Displaying publications 201 - 220 of 635 in total

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  1. Loh SY, Ong L, Ng LL, Chew SL, Lee SY, Boniface G
    Asian Pac J Cancer Prev, 2011;12(6):1489-95.
    PMID: 22126487
    BACKGROUND: Increasing survivorship warrants evidence-based intervention to help women manage living effectively with breast cancer. Breast cancer survivors may have many medical and psychosocial issues in the post- treatment period. Qualitative research was carried out to assess survivors' overall experience and if intervention helps in survivorship care. This paper reports exploration of benefit-findings from participation in an earlier 4-week self management intervention.

    METHODS: We used a grounded theory approach to analyze three focus groups conducted between May and August 2010 in Kuala Lumpur. We used random sampling to recruit the informants (n=21), all of whom had earlier participated in the 4 week self-management program held two years previously.

    FINDINGS: The women reported positive experience and growth with the self management program. Self-efficacy appears as an important underlying theme for successful experiences. The lack of proactive plans to provide bereavement support to surviving women was a key negative experience.

    CONCLUSION: The intervention successfully brought women together to work in close partnership with health professionals on ways to self manage the medical, emotional and role task as they live indefinitely with breast cancer, a new chronic illness. The beneficial effect from the 4 week intervention was expressed by women even at 2 years after the program. Having successfully developed a tightly knitted group, a major oversight was the lack of professional support on bereavement for grieving members when close friends passed away.

  2. Rashwan H, Lubis SH, Ni KA
    Asian Pac J Cancer Prev, 2011;12(7):1837-41.
    PMID: 22126576
    Cervical cancer is the third most common cancer in women in peninsular Malaysia and very prevalent worldwide. HPV vaccination and routine Pap smear testing are the best preventive measures. The objective of this study was to determine the knowledge level of secondary school students from Sarawak, East Malaysia regarding cervical cancer and its prevention. Multistage random sampling with various methods in each step was employed to select the sample of 76 students. Results showed that 61.8% had poor knowledge level of cervical cancer and its prevention. There were 60.5% of students who were aware of cervical cancer with Chinese and form four students showing significantly the highest awareness (p<0.05). The main source of cervical cancer information was from their parents (25.9%). HPV vaccination acceptance among students was 22.3% and an association was found between knowledge of cervical cancer with race and HPV vaccination acceptance (p<0.05). In conclusion, the students had poor knowledge level of cervical cancer, its prevention and HPV vaccination acceptance. More efforts should be made to improve cervical cancer knowledge and awareness of the public especially secondary school students in Sarawak. This in turn will enhance the practice of prevention against cervical cancer among students.
  3. El-Sherbieny E, Rashwan H, Lubis SH, Choi VJ
    Asian Pac J Cancer Prev, 2011;12(7):1739-43.
    PMID: 22126556
    BACKGROUND: Nasopharyngeal carcinoma is the third most common cancer among men in Peninsular Malaysia. However, no information is available about the prognostic factors. The objective of this study was to identify factors with an influence on outcome in patients treated in Hospital Kuala Lumpur.

    METHODS: A total of 159 patients with non-metastatic nasopharyngeal carcinoma treated during 2002-2003 in Hospital Kuala Lumpur were included in this study. All received radiotherapy. Fifty three patients were treated with radiotherapy alone, while 106 patients received combination chemotherapy. Overall survival and local recurrence-free survival were analyzed using the Kaplan-Meier method and univariate analysis was performed using the log-rank test.

    RESULTS: This study found out that 5-year overall survival and 5-year local recurrence-free survival rates were 58.6% and 54.2% respectively. The stage specific 5-year overall survival rates were: Stage I, 100%; Stage II; 93.3%, Stage III, 62.7%; Stage IVA, 42.2%; and Stage IVB, 40.6%. On univariate analysis, gender (p<0.05), T-classification (p<0.001), N-classification (p<0.05), stage (p<0.05) and cranial nerve involvement (p<0.001) were found to be significant prognostic factors for 5-year overall survival, while gender (p<0.05) and N-classification (p<0.05) were significant prognostic factors for 5-year local recurrence-free survival.

    CONCLUSION: The overall survival rate of patients for this study was low. The patient factor that significantly affected 5-year overall survival was gender, while disease factors were stage, T-classification, N-classification and cranial nerve involvement.

