Current Oncology
Understanding the burden and factors related to chemotherapy-induced toxicity is important in treatment planning for breast cancer patients. We conducted a prospective study among 396 newly diagnosed and chemotherapy-treated breast cancer patients recruited in two major cancer hospitals in northern Vietnam. Toxicities were captured through medical chart reviews and patient self-reports and graded using NCI CTCAE classification. Associations for sociodemographic and clinical factors with chemotherapy-induced toxicities during first-line chemotherapy were evaluated via multivariable logistic regression. Severe (i.e., grade ≥ 3) hematological (38.6%), and gastrointestinal (12.9%) toxicities were common. A pre-existing nephrological condition was significantly associated with the risk of severe hematological toxicity with adjusted odds ratios (OR) and 95% confidence intervals (CIs) of 2.30 (1.32–4.01). Patients living in rural areas had a lower risk of severe hematological toxicity (OR = 0.48; 95% CI, 0.30–0.77). Patients diagnosed with stage II and stage III–IV had a lower risk of severe gastrointestinal toxicity with ORs and 95% CIs of 0.26 (0.12–0.59) and 0.47 (0.20–1.10), respectively. Triple-negative/basal-like subtype was associated with a higher risk of severe hematological (OR = 3.15; 95% CI, 1.56–6.34) and gastrointestinal toxicities (OR = 3.60; 95% CI, 1.45–8.95) comparing to hormone receptor (HR)-positive HER2-negative subtype. Further research investigating underlying mechanisms would facilitate the development and delivery of personalized treatment and care plans.
Sang M. Nguyen, Huong T.T. Tran, Lan M. Nguyen, Oanh Thi Bui, Dong V. Hoang, Martha J. Shrubsole, Qiuyin Cai, Fei Ye, Wei Zheng, Hung N. Luu, Thuan V. Tran, Xiao-Ou Shu
Cancer Epidemiology, Biomarkers & Prevention
Background: Evidence on associations between dietary intake and risk of breast cancer subtypes is limited and inconsistent. We evaluated associations of fruit, vegetable, meat, and fish consumption with risk of breast cancer overall and by molecular subtype in the Vietnamese Breast Cancer Study (VBCS). Method: VBCS includes 476 incident breast cancer cases and 454 age-matched controls. Dietary habits over the past 5 years were assessed by in-person interviews using a validated food frequency questionnaire. Associations of food groups with breast cancer were evaluated via logistic regression for overall and molecular subtype with adjustment for age, education, income, family history of cancer, menopausal status, body mass index, exercise, total energy intake, and other potential dietary confounders. Odds ratio (OR) was used to approximate relative risk. Results: High fruit intake was inversely associated with breast cancer risk, with adjusted ORs [95% confidence intervals (CI)] of 0.67 (95% CI, 0.47–0.95) and 0.41 (95% CI, 0.27–0.61) for second and third tertiles versus first tertile, respectively (Ptrend < 0.001). This association was stronger for triple-negative than other subtypes (Pheterogeneity < 0.001). High intake of freshwater fish was inversely associated with overall breast cancer (ORT3vsT1 ¼ 0.63; 95% CI, 0.42–0.95; Ptrend ¼ 0.03). An inverse association was observed between HER2-enriched subtype and red and organ meat intake (ORT3vsT1¼0.40; 95% CI, 0.17–0.93;Ptrend¼0.04;Pheterogeneity¼0.50). Conclusions: High intakes of fruit and freshwater fish were associated with reduced breast cancer risk; association for the former was stronger for triple-negative subtype. Impact: Our findings suggest high intakes of fruit and freshwater fish may reduce breast cancer risk among Vietnamese women.
