Epidemiological Trends of GI Cancers in Patients Visiting a Tertiary Care Hospital in Chandigarh, North India

Sharma, Munesh K,Singh, Tarundeep,Pandey, Avdesh K,Kankaria, Ankita Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.8

Background: Cancer has become an epidemic disease. Nearly ten million new cancer cases are diagnosed annually in the world and out of these about half are from the developing world. To appropriately plan for treatment, management and prevention of the disease, it becomes necessary to study the trends about morbidity caused by cancers. Materials and Methods: Data for patients diagnosed with any form of gastrointestinal (GI) cancers was extracted from records maintained in the outpatient department registers of the Oncology Department of Government Medical College and Hospital in Chandigarh from 1999 to 2012. Trends were analysed for different categories of GI cancers for the period of 12 years. Results: In present study GI cancers accounted for 23 % of all registered cases (n-9603) of carcinomas. Males predominated for all GI cancers except in the gall bladder. Gastrointestinal cancers as a proportion of total cancers increased from 21% in 1999 to 25.9% in 2012 with a significant increasing trend in our series (${\chi}^2$ for linear trend=9.36, p<0.003). Cancers of the tonsil, oral cavity and pharynx taken together showed an increasing trend over the years (${\chi}^2$ for trend=55.2, p<0.001) whereas cancers of the lower GI (${\chi}^2=19.6$, p<0.0001) and gall bladder (${\chi}^2=19.5$, p<0.0001) showed a declining trend in our series. Conclusions: GI cancers form a significant proportion of all cancers reporting to our data. In depth studies to ascertain the reasons for the changing trends are required to design intervention programs. Further information is necessary from cancer registries and from the hospital records of oncology departments.

위장관 ( 胃腸管 ) : 소화기암과 연관되어 발생한 다발적 원발성 악성종양

윤용범(Yong Bum Yoon),송인성(In Sung Song),김정룡(Chung Yong Kim),이효석(Hyo Suk Lee),최상운(Sang Woon Choi),최규완(Kyu Wan Choi),김용태(Yong Tae Kim),한철주(Cheol Joo Han),이준혁(Joon Hyeok Lee),류지곤(Ji Kon Ryu),정현채(Hyun Chae C 대한소화기학회 1991 대한소화기학회지 Vol.23 No.3

N/A Owing to the development of diagnostic techniques and treatment modalities, more and more cases of multiple primary cancers are being discovered and active researches concerning maltiple primary cancers are being done. The mortrality due to cancers of gastrointestinal tract occupies more than two thirds (68.4%) of total number of deathes due to cancers in Korea, but researches on multiple primary cancers concerning gastrointestinal tract are lacking. We reviwed 70 cases of multiple primary cancers concerning gastrointestinal tract, we experienced in the past decade. The ratio of male to female was 3.7:1, the mean age was 52.8 years. From 70 patients with multiple primary cancers, sixty patients had synchronous multiple primary cancers and ten patients had metachronous ones. The frequent sites involved were stomach (51.9%) and liver (21.2%). The most frequent combination of primary and secondary cancer was stomach cancer and primary liver cancer (27%). These results may be contributed to the actual incidence of each cancer, and routine staging work-up of liver for stomach cancer and routine gastroopy for primary liver cancer. In synchronous cancers, majority of the second cancers were found incidentally during routine staging work-up (58.3%) or during operation (8.4%), whereas only 33.3% of second cancers were found due to concomittent symtoms. Thus the incidence of each multiple primary cancer in our study may reflect the relative frequency of each cancer in Korea. In order to determine the true risk of occurrence of multiple primary cancers in Korea, prospective studies based on the large population of community should be conducted.

Clinical Characteristics of Multiple Primary Colorectal Cancers

윤주원,이승현,안병권,백승언 대한암학회 2008 Cancer Research and Treatment Vol.40 No.2

Purpose: Although multiple primary colorectal cancer has been recognized as a significant clinical entity, its clinical and pathological features and its prognosis are still controversial. The purpose of this study was to clarify clinical and pathological features of multiple primary colorectal cancer. Materials and Methods: Among 1669 patients who underwent surgery for primary colorectal cancer from January 1997 to June 2005, 26 patients (1.6%) with multiple primary colorectal cancer were identified. We reviewed clinical characteristics including diagnostic interval, lesions, operating methods, and TNM stage, and we defined the index lesion as the most advanced lesion among the synchronous lesions. For the purposes of the study, the colon and rectum were classified into three segments. The right-side colon included the appendix, cecum, ascending colon, hepatic flexure, and transverse colon, and the left-side colon included the splenic flexure, descending colon, and sigmoid colon. Results: Of the 26 patients with multiple primary colorectal cancers, nineteen patients were male and seven patients were female, with a mean age of 61.5 years. Nineteen patients had synchronous colorectal cancers and seven patients had metachronous colorectal cancers. In the metachronous cases, the mean diagnostic interval was 36.8 months. The site of the first lesion in metachronous colorectal cancers was the right colon in five cases (71.4%) and the left colon in two cases (28.6%), and the site of the second lesion was the rectum in six cases (55.5%), the right colon in three cases (33.3%), and the left colon in one case. The TNM stage of the second lesions in the metachronous colorectal cancers was stage II in four cases (57.1%), stage III in one case (14.3%), and stage IV in one case (14.3%). For the synchronous colorectal cancers, the operation methods were single-segment resection combined with endoscopic mucosal resection in five cases (26.3%), single- segment resection alone in six cases, two-segment resection in six cases, and total colectomy in two cases. Conclusion: In metachronous colorectal cancers, the secondary lesions were later-stage cancer. Therefore, careful postoperative follow-up is necessary for patients who have undergone surgery for colorectal cancers. Further study of therapeutic modalities is important for synchronous colorectal cancers.

Cancers among South-East Asian Nationals in Brunei Darussalam

Chong, Vui Heng,Telisinghe, Pemasari Upali,Lim, Edwin,Tan, Jackson,Chong, Chee Fui Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.2

Background: Worldwide, the incidence of cancers is increasing and is becoming a major public health issue, including those in the Asia Pacific region. South-East Asia is a region with diverse populations with different disease spectra. This study looked at the spectrum of cancers among South-East Asians working in Brunei Darussalam. Materials and Methods: The cancer registry from 1994 to 2012 maintained by the State Laboratory was retrospectively reviewed. Crude incidence rates were calculated based on the population census of 2010. Results: Altogether, there was a total of 418 cancer cases diagnosed among South-East Asians, giving an incidence of 5.1% (n=418/8,253). The affected nationals in decreasing frequency were Malaysians (53.1%), followed by Filipinos (25.8%), Indonesians (15.3%), Thais (3.8%), Myanmese (1.7%) and Vietnamese (0.2%) with no recorded cases for Singapore and the People's Republic of Laos. The overall mean age of diagnosis was $46.1{\pm}4.2$ years old, with an increasing trend over the years (p<0.05 ANOVA). The overall gender ratio was 42.3:57.7 (male:female), more females among the Filipinos and Indonesians, more males among the Thais, and equal representation among the Malaysians and the Myanmese. The most common were cancers of the digestive system (19.9%), followed by female reproductive/gynecologic system (16.0%), breast (15.6%), hematological/lymphatic (12.0%) and head/neck (8.1%). There were differences in the prevalence of cancers among the various nationalities with highest crude incidence rate among the Myanmese (141.2/100,000), followed by the Malaysian (88.5/100,000), and the Filipinos (40.6/100,000) and the lowest among the Thais (18.4/100,000), Indonesians (10.5/100,000) and the Vietnamese (6.3/100,000). Conclusions: Cancers among South-East Asian residing in Brunei Darussalam accounted for 5.1% of all cancers. The most common cancers were cancers of the digestive, gynecologic/female reproductive system and breast with certain types slowly increasing in proportions. There mean age of diagnoses was increasing.

Lymphoproliferative Disorders in Multiple Primary Cancers

Demirci, Umut,Ozdemir, Nuriye,Benekli, Mustafa,Babacan, Nalan Akgul,Cetin, Bulent,Baykara, Meltem,Coskun, Ugur,Zengin, Nurullah,Buyukberber, Suleyman Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.1

Background: Cancer survivors are at increased risk of second cancers. Lymphoproliferative disorders (LPD) are common neoplasms that are primary or subsequent cancers in cases of multiple primary cancer. We here analyzed metachronous or synchronous LPD in multiple primary cancers. Methods: Between 2001 and 2010, LPD were assessed retrospectively in 242 multiple primary cancers patients. Results: Forty nine (20.2%) patients with LPD were detected. Six patients had two LPD where one patient had three LPD. The median age of patients was 60.5 years (range: 28-81). LPD were diagnosed in 29 patients as primary cancer, in 23 patients as second cancer, and in three patients as third cancer in multiple primary cancers. Primary tumor median age was 56 (range: 20-79). Diffuse large B cell lymphoma (n=16), breast cancer (n=9), and lung cancer (n=6) were detected as subsequent cancers. Alklylating agents were used in 19 patients (43.2%) and 20 patients (45.5%) had received radiotherapy for primary cancer treatment. The median follow-up was 70 months (range: 7-284). Second malignancies were detected after a median of 51 months (range: 7-278), and third malignancies with a median of 18 months (range: 6-72). Conclusions: In this study, although breast and lung cancer were the most frequent detected solid cancers in LPD survivors, diffuse large B cell lymphoma was the most frequent detected LPD in multiple primary cancers.

Epidemiology of Female Reproductive Cancers in Iran: Results of the Gholestan Population-Based Cancer Registry

Taheri, NegarSadat,Fazel, Abdolreza,Mahmoodzadeh, Habibollah,Omranpour, Ramesh,Roshandel, Gholamreza,Gharahjeh, Saeedeh,Sedaghat, Seyed Mehdi,Poorabbasi, Mohammad,Moghaddami, Abbas,Semnani, Shahryar Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.20

Background: Malignancies of the female reproductive tract are estimated to be the third most common group of cancers in women. Objectives: We here aimed to present their epidemiological features in Golestan province located in Northeast of Iran. Materials and Methods: Data on primary female reproductive cancers diagnosed between 2004-2010 were obtained from Golestan Population-based Cancer Registry (GPCR). CanReg-4 and SPSS software were used for data entry and analysis. Age standardized incidence rates (ASR) (per 100,000 person-years) were calculated using the world standard population. Poisson regression analysis was used to compare incidence rates. P-values of less than 0.05 were considered as significant. Results: A total of 6,064 cancer cases were registered in Golestan females in the GPCR during 2004-2010, of which 652 cases (11%) were female reproductive cancers. Cancers of the ovary (ASR=6.03) and cervix (ASR=4.97) were the most common. We found significant higher rates in females living in cities than in villages. Our results showed a rapid increase in age specific incidence rates of female reproductive cancers at the age of 30 years. Conclusions: We found significant higher rates of female reproductive cancers among residents of cities than villages. Differences in the prevalence of risk factors including reproductive behavior between the two populations may partly explain such diversity. Our results also showed a rapid increase in incidence rates of these cancers in young age females. Further studies are warranted to determine risk factors of female reproductive cancers in our population.

