Tanta Cancer Center

Tanda, Egypt

Tanta Cancer Center

Tanda, Egypt

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Dey S.,University of Michigan | Soliman A.S.,University of Michigan | Hablas A.,Gharbiah Cancer Society | Seifeldin I.A.,Tanta Cancer Center | And 8 more authors.
Breast Cancer Research and Treatment | Year: 2010

Breast cancer incidence is higher in developed countries with higher rates of estrogen receptor positive (ER+) tumors. ER+ tumors are caused by estrogenic exposures although known exposures explain approximately 50% of breast cancer risk. Unknown risk factors causing high breast cancer incidence exist that are estrogenic and development-related. Xenoestrogens are such risk factors but are difficult to study since developed countries lack unexposed populations. Developing countries have urban-rural populations with differential exposure to xenoestrogens. This study assessed urban-rural breast cancer incidence classified by hormone receptor status using data from Gharbiah population-based cancer registry in Egypt from 2001 to 2006. Urban ER+ incidence rate (per 100,000 women) was 2-4 times (IRR = 3.36, 95% CI = 4.84, 2.34) higher than rural incidence rate. ER-incidence rate was 2-3 times (IRR = 1.86, 95% CI = 2.38, 1.45) higher in urban areas than in rural areas. Our findings indicate that urban women may probably have a higher exposure to xenoestrogens. © 2009 Springer Science+Business Media, LLC.


Dey S.,Indian Institute of Public Health | Zhang Z.,University of Michigan | Hablas A.,Tanta Cancer Center | Seifeldein I.A.,Tanta Cancer Center | And 3 more authors.
Cancer Epidemiology | Year: 2011

Background: We investigated the variation in cancer incidence in Gharbiah, Egypt to explore geographic differences in relation to demographic and environmental exposures. Methods: Using data from the only population-based cancer registry of Gharbiah, we studied the 10 most common cancers in men and women over 4 years (1999-2002). Census data provided denominators and urban-rural definitions. Crude and adjusted incidence rates (IRs), incidence rate ratios (IRRs) and 95% confidence intervals (CIs) were estimated using Poisson regression. Results: Incidence of all common cancers was higher among men than women and urban incidence was higher than rural incidence for all cancer sites. Among men and women urban-rural incidence difference was highest for prostate cancer (IRR. = 4.85, 95% CI. = 3.76, 6.26) and uterus (IRR. = 6.05, 95% CI. = 4.17, 8.78), respectively. Among men and women, El-Santa district had the highest urban-rural difference within districts for laryngeal cancer (IRR. = 29.45, 95% CI. = 10.63, 81.61) and uterine cancer (IRR. = 15.98, 95% CI. = 2.69, 95.10), respectively. El-Santa also showed the highest urban incidence among all eight districts for most cancer sites. Conclusions: Geographic differences of cancers in Gharbiah need in-depth investigation with respect to specific environmental factors that explain the geographic cancer in this region. © 2010.


Mousa S.M.,University of Michigan | Seifeldin I.A.,Tanta Cancer Center | Hablas A.,Gharbiah Cancer Society | Elbana E.S.,Tanta Cancer Center | Soliman A.S.,University of Michigan
Breast | Year: 2011

Breast cancer is the most common cancer among Egyptian women, accounting for 37.6% of female tumors, and is often diagnosed at later stages. The objective of this study was to investigate breast cancer patient navigation through the health care system in the Nile Delta. Interviews were conducted with 163 newly diagnosed breast cancer patients at the Tanta Cancer Center (TCC), the major cancer center of the region. Patients described their medical care pathway from the initial symptom experienced until their arrival at TCC. Patients whose initial contact was with a general surgeon (OR: 7.6, 95% CI: 2.1, 27.6), primary care provider (OR: 12.2, 95% CI: 2.9, 51.0), or gynecologist (OR: 8.6, 95% CI: 1.4, 53.4) were significantly more likely to experience a delay in reaching the TCC as compared to those visiting a surgical oncologist. Overcoming health care system and patient navigation barriers in developing countries may reduce the time for breast cancer patients to reach a cancer center for early management. © 2011.


