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Objective@#In Malaysia, a cytology based program for cervical screening was implemented in 1969. Unfortunately, pap smear uptake has been low. The most common barriers to screening were embarrassment, time constraint and poor awareness to screening. As Malaysia is transitioning from a cytology-based screening to self-sampling human papillomavirus (HPV) testing as the primary screening method, it is therefore important to assess the acceptability of this screening approach in this multiethnic setting. @*Methods@#This was a cross-sectional study which recruited women aged 30–65 from several community-based cervical screening programs using self-sampling HPV testing across urban and suburban areas in all over Malaysia from April 2018 to May 2022. All women were instructed to self-collect vaginal samples for HPV testing using a dry flocked swab. All samples were genotyped on a clinically validated platform which allowed the detection of any high-risk HPV DNA. Approximately 2,000 women were randomly selected and interviewed to document their screening experience after the self-sampling procedure. @*Results@#A total of 19,835 women participated in the community-based cervical screening program using self-sampling HPV testing. The major ethnic group was Malay (68.4%) followed by Chinese (16.4%) and Indians (9.9%). Of these, 1,113 (5.7%) were positive for any high-risk HPV infection whereas 371 (1.9%) did not yield valid HPV results due to insufficient human DNA. A total of 2,012 participants responded to an interview regarding their screening experience using self-sampling HPV testing. Among these women, 1,179 (58.5%) did not attend regular Pap smear screening. Out of those who had ever performed Pap smear, 83.2% of them indicated a preference towards self-sampling HPV testing over Pap smear. Furthermore, 99% of them were willing to repeat this screening test as a routine screening method in the future. More than 95% of women perceived self-sampling HPV testing as easy, convenient and not embarrassing. Additionally, more than 80% of women felt comfortable and confident collecting their vaginal samples. This implies that self-sampling HPV testing is highly acceptable in our setting. @*Conclusion@#HPV testing via self-collection method is highly acceptable and preferred over Pap smear in the Malaysian multiethnic population. It is a promising approach to increase screening coverage which is an essential key target to be achieved in order to eliminate cervical cancer in Malaysia.
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BACKGROUND/OBJECTIVES: This cross-sectional study assessed household food security status and determined its association with diet quality and weight status among indigenous women from the Mah Meri tribe in Peninsular Malaysia. SUBJECTS/METHODS: The Radimer/Cornell Hunger and Food Insecurity Instrument and the Malaysian Healthy Eating Index (HEI) were used to assess household food security status and diet quality, respectively. Information on socio-demographic characteristics and 24-hour dietary recall data were collected through face-to-face interview, and anthropometric measurements including weight, height, and body mass index (BMI) were obtained from 222 women. RESULTS: Majority of households (82.9%) experienced different levels of food insecurity: 29.3% household food insecurity, 23.4% individual food insecurity, and 30.2% fell into the child hunger group. The food-secure group had significantly fewer children and smaller household sizes than the food-insecure groups (P < 0.05). The mean household income, income per capita, and food expenditure significantly decreased as food insecurity worsened (P < 0.001). The food-secure group had significantly higher Malaysian HEI scores for grains and cereals (P < 0.01), as well as for meat, poultry, and eggs (P < 0.001), than the food-insecure groups. The child-hunger group had significantly higher fat (P < 0.05) and sodium (P < 0.001) scores than the food-secure and household food-insecure groups. Compared to the individual food-insecure and child-hunger groups, multivariate analysis of covariance showed that the food-secure group was significantly associated with a higher Malaysian HEI score while the household food-insecure group was significantly associated with a higher BMI after controlling for age (P < 0.025). CONCLUSIONS: The majority of indigenous households faced food insecurity. Food insecurity at the individual and child levels was associated with lower quality of diet, while food insecurity at the household level was associated with higher body weight. Therefore, a substantial effort by all stakeholders is warranted to improve food insecurity among poorer households. The results suggest a pressing need for nutritional interventions to improve dietary intake among low income households.
