First trial of cervical cytology in healthy women of urban Laos using by self-sampling instrument.

Cervical cancer is the most common cancer in Laos women and a screening programme, even with the PAP smear test (PAP test), has yet to be established for routine use. The Pap test is accepted as the most appropriate for cervical cancer screening in some settings but it is not commonly available in Laos hospitals, because there are few cytopathologists and gynecologists have little experience. As a pilot program, seminars for the PAP test were given in 2007 and 2008, and then PAP tests were carried out using self-sampling instrument (Kato's device) with 200 healthy volunteers in Setthathirath hospital, Laos, in 2008. The actual examination number was 196, divided into class I 104 (53.1%), class II 85 (43.3%), class IIIa 4 (2.0%), class IIIb 1 (0.5%), and class V 1 (0.5%) by modified Papanicolau classification. Four cases had menstruation. There were 6 cases with epithelial cell abnormalities including malignancy. There were 7 cases with fungus and 2 cases with trichomonas in Class II. More than 70% volunteers felt comfortable with the Kato's device and wanted to use it next time, because of the avoidance of the embarrassment and a low cost as compared with pelvic examination by gynecologists. This first trial for PAP test for healthy Laos women related to a hospital found three percent to have abnormal cervical epithelial cells. Therefore, this appraoch using a self-sampling device suggests that it should be planned for cervical cancer prevention in Laos.

Cancer deaths in a cohort of Japanese barbers in Aichi Prefecture.

Barbers have frequent occasion to come in contact with hair and beauty products that contain many chemical substances, which could have harmful effects on health. Subjects were barbers belonging to the Barbers' Union of Aichi Prefecture who responded to a questionnaire in 1976. Deaths from all sites of cancers in the subjects were observed over 27 years. Mortalities of several cancers in the subjects were compared with individuals in the Japanese population, calculating standardized mortality ratios (SMRs) using the general Japanese population as a standard. Subjects included 8,360 people (4,674 men). There were a total of 551 deaths (469 men) during the follow-up period, and 277 deaths (211 men) from all cancers. The male and female SMRs (95% CI) were 0.62 (0.58-0.66) and 0.25 (0.16-0.34) for all deaths, 0.46 (0.39-0.53) and 0.41 (0.35-0.53) for all cancers combined, 0.49 (0.35-0.63) and 0.40 (0.12-0.68) for stomach, 0.40 (0.24-0.56) and 0.30 (0.10-0.70) for lung, 0.56 (0.39-0.73) and 0.26 (0.02-0.76) for liver, 0.38 (0.16-0.60) and 0.30 (0.07-0.67) for colon, and 0.48 (0.08-0.88) and 0.22 (0.04-0.79) for blood cancers, respectively, with significantly fewer deaths than in the general populace. The female SMRs were 0.90 (0.74-4.06) for breast and 0.55 (0.06-1.04) for ovarian, lacking significance. Thus, no excess mortality of any cancer sites was observed compared with the general population in both Japan and Aichi Prefecture.

Cardiovascular disease mortality and serum carotenoid levels: a Japanese population-based follow-up study.

BACKGROUND: Some observational epidemiologic studies suggest that dietary and serum carotenoids are associated with reduced cardiovascular disease mortality. METHODS: Three thousand and sixty-one subjects (1,190 males and 1,871 females), aged 39 to 80 years, were recruited from residents of Hokkaido, Japan who had attended comprehensive health check-up programs from 1988 through 1995. Serum levels of alpha-carotene, beta-carotene, and lycopene were separately determined by high-performance liquid chromatography. Serum levels of total carotene consisted of the sum of alpha-carotene, beta-carotene, and lycopene levels. Each serum level of alpha-carotene, beta-carotene, lycopene, total carotene, triglyceride, and alanine transaminase (ALT) activity was transformed logarithmically. The hazard ratios of serum alpha- and beta-carotenes, lycopene, and total carotene values were estimated by the Cox proportional hazard model after adjusting for sex, age, and other potential confounding factors. RESULTS: During the 11.9-year follow-up period, 80 deaths (49 males and 31 females) from cardiovascular disease, 40 deaths from heart disease, and 37 deaths from stroke were identified among the cohort subjects. High serum values of carotenoids such as alpha- and beta-carotenes, and lycopene were found to be significantly associated with low hazard ratios for cardiovascular disease mortality. However, a significant inverse association between high serum lycopene value and the risk for stroke mortality was not always observed. CONCLUSIONS: High serum levels of total carotene, comprising alpha- and beta-carotenes and lycopene, may reduce the risk for cardiovascular disease mortality among the Japanese population.

