Nevin Manimala

Asian Pac J Cancer Prev. 2025 Feb 1;26(2):573-577. doi: 10.31557/APJCP.2025.26.2.573.

ABSTRACT

OBJECTIVES: The aim of this study was to develop an understanding of physiotherapy services for patients with cancer in Oman, including the type of services offered, the clinicians involved and referral pathways, to identify possible barriers and limitations.

METHOD: An online survey was developed to meet the aim and objectives of the study. The Qualtrics online platform was used to collect and initially analyze results. The primary outcomes included clinical experience, post-qualification education, details of place of work and the physiotherapy services provided, the referral process for patients, and barriers and obstacles preventing the development of oncology rehabilitation services. The Omani Physiotherapy Association and Medical Rehabilitation department sent the survey to all Oman-based physiotherapists between June 2023 and September 2023. One hundred and five physiotherapists commenced answering the survey, and 51 completed it. All 51 physiotherapists met the inclusion criteria as they were actively treating patients with cancer.

RESULTS: Fifty-one physiotherapists who regularly treat patients with cancer completed the survey. Thirty-nine (77%) had more than 5 years of clinical experience and 24/51 (47%) had engaged in post qualification education in oncology. Eleven participants (27%) reported the delivery of oncology exercise programme at their place of work, while 13/41 (32%) reported availability of specialized staff to deliver such a programme.

CONCLUSION: Findings suggest a shortage of specialized physiotherapy staff in oncology, insufficient training for oncology physiotherapists, and centralization of services in Muscat city. Study showed low referral rate, mainly after finishing cancer treatment or while on treatment.

PMID:40022703 | DOI:10.31557/APJCP.2025.26.2.573

Asian Pac J Cancer Prev. 2025 Feb 1;26(2):565-572. doi: 10.31557/APJCP.2025.26.2.565.

ABSTRACT

BACKGROUND: Lung cancer is a leading cause of global morbidity and mortality, severely affecting patients’ quality of life (QoL). Understanding the factors associated with QoL in these patients is crucial for improving treatment and care. This study aimed to assess QoL among lung cancer patients and identify the factors influencing it.

METHODS: This cross-sectional analytic study included 130 patients diagnosed with lung cancer at a tertiary facility in Northeastern Thailand. QoL was evaluated using the FACT-L interview, covering subscales such as physical, social/family, emotional, and functional well-being, as well as a lung cancer subscale, and the FACT-L Trial Outcome Index (TOI) and FACT-G. Descriptive statistics and multiple logistic regression were used for data analysis.

RESULTS: The majority of subjects had low overall QoL (52.31%; Mean ± SD: 45.24 ± 11.33), low FACT-L TOI (83.08%; 21.05 ± 9.21), and low FACT-G (57.69%; 35.72 ± 8.70). Subscale analysis revealed low levels of physical well-being (85.38%; 6.56 ± 3.54), emotional well-being (85.38%; 6.15 ± 3.67), and functional well-being (96.15%; 4.97 ± 3.82). However, about half of the subjects reported moderate social/family well-being (50.77%; 18.04 ± 4.17) and lung cancer subscale scores (56.15%; 9.51 ± 4.31). Multivariate analysis identified factors significantly associated with higher QoL, including age (AOR = 1.05, 95% CI: 1.01-1.10), absence of comorbidities (AOR = 3.95, 95% CI: 1.60-9.74), and absence of lymph node invasion (AOR = 4.42, 95% CI: 1.26-15.56). Conversely, sleep problems (AOR = 0.26, 95% CI: 0.08-0.81), local metastasis (AOR = 0.25, 95% CI: 0.09-0.72), and undergoing radiotherapy (AOR = 0.25, 95% CI: 0.07-0.98) were associated with lower QoL.

CONCLUSIONS: These findings suggest that lung cancer patients with sleep problems, local metastasis, or undergoing radiotherapy should receive intensive palliative care to improve their QoL during the end of life stage.

PMID:40022702 | DOI:10.31557/APJCP.2025.26.2.565

Asian Pac J Cancer Prev. 2025 Feb 1;26(2):557-563. doi: 10.31557/APJCP.2025.26.2.557.

ABSTRACT

BACKGROUND: A comprehensive ban on tobacco advertising, promotion, and sponsorship (TAPS) is known to significantly reduce tobacco consumption and has been incorporated into the Framework Convention on Tobacco Control since 2003. Though Indian legislation also comprehensively bans TAPS, existing literature indicates poor and non-uniform implementation across the country. This study aims to assess the exposure to TAPS among adults residing in an urbanised village in South Delhi.

