintenance phase, USD 700; 95% CI [-1,142 to 2,541]; p = 0.457. A crude comparison of IPW estimate with unweighted average displayed a significant difference in the initial phase, with the latter being continuously higher across all groups. IPW method was shown to be able to use data more efficiently by adjusting cost according to survival and follow-up. While cost is not a primary consideration in treatment recommendations, our analysis demonstrates the potential economic benefit of investing in preventive medicine and early detection.

Matched MeSH terms: Early Detection of Cancer
Natural bioactive compounds as a new source of promising G protein-coupled estrogen receptor (GPER) modulators: comprehensive in silico approach

Khan SU, Ahemad N, Chuah LH, Naidu R, Htar TT

J Biomol Struct Dyn, 2020 Oct 15.
PMID: 33054574 DOI: 10.1080/07391102.2020.1830853

Cancer ranks in second place among the cause of death worldwide. Cancer progress in multiple stages of carcinogenesis and metastasis programs through complex pathways. Sex hormones and their receptors are the major factors in promoting cancer progression. Among them, G protein-coupled estrogen receptor-1 (GPER) has shown to mediate cellular signaling pathways and cancer cell proliferation. However, the lack of GPER protein structure limited the search for new modulators. In this study, we curated an extensive database of natural products to discover new potential GPER modulators. We used a combination of virtual screening techniques to generate a homology model of GPER and subsequently used that for the screening of 30,926 natural products from a public database to identify potential active modulators of GPER. The best hits were further screened through the ADMET filter and confirmed by docking analysis. Moreover, molecular dynamics simulations of best hits were also carried out to assess the stability of the ligand-GPER complex. This study predicted several potential GPER modulators with novel scaffolds that could be further investigated and used as the core for the development of novel GPER modulators.Communicated by Ramaswamy H. Sarma.

Matched MeSH terms: Early Detection of Cancer
Fulltext Impact of dietitian delivered intensive nutrition intervention on dietary intake and weight outcome among gynecology cancer outpatient prior to surgery

Aini Masitah Mohammad, Zalina Abu Zaid, Ho Chiou Yi, Zuriati Ibrahim, Zulfitri ‘Azuan Mat Daud, Nor Baizura Md. Yusop, et al.

Malaysian Journal of Medicine and Health Sciences, 2020;16(106):122-130.
MyJurnal

Introduction: This is open label randomised control trial, aimed to identify whether an early (commenced at the time of diagnosis) and intensive nutrition intervention (INI) (individualised dietary counselling, oral nutritional sup- plements [ONS], telephone, and home visit) can improve weight and dietary intake of gynaecological cancer (GC) patients preoperatively. Methods: Selected GC patients planned for surgery were randomly grouped into control group (CG) (n = 35) and intervention group (IG) (n = 34). Malnutrition screening tool (MST) was used as a screening tool, while Patient-Generated Subjective Global Assessment (PG-SGA) was used as a nutrition assessment tool. IG received an intensive individualised dietary counselling with the supply of ONS at baseline (Day 1). This continued with telephone and home visit follow-up by research dietitian (Day 3 and Day 6). Meanwhile, CG only received general nutritional counselling without supply of ONS. Final assessment was conducted on Day 14. The primary outcomes included weight changes measured using TANITA and dietary intake assessment using 24-hour diet recall. Results: Mean duration of INI was 14 days. At the end of the treatment period, there was a significant weight change between groups (p < 0.001), with 0.14% weight gain in IG and 1.3% weight reduction in CG. Mean energy and protein intake of IG were higher compared to CG by +329 kcal/day and +12.2 g/day, respectively. Conclusion: This study showed that INI that incorporated individualised dietary counselling, ONS, telephone counselling, and home visit can increase energy and protein intake of GC patients, resulting in weight gain.

Matched MeSH terms: Early Detection of Cancer
Fulltext Recent trend of androgen deprivation therapy in newly diagnosed prostate cancer patients: Comparing between high- and middle-income Asian countries

Lim J, Onozawa M, Saad M, Ong TA, A-CaP (Asian Prostate Cancer) Study, J-CaP (Japan Prostate Cancer Study Group), et al.

