METHODOLOGY: A cross-sectional study was conducted among 200 women in Shah Alam, Selangor; Malaysia. The questionnaire contained 27 questions and was comprised of two sections; socio-demographic characteristics and practices, knowledge and barriers of mammography. All the data were analyzed using the Statistical Package for the Social Sciences (SPSS) 13.0.
RESULTS: Of the 200 Malaysian women who participated in this study, the majority were under the age of 50 years (65.5%), Malay (86%), and married (94.5%). Regarding any family history of cancer in general, the majority of the participants had none (78%). However, some did report a close relative with breast cancer (16.5%). While the majority of them knew about mammography (68%), 15% had had a mammogram once in their life and only 2% had the procedure every two or three years. Univariate analysis showed that age, family history of cancer, family history of breast cancer, regular supplement intake, regular medical check-up and knowledge about mammogram were significantly associated with mammogram practice among the general population (p=0.007, p=0.043, P=0.015, p=0.01, p=0.001, p<0.001; respectively). Multivariate analysis using multiple linear regression test showed that age, regular medical check-up and knowledge about mammography testing were statistically associated with the practice of mammography among the general population in Malaysia (p=0.035, p=0.015 and p<0.001; respectively). Lack of time, lack of knowledge, not knowing where to go for the test and a fear of the test result were the most important barriers (42.5%, 32%, 21%, 20%; respectively).
CONCLUSION: The practice of mammogram screening is low among Malaysian women.
METHODS: The study was divided into two phases: (I) Marker discovery by miRNA microarray using paired cancer tissues (n = 30) and blood samples (CRC, n = 42; control, n = 18). (II) Marker validation by stem-loop reverse transcription real time PCR using an independent set of paired cancer tissues (n = 30) and blood samples (CRC, n = 70; control, n = 32). Correlation analysis was determined by Pearson's test. Logistic regression and receiver operating characteristics curve analyses were applied to obtain diagnostic utility of the miRNAs.
RESULTS: Seven miRNAs (miR-150, miR-193a-3p, miR-23a, miR-23b, miR-338-5p, miR-342-3p and miR-483-3p) have been found to be differentially expressed in both tissue and blood samples. Significant positive correlations were observed in the tissue and blood levels of miR-193a-3p, miR-23a and miR-338-5p. Moreover, increased expressions of these miRNAs were detected in the more advanced stages. MiR-193a-3p, miR-23a and miR-338-5p were demonstrated as a classifier for CRC detection, yielding a receiver operating characteristic curve area of 0.887 (80.0% sensitivity, 84.4% specificity and 83.3% accuracy).
CONCLUSION: Dysregulations in circulating blood miRNAs are reflective of those in colorectal tissues. The triple miRNA classifier of miR-193a-3p, miR-23a and miR-338-5p appears to be a potential blood biomarker for early detection of CRC.
MATERIALS AND METHODS: A cross-sectional study was conducted among 508 women aged 18 to 55 years from four non-governmental organizations (NGO) in Baghdad city, Iraq. A self-administered questionnaire on breast cancer knowledge and practice was distributed to participants during weekly activity of the NGO.
RESULTS: A total of 61.2% of the respondents had poor knowledge, only 30.3% performed breast self-examination (BSE) and 41.8% said that they did not know the technique to perform BSE. Associations between knowledge and marital status and age were significant. For practice, working status, education, age and family income were significant. After controlling for cofounders, the most important contributing factors for poor knowledge among respondents were marital status and not performing BSE, with adjusted odds ratio of 1.6 and 1.8 respectively.
CONCLUSIONS: Breast cancer knowledge and practice of BSE are poor among women in Baghdad city, Iraq. More promotion regarding breast cancer signs and symptoms and also how to perform BSE should be conducted using media such as television and internet as these constituted the main sources of information for most women in our study.
METHODS: From October 2011 to June 2015, 1,778 asymptomatic women, aged 40-74 years, underwent subsidised mammographic screening. All patients had a clinical breast examination before mammographic screening, and women with mammographic abnormalities were referred to a surgeon. The cancer detection rate and variables associated with a recommendation for adjunct ultrasonography were determined.
RESULTS: The mean age for screening was 50.8 years and seven cancers (0.39%) were detected. The detection rate was 0.64% in women aged 50 years and above, and 0.12% in women below 50 years old. Adjunct ultrasonography was recommended in 30.7% of women, and was significantly associated with age, menopausal status, mammographic density and radiologist's experience. The main reasons cited for recommendation of an adjunct ultrasound was dense breasts and mammographic abnormalities.