  4. Chang G, Chan CW, Hartman M
    Asian Pac J Cancer Prev, 2011;12(6):1635-9.
    PMID: 22126512
    Breast cancer is the most common cancer in Singaporean women and the rate of increase in incidence is one of the highest in the world. In view of the significant contribution of delayed presentation to the disease burden in South East Asia, we reviewed the incidence of late presentation of breast cancer and the contributing factors in Singapore. Disease presentation was analysed using studies based on the Singapore Cancer Registry 2004-2008 and with data from women with breast cancer at the National University Hospital (NUH) in Singapore 1990-2007. Available literature from Singapore on factors contributing to delayed presentation was reviewed and presented here. The overall age-standardized 5-year relative survival for Singaporean women was 70% with only half diagnosed with localized cancer. Of all women diagnosed at NUH close to 20% presented at Stages III and IV. Given the magnitude of the problem of women presenting with more advanced stages of breast cancer, the National University of Singapore has joined a collaborative team with the University of Leeds (UK), the University of Malaya, and University of UAE to set up the UK-SEA-ME Psychosocial-Cultural Cancer Research Network to better understand late presentation.
  5. Khoo CL, Teoh S, Rashid AK, Zakaria UU, Mansor S, Salleh FN, et al.
    Asian Pac J Cancer Prev, 2011;12(6):1429-33.
    PMID: 22126476
    INTRODUCTION: As the second most common cancer in women worldwide, cervical cancer causes major health and economic burdens. Recent introduction of HPV immunization program locally has been encouraging but vaccine uptake remains poor. In addition, no study has been conducted to explore the people' s awareness and knowledge on cervical cancer, HPV and its vaccine in a rural setting in Malaysia after the inception of the HPV vaccination program.
    OBJECTIVE: This study was conducted to determine the awareness of cervical cancer, HPV vaccination and its affordability among people in a rural area in Malaysia.

    METHOD: A cross-sectional study was conducted among 116 participants in a village in Penang. All consenting female villagers aged 13 years and above, and males who were married were interviewed using a questionnaire.
    RESULTS: Most participants (88.8%) had heard of cervical cancer, however only 29.3% and 42.2% of them had heard of HPV and HPV vaccination respectively. Only 5.2% knew the actual market price for the vaccine. They were willing to pay an average of RM 96.7 (USD $27.7) for the full course of vaccination if it is not given to them for free, whereas the market price is RM1200 (USD $342.85).
    CONCLUSION: Awareness among the Malaysian population in a rural setting on HPV and HPV vaccination is low. Educating the public on the infection can help control the illness. Cost of the HPV vaccine is a serious barrier to the success of the vaccination program in Malaysia.
  6. Abdul Rasool Hassan B, Yusoff ZB, Bin Othman S
    Asian Pac J Cancer Prev, 2011;12(6):1425-8.
    PMID: 22126475
    INTRODUCTION: Neutropenia, defined as a decrease in the absolute neutrophil count lower than the normal that is < 1500 cell/ ?l, has a detrimental effect on cancer patients' quality of life, also possibly resulting in a reduction in the chemotherapy dose which could lead to an increment in the size of a cancer. There are so many causative factors for neutropenia like hematological disorders, autoimmune diseases and infection, drugs reactions and chemotherapy or radiotherapy. So the main aim of this study is to find the association between chemotherapy drug or regimens, schedule of administration used for treatment of solid cancer diseases with neutropenia onset and severity.

    METHODS: This is an observational retrospective study carried out in a general hospital on 117 solid tumor patients who admitted between January 2003 to December 2006. The main statistical tests used were Chi- square test and Fisher' s Exact test. The significance of the result will be when the P<0.05, while the confidence interval for this study was 95%.

    RESULTS: The highest chemotherapeutic regimen was (5-FU+epirubicin+cyclophosphamide) (47, 40.2%) followed by (gemcitabine+cisplatin) (6, 5.1%) and many others. Majority of the patients receive their chemotherapy schedule of administration was one day schedule (90, 76.9%) followed by more than one day schedule (27, 23.1%).