Cancer Sci, 2021 Jun;112(6):2071-2080.
PMID: 33738901 DOI: 10.1111/cas.14889

The number of newly diagnosed prostate cancer cases varies across Asia, with higher mortality-to-incidence ratio reported in developing nations. Androgen deprivation therapy (ADT), alone or in combination, remains the mainstay of first-line treatment for advanced prostate cancer. Key findings of extensive research and randomized controlled trials have shaped current clinical practice and influenced clinical guideline recommendations. We describe here the recent trend of ADT in newly diagnosed prostate cancer for Asia focusing on Japan (high-income country) and Malaysia (middle-income country) based on the Asian Prostate Cancer (A-CaP) Study. The combination of radiotherapy and ADT or ADT alone was common in patients with intermediate-to-high risk localized and locally advanced disease. For metastatic prostate cancer, maximum androgen blockade (gonadotrophin-releasing hormone [GnRH] agonist/antagonist plus antiandrogen) was prevalent among the Japanese patients while primary ADT alone with GnRH agonist/antagonist was widely practiced in the Malaysian cohort. Upfront combined therapy (ADT plus docetaxel or androgen receptor pathway inhibitor) has significantly improved the outcomes of patients with metastatic castration-naïve prostate cancer. Its application, however, remains low in our cohorts due to patients' financial capacity and national health insurance coverage. Early detection remains the cornerstone in prostate cancer control to improve treatment outcome and patient survival.

Matched MeSH terms: Early Detection of Cancer
18[F]FDG-PET/CT is a useful molecular marker in evaluating tumour aggressiveness: a revised understanding of an in-vivo FDG-PET imaging that alludes the alteration of cancer biology

Fathinul F, Nordin AJ, Lau WF

Cell Biochem Biophys, 2013 May;66(1):37-43.
PMID: 22790883 DOI: 10.1007/s12013-012-9395-5

Molecular imaging employing (18)[F]FDG-PET/CT enables in-vivo visualization, characterisation and measurement of biological process in tumour at the molecular and cellular level. In oncology, this approach can be directly applied as translational biomarkers of disease progression. In this article, the improved roles of FDG as an in-vivo glycolytic marker which reflect biological changes across in-vitro cellular environment are discussed. New understanding in how altered metabolism via glycolytic downstream drivers of malignant transformation as reviewed below offers unique promise as to monitor tumour aggressiveness and hence optimize the therapeutic management.

Matched MeSH terms: Early Detection of Cancer
Fulltext Perception of Cancer Risk and Its Associated Risk Factors among Young Iraqis living in Baghdad

Alaa H, Shah SA

Asian Pac J Cancer Prev, 2019 08 01;20(8):2339-2343.
PMID: 31450904 DOI: 10.31557/APJCP.2019.20.8.2339

Cancer is responsible for substantial burden on communities and more specifically on less developed countries. The incidence of cancer is on the rise due to population growth and aging, also due to increment of the risk factors such as smoking, increasing weight, low physical activity associated with adoption of western lifestyle. Around 14 million cases of new cancer and 8 million deaths from cancer is estimated to occur by 2012. This cross-sectional study was conducted in Baghdad from June 2016 to October 2016. Participants were selected according to our inclusion criteria, namely aged between 18 to 40 years and not being diagnosed with any chronic diseases. Those who fulfilled the inclusion criteria were 700 participants who completed the questionnaire. Results showed that most of our participants had low perceived susceptibility to cancer risk (62.4%), low perceived severity (59.8%), but good perceived benefits of screening (56.6%). Hierarchal linear regression analysis showed that sociodemographic factors of gender, marital status, and education level were statistically significant. Moreover, factors of health behaviour such as practice towards health and preventive behaviour were associated with the outcome. Finally, treatment control and emotional factors were mostly predicting the outcome. Perceived susceptibility to cancer along with its psychological factors and behaviour were important contributors to self-perceived health in this study. Hence there is association between perception and future morbidity and mortality, thus it is crucial for public health policy. Comprehensive health programs that include health promotion campaigns and proper health care services that deals with secondary prevention.

Matched MeSH terms: Early Detection of Cancer
Fulltext Awareness of colorectal cancer among the urban population in the Klang Valley

Sindhu CK, Nijar AK, Leong PY, Li ZQ, Hong CY, Malar L, et al.

