Displaying publications 1 - 20 of 532 in total

  1. Yajid AI, Mohd Nafi SN, Salehan NA, Tuan Sharif SE
    Asian Pac. J. Cancer Prev., 2020 May 01;21(5):1241-1245.
    PMID: 32458628 DOI: 10.31557/APJCP.2020.21.5.1241
    BACKGROUND: Chromosomal translocation t(X;18)(p11.2;q11.2) is the cytogenetic hallmark of synovial sarcoma and have been identified as an alternative diagnostic strategy in differentiating synovial sarcoma from other histologic mimics. This study was carried out to test the efficacy of two FISH protocols using the SYT-SSX break apart probe from Cytocell.

    METHODOLOGY: Representative paraffin blocks of synovial sarcoma were utilized in this study. FISH study was performed on formalin-fixed paraffin embedded tissue sections using the SYT-SSX break apart probe from Cytocell, to detect two form of SYT-SSX transcript, SYT-SSX1 and SYT-SSX2. FISH protocol, including the hybridization was done following two different protocols, Cytocell FISH protocol and Optimized Dako FISH protocol.

    RESULTS: Tissue samples subjected to FISH using Cytocell FISH protocol showed the absence of signal corresponding to the probe used. Utilizing Optimized Dako FISH protocol, the two signals (red and green) corresponding to the break-apart probes was detected. These findings suggested that Optimised Dako FISH protocol is more suited for use with the tested probe on paraffin embedded tissues in comparison to Cytocell FISH protocol.

    CONCLUSION: Optimised Dako FISH protocol was noted to be more suited for detecting SYT-SSX FISH signals on paraffin embedded tissues in comparison to Cytocell FISH protocol.

  2. Kord-Varkaneh H, Salehi-Sahlabadi A, Zarezade M, Rahmani J, Tan SC, Hekmatdoost A, et al.
    Asian Pac. J. Cancer Prev., 2020 May 01;21(5):1363-1367.
    PMID: 32458645 DOI: 10.31557/APJCP.2020.21.5.1363
    OBJECTIVE: Diet quality is known to influence cancer risk. The Healthy Eating Index (HEI) is one of the most frequently used measures of diet quality. However, the association between HEI-2015 and breast cancer risk is not known. The present study was undertaken to evaluate the association between HEI-2015 and breast cancer risk.

    METHODS: A case-control study comprising 134 breast cancer patients and 265 cancer-free controls were conducted. Dietary intakes were assessed using a validated food frequency questionnaire (FFQ), from which the HEI-2015 score was calculated. Logistic regression was used to derive the odds ratios (ORs) for measuring the association between HEI-2015 scores and breast cancer risk.

    RESULTS: Subjects in the top quartile of HEI-2015 had a 46% lower chance of breast cancer compared with subjects in the bottom quartile (OR 0.54; 95% CI 0.30, 0.98). After adjustment for potential confounders such as age, age at menarche, oral contraceptive drug use, menopausal status, marital status, body mass index, smoking and education level, the association between HEI-2015 score and a lower risk of breast cancer was enhanced (OR 0.32; 95% CI 0.16, 0.65).

    CONCLUSION: We successfully demonstrated that a higher HEI-2015 score was associated with a reduced breast cancer risk.

  3. Mohd Suan MA, Tan WL, Ismail I, Abu Hassan MR
    Asian Pac. J. Cancer Prev., 2020 May 01;21(5):1253-1258.
    PMID: 32458630 DOI: 10.31557/APJCP.2020.21.5.1253
    BACKGROUND: Patients with positive immunochemical faecal occult blood test results were found to have poor compliance for a subsequent colonoscopy procedure. This study was conducted to explore patients' perceived deterrence for colonoscopy following a positive stool test.

    METHODS: Using qualitative study method, a phone interview was conducted with 16 patients to elicit their views on the reasons for failure to attend the colonoscopy procedure following a positive stool test. The interviews were audio recorded, transcribed verbatim and translated before proceeded with the data analysis. Content analysis was made on the translated interview, followed by systematic classification of data by major themes.

    RESULTS: Reasons for nonattendance were categorized under five main themes; unnecessary test, fear of the procedure, logistic obstacles (subthemes; time constraint, transportation problem), social influences, and having other health priority. Lacking in information about the procedure during the referral process was identified to cause misperception and unnecessary worry towards colonoscopy. Fear of the procedure was commonly cited by female respondents while logistic issues pertaining to time constraint were raised by working respondents.