    CONCLUSION: The doses of these drugs were not high enough to produce a sufficient pharmacological effect to cause bone marrow suppression and lead to neutropenia. Besides the schedule of administration for each drug was long enough to overcome neutropenia also the high uses of granulocyte colony stimulation factor (G-CSF) which will play a major role in reducing the time and severity of neutropenia. All these factors play an important role in giving non- significant association between neutropenia onset and severity with chemotherapeutics drugs and their schedule of administration.

  7. Taib NA, Yip CH, Low WY
    Asian Pac J Cancer Prev, 2011;12(6):1601-8.
    PMID: 22126506
    INTRODUCTION: Advanced presentation of breast cancer and the problem of late diagnosis is well documented. Patient delay beyond three months has been shown to reduce survival. This paper aims to explore the experience of Malaysian women presenting with advanced breast cancer with regards to their interpretation of breast symptoms.

    METHOD: Purposive sampling of 19 breast cancer patients presenting with delayed treatment and/ or advanced cancer diagnosed within two years at the University Malaya Medical Centre, Kuala Lumpur were carried out. In-depth interviews were conducted using a self-devised interview guide. The interview guide covered the journey of the patient from discovering of symptoms to their present state. The audiotaped interviews were transcribed verbatim. NVivo 8 qualitative software was utilised for data management. Grounded theory with thematic analysis was utilised.

    RESULTS: Nine women delayed seeking diagnosis although recognizing the symptom, five did not recognize symptom, three delayed treatment and two did not delay health attention. Themes that emerged with regards to triggering help seeking behavior were: a) poor symptom knowledge and recognition; b) importance of knowledge of the disease and its' outcomes; c) role of coping mechanisms and affect; and lastly d) role of significant others in appraising a breast symptom.

    CONCLUSION: Symptom recognition remains an important public health issue in Malaysia. Educating women, their significant others and primary health and primary care providers in detecting early staged breast cancer are needed. Supporting and sanctioning women with breast symptoms are important. The psycho-social-cultural model of symptom appraisal may serve as an important addition to the fight against cancer in countries that do not have the resources for population based screening mammogram programmes.
  8. Hassan BA, Yusoff ZB
    Asian Pac J Cancer Prev, 2011;12(6):1573-6.
    PMID: 22126501
    INTRODUCTION: Anemia is one of the most frequent hematological demonstration of malignant diseases, leading to impairment of function in all tissues and organs of cancer patients and associated with serious stress. This major problem may be exacerbated by radiotherapy or chemotherapy. It is characterized by lower hemoglobin (Hb) level or inadequate circulating red blood cells (RBCs). The present study evaluated the effectiveness of treatment guidelines for anemia among solid cancer patients in Penang hospital and to find associations between treatments and anemia onset and severity.

    METHODS: This is a retrospective observational study was conducted on 534 cancer patients with anemia who were admitted to a government hospital on Penang island i.e., Penang General Hospital in the period between 2003 to 2009.

    RESULTS: Effectiveness of standard anemia treatment guidelines was not sufficient because correction of anemia was just temporary.

    CONCLUSION: According to the results, erythropoietin must be used as a cornerstone even for patients who suffer from moderate anemia and blood transfusion should be used just for emergency cases when anemia leads to a critical situation.
  9. Loh SY, Chew SL, Lee SY
    Asian Pac J Cancer Prev, 2011;12(6):1483-8.
    PMID: 22126486
    BACKGROUND: Many cancer survivors are still not active enough to reap the benefits of physical activity. This study aimed to explore the correlation between perceived barriers and participation in exercise among multi- ethnic Malaysian women with breast cancer.

    METHODS: A cross-sectional study using a pre-post questionnaire and a media-clip as a cancer control strategy was conducted on a random sample of women with breast cancer. The tools were structured questionnaires to collect socio-medical demographic and physical activity data (e.g. barriers, exercise self-efficacy).

    RESULTS: A statistically significant relationship between level of physical activity before and after diagnosis of breast cancer (n=51, χ2=70.14, p<0.01) was found, whereby participants who rated more hours of physical activity before diagnosis were likely to persevere with exercise after diagnosis, r(49)=0.73, p<01. Some 76.5% of women engaged in low level activity and 23.5% of the participants engaged in moderate level of physical activity.