Malays Fam Physician, 2019;14(3):18-27.
PMID: 32175037

Background: Colorectal cancer (CRC) is the second most common cancer in Malaysia. Awareness of risk factors, symptoms and warning signs of CRC will help in early detection. This paper presents the level of CRC awareness among the urban population in Malaysia.
Method: A cross-sectional study was conducted from November 2015 till December 2016 at three government clinics in the Klang Valley. The validated Bowel Cancer Awareness Measure questionnaire in both English and Malay was used. The mean knowledge scores for the warning signs and risk factors of CRC in different socio-demographic groups were compared using ANOVA in SPSS version 23. Statistical significance was set at p<0.05 and a 95% confidence level.
Results: Of the 426 respondents, 29.1% were unable to recall the warning signs and symptoms of CRC. Average recall was less than two warning signs and symptoms (mean 1.62, SD 1.33). The mean total knowledge score for CRC was 9.91 (SD 4.78), with a mean knowledge scores for warning signs and risk factors at 5.27 (SD 2.74) and 4.64 (SD 2.78), respectively. Respondents with a higher level of education were found to have higher level of knowledge regarding the warning signs of CRC. There was a significant positive association between knowledge score for warning signs and level of confidence in detecting warning signs. Regarding the total knowledge score for CRC, 3.3% of respondents scored zero. For warning signs and risk factors, 8.2% and 8.5% of respondents had zero knowledge scores, respectively.
Conclusions: Generally, awareness of CRC is poor among the urban population of Klang Valley. Greater education and more confidence in detecting warning signs are significantly associated with better knowledge of warning signs. CRC awareness programs should be increased to improve awareness.

Matched MeSH terms: Early Detection of Cancer
Fulltext The prevalence and risk factors of major depressive disorders in gynaecological cancer patients

Tee, B.C., Phang, C.K., Rasidi, A., Rushdan, M., Aliyasand, I., Hatta, S.

Malaysian Journal of Medicine and Health Sciences, 2013;9(2):53-61.
MyJurnal

Major Depressive Disorder (MDD) in gynaecological cancer patients is a disabling illness with significant mental and physical suffering. Determining the risk factors of MDD in cancer patients enables us to pay more attention to those who are vulnerable and to device effective strategies for prevention, early detection, and treatment. The objective of the study is to determine the prevalence of MDD and its associated risk factors in gynaecological cancer patients at Hospital Sultanah Bahiyah, Alor Star. This is a hospital-based cross-sectional descriptive study of 120 gynaecological cancer patients in Gynae-Oncology Unit in Hospital Sultanah Bahiyah, Alor Star. Mini International Neuropsychiatry Interview (MINI) was used for diagnosis of MDD. Socio-demographic data and clinical variables were collected. MVFSFI (Malay version Female Sexual Function Index) was used to determine sexual dysfunction, and WHOQOL-BREF (World Health Organization – Quality of Life-26) was performed to assess quality of life. The prevalence of MDD in gynaecological cancer patients in the study was 18%. The variables found to be significantly associated with MDD were lack of perceived social support, greater physical pain perception, presence of past psychiatric history, and poorer quality of life. Meanwhile, sexual dysfunction was not associated with MDD. Logistic regression analysis revealed that only the psychological health domain of QOL was significantly associated with MDD, and contributed to 60% of the variation in MDD. The prevalence of MDD in gynaecological cancer patients is higher than those in the general population. In view that MDD can compromise cancer prognosis and patient’s well-being, psychosocial intervention is recommended as a part of multi- disciplinary and comprehensive management of gynaecological cancer.

Matched MeSH terms: Early Detection of Cancer
Fulltext ROC analysis of MAMMEX and SOUNDEX — expert systems for the diagnoses of breast diseases

Ngah, U.K., Aziz, S.A., Aziz, M.E., Murad, M., Mahdi, N.M.N., Shakaff, A.Y.M., et al.