DISCUSSION: The cancer detection rate is similar to population-based screening mammography programmes in high-income Asian countries. Unlike population-based screening programmes in Caucasian populations where the adjunct ultrasonography rate is 2-4%, we report that 3 out of 10 women attending screening mammography were recommended for adjunct ultrasonography. This could be because Asian women attending screening are likely premenopausal and hence have denser breasts. Radiologists who reported more than 360 mammograms were more confident in reporting a mammogram as normal without adjunct ultrasonography compared to those who reported less than 180 mammograms.
CONCLUSION: Our subsidised opportunistic mammographic screening programme is able to provide equivalent cancer detection rates but the high recall for adjunct ultrasonography would make screening less cost-effective.
METHODOLOGY: In-depth interviews were conducted among 36 male university students from the Management and Science University, Malaysia, selected by simple random sampling. The themes of the interview were: knowledge of male breast cancer and male breast self-examination, sources of knowledge and attitudes towards male BSE. The data obtained were classified into various categories and analyzed manually.
RESULTS: The majority of participants mentioned that there is a low possibility for males to get breast cancer. They also believed that the cause of breast cancer among men is due to the carcinogens from cigarettes. The majority of participants mentioned that they know about breast self-examination from the mass media and that the presence of a lump in the breast is the main symptom of breast cancer in men. The majority of participants mentioned that they encourage their family members to practice breast self-examination but considered that BSE is not important for men because they have a low probability of getting breast cancer.
CONCLUSIONS: Misconceptions regarding male breast cancer and breast self-examination among men still exist among male university students. Therefore special attention should be given to educate men about male breast cancer and male BSE.
MATERIALS AND METHODS: A descriptive, cross sectional survey was conducted using a sample of 500 Malaysian adolescents from the age of 15 to 19 years. A self-administered questionnaire was used to gather socio- demographic characteristics, knowledge of BSE, knowledge of risk factors for breast cancer and BSE practices.
RESULTS: The findings of this study indicated that female adolescents in Malaysia demonstrated an inadequate knowledge level of BSE and risk factors for breast cancer. Only 27.8% of female adolescents performed BSE regularly. BSE practice, knowledge of BSE and knowledge of risk factors for breast cancer showed significant positive relationships.
CONCLUSIONS: The study highlighted the importance of planning and implementing breast health education programs for female students in secondary schools in Malaysia. It will also provide the health care providers an avenue to stress on the importance of imparting breast health education to adolescents.
Case Report: We report a case study of parotid squamous cell carcinoma in a 29-year-old male masquerading as an ear polyp.
Conclusion: Parotid gland primary squamous cell carcinoma is a rapidly advancing neoplasm which carries poor prognosis despite multimodality treatment. Diligent clinical and histopathological evaluation is imperative to discriminate this rare aggressive disease from the metastatic and other primary cancers of the parotid. A high index of suspicion is crucial in refractory aural polyps to arrive at early diagnosis.
METHODS: A desk review was conducted from August to October in 2018, to examine, review and describe the historical perspective, strategic planning and implementation of the current CRC screening program in Malaysia.
RESULTS: The main policy documents related to CRC screening are the National Strategic Plan for Cancer Control Programme 2016-2020, the Clinical Practice Guideline for Management of Colorectal Carcinoma 2017, and the Implementation Guideline for CRC Screening in Malaysia 2014. Several papers have been published on the epidemiology of CRC in Malaysia. Between 2014 and 2018, 127,957 men and women were screened using immunochemical Faecal Occult Blood Test (iFOBT); 9.3% had positive iFOBT results and were referred for colonoscopy. For those who underwent colonoscopy, CRC detection rate was 4.1% and 13.9% for pre-malignant conditions. Barriers were identified along the continuum of screening process, including patient, provider, and system factors.
CONCLUSION: Although population-level organised screening programmes are preferable to opportunistic screening, the CRC programme in Malaysia was tailored to meet the needs of the population based on available existing resources. A well-mapped budget for the entire screening programme continuum, a strong partnership between stakeholders and an opportunistic screening strategy is crucial to address the rising incidence of CRC.
METHODS: Dentists were recruited through two main dental associations in Malaysia and attended a 1-day training session on recognizing abnormalities within the oral cavity. Following the training, the dentists conducted screening and provided risk habits cessation advice at their respective clinics for 6 months. The impact of the program was evaluated by determining the number of patients who were screened and/or provided with risk habits cessation advice.
RESULTS: Twenty-six dentists took part in the program and conducted opportunistic screening on a total of 2603 individuals. On average, they screened about 23.0% of their patients and 5.1% were given risk habits cessation advice. Notably, dentists who had lower patient load were more likely to conduct opportunistic screening.
CONCLUSIONS: While the participating private dentists state that they have a role in performing opportunistic screening and providing risk habits cessation advice, these activities are still not a priority area in the private clinics, strongly suggesting that strategies to motivate dentists in this setting are urgently needed.