METHODS: It was a community-based cross-sectional house-to-house survey conducted in Aliganj, Delhi, between Apr 21 and Jun 21. 490 residents aged ≥ 15 years were included in the study. The interview was conducted using the Global Adult Tobacco Survey questionnaire. Data was analyzed using SPSS 21. Multivariable logistic regression analysis was conducted to identify the channels of communication where exposure to messaging encouraged thoughts of quitting.

RESULTS: Out of 490 study participants, 93(18.9%) were exposed to TAPS for smoked tobacco products, 88(17.9%) for smokeless tobacco products, and 74(15.1%) for both smoked and smokeless tobacco on various platforms. Exposure to TAPS for smokeless tobacco was more likely at stores where the products are sold (aOR = 2.19;95% C.I.-1.19-3.98), on television (aOR = 4.12;95% C.I.-1.49-11.39), billboards (aOR = 3.48;95% C.I.-1.18-10.29), and posters (aOR = 3.04;95% C.I.-1.22-7.60). Among smokers, 77.1%, and smokeless tobacco users, 75.4% had to quit thoughts triggered by packet warnings. Education and employment were found to be significantly associated.

CONCLUSION: Almost one-fifth of the participants were exposed to TAPS through various channels. Our findings indicate that implementing the TAPS ban remains partial in our study area, especially regarding smokeless tobacco products, compared to state and national level estimates. Focusing on mass media anti-tobacco campaigns for both smoked and smokeless products, through television, newspapers, and magazines, in addition to comprehensive TAPS ban enforcement, can contribute effectively to reducing tobacco consumption in our study population.

PMID:40022701 | DOI:10.31557/APJCP.2025.26.2.557

Asian Pac J Cancer Prev. 2025 Feb 1;26(2):533-539. doi: 10.31557/APJCP.2025.26.2.533.

ABSTRACT

OBJECTIVE: This study was conducted to investigate the relationship between rs4143815 (C>G) and rs2890658 (A>C) of the PD-L1 (Programmed Death-Ligand 1) gene and the risk of developing non-Hodgkin’s lymphoma (B-NHL) in a cohort of Egyptian population.

METHODS: In this case-control study, which included one hundred patients (males and females) diagnosed with B-NHL from Kasr El Aini hematology clinic, their age ranged between 18 and 71 years and 100 age and sex matched healthy controls from outpatient clinic. Three ml venous blood was withdrawn from all subjects and collected in EDTA vacutainer® and kept frozen at -20˚C till time of DNA extraction. DNA samples were extracted from blood samples using GeneJETTM Genomic DNA Purification Kit from Thermo Fisher. Genotyping was determined using Custom TaqMan® SNP Genotyping Assays from Applied biosystems by real-time PCR, and subsequently extensive statistical analysis was performed to investigate the clinical value of these polymorphisms. Patients’ clinical information was obtained from patient’s medical records.

RESULTS: The obtained results of the current study demonstrated GG genotype of PD-L1 rs4143815 and the CC genotype of PD-L1 rs2890658 were observed to be more prevalent among NHL patients compared to those reported for the healthy controls (62%, 80% vs 58%, 77%), respectively, however these results revealed no significant association between the studied SNPs of PDL1 gene and risk of NHL (p=0.837, *). Regarding survival analysis, results of 36 and 60 months DFS for the common genotype (GG) of rs4143815 versus the combined genotype (GC & CC) were (67%, 44.6% vs 63.8%, 63.8%), respectively (p=0.249) as well as results of 36, 60 months DFS for the common genotype (CC) of rs2890658 versus the combined genotype (AA & AC) revealed (61.5%, 46.1% vs 83.3%, 83.3%), respectively which was statistically insignificant (p=0.599), therefore PDL1 rs4143815 & rs2890658 polymorphisms have no significant impact on patients’ DFS.

CONCLUSIONS: Our findings provided the first evidence that PD-L1 rs4143815 (C>G) and rs2890658 (A>C) are not molecular susceptibility markers for B-NHL in Egyptians, at least in the studied population.

PMID:40022698 | DOI:10.31557/APJCP.2025.26.2.533

Asian Pac J Cancer Prev. 2025 Feb 1;26(2):515-524. doi: 10.31557/APJCP.2025.26.2.515.

ABSTRACT

BACKGROUND: Despite a range of clinical practice guidelines and public health advisories promoting the use of colorectal cancer screening in the general population, screening rates remain less than ideal in many countries.

AIM: This study evaluated the health beliefs regarding colorectal cancer and factors affecting the participation of men aged 50-75 in colorectal cancer screening in three selected Muslim countries (Turkey (TR), Saudi Arabia (SA), and Malaysia (MY)).

METHODS: This study employed a descriptive comparative design with stratified sampling, with the sample size of 540 participants. The Colorectal Cancer Health Belief Model (HBM) Scale and the Fatalism Tendency scale were used to evaluate men’s health beliefs about colorectal cancer. The scales were in a 5-point Likert scale. The SPSS 22.0 statistical package program evaluated the data using descriptive statistics and ANOVA tests.