    CONCLUSIONS: More effective communication between patients and health care providers are warranted to avoid misconception regarding colonoscopy procedure. Support from primary care doctors, customer-friendly appointment system, use of educational aids and better involvement from family members were among the strategies to increase colonoscopy compliance.

  4. Adebayo IA, Arsad H, Gagman HA, Ismail NZ, Samian MR
    Asian Pac. J. Cancer Prev., 2020 May 01;21(5):1247-1252.
    PMID: 32458629 DOI: 10.31557/APJCP.2020.21.5.1247
    BACKGROUND: Recently, nanoparticle synthesis by eco-friendly methods has received tremendous attention due to the method advantages and also because of the application of the nanoparticles in cancer research. Therefore, in this study, we synthesized silver nanoparticles from Detarium microcarpum leaf phytochemicals and evaluated its inhibitory effect on pancreatic and cervical cancer cells.

    MATERIALS AND METHODS: Silver nanoparticles (dAgNps) were synthesized by reacting phytochemicals of D. microcarpum leaves with silver nitrate for 12 hours. Cell viability assay was carried out to investigate the cytotoxic effect of dAgNps on HeLa and PANC-1 cells.

    RESULTS: Scanning electron microscopy (SEM) and transmission electron microscopy(TEM) results revealed the average sizes of dAgNps are 81 nm and 84 nm respectively. The x-ray diffraction (XRD) pattern of dAgNps was similar to that of face centered cubic(fcc) structure of silver as reported by joint committee on powder diffraction standards (JCPDS) and fourier-transform infrared spectroscopy (FTIR) analysis showed that some phytochemicals of D. microcarpum such as polyphenols and flavonoids were likely involved in the reduction of Ag+ to form nanoparticles. Finally, cell viability assay revealed dAgNps inhibited PANC-1 and HeLa cell proliferations with IC50 values of 84 and 31.5 µg/ml respectively.

    CONCLUSION: In conclusion, the synthesized nanoparticles from D. microcarpum leaves (dAgNps) have inhibitory effect on pancreatic and cervical cancer cells.

  5. Wan Ibrahim NR, Chan HK, Soelar SA, Azmi AN, Mohd Said R, Abu Hassan MR
    Asian Pac. J. Cancer Prev., 2020 Apr 01;21(4):1057-1061.
    PMID: 32334470 DOI: 10.31557/APJCP.2020.21.4.1057
    BACKGROUND: While the world witnesses an increasing trend of young-onset colorectal cancer (CRC), the information regarding the impact of age on CRC is limited in Malaysia. This study aimed to compare the incidence, clinic-demographic profiles and survival rates of CRC between patients above and under 50 years of age in northern Malaysia.

    METHODS: This was a registry-based, cross-sectional study. All the CRC cases reported by 18 hospitals to the National Cancer Patient Registry - Colorectal Cancer (NCPR-CC) between January 2007 and December 2017 were included in the analysis. The patients were categorized by age into the above-50 and under-50 groups. The changes in the age-standardized incidence and mortality rates of both the age groups were determined using the time-series analysis, and the impact of age on the mortality risk was assessed using the Cox regression analysis.

    RESULTS: Of the 6,172 CRC patients enrolled in the NCPR-CC, 893 (14.5%) were in the under-50 group. As compared with their older counterparts, the patients in the under-50 group were more likely to be female, be of Malay ethnicity, be non-smokers, have a family history of CRC, and present late for treatment. The age-standardized incidence and mortality rates of CRC in the under-50 group remained stable over the years, while a decreasing trend was clearly seen in the mortality rates of CRC in the above-50 group (p=0.003). Nevertheless, the two age groups also did not differ in the mortality risk (adjusted hazards ratio: 1.10; 95% CI: 0.90, 1.36).

    CONCLUSION: Young-onset CRC constituted a considerable proportion of CRC cases in Malaysia. However, in contrast with the findings of most studies, it demonstrated neither an uptrend in age-standardized incidence rates nor a higher mortality risk. Our findings suggest the need to upscale and lower the recommended age for CRC screening in Malaysia.

  6. Al-Tayar BA, Ahmad A, Yusoff ME, Abdullah SF, Mohamad NK, Md Hashim SN, et al.
    Asian Pac. J. Cancer Prev., 2020 Apr 01;21(4):1005-1009.
    PMID: 32334462 DOI: 10.31557/APJCP.2020.21.4.1005
    BACKGROUND: Betel quid chewing is more common among the older generation in rural areas of Malaysia. Oral cancer in Asia has been associated with the habit of chewing betel quid and areca nut.