    CONCLUSIONS: Despite the many benefits of physical activity, the majority of survivors in this study were not found to be physically active, and did not even consciously think of exercise participation. Lack of time is the main barrier amongst those survivors who are predominantly 40-50 year old housewives juggling with household chores, childcare and/or job commitments. Public health messages stressing that short bouts of exercise or some exercise are better than no exercise needs to be emphasised consistently.
  10. Yasin SM, Taib KM, Zaki RA
    Asian Pac J Cancer Prev, 2011;12(6):1439-43.
    PMID: 22126478
    The transtheoretical model (TTM) has been used as one of the major constructs in developing effective cognitive behavioural interventions for smoking cessation and relapse prevention, in Western societies. This study aimed to examine the reliability and construct validity of the translated Bahasa Malaysia version of TTM questionnaire among adult smokers in Klang Valley, Malaysia. The sample consisted of 40 smokers from four different worksites in Klang Valley. A 26-item TTM questionnaire was administered, and a similar set one week later. The questionnaire consisted of three measures; decisional balance, temptations and impact of smoking. Construct validity was measured by factor analysis and the reliability by Cronbach' s alpha (internal consistency) and test-retest correlation. Results revealed that Cronbach' s alpha coefficients for the items were: decisional balance (0.84; 0.74) and temptations (0.89; 0.54; 0.85). The values for test retest correlation were all above 0.4. In addition, factor analysis suggested two meaningful common factors for decisional balance and three for temptations. This is consistent with the original construct of the TTM questionnaire. Overall results demonstrated that construct validity and reliability were acceptable for all items. In conclusion, the Bahasa Malaysia version of TTM questionnaire is a reliable and valid tool in ass.
  11. Dahlui M, Ramli S, Bulgiba AM
    Asian Pac J Cancer Prev, 2011;12(6):1631-4.
    PMID: 22126511
    Breast cancer is the most common cancer in Malaysian females. The National Cancer Registry in 2003 and 2006 reported that the age standardized incidence of breast cancer was 46.2 and 39.3 per 100,000 populations, respectively. With the cumulative risk at 5.0; a woman in Malaysia had a 1 in 20 chance of developing breast cancer in her lifetime. The incidence of cancer in general, and for breast cancer specifically was highest in the Chinese, followed by Indians and Malays. Most of the patients with breast cancers presented at late stages (stage I: 15.45%, stage II: 46.9%, stage III: 22.2% and stage IV: 15.5%). The Healthy Lifestyles Campaign which started in the early nineties had created awareness on breast cancer and after a decade the effort was enhanced with the Breast Health Awareness program to promote breast self examination (BSE) to all women, to perform annual clinical breast examination (CBE) on women above 40 and mammogram on women above 50. The National Health Morbidity Survey in 2006 showed that the prevalence rate of 70.35% by any of three methods of breast screening; 57.1% by BSE, 51.8% by CBE and 7.6% by mammogram. The current screening policy for breast cancer focuses on CBE whereby all women at the age of 20 years and above must undergo breast examination by trained health care providers every 3 years for age between 20-39 years, and annually for age 40 and above. Several breast cancer preventive programs had been developed by various ministries in Malaysia; among which are the RM50 subsidy for mammogram by the Ministry of Women, Family and Community Development and the SIPPS program (a call-recall system for women to do PAP smear and CBE) by the Ministry of Health. Measures to increase uptake of breast cancer screening and factors as to why women with breast cancer present late should be studied to assist in more development of policy on the prevention of breast cancer in Malaysia.
  12. Lim JN
    Asian Pac J Cancer Prev, 2011;12(6):1627-9.
    PMID: 22126510
    Psychosocial and cultural factors influencing cancer health behaviour have not been systematically investigated outside the western culture, and qualitative research is the best approach for this type of social research. The research methods employed to study health problems in Asia predominantly are quantitative techniques. The set up of the first psychosocial cancer research network in Asia marks the beginning of a collaboration to promote and spearhead applied qualitative healthcare research in cancer in the UK, Southeast Asia and the Middle East. This paper sets out the rationale, objectives and mission for the UK-SEA-ME Psychosocial-Cultural Cancer Research Network. The UK-SEA-ME network is made up of collaborators from the University of Leeds (UK), the University of Malaya (Malaysia), the National University of Singapore (Singapore) and the University of United Arab Emirates (UAE). The network promotes applied qualitative research to investigate the psychosocial and cultural factors influencing delayed and late presentation and diagnosis for cancer (breast cancer) in partner countries, as well as advocating the use of the mixed-methods research approach. The network also offers knowledge transfer for capacity building within network universities. The mission of the network is to improve public awareness about the importance of early management and prevention of cancer through research in Asia.
  13. Muhamad M, Afshari M, Kazilan F
    Asian Pac J Cancer Prev, 2011;12(6):1389-97.
    PMID: 22126470
