Tag: pubmed

Asian Pac J Cancer Prev. 2026 Apr 1;27(4):1313-1321. doi: 10.31557/APJCP.2026.27.4.1313.

ABSTRACT

BACKGROUND: The association between green tea consumption and the risk of liver cancer has been reported inconsistently. This study aimed to investigate this association in a large, prospective cohort study of Japanese adults. Methods: The Japan Collaborative Cohort (JACC) Study included 41,999 participants (18,205 men and 23794 women) aged 40-79 years, free from liver cancer at baseline between 1988 and 1990. Validated self-administered questionnaires were used to assess individual socio-demographics, medical history, and lifestyles. Participants were then followed for liver cancer incidence until the end of 2009. Cox proportional hazard models were utilized to calculate hazard ratios (HRs) with 95% confidence intervals (95% CIs) of liver cancer based on the frequency of green tea consumption of <1 cup (reference), 2-4, 5-6, and ≥7 cups/day, after adjusting for potential confounding factors, including age, sex, study area, education, histories of diabetes, liver diseases, and gallbladder disease, body mass index, drinking status, smoking status, coffee consumption, sports participation, and walking. Major confounders, including coffee consumption, drinking status, and a history of liver disease, were further stratified in the analysis. Population-attributable fractions (PAFs) of liver cancer was also calculated based on green tea consumption.

RESULTS: Green tea consumption was associated with a trend of lower risk of liver cancer with the multivariable HR (95% CI) of 0.87 (0.61-1.23) for 2-4 cups/day, 0.87 (0.61-1.25) for 5-6 cups/day, and 0.61 (0.40-0.95) for ≥7 cups/day, compared to <1 cup/day (p for trend= 0.029). The inverse association was statistically significant for men, people without a history of liver diseases other than cancer, and current drinkers. The multivariable PAF (95%CI) for ≥7 cups/day was 7.1% (0.9-11.4).

CONCLUSION: Green tea consumption was associated with a lower risk of liver cancer in Japanese adults in a dose-response manner, ranging from <1 cup/day to ≥7 cups/day.

PMID:41945949 | DOI:10.31557/APJCP.2026.27.4.1313

Asian Pac J Cancer Prev. 2026 Apr 1;27(4):1287-1294. doi: 10.31557/APJCP.2026.27.4.1287.

ABSTRACT

OBJECTIVE: To evaluate the levels of knowledge, attitudes, and practices (KAP) regarding cancer among patients and their caregivers, and to determine how these factors influence health-seeking behavior and early detection practices. Additionally, the study aimed to identify key gaps and barriers that may hinder effective cancer prevention and timely treatment.

METHODS: A cross-sectional study was conducted with 140 participants, using a structured, pretested questionnaire. KAP scores were analyzed using descriptive statistics, t-tests, and regression analysis to determine the predictors of health behaviors. Correlation analysis was used to assess the interrelationships among KAP components.

RESULT: Moderate levels of knowledge (mean score: 62.2 ± 9.7) and attitudes (71.1 ± 8.0) were observed, with notable gaps in awareness of risk factors and early detection methods. Practice scores (82.6 ± 9.5) were influenced by both attitude and knowledge levels, with knowledge showing the strongest correlation with practice (r = 0.51, p < 0.001). Regression analysis identified education level (β = 0.33, p < 0.001) and economic status (β = 0.23, p = 0.03) as significant predictors of KAP scores.

CONCLUSION: Knowledge and attitudes are key determinants of cancer-related health behaviors. Enhancing awareness and fostering positive attitudes through targeted educational interventions can improve early detection, treatment adherence, and preventive practices. Strengthening public health initiatives, addressing stigma, and improving access to healthcare are critical for optimizing cancer outcomes and promoting sustainable behavioral change.

PMID:41945946 | DOI:10.31557/APJCP.2026.27.4.1287

Asian Pac J Cancer Prev. 2026 Apr 1;27(4):1277-1286. doi: 10.31557/APJCP.2026.27.4.1277.

ABSTRACT

OBJECTIVE: Chronic inflammation and oxidative stress play important roles in breast cancer progression. Cyclooxygenase-2 (COX-2) is a major proinflammatory enzyme that is often overexpressed in tumor cells. Eleutherine bulbosa (Dayak onion) is a traditional Indonesian medicinal plant with antioxidant and anti-inflammatory properties. This study aimed to evaluate the effect of a combination of ethanol extract of E. bulbosa and tamoxifen on COX-2 levels in a 7,12-dimethylbenz[a]anthracene (DMBA)-induced BALB/c mouse model.