ASM Science Journal, 2008;2(1):1-11.
MyJurnal

The incidences of breast cancer have been rising at an alarming rate. Mass breast screening programmes involving mammography and ultrasound in certain parts of the world have also proven their benefits in early detection. However, radiologists may be confronted with increased workload. An attempt has been made in this paper to rectify part of the problems faced in this area. Expert systems based on the interpretation of mammographic and ultrasound images for classifying patient cases could be utilized by doctors (expert and non-expert) in screening. These softwares consist of MAMMEX (for mammogram) and SOUNDEX (for breast ultrasound) could be used to deduce cases according to Breast Imaging Recording and Data System (BI-RADS), based on patients’ history, physical and clinical assessment, mammograms and breast ultrasound images. A total of 179 retrospective cases from the Radiology Department, hospital of the University of Science Malaysia, Kubang Kerian, Kelantan were used in this study. A receiver operating characteristic (ROC) curve analysis was implemented, based on the usage of a two-class forced choice of classifying suspicious and malignant findings as positive with normal, benign and probably benign classified as negative. Results yielded an area under the curve (AUC) of 0.997 with the least standard error value of 0.003 for MAMMEX while an AUC of 0.996 with the least standard error of 0.004 was accomplished for SOUNDEX. A system which very closely simulated radiologists was also successfully developed in this study. The ROC curve analysis indicated that the expert systems developed were of high performance and reliability.

Matched MeSH terms: Early Detection of Cancer
Fulltext Complementary and alternative medicine (CAM) use and delays in presentation and diagnosis of breast cancer patients in public hospitals in Malaysia

Mohd Mujar NM, Dahlui M, Emran NA, Abdul Hadi I, Wai YY, Arulanantham S, et al.

PLoS One, 2017;12(4):e0176394.
PMID: 28448541 DOI: 10.1371/journal.pone.0176394

Complementary and alternative medicine (CAM) is widely used among the breast cancer patients in Malaysia. Delays in presentation, diagnosis and treatment have been shown to impact the disease prognosis. There is considerable use of CAM amongst breast cancer patients. CAM use has been cited as a cause of delay in diagnosis and treatments in qualitative studies, however there had not been any confirmatory study that confirms its impact on delays. The purpose of this study was to evaluate whether the use of CAM among newly diagnosed breast cancer patients was associated with delays in presentation, diagnosis or treatment of breast cancer. This multi-centre cross-sectional study evaluating the time points of the individual breast cancer patients' journey from first visit, resolution of diagnosis and treatments was conducted in six public hospitals in Malaysia. All newly diagnosed breast cancer patients from 1st January to 31st December 2012 were recruited. Data were collected through medical records review and patient interview by using a structured questionnaire. Complementary and alternative medicine (CAM) was defined as the use of any methods and products not included in conventional allopathic medicine before commencement of treatments. Presentation delay was defined as time taken from symptom discovery to first presentation of more than 3 months. The time points were categorised to diagnosis delay was defined as time taken from first presentation to diagnosis of more than 1 month and treatment delay was defined as time taken from diagnosis to initial treatment of more than 1 month. Multiple logistic regression was used for analysis. A total number of 340 patients participated in this study. The prevalence of CAM use was 46.5% (n = 158). Malay ethnicity (OR 3.32; 95% CI: 1.85, 5.97) and not interpreting symptom as cancerous (OR 1.79; 95% CI: 1.10, 2.92) were significantly associated with CAM use. The use of CAM was associated with delays in presentation (OR 1.65; 95% CI: 1.05, 2.59), diagnosis (OR 2.42; 95% CI: 1.56, 3.77) and treatment of breast cancer (OR 1.74; 95% CI: 1.11, 2.72) on univariate analyses. However, after adjusting with other covariates, CAM use was associated with delays in presentation (OR 1.71; 95% CI: 1.05, 2.78) and diagnosis (OR 2.58; 95% CI: 1.59, 4.17) but not for treatment of breast cancer (OR 1.58; 95% CI: 0.98, 2.55). The prevalence of CAM use among the breast cancer patients was high. Women of Malay ethnicity and not interpreting symptom as cancerous were significantly associated with CAM use. The use of CAM is significantly associated with delay in presentation and resolution of diagnosis. This study suggests further evaluation of access to breast cancer care is needed as poor access may cause the use of CAM. However, since public hospitals in Malaysia are heavily subsidized and readily available to the population, CAM use may impact delays in presentation and diagnosis.

