암줄기세포 : 근원적인 암치료를 새로운 타겟

허정훈,김영호 고신대학교(의대) 고신대학교 의과대학 학술지 2009 고신대학교 의과대학 학술지 Vol.24 No.1

Typical cancer treatments including chemotherapy and radiation therapy has a limitation to eradiate cancer cells completely, which results in recurrence of cancer after treatment. Cancers have been known as morphologically and functionally heterogeneous population of cells. While majority of cells are the differentiated cancer cells that have limited proliferation, minority of cells, termed cancer stem cells have the ability to self-renew and to initiate cancer. Cancer stem cells express drug transporters and DNA repair systems, which allow a cancer stem cells to resist against chemotherapy or radiation therapy. To eradiate cancer completely, therefore, cancer stem cells rather than mature cancer cells should be targeted. This review describes the general concept and specific property of cancer stem cells and suggests novel strategies for cancer stem cell treatment.

도농복합지역 여성의 암검진 수검 및 유소견자 검진 실태

황태윤,강복수,이경수,황인섭 한국모자보건학회 2008 한국모자보건학회지 Vol.12 No.1

Objectives: The specific objectives of this study was to identify the longitudinal change of the screening rates according to type of cancer, whether follow up examination had been conducted to those subjects had abnormal findings after cancer screening, and association between the cancer screening experiences and general characteristics and health behaviors of the subjects. Methods: For this study, 353 female respondents in four Dongs (urban areas) and five Ub/Myeons (rural areas) of Gyeongju city, Gyeongsangbuk-do province were selected using stratified random cluster sampling and administered questionnaire. This study was conducted from December 2005 to February 2006. The sample for this study is composed of 332 females, and interviews with 299 females was completed. Subjects were asked about their general characteristics, health behaviors, experiences of cancer screening, results of cancer screening, whether participated the follow up examination after abnormal findings on the cancer screening, and the reasons to participate in cancer screening for both those participated and those not participated cancer screening on the survey. Study subjects in stomach cancer screening were asked about their experiences of gastroscopy and upper GI examination. Participants in the breast, and colorectal cancer screening were asked about their experiences of mammogram, colonoscopy and double contrast barium enema examination, respectively. For the assessment, we used the recommended guidelines of cancer screening in order to judge how the subjects observed the standard. Recommended guidelines, which we used, of cancer screening for the stomach and breast is doing examination every two years, for the FOBT is every year, for the colonoscopy and double contrast barium enema examination is every five years. The analysis was conducted using SPSS version 12.0. And chi -square test, and Fisher's exact test were used for statistical test. Results: Utilizing recommended guidelines, the participation rates for the stomach, breast, and colorectal cancer screening were 29.4%, 24.4%, 17.5%, respectively and for the fecal occult blood test (FOBT) was 9.2%. And followings are the cancer screening rates in the past five years. Screening rate for stomach cancer is 38.8%, for breast cancer 30.8%, for colorectal cancer 17.5% and for FOBT is 9.2%. The most prominent motive for those participated the cancer screening was "Had a chance for cancer screening", which consists the reason for stomach cancer screening 80.4%, for breast cancer: 88.7%, for colonoscopy: 87.5%, for FOBT was 93.0%. Subjects who responded never had experienced cancer screening had the reasons of "Not having any health problem" the most frequently. Age is the only statistically significant factor association with cancer screening rates. Other general characteristics and health behavior were not associated with cancer screening rates. Conclusions: This study suggests the need for education and public campaigns, particularly targeting on forties and seventies, of age to raise the cancer screening rates and follow up examination rates after abnormal screening results.