Tobacco Induced Diseases
INTRODUCTION Smoking behavior can change with time and lead to different health outcomes. This study explored the trajectory of smoking and its relationship with cancer incidence and mortality among Korean male adults. METHODS We used 2002–2018 data from the National Health Insurance Service (NHIS). Smoking status was repeatedly measured in four waves of general health examinations provided by the NHIS between 2002 and 2009. Cancer incidence and mortality were tracked from 2010 to 2018. Trajectory analysis was used to identify the patterns of smoking. The hazard ratio was calculated using Cox proportional regression models. RESULTS For the 2448548 men (≥20 years), 137788 cases of cancers and 41146 cancer deaths were found. We identified six trajectory groups: never smokers, former smokers, new current smokers, decreasing light smokers, steady moderate smokers, and steady heavy smokers. All smoking groups had an increased risk of cancer. The steady heavy smokers showed higher cancer incidence and mortality rate than the steady non-smokers (hazard ratio, HR=1.53; 95% CI: 1.49–1.58 and HR=2.64; 95% CI: 2.50–2.79, respectively). The cancer-specific analysis showed that the larynx and lung cancer incidence and mortality rate of the smoking group were higher than in never smokers. CONCLUSIONS Smoking, even at low doses, increases the risk of most cancers in men. Quitting or reducing smoking, especially at a young age, can lower cancer incidence and mortality. This study may provide more objective results on the relationship between smoking and cancer, because smoking behavior was examined at multiple time points.
Tobacco consumption, as a worldwide problem, is a risk factor for several types of cancer. In Vietnam, tobacco consumption in the form of waterpipe tobacco smoking is common. This prospective cohort study aimed to study the association between waterpipe tobacco smoking and gastric cancer mortality in Northern Vietnam. A total of 25,619 eligible participants were followed up between 2008 and 2019. Waterpipe tobacco and cigarette smoking data were collected; semi-quantitative food frequency and lifestyle questionnaires were also utilized. Gastric cancer mortality was determined via medical records available at the state health facilities. A Cox proportional hazards model was used to estimate hazard ratios (HR) and 95% confdence intervals (95% CI). During 314,992.8 person-years of followup, 55 men and 25 women deaths due to gastric cancer were identifed. With never-smokers as the reference, the risk of gastric cancer mortality was signifcantly increased in participants who were ever-smoking (HR=2.43, 95% CI=1.35–4.36). The positive risk was also observed in men but was not signifcantly increased in women. By types of tobacco use, exclusive waterpipe smokers showed a signifcantly increased risk of gastric cancer mortality (HR=3.22, 95% CI=1.67–6.21) but that was not signifcantly increased in exclusive cigarette smokers (HR=1.90, 95% CI=0.88– 4.07). There was a signifcant positive association between tobacco smoking and gastric cancer death for indicators of longer smoking duration, higher frequency per day, and cumulative frequency of both waterpipe and cigarette smoking. Waterpipe tobacco smoking would signifcantly increase the risk of gastric cancer mortality in the Vietnamese population. Further studies are required to understand the waterpipe tobacco smoking-driven gastric cancer burden and promote necessary interventions.
Objective: This study examined relationships between weight-change trajectories and all cancers and obesity-related cancer risks. Methods: A total of 1,882,304 men and 899,912 women from the 2002 to 2017 National Health Insurance Service cohort were included. Weight-change trajectories in 2002 to 2009, according to BMI, were determined using group-based trajectory modeling. Cox proportional hazards regression assessed associations between trajectories and cancer incidence. Results: Overall, >50% of individuals maintained stable weight, as did two-thirds of those in the overweight and obesity groups. A total of 64,725 men and 37,608 women developed incident cancer. Weight stability in overweight or obesity groups was associated with greater cancer risk. In both sexes, higher weight across BMI groups increased risks of all cancers, obesity-related cancers and thyroid, colorectal, stomach, liver, prostate, and postmenopausal breast cancer. Stratified by BMI, weight gain increased risks of all cancers and obesity-related cancers in men with obesity class I and women with overweight. Weight loss decreased risks of obesity-related cancers, thyroid cancer, and kidney cancer among men with overweight, premenopausal breast, endometrial, and ovarian cancer in women with overweight, and obesity-related cancers and thyroid cancer in women with class I obesity. Conclusions: Maintaining weight and avoiding weight gain are crucial for reducing cancer risk, but achieving a stable, normal BMI optimizes cancer prevention
Cancer Epidemiology