Early history of cancer epidemiology and prevention in Japan.

Cancer epidemiological research has a long and distinguished history and as we continue our work in ever expanding new fields, molecular or otherwise, it is perhaps worthwhile to take time out occasionally to ponder what lessons we can learn from the past. Many of the paradigms which are presently accorded respect in fact were hinted at by very early work and it is fitting that we take a look at how previous developments knit with the present status of cancer research in different areas of the world. For this purpose the present review focuses on cancer epidemiology in Japan, in the hope of gleaning advantage from past experience in planning future programs.

A population-based follow-up study on mortality from cancer or cardiovascular disease and serum carotenoids, retinol and tocopherols in Japanese inhabitants.

OBJECTIVE: Observational epidemiologic studies have shown that a high intake of dietary and high serum levels of carotenoids are associated with a reduced risk of mortality from cancer and cardiovascular disease. To investigate whether high serum levels of carotenoids can reduce mortality rates, a population-based follow-up study was conducted among Japanese inhabitants. MATERIALS AND METHODS: Three thousand two hundred and fifty-four subjects (1,260 males and 1,994 females) aged from 39 to 85 years who had attended health check-up programs from 1989 to 1995 were recruited from the Japanese population. Serum levels of carotenoids, retinol and tocopherols were separately determined by high-performance liquid chromatography. Hazard ratios for serum values of carotenoids, retinol and tocopherols were estimated by Cox's proportional hazard model after adjusting for sex, age, and other confounding factors. RESULTS: During the 11.7-year follow-up period, 140 deaths (86 males and 54 females) from cancer of all sites were identified among the cohort subjects, including 41 from lung , 17 from stomach , 16 from colorectal and 12 from liver cancer, as well as 89 deaths from cardiovascular disease, including 45 from heart disease and 37 from stroke. High serum values of carotenoids including xanthophylls were apparently associated with low hazard ratios for mortality rates of cancer of all sites or of cardiovascular disease. High serum values of beta-carotene, total carotene, provitamin A and total carotenoid for colorectal cancer or stroke also appeared to be related to low hazard ratios. Those of retinol and tocopherols were not associated with any reduction in risk of mortality from cancer or cardiovascular disease. CONCLUSIONS: Our follow-up study demonstrated that a typical Japanese diet related to elevating serum levels of carotenoids with provitamin A activity may significantly reduce risk of mortality from cancer of certain sites or cardiovascular disease, especially colorectal cancer or stroke, while high serum levels of some xanthophylls, retinol and tocopherols do not.

Cancer mortality and serum levels of carotenoids, retinol, and tocopherol: a population-based follow-up study of inhabitants of a rural area of Japan.

A total of 3,182 subjects (1,239 males and 1,943 females) aged from 39y to 79y, were recruited from the inhabitants of a rural area in Japan who participated in health check-up programs from 1988 to 1995. During the 10.5 year follow-up, 287 deaths (175 males and 112 females) from all causes, 134 (81 males and 53 females) from cancer of all sites, 31 from lung cancer, 21 from colorectal cancer, 20 from stomach cancer, and 62 from other cancers, were identified among the cohort subjects. Fasting serum samples were taken at the time of the health check-ups, and serum levels of carotenoids, retinol and tocopherols were separately determined by HPLC. Statistical analyses were performed using Cox's proportional hazard model after adjusting for sex, age, and other confounding factors. High serum levels of alpha- and beta- carotenes and lycopene were found to marginally significantly or significantly reduce the risk for mortality rates of cancer of all sites and of colorectal cancers. High serum levels of beta-cryptoxanthin also showed an inversely relation with the risk of mortality from lung and stomach cancers, but this was not statistically significant. High intake of green-yellow vegetables contributing to serum levels of alpha- and beta- carotenes, as well as lycopene, may reduce the risk of cancer mortality, especially from colorectal cancer, in rural Japanese.

