Introduction: Colon cancer incidence and mortality rates in Canada are among the highest worldwide. If detected early colon cancer is highly curable and regular screening can significantly decrease risk of colon cancer mortality. Despite this, screening rates in Canada are consistently low and immigrant and senior populations are particularly vulnerable due to low health literacy and language barriers. This research consists of three studies that were designed to explore the cancer prevention experiences of older English-as-a-Second Language (ESL) Chinese immigrant women in Canada. This includes an investigation of colon and breast cancer screening utilization, health literacy skills and comprehension of colon cancer prevention information, and experiences and preferences when seeking cancer information by these immigrant women. Methods: A convenience sample of 110 Mandarin and Cantonese-speaking ESL immigrant women were recruited from two Southern Ontario communities. For study inclusion participants were required to: (1) be 50 years of age or older, (2) have immigrated to Canada, (3) have Cantonese or Mandarin as their first language and English as their second language, and (4) be able to read in English. Participants were excluded if they or their spouse had been previously diagnosed with any type of cancer. Participants completed a battery of questionnaires assessing demographic characteristics, use of breast and colon cancer screening, acculturation, self-efficacy, health beliefs and health literacy. Health literacy was assessed using the Short Test of Functional Health Literacy in Adults (S-TOFHLA) and comprehension of a colon cancer prevention information sheet from Cancer Care Ontario was assessed using the cloze procedure. Participants participated in a semi-structured interview to explore cancer information seeking preferences and experiences, and their understanding of cancer prevention information. Multivariate logistic regression was used to identify predictors of colon and breast cancer screening. To identify variables significantly associated with performance on the S-TOFHLA and cloze test regression analyses were performed. Directed content analysis was used to identify themes associated with barriers to cancer information seeking and understanding that emerged from the interviews. Results: Study #1: There was high self-reported screening for breast and colon cancer. Eighty-five percent of the women were current mammography screeners and 75% were current colon cancer screeners. Recommendation from a physician (OR=.140; 95% CI= .044, -.448), having a female physician (OR=.141; 95% CI= .033, .591), and high or moderate proficiency in English (OR=.283; 95% CI= .089, .902) significantly predicted mammography screening. Physician recommendation (OR=.103; 95% CI= .031, .349), first language (OR= 1.85; 95% CI= .055, .628) and higher self-efficacy (OR= 3.613; 95% CI= 1.179, 11.070) predicted use of colon cancer screening. Other important predictors included greater health literacy and longer residency in Canada. Study #2: Only 38.7% of the women had adequate health literacy on S-TOFHLA and 54.3% had adequate comprehension of the colon cancer information. Comprehension of the colon cancer information was significantly lower among women who received the information in English, compared to those who received the information in Chinese (p<0.01). Age, acculturation, self-reported proficiency reading English, and education were significant predictors of health literacy but varied depending on the measure (S-TOFHLA, cloze) and language of information (English, Chinese). Study #3: There were unique health information seeking preferences among the older Chinese immigrant women including a strong preference for interpersonal and interactive cancer information from their physician and trusted others, such as friends and family. Barriers to cancer information seeking included language difficulties and limited time with physicians. Differences in health literacy did not distinguish the women on any of the major themes. Conclusion: Language, culture, health literacy and the role of the physician emerged across all three studies examining the cancer prevention experiences of older Chinese immigrant women. While language concordant educational materials may improve understanding of cancer information, the results from this study suggest that it is important to consider factors other than language alone and to address important cultural issues that play a role in the access, use, and understanding of cancer information.