한국 보훈대상자의 암발생률

박운제 ( Un Je Park ),박소희 ( So Hee Park ) 한국보건정보통계학회(구 한국보건통계학회) 2018 보건정보통계학회지 Vol.43 No.2

목적: 한국의 초고령화 사회로의 진입이 가속화됨에 따라 고령자가 많은 국가 보훈대상자의 진료 및 치료를 담당하는 보훈병원 내의 암 환자 수가 더욱 증가할 것으로 예상되어 우리나라 보훈대상자의 암 발생률을 파악하고자 한다. 방법: 전국 5개의 보훈병원에서 2013년 1월 1일부터 2016년 6월 30일까지의 자료를 바탕으로 2013년도 초진 암발생 환자의 의무기록 자료를 조사하였다. 보훈대상자 암환자의 인구사회학적 특성, 임상적 특성을 규명하고 조발생률 및 연령표준화 발생률을 구하였다. 결과: 2013년 우리나라 보훈대상자 672,532명 중에서 초진 암환자는 2,070명으로 전체 보훈대상자 중 0.3%를 차지하였으며, 보훈대상자 유형별로는 베트남참전유공자가 가장 많았다. 호발 암 원발 부위별로는 전립샘암이 가장 많았고, 다음은 위암, 폐암, 대장·직장암, 간암 순으로 발생하였다. 보훈대상자의 암 발생률에서 조발생률은 307.8명이었으며, 전립샘암이 59.2명으로 가장 많았고, 위암 51.0명, 폐암 50.6명, 대장·직장암 48.2명, 간암이 22.9명으로 뒤를 이었으며, 연령표준화 발생률은 인구 10만 명당 51.1명, 위암 8.9명, 전립샘암 8.8명이었다. 결론: 2013년 보훈대상자 초진 암환자는 2,070명으로 그 중 60세 이상이 97.9%로서 우리나라 일반국민 암환자 60세 이상의 52.8%보다 암 발생률이 약 1.8배 높았다. 이와 같이 우리나라 전체 국민보다 고령 인구의 비율이 훨씬 높은 보훈대상자들의 특성을 고려했을 때 보훈대상자들의 향후 암 발생률이 지속적으로 증가할 것으로 예상한다. Objectives: The purpose of this study is to understand the rate of cancer incidence in veterans hospitals, which is in charge of care and treatment of Korean veterans, as Korea is accelerating its entry into the aging society. Methods: Cancer incidence data from January 1st 2013 to June 30th 2016 were obtained from Veterans hospitals in 5 different regions, nationwide. The incidence was defined by the number of cancer patients diagnosed in 2013. We investigated the sociodemographic and clinical characteristics of subjects. CR rates and ASR were calculated. Results: In 2013, 2,070 Korea veterans out of 672,532 were newly diagnosed with cancer which was 0.3% of the total. Vietnam War veterans showed the highest rate of cancer incidence. Prostate cancer was the most commonly diagnosed cancer and followed by stomach, lung, colorectal and liver cancer. The total CR for overall cancer incidence of veterans was 307.8 and the CR for prostate cancer was the highest (59.2) followed by stomach (51.0), lung (50.6), colorectal (48.2), and liver (22.9). Furthermore, the total ASR rates were 51.1 followed by lung (8.9), prostate cancer (8.8). Conclusions: In 2013, there were 2,070 veterans who were newly diagnosed cancer and over 97.9% of them were over the age of 60. Compared to IR for overall cancer incidence of the non-veteran Koreans (52.8%), the rate of IR of veterans (97.9%) were 1.8 times higher. Like that, at considering the characteristic of war veterans that elderly population rate is much higher comparing to the whole population in Korea, it is expected that the cancer incidence of war veterans will be continually increased.