The relationship between smoking habits and serum levels of 8-OHdG, oxidized LDL antibodies, Mn-SOD and carotenoids in rural Japanese residents.

This study investigated the relationship between smoking habits and serum levels of 8-OHdG, oxidized LDL antibodies (oLAB), Mn-SOD, and carotenoids. Subjects were 79 males (mean age +/- standard deviation; 62.1 +/- 10.0 years) and 79 females (60.3 +/- 10.3 y) who attended a health examination screening in the town of Hokkaido, Japan. Serum 8-OHdG, Mn-SOD, and oLAB levels were measured by ELISA and serum carotenoids levels were measured by HPLC. Smoking habits were assessed by public health nurses using a questionnaire. Serum 8-OHdG levels were significantly higher in males than in females. On the other hand, serum levels of beta-carotene, alpha-carotene, beta-cryptoxanthin, and zeaxanthin and lutein were significantly lower in males than in females. Serum beta-carotene, beta-cryptoxanthin, and zeaxanthin and lutein were significantly lower in males who were current smokers, compared to non-smokers. Serum 8-OHdG levels were also significantly higher in current smokers. Furthermore, in males, serum oLAB and beta-carotene levels were significantly and negatively correlated with the number of cigarettes smoked per day. Serum Mn-SOD levels were unrelated to smoking habits in males. In conclusion, this preliminary study suggests that cigarette smoking increases serum 8-OHdG levels and reduces serum levels of oLAB and carotenoids, such as beta-carotene, beta-cryptoxanthin, and zeaxanthin and lutein in healthy male subjects. Serum levels of 8-OHdG, oLAB, and carotenoids may be useful biomarkers of oxidative conditions affected by smoking.

Relationship between serum carotenoids and hyperglycemia: a population-based cross-sectional study.

The present study investigated the relationship between hyperglycemia and both serum carotenoids and intake of vegetables and fruits. Subjects with a history of diabetes mellitus (DM group, n = 133) or with hyperglycemia diagnosed using a 5.6% cutoff value for hemoglobin A1c (High HbA1c group, n = 151) were recruited from among inhabitants of a rural area in Hokkaido, Japan. Intake frequencies of vegetables and fruits were assessed using a questionnaire administered by public health nurses. Serum levels of carotenoids and retinol were measured using high-performance liquid chromatography. The relationships between high HbA1c or DM and both serum carotenoids and intake frequencies of vegetables and fruits were analyzed using logistic regression modeling for a case-control study; each case (High HbA1c or DM) was matched to two controls (healthy subjects without any history of disease) matched for sex and age (within 3 years). The odds ratio (OR) for high HbA1c was 0.49 (95% confidence interval: 0.29-0.85) on high intake frequency of carrot and pumpkin and the OR for DM was 1.21 (95% Cl: 0.79-1.84). No significant relationships were observed between high HbA1c and intake frequencies of other vegetables and fruits. The ORs on high serum levels of alpha- and beta-carotenes, lycopene, beta-cryptoxanthin and zeaxanthin and lutein were 0.38 (0.22-0.65), 0.35 (0.21-0.59), 0.57 (0.35-0.93), 0.35 (0.20-0.59), and 0.88 (0.54-1.46) for high HbA1c, respectively. In conclusion, intake of vegetables and fruits rich in carotenoids might be a protective factor against hyperglycemia.

Serum antioxidants and subsequent mortality rates of all causes or cancer among rural Japanese inhabitants.

