Due to the constantly increasing epidemiological burden of our population on oncological diseases, nationwide preventive programs for selected types of malignant tumors have been introduced within the Czech health system. The aim of this thesis is to analyze and evaluate these screenings, such as mammographic screening, cervical screening and screening of the colon and rectum. The subject of the analysis is the mortality rates for breast cancer (C50), cervix (C53) and colon and rectum cancer (C18-21) between 1994 and 2015. The main focus is on question of whether the development of the mortality rate for selected neoplasms depends on the degree of coverage rate by a preventive program.

This diploma thesis deals with the national screening programs for cancer diagnosis. The goal of this thesis is to find a proper way how to evaluate the effectivity of screening programs as well as their influence on the intensity of mortality from certain types of cancer. For the purpose of finding out necessary information were used data related to the diagnosis of colorectal cancer, a diagnosis of cervical cancer and breast cancer in the population of the Czech Republic between 1977 - 2011. This thesis is divided into eight chapters. The first chapter is an introduction to the topic and contains the description of the main goals. The second chapter defines terms that are crucial for this thesis. The third chapter is devoted to data sources and institutions that collect different types of data and health statistics. The next chapter deals with the epidemiology of all described types of cancer and also provide information on risk factors and symptoms of the disease. The fifth chapter looks back at trends in mortality and incidence of the most common malignant tumors in the Czech Republic. The sixth chapter describes planning and implementation of screening processes. The seventh history of screening programs in the Czech Republic. The eighth chapter deals with the rules and regulations of the EU Council and the World Health Organization. The ninth chapter represents the final assessment of Czech screening programs, compared both to the WHO guidelines and the results in the world. The last chapter is including description of mortality and their reaction on screening programs. Text describes even comparison with two other European countries (Germany, France).

