Tobacco Alcohol Research Articles

Современная концепция использования лучевой терапии при раке полости рта и орофарингеальной зоны

In the world, there is a rise of cancer incidence, including cancer of the head and neck. The incidence cancer of the head and neck is 4.8 cases per 100 000 population. Oral and oropharyngeal cancers are the most frequently forms cancer of the head and neck – 4,8–27 % of all cancer with this location. Among the causes of oral and oropharyngeal cancer noted alcohol abuse, tobacco and infection with human papilloma virus (HPV-16). Mortality from oral and oropharyngeal cancer is on 8 rank among patients with all tumors. Now when deciding about treatment of oral and oropharyngeal cancer is applied a new classification АJCC8th, the main differences from the previous version are the inclusion of data on the depth of tumor invasion and the presence of extranodal growth of lymphogenic metastasis.
 The chemoradiotherapy to a total dose 60–74 Gy is the most common treatment used in oral and oropharyngeal cancer. When planning irradiation, both the tumor itself (or its residual component) and lymphogenic metastases or lymph nodes with a high risk of metastatic lesions are included in the target volume. The most commonly used chemotherapy drug is cisplatin. The duration of life of patients is significantly influenced by the stage of the tumor process. So 5-year relapse-free survival among patients with oral cancer is 91 % at T1–2, 83 % – at T3 and 12 % – at T4. During the first 5 years after completion of treatment, the probability of locoregional recurrence in patients with oropharyngeal cancer is much shorter in infected HPV-16 – 28.9 % and 54.9 %, respectively. 
 The effective multimodal treatment of oral and oropharyngeal cancer can be only if the evaluation of the tumor process under the current classification, comply with the requirements of treatment standards and clinical guidelines as well as take into account the latest achievements of the relevant field of medical science.

Otolaryngology needs among an adult homeless population: a prospective study

BackgroundHomeless individuals frequently experience poor access to healthcare, delayed clinical presentation, and higher disease burden. Providing subspecialty otolaryngology care to this population can be challenging. We previously reported on the prevalence of hearing impairment in Toronto’s homeless community. As a secondary objective of this study, we sought to define otolaryngology specific need for this population.MethodsOne hundred adult homeless individuals were recruited across ten homeless shelters in Toronto, Canada using a stratified random sampling technique. An audiometric evaluation and head and neck physical examination were performed by an audiologist and otolaryngology resident, respectively. Basic demographic and clinical information was captured through verbal administration of a survey. Descriptive statistics were used to estimate frequency of otolaryngology specific diseases for this population.ResultsOf the 132 individuals who were initially approached to participant, 100 (76%) agreed. There were 64 males, with median age of 46 years (IQR 37–58 years). The median life duration of homelessness was 24 months (IQR 6–72 months). Participants had a wide range of medical comorbidities, with the most common being current tobacco smoking (67%), depression (36%), alcohol abuse (32%), and other substance abuse (32%). There were 22 patients with otolaryngology needs as demonstrated by one or more abnormal findings on head and neck examination. The most common finding was nasal fracture with significant nasal obstruction (6%). Eleven patients required referral to a staff otolaryngologist based on concerning or suspicious findings, including two head and neck masses, 6 were later seen in follow-up.ConclusionThere were substantial otolaryngology needs amongst a homeless population within a universal healthcare system. Future research should focus on further elucidating head and neck related issues in this population and expanding the role of the otolaryngologist in providing care to homeless individuals.

P282 Elevated serum uric acid associated with both electrocardiographic and echocardiographic left ventricular hypertrophy independent of blood pressure in healthy individuals