Impact of Prior Cancer History on the Clinical Outcomes in Advanced Breast Cancer: A Propensity Score–Adjusted, Population-Based Study

Caijin Lin,Jiayi Wu,Shuning Ding,Chihwan Goh,Lisa Andriani,Kunwei Shen,Li Zhu 대한암학회 2020 Cancer Research and Treatment Vol.52 No.2

Purpose Despite the rapid growing of cancer survivors, prior cancer history is a commonly adopted exclusion criterion. Whether prior cancer will impact the survival of patients with advanced breast cancer (ABC) remains uncertain. Materials and Methods Patients with ABC diagnosed between 2004 and 2010 were identified using Surveillance, Epidemiology, and End Results (SEER) database. Timing, stage, and type were used to characterize prior cancer. Multivariable analyses using propensity score–adjusted Cox regression and competing risk regression were conducted to evaluate the prognostic effect of prior cancer on overall survival (OS) and breast cancer-specific survival (BCSS). Results A total of 14,176 ABC patients were identified, of whom 10.5% carried a prior cancer history. The most common type of prior cancer was female genital cancer (32.4%); more than half (51.7%) were diagnosed at localized stage; most were diagnosed more than 5 years (42.9%) or less than 1 year (28.3%) prior to the index cancer. In multivariate analyses, patients with prior cancer presented a slightly worse OS (hazard ratio, 1.18; 95% confidence interval [CI], 1.07 to 1.30; p=0.001) but a better BCSS (subdistribution hazard ratio, 0.64; 95% CI, 0.56 to 0.74; p < 0.001). In subset analyses, no survival detriment was observed in patients with prior malignancy from head and neck or endocrine system, at in situ or localized stage, or diagnosed more than 4 years. Conclusion Prior cancer provides an inferior OS but a superior BCSS for patients with ABC. It does not affect the survival adversely in some subgroups and these patients should not be excluded from clinical trials.

Risk of Cancer with Combined Oral Contraceptive Use among Iranian Women

Vaisy, Afasaneh,Lotfinejad, Shirin,Zhian, Faegh Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.14

Oral contraceptive use is the most common type of contraception. More than 300 million women worldwide take oral contraceptives every day. However, there is a concern about the relationship with the incidence of cancer. This analytical retrospective study aimed to investigate the relationship between the incidence of cervical and breast cancers and oral contraceptive use in 128 Iranian patients with cervical cancer, 235 with breast cancer and equal numbers of controls. Data were collected through interviews with an organized set of questions. Details were also extracted from patient files. Data were analyzed using Student's t-test, chi-square and Fisher's exact tests, and Pearson's correlation analysis. The result revealed correlations between both cervical and breast cancers and history of contraceptive pills use. While cervical cancer significantly correlated with duration of use of pills, breast cancer had significant correlations with the type of oral contraceptive and age at first use. No significant relationships were found between the two types of cancer and age at discontinuation of oral contraceptives, patterns of use, and intervals from the last use. The use of oral contraceptives may triple the incidence of cervical cancer and doubles the incidence of breast cancer. Therefore, performing Pap smears every six months and breast cancer screening are warranted for long-term oral contraceptive users.