<p>Vitamin E is a natural lipophilic antioxidant contains eight structurally related forms, i.e., α-, β-, γ-, δ-tocopherols (αT, βT, γT, and δT) and corresponding tocotrienols. Recent research indicates that vitamin E forms are differentially metabolized to various carboxychromanols. Some these vitamin E metabolites have been shown to exhibit strong anti-inflammatory and anticancer effects, yet little is known about their bioavailability. Without this knowledge, it is impossible to assess the role of vitamin E metabolism in biological functions of vitamin E forms and their protective effects on chronic diseases. While αT and γT appear to improved gut health, the underlying mechanisms are not well understood. Furthermore, specific forms of vitamin E such as γT have been reported to have cancer-preventing effects, but their anticancer efficacy is relatively modest. For these reasons, this dissertation focused on the characterization of the pharmacokinetic formation of vitamin E metabolites after supplementation, and the investigation of the underlying mechanisms of the protective effect of vitamin E forms, αT and γT, on gut health, as well as anticancer efficacy of the combination of aspirin and γT on carcinogen-induced colon tumorigenesis.</p><p><br></p><p>The first project focuses on characterizing the pharmacokinetic formation of vitamin E metabolites after single dose supplementation of γ-tocopherol-rich mixed tocopherol (γTmT) and δ-tocotrienol (δTE). With our recently developed LC/MS/MS assay for quantifying vitamin E metabolites, we can simultaneously quantify the level of short-chain, long-chain, and sulfated carboxychromanols in plasma, urine, and fecal samples of supplemented animals. In this study, we investigated the pharmacokinetics including excretion of vitamin E forms and the formation of their metabolites after a single dose intragastric administration of tocopherols and tocotrienols in rats. We also measured vitamin E metabolites in the serum obtained from healthy humans after gT supplementation. In the plasma of rat, the pharmacokinetic profiles of γT and δTE are described as the following: γT, Cmax = 25.6 ± 9.1 μM, Tmax = 4 h; δTE, Cmax = 16.0 ± 2.3 μM, Tmax = 2 h. Sulfated CEHCs and sulfated 11’-COOHs were the predominant metabolites in the plasma of rat with Cmax of 0.4-0.5 μM (Tmax ~ 5-7 h) or ~0.3 μM (Tmax at 4.7 h), respectively. In 24-h urine, 2.7% of γT and 0.7% of dTE were excreted as conjugated CEHCs, the major identified urinary metabolites. In the feces, 17-45% of supplemented vitamers were excreted as un-metabolized forms and 4.9-9.2% as metabolites. The majority of metabolites excreted in feces were unconjugated carboxychromanols, among which 13’-COOHs constituted ~50% of total metabolites. Interestingly, 13’-COOHs derived from δTE were 2-fold higher than 13’-COOH from γT. Unlike rats, γ-CEHC is the predominant metabolites found in human plasma, although 11’-COOHs and 13’-COOHs (sulfated and unconjugated) were elevated by >20 folds responding to γT supplement. In this study, we found that tocopherols and tocotrienols, when taken as supplements, are mainly excreted as un-metabolized forms and long-chain carboxychromanols in feces. High fecal availability of 13’-COOHs may contribute to modulating effects on gut health.</p><p><br></p><p>The second project of my dissertation investigated the effect of vitamin E forms, αT and γT, on intestinal barrier function in a cellular model and a mouse colitis model. Inflammatory bowel diseases (IBD) are chronic idiopathic inflammatory conditions characterized by disruption of intestinal barrier integrity. Previous studies by others and us had demonstrated that vitamin E forms, αT and γT, can protect against chemical-induced colitis in animal models. However, the role of these vitamin E forms on intestinal barrier function has not been studied. Herein, we investigated the potential protective effects of vitamin E forms, αT and γT, on intestinal barrier function in a Caco-2 colon epithelial cell model and a dextran sodium sulfate (DSS)-induced colitis mouse model. In Caco-2 cells, pretreatment with 25mM αT and γT attenuated Caco-2 monolayer barrier dysfunction induced by 10 ng/mL TNF-α/IFN-γ, suggesting that these vitamin E forms protect intestinal barrier integrity in this cellular model. In male BALB/c mice, the supplementation of αT (0.05%) or γTmT (0.05%) when given 3 weeks before DSS treatment or at the same time as DSS treatment alleviated DSS-induced fecal bleeding and diarrhea symptoms in mice, and attenuated colon inflammation and colitis-associated damages. Additionally, αT and γTmT supplementation attenuated DSS-induced intestinal barrier dysfunction, as indicated by improving the level of occludin, a tight junction protein, in the colon and reducing lipopolysaccharide-binding protein (LBP) in the plasma. Furthermore, gut microbiota analysis demonstrated that αT and γTmT supplementation could modulate intestinal microbiome composition in mice with DSS treatment. DSS treatment reduced the relative abundance of Lachnospiraceae compared to healthy mice, and supplementation of αT and γT partially reversed this effect. Interestingly, the family Lachnospiraceae has been reported to decrease in IBD patients. Our study demonstrated the protective effects of vitamin E forms on intestinal barrier integrity in a cell-based model and a colitis model in mice. Furthermore, we demonstrated that these vitamin E forms caused favorable changes in the intestinal microbial population under colitis condition.</p><p><br></p><p>The third project of my dissertation evaluated the anticancer efficacy of the combination of aspirin and γT using an azoxymethane (AOM)-induced and colitis-promoted colon tumorigenesis mouse model. Extensive inflammation in the colon promotes the development of colorectal cancer (CRC). Eicosanoid production by pro-inflammatory enzymes, cyclooxygenases (COX-1 and COX-2) and 5-lipoxygenase (5-LOX) play a critical role in the initiation, progression, and invasion of CRC. Thus, nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, have been recommended for chemoprevention of CRC. However, long-term use of aspirin can cause many side effects, and the anticancer activity of aspirin is very modest. Previously, we have demonstrated that the combination of γT with aspirin prolonged the anti-inflammatory activity of aspirin and alleviated aspirin-associated adverse effects in a carrageenan-induced inflammation model in rats. Additionally, we found that the combination of γT and aspirin has stronger anticancer activity than aspirin or γT alone against HCT-116 human colorectal carcinoma cells. Therefore, we examined the anticancer effect of the combination of 0.025% aspirin and 0.05% γT against AOM-induced and DSS-promoted tumorigenesis in mice. In this study, we have found that the combination of aspirin and γT, but not aspirin or γT alone, suppressed colon tumorigenesis in mice, as indicated by 40% and 50% reduction in the multiplicity of total polyps (P < 0.05) and large adenomatous polyps (>2mm2, P < 0.05), respectively. More strikingly, the combination of aspirin and γT reduced the overall tumor area by 60% (P < 0.05). Noteworthy, the supplementation of γT also alleviated aspirin-induced stomach lesion and appeared to modulate intestinal microbial composition. Our study demonstrated that the combination of aspirin and γT has stronger anticancer activity than aspirin or γT alone while alleviates aspirin-associated adverse effect, suggesting that the combination of γT and aspirin is a more effective and safer chemopreventive agent for CRC than aspirin alone.</p>