RESULTS: The average self-report risk in terms of cancer was 3.9 ± 2.20 (TR), 2.6 ± 2.69 (SA), and 3.9 ± 2.20 (MY), 75% don’t know how to prevent colorectal cancer (TR) 84% (SA) and 82.2% (MY). The HBM Scale and sub-dimensions and Fatalism Tendency scale average scores of Malaysian participants were higher than Turkish and Saudi participants. A positive, statistically significant relationship existed between the scales and sub-scales mean score (p < .01).

CONCLUSION: Interventions can be designed to address specific components of the HBM, such as promoting awareness campaigns, addressing cultural and psychological barriers, incorporating cues to action, and culture-sensitive colorectal cancer screening guides that should be prepared for Muslim men to increase participation in colorectal cancer screening.

PMID:40022696 | DOI:10.31557/APJCP.2025.26.2.515

Asian Pac J Cancer Prev. 2025 Feb 1;26(2):505-513. doi: 10.31557/APJCP.2025.26.2.505.

ABSTRACT

OBJECTIVE: Breast cancer is the most common cancer among women, however the majority of them visit hospitals at the advanced stage. Knowledge of the pathway of care will aid in timely intervention and better prognosis.

METHODS AND ANALYSIS: A mixed method cross-sectional study was conducted at AIIMS Patna among breast cancer patients. A total of 171 breast cancer patients were enrolled in this study. Piloted study tools were used. Descriptive analysis for quantitative part and manual thematic analysis for the qualitative part were performed.

RESULTS: Out of total 171 participants, the majority 88.9% (83.3-92.77%) had visited AIIMS Patna indirectly. About 60(20.6%) visited informal providers/quacks and 60(39.5%) of the study participants visited more than one hospital before arriving at AIIMS Patna. The place of residence, treatment delay, and stage of cancer were found to be the independent predictor for the pathway of healthcare for breast cancer. The reasons behind seeking delayed definitive care were identified under two major themes: presentation delay (Misunderstanding/difficulty in identifying symptoms, neglect of disease, lack of awareness about the disease, family support, financial constraints) and treatment delay (misdiagnosis, multiple referrals, dissatisfaction with the treatment, COVID-19 lockdown, informal providers/quacks).

CONCLUSION: 9 out of 10 breast cancer patients had not come directly for definitive care and among them, 3 out of 5 had visited multiple healthcare providers. So, it is important to educate the public on breast cancer, make systematized referral pathways, to orient private sectors, and to have trained manpower for screening purposes.

PMID:40022695 | DOI:10.31557/APJCP.2025.26.2.505

Asian Pac J Cancer Prev. 2025 Feb 1;26(2):489-495. doi: 10.31557/APJCP.2025.26.2.489.

ABSTRACT

OBJECTIVE: This study strives to look for the knowledge, attitudes, and practices of areca nut use among health care workers in a tertiary hospital in North-East India.

METHODS: A prospective, cross-sectional, questionnaire-based study was conducted among all health care and allied workers at a public sector teaching hospital in Meghalaya, Northeast India. A questionnaire, which was validated for content, was administered to the target population. Three domains of learned behavior towards areca nut viz. knowledge (cognitive), attitude (affective) and practice (psychomotor) were assessed. Data was analyzed using SPSS V21.0. Descriptive statistics were used.

RESULT: A total of 434 participants completed the questionnaire. Majority of the respondents [52.8% (229)] had consumed Kwai (Areca nut) in the past 12 months. Kwai was perceived to have beneficial effects by 17.9% (78) of respondents. A total of 76.3% (331), 72.8% (316) and 62.2% (210) of respondents thought that Kwai consumption caused throat, oral and esophageal cancers respectively.48.0% (110) of the respondents swallowed the kwai juice in contrast to 32.4% (69) who spit the kwai juice. 61.6% (141) Kwai chewers tried quitting, out of which 41.8% (59) managed to stay away from Kwai for more than a year but eventually ended consuming Kwai again.62.4% (143) of the respondents claimed that the children in their family/neighbor consumed Kwai.

CONCLUSION: Among our study population, the knowledge about harmful effects of areca nut is good. However, this knowledge has not translated into change in practices.

PMID:40022693 | DOI:10.31557/APJCP.2025.26.2.489

Asian Pac J Cancer Prev. 2025 Feb 1;26(2):435-441. doi: 10.31557/APJCP.2025.26.2.435.

ABSTRACT

BACKGROUND: Liver cancer is one of the leading causes of cancer-related death in Peru, and some reports have indicated an increase in mortality rates among the largest cities. To our knowledge, no study has been carried out at a national level or by geographic area in recent years. Thus, our objective was to examine overall, regional and sex-specific liver cancer mortality rates in Peru between 2003-2017.

