Although follow-up data on women with positive test results were inadequately documented, the present findings indicate that provision of cytology services through the existing healthcare system is feasible.

Estrogen and its metabolites are believed to play important roles in breast cancer, and its determinants include both genetic and lifestyle factors. The objective of the study is to investigate the association of breast cancer risk in Thailand with genetic polymorphisms in several genes involved in estrogen synthesis and metabolism. Five hundred and seventy patients with histopathologically confirmed breast cancer and 497 controls were included in the present study. Forty single nucleotide polymorphisms (SNPs) in the CYP1A1, CYP1A2, CYP1B1, CYP17, CYP19, CYP2C9, CYP2C19, AhR, ESR1, PGR, ERRG, COMT, HSD17B1, HSD17B2, EPHX1 and NQO1 genes were genotyped. Association of genotypes with breast cancer risk was evaluated using multivariate logistic regression, which suggested an altered risk for the following SNPs [gene, odds ratio (OR) . In addition, a stratified analysis by menopausal status indicated that the association of the CYP1A2 (rs762551) and CYP17 (rs743572) polymorphisms with breast cancer risk were mainly evident in premenopausal, while ERRG (rs1857407) was significant in postmenopausal women. These findings suggest that CYP1A2, CYP2C19, AhR, ERRG and CYP17 polymorphisms may play an important role in estrogen metabolism and modify individual susceptibility to breast cancer in Thai women. ' UICCKey words: breast cancer; estrogen metabolizing enzyme; single nucleotide polymorphisms Much of the variability in global breast cancer rates has been attributed to country-specific differences in the prevalence of risk factors that determine lifetime exposure to estrogen. Comparatively younger ages at menarche, older ages at first birth and/or menopause and a higher prevalence of postmenopausal obesity have been proposed as explanations for the disparate breast cancer incidence rates among American Caucasian (97/100,000) and Asian women (27/100,000).1,2 Cross cultural differences in height, diet, alcohol consumption and exogenous estrogen use are also believed to contribute to international differences, but to a lesser extent. 3,4 Age-specific breast cancer incidence also varies between high-and low-risk countries: the mean age at diagnosis in developing countries is lower than that for European and American populations.It can be hypothesized that estrogen metabolites contribute to the activation of the estrogen receptor and the generation of DNAdamaging molecular species. 5 The genes involved in the disposition of female sex hormones are well known, and include COMT (catechol-O-methyltransferase), HSD17B1 (17 b-hydroxysteroid dehydrogenase type 1), HSD17B2, ESR a (estrogen receptor a), PGR (progesterone receptor), ERRG (estrogen-related receptor g), NQO1 (NADPH quinine oxoreductase), EPHX1 (epoxide hydrolase), AhR (aryl hydrocarbon receptor a) and members of the cytochrome P450 family including CYP1A1, CYP1A2, CYP1B1, CYP17, CYP19, CYP2C9 and CYP2C19.Because Asian women have, on average, a 20% lower serum estradiol level than Western women, 6 it is possible that the effects of genetic polymorphisms of estrogen-...

ObjectiveColorectal cancer (CRC) is the third-most and fifth-most common cancer in men and women, in Thailand. The increasing CRC incidence and mortality can be reduced by screening and treating adenomas and early cancers. A pilot CRC screening programme using immunochemical faecal occult blood testing (iFOBT) and colonoscopy for test-positives were implemented through the routine Government Health Services in Lampang Province, to inform the acceptability, feasibility and scaling-up of screening in Thailand. This report describes the implementation, coverage and performance indicators of this project.DesignA target population aged 50–65 years was informed about and invited face to face to undergo CRC screening by community health workers (HWs). The HWs provided faecal sample collection kits and participants brought their samples to one of the primary health units or community hospitals where nurses performed iFOBT. iFOBT-positive persons were referred for colonoscopy at the Lampang cancer hospital, and endoscopic polypectomy/biopsies were performed according to the colonoscopic findings. Those with confirmed CRC received appropriate treatment.ResultsOf the 127 301 target population, 62.9% were screened using iFOBT between April 2011 and November 2012. Participation was higher among women (67.8%) than men (57.8%) and lower in 50–54 year-old persons than in 60–65-year-olds. Of those screened, 873 (1.1%) were found positive; positivity was higher in men (1.2%) than in women (1.0%). To date 627 (72.0%) iFOBT-positive persons have had colonoscopy in which 3.7% had CRC and 30.6% had adenomas.ConclusionsThe successful implementation of the pilot CRC screening with satisfactory process measures indicate the feasibility of scaling-up organised CRC screening through existing health services in Thailand.

Dietary folate as well as polymorphic variants in one-carbon metabolism genes may modulate risk of breast cancer through aberrant DNA methylation and altered nucleotide synthesis and repair. Alcohol is well recognized as a risk factor for breast cancer, and interactions with one-carbon metabolism has also been suggested. The purpose of this study is to test the hypothesis that genetic polymorphisms in the folate and alcohol metabolic pathway are associated with breast cancer risk. Twenty-seven single nucleotide polymorphisms (SNPs) in the MTR, MTRR, MTHFR, TYMS, ADH1C, ALDH2, GSTP1, NAT1, NAT2, CYP2E1 DRD2, DRD3, and SLC6A4 were genotyped. Five hundred and seventy patients with histopathogically confirmed breast cancer and 497 controls were included in the present study. Association of genotypes with breast cancer risk was evaluated using multivariate logistic regression to estimate odds ratios (OR) and their 95% confidence intervals (95% CI). Increased risk was observed for homozygotes at the MTR SNPs (rs1770449 and rs1050993) with the OR = 2.21 (95% CI 1.18-4.16) and OR = 2.24 (95% CI 1.19-4.22), respectively. A stratified analysis by menopausal status indicated the association between the NAT2 SNP (rs1799930) and breast cancer was mainly evident in premenopausal women (OR 2.70, 95% CI 1.20-6.07), while the MTRR SNP (rs162049) was significant in postmenopausal women (OR 1.61, 95% CI 1.07-2.44). Furthermore, SNPs of the genes that contribute to alcohol behavior, DRD3 (rs167770), DRD2 (rs10891556), and SLC6A4 (rs140701), were also associated with an increased risk of breast cancer. No gene-gene or gene-environment interactions were observed in this study. Our results suggest that genetic polymorphisms in folate and alcohol metabolic pathway influence the risk of breast cancer in Thai population.

Cancers of the colon and rectum are rare in developing countries, in contrast to the high incidence rates in countries of Europe, North America, Australia and Japan. Significant differences also exist within continents. Colorectal cancer mortality and incidence rates have decreased in the USA. However, the incidence in Japan and Thailand is rising, probably due to the acquisition of Western lifestyle. Incidence also increases with age: carcinomas are rare before the age of 40 years except in individuals with genetic predisposition or predisposing conditions. The incidence rate of colorectal cancer in Thailand is low when compared with other countries. It is the third in frequency in males after liver and bile duct and lung cancers, and the fifth after cancers of the cervix, breast, liver and bile duct and lung for females. The highest incidence for both sexes is seen in Bangkok. The number of cases of colorectal cancer in both sexes is increasing and will probably exceed that of lung cancer in the next decade. Thus, we are planning to have colorectal cancer screening programme. We should pay more attention on primary and secondary prevention to control colorectal cancer in Asian countries.