Background: Exemestane is a drug of great interest for breast cancer prevention, because it inhibits estrogen production. Estrogen may operate by increasing breast density, a well-established biomarker for increased breast cancer risk. The NCIC CTG MAP.2 trial examined the efficacy of exemestane in decreasing breast density. Menopausal health-related quality of life (HRQL) and adverse events were also carefully monitored during the study. Purpose: To elucidate the impact of exemestane on menopausal HRQL and to examine the relationship between clinician and participant methods of reporting side effects. Methods: 98 postmenopausal women with increased breast density were randomized to exemestane or placebo daily for one year. HRQL was measured with the MENQOL questionnaire, which has four domains. Mean changes in MENQOL domain scores from baseline were compared between treatment groups using the Wilcoxon rank-sum test. The difference between groups in the proportion of women with a clinically meaningful decline was compared by domain with the Chi-square test; change scores were considered worsened if increased by ≥ 0.5 points. The association between time-to-decline in menopausal HRQL and treatment was evaluated using Cox PH regression. The kappa statistic quantified the level of agreement between participant-reported and clinician-reported symptoms. Kaplan-Meier estimates of time-to-decline as communicated by clinicians and participants were compared, using three thresholds to define meaningful change. Results: No significant differences in mean change scores were detected, however, a significantly greater proportion of women on exemestane experienced a clinically meaningful decline in physical menopausal HRQL at three months (absolute difference=19%, p= 0.03), while the absolute difference approached significance for vasomotor menopausal HRQL at six months (21%, p= 0.05), and at nine months (21%, p=0.06). The rate of decline in physical menopausal HRQL was 2.08 times greater (95% CI 1.10-3.94) in the exemestane group compared to the placebo group. Agreement between raters was low for all symptoms except hot flashes; in general participants detected symptoms more rapidly than clinicians, regardless of the defined cut-off for meaningful change on the MENQOL. Conclusions: A subset of women on exemestane experienced significant declines in physical and vasomotor symptoms. Generally, participants reported symptoms more frequently and faster than clinicians. / Thesis (Master, Community Health & Epidemiology) -- Queen's University, 2012-06-06 23:55:24.011

The current study examined the impact of plant sterols, stanols, sterol esters, and stanol esters on (i) cholesterol-lowering efficiency, (ii) gene expression of ABCG5 and ABCG8 sterol transporters in the liver and small intestine, and (iii) colon mucosal cell proliferation in hamsters. After 5 weeks on experimental diets, plasma total cholesterol levels were reduced ( P<0.05) by stanols, sterol esters and stanol esters compared to cholesterol-control diet. Different PS analogs did not alter ABCG5 and ABCG8 mRNA levels in small intestine and liver as compared to cholesterol control. In addition, colon mucosal cell proliferation was 21.4% lower (P<0.01) in group fed 0.7% stanol esters relative to cholesterol control. Results suggest that hypocholesterolemic effects of PS analogs are not associated with changes of liver and small intestine ABCG5 and ABCG8 sterol transporters. Data also indicated that plant stanol ester may possess anticarcinogenic properties.

This research is a follow up of a "Breast Week" which was organized in Freetown, Sierra Leone. The specific objective of this study was to assess the effectiveness of the knowledge and teachings given to the women who participated in this project. The unrecorded cases of breast lumps and breast cancer observed in women in Sierra Leone prompted the researcher to undertake this present study. A quantitative approach was adopted and a structured interview schedule and an observational checklist guided the data collection process. A sample size of 120 women (10%) who participated in the "breast week" was obtained through systematic sampling. The first part of the study involved assessment of the theoretical background of the research topic followed by the second phase during which the women demonstrated Breast Self-Examination to detect abnormalities of the breasts. Discussions and analysis of the findings are presented in three sections. Texts from open ended questions were categorized and explained in numerical terms as the study was quantitative in nature. The data was processed through use of SPSS and Microsoft Excel. Frequency counts were applied to the data, use of non-parametric tests on the number of women who practiced Breast Self-Examination before and after the breast week showed a statistically significant difference in the number of women now practicing BSE as a screening method for breast cancer after receiving the health education. It was found that the majority of the women linked breast cancer to the signs and symptoms associated with it and were able to describe the disease as one that kills women if not promptly detected and/or treated appropriately. Findings indicate that the majority of the women (78.3%) had previously had mmor breast problems. An assessment of the effectiveness of knowledge on breast cancer showed that these women could identify breast cancer as a disease that affects women and may cause deaths if not detected on time or treated promptly. These women were able to demonstrate to the researcher how they examine their breasts to exclude abnormalities. Three women had breast lumps detected through examination of the breasts during the breast week. Two of them had had the lumps removed and are currently on medication. One of the women who had a breast lump detected was financially constrained and could not afford the cost of surgery. The number of women who can now perform BSE increased (95.0%) after having the knowledge on breast cancer and BSE. The majority of the women (97.4%) received information on how to examine their breasts for breast cancer through the information provided during the breast week. It is thus concluded that the objectives of the breast week were met. / Thesis (M.N.)-University of Natal, Durban, 2004.