대장암을 포함하는 다발성 원발성 악성종양

김수홍,김형진,이재임,이윤석,강원경,박종경,오승택 대한대장항문학회 2008 Annals of Coloproctolgy Vol.24 No.6

Purpose: With advance in diagnostic techniques and treatment modalities, it has been increasing that the patients with colorectal cancer experience another primary malignancies. Understanding the characteristics of multiple primary malignancies is important to establish an effective surveillance program for the early detection of second cancer. Methods: The database of 2,709 patients diagnosed with colorectal cancer between 1985 and 2007 in Kangnam St. Mary's Hospital was analyzed retrospectively. Results: Out of 2,709 patients, 102 (3.76%) of them were found to have multiple malignancies. Among them, 37 patients had synchronous cancers and 65 patients had metachronous cancers. The most common site of multiple primary malignancies was the stomach, followed by kidney, thyroid and breast. Conclusions: In the patients with colorectal cancer, it should be considered to evaluate multiple primary malignancies, especially stomach, during the routine follow up. And the most frequent multiple primary cancer before colorectal cancer was also stomach cancer. Careful attention should be paid to the colorectal cancer in stomach cancer patients. Purpose: With advance in diagnostic techniques and treatment modalities, it has been increasing that the patients with colorectal cancer experience another primary malignancies. Understanding the characteristics of multiple primary malignancies is important to establish an effective surveillance program for the early detection of second cancer. Methods: The database of 2,709 patients diagnosed with colorectal cancer between 1985 and 2007 in Kangnam St. Mary's Hospital was analyzed retrospectively. Results: Out of 2,709 patients, 102 (3.76%) of them were found to have multiple malignancies. Among them, 37 patients had synchronous cancers and 65 patients had metachronous cancers. The most common site of multiple primary malignancies was the stomach, followed by kidney, thyroid and breast. Conclusions: In the patients with colorectal cancer, it should be considered to evaluate multiple primary malignancies, especially stomach, during the routine follow up. And the most frequent multiple primary cancer before colorectal cancer was also stomach cancer. Careful attention should be paid to the colorectal cancer in stomach cancer patients.

Cyclooxygenase-2 Expression Is Related to the Epithelial-to-Mesenchymal Transition in Human Colon Cancers

장태정,전규하,정기훈 연세대학교의과대학 2009 Yonsei medical journal Vol.50 No.6

Purpose: Down-regulation of E-cadherin is a hallmark of the epithelial-to-mesenchymal transition (EMT). EMT progression in cancer cells is associated with the loss of certain epithelial markers and the acquisition of a mesenchymal phenotype, as well as migratory activities. Cyclooxygenase-2 (COX-2) expression is associated with tumor invasion and metastasis in colon cancer. This study investigated the relationship between E-cadherin and COX-2 in colon cancer cells and human colon tumors. Materials and Methods: Colon cancer cell lines and immunohistochemistry were used. Results: E-cadherin expression was inversely related to the expressions of COX-2 and Snail in colon cancer cells. Ectopic expression of COX-2 or Snail reduced E-cadherin and induced a scattered, flattened phenotype with few intercellular contacts in colon cancer cells. Treatment of cancer cells with phorbol 12-myristate 13-acetate increased the expressions of COX-2 and Snail, decreased 15-hydroxyprostaglandin dehydrogenase expression, and increased the cells’ motility. In addition, exposure to prostaglandin E2 increased Snail expression and cell motility, and decreased E-cadherin expression. Membranous E-cadherin expression was lower in adenomas and cancers than in the adjacent, non-neoplastic epithelium. In contrast, the expressions of Snail and COX-2 were higher in cancers than in normal tissues and adenomas. The expressions of COX-2 and Snail increased in areas with abnormal E-cadherin expression. Moreover, COX-2 expression was related to higher tumor stages and was significantly higher in nodal metastatic lesions than primary cancers. Conclusion: This study suggests that COX-2 may have a role in tumor metastasis via EMT. Purpose: Down-regulation of E-cadherin is a hallmark of the epithelial-to-mesenchymal transition (EMT). EMT progression in cancer cells is associated with the loss of certain epithelial markers and the acquisition of a mesenchymal phenotype, as well as migratory activities. Cyclooxygenase-2 (COX-2) expression is associated with tumor invasion and metastasis in colon cancer. This study investigated the relationship between E-cadherin and COX-2 in colon cancer cells and human colon tumors. Materials and Methods: Colon cancer cell lines and immunohistochemistry were used. Results: E-cadherin expression was inversely related to the expressions of COX-2 and Snail in colon cancer cells. Ectopic expression of COX-2 or Snail reduced E-cadherin and induced a scattered, flattened phenotype with few intercellular contacts in colon cancer cells. Treatment of cancer cells with phorbol 12-myristate 13-acetate increased the expressions of COX-2 and Snail, decreased 15-hydroxyprostaglandin dehydrogenase expression, and increased the cells’ motility. In addition, exposure to prostaglandin E2 increased Snail expression and cell motility, and decreased E-cadherin expression. Membranous E-cadherin expression was lower in adenomas and cancers than in the adjacent, non-neoplastic epithelium. In contrast, the expressions of Snail and COX-2 were higher in cancers than in normal tissues and adenomas. The expressions of COX-2 and Snail increased in areas with abnormal E-cadherin expression. Moreover, COX-2 expression was related to higher tumor stages and was significantly higher in nodal metastatic lesions than primary cancers. Conclusion: This study suggests that COX-2 may have a role in tumor metastasis via EMT.