The purpose of this study was to investigate whether a relationship exists between mortality rates and serum antioxidant levels among Japanese inhabitants. The follow-up subjects, who participated in comprehensive health examinations, consisted of 2444 inhabitants (949 males and 1495 females) of a rural area in Hokkaido, Japan. Between 1991 and December 2000, 146 subjects (94 males and 52 females) died, with cancer accounting for 76 of these deaths (48 males and 28 females). Serum samples at fasting were collected at entry into the study, and serum levels of beta- and alpha-carotenes, lycopene, beta-cryptoxanthin, canthaxanthin, zeaxanthin/lutein, tocopherols, and retinol were measured separately by high-performance liquid chromatography (HPLC). The statistical analyses were conducted using the Cox proportional hazard model. Age- and gender-adjusted hazard ratios of the groups with high serum levels of lycopene, beta-carotene, zeaxanthin/lutein, and total carotenoids compared to those with low serum levels were 0.36 (95% C.I: 0.19-0.69), 0.53 (0.29-0.95), 0.73 (0.43-1.25), and 0.52 (0.30-0.92) for cancers of all sites, and 0.44 (95% C.I: 0.28-0.69), 0.59 (0.39-0.90), 0.61 (0.40-0.93), and 0.50 (0.33-0.76) for all causes, respectively. Similar results were found after adjusting for gender, age, smoking habits, alcohol consumption, and serum levels of total cholesterol and glutamic pyruvic transaminase (GPT) activity. Moreover, after excluding mortality within the first three years of follow-up, the hazard ratios of subjects with high serum levels of lycopene, total carotenes, and total carotenoids were significantly and inversely associated with subsequent mortality from all causes and cancers of all sites after adjusting for gender, age, and serum levels of total cholesterol, alpha-tocopherol, and retinol. These results suggest that high serum levels of antioxidants, such as lycopene, beta-carotene and zeaxanthin/lutein, play roles in preventing death from cancer and from all causes. However, high serum levels of tocopherols and retinol did not demonstrate clear associations with either low mortality rates from all causes or cancer of all sites.

Mortality rates from cancer or all causes and SOD activity level and Zn/Cu ratio in peripheral blood: population-based follow-up study.

A total of 507 residents (232 males and 275 females) of a rural area of Hokkaido, Japan, were enrolled in the present follow-up study as the follow-up cohort. We investigated the relationship between mortality rates from cancer or all causes and blood levels of SOD activity and Zn/Cu ratio, and serum levels of SOD activity and lipid peroxides (TBARS), by following up our subjects over the course of 18 years. The hazard ratios of lowest blood levels of SOD activity and Zn/Cu ratios to mortality rates from cancer were 1.36 (95% C.I.: 0.59-3.10) and 1.97 (95% C.I.: 0.84-4.63), and those to mortality rates from all causes were 1.31 (95%C.I: 0.76-2.27) and 1.99 (95%C.I.: 1.14-3.46), respectively, in comparison with subjects with highest values for these factors. Hazard ratios of lowest serum levels of SOD activity and TBARS to mortality rates from cancer were 2.68 (95%C.I.: 1.05-6.82) and 0.71 (95%C.I.: 0.31-1.67), and those to mortality rates from all causes were 1.55 (95% C.I., 0.90-2.66) and 0.88 (95%C.I.: 0.51-1.50), respectively. The results of this follow-up study indicate that high serum SOD activity is associated with protective effects against mortality from cancer, and that high blood Zn/Cu ratio is associated with low mortality from other causes. In contrast, serum TBARS levels do not appear to be a biomarker for the risk of death from cancer.

Contributions to Cancer Prevention of Non-Governmental Organizations 1. Establishment of the UICC and its Activities.

The objectives of the UICC declared at the outset were of an essential nature for preventive oncology and have very slowly been carried forward. Activities have rapidly expanded with progress in medicine and biology. Strengthening of the International cooperative network since 1980 has accelerated this trend. Most of the initial aims of the Union have now been achieved, I believe, but there appear many further problems to be resolved in cancer prevention, not only in economically developed areas but also in developing regions. Obtaining finance continues to be a big task with regard to accomplishing the many objectives of the UICC. Personal donations from individuals joining the Roll of Honor have provided part support for many projects, but the efforts of the Finance Committee, in coordination with member organizations, are still keys to maintaining activities and reaching the final goal of effective cancer control.

A New Model Population-based Cancer Registration System in Aichi Prefecture, Japan.

A dramatic overhaul of the population-based cancer registration system in Aichi Prefecture, Japan - Aichi Cancer Registry (ACR) - was undertaken in 1998, with a view to rationalization and strengthening of its effectiveness, supported by a grant from the Ministry of Health and Welfare. A more comprehensive organization encompassing the prefectural cancer center and prefectural public health centers (PPHCs), promoting PPHC-based primary and secondary cancer prevention has now been in operation since January 1999. Application of its basic components is also feasible for other population-based cancer registries in Japan, which share similar operation characteristics. This paper introduces the new cancer registration system in Aichi Prefecture, Japan.