    OBJECTIVE:   This study aims to investigate the cytotoxic effects of betel quid and areca nut extracts on the fibroblast (L929), mouth-ordinary-epithelium 1 (MOE1) and oral squamous cell carcinoma (HSC-2) cell lines.

    METHODS: L929, MOE1 and HSC-2 cells were treated with 0.1, 0.2 and 0.4 g/ml of betel quid and areca nut extracts for 24, 48 and 72 h. MTT assay was performed to assess the cell viability.

    RESULTS: Both extracts, regardless of concentration, significantly reduced the cell viability of L929 compared with the control (P<0.05). Cell viability of MOE1 was significantly enhanced by all betel quid concentrations compared with the control (P<0.05). By contrast, 0.4 g/ml of areca nut extract significantly reduced the cell viability of MOE1 at 48 and 72 h of incubation. Cell viability of HSC-2 was significantly lowered by all areca nut extracts, but 0.4 g/ml of betel quid significantly increased the cell viability of HSC-2 (P<0.05).

    CONCLUSION: Areca nut extract is cytotoxic to L929 and HSC-2, whereas the lower concentrations of areca nut extract significantly increased the cell viability of MOE1 compared to the higher concentration and control group. Although betel quid extract is cytotoxic to L929, the same effect is not observed in MOE1 and HSC-2 cell lines. Further investigations are needed to clarify the mechanism of action.

  7. Zakaria N, Mohd KS, Ahmed Saeed MA, Ahmed Hassan LE, Shafaei A, Al-Suede FSR, et al.
    Asian Pac. J. Cancer Prev., 2020 Apr 01;21(4):943-951.
    PMID: 32334454 DOI: 10.31557/APJCP.2020.21.4.943
    BACKGROUND: Uterine fibroids are a common type of solid tumor presenting in women of reproductive age. There are very few alternative treatment available from conventional treatment involving surgeries. Labisia pumila var. alata or locally known as 'Kacip Fatimah' was widely used as traditional medicine in Malaysia. This plant has been used to maintain a healthy female reproductive system. The present study aimed to evaluate anti fibroid potential of L. pumila extracts through in vitro apoptosis activity against uterine leiomyoma cells (SK-UT-1) and in uterine leiomyoma xenograft model. Evaluation of bioactive markers content were also carried out.

    METHODS: Apoptotic induction of the extracts was determined by morphological examination of AO/PI dual staining assay by flourescent microscopy and flow cytometry analysis on Annexin V-FITC/PI stained cells. In vivo study was done in immune-compromised mouse xenograft model. HPLC analysis was employed to quantify marker compounds.

    RESULTS: Morphological analysis showed L. pumila induced apoptosis in a dose dependent manner against SK-UT-1 cells. In vivo study indicated that L. pumila significantly suppressed the growth of uterine fibroid tumor. All tested extracts contain bioactive marker of gallic acid and cafeic acid.

    CONCLUSION: This work provide significant data of the potential of L. pumila in management of uterine fibroids.

  8. Chong ZX, Ho WY, Yan P, Alshagga MA
    Asian Pac. J. Cancer Prev., 2020 Apr 01;21(4):881-895.
    PMID: 32334447 DOI: 10.31557/APJCP.2020.21.4.881
    BACKGROUND: Conducting systematic review to evaluate plant use as a risk factor to cancer could be challenging. A systematic and well-balanced method should be applied to accommodate in vivo and in vitro studies to make a final decision. In this article, khat, a recreational plant used in some Arabic and African regions, was employed as an example to systematically determine its relationships to the premalignant and cancerous conditions.

    METHODS: Systematic database search was performed to recruit original human, animal or in vitro studies on khat and cancer. Sixteen studies fulfilled the inclusion criteria and subjected to assessment using Risk of Bias (RoB). Office of Health and Translation (OHAT) approach was used to rate the confidence level in the body of evidence. The evidence was integrated to establish the relationships between khat, premalignant conditions and cancer.

    RESULTS: Seven out of eight studies showed that khat causes premalignant oral lesions with moderate evidence level. Four studies showed that khat causes cancer with low evidence level and another three studies showed that khat has anti-cancer effect with moderate to high evidence level. Only one study suggested that khat is unrelated to cancer.