    This paper raises issues about the role of family members in providing support for breast cancer survivors. Data were collected from 400 breast cancer survivors in Peninsular Malaysia through a custom-designed questionnaire fielded at hospitals and support group meetings. The data were analyzed using descriptive statistics. The analyses show that all family members could be supportive, especially in decision making and help with emotional issues. The spouse was the main support provider among the family members (others were children, parents, siblings and more distant relatives). The results also indicated that a significant percentage practiced collaborative decision-making. Breast cancer survivors needed their family members' support for information on survivorship strategies such as managing emotions, health, life style and dietary practice. The family members' supportive role may be linked to the Malaysian strong family relationship culture. For family members to contribute more adequately to cancer survivorship, it is suggested that appropriate educational intervention also be provided to them.
  14. Al-Naggar RA, Al-Naggar DH, Bobryshev YV, Chen R, Assabri A
    Asian Pac J Cancer Prev, 2011;12(5):1173-8.
    PMID: 21875261
    INTRODUCTION: The etiology of breast cancer is still unknown and adequate primary prevention strategies or interventions are still not possible. Therefore, early detection remains the first priority and regular practice of breast self-examination (BSE) influences treatment, quality of life, survival, and prognosis of breast cancer patients.
    OBJECTIVES: The objective of this study was to determine the practices and barriers towards breast self-examination among young Malaysian women.
    METHODOLOGY: Cross-sectional study was conducted among 251 female students at the Management and Science University, Shah Alam, Selangor, Malaysia. Questionnaires were distributed at gathering places such as the university cafeteria, the university plaza, the Islamic center, and at the library. In addition, questionnaires were distributed in the lecture halls. The proposal of this study was approved by the Ethics and Research Committee of Management and Science University. Data was analysis using SPSS version 13, t-test was used to analyze the associated factors toward the practice of BSE.
    RESULTS: A total number of 251 students participated in this study. The majority of them were older than 20 years old,of Malay racial origin, single and from urban areas (66.5%; 63.7%; 96%; 70.9% respectively). Regarding their lifestyle practices, the majority of participants do exercise, are non-smokers and do not drink alcohol (71.3%; 98.4%; 94.4% respectively). More than half of the study participants mentioned that they have practiced BSE (55.4%). Regarding the sources of information about BSE, the majority mentioned that radio and TV were their main sources of information (38.2%). Age, exercise and family history of cancer significantly influenced the practice of BSE (p = 0.045; p=0.002; p=0.017 respectively). Regarding the barriers to BSE, the majority who never practiced BSE mentioned that lack of knowledge, not having any symptoms, and being afraid of being diagnosed with breast cancer were the main barriers to practicing BSE (20.3%; 14.3%; 4.4% respectively).
    CONCLUSION: More than half of the participants practiced BSE. Age, exercise and family history of cancer significantly influenced the practice of the BSE. Lack of knowledge, not having any symptoms and being afraid of being diagnosed with breast cancer were the main barriers to practicing BSE. There is an urgent need to develop a continuous awareness campaign among university students on the importance of performing BSE.
  15. Karen-Ng LP, Marhazlinda J, Rahman ZA, Yang YH, Jalil N, Cheong SC, et al.
    Asian Pac J Cancer Prev, 2011;12(5):1161-6.
    PMID: 21875259
    Dietary isothiocyanates (ITCs) found in cruciferous vegetables (Brassica spp.) has been reported to reduce cancer risk by inducing phase II conjugating enzymes, in particular glutathione S-transferases (GSTs). This case-control study was aimed at determining associations between dietary ITCs, GSTs polymorphisms and risk habits (cigarette smoking, alcohol drinking and betel-quid chewing) with oral cancer in 115 cases and 116 controls. Information on dietary ITC intake from cruciferous vegetables was collected via a semi-quantitative food frequency questionnaire (FFQ). Peripheral blood lymphocytes were obtained for genotyping of GSTM1, GSTT1 and GSTP1 using PCR multiplex and PCR-RFLP. Chi-square and logistic regression were performed to determine the association of ITC and GSTs polymorphism and risk of oral cancer. When dietary ITC was categorized into high (greater than/equal to median) and low (less than median) intake, there was no significant difference between cases and control group. Logistic regression yielding odd ratios resulted in no significant association between dietary ITC intake, GSTM1, GSTT1 or GSTP1 genotypes with oral cancer risk overall. However, GSTP1 wild-type genotype was associated with later disease onset in women above 55 years of age (p= 0.017). Among the men above 45 years of age, there was clinical significant difference of 17 years in the age of onset of oral cancer between GSTP1 wild-type + low ITC intake and GSTP1 polymorphism + high ITC intake (p= 0.001). Similar conditions were also seen among men above 45 years of age with risk habits like drinking and chewing as the earlier disease onset associated with GSTP1 polymorphism and high ITC intake (p< 0.001). This study suggests that combination effects between dietary ITCs, GSTP1 polymorphism and risk habits may be associated with the risk of oral cancer and modulate the age of disease onset.
  16. Abdullah F, Aziz NA, Su TT
    Asian Pac J Cancer Prev, 2011;12(5):1347-52.
    PMID: 21875295
    INTRODUCTION: The Pap smear test has been regarded as a promising cervical screening tool since 1940s. Yet its importance has been overlooked by beneficiaries in Malaysia. This underlines the need to identify the prevalence of Pap smear practice and influencing factors towards the practice among educated working women.