Elbedewy T.A.,Tanta University | Elashtokhy H.E.A.,Tanta Cancer Center | Rabee E.S.,Tanta University | Kheder G.E.,Tanta Cancer Center
Journal of the Egyptian National Cancer Institute | Year: 2015

Background: Occult hepatitis B infection (OBI) is characterized by negative hepatitis B surface antigen (HBsAg) and detectable hepatitis B virus (HBV)-DNA in the liver and/or serum, with or without hepatitis B core antibody (anti-HBc). Anti-HBc is the most sensitive marker of previous HBV. HBV reactivation in patients under immunosuppressive treatment is life-threatening, occurring in both overt and occult HBV especially in hematological malignancies. Aim of the work: To evaluate the prevalence and chemotherapy-induced reactivation of OBI among hepatitis B surface antigen negative patients with diffuse large B-cell lymphoma (DLBCL) patients and to determine the significance of anti-HBc screening among this group of patients before receiving chemotherapy. Patients and methods: This cross-sectional study included 72 DLBCL patients negative for HBsAg, HBsAb and hepatitis C virus antibodies (anti-HCV). Patients were subjected to investigations including anti-HBc. All patients underwent alanine transaminase (ALT) monitoring before each cycle of chemotherapy and monthly for 12. months after the end of chemotherapy. Patients with suspected OBI were tested for HBV-DNA using real-time polymerase chain reaction (PCR). Results: Anti-HBc was detected in 10 of 72 HBsAg negative sera (13.89%) (95% confidence interval 6.9-22.2%). Five of the 10 anti-HBc positive patients in this study had OBI reactivation. Conclusion: The study concluded that anti-HBc screening is mandatory before chemotherapy. HBsAg-negative/anti-HBc-positive patients should be closely observed for signs of HBV reactivation through the regular monitoring of ALT. Prophylaxis lamivudine is recommended for anti-HBc positive patients before chemotherapy. © 2015 Production and hosting by Elsevier B.V.


Zeeneldin A.A.,Cairo University | Saber M.M.,Cairo University | El-Din I.A.S.,Tanta Cancer Center | Frag S.A.,Tanta Cancer Center
Journal of the Egyptian National Cancer Institute | Year: 2013

Background: Small intestinal cancers (SICs) are very rare all over the world and little is known about them in Egypt. Methods: This a retrospective study. Between 2000 and 2002, 30 cases with SICs were identified in the Gharbiah population based cancer registry (GPBCR); 17 cases of whom were treated at Tanta Cancer Center (TCC). Results: The median age was 51. years with female predominance. The duodenum was the commonest site (43%) followed by the ileum then the jejunum. Adenocarcinoma (AC), carcinoids, gastrointestinal stromal tumors (GISTs), lymphoma and sarcoma represented 50%, 10%, 17%, 13% and 10% respectively. Abdominal pain was the commonest symptom and localized disease was the commonest presentation. Surgery, chemotherapy and radiotherapy were employed in 65%, 35% and 0% of patients, respectively. The median overall survival and progression free survival (OS, PFS) were 18 and 15. months (95% CI: 10.4-25.6 and 3.6-26.4), respectively. AC had inferior OS and PFS to other histologies (p= 0.08 and 0.12, respectively). Also, duodenum subsite was inferior in OS and PFS to other sites (p= 0.25 and 0.35, respectively). Conclusions: SICs in Gharbiah, Egypt are characterized by predominance of female gender and adenocarcinoma histology. One year survival is 64% with a poor outcome for adenocarcinoma and duodenal subsite. © 2013.