    CONCLUSION: RoB and OHAT approach are reliable systematic tools to evaluate plant risk to cancer and provide objective and uniform summary regardless of the study type. In conclusion, our pooled analysis did not find a direct relationship between khat and cancer but anti-cancer effect would require to be proofed on human studies.

  9. Romli R, Shahabudin S, Saddki N, Mokhtar N
    Asian Pac. J. Cancer Prev., 2020 Mar 01;21(3):853-859.
    PMID: 32212817 DOI: 10.31557/APJCP.2020.21.3.853
    OBJECTIVE: We examined the effectiveness of a health education program to improve; knowledge and attitude towards cervical cancer and Pap smear, and uptake of Pap smear test among female entrepreneurs in Kedah, a northern state of Malaysia.

    METHODS: This controlled community trial involved 210 women from the districts of Alor Setar and Sungai Petani. Simple random sampling was applied to select 105 women from each district. Self-administered questionnaires were used to obtain information about the variables of interest. Health education intervention program included educational talk, demo video, experience sharing, pamphlet distribution, and text message reminders. Evaluation of outcomes was performed twice. The text message reminders acted as the cues to action that were sent between the two evaluation times at one-month interval. Women in the control group received educational talk alone. In the control group, evaluation of outcomes was done only once, which was one month after the educational talk.

    RESULTS: Knowledge on cervical cancer and Pap smear, and attitude towards Pap smear among women in both intervention and control group improved significantly at Evaluation stage 1. However, no further improvements were observed in the intervention group at Evaluation stage 2. The uptake of Pap smear in the intervention group increased significantly from 48.0% at Baseline to 68.0% at Evaluation stage 1 (P<0.001), and from 68.0% to 79.0% at Evaluation stage 2 (P<0.001). A significant increase in Pap smear uptake was also seen in the control group from 63.0% at Baseline to 76.0% at Evaluation stage 1 (P=0.003).

    CONCLUSIONS: Educational talk alone was effective in improving knowledge on cervical cancer and Pap smear, attitude towards the test, and the actual uptake of the test. However, text reminders were more effective than having an educational talk alone in increasing uptake of Pap smear test among participants.

  10. Mustapar N, Zawawi MSF, Tuan Sharif SE
    Asian Pac. J. Cancer Prev., 2020 Mar 01;21(3):699-705.
    PMID: 32212796 DOI: 10.31557/APJCP.2020.21.3.699
    BACKGROUND: Diagnosis of malignant peripheral nerve sheath tumor (MPNST) is rather challenging due to its divergent morphologic heterogeneity and lack of specific ancillary test. The emergence of H3K27 trimethylation (H3K27me3) as a new immunohistochemistry (IHC) marker for MPNST have recently available to assist pathologists in differentiating MPNST from other histologic mimics. We aim to study the expression pattern of H3K27me3 in MPNST and its histologic mimickers and their association with the clinicopathological data.

    METHODOLOGY: A total of 59 benign and malignant spindle cell tumours (18 MPNST and 41 of its histologic mimickers which included 10 schwannoma, 13 neurofibroma, 4 synovial sarcoma, 3 fibrosarcoma, 2 gastrointestinal stromal tumour (GIST), 4 leiomyosarcoma, 1 spindle cell liposarcoma, 1 solitary fibrous tumour, 2 low grade fibromyxoid sarcoma and 1 unclassified spindle cell sarcoma), diagnosed from January 1998 to April 2018 in Hospital Universiti Sains Malaysia (HUSM) were tested for H3K27me3 by IHC. The MPNST histological grade was assessed based on the French Fe'de' ration Nationale des Centres de LutteContre le Cancer (FNCLCC) for 3 tiers system (low grade, intermediate grade and high grade). The clinicopathological data were retrieved from the patients' record.

    RESULTS: A total of 61.1% (11/18 MPNST) showed loss of H3K27me3 expression which is statistically significant as compared to its histologic mimics (p<0.001). Similar findings (p=0.026) were also observed in high grade MPNST (81.8%), intermediate grade MPNST (100%) and 0% in low grade MPNST.

    CONCLUSION: H3K27me3, combined with other panel of markers, is useful in MPNST diagnosis to differentiate it from the histological mimickers.

  11. Thomas G, Tr S, George S P, Somanathan T, Sarojam S, Krishnankutti N, et al.
    Asian Pac. J. Cancer Prev., 2020 Feb 01;21(2):309-316.
    PMID: 32102504 DOI: 10.31557/APJCP.2020.21.2.309
    BACKGROUND: Although leukoplakia shows a higher risk for malignant transformation to oral cancer, currently there are no clinically relevant biomarker which can predict the potentially high risk leukoplakia. This study aimed to investigate the genetic alterations such as DNA ploidy, telomerase expression and DNA repair capacity as predictive markers of malignant transformation risk of leukoplakia.