    METHODS: A survey was conducted with 403 female teachers from 40 public secondary schools in Malaysia selected by cluster random sampling. Data were collected from January to March 2010 using a self-administered questionnaire. Multivariate logistic regression was performed to identify the factors related to the Pap smear practice.

    RESULTS: The rate for participants who ever had Pap test was only 38% and poor practice of was significantly higher among: those with aged less than 35 years; those practicing hormonal contraceptive method; and individuals perceiving barriers to the Pap smear screening test. In contrast, the findings were significantly lower in women with longer duration of teaching service; higher income groups; ever pregnant; having chronic diseases; health insurance coverage; and who had perceived benefit of Pap smear screening.

    CONCLUSION: Barriers towards practicing Pap smear exist even among educated career women. Tailor-made health promotion and education on cervical cancer and the benefit of Pap smear screening are essential to change the behavior of the study population.
  17. Nargesi MM, Ismail P, Razack AH, Pasalar P, Nazemi A, Oshkoor SA, et al.
    Asian Pac J Cancer Prev, 2011;12(5):1265-8.
    PMID: 21875279
    PURPOSE: Prostate cancer differs markedly in incidence across ethnic groups. Since this disease is influenced by complex genetics, it is many genetic factors may affect the level of susceptibility to development of the disease. In this study, four Y-linked short tandem repeats (STRs), DYS388, DYS435, DYS437, and DYS439, were genotyped to compare Malaysian prostate cancer patients and normal control males.

    MATERIALS AND METHODS: A total of 175 subjects comprising 84 patients and 91 healthy individuals were recruited. Multiplex PCR was optimized to co-amplify DYS388, DYS435, DYS437, and DYS439 loci. All samples were genotyped for alleles of four DYS loci using a Genetic Analysis System.

    RESULTS: Of all DYS loci, allele 10 (A) of DYS388 had a significantly lower incidence of disease in compare with other alleles of this locus, while a higher incidence of disease was found among males who had either allele 12 (C) of DYS388 or allele 14 (E) of DYS439. Moreover, a total of 47 different haplotypes comprising different alleles of four DYS loci were found among the whole study samples, of which haplotypes AABC and CAAA showed a lower and higher frequency among cases than controls, respectively.

    CONCLUSIONS: It is likely that Malaysian males who belong to Y-lineages with either allele 12 of DYS388, allele 14 of DYS439, or haplotype CAAA are more susceptible to develop prostate cancer, while those belonging to lineages with allele 10 of DYS388 or haplotype AABC are more resistant to the disease.