METHODS: A total of thirty-six 8-10-week-old female BALB/c mice were randomly divided into six groups: a negative control, a positive control (DMBA alone), and four treatment groups that received E. bulbosa extract (180 mg/kg BW), tamoxifen (10 mg/kg BW), or their combination for 14 days. COX-2 levels were measured using an enzyme-linked immunosorbent assay (ELISA). Statistical analysis included the Shapiro-Wilk test (normality), Levene’s test (homogeneity), Brown-Forsythe test, and Games-Howell post hoc test.

RESULT: All treatment groups showed a decrease in COX-2 levels compared to the positive control. The combination group (tamoxifen + E. bulbosa) exhibited the lowest COX-2 levels (3.86 ng/mL), close to the value observed in the negative control group (3.07 ng/mL), indicating a synergistic effect between the two agents.

CONCLUSION: The combination of tamoxifen and E. bulbosa ethanol extract significantly reduced COX-2 levels in DMBA-induced breast cancer models. These results suggest the potential of this combination as an effective adjuvant therapy. Further studies are needed to confirm the underlying molecular mechanisms and to evaluate its toxicity profile.

PMID:41945945 | DOI:10.31557/APJCP.2026.27.4.1277

Asian Pac J Cancer Prev. 2026 Apr 1;27(4):1239-1248. doi: 10.31557/APJCP.2026.27.4.1239.

ABSTRACT

BACKGROUND: Acute myeloid leukemia (AML) is a genetically heterogeneous malignancy. However, the immune microenvironment-including immune checkpoint pathways and metabolic regulators also plays a pivotal role in disease progression.

AIMS: To investigate the immune-metabolic landscape of newly diagnosed AML patients, focusing on the PDL1-PD1 and IDO-Kynurenine-AhR pathways, and their association with vitamin D levels.

SETTING: A prospective, observational study conducted at a tertiary care academic hospital.

MATERIALS: A total of 127 newly diagnosed AML patients were enrolled. Flow cytometry was used to assess PD-L1 expression on blasts and immune T cell subsets. Serum levels of tryptophan, kynurenine, and vitamin D were measured using enzyme-linked Immunosorbent Assay (ELISA) and Chemiluminescent Immunoassay (CLIA).

STATISTICS: Correlation analysis and chi-square test/Mann-Whitney U test were applied. A p-value <0.05 was considered significant.

RESULTS: PDL1 expression on blasts inversely correlated with CD8+ T cells (p=0.044), indicating immune evasion. CD3+ positively correlated with CD8+ T cells (p=0.007), while CD4+ negatively correlated with CD8+ T cells (p<0.001), suggesting divergent immune roles. Elevated tryptophan/kynurenine correlated with increased PD1+CD4+ T cells (p=0.039), which in turn were associated with higher Treg frequencies (p=0.001). Low vitamin D levels were associated with higher odds of aTregs (OR 2.7; 95% CI 1-7).

CONCLUSIONS: An immunosuppressive microenvironment in AML is driven by PD-L1 expression, kynurenine pathway activation, and low vitamin D levels. These findings suggest potential immunotherapeutic targets and highlight vitamin D’s immunomodulatory role.

PMID:41945941 | DOI:10.31557/APJCP.2026.27.4.1239

Asian Pac J Cancer Prev. 2026 Apr 1;27(4):1219-1230. doi: 10.31557/APJCP.2026.27.4.1219.

ABSTRACT

BACKGROUND: The present study was planned to examine the possible association of polymorphisms in the superoxide dismutase and catalase genes with adverse normal tissue effects or injury resulting from radiotherapy in HNC patients.

METHODS: A total of two hundred and fifty head and neck cancer (HNC) patients undergoing therapeutic radiotherapy were enrolled in this study, wherein acute radiation induced toxicity and treatment response were systematically documented. The investigation aimed to assess the potential association between oxidative stress-related gene polymorphisms and susceptibility to acute skin toxicity. Specifically, single nucleotide polymorphisms (SNPs) in SOD1 (A251G, rs2070424), SOD2 (C299T, rs1141718), SOD3 (G172A, rs2536512), and two SNPs in the CAT gene (A21T, rs7943316; C262T, rs1001179) were genotyped using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) methodology.

RESULTS: The findings revealed a statistically significant negative association between both the combined variant genotype and the heterozygous SOD3 G172A genotype and the risk of acute radiation-induced skin toxicity, suggesting a potential protective effect (OR = 0.48, 95% CI: 0.26-0.88; p = 0.018). In contrast, the homozygous recessive SOD3 172A/A genotype demonstrated a strong positive correlation with the incidence of oral mucositis in HNC patients, exhibiting a markedly elevated risk (OR = 10.47, 95% CI: 4.48-24.44; p < 0.0001). Additionally, individuals carrying the heterozygous 172G/A genotype showed a 2.25-fold increased susceptibility to severe mucositis (OR = 2.25, 95% CI: 1.21-4.17; p = 0.009). Furthermore, the heterozygous A21T genotype of the CAT gene (rs7943316) was significantly associated with an increased risk of oral mucositis following radiotherapy in HNC patients (OR = 1.79, 95% CI: 1.00-3.22; p = 0.049).