    METHODS: The study was initiated in September 2005 and patients were followed up to March 2014. Two hundred patients with oral leukoplakia, 100 patients with oral cancer and 100 healthy, age and sex matched adults with normal oral mucosa as controls were recruited. The DNA ploidy content was measured by high resolution flow cytometry, level of telomerase expression was identified by TRAP assay and intrinsic DNA repair capacity was measured by mutagen induced chromosome sensitivity assay of cultured peripheral blood lymphocytes. The Chi-square test or Fisher's Exact test was used for comparison of categorical variables between biomarkers. A p value less than or equal to 0.05 was considered as statistically significant. Analysis was performed with SPSS software version 16. Logistic regression was used to find the association between the dependent and three independent variables.

    RESULTS: There was significant difference in the distribution of ploidy status, telomerase activity and DNA repair capacity among control, leukoplakia and oral cancer group (p<0.001). When the molecular markers were compared with histological grading of leukoplakia, both DNA ploidy analysis and telomerase activity showed statistical significance (p<0.001). Both aneuploidy and telomerase positivity was found to coincide with high-risk sites of leukoplakia and were statistically significant (p.

  12. Htay MNN, Donnelly M, Schliemann D, Loh SY, Dahlui M, Ibrahim Tamin NSB, et al.
    Asian Pac. J. Cancer Prev., 2020 Jan 01;21(1):217-223.
    PMID: 31983187 DOI: 10.31557/APJCP.2020.21.1.217
    BACKGROUND: Breast cancer is the most common cancer among women in Malaysia, and the incidence of 31.1 per 100,000 population is comparatively higher than other Southeast Asian countries. Diagnosis tends to occur at later stages which may be due, partly, to inadequate knowledge about warning signs and symptoms. Therefore, this study investigated the validity and reliability of a UK-developed measure in the context of assessing women's awareness of breast cancer in Malaysia.

    AIMS: This study aimed to translate, adapt and validate the internationally recognised Breast Cancer Awareness Measure (B-CAM) into the Malay language.

    METHODS: The original B-CAM (Cancer Research UK) was forward and backward translated and content validation was ascertained. Face validity (n=30), test-retest reliability (n=50) and the internal consistency of the B-CAM-M (M for Malay language) were assessed in a community sample of adults (n=251) in 2018.

    RESULTS: The translated B-CAM-M was validated by an expert panel. The Item-Content Validity Index ranged from .83 to 1.00. The results from the survey (n=251) indicated that the B-CAM-M was well received by Malay-speaking women across the main ethnic groups (85 Malay, 84 Chinese and 82 Indian adults). Cronbach alpha scores for the knowledge about breast cancer symptoms (0.83) and the barriers to healthcare seeking items (0.75) were high. Test-retest reliability (separated by 2-week-interval) with 50 randomly selected participants from the community survey produced intra-class correlations ranging from 0.39 to 0.69.

    CONCLUSION: The Malay-version, the B-CAM-M, is a culturally acceptable, valid and reliable assessment tool with which to measure breast cancer awareness among Malay-speaking women.

  13. Leong E, Ong SK, Madli F, Tan A, Lai D, Basir N, et al.
    Asian Pac. J. Cancer Prev., 2020 Jan 01;21(1):259-265.
    PMID: 31983194 DOI: 10.31557/APJCP.2020.21.1.259
    BACKGROUND: Colorectal cancer (CRC) is the third most common cancer in both men and women. In most Asian countries, both the incidence and mortality rates of CRC are gradually increasing. In Brunei Darussalam, CRC ranks first and second in lifetime risk among men and women respectively. This study aims to report the overall survival rates and associated factors of CRC in Brunei Darussalam.

    METHODS: This is a retrospective study examining CRC data for the period 2007 to 2017 retrieved from a population based cancer registry in Brunei Darussalam. A total of 728 patients were included in the analysis. Kaplan Meier method was used to estimate survival rates. Univariate analysis using log-rank test was used to examine the differences in survival between groups. Multivariate analysis using Cox PH regression was used to estimate hazard of death and obtain significant predictors that influence CRC patients' survival.