METHODS: We retrieved data on liver cancer deaths between 2003 and 2017 from the mortality database of the Peruvian Ministry of Health. Age-standardized mortality rates (ASMR) were estimated per 100,000 person-years using the world standard SEGI population. We analyzed mortality trends using Joinpoint regression Program Version 4.7.0. To examine the spatial distribution of the mortality rates, we used GeoDa software.

RESULTS: Between 2003 and 2017, 31,473 deaths from liver cancer were reported in Peru. Overall, liver cancer mortality rates have decreased significantly among Peruvian women since 2005 (-3.1% annually) with decreases in the coastal and highland regions ranging from 2.8% to 3.5%. In Arequipa, Cusco, La Libertad, Lima, and Moquegua, rates decreased bewteen 2003 and 2017. Among men in Ancash a significant increase (+12.5 annually) was observed from 2003-2011, followed by a sharpdecline (-10.5 annually) between 2011 and 2017. In contrast, rates in Cajamarca, Junin, and Ucayali decreased between 2003 and 2017.

CONCLUSIONS: Although decreases in liver cancer mortality rates were observed in some regions of Peru, these trends were not statistically significant. In addition, some provinces experienced increases in rates. Effective interventions, such as expanding access to healthcare and controlling the various risk factors for liver cancer, remains a key challenge for the country.

PMID:40022687 | DOI:10.31557/APJCP.2025.26.2.435

Asian Pac J Cancer Prev. 2025 Feb 1;26(2):405-410. doi: 10.31557/APJCP.2025.26.2.405.

ABSTRACT

BACKGROUND: Diffuse large B-cell lymphoma (DLBCL) is classified into germinal center B-cell-like (GCB) and non-GCB subtypes. This study aimed to evaluate the immunohistochemical expression of CTLA-4 in these subtypes and its association with prognostic factors.

METHODS: This retrospective study analyzed 50 cases of DLBCL. Clinical and histopathological data were collected, and CTLA-4 expression was assessed using immunohistochemistry. Statistical significance was determined using an unpaired t-test.

RESULT: The average CTLA-4 expression in DLBCL was 50.46 cells per high-power field. Higher CTLA-4 expression was observed in the non-GCB subtype, patients younger than 60 years, females, those with stage III-IV disease, involvement of more than one extranodal site, and a low International Prognostic Index (IPI) score (0-2). A significant association was found between CTLA-4 expression and age (p = 0.045, 95% CI: 44.67-75.86).

CONCLUSION: CTLA-4 expression was present in the tumor microenvironment of DLBCL. Higher expression was significantly associated with patients younger than 60 years.

PMID:40022684 | DOI:10.31557/APJCP.2025.26.2.405

Asian Pac J Cancer Prev. 2025 Feb 1;26(2):391-398. doi: 10.31557/APJCP.2025.26.2.391.

ABSTRACT

BACKGROUND: Gastrointestinal cancer (GI) is one of the most common cancer worldwide rapidly increasing in India too. Cytochrome P450 (CYP) family comprise a group of phase I metabolizing enzymes which are important in xenobiotics and carcinogen metabolism. Several studies revealed the association of metabolic genes with risk of cancers, but the results were ambiguous to support the evidences in case of GI cancer risk. These differences in earlier studies directed us to review the association of polymorphisms of metabolic genes including CYP17 and CYP2C19 (CYP2C19*2, CYP2C19*3) with GI cancer susceptibility in rural population of Maharashtra.

METHODS: Genetic polymorphism of CYP17 and CYP2C19 (CYP2C19*2, CYP2C19*3) genes among two hundred histologically confirmed gastrointestinal cancer cases and equal number of age and sex matched controls was studied by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. The Odds ratio (OR) with 95% confidence interval and p-value were evaluated to get the level of association of polymorphisms with risk of GI cancer, where p ≤0.05 was considered as statistically significant.

RESULTS: After the regression analysis the results of genetic polymorphisms of CYP17 and CYP2C19 showed significant deviation from Hardy-Weinberg equilibrium for variant genotype of CYP2C19*2 (rs4244285) (OR=3.37 95% CI: 1.74-6.53; p=0.0003) which indicated functional association of CYP2C19*2 with GI cancer risk in the studied population. Similarly when we studied the association of CYP2C19*3 and CYP17 polymorphism, the variant genotypes did not show association with development of GI cancer among rural population of south-western Maharashtra.

CONCLUSION: The findings obtained from this study signified evident association of rs4244285 SNP of CYP2C19*2 with GI cancer risk in the studied rural population.

PMID:40022682 | DOI:10.31557/APJCP.2025.26.2.391