Background: Cancer and diabetes are the second and twelfth leading global causes of death, respectively. Cancer incidence is increased in diabetics compared to non-diabetics. Common pathobiological pathways are shared by the two diseases: hyperglycaemia, hyperinsulinaemia, chronic inflammation and altered concentrations of endogenous hormones. These pathways can all directly or indirectly be linked to chronic hyperglycaemia. Lifestyle factors also affect cancer, diabetes and hyperglycaemia. Hypothesis: Chronic hyperglycaemia is the common biological pathway linking cancer, diabetes and lifestyle factors. Chronic hyperglycaemia can be assessed by monitoring glycated haemoglobin (HbA1c) levels. Aim: The first aim is to investigate whether the link between diabetes and increased cancer risk can be explained by increasing HbA1c levels. Secondly, glycaemic and overall models of lifestyle factors should be developed and compared to determine the relative influence of lifestyle factors on blood glucose level and, subsequently, cancer risk. This could clarify whether improved glycaemic control via lifestyle factors is sufficient to significantly reduce cancer risk. Method: Dose-response meta-analyses on cancer risk and HbA1c levels were performed and the results communicated via a research article. Statistical glycaemic and overall models were developed from published studies on colorectal cancer (CRC), lifestyle factors and HbA1c, via meta-analysis. Log-linear and restricted cubic spline models were considered for studies relating CRC risk to lifestyle factors or HbA1c. Linear models were considered for studies relating HbA1c to lifestyle factors. Only statistically significant models were compared. Results: Increased cancer risk with increasing HbA1c levels was present for a number of cancers, with some cancer types also showing increased risk in the pre-diabetic and normal HbA1c ranges. Comparison of the glycaemic and overall models revealed that HbA1c significantly affected cancer risk and was significantly affected by lifestyle factors. However, the overall effects of lifestyle factors were much stronger than their glycaemic effects (between 9% and 25% difference in risk between overall effects and glycaemic effects at the exposure levels analysed). Glycaemic and overall models for cigarette smoking and chronic stress revealed increased cancer risk with increasing exposure, but decreased cancer risk for increased dietary fibre intake. The glycaemic model for alcohol consumption displayed decreased cancer risk, while the overall model revealed increased cancer risk, emphasising the strong effect of carcinogenic substances in alcohol. Conclusions: Risk for a number of cancers increased with HbA1c levels in diabetic and non-diabetic persons. Cancer prevention by improved blood glucose control seems plausible. The overall effects of lifestyle factors on cancer risk are much stronger than their glycaemic effects. Lifestyle factors alone do not provide enough reduction in blood glucose levels. Other therapeutic strategies for reducing blood glucose levels, such as pharmacotherapeutics or fasting, should be investigated. The possible harmful effects of reducing blood glucose levels, such as neuroglycopaenia, should be considered before implementation of therapeutic strategies. Although there seems to be a strong association between HbA1c and cancer risk, this does not imply causality. The possibility of residual confounding cannot be ignored, even though the most adjusted estimates were used to develop the models, where possible. / MIng (Electrical and Electronic Engineering), North-West University, Potchefstroom Campus, 2014

Steady increases in breast cancer burden have recently been observed in Ghana. Despite the low incidence of the disease compared with other African countries, breast cancer deaths are high in this West African country. However, the uptake of breast cancer screening programs remains extremely low among Ghanaian women. Using a mixed methods approach comprising quantitative surveys and focus groups interviews, this study examined the influences of individual and contextual level factors on Ghanaian women’s intention to perform breast self-examination or undergo clinical breast examination and mammography screening. The results suggest that health beliefs, knowledge, and sociodemographic, cultural and health system factors individually and collectively influence intentions towards breast cancer screening. These findings highlight the need for health education interventions to promote breast cancer screening programs, while addressing systemic, psychosocial, and cultural barriers to screening. / viii, 187 leaves ; 29 cm