Background: Survival for Primary Liver Cancer (PLC) has been investigated in Australia, but limited work has been conducted on the burden for people with different socioeconomic status, region of residence, causes of PLC, and culturally and linguistically diverse (CALD) backgrounds. This study aimed to cover this gap in the literature by investigating PLC survival with the aforementioned factors. Methods: This study linked four administrative datasets: Victorian Cancer Registry, Admitted Episodes Dataset, Emergency Minimum Dataset, and Death Index. The cohort was all cases with a PLC notification within the Victorian Cancer Registry between 01/01/2008 and 01/01/2016. The Kaplan-Meier method was used to estimate survival probabilities and the log-rank test was used to compare the difference in survival between subgroups. The Cox proportional hazard model was used to explore factors associated with PLC survival. Results: The 1-, 3- and 5-year survival rates were 50.0%, 28.1% and 20.6%, respectively, with a median survival of 12.0 months (95% confidence interval (CI): 11.0 – 12.9 months). Higher survival was associated with younger age, hepatocellular carcinoma, and higher socio-economic status. People born in Asian, African, and American regions had higher survival than those born in Australia and New Zealand. Cases with viral hepatitis as an identified aetiology had higher survival than those whose PLC was related to alcohol consumption (hazard ratio=1.52, 95% CI: 1.19 – 1.96), diabetes and fatty liver disease (hazard ratio=1.35, 95% CI: 1.08 – 1.68). Conclusion: Survival outcomes for people diagnosed with PLC were still poor and affected by many factors. Asian and African cases had better survival than Australian and New Zealand patients as PLC in Asian and African cases was mostly caused by viral hepatitis. Metropolitan areas were associated with a higher survival than rural areas, not only due to accessibility to surveillance and healthcare services but also because the majority of overseasborn patients reside in metropolitan areas.
Australian Health Review
Objective. This study aimed to estimate the public hospital costs associated with primary liver cancer (PLC) in the first and second years following the cancer diagnosis. Methods. This study linked administrative datasets of patients diagnosed with PLC in Victoria, Australia, from January 2008 to December 2015. The health system perspective was adopted to estimate the direct healthcare costs associated with PLC, based on inpatient and emergency costs. Costs were estimated for the first 12 months and 12–24 months after the PLC diagnosis and expressed in 2017 Australian dollars (A$). The cost estimated was then extrapolated nationally. The linear mixed model with a Box–Cox transformation of the costs was used to explore the relationship between costs and patients’ sociodemographic and clinical characteristics. Results. For the first 12 months, the total and annual per-patient cost was A$211.4 million and A$63 664, respectively. Costs for the subsequent year were A$49.7 million and A$46 751, respectively. Regarding the cost extrapolation to Australia, the total cost was A$137 million for the first 12 months after notification and A$42.6 million for the period from 12 to 24 months. Higher costs per episode of care were mostly associated with older age, hepatocellular carcinoma type of PLC, metropolitan hospitals, and Asian birth region. Conclusion. This study showed the public hospital admission and emergency costs associated with PLC and the substantial economic burden this cancer has placed on the Australian health system
: Having a good understanding of cancer patients’ health literacy in the early stage of diagnosis can help to implement strategies to improve the management process and overall health outcomes. The study aims to describe health literacy and its association with sociodemographic characteristics among newly admitted cancer patients. A cross-sectional study was conducted on 262 newly admitted patients of a cancer hospital in Vietnam using the Vietnamese version of the HLS-SF12 questionnaire. Descriptive analytics and regression analysis were used to describe health literacy and examine associated factors. Older age, lower level of education, and living in rural areas were associated with lower health literacy while there was no significant relationship between gender and health literacy among newly admitted cancer patients. Many newly admitted patients, especially the older patients have difficulties understanding the different treatment options (54%) and evaluating the reliability of health information on the internet (43%). During the early stage of treatment, strategies should be implemented with regards to patients’ health literacy, to properly educate patients and their caregivers to improve communication, adherence to medication, lifestyle, and overall better quality of life and treatment outcome
Tạp chí nghiên cứu Y học
Cervical cancer is really a public health problem that should be prioritized for prevention interventions and early screening, especially in developing countries. A cross-sectional study was conducted at a Hanoi Medical University vaccination unit in 2018 to identify the prevalence of and related factors with cervical cancer screening among female clients in Hanoi, Vietnam. We collected data using a structured questionnaire among 405 female clients. The results showed that the prevalence of study participants who had the decision on cervical cancer screening was 79.5%. Associated factors of cervical cancer screening among female clients were have had sex with 1 person (OR= 42.5; 95%CI= 5.6-311.2), 2 people (OR= 29.7; 95%CI= 3.84- 230) and 3 people (OR= 41.6; 95%CI= 4.68- 369.9). There is a statistically significant relationship between two variables [average monthly income (OR= 2.79, 95%CI= 1.19- 6.56), and sex status (OR=20.9, 95%CI= 2.52- 173.39) with the decision to screen for cervical cancer. Enhancing the proportion of cervical cancer screening by fostering knowledge and awareness about human papillomavirus, and cervical cancer and using health services assessment will be highly recommended in Vietnam.
