Rapid changes in social and economic development have led to cancer becoming a major cause of national morbidity and mortality in Thailand. Cancer registries have been critical in documenting subnational cancer patterns and transitions in the country; with the establishment of six registries in northern Thailand, a comprehensive assessment of the scale and profile of cancer is now possible in the region. Cancers of the liver, lung, colorectum, breast and cervix were the major cancers 2008-2012, although variations in the profiles of cancer were observed, with a very high incidence of liver cancer seen among males in Phrae, corresponding to one in 11 men developing the disease in a lifetime. Based on data from Lampang and Chiang Mai 1993-2012, rates of lung and cervical cancer incidence have declined, while liver, colorectal and breast cancer incidence have been increasing up to 2012. A more detailed investigation of the incidence trends for specific cancer sites and subtypes at the local level are crucial to the monitoring and evaluation of the cancer control interventions implemented within the Thai national cancer control programme (NCCP). Priority should be given to extend the capacity of the new registries in northern Thailand, ensuring improvement in quality and utilization of the data to drive epidemiologic research and cancer control.
The screening program is successful in the target group at downshifting the stage distribution of malignant tumors and reducing incidence of malignant tumors with in situ cases being captured. However, the high incidence of malignant tumors in women over age 60 will continue to be clinically relevant for cervical cancer management until younger generations undergoing screening enter this age group.
Background The change over time of distribution of breast cancer subtypes using population-based data has not been reported. Objective To describe the change over time of the distribution of female breast cancer by clinical subtype among the population in Chiang Mai, Thailand. Methods Data of breast cancer patients from Chiang Mai Cancer Registry, diagnosed from 2004 to 2013 were combined with immunohistochemical status from medical record, and used to describe the proportions of clinical breast cancer subtypes: (1) luminal A-like (ER+/PR+ and HER2-), (2) luminal B-like (ER+/PR+ and HER2+), (3) HER2 (ER- and PR- and HER2+), (4) triple-negative (ER- and PR- and HER2-). The distribution of breast cancer subtypes by age group was also described. Results Among 3,228 female breast cancer cases diagnosed during 2004–2013, the median age was 52 years and most patients presented at the regional stage. The unknown tumor subtype was lower than 25% in the periods 2008– 2009, 2010–2011, and 2012–2013. In those periods, the proportions of luminal A-like were 33%, 36%, and 48%; the proportions of luminal B-like were 14%, 20%, and 16%, the proportions of HER2 were 15%, 14%, and 13%; and the proportions of triple-negative were 16%, 14%, and 13%, respectively. In comparison with other groups, women aged ≥60 years had a significantly higher proportion of luminal A-like (P = 0.001), while women aged <40 years tended to have a higher proportion of triple-negative (P = 0.10). Conclusions The proportion of breast cancer with luminal subtypes is increasing. Thus, in the future, treatment protocols with a variety of hormone therapies should be provided in order to improve efficacy and coverage of treatment for this population.
Background The Ministry of Public Health of Thailand established universal health coverage (UHC) in 2002, which also included national-level screening for cervical cancer in 2005. This study examined the changes in mortality of cervical cancer in rural and urban areas in Chiang Mai Province of northern Thailand during the era of UHC and the immediately preceding period. Methods Data of cervical cancer patients in Chiang Mai in northern Thailand, who died from 1998 through 2012, were used to calculate the change in age-standardized rates of mortality (ASMR) using a joinpoint regression model and to calculate estimated annual percent changes (APC). The change in mortality rate by age groups along with changes by geographic area of residence were determined. Results Among the 1177 patients who died from cervical cancer, 13(1%), 713 (61%) and 451 (38%) were in the young age group (aged < 30), the screening target group (aged 30–59) and the elderly group (aged ≥60), respectively. The mortality rate among women aged 30–59 significantly declined by 3% per year from 2003 through 2012 (p < 0.001). By area of residence, the mortality rate in women targeted by the screening program significantly decreased in urban areas but remained stable in more rural areas, APC of − 7.6 (95% CI: − 12.1 to − 2.8) and APC of 3.7 (95% CI: − 2.1 to 9.9), respectively. Conclusion The UHC and national cervical cancer screening program in Thai women may have contributed to the reduction of the mortality rate of cervical cancer in the screening target age group. However, this reduction was primarily in urban areas of Chiang Mai, and there was no significant impact on mortality in more rural areas. These results suggest that the reasons for this disparity need to be further explored to equitably increase access to cervical cancer services of the UHC.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.