Thesis (MFamMed)--Stellenbosch University, 2014. / OBJECTIVE: The purpose of the study was to assess the safety, acceptability and feasibility of Visual Inspection with Acetic Acid and Cervicography (VIAC) followed by Cryotherapy or Loop Electrical Excision Procedure (LEEP) at a single visit for prevention of cancer of the cervix in Bulawayo, Zimbabwe. STUDY DESIGN: The study was descriptive using retrospective data extracted from electronic medical records of women attending the VIAC clinic at United Bulawayo Hospital in the period 1st February2010 to 31st December2012.Over 24 months 4641 women visited the clinic and were screened for cervical cancer using VIAC. If positive and eligible, cryotherapy or LEEP was offered immediately. Treated women were followed up at 3months and 1 year. RESULTS: The VIAC test positive rate was 10.8%.Of those eligible,17.0% received immediate cryotherapy, 44.1%received immediate LEEP, 1.9% delayed treatment and 37.0% were referred to a gynaecologist. No major complications were recorded after cryotherapy or LEEP. Among those treated99.5% expressed satisfaction with their experience. Only 3.2% of those treated at the clinic were VIAC positive one year later. The service was shown to be feasible to sustain over time with the necessary consumables. There were no service-related treatment postponements and the clinic staff and facility were able to meet the demand for the service. CONCLUSION: A single visit approach using VIAC, followed by cryotherapy or LEEP proved to be safe, acceptable and feasible in an urban African setting in Bulawayo, Zimbabwe. / AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar.

Situou,se a ocorrência do câncer cérvico-uterino no contexto da presença, já expressiva, das neoplasias malignas no perfil de morbimortalidade da população brasileira. Discutiu-se o padrão peculiar de coexistência, no país, de riscos igualmente altos e crescentes para formas de câncer típicas de sociedades em diferentes estágios de desenvolvimento socioeconômico. Em relação ao câncer cervical, verificou-se sua ocorrência mais elevada, e em idades mais precoces,nas regiões menos desenvolvidas do país; a magnitude e distribuição etária em todas as áreas, entretanto, foram compatíveis com as observadas em regiões do mundo com alta frequência da doença. As altas taxas de detecção das lesões precursoras entre os exames citológicos indicam, além de riscos elevados, um atendimento voltado principalmente para a clientela sintomática. Conjecturou- se sobre a ascensão previsível da ocorrência, em função da persistência de precárias condições de vida, da maior exposição a fatores de risco e da incipiência das atividades de controle. Foram discutidas as baixas cobertura e efetividade das ações de controle, e os problemas determinantes dessa situação em cada nível da atividade. Criticou-se a inadequação das normas vigentes em relação a população-alvo e a periodicidade do exame colpo citológico, assim como a insuficiência dos parâmetros de avaliação existentes. Sugeriram-se alguns indicadores e delinearam-se os aspectos fundamentais de um sistema integrado de informações operacionais e epidemiológicas. / Was situated the occurrence of cervical cancer in the context of the presence, as expressive of malignant neoplasms in the morbidity profile of the population. Discussed the peculiar pattern of coexistence in the country, also high and rising for typical forms of cancer societies at different stages of socioeconomic development risks . In relation to cervical cancer , there was a higher occurrence , and at younger ages , in the less developed regions of the country, the magnitude and age distribution in all areas , however, were consistent with those observed in regions of the world with high frequency of the disease. The high rates of detection of precursor lesions between the cytological examinations indicate, in addition to high risks, service catering mainly for symptomatic clientele. Is conjectured about the predictable rise of occurrence, depending on the persistence of poor living conditions, greater exposure to risk factors and the paucity of control activities. Low coverage and effectiveness of control measures, and the determinants of this situation problems at every level of activity were discussed. Criticized the inadequacy of rules in relation to the target population and the frequency of colpo cytological examination, as well as the failure of the parameters of assessment. Have been suggested and outlined some indicators are the key aspects of an integrated operational and epidemiological information.