Saber M.M.,Cairo University | Zeeneldin A.A.,Cairo University | Samra M.A.,Cairo University | Farag S.A.,Tanta Cancer Center
Journal of the Egyptian National Cancer Institute | Year: 2013

Introduction: Gastrointestinal lymphoma (GIL) is the most common extranodal form of non-Hodgkin's lymphoma (NHL) with geographical and age variation of its various subtypes. Aim: To study GIL in Gharbiah, Egypt and to recognize the treatments employed and their outcomes including survival. Methods: This is a retrospective study. Between 2000 and 2002, 40 adult patients with GIL were identified in the Gharbiah population based cancer registry (GPBCR); 26 cases of whom were treated at Tanta Cancer Center (TCC). Results: GIL in Gharbiah, Egypt represented 6.2% of all GIT cancers. The median age was 47. years with slight male predominance. The commonest primary site was the stomach followed by the colon/rectum then the small intestine (67.5%, 25% and 7.5%, respectively). The commonest histological subtypes were the diffuse large B-cell (41.5%) followed by marginal zone B-cell (39%). The commonest symptoms were abdominal pains followed by vomiting. Only 18% of GILs were surgically resected. Most patients (77%) received chemotherapy with a 60% complete response (CR) rate. Once in CR, relapses are occasional. The median overall survival (OS) and progression free survival (PFS) were 31 and 14. months (95% CI, 13.2-48.7 and 6.4-21.6. months, respectively). Gastric primary site and diffuse large B cell subtype carry a non-significant worse OS and PFS than those of other sites and subtypes. Conclusions: GILs in Gharbiah, Egypt are characterized by predominance of male gender, gastric site and marginal zone histology. Survival is worse for gastric and diffuse large B-cell GILs compared to other sites and histologies. © 2013.


Zeeneldin A.A.,Cairo University | Ramadan M.,Tanta Cancer Center | Gaber A.A.,Cairo University | Taha F.M.,Cairo University
Journal of the Egyptian National Cancer Institute | Year: 2013

Background: Breast cancer (BC) is a major worldwide health care problem that mostly afflicts the elderly population in the more developed countries. It is not known how common is breast cancer among elderly Egyptian patients and whether this differs from the disease in younger patients. Aims: To study the clinico-pathological features of BC in elderly Egyptian patients (≥65. years of age) among the population of an Egyptian Governorate, Gharbiah, and to compare these features with those of younger patients (<65. years). Methods: This is a cross sectional study that compares elderly BC (EBC) and the non-elderly BC (NEBC) using the information from the Gharbiah Population-based Cancer registry (GPCR) during the years 1999-2007. Results: Out of 6078 BCs, 12% were EBCs and 88% were NEBCs. Between 1999 and 2007, the crude incidence rate (CIR, per 100,000 populations) of EBC increased from 47 to 71 and that of NEBC increased from 16 to 17. Compared to NEBC patients, EBC patients were more likely to have a positive family history and present with a distant disease and less likely to present with a localized disease. EBCs were more likely to have lung metastases and less likely to have liver metastases. Histology, grade, hormone and HER-2 receptor statuses were comparable in both groups. Apart from hormonal therapies, the elderly were less likely to receive surgery, radiotherapy or chemotherapy. Conclusion: EBC patients in Egypt present with advanced disease and are less likely to receive surgery, radiotherapy or chemotherapy compared to NEBC patients. © 2012.


Stapleton J.M.,University of Michigan | Mullan P.B.,University of Michigan | Dey S.,University of Michigan | Hablas A.,Tanta Cancer Center | And 4 more authors.
Psycho-Oncology | Year: 2011

Objective: Breast cancer fatality rates are high in low- and middle-income countries because of the late stage at diagnosis. We investigated patient-mediated determinants for late-stage presentation of breast cancer in Egypt. Methods: A case-case comparison was performed for 343 women with breast cancer, comparing those who had been initially diagnosed at Stage I or II with those diagnosed at Stage III or IV. Patients were recruited from the National Cancer Institute of Cairo University and Tanta Cancer Center in the Nile delta. Patients were either newly diagnosed or diagnosed within the year preceding the study. Interviews elicited information on disease history and diagnosis, beliefs and attitudes toward screening practices, distance to treatment facility, education, income, and reproductive history. Results: Forty-six per cent of the patients had presented at late stage. Women seen in Cairo were more likely to present at late stages than patients in Tanta (OR = 5.05; 95% CI = 1.30, 19.70). Women without any pain were more likely to present at later stage (OR = 2.68; 95% CI = 1.18, 6.08). Knowledge of breast self-examination increased the likelihood of women to present in early stages significantly (OR = 0.24; 95% CI = 0.06, 0.94). Conclusions: Despite increasing numbers of cancer centers in Egypt during the past 20 years, additional regional facilities are needed for cancer management. In addition, increasing awareness about breast cancer will have significant long-term impact on breast cancer prevention. Copyright © 2010 John Wiley & Sons, Ltd.