Matched MeSH terms: Early Detection of Cancer
Fulltext The prevalence and risk factors of sexual dysfunction in gynaecological cancer patient

Tee, B.C., Ahmad Rasidi, M.S., Mohd Rushdan, M.N., Ismail, A., Sidi, H.

Medicine & Health, 2014;9(1):53-61.
MyJurnal

Sexual dysfunction is highly prevalent in gynaecological cancer patients. Most of the time, sexual dysfunction in gynaecological cancer is underdiagnosed as there is overlapping of symptoms with other psychological morbidities, interplaying of multiple risks, patients’ reluctance to complain or incompetence of health care provider to assess. Determining the risk factors of sexual dysfunction in cancer patients enables us to pay more attention to those who are vulnerable and to device strategies for early detection, prevention and treatment of sexual dysfunction in them. The main aim of the study was to determine the prevalence of sexual dysfunction and its risk factors in gynaecological cancer patients in Hospital Sultanah Bahiyah, Alor Star, Malaysia. Sexual function of eighty-three gynaecological cancer patients who were married were assessed with self-rated MVFSFI (Malay version Female Sexual Function Index). Self-rated WHOQOL-BREF (World Health Organization- Quality of Life- 26) which assessed the domains of quality of life was used while MINI (Mini International Neuropsychiatry Interview) was used for diagnosis of major depressive disorder. The prevalence of sexual dysfunction among the married gynaecological cancer patients was 65% (54/83). Sexual dysfunction was significantly associated with low education level (OR 3.055, CI 1.009-9.250), shorter duration of cancer (OR 0.966, CI 0.966- 0.998), ongoing chemotherapy (OR 3.045, CI 1.149-8.067), pain perception (OR 3.230, CI 1.257-8.303), absence of sexual intercourse for more than one month (OR 1.862) and three domains of quality of life such as physical health, psychological health and social relationship (OR 0.942, CI 0.908-0.978; OR 0.955, CI 0.916-0.995; OR 0.933, CI 0.894-0.973, respectively). However, sexual dysfunction was not associated with major depressive disorder (χ2 ² = 1.224, p = 0.268). The prevalence of sexual dysfunction in gynaecological cancer patients was comparable to other studies of similar population. Since, the risk factors of sexual dysfunction in gynaecological cancer patients are multidimensional, the process of assessment and management need to be holistic and patient-oriented.

Matched MeSH terms: Early Detection of Cancer
Awareness of Breast Cancer among Surgical Patients in a Tertiary Hospital in Malaysia

Kirubakaran R, Chee Jia T, Mahamad Aris N

Asian Pac J Cancer Prev, 2017 01 01;18(1):115-120.
PMID: 28240018

Background: Breast cancer is the commonest cancer among women worldwide. About one in nineteen women in
Malaysia are at risk, compared to one in eight in Europe and the United States. The objectives of this study were: (1) to
assess patients’ knowledge on risk factors, symptoms and methods of screening of breast cancer; and (2) to determine
their perceptions towards the disease treatment outcomes. Methods: A cross-sectional survey using a validated selfadministered
questionnaire was conducted among 119 consecutive surgical female patients admitted from 1st of
September to 8th of October 2015 in Hospital Sultan Abdul Halim, Kedah. Data were analyzed using General linear
regression and Spearman’s correlation with Statistical Package for Social Science (SPSS) version 20. Results: Mean (SD)
age was 40.6 (15.1) years and majority of the patients were Malay (106, 89.1%). Mean scores for general knowledge,
risk factors and symptoms of breast cancer were 50.2 (24.0%), 43.0 (22.9%) and 64.4 (28.4%) respectively. Mean
total knowledge score was 52.1(19.7%). 80 (67.2%) and 55 (46.2%) patients were aware of breast self-examination
and clinical breast examination recommendations, respectively. Generally, patients had positive perceptions towards
breast cancer treatment outcomes. However, majority (59.7%) considered that it would be a long and painful process.
Knowledge was significantly better among married women with spouses (p=0.046), those with personal history of
breast cancer (p=0.022) and with monthly personal income (p=0.001) with the coefficient of determination, R2=0.16.
Spearman’s correlation test showed a significant positive relationship between monthly personal income and breast
cancer awareness (r = 0.343, p <0.001). Conclusion: Awareness on breast cancer among our patients was average. Thus,
there is a need for more awareness programs to educate women about breast cancer and promote its early detection.