Indiana University-Purdue University Indianapolis (IUPUI) / The aims of this research were to evaluate the merit of a communication-based medical approach to cancer prevention in Taiwan and to give deeper understanding of whether physicians view this type of method as a possible solution to public health problems. It is also hoped that this research will be able to find out whether doctors support the use of COMBI for managing public health issues in Taiwan. The results show that Taiwanese physicians perceive communication-based approach and communication methods as a way for managing public health problems, and they also agree that COMBI can be used for cancer or other public health issues prevention. The World Health Organization has used COMBI to deal with public health issues and has made a huge impact in many countries, combating diseases such as dengue fever, leprosy, lymphatic filariasis, tuberculosis, malaria, and HIV/AIDS with successful results. There is also a large body of research indicating that there is a strong relationship between eating fruits and vegetables and cancer prevention. In Taiwan, cancer has been both the top cause of death for 18 years and one of the top ten causes of death for 30 years. However, more than 80% of people in Taiwan still do not consume enough fruits and vegetables daily. Thus, this COMBI plan is hoped to help change these people’s eating habits for cancer prevention. The plan is also evaluated by doctors from Taiwan in terms of its pros and cons in this document, and suggestions for changes are made. These doctors view communication-based strategies like COMBI as a key component for managing public health problems, and they also believe that this COMBI plan will accomplish its goal of increasing people's fruit and vegetable intake for cancer prevention in Taiwan. Up till now, only minimal research has been conducted on the use of COMBI in Taiwan. Therefore, this investigation is hoped to initiate this research and provide a guideline for future COMBI-based actions taken in Taiwan.

The objective of this thesis is to design a new Center for Prevention and enlargement of Clinic of Radiation Oncology of Masaryk Memorial Oncology Institute in Brno. The building will consist of the center for prevention itself, the inpatient department for mobile patients, the proton therapy center, and a space for rent. The Center for Prevention will, on top of expert medical procedures, provide spaces for patient counseling, education of both professional and general public and administration for a commercial oncology prevention program.

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Submitted by Filipe dos Santos (fsantos@pucsp.br) on 2018-04-09T13:03:08Z No. of bitstreams: 1 Gláucia Pina Guimarães Porto.pdf: 1499688 bytes, checksum: 9b69a1bc17f6ff424722f5c5d389b4b0 (MD5) / Made available in DSpace on 2018-04-09T13:03:08Z (GMT). No. of bitstreams: 1 Gláucia Pina Guimarães Porto.pdf: 1499688 bytes, checksum: 9b69a1bc17f6ff424722f5c5d389b4b0 (MD5) Previous issue date: 2018-03-02 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Understanding breast health from needs and conditions in a socially contextualized way can be a way to develop consistent public policies for the promotion of breast and woman health as a tool for the prevention and early detection of breast cancer through institutions and organizations committed to social development in combating the disease. The overall objective of this study was to conduct a systematic review of the literature regarding the beliefs and perceptions that healthy women have about breast cancer. The research problem arose from the observation of the psychosocioeducational difficulties of women in cases of breast cancer, as well as for preventive care and early detection of the disease, for approximately two years, in a pilot project of health intervention with emphasis on the public roles of women in the fight against breast cancer, through an intervention research with a multidisciplinary character. The method was the systematic review of literature. The initial selection of articles was done through the reading of the title and abstract, and the exclusion of duplicate results was performed by the identification of the main author. As an inclusion criterion for the analysis of the results, the strength of evidence of the selected studies was summarized and the relevance of the most interesting descriptors was considered, aiming at the accomplishment of a qualitative synthesis. From 2,926 studies found, 96.24% were mastectomized women, and 2.90% were eligible studies whose study object considers behaviors of healthy women, their beliefs, perceptions and / or knowledge about prevention and early detection of the disease . The results indicate that the production of knowledge about the problem is scarce, with consequences on the limits of changing beliefs and perceptions about breast cancer. The reassignment of healthy women on breast cancer based on correct information can increase the rate of detection of the disease, which can avoid many deaths, and reduce the expenditure of public funds with treatments for advanced diagnoses. This change in attitude makes it possible for early detection not to be seen as a threat but as the best path to health / Compreender a saúde da mama a partir das necessidades e condições de forma contextualizada socialmente pode ser uma via para o desenvolvimento de políticas públicas consistentes de promoção da saúde das mamas e da mulher, como ferramenta de prevenção e detecção precoce do câncer de mama, por meio de instituições e organizações comprometidas com o desenvolvimento social em combater a doença. O objetivo geral deste estudo foi de realizar uma revisão sistemática da literatura a respeito de crenças e percepções que as mulheres saudáveis possuem sobre câncer de mama. O problema de pesquisa surgiu a partir da observação das dificuldades psicossocioeducacionais de mulheres frente aos casos de câncer de mama e também para realização dos cuidados preventivos e de detecção precoce da doença, durante aproximadamente dois anos, em um projeto piloto de intervenção em saúde, com ênfase nos papéis públicos das mulheres no combate ao câncer de mama, por meio de uma pesquisa-intervenção com caráter multidisciplinar. O método foi o da revisão sistemática de literatura. A seleção inicial dos artigos se deu por meio da leitura do título e resumo, e a exclusão dos resultados duplicados foi realizada pela identificação do autor principal. Como critério de inclusão para análise dos resultados, a força de evidência dos estudos selecionados foi sumarizada e a relevância dos descritores de maior interesse foi considerada, visando a realização de uma síntese qualitativa. Entre os 2.926 estudos encontrados 96,24% tinham como objeto de estudo mulheres mastectomizadas, e 2,90% foram estudos elegíveis cujo objeto de estudo considere comportamentos de mulheres saudáveis, suas crenças, percepções e/ou conhecimentos sobre prevenção e detecção precoce da doença. Os resultados indicam que a produção de conhecimento sobre o problema é escassa, com consequências nos limites quanto à mudança de crenças e percepções sobre câncer de mama. A ressignificação da mulher saudável sobre câncer de mama com base em informações corretas pode aumentar o índice de detecção da doença, o que pode evitar muitas mortes, além de reduzir o gasto de verbas públicas com tratamentos para diagnósticos avançados. Esta mudança de atitude possibilita que a detecção precoce não seja vista mais como ameaça, mas como o melhor caminho para a saúde