Abstract Funding Acknowledgements TSGH 108-11 Background Elevated serum uric acid (SUA) is associated with cardiac fibrosis and hypertrophy. A growing body of evidence showed the positive correlation between hyperuricemia (HUA) and left ventricular hypertrophy (LVH), but most studies defined LVH by a single method such as electrocardiogram or echocardiogram; the former is generally used in massive screen but the latter take advantage of the accuracy of LVH. Purpose We conducted this study to concomitantly investigate the association between SUA and electrocardiographic and echocardiographic LVH. Methods We initially enrolled 17,913 healthy individuals, who routinely underwent an annual health exam at our hospital between 2016/1/1∼2016/12/31. Of them, 347 individuals received transthoracic echocardiography because of abnormal results in their electrocardiogram. Amplitudes of 12-lead electrocardiogram were artificially measured by a study assistant under the supervision and by artificial intelligence. HUA is defined as an SUA level of ≥7 mg/dl in men and ≥6 mg/dl in women. Electrocardiographic LVH is defined by the criteria of Cornel voltage and product and Sokolow-Lyon and the Minnesota Code ECG classification. Echocardiographic LVH is defined by LV mass index ≥115g/m² in men or ≥95g/m² in women. Results The HUA group (n = 233) vs. normouricemic group (n = 114) was older and predominant male with greater values of body mass index, systolic and diastolic blood pressure and laboratory biomarkers, including non-high density total cholesterol, fasting glucose impairment, creatinine clearance, and haemoglobin. The two groups had comparable lifestyle choices, including tobacco use, alcohol intake, and physical activities per week. The HUA group compared with the normouricemic group had greater values of S amplitude of V1 plus R amplitude of V5 (3031 ± 2055 uV vs. 2566 ± 1021 uV, P = 0.005), R amplitude in lead I plus S amplitude in lead III (842 ± 443 uV vs. 696 ± 386 uV, P = 0.002) and LV mass index (95 ± 23 g/m² vs. 85 ± 30 g/m², P = 0.001). The prevalence of electrocardiographic and echocardiographic LVH was greater in the HUA group than the normouricemic group (7.0% vs. 2.1%, P = 0.034 for electrocardiographic LVH and 15.8% vs. 7.7%, P = 0.025 for echocardiographic LVH). In multivariate logistic regression analyses, elevated SUA was associated with LVH after the confounders were fully adjusted (OR: 1.38, 95% CI: 1.07-1.77, P = 0.012 for electrocardiographic LVH and OR: 1.58, 95% CI 1.15-2.17, P = 0.004 for echocardiographic LVH). Conclusion Elevated SUA is independently associated with the prevalence of both electrocardiographic and echocardiographic LVH in healthy individuals from Taiwan. Future studies might evaluate urate-lowering effects on the regression of LVH.

Study of sociodemographic factors affecting outcome of babies admitted in neonatal care unit

Background: A country needs sound epidemiological information to prioritize, plan and implement the public health care system effectively. Outcome data from hospitalized patients reflect the causes of major illnesses and care seeking behaviour of the community. Thus, we felt the need to conduct this study at our hospital to assess the socio-demographic factors affecting outcome of babies admitted in neonatal intensive care unit.Methods: The present study was a hospital based observational descriptive study. The study was undertaken in neonatal intensive care unit (NICU) of department of paediatrics of tertiary care centre. The study period was from January 2013 to December 2013 i.e. total period of one year.Results: Among 1050 total neonatal admissions 601 (57.29%), were from rural area and 449 (42.70%) were from urban area. Multinomial regression analysis reveals that socio-demographic factors like age of mother, parental intake of tobacco alcohol in any form, socioeconomic class IV, in born place of delivery, occupation and education of father, low birth weight and male sex of baby affects the outcome of babies.Conclusions: Cure rate in NICU admissions was 69% which may be due to available speciality staff and logistics. Taking this into account, 40 bedded NICU in tertiary care hospital seemed to be essential and sufficient.

A RETROSPECTIVE STUDY OF BIOPSIED ORAL LESIONS IN A POPULATION FROM A BRAZILIAN FAVELA

Oral lesions may vary significantly from 1 region to another, considering the socioeconomic, environmental, cultural, and infrastructural conditions of the patients. Epidemiologic data are essential to evaluate the distribution of oral diseases and to develop appropriate prevention methods. Objective: The aim of the present study is to report a survey of oral lesions biopsied in patients from one of the largest favela (slums) from Brazil. Study Design: Clinical records and microscopic diagnosis of oral lesions of these patients were retrieved from the files of an oral pathology laboratory from Brazil between 2016 and 2017. Results: A total of 84 biopsies were performed. Most patients (66%) were women with average age of 44 years. Twenty-five different diagnoses were signed out, being the most common: fibrous hyperplasia (38.5%), mucocele (12%), and squamous cell carcinoma (SCC) (9.5%). Conclusion: There was a significant number of SCC, the most common oral cancer, which was commonly detected in smokers and drinkers of this population. Preventive actions against tobacco use and alcohol consumption habits are required in order to decrease the incidence of oral cancer in this favela population. These actions should include proposals that can help to improve the social reality of this community.

CHANGES IN THE HARMFUL HABITS OF RISK FOR ORAL CANCER OVER 27 YEARS IN THE STATE OF PARANÁ, BRAZIL

Tobacco smoking and alcohