Perceptions of Cancer Risk and Cause of Cancer Risk in Korean Adults

Kye, Su Yeon,Park, Eun Young,Oh, Kyounghee,Park, Keeho Korean Cancer Association 2015 Cancer Research and Treatment Vol.47 No.2

<P><B>Purpose</B></P><P>The aims of the present study were to assess the prevalence of perceived risk for cancer; to explore associations between sociodemographics and family history of cancer and perceived cancer risk; to identify perceived cause of cancer risk; and to examine the associations between sociodemographics and family history of cancer and perceived cause of cancer risk.</P><P><B>Materials and Methods</B></P><P>This cross-sectional study was conducted among 1,009 participants aged 30-69 years, selected from a population-based database in October 2009 through multiple-stratified random sampling. Information was collected about the participants’ perceived cancer risk and perceived cause of cancer risk.</P><P><B>Results</B></P><P>Overall, 59.5% of the respondents thought they had the chance of developing cancer. Female sex, younger age, lower income, and family history of cancer were positively associated with perceived cancer risk. The most important perceived cause of cancer risk was stress. There was a difference between sociodemographics and family history of cancer and perceived cause of cancer risk.</P><P><B>Conclusion</B></P><P>Factors affecting perceptions of cancer risk and cause of cancer risk need to be addressed in risk communications. The results provide important directions for the development of educational strategies to promote awareness and self-appraisal of cancer risk and risk factors.</P>

Genetic Risk Score, Combined Lifestyle Factors and Risk of Colorectal Cancer

조영애,이정희,오재환,장희진,손대경,신애선,김정선 대한암학회 2019 Cancer Research and Treatment Vol.51 No.3

Purpose Both genetic and lifestyle factors contribute to the risk of colorectal cancer, but each individual factor has a limited effect. Therefore, we investigated the association between colorectal cancer and the combined effects of genetic factors or/and lifestyle risk factors. Materials and Methods In a case-control study of 632 colorectal cancer patients and 1,295 healthy controls, we quantified the genetic risk score for colorectal cancer using 13 polymorphisms. Furthermore, we determined a combined lifestyle risk score including obesity, physical activity, smoking, alcohol consumption, and dietary inflammatory index. The associations between colorectal cancer and risk score using these factors were examined using a logistic regression model. Results Higher genetic risk scores were associated with an increased risk of colorectal cancer (odds ratio [OR], 2.57; 95% confidence interval [CI], 1.89 to 3.49 for the highest tertile vs. lowest tertile). Among the modifiable factors, previous body mass index, physical inactivity, heavy alcohol consumption, and a high inflammatory diet were associated with an increased risk of colorectal cancer. A higher lifestyle risk score was associated with an increased risk of colorectal cancer (OR, 5.82; 95% CI, 4.02 to 8.44 for the highest tertile vs. lowest tertile). This association was similar in each genetic risk category. Conclusion Adherence to a healthy lifestyle is associated with a substantially reduced risk of colorectal cancer regardless of individuals’ genetic risk.

Awareness of Risk Factors for Cancer among Omani adults- A Community Based Study

Al-Azri, Mohammed,AL-Rasbi, Khadija,Al-Hinai, Mustafa,Davidson, Robin,Al-Maniri, Abdullah Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.13

Background: Cancer is the leading cause of mortality around the world. However, the majority of cancers occur as a result of modifiable risk factors; hence public awareness of cancer risk factors is crucial to reduce the incidence. The objective of this study was to identify the level of public awareness of cancer risk factors among the adult Omani population. Materials and Methods: A community based survey using the Cancer Awareness Measure (CAM) questionnaire was conducted in three areas of Oman to measure public awareness of cancer risk factors. Omani adults aged 18 years and above were invited to participate in the study. SPPSS (ver.20) was used to analyse the data. Results: A total of 384 participated from 500 invited individuals (response rate =77%). The majority of respondents agreed that smoking cigarettes (320, 83.3%), passive smoking (279, 72.7%) and excessive drinking of alcohol (265, 69%) are risks factors for cancer. However, fewer respondents agreed that eating less fruit and vegetables (83, 21.6%), eating more red or processed meat (116, 30.2%), being overweight (BMI> 25) (123, 32%), doing less physical exercise (119, 31%), being over 70 years old (72, 18.8%), having a close relative with cancer (134, 34.9%), infection with human papilloma virus (HPV) (117, 30.5%) and getting frequent sunburn during childhood (149, 38.8%) are risk factors for cancer. A significant association was found between participant responses and their educational level. The higher the educational level, the more likely that respondents identified cancer risk factors including smoking (p<0.0005), passive smoking (p= 0.007), excessive drinking of alcohol (p<0.0005), eating less fruit and vegetables (p= 0.001) and infection with HPV (p<0.0005). Conclusions: The majority of respondents in this study in Oman were not aware of the common risk factors for cancer. It may be possible to reduce the incidence of cancers in Oman by developing strategies to educate the public about these risk factors.

Breast Cancer Risk and Early Diagnosis Applications in Turkish Women Aged 50 and Over

Ceber, Esin,Mermer, Gulengul,Okcin, Figen,Sari, Dilek,Demireloz, Mahide,Eksioglu, Aysun,Ogce, Filiz,Cakır, Dilek,Ozenturk, Gulsun Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.10

Background: The aim of the study was to determine breast cancer risk and early diagnosis applications in women aged ${\geq}50$. Materials and Methods: This cross-sectional, descriptive field study focused on a population of 4,815 in Mansuro$\breve{g}$lu with a 55.1% participation rate in screening. In the study, body mass index (BMI) was also evaluated in the calculation of breast cancer risk by the Breast Cancer Risk Assessment Tool (BCRA) (also called the "Gail Risk Assessment Tool"). The interviewers had a three-hour training provided by the researchers, during which interactive training methods were used and applications were supported with role-plays. Results: The mean age of the women participating in the study was $60.1{\pm}8.80$. Of these women, 57.3% were in the 50-59 age group, 71.7% were married, 57.3% were primary school graduates and 61.7% were housewives. Breast-cancer development rate was 7.4% in the women participating in the study. When they were evaluated according to their relationship with those with breast cancer, it was determined that 73.0% of them had firstdegree relatives with breast cancer. According to the assessment based on the Gail method, the women's breast cancer development risk within the next 5 years was 17.6%, whereas their calculated lifetime risk was found to be as low as 0.2%. Statistically significant differences (P=0.000) were determined between performing BSE-CBE and socio-demographic factors. Conclusions: It was determined that 17.6% of the participants had breast cancer risk. There was no statistically significant difference between the women with and without breast cancer risk in terms of early diagnosis practices, which can be regarded as a remarkable finding. It was planned to provide training about the early diagnosis and treatment of breast cancer for people with high-risk scores, and to conduct population-based breast cancer screening programs.

Preventive and Risk Reduction Strategies for Women at High Risk of Developing Breast Cancer: a Review

Krishnamurthy, Arvind,Soundara, Viveka,Ramshankar, Vijayalakshmi Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.3

Breast cancer is the most commonly diagnosed invasive cancer among women. Many factors, both genetic and non-genetic, determine a woman's risk of developing breast cancer and several breast cancer risk prediction models have been proposed. It is vitally important to risk stratify patients as there are now effective preventive strategies available. All women need to be counseled regarding healthy lifestyle recommendations to decrease breast cancer risk. As such, management of these women requires healthcare professionals to be familiar with additional risk factors so that timely recommendations can be made on surveillance/risk-reducing strategies. Breast cancer risk reduction strategies can be better understood by encouraging the women at risk to participate in clinical trials to test new strategies for decreasing the risk. This article reviews the advances in the identification of women at high risk of developing breast cancer and also reviews the strategies available for breast cancer prevention.

Roles of E-Cadherin (CDH1) Genetic Variations in Cancer Risk: a Meta-analysis

Deng, Qi-Wen,He, Bang-Shun,Pan, Yu-Qin,Sun, Hui-Ling,Xu, Ye-Qiong,Gao, Tian-Yi,Li, Rui,Song, Guo-Qi,Wang, Shu-Kui Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.8

E-Cadherin (CDH1) genetic variations may be involved in invasion and metastasis of various cancers by altering gene transcriptional activity of epithelial cells. However, published studies on the association of CDH1 gene polymorphisms and cancer risk remain contradictory, owing to differences in living habits and genetic backgrounds. To derive a more better and comprehensive conclusion, the present meta-analysis was performed including 57 eligible studies of the association between polymorphisms of CDH1 gene promoter -160 C>A, -347 G>GA and 3'-UTR +54 C>T and cancer risk. Results showed that these three polymorphisms of CDH1 were significantly associated with cancer risk. For -160 C>A polymorphism, -160A allele carriers (CA and CA+AA) had an increased risk of cancer compared with the homozygotes (CC), and the similar result was discovered for the -160A allele in the overall analyses. In the subgroup analyses, obvious elevated risk was found with -160A allele carriers (AA, CA, CA+AA and A allele) for prostate cancer, while a decreased colorectal cancer risk was shown with the AA genotype. For the -347 G>GA polymorphism, the GAGA genotype was associated with increased cancer risk in the overall analysis with homozygous and recessive models. In addition, results of subgroup analysis indicated that the elevated risks were observed in colorectal cancer and Asian descendants. For +54 C>T polymorphism, a decreased risk of cancer was found in heterozygous, dominant and allele models. Moreover, +54T allele carriers (CT, CT+TT genotype and T allele) showed a potential protective factor in gastric cancer and Asian descendants.

Association of Metabolic Risk Factors with Risks of Cancer and All-Cause Mortality in Patients with Chronic Hepatitis B Virus Infection: A Korean Nationwide Cohort Study

( Yun Bin Lee ),( Hyemi Moon ),( Jeong-hoon Lee ),( Eun Ju Cho ),( Su Jong Yu ),( Yoon Jun Kim ),( Fabien Zoulim ),( Juneyoung Lee ),( Jung-Hwan Yoon ) 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1

Aims: Long-term antiviral therapy can effectively suppress viral replication and improve clinical outcomes in chronic hepatitis B patients, but it cannot eliminate the risk of hepatocellular carcinoma (HCC). We investigated the association of metabolic risk factors with the risks of cancer and all-cause mortality in chronic hepatitis B patients using the Korean National Health Insurance Service database. Methods: We collected baseline data on metabolic risk factors, including obesity, hypercholesterolemia, insulin resistance, and hypertension. The risks of developing HCC, non-HCC cancer, and overall death were analyzed according to the metabolic risk profile. The risks of HCC and non-HCC cancer were analyzed after adjusting death as a competing risk event. Results: The study population consisted of 317,856 adults with chronic hepatitis B. A total of 18,850 HCCs, 22,164 non-HCC cancers, and 15,768 deaths were observed during a median follow-up period of 8.5 years. The cumulative incidences of HCC (P<.0001; panel A), non-HCC cancer (P<.0001; panel B), and death (P<.0001; panel C) rose with increasing number of metabolic factors. The metabolic risk factor burden was positively associated with the risks of HCC, non-HCC cancer, and all-cause mortality (all P<.0001 for trend). Patients with ≥3 metabolic risk factors, compared to those without metabolic risk factors, showed adjusted hazard ratios of 1.23 (95% confidence interval [CI], 1.16-1.31) for HCC, 1.34 (95% CI, 1.27-1.41) for non-HCC cancer, and 1.31 (95% CI, 1.23-1.39) for all-cause mortality. Among patients receiving antiviral therapy for over 5 years, the risk-increasing association of the sum of metabolic risk factors with the risks of HCC and overall death was consistent. Conclusions: In this Korean nationwide cohort study, the burden of metabolic risk factors was associated with increased risk of HCC, non-HCC cancer, and all-cause mortality in patients with chronic HBV infection.

대한갑상선학회 갑상선분화암 진료권고안; Part I. 갑상선분화암의 초기치료 - 제5장 갑상선분화암의 수술 후 초기 질병 상태와 재발위험도 평가 및 초기위험군 분류 2024

이은경 대한갑상선학회 2024 International Journal of Thyroidology Vol.17 No.1

The American Joint Committee on Cancer/Union for International Cancer Control (AJCC/UICC) staging classification of thyroid cancer can predict death but cannot determine the type and frequency of follow-up testing. Risk stratification is a concept proposed by the American Thyroid Association that uses additional prognostic factors that are not included in the AJCC/UICC classification, such as number or size of metastatic lymph nodes, genetic mutations, and vascular invasion in follicular cancer, to further refine the prognosis of thyroid cancer. The risk of recurrence was categorized as low, intermediate, and high risk, and the need for total thyroidectomy, radioiodine therapy, or thyroid-stimulating hormone suppression was determined depending on each risk level. This approach has been accepted worldwide, and the previous recommendations of the Korean Thyroid Association followed a similar line of thinking but these have been modified in the revised 2024 guidelines. For the revised initial risk stratification, after careful review of the results of the recent meta-analyses and large observational studies and after a multidisciplinary meeting, four major changes were made: 1) thyroid cancer was reclassified according to the World Health Organization (WHO) 2022 tumor classification system; 2) recurrence risk was stratified by combining encapsulated follicular variant papillary thyroid cancer, follicular thyroid cancer, and oncocytic thyroid cancer, which have similar recurrence risk and associated factors, into follicular-patterned tumor; 3) low-risk groups were defined as those with a known recurrence rate of ≤5%, high-risk groups were upgraded to those with a known recurrence rate of ≥30%, and intermediate-risk groups were those with a recurrence risk of 5–30%; and 4) the intermediate risk group had the recurrence rate presented according to various clinicopathological factors, mainly based on reports from Korea. Thus, it is recommended to evaluate the initial risk group by predicting the recurrence rate by combining each clinical factor in individual patients, rather than applying the recurrence rate caused by single risk factor.

한국인 유방암의 역학적 특성

박수경,강대희,김연주,유근영 대한의사협회 2009 대한의사협회지 Vol.52 No.10

Breast cancer has been the most common cancer among Korean women since 2001 and will continue to increase for the next 20 years, at the least. Many of the established risk factors are linked to the exposure to female hormones: breast cancer risk is increased by early menarche, late menopause, nulliparity and later first full-term pregnancy, and obesity in postmenopausal women. In addition, other established risk factors such as alcohol consumption and family history of breast cancer are associated with an increased risk of breast cancer. Physical activity, breast feeding, higher number of children, and fruit and vegetable consumption seem to reduce breast cancer risk. Smoking also probably increases the risk. Both oral contraceptives in premenopausal women and hormonal replacement therapy in postmenopausal women may increase risk. Above-mentioned risk and protective factors were reported in Korean populations and the breast cancer risk by those factors is similar to that in western population. Currently, a study is being done in Korea to examine the associated risk, and population attributable risk of genetic variants in high penetrance genes including BRCA 1 and 2 and breast cancer risk among Koreans will be reported soon. Other studies conducted in Korea that investigated low penetrance genes have already been published. While the individual risk was small, there was an effect from interaction with environmental factors. Numerous Korean studies about these risk factors helped to establish a model to predict individual breast cancer risk that is utilized in the Personalized Preventive and Predictive medicine.

Assessing Breast Cancer Risk among Iranian Women Using the Gail Model

Khazaee-Pool, Maryam,Majlessi, Fereshteh,Nedjat, Saharnaz,Montazeri, Ali,Janani, leila,Pashaei, Tahereh Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.8

Background: Breast cancer risk assessment is a helpful method for estimating development of breast cancer at the population level. Materials and Methods: In this cross-sectional study, participants consisted of a group of 3,847 volunteers ($mean{\pm}SD$ age: $463{\pm}7.59$ years) in a convenience sample of women referred to health centers affiliated to Tehran University of Medical Sciences in Tehran, Iran. The risk of breast cancer was estimated by applying the National Cancer Institute's online version of the Gail Risk Assessment Tool. Results: Some 24.9% of women reported having one first-degree female relative with breast cancer, with 8.05% of them having two or more first-degree relatives with breast cancer. The mean five-year risk of breast cancer for all participants was $1.61{\pm}0.73%$, and 9.36% of them had a five-year risk of breast cancer >1.66%. The mean lifetime risk of breast cancer was $11.7{\pm}3.91%$. Conclusions: The Gail model is useful for assessing probability of breast cancer in Iranian women. Based on the their breast cancer risk, women may decide to accept further screening services.