  18. Mohd Hashim S, Tong SF, Omar K, Abdul Rashid MR, Shah SA, Sagap I
    Asian Pac J Cancer Prev, 2011;12(8):2007-11.
    PMID: 22292642
    BACKGROUND: Knowledge is believed to be a driving factor for patients' early presentation for healthcare. This study was conducted to assess knowledge of colorectal cancer among subjects presenting with rectal bleeding and to determine its association with late presentation.

    METHODS: A cross-sectional study of 80 patients with rectal bleeding, aged 40 and above, was conducted between December 2008 and June 2009 in the endoscopy unit, University Kebangsaan Malaysia Medical Centre. The research instruments used in this study was a self-administered questionnaire including data on duration of rectal bleeding, first medical consultation and knowledge of colorectal cancer.

    RESULTS: Sixty percent of subjects with rectal bleeding delayed seeking medical advice. Subjects were more aware of symptoms of non-colorectal cancers compared to symptoms of colorectal cancer. The majority of subjects (63.8%) correctly identified rectal bleeding as a symptom but were not aware of the best screening method to detect colorectal cancer. Half of the subjects knew increasing age and genetic background to be risk factors for colorectal carcinoma. However, knowledge of colorectal cancer was not found to be significantly associated with delay in seeking help.

    CONCLUSION: Findings indicate poor awareness of colorectal cancer among the subjects. Although public education of colorectal cancer is important for early presentation on rectal bleeding, further studies are advocated to evaluate other factors influencing patients' help seeking behavior other than knowledge.
  19. Voon NS, Chelliah KK
    Asian Pac J Cancer Prev, 2011;12(8):1969-72.
    PMID: 22292635
    The purpose of this study was to evaluate the influence of dietary habit on breast density, which is an important risk factor for breast cancer. This cross-sectional study was performed on 64 Malaysian women of all races between the age of 35 to 70 years. All subjects underwent mammography and the breast density was analyzed from the images using BI-RADS by two independent radiologists. A validated food-frequency questionnaire was used to evaluate the nutrient intake. The data were analyzed using Chi-square test to evaluate the association of dietary habits to breast density. Based on the results, mutton, pork, vegetables, sweets, snacks, soy bean and eggs intake showed associations with increased breast density (p < 0.05) while grains, meat, beverages, oil and fruits, did not show any association (p > 0.05). As a conclusion, this study showed diet may make changes to the breast density as a risk factor for breast cancer.
  20. Hassan BA, Yusoff ZB
    Asian Pac J Cancer Prev, 2011;12(1):185-91.
    PMID: 21517255
    INTRODUCTION: Nausea and vomiting are recognized as two separate and distinct conditions with a wide spectrum of etiologies either directly associated with cancer itself or its treatment. According to the new ranking of chemotherapy side effects, nausea is the number one or the most disturbing side effects while vomiting is the third and sometimes the fifth. The introduction of 5-HT3-recptor antagonists in the early of 1990s has revolutionized the treatment of nausea and vomiting, these agents remaining the mainstay of antiemetic therapy today. Ethnic variation (due to genetic polymorphisms) may lead to diversity in antiemetic treatment pharmacokinetic and pharmacodynamic properties, in terms of distribution, elimination, disposition and clinical effects. The aim of the present study was to clarify genetic polymorphism effects in the three main races in Malaysia i.e., Malay, Chinese and Indian, on the clinical antiemetic effects of granisetron.

    METHODS: In this longitudinal prospective observational study, 158 breast cancer patients treated with chemotherapy were monitored for nausea and vomiting in the first 24 hours after chemotherapy administration. The patients were then followed up again after 3 to 5 days of chemotherapy.

    RESULTS: Genetic polymorphisms in the three races in Malaysia have significant effect on granisetron clinical antiemetic action because each is characterized by variant CYP3A4 enzymatic action.

    CONCLUSION: According to the result, different type of 5-HT3 receptor antagonists, such as tropisetron and dolasetron which are predominantly metabolized by CYP2D6, should be used especially for Chinese breast cancer patients.

    Study site: Hospital Pulau Pinang
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