성인 암 생존자의 흡연 양상과 현재 흡연 관련 요인

변정애,양연수,김희진,윤지은,지선하 대한금연학회 2019 대한금연학회지 Vol.10 No.1

Background: Cancer survivors have high risk of secondary cancer and diseases other than cancer. However, there are persistent smokers among them. This study aims to explore the tobacco use patterns and associated factors with current smoking among cancer survivors. Methods: The results of surveys and blood tests collected from the Korea Medical Institute (KMI) from 2007 through 2011 were used as data. The subjects of this study were 91,040 adults (59,132 men) aged 20-64, and they were divided into cancer survivor group (1,375 men, 671 women) and non-cancer counterparts according to their past history of cancer. Results: The current smoking rate of cancer survivors was lower than that of non-cancer survivors, but 33.53% of men and 2.53% of women among cancer survivors were still current smokers. In the cancer survivors, in men, the younger they were, the higher the risk of current smoking became (The odds ratio of smoking in those aged 20-39 to 51-64 was 2.47 while that of smoking in 40-50, 1.43); and that the odds ratio of smoking in persons in drinkers to non-drinkers, 2.80 (95% CI: 2.02-3.88). In women cancer survivors, the odds ratio of current smoking was 21.15 (95% CI: 2.72-164.35) in alcohol drinkers to non-drinkers. Conclusion: Young age in men and alcohol use in both men and women were important factors correlated with tobacco smoking among cancer survivors. Further research and policy is needed to support cancer survivors’ smoking cessation and health promotion. 연구배경: 암 생존자는 이차암 및 질환 위험이 높다. 그러나 이들 중에도 흡연을 지속하는 경우가 남아있다. 이 연구에서는 암 생존자의 흡연 양상과 이들의 현재 흡연과의 관련요인을 살펴보고자 한다. 방법: 2007-2011년도에 한국의학연구소(Korea Medical Institute, KMI)에 내원한 연구 동의자 20-64세 성인 91,040 명(남자 59,132명)을 대상으로, 암 과거력 유무에 따라 암 생존자군(남 1,375명, 여 671명)과 비(非) 암 생존자군으로 나누어 설문, 신체계측, 혈액검사 자료를 분석하였다. 결과: 암 생존자의 현재흡연률은 비(非) 암 생존자에 비해 낮았으나 남성 암 생존자의 33.53%, 여성 암 생존자의 2.53%가 여전히 현재 흡연자였다. 암 생존자 중 남성은 50세 이하젊은 연령, 만성질환 과거력, 음주를 하는 경우, 신체활동을 하지 않는 경우 현재 흡연 위험이 높았다. 여성은 음주를 하는 경우, 신체활동을 하지 않는 경우 현재 흡연 위험이 높았다. 암 생존자에서, 남성이 현재 흡연할 오즈비는 51-64세에 비해 20-39세 2.47, 51-64세 1.43으로 높았으며, 음주 시 비음주군에 비해 현재 흡연할 오즈비도 남성 2.80(95% CI:2.02-3.88), 여성 21.15(95% CI:2.72-164.35)로 높았다. 결론: 남성의 젊은 연령과 남녀 음주는 암 생존자의 현재 흡연 지속과 관련된 중요한 요인이다. 향후 지속적인 연구와 개입 방법 개발을 통해 암 생존자의 금연과 건강증진을 위한 지원이 필요하다.

Clinical Characteristics of Multiple Primary Colorectal Cancers

윤주원,이승현,안병권,백승언 대한암학회 2008 Cancer Research and Treatment Vol.40 No.2

Purpose: Although multiple primary colorectal cancer has been recognized as a significant clinical entity, its clinical and pathological features and its prognosis are still controversial. The purpose of this study was to clarify clinical and pathological features of multiple primary colorectal cancer. Materials and Methods: Among 1669 patients who underwent surgery for primary colorectal cancer from January 1997 to June 2005, 26 patients (1.6%) with multiple primary colorectal cancer were identified. We reviewed clinical characteristics including diagnostic interval, lesions, operating methods, and TNM stage, and we defined the index lesion as the most advanced lesion among the synchronous lesions. For the purposes of the study, the colon and rectum were classified into three segments. The right-side colon included the appendix, cecum, ascending colon, hepatic flexure, and transverse colon, and the left-side colon included the splenic flexure, descending colon, and sigmoid colon. Results: Of the 26 patients with multiple primary colorectal cancers, nineteen patients were male and seven patients were female, with a mean age of 61.5 years. Nineteen patients had synchronous colorectal cancers and seven patients had metachronous colorectal cancers. In the metachronous cases, the mean diagnostic interval was 36.8 months. The site of the first lesion in metachronous colorectal cancers was the right colon in five cases (71.4%) and the left colon in two cases (28.6%), and the site of the second lesion was the rectum in six cases (55.5%), the right colon in three cases (33.3%), and the left colon in one case. The TNM stage of the second lesions in the metachronous colorectal cancers was stage II in four cases (57.1%), stage III in one case (14.3%), and stage IV in one case (14.3%). For the synchronous colorectal cancers, the operation methods were single-segment resection combined with endoscopic mucosal resection in five cases (26.3%), single- segment resection alone in six cases, two-segment resection in six cases, and total colectomy in two cases. Conclusion: In metachronous colorectal cancers, the secondary lesions were later-stage cancer. Therefore, careful postoperative follow-up is necessary for patients who have undergone surgery for colorectal cancers. Further study of therapeutic modalities is important for synchronous colorectal cancers.