    RESULTS: The median survival time for colorectal, colon and rectal cancer patients were 57.0, 85.8 and 40.0 months respectively. The overall 1-, 3- and 5- year survival rates for CRC patients were 78.0%, 57.7% and 49.6% respectively. In univariate analysis, age at diagnosis, ethnicity, cancer stage, tumour location and histology were found to have significant difference in CRC patients' survival. In the Cox PH analysis, older age (≥70 years), cancer stage, ethnicity and other histological type were determined as associated factors of CRC patients' survival.

    CONCLUSION: This study found the overall 5-year survival rate of CRC in Brunei Darussalam is similar to that in some Asian countries such as Singapore and Malaysia. However, more efforts need to be carried out in order to raise awareness of CRC and improve the survival of CRC patients.

  14. Chaudhry GE, Jan R, Naveed Zafar M, Mohammad H, Muhammad TST
    Asian Pac. J. Cancer Prev., 2019 Dec 01;20(12):3555-3562.
    PMID: 31870094 DOI: 10.31557/APJCP.2019.20.12.3555
    OBJECTIVE: Breast cancer is the most frequently diagnosed cancer worldwide. The main objective of the present study was to evaluate the cytotoxic effects and mechanism of cell death induced by the extract and fractions of Vitex rotundifolia (leaves) in breast cancer cell line, T-47D.

    METHODS: The cytotoxicity activity was measured using MTS assay. The mode of cell death was analysed by early (phosphatidylserine externalization) and late apoptosis (DNA fragmentation). The caspases 8, 9, 3/7 and apoptotic proteins bax, bcl-2 study were done by western blot and ELISA method.

    RESULTS: The methanol extract was found to inhibit 50% growth of T-47D cells at the concentration of 79.43µg/ml respectively after 72hr. From seven fractions, fraction F1, F2 and F3 produced cytotoxicity effects in T-47D cell line with IC50 (72hr) < 30µg/ml. The results obtained by Annexin V/PI apoptosis detection assay and TUNEL assay suggest that active fractions of  Vitex rotundifolia induced early and late apoptosis (DNA fragmentation) in T-47D cell line. Moreover, western blot analysis and Caspase GloTM luminescent assay demonstrated that fractions F2 and F3 triggered apoptotic cell death via activation of caspases -8, -9 and -3/7 and up-regulation of  Bax and down-regulation of Bcl-2 protein.  Furthermore, chemical profiling confirms the presence of potential metabolites (vitexicarpin) in fractions of Vitex rotundifolia.

    CONCLUSION: Thus, the present study suggests the remarkable potential of active metabolites in fractions of Vitex rotundifolia as future cancer therapeutic agent for the treatment of breast cancer.

  15. Anuar N, Idris NS, Mohd Zin F, Abdul Rahman R, Ahmad I, Ibrahim MI
    Asian Pac. J. Cancer Prev., 2019 Nov 01;20(11):3353-3359.
    PMID: 31759359 DOI: 10.31557/APJCP.2019.20.11.3353
    OBJECTIVE: To study the effectiveness of the smoking prevention module towards knowledge on smoking and its harmful effects and smoking refusal skills among secondary school students in Kelantan, Malaysia.

    METHODS: A quasi experimental interventional study involving 166 non-smokers adolescents, aged 13 to 14 years old were carried out in two schools located in two different suburbs. Both schools had equal number of participants. One school was given the smoking prevention module for intervention while the control school only received the module after the study had been completed. The knowledge on smoking and its harmful effects and smoking refusal skill score were assessed using a set of validated Malay questionnaires at baseline, two weeks and eight weeks after the intervention. Repeated measure ANCOVA was used to analyse the mean score difference of both groups at baseline and after intervention.

    RESULT: Baseline analysis shows no significant difference in knowledge score between the study groups (p = 0.713) while post intervention, it shows significant inclination of knowledge score in intervention group and the difference was significant after controlling the gender [F(df) = 15.96(1.5), p <0.001]. The mean baseline for refusal skills score in the control and intervention groups were 30.89(6.164) and 28.02(6.241) respectively (p= 0.003). Post intervention, there is a significant difference in the crude mean and the estimated marginal means for smoking refusal skills score between the two groups after controlling for sex [F(df) = 5.66(1.8), p = 0.005].

    CONCLUSION: This smoking prevention module increased the level of knowledge on smoking and its harmful effects and smoking refusal skill among the secondary school students. Thus, it is advocated to be used as one of the standard modules to improve the current method of teaching in delivering knowledge related to harmful effects of smoking and smoking refusal skill to the adolescents in Malaysia.