Subject(s)
Child , Female , Humans , Body Mass Index , Body Weight , Cross-Sectional Studies , Diet , Eating , Edible Grain , Eggs , Family Characteristics , Food Supply , Health Expenditures , Hunger , Malaysia , Meat , Multivariate Analysis , Ovum , Poultry , SodiumABSTRACT
Objective To compare the 7th edition of International Union Against Cancer ( UICC) staging system with the Chinese 2008 staging system for nasopharyngeal carcinoma ( NPC) , and to provide evidence for further updating of the staging system. Methods A retrospective analysis was performed among 767 patients who were pathologically and newly diagnosed with non?metastatic NPC and treated with intensity?modulated radiotherapy from 2006 to 2012. Based on the main prognostic indices, overall survival ( OS) , locoregional failure?free survival( LFFS) local relapse?free survival ( LRFS) , and distant metastasis?free survival ( DMFS) rates, the value of T stage, N stage, and clinical stage in prognostic prediction was compared between the two staging systems. The Kaplan?Meier method was used for calculating survival rates. The log?rank test was used for survival difference analysis. The Cox model was used for multivariate prognostic analysis. Results In terms of T stage, the Chinese 2008 staging system was a significantly better predictor of the OS and LRFS rates than the 7th edition of UICC staging system. In terms of N stage, they were comparable in the prediction of the OS and DMFS rates. In terms of clinical stage, the 7th edition of UICC staging system was a significantly better predictor of the OS rate than the Chinese 2008 staging system. For the new staging system proposed based on the statistical results, the T, N, and clinical staging gave significantly better prognostic prediction. Conclusions The 7th edition of UICC staging system and the Chinese 2008 staging system for NPC have their own advantages in prognostic prediction. The new staging system proposed in this study could contribute to the updating of the current staging system for NPC.
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Objective To evaluate the clinical characteristics,outcome and prognostic factom of adolescent nasopharyngeal carcinoma.Methods Between Jan 1990 and Dec 2009,totally 148 pathological confirmed nasopharyngeal carcinoma(NPC)patients with age≤20 years were treated in our hospital,including stage Ⅱ 8,stage Ⅲ 58,stage Ⅳ 81,and unknown 1 when restaged by TNM system(UICC 2002),ninty-four(63.5%)patients were treated with radiotherapy alone,54(36.5%)patients were treated with radiotherapy combined with cisplatin-based chemotherapy.Results The median follow-up time for all patients was 44.5 months.The 5-year overall survival(OS),local-regional control(LRC)and distant metastasis-free survival(DMFS)rateswere 82.9%,85.1%and 78.6%.There were 42 patients(28.4%)failed with 16 regional recurrence and 29 distant metastasis,and 3 with both;bone metastasis was the most common site of distant metastasis(22/29).In univariate analysis,the adverse prognostic factors for OS were stage T4(X2=5.61,P=0.018),radiation dose<70 Gy(X2=5.30,P=0.021),for LRC was radiation dose<70 Gy and for distant metastasis-free survival was the disease history≥6month(X2=4.24,P=0.039).In multivariate analysis,radiation dose<70 Gy and stage T4 were the independent prognostic factors for OS(X2=5.73、5.56,P=0.017、0.018),for LRC was radiation dose<70 Gy(X2=5.81,P=0.016).Conclusions The outcome of the present series was excellent,total nagopharyngeal radiation dose less than 70 Gy is inappropriate.Reduce the distant metastasis and late toxicities were the future direction for the treatment of adolescent nasopharyngeal carcinoma.
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<p><b>OBJECTIVE</b>To explore the prevalence of vision, mental, audibility, language, psychiatry, extremity, and influence factors in the 0 - 7 year olds.</p><p><b>METHODS</b>A total number of 77,727 0 - 7 year old children living in Shenzhen city were tested with tree phase screening under the Chinese standard of evaluation in disabilities.</p><p><b>RESULTS</b>The prevalence of all disabilities was 5.59 per thousand (adjusted rate was 8.49 per thousand with a false negative of 3.1 per thousand ). The prevalence of mental disease was the highest (1.88 per thousand, with adjusted rate 3.43 per thousand ), the prevalence of language disability was 1.88 per thousand (including retarded language development, with adjusted rate 3.43 per thousand ). The prevalence rates of psychiatry, extremity and audibility disability were 1.59 per thousand, 1.56 per thousand, 1.11 per thousand respectively with of vision the lowest (0.37 per thousand ). The prevalence of all disabilities, audibility, language and mental was on the increase with age. The difference was statistically significant. Among all different age groups regarding psychiatric disease, the highest fell in the 2 - 4 year olds. The prevalence of extremity was not statistically different among age groups. The suspected agents of disease which occurred before or during pregnancy took up 45.7%.</p><p><b>CONCLUSION</b>The prevalence of six kinds disabilities in Shenzhen was about 10 per thousand lower than that of the samples of the nation in 1989, but two times higher than that of similar studies in Japan. The prevalence rates of language and psychiatric disease were higher than that of the nation in 1989. The causation should be further studied.</p>