ABSTRACT
OBJECTIVE: To measure beliefs about cancer causation, cancer screening behaviors, access to information about and resources for cancer screening, and interest in cancer genetics services in two underserved predominantly Latino communities. METHODS: An anonymous survey, in both English and Spanish, was distributed at the registration desk to all attendees of selected general medicine clinics in two underserved healthcare systems. RESULTS: There were a total of 312 respondents, representing 98% of eligible candidates. The reported data focus on 75.3% (n=235) of Latino respondents; mean age 43 years; 78% female; 72% less than high school education. Heredity was perceived as the most frequent cause of cancer, after smoking. Only 37% knew of free cancer screening programs. Over 85% expressed interest in obtaining information about personal cancer risk and motivation to participate in cancer genetics services. CONCLUSIONS: The results of this survey demonstrate an awareness of heredity as a potential cause of cancer. The observed high level of interest in cancer genetics services suggests the acceptability of cancer genetics services in this predominantly underserved Latino population. Furthermore, cancer genetics services would likely augment awareness and utilization of available cancer screening services in the community.
Subject(s)
Health Knowledge, Attitudes, Practice , Hispanic or Latino/psychology , Mass Screening/statistics & numerical data , Medically Underserved Area , Neoplasms , Risk Assessment , Adolescent , Adult , Aged , Aged, 80 and over , Community Health Centers , Community-Institutional Relations , Female , Health Education , Health Surveys , Hispanic or Latino/education , Humans , Information Dissemination , Los Angeles/epidemiology , Male , Middle Aged , Neoplasms/diagnosis , Neoplasms/etiology , Neoplasms/genetics , Neoplasms/psychology , Risk Factors , Vulnerable PopulationsABSTRACT
Appendicitis is a common surgical problem that is associated with a systemic inflammatory response. Previous studies have shown that cytokines are activated early in acute inflammation and sepsis and may serve as indicators of clinical severity. In this study we examined the role of cytokines as serum markers to distinguish nonperforated versus perforated appendicitis. Patients with the presumptive diagnosis of appendicitis had serum drawn preoperatively. Only patients (n = 59) with an intraoperative diagnosis of nonperforated (n = 34) and perforated (n = 25) appendicitis had serum drawn 12 hours postoperatively. Diagnosis was later confirmed by pathologic examination. The serum specimens were batch analyzed using enzyme-linked immunosorbent assays specific for interleukin (IL)-1beta, IL-2, IL-6, IL-8, and IL-10. Serum from normal healthy subjects served as control specimens (n = 9). Patients in the nonperforated and perforated groups were similar with regard to age, gender, race, white blood cell count, and fever. All cytokine levels including preoperative, postoperative, nonperforated, and perforated were higher in patients with appendicitis as compared with controls. IL-1beta, IL-2, and IL-10 levels were not different between groups with appendicitis. Preoperative serum levels of IL-6 (P = 0.036) and IL-8 (P = 0.047) were higher in patients with perforated versus nonperforated appendicitis. In addition postoperative serum levels of IL-6 (P = 0.0001) remained higher in the perforated group versus the nonperforated group. Serum levels of IL-6 and IL-8 may have a role in discerning the extent of disease in this condition. This initial step in systemically studying the role of cytokines in this disease may ultimately lead to the development of molecular indicators to aid in diagnosis and differentiate appendicitis from other conditions.