  16. Okekpa SI, S M N Mydin RB, Mangantig E, Azmi NSA, Zahari SNS, Kaur G, et al.
    Asian Pac. J. Cancer Prev., 2019 Nov 01;20(11):3505-3514.
    PMID: 31759378 DOI: 10.31557/APJCP.2019.20.11.3505
    OBJECTIVE: Risk factors of nasopharyngeal carcinoma (NPC) have been linked with diets, life style and viral
    infections. NPC is more rampant in Asian populations than non-Asian countries. Our study aims to assess the validity
    of the suggestions provided by multiple case control studies demonstrating that salted fish consumption, smoking and
    alcohol consumption are associated with the risk of NPC in Asia.

    METHODS: Search for related literature on salted fish,
    smoking and alcohol consumption were performed via Science Direct, PubMed databases and Google Scholar. Articles
    included in this study were from 2009 to 2017, with specific focus on salted fish, smoking and alcohol consumption
    as risk factors of NPC. This study excluded all articles published prior to 2009 and articles involving other cancers.
    Data were extracted independently by two different researchers and harmonized. Meta-analysis was conducted on the
    obtained data, by using R package Meta to create funnel and forest plots.

    RESULTS: The meta-analysis revealed that
    salted fish, smoking and alcohol consumption were significantly associated to NPC risk with random effect model score
    showing OR of 1.41 at 95% confidence interval (CI) of 1.13-1.75 (P<0.01), OR of 1.89 at 95 % CI of 1.49 - 2.38, and
    OR: 1.42 at 95 % CI of 1.23 - 1.65 respectively. Our results also revealed significant association of salted meat, salted
    vegetables, house type, wood dust exposure associated with NPC risk with p values less than 0.05.

    study proposes that salted fish intake, smoking and alcohol consumption might be linked to NPC risk in Asians. Further
    studies are necessary to ascertain the molecular mechanisms and clarify if the associated path that could function as
    therapeutic target.

  17. Assayaghi RM, Alabsi AM, Swethadri G, Ali AM
    Asian Pac. J. Cancer Prev., 2019 Oct 01;20(10):3071-3075.
    PMID: 31653156 DOI: 10.31557/APJCP.2019.20.10.3071
    BACKGROUND: Treatment of cancer with chemo-radiotherapy causes severe side effects due to cytotoxic effects towards normal tissues which often results in morbidity. Therefore, developing anticancer agents which can selectively target the cancer cells and cause less side effects are the main objectives of the new therapeutic strategies for treatment advanced or metastatic cancers. Newcastle disease virus strains AF2240 and V4-UPM were shown to be cytolytic against various cancer cells in-vitro and very effective as antileukemicagents.

    METHODS: 45 rats at 6 weeks of age, were randomly assigned to nine groups with 5 rats in each group, both azoxymethane (AOM) and 5-Fluorouracil (5-FU) were given to rats according to the body weight. NDV virus strains (AF2240 and V4-UPM) doses were determined to rats according to CD50 resulted from MTT assay. After 8 doses of NDV strians and 5-FU, tissue sections preparations and histopathological study of rats' organs were done.

    RESULTS: In this article morphological changes of rats' organs, especially in livers, after treatment with a colon carcinogen (azoxymethane) and Newcastle disease virus strains have been recorded. We observed liver damage caused by AOM evidenced by morphological changes and enzymatic elevation were protected by the oncolytic viruses sections. Also we found that combination treatment NDV with 5-FU had greater antitumor efficacy than treatment with NDV or 5-FU alone.

    CONCLUSION: We noted morphological changes in liver and other rats' organs due to a chemical carcinogen and their protection by NDV AF2240 and NDV V4-UPM seems to be most protective.

  18. Kaur G, Balasubramaniam SD, Lee YJ, Balakrishnan V, Oon CE
    Asian Pac. J. Cancer Prev., 2019 Oct 01;20(10):3043-3049.
    PMID: 31653153 DOI: 10.31557/APJCP.2019.20.10.3043
    OBJECTIVE: Minichromosome maintenance complex (MCM) proteins are essential for the process of DNA replication and cell division. This study aimed to evaluate MCM genes expression profiles and MCM2 protein in HPV-associated cervical carcinogenesis.