Kim J.H.,University of Michigan | Rozek L.S.,University of Michigan | Soliman A.S.,University of Nebraska Medical Center | Sartor M.A.,University of Michigan | And 6 more authors.
Environmental Health: A Global Access Science Source | Year: 2013

Background: There is now compelling evidence that epigenetic modifications link adult disease susceptibility to environmental exposures during specific life stages, including pre-pubertal development. Animal studies indicate that bisphenol A (BPA), the monomer used in epoxy resins and polycarbonate plastics, may impact health through epigenetic mechanisms, and epidemiological data associate BPA levels with metabolic disorders, behavior changes, and reproductive effects. Thus, we conducted an environmental epidemiology study of BPA exposure and CpG methylation in pre-adolescent girls from Gharbiah, Egypt hypothesizing that methylation profiles exhibit exposure-dependent trends. Methods. Urinary concentrations of total (free plus conjugated) species of BPA in spot samples were quantified for 60 girls aged 10 to 13. Genome-wide CpG methylation was concurrently measured in bisulfite-converted saliva DNA using the Infinium HumanMethylation27 BeadChip (N = 46). CpG sites from four candidate genes were validated via quantitative bisulfite pyrosequencing. Results: CpG methylation varied widely among girls, and higher urinary BPA concentrations were generally associated with less genomic methylation. Based on pathway analyses, genes exhibiting reduced methylation with increasing urinary BPA were involved in immune function, transport activity, metabolism, and caspase activity. In particular, hypomethylation of CpG targets on chromosome X was associated with higher urinary BPA. Using the Comparative Toxicogenomics Database, we identified a number of candidate genes in our sample that previously have been associated with BPA-related expression change. Conclusions: These data indicate that BPA may affect human health through specific epigenomic modification of genes in relevant pathways. Thus, epigenetic epidemiology holds promise for the identification of biomarkers from previous exposures and the development of epigenetic-based diagnostic strategies. © 2013 Kim et al.; licensee BioMed Central Ltd.


Attar E.,University of Michigan | Dey S.,University of Michigan | Hablas A.,Tanta Cancer Center | Seifeldin I.A.,Tanta Cancer Center | And 3 more authors.
Oral Oncology | Year: 2010

Head and neck cancer (HNC) has been studied in different regions of the world but little is known about its incidence patterns in the Middle East and Egypt. In this study from Egypt's only population-based registry, we analyzed data from 1999 to 2006, to estimate incidence, incidence rate ratios (IRRs) and 95% confidence intervals (CIs) categorized by age, district and subsites. Overall urban incidence of HNC was twice or more that of rural incidence for both males (IRR = 2.59; 95% CI = 2.26, 2.97) and females (IRR = 2.00; 95% CI = 1.64, 2.43). Highest urban-rural difference for males was seen in 40-49 years (IRR = 2.79; 95% CI = 1.92, 4.05) and for females in 30-39 years (IRR = 2.94; 95% CI = 1.60, 5.40). Among subsites, highest incidence among males was for larynx (1.53/105) and among females for gum and mouth (0.48/10 5). Maximum urban-rural difference in males was for paranasal sinus (IRR = 4.66; 95% CI = 1.88, 11.54) and in females for lip (IRR = 8.91; 95% CI = 1.89, 41.98). The study underscores the patterns of HNC incidence in Egypt while indicating the need for future analytical studies investigating specific risk factors of HNC in this population. © 2010 Elsevier Ltd. All rights reserved.

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