1.Trends in gynecologic cancer mortality in East Asian regions.
Jung Yun LEE ; Eun Yang KIM ; Kyu Won JUNG ; Aesun SHIN ; Karen K L CHAN ; Daisuke AOKI ; Jae Weon KIM ; Jeffrey J H LOW ; Young Joo WON
Journal of Gynecologic Oncology 2014;25(3):174-182
OBJECTIVE: To evaluate uterine and ovarian cancer mortality trends in East Asian countries. METHODS: For three Asian countries and one region (Japan, Korea, Singapore, and Hong Kong), we extracted number of deaths for each year from the World Health Organization (WHO) mortality database, focusing on women > or =20 years old. The WHO population data were used to estimate person-years at risk for women. The annual age-standardized, truncated rates were evaluated for four age groups. We also compared age-specific mortality rates during three calendar periods (1979 to 1988, 1989 to 1998, and 1999 to 2010). Joinpoint regression was used to determine secular trends in mortality. To obtain cervical and uterine corpus cancer mortality rates in Korea, we re-allocated the cases with uterine cancer of unspecified subsite according to the proportion in the National Cancer Incidence Databases. RESULTS: Overall, uterine cancer mortality has decreased in each of the Asian regions. In Korea, corrected cervical cancer mortality has declined since 1993, at an annual percentage change (APC) of -4.8% (95% confidence interval [CI], -5.3 to -4.4). On the other hand, corrected uterine corpus cancer mortality has abruptly increased since 1995 (APC, 6.7; 95% CI, 5.4 to 8.0). Ovarian cancer mortality was stable, except in Korea, where mortality rates steadily increased at an APC of 6.2% (95% CI, 3.4 to 9.0) during 1995 to 2000, and subsequently stabilized. CONCLUSION: Although uterine cancer mortality rates are declining in East Asia, additional effort is warranted to reduce the burden of gynecologic cancer in the future, through the implementation of early detection programs and the use of optimal therapeutic strategies.
Adult
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Age Distribution
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Aged
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Databases, Factual
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Far East/epidemiology
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Female
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Genital Neoplasms, Female/*mortality
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Humans
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Middle Aged
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Mortality/trends
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Ovarian Neoplasms/mortality
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Uterine Neoplasms/mortality
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Young Adult
2.Distinguishing benign from malignant pelvic mass utilizing an algorithm with HE4, menopausal status, and ultrasound findings.
Sarikapan WILAILAK ; Karen K L CHAN ; Chi An CHEN ; Joo Hyun NAM ; Kazunori OCHIAI ; Tar Choon AW ; Subathra SABARATNAM ; Sudarshan HEBBAR ; Jaganathan SICKAN ; Beth A SCHODIN ; Chuenkamon CHARAKORN ; Walfrido W SUMPAICO
Journal of Gynecologic Oncology 2015;26(1):46-53
OBJECTIVE: The purpose of this study was to develop a risk prediction score for distinguishing benign ovarian mass from malignant tumors using CA-125, human epididymis protein 4 (HE4), ultrasound findings, and menopausal status. The risk prediction score was compared to the risk of malignancy index and risk of ovarian malignancy algorithm (ROMA). METHODS: This was a prospective, multicenter (n=6) study with patients from six Asian countries. Patients had a pelvic mass upon imaging and were scheduled to undergo surgery. Serum CA-125 and HE4 were measured on preoperative samples, and ultrasound findings were recorded. Regression analysis was performed and a risk prediction model was developed based on the significant factors. A bootstrap technique was applied to assess the validity of the HE4 model. RESULTS: A total of 414 women with a pelvic mass were enrolled in the study, of which 328 had documented ultrasound findings. The risk prediction model that contained HE4, menopausal status, and ultrasound findings exhibited the best performance compared to models with CA-125 alone, or a combination of CA-125 and HE4. This model classified 77.2% of women with ovarian cancer as medium or high risk, and 86% of women with benign disease as very-low, low, or medium-low risk. This model exhibited better sensitivity than ROMA, but ROMA exhibited better specificity. Both models performed better than CA-125 alone. CONCLUSION: Combining ultrasound with HE4 can improve the sensitivity for detecting ovarian cancer compared to other algorithms.
Adult
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*Algorithms
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Biomarkers, Tumor/*blood
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CA-125 Antigen/blood
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Decision Support Techniques
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Diagnosis, Differential
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Female
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Humans
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Menopause
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Middle Aged
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Ovarian Neoplasms/*diagnosis/ultrasonography
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Predictive Value of Tests
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Prospective Studies
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Proteins/*analysis
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ROC Curve
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Risk Assessment/methods
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Sensitivity and Specificity
3.Association of Cord Blood Thyroid-Stimulating Hormone Levels with Maternal, Delivery and Infant Factors.
Karen M L TAN ; Anne H Y CHU ; See Ling LOY ; Victor Samuel RAJADURAI ; Clement K M HO ; Yap Seng CHONG ; Neerja KARNANI ; Yung Seng LEE ; Fabian Kok Peng YAP ; Shiao Yng CHAN
Annals of the Academy of Medicine, Singapore 2020;49(12):937-947
INTRODUCTION:
This study examined maternal, delivery and infant factors associated with cord thyroid-stimulating hormone (TSH) concentrations in an Asian population.
METHODS:
The Growing Up in Singapore Towards healthy Outcomes (GUSTO) study is a mother-offspring birth cohort from 2 major hospitals in Singapore. Cord serum TSH was measured using the Abbott ARCHITECT TSH Chemiluminescent Microparticle Immunoassay and the ADVIA Centaur TSH-3 Immunoassay. After excluding infants with a maternal history of thyroid disease, screening cord TSH results from 604 infants were available for multivariable regression analysis in relation to the factors of interest.
RESULTS:
Babies born by vaginal delivery had significantly higher cord serum TSH concentrations than babies born by caesarean section. Cord serum TSH concentrations differed significantly by measurement method. There was no association of cord TSH concentrations with ethnicity, sex, birth weight, gestational age, maternal body mass index, gestational weight gain, gestational diabetes mellitus status and other maternal, delivery and infant factors studied.
CONCLUSION
Interpretation of cord serum TSH results may need to take into account mode of delivery and measurement method.