    METHODOLOGY: MCM2, 4, 5 and 7 genes expression profiles were evaluated in three cervical tissue samples each of normal cervix, human papillomavirus (HPV)-infected low grade squamous intraepithelial lesion (LSIL), high grade squamous intraepithelial lesion (HSIL) and squamous cell carcinoma (SCC), using Human Transcriptome Array 2.0 and validated by nCounter® PanCancer Pathway NanoString Array. Immunohistochemical expression of MCM2 protein was semi-quantitatively assessed by histoscore in tissue microarrays containing 9 cases of normal cervix, 10 LSIL, 10 HSIL and 42 cases of SCC.

    RESULTS: MCM2, 4, 5 and 7 genes expressions were upregulated with increasing fold change during the progression from LSIL to HSIL and the highest in SCC. MCM2 gene had the highest fold change in SCC compared to normal cervix. Immunohistochemically, MCM2 protein was localised in the nuclei of basal cells of normal cervical epithelium and dysplastic-neoplastic cells of CIN and SCC. There was a significant difference in MCM2 protein expression between the histological groups (P = 0.039), and histoscore was the highest in HSIL compared to normal cervix (P = 0.010).

    CONCLUSION: The upregulation of MCM genes expressions in cervical carcinogenesis reaffirms MCM as a proliferative marker in DNA replication pathway, whereby proliferation of dysplastic and cancer cells become increasingly dysregulated and uncontrolled. A strong expression of MCM2 protein in HSIL may aid as a concatenated screening tool in detecting pre-cancerous cervical lesions.

  19. Che Mohamed N, Moey SF, Lim BC
    Asian Pac. J. Cancer Prev., 2019 09 01;20(9):2865-2873.
    PMID: 31554389 DOI: 10.31557/APJCP.2019.20.9.2865
    Background: Early detection of breast cancer is essential in improving overall women’s health. The researchers
    sought to develop a comprehensive measure that combined the basic components of the health belief model (HBM)
    with a focus on breast self-examination (BSE) and screening mammogram amongst women. Methods: Questionnaire
    items were developed following a review of relevant literature of HBM on BSE and screening mammogram. The
    sampling frame for the study was Malaysian women aged 35 to 70 years old, living in Kuantan, Pahang and able to
    read or write in Bahasa Malaysia or English. As such, 103 women were randomly selected to participate in the study.
    Tests of validity using exploratory factor analysis (EFA) and reliability were subsequently performed to determine the
    psychometric properties of the questionnaire. Results: The EFA revealed nine factors (self-efficacy of mammogram,
    perceived barriers of BSE and mammogram, perceived susceptibility of breast cancer, perceived severity of breast
    cancer, cues to action for mammogram screening, perceived benefits of BSE, health motivation, perceived benefits
    of mammogram and self-efficacy of BSE) containing 54 items that jointly accounted for 74.2% of the observed
    variance. All nine factors have good internal consistency with Cronbach’s alpha ≥ 0.8. Fifty-four items remained in
    the final questionnaire after deleting 13 problematic items. The scale also showed good convergent and discriminant
    validity. Conclusion: The findings showed that the designed questionnaire was a valid and reliable instrument for the
    study involving women in Kuantan, Pahang. The instrument can help to assess women’s beliefs on BSE adoption and
    mammogram screening in health care practice and research.
  20. Sharif Nia H, Rezapour M, Allen KA, Pahlevan Sharif S, Jafari A, Torkmandi H, et al.
    Asian Pac. J. Cancer Prev., 2019 09 01;20(9):2803-2809.
    PMID: 31554380 DOI: 10.31557/APJCP.2019.20.9.2803
    Objectives: The Center for Epidemiologic Studies Depression Scale (CES-D) was specifically created to assess
    depression in cancer patients. However, to date, the CES-D has not been validated in Farsi. Therefore, this study aimed to
    assess the psychometric properties of the CES-D in Iranian cancer patients. Methods: During a three-month period
    (October to December, 2015), a total of 380 cancer patients completed a Farsi version of the CES-D. The construct
    validity of the scale was evaluated by exploratory factor analysis. Reliability was assessed using Cronbach’s alpha
    and McDonald Omega. All of the statistical procedure were run by SPSS 22 (SPSS Inc., Chicago, IL, USA). Results:
    The construct validity of the CES-D determined three factors (somatic affect, negative affect, and positive affect),
    which explained 65.60% of the total variance. The internal consistency was greater than 0.70. Conclusion: Findings
    revealed that the Farsi version of the CES-D has acceptable validity and reliability, which can be used to measure
    depression in Iranian cancer patients.
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