Awareness of Risk Factors for Cancer among Omani adults- A Community Based Study

Al-Azri, Mohammed,AL-Rasbi, Khadija,Al-Hinai, Mustafa,Davidson, Robin,Al-Maniri, Abdullah Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.13

Background: Cancer is the leading cause of mortality around the world. However, the majority of cancers occur as a result of modifiable risk factors; hence public awareness of cancer risk factors is crucial to reduce the incidence. The objective of this study was to identify the level of public awareness of cancer risk factors among the adult Omani population. Materials and Methods: A community based survey using the Cancer Awareness Measure (CAM) questionnaire was conducted in three areas of Oman to measure public awareness of cancer risk factors. Omani adults aged 18 years and above were invited to participate in the study. SPPSS (ver.20) was used to analyse the data. Results: A total of 384 participated from 500 invited individuals (response rate =77%). The majority of respondents agreed that smoking cigarettes (320, 83.3%), passive smoking (279, 72.7%) and excessive drinking of alcohol (265, 69%) are risks factors for cancer. However, fewer respondents agreed that eating less fruit and vegetables (83, 21.6%), eating more red or processed meat (116, 30.2%), being overweight (BMI> 25) (123, 32%), doing less physical exercise (119, 31%), being over 70 years old (72, 18.8%), having a close relative with cancer (134, 34.9%), infection with human papilloma virus (HPV) (117, 30.5%) and getting frequent sunburn during childhood (149, 38.8%) are risk factors for cancer. A significant association was found between participant responses and their educational level. The higher the educational level, the more likely that respondents identified cancer risk factors including smoking (p<0.0005), passive smoking (p= 0.007), excessive drinking of alcohol (p<0.0005), eating less fruit and vegetables (p= 0.001) and infection with HPV (p<0.0005). Conclusions: The majority of respondents in this study in Oman were not aware of the common risk factors for cancer. It may be possible to reduce the incidence of cancers in Oman by developing strategies to educate the public about these risk factors.

