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    ABSTRACT: The current incidence of cancer in the world is 14 million cases in 2012, with a mortality rate of 8.2 million in that year. The incidence of cancer in Spain exceeds 215,000 cases a year, and survival rates are the highest when compared to those of our neighbouring countries. Among the reasons for the steady decrease in cancer mortality rates in Spain, two causes must be highlighted: the increasing efficacy of treatment and prevention measures. It is important evaluate the opportunity of early detection and prevention in these tumors.
    Clinical and Translational Oncology 10/2014; 16(12). DOI:10.1007/s12094-014-1215-5 · 1.60 Impact Factor
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    ABSTRACT: Background: Breast cancer risk prediction models are widely used in clinical practice. They should be useful in identifying high risk women for screening in limited-resource countries. However, previous models showed poor performance in derived and validated settings. Therefore, we aimed to develop and validate a breast cancer risk prediction model for Thai women. Materials and Methods: This cross-sectional study consisted of derived and validation phases. Data collected at Ramathibodi and other two hospitals were used for deriving and externally validating models, respectively. Multiple logistic regression was applied to construct the model. Calibration and discrimination performances were assessed using the observed/expected ratio and concordance statistic (C-statistic), respectively. A bootstrap with 200 repetitions was applied for internal validation. Results: Age, menopausal status, body mass index, and use of oral contraceptives were significantly associated with breast cancer and were included in the model. Observed/expected ratio and C-statistic were 1.00 (95% CI: 0.82, 1.21) and 0.651 (95% CI: 0.595, 0.707), respectively. Internal validation showed good performance with a bias of 0.010 (95% CI: 0.002, 0.018) and C-statistic of 0.646(95% CI: 0.642, 0.650). The observed/expected ratio and C-statistic from external validation were 0.97 (95% CI: 0.68, 1.35) and 0.609 (95% CI: 0.511, 0.706), respectively. Risk scores were created and was stratified as low (0-0.86), low-intermediate (0.87-1.14), intermediate-high (1.15-1.52), and high-risk (1.53-3.40) groups. Conclusions: A Thai breast cancer risk prediction model was created with good calibration and fair discrimination performance. Risk stratification should aid to prioritize high risk women to receive an organized breast cancer screening program in Thailand and other limited-resource countries.
    Asian Pacific journal of cancer prevention: APJCP 08/2014; 15(16):6811-7. DOI:10.7314/APJCP.2014.15.16.6811 · 1.50 Impact Factor
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    ABSTRACT: Background Self-report may not be an accurate method of determining cervical, breast and colorectal cancer screening rates due to recall, acquiescence and social desirability biases, particularly for certain sociodemographic groups. Therefore, the aims of this study were to determine the validity of self-report of cancer screening in Ontario, Canada, both for people in the general population and for socially disadvantaged groups based on immigrant status, ethnicity, education, income, language ability, self-rated health, employment status, age category (for cervical cancer screening), and gender (for fecal occult blood testing).Methods We linked multiple data sources for this study, including the Canadian Community Health Survey and provincial-level health databases. Using administrative data as our gold standard, we calculated validity measures for self-report (i.e. sensitivity, specificity, positive and negative likelihood ratios, positive and negative predictive values), calculated report-to-record ratios, and conducted a multivariable regression analysis to determine which characteristics were independently associated with over-reporting of screening.ResultsSpecificity was less than 70% overall and for all subgroups for cervical and breast cancer screening, and sensitivity was lower than 80% overall and for all subgroups for fecal occult blood testing FOBT. Report-to-record ratios were persistently significantly greater than 1 across all cancer screening types, highest for the FOBT group: 1.246 [1.189-1.306]. Regression analyses showed no consistent patterns, but sociodemographic characteristics were associated with over-reporting for each screening type.Conclusions We have found that in Ontario, as in other jurisdictions, there is a pervasive tendency for people to over-report their cancer screening histories. Sociodemographic status also appears to influence over-reporting. Public health practitioners and policymakers need to be aware of the limitations of self-report and adjust their methods and interpretations accordingly.
    BMC Public Health 01/2015; 15(1):28. DOI:10.1186/s12889-015-1441-y · 2.32 Impact Factor

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