Evaluation of the Histo-Epidemiological Profile of Solid Childhood Cancers in Togo

Darre, Tchin,Maneh, Nidain,Kpatcha, Matchonna,Boume, Azanledji,Padaro, Essohana,Amegbor, Koffi,Napo-Koura, Gado Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.1

Background: Cancer is a subject of continuing concern, more common in adults than in children, but often with a poor outcome in the latter. Our study set itself the objective to describe the epidemiological and histological aspects of solid cancers in children in Togo. Materials and Methods: This descriptive, cross-sectional study focused on cases of solid cancers in children diagnosed from 2010 to 2014 (5 years) at the pathology laboratory of the Tokoin teaching hospital. Data were collected from the records of that laboratory. Results: We collected 66 cases of childhood cancer representing 5% of all solid cancers. The annual incidence was 13.2 cases. The sex ratio (M/F) was 1.4; mean age was of $7.2{\pm}1.6years$. The age group most affected was that of 5-9 years (40.9%). Four histological groups of solid childhood cancers were listed: lymphoma (n=34 cases; 51.5%), embryonic cancer (n=17 cases; 25.8%), sarcomas (n=13 cases; 19.7%) and carcinoma (n=2 cases; 3%). The most common histological types were Burkitt lymphoma (36.4%), nephroblastoma (10.6%) and retinoblastoma (10.6%). Conclusions: This study shows that solid cancers in children are relatively frequent in Togo with a male predominance. They are still largely dominated by Burkitt lymphoma, followed by retinoblastoma and nephroblastoma.

위암 검진사업 현황

김영일,최일주 대한의사협회 2022 대한의사협회지 Vol.65 No.5

Background: In 2019, gastric cancer was one of the most common cancers in Korea. As a secondary prevention strategy for gastric cancer, the cancer screening has been provided since 1999 by the National Cancer Screening Program every 2 years for adults aged ≥40 years. Current Concepts: The participation rates for gastric cancer screening program have increased from 7.4% in 2002 to 62.9% in 2019. Until 2017, either upper gastrointestinal series or endoscopy were recommended for screening method. Since 2018, endoscopy has become the preferred screening method and 89.1% of the participants underwent endoscopy in 2019. After the introduction of the screening program, the 5-year relative survival rates have markedly improved (43.9% between 1993 and 1995 vs. 77.5% between 2015 and 2019), and the proportion of early gastric cancer detection has increased (28.6% in 1995 vs. 63.6% in 2019). The risk of death from gastric cancer decreased by 47% in participants who had undergone endoscopy screening. Additionally, the gastric cancer screening program is cost-effective, and endoscopy-associated adverse events rarely occur. Discussion and Conclusion: With the implementation of the screening program, mortality due to gastric cancer has decreased owing to early detection. After the completion of ongoing clinical trials in the general population, the primary prevention strategy of Helicobacter pylori eradication should be considered to effectively reduce the incidence of gastric cancer. Further studies are also required to provide optimal screening interval according to the presence of risk factors including H. pylori infection and presence of gastric mucosal atrophy