성인 암 생존자의 흡연 양상과 현재 흡연 관련 요인

변정애,양연수,김희진,윤지은,지선하 대한금연학회 2019 대한금연학회지 Vol.10 No.2

Background: Cancer survivors have high risk of secondary cancer and diseases other than cancer. However, there are persistent smokers among them. This study aims to explore the tobacco use patterns and associated factors with current smoking among cancer survivors. Methods: The results of surveys and blood tests collected from the Korea Medical Institute (KMI) from 2007 through 2011 were used as data. The subjects of this study were 91,040 adults (59,132 men) aged 20-64, and they were divided into cancer survivor group (1,375 men, 671 women) and non-cancer counterparts according to their past history of cancer. Results: The current smoking rate of cancer survivors was lower than that of non-cancer survivors, but 33.53% of men and 2.53% of women among cancer survivors were still current smokers. In the cancer survivors, in men, the younger they were, the higher the risk of current smoking became (The odds ratio of smoking in those aged 20-39 to 51-64 was 2.47 while that of smoking in 40-50, 1.43); and that the odds ratio of smoking in persons in drinkers to non-drinkers, 2.80 (95% CI: 2.02-3.88). In women cancer survivors, the odds ratio of current smoking was 21.15 (95% CI: 2.72-164.35) in alcohol drinkers to non-drinkers. Conclusion: Young age in men and alcohol use in both men and women were important factors correlated with tobacco smoking among cancer survivors. Further research and policy is needed to support cancer survivors’ smoking cessation and health promotion. 연구배경: 암 생존자는 이차암 및 질환 위험이 높다. 그러나 이들 중에도 흡연을 지속하는 경우가 남아있다. 이 연구에서는 암 생존자의 흡연 양상과 이들의 현재 흡연과의 관련요인을 살펴보고자 한다. 방법: 2007-2011년도에 한국의학연구소(Korea Medical Institute, KMI)에 내원한 연구 동의자 20-64세 성인 91,040 명(남자 59,132명)을 대상으로, 암 과거력 유무에 따라 암 생존자군(남 1,375명, 여 671명)과 비(非) 암 생존자군으로 나누어 설문, 신체계측, 혈액검사 자료를 분석하였다. 결과: 암 생존자의 현재흡연률은 비(非) 암 생존자에 비해 낮았으나 남성 암 생존자의 33.53%, 여성 암 생존자의 2.53%가 여전히 현재 흡연자였다. 암 생존자 중 남성은 50세 이하젊은 연령, 만성질환 과거력, 음주를 하는 경우, 신체활동을 하지 않는 경우 현재 흡연 위험이 높았다. 여성은 음주를 하는 경우, 신체활동을 하지 않는 경우 현재 흡연 위험이 높았다. 암 생존자에서, 남성이 현재 흡연할 오즈비는 51-64세에 비해 20-39세 2.47, 51-64세 1.43으로 높았으며, 음주 시 비음주군에 비해 현재 흡연할 오즈비도 남성 2.80(95% CI:2.02-3.88), 여성 21.15(95% CI:2.72-164.35)로 높았다. 결론: 남성의 젊은 연령과 남녀 음주는 암 생존자의 현재 흡연 지속과 관련된 중요한 요인이다. 향후 지속적인 연구와 개입 방법 개발을 통해 암 생존자의 금연과 건강증진을 위한 지원이 필요하다.

Patterns of Cancer in Kurdistan - Results of Eight Years Cancer Registration in Sulaymaniyah Province-Kurdistan-Iraq

Khoshnaw, Najmaddin,Mohammed, Hazha A,Abdullah, Dana A Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.18

Background: Cancer has become a major health problem associated with high mortality worldwide, especially in developing countries. The aim of our study was to evaluate the incidence rates of different types of cancer in Sulaymaniyah from January-2006 to January-2014. The data were compared with those reported for other middle east countries. Materials and Methods: This retrospective study depended on data collected from Hiwa hospital cancer registry unit, death records and histopathology reports in all Sulaymaniyah teaching hospitals, using international classification of diseases. Results: A total of 8,031 cases were registered during the eight year period, the annual incidence rate in all age groups rose from 38 to 61.7 cases/100,000 population/year, with averages over 50 in males and 50.7 in females. The male to female ratio in all age groups were 0.98, while in the pediatric age group it was 1.33. The hematological malignancies in all age groups accounted for 20% but in the pediatric group around half of all cancer cases. Pediatric cancers were occluding 7% of total cancers with rates of 10.3 in boys and 8.7 in girls. The commonest malignancies by primary site were leukemia, lymphoma, brain, kidney and bone. In males in all age groups they were lung, leukaemia, lymphoma, colorectal, prostate, bladder, brain, stomach, carcinoma of unknown primary (CUP) and skin, while in females they were breast, leukaemia, lymphoma, colorectal, ovary, lung, brain, CUP, and stomach. Most cancers were increased with increasing age except breast cancer where decrease was noted in older ages. High mortality rates were found with leukemia, lung, lymphoma, colorectal, breast and stomach cancers. Conclusions: We here found an increase in annual cancer incidence rates across the period of study, because of increase of cancer with age and higher rates of hematological malignancies. Our study is valuable for Kurdistan and Iraq because it provides more accurate data about the exact patterns of cancer and mortality in our region.