CONCLUSION: The analysis of genetic polymorphisms in extracellular superoxide dismutase (SOD3) revealed a statistically significant association with radiation-induced skin toxicity and mucositis among HNC patients in the studied population.

PMID:41945939 | DOI:10.31557/APJCP.2026.27.4.1219

Asian Pac J Cancer Prev. 2026 Apr 1;27(4):1211-1217. doi: 10.31557/APJCP.2026.27.4.1211.

ABSTRACT

BACKGROUND: Cervical cancer is a leading cause of cancer-related morbidity and mortality among women in Thailand. Despite the availability of national cervical cancer screening programs, participation rates remain low in Northern Thailand due to barriers such as limited accessibility and discomfort with clinical sample collection. Self-collected HPV DNA testing offers a promising alternative to traditional screening methods by addressing these barriers and improving access to care.

OBJECTIVE: Cervical cancer is a major health burden in Thailand, yet participation in national screening programs remains low, particularly in Northern Thailand. This study evaluated satisfaction with self-collected HPV DNA testing and examined factors influencing screening acceptance to inform strategies for increasing uptake.

METHODS: A cross-sectional study was conducted among 299 women aged 30-60 years attending the national cervical cancer screening program at Maharaj Nakorn Chiang Mai Hospital. Participants performed self-collection following a demonstration and completed a five-point Likert scale satisfaction survey. Descriptive statistics and logistic regression were used to assess satisfaction and identify predictors of screening intention.

RESULTS: Most participants (85.95%) strongly agreed that self-collected HPV DNA testing improved screening accessibility, and 100% found the process easy to follow. Mean satisfaction scores were high for accessibility (4.85/5), effectiveness (4.82/5), and reliability (4.81/5). No invalid samples were reported, and beta-globin Ct values confirmed high-quality sample collection (mean Ct = 29.00 ± 1.70). Education level significantly influenced screening intention (OR = 17.61, p = 0.039).

CONCLUSION: Self-collected HPV DNA testing was highly satisfactory and could enhance national screening programs, especially in underserved populations.

PMID:41945938 | DOI:10.31557/APJCP.2026.27.4.1211

Asian Pac J Cancer Prev. 2026 Apr 1;27(4):1161-1170. doi: 10.31557/APJCP.2026.27.4.1161.

ABSTRACT

OBJECTIVE: This meta-analysis aims to evaluate the diagnostic efficacy of [68Ga]Ga-FAPI PET imaging in breast, ovarian, and cervical cancers by conducting a systematic review of the existing literature.

METHODS: A systematic review of PubMed, Web of Science, Scopus, and Google Scholar databases, following by a meta-analysis of the included studies, was performed using a random-effects statistical model.

RESULT: Ten eligible studies that described the effectiveness of [⁶⁸Ga]Ga-FAPI PET imaging in breast, ovarian, and cervical cancers were included in this review. The total number of participants was 253 females. Aggregated data from nine studies indicate a remarkably high diagnostic odds ratio (DOR) of 48.69 (95% CI: [16.94-139.96]) for detecting primary tumors, and a DOR of 207.50 (95% CI: [46.18-932.34]) from seven studies for detecting lymph node metastasis. [⁶⁸Ga]Ga-FAPI PET demonstrated high diagnostic accuracy in identifying both primary lesions and metastatic lymph nodes in breast, ovarian, and cervical cancers.

CONCLUSION: [68Ga]Ga-FAPI PET imaging could function as a supplementary technique to [18F]F-FDG PET imaging modalities, offering a more comprehensive evaluation for cancer staging, assessment of treatment response, and guidance in radiation therapy planning.

PMID:41945933 | DOI:10.31557/APJCP.2026.27.4.1161

Arch Cardiol Mex. 2026 Apr 7. doi: 10.24875/ACM.25000234. Online ahead of print.

ABSTRACT

BACKGROUND: Venovenous extracorporeal membrane oxygenation (VV ECMO) is a fundamental strategy in the management of refractory respiratory failure. In this context, the National Institute of Cardiology Ignacio Chávez (INCICh) has implemented VV ECMO within its cardiovascular intensive care unit (CICU).

OBJECTIVE: To describe the experience and clinical outcomes of VV ECMO use in patients with severe respiratory failure in a Latin American cardiovascular center.