Matched MeSH terms: Early Detection of Cancer
Nanomedicines guided nanoimaging probes and nanotherapeutics for early detection of lung cancer and abolishing pulmonary metastasis: Critical appraisal of newer developments and challenges to clinical transition

Gao X, Guo L, Li J, Thu HE, Hussain Z

J Control Release, 2018 12 28;292:29-57.
PMID: 30359665 DOI: 10.1016/j.jconrel.2018.10.024

Lung cancer (LC) is the second most prevalent type of cancer and primary cause of mortality among both men and women, worldwide. The most commonly employed diagnostic modalities for LC include chest X-ray (CXR), magnetic-resonance-imaging (MRI), computed tomography (CT-scan), and fused-positron-emitting-tomography-CT (PET-CT). Owing to several limitations associated with the use of conventional diagnostic tools such as radiation burden to the patient, misleading diagnosis ("missed lung cancer"), false staging and low sensitivity and resolution, contemporary diagnostic regimen needed to be employed for screening of LC. In recent decades, nanotechnology-guided interventions have been transpired as emerging nanoimaging probes for detection of LC at advanced stages, while producing signal amplification, better resolution for surface and deep tissue imaging, and enhanced translocation and biodistribution of imaging probes within the cancerous tissues. Besides enormous potential of nanoimaging probes, nanotechnology-based advancements have also been evidenced for superior efficacy for treatment of LC and abolishing pulmonary metastasis (PM). The success of nanotherapeutics is due to their ability to maximise translocation and biodistribution of anti-neoplastic agents into the tumor tissues, improve pharmacokinetic profiles of anti-metastatic agents, optimise target-specific drug delivery, and control release kinetics of encapsulated moieties in target tissues. This review aims to overview and critically discuss the superiority of nanoimaging probes and nanotherapeutics over conventional regimen for early detection of LC and abolishing PM. Current challenges to clinical transition of nanoimaging probes and therapeutic viability of nanotherapeutics for treatment for LC and PM have also been pondered.

Matched MeSH terms: Early Detection of Cancer
Fulltext Diagnostic Accuracy of FOBT and Colorectal Cancer Genetic Testing: A Systematic Review & Meta-Analysis

Ramdzan AR, Abd Rahim MA, Mohamad Zaki A, Zaidun Z, Mohammed Nawi A

Ann Glob Health, 2019 05 15;85(1).
PMID: 31099505 DOI: 10.5334/aogh.2466

INTRODUCTION: Colorectal cancer (CRC) is the second leading cause of cancer related death in the world after lung cancer. Early detection of CRC leads to improvement in cancer survival rate. In recent years, efforts have been made to discover a non-invasive screening marker of higher sensitivity and specificity. Fecal occult blood testing (FOBT) and genetic testing become alternative modalities to screen CRC in the population other than colonoscopy. The aim of this systematic review and meta-analysis is to determine the diagnostic accuracy, sensitivity and specificity of FOBT and genetic testing as screening tools in colorectal cancer.
METHODS: A literature search of PubMed, ScienceDirect, and Scopus was carried out. The search strategy was restricted to human subjects and studies are published in English. Data on sensitivity and specificity were extracted and pooled. Heterogeneity was assumed at significance level of p < 0.10 and was tested by chi squared. Degree of heterogeneity was quantified using the I2 statistic, and values of less than 25% is considered as homogenous. All analyses were performed using the software Meta-Disc.
RESULTS: A total of eleven studies were suitable for data synthesis and analysis. Five studies were analyzed for the accuracy of genetic testing, the pooled estimate for sensitivity and specificity were 71% (95% CI: 66, 75%) and 95% (95% CI: 93, 97%) respectively. Another group of studies which had been evaluated for the accuracy of FOBT, the pooled sensitivity was 31% (95% CI: 25, 38%) while the pooled specificity was 87% (95% CI: 86, 89%).
CONCLUSIONS: FOBTs is recommended to use as population-based screening tools for colorectal cancer while genetic testing should be focusing on patients with moderate and high risk individuals.

Matched MeSH terms: Early Detection of Cancer

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