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Tanda, Egypt

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. Source


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. Source


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. Source


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. Source


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. Source

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