METHOD: A retrospective observational study was conducted including patients who received VV-ECMO support at INCICh. Demographic, clinical, and hemodynamic variables, cannulation type, duration of support, complications, and hospital outcomes were analyzed. The primary outcome was in-hospital mortality. Data were analyzed using nonparametric tests and Kaplan-Meier survival curves.

RESULTS: Twenty patients were included, with a median age of 41.5 years (IQR: 23-59) and a predominance of males (80%). The main indication was respiratory failure due to SARS-CoV-2 infection (55%). In-hospital survival was 70%, higher than that reported in international series. Comorbidities and anthropometric variables were not associated with mortality. Non-survivors had longer stays in the CICU, mechanical ventilation, and ECMO support, though without statistical significance. Acute kidney injury was the most frequent complication, with no direct impact on mortality.

CONCLUSIONS: VV-ECMO therapy at INCICh demonstrated lower mortality compared with other series, underscoring the importance of specialized teams and established protocols to optimize outcomes in patients with refractory respiratory failure.

PMID:41945927 | DOI:10.24875/ACM.25000234

J Med Internet Res. 2026 Apr 7;28:e82564. doi: 10.2196/82564.

ABSTRACT

BACKGROUND: Autism spectrum disorder (ASD) is often underdiagnosed in low- and middle-income countries due to limited specialist access, sociocultural stigma, and fragmented screening systems. Artificial intelligence (AI)-powered screening tools may improve early detection by enabling low-cost, accessible assessments. However, adoption depends on stakeholder trust, ethical safeguards, and alignment with local health system capacities.

OBJECTIVE: This study explored the feasibility, acceptability, and perceived ethical and practical enablers and barriers to implementing AI-powered tools for early ASD screening in Egypt, with attention to urban-rural disparities and integration into existing care pathways.

METHODS: We used a qualitative design with semistructured focus group discussions with 49 participants (21 parents of children with ASD and 28 health care professionals) recruited from urban and rural governorates. Discussions were audio-recorded, transcribed verbatim, and analyzed using Braun and Clarke’s reflexive thematic analysis, supported by NVivo software (Lumivero). Methodological integrity was ensured through reflexivity, triangulation, and peer debriefing. Thematic saturation was monitored across groups, and participant diversity was prioritized across contexts.

RESULTS: Five themes emerged: (1) AI as a supportive tool rather than a replacement for clinicians, emphasizing scalability and assistance for nonspecialists; (2) the need for cultural and contextual adaptation to ensure local relevance; (3) privacy, trust, and transparency concerns, including data security, consent, and algorithmic opacity; (4) reducing diagnostic inequities by addressing urban-rural disparities and strengthening community-based deployment; and (5) the preference for hybrid AI-human models, with conditions for adoption including cultural sensitivity, human oversight, and digital literacy support. Counts (n/N) of parents and health care professionals contributing to each theme were used descriptively as indicators of pattern salience rather than as statistical estimates of prevalence. Participants expressed cautious optimism, with parents emphasizing accessibility and speed, while health care professionals highlighted concerns about reliability, cultural adaptation, and data governance.

CONCLUSIONS: AI-powered ASD screening has potential to advance equitable early detection in underserved areas. Adoption requires transparent data governance, integration into hybrid human-AI models, culturally adaptive design, and targeted digital literacy initiatives. These findings provide an evidence-based roadmap for policymakers, technologists, and health system leaders to implement AI screening tools that are ethically sound, contextually relevant, and equity-focused.

PMID:41945920 | DOI:10.2196/82564

Acta Med Port. 2026 Feb 27;39(4):287-290. doi: 10.20344/amp.23956. Epub 2026 Apr 1.

ABSTRACT

Adolescents with severe suicide attempts requiring intensive care represent a major public health challenge, with high morbidity and resource utilization. This retrospective study reviewed all cases of young people aged 10 to 18 years admitted to a pediatric intensive care unit between 2014 and 2024 following a suicide attempt. Eighteen cases were identified, predominantly female patients (72%) with a median age of 15.5 years. The most common methods were drug overdose (56%) and major trauma due to jumping from heights (39%). Most patients required invasive mechanical ventilation (89%), with a mean pediatric intensive care unit stay of 5.6 days and a total hospital stay of 29 days, markedly longer in trauma cases. No deaths occurred, but three patients developed severe sequelae. Family conflict, gender/sexuality concerns and school-related problems were frequent precipitating factors; only one patient had a previously recorded suicide attempt. Following discharge, 89% were referred for psychiatric follow-up, with post-discharge diagnoses of depression, anxiety, personality disorder and substance abuse. These findings highlight the need for systematic suicide risk screening in primary care and emergency settings, community- and family-based interventions, and structured post-discharge protocols to prevent recurrence and reduce long-term complications.

PMID:41945913 | DOI:10.20344/amp.23956