Magister Scientiae - MSc (Biotechnology) / Breast cancer is regarded as the most common form of cancer in women and it comprises of approximately 23 % of female cancers, while affecting women at any age range. For oestrogen receptor positive patients, tamoxifen is used as a prescribed medication for breast cancer therapy. However, tamoxifen in its natural form is not active to achieve the required treatment and prevention of breast cells proliferation. Since tamoxifen is a prodrug, it need to be converted into its active form, endoxifen, for which it is achieved by the action of the cytochrome P450 enzymes. Cytochrome P450 2D6 (CYP2D6) is a member of cytochrome P450 enzymes for which are superfamily of heme enzymes characterised by their ability to catalyse the oxidative reactions of compounds, including the pathway of tamoxifen metabolism. However, due to polymorphism that lead to inactive phenotypes of CYP2D6 in this gene, there is a challenge of diagnosing if a patient can metabolise tamoxifen or not. The current diagnostic tool, Amplichip CYP450, for CYP2D6 is based on genotypes, and it lead to uncertainness as to whether the presence of functionalCYP2D6 alleles of CYP2D6 may lead to coding of active protein, thus leading to wrong treatment measures and overdose of tamoxifen. Electrochemical techniques have provided reliable, simple, quick, and sensitive methods for the determination of drug metabolism by enzymes. Therefore, it is important to develop a CYP2D6 phenotype-based sensor to detect and tell whether a particular individual can metabolise the drug or not.

Situou,se a ocorrência do câncer cérvico-uterino no contexto da presença, já expressiva, das neoplasias malignas no perfil de morbimortalidade da população brasileira. Discutiu-se o padrão peculiar de coexistência, no país, de riscos igualmente altos e crescentes para formas de câncer típicas de sociedades em diferentes estágios de desenvolvimento socioeconômico. Em relação ao câncer cervical, verificou-se sua ocorrência mais elevada, e em idades mais precoces,nas regiões menos desenvolvidas do país; a magnitude e distribuição etária em todas as áreas, entretanto, foram compatíveis com as observadas em regiões do mundo com alta frequência da doença. As altas taxas de detecção das lesões precursoras entre os exames citológicos indicam, além de riscos elevados, um atendimento voltado principalmente para a clientela sintomática. Conjecturou- se sobre a ascensão previsível da ocorrência, em função da persistência de precárias condições de vida, da maior exposição a fatores de risco e da incipiência das atividades de controle. Foram discutidas as baixas cobertura e efetividade das ações de controle, e os problemas determinantes dessa situação em cada nível da atividade. Criticou-se a inadequação das normas vigentes em relação a população-alvo e a periodicidade do exame colpo citológico, assim como a insuficiência dos parâmetros de avaliação existentes. Sugeriram-se alguns indicadores e delinearam-se os aspectos fundamentais de um sistema integrado de informações operacionais e epidemiológicas. / Was situated the occurrence of cervical cancer in the context of the presence, as expressive of malignant neoplasms in the morbidity profile of the population. Discussed the peculiar pattern of coexistence in the country, also high and rising for typical forms of cancer societies at different stages of socioeconomic development risks . In relation to cervical cancer , there was a higher occurrence , and at younger ages , in the less developed regions of the country, the magnitude and age distribution in all areas , however, were consistent with those observed in regions of the world with high frequency of the disease. The high rates of detection of precursor lesions between the cytological examinations indicate, in addition to high risks, service catering mainly for symptomatic clientele. Is conjectured about the predictable rise of occurrence, depending on the persistence of poor living conditions, greater exposure to risk factors and the paucity of control activities. Low coverage and effectiveness of control measures, and the determinants of this situation problems at every level of activity were discussed. Criticized the inadequacy of rules in relation to the target population and the frequency of colpo cytological examination, as well as the failure of the parameters of assessment. Have been suggested and outlined some indicators are the key aspects of an integrated operational and epidemiological information.