First Nations women face nearly three times the risk of cervical cancer and mortality rates of up to six times higher than their non-Aboriginal counterparts. While cervical cancer is almost completely preventable, Southern Alberta First Nations women seldom access cervical screening services. The purpose of this qualitative focused ethnography was to gain an understanding of the cervical screening needs of un- and under-served First Nations women living off-reserve. Thirteen purposefully selected First Nations women participated in three focus groups utilizing semi-structured interviews. Personal self-worth and cervical screening awareness and relevance are essential to the pursuit of cervical screening. Barriers and incentives for screening and opportunities for acceptability and sustainability are explored. A holistic approach, intersectoral collaboration and cultural safety are described by focus group participants as foundational for optimal service delivery. / xii, 223 leaves ; 29 cm.

Background: Several studies suggest that most school-age children are poorly informed about cancer risk factors. This study examines the effectiveness of the ‘Be smart against cancer’ (BSAC) program in promoting cancer awareness and intentions to engage in health-promoting behavior. Methods: 235 seventh-grade students were randomized to either the intervention (N = 152) or the wait-control group (N = 83). The intervention included the modules: “What is cancer?,” “Sun protection,” “Non smoking,” and “Physical activity, Healthy nutrition, and Limited alcohol consumption.” Outcomes measured at baseline and at the end of the one week BSAC program included knowledge of cancer and its behavioral risk factors, health-promoting intentions, and reported risk behavior. Results: BSAC was effective in increasing knowledge about cancer and risk factors for cancer (p < .001), as well as in increasing intentions to engage in health-promoting behavior (p < .001), independent of a student’s risk profile. Knowledge did not serve as a mediator for intention building. Conclusions: The BSAC is an effective school-based program for raising awareness of cancer, associated risk factors and intentions to engage in cancer-preventive behavior. The results indicate that the effectiveness of BSAC is independent of a student’s risk profile. Therefore, it holds considerable promise as a broadly applicable program to raise cancer awareness and promote healthy behavior intentions.

[Truncated abstract] The role of fish consumption and omega-3 polyunsaturated fatty acids (PUFAs) in the prevention of disease has been the subject of much investigation in recent years. A clue that these factors might be of importance was the observation that populations consuming high levels of marine omega-3 PUFAs had lower rates of morbidity and mortality from cardiovascular disease. From there, research in this area has expanded to include a range of chronic diseases and their prevention. An area of particular interest is the role of fish consumption in the prevention of various cancers. In Australia, one in three men and one in four women are expected to be diagnosed with cancer by the age of 75. Identifying preventive factors that can be translated into constructive health promotional messages is of great importance in addressing this group of diseases that has such a large impact on the health and wellbeing of the population. ... Results and conclusions Analysis of the data from the population-based case-control study suggests a protective effect of preserved fish consumption, possibly due to the high oil content of these fish. The developed questionnaire is a valid and reliable tool for measuring fish and seafood consumption as determined by regression analysis with an independent biomarker and reliability analysis using intra-class correlation. Importantly, reliability can be maintained despite asking a high level of detail from participants. For ranking according to overall fish consumption, detailed questioning is probably not necessary, however inclusion of variables representing multiple categories of fish and seafood consumption in a regression model enables us to better account for variation in blood omega-3 PUFA levels than a single variable representing overall consumption. For the purpose of questionnaire validation, plasma phospholipid and erythrocyte membrane levels of EPA and DHA are equivalent biomarkers of fish and seafood consumption. The choice between them by future investigators will be based on more practical aspects such as convenience and the fasting state of subjects. The tangible product of this thesis is additional evidence to support a protective association between fish consumption and prostate and breast cancers, and a valid and reliable questionnaire v for measuring habitual consumption of fish and seafood in a West Australian population, that could also be applied to other populations after minor adjustment for local fish and seafood consumption patterns.