Supportive Care in Cancer
Expert Review of Pharmacoeconomics & Outcomes Research
Tran Van Thuan, Dao Van Tu, Nguyen Khac Dung, Ta Van To, Vu Truong Khanh, Trinh Hong Son, Nguyen Cong Hoang, Bui Thi Oanh, Nguyen Quang Tien, Vu Duc Hoan, Nguyen Le Hiep, Tran Thanh Huong
Cancer Medicine
Tran Thi Thanh Huong, Nguyen M. Sang, Nguyen K. Khiem, Pham X. Dung, Nguyen H. Uoc, Le T.Anh, Nguyen H.Giang, Tran V.Dung, Phuong H.D.Son, Do M. Hung, Tran V. Thuan, Shu Xiao-Ou, Raymond U. Osarogiagbon
Journal of Thoracic Oncology
Healthcare (Basel)
Healthcare (Basel)
Cancer Medicine
Xuan Thi Thanh Le, Phuong Thi Ngoc Nguyen, Toan Thi Thanh Do, Thang Huu Nguyen, Huong Thi Le, Cuong Tat Nguyen, Giang Hai Ha, Chi Linh Hoang, Bach Xuan Tran, Carl A. Latkin, Roger C.M. Ho, Cyrus S.H. Ho
International Journal of Environmental Research and Public Health
This study aimed to describe mental health service utilization and examine associated factors among students in Vietnam. Data were collected at eight universities in Hanoi, Vietnam, in 2018 using an administered questionnaire. The total number of participants was 9,120 (95.1% response rate). Among stu dents participating in our survey, 12.5% (95% CI: 10.9–14.1) with depression and/or anxiety symptoms used mental health service in the last 12 months. In the multivariable regression models, significant factors associated with mental health ser vice utilization were marital status, types of housemate, men tal health problems, physical activity, smoking status, and alcohol drinking. Our study made recommendations to stake holders for improving mental health services utilization among students in Vietnam. These findings had important implica tions for future research on factors associated with mental health service utilization among university students.
cancer, cancer control, cancer burden, prevention, early detection, screening, treatment, health systems, health policy, review, NCDs, Vietnam
This study aimed to describe mental health service utilization and examine associated factors among students in Vietnam. Data were collected at eight universities in Hanoi, Vietnam, in 2018 using an administered questionnaire. The total number of participants was 9,120 (95.1% response rate). Among stu dents participating in our survey, 12.5% (95% CI: 10.9–14.1) with depression and/or anxiety symptoms used mental health service in the last 12 months. In the multivariable regression models, significant factors associated with mental health ser vice utilization were marital status, types of housemate, men tal health problems, physical activity, smoking status, and alcohol drinking. Our study made recommendations to stake holders for improving mental health services utilization among students in Vietnam. These findings had important implica tions for future research on factors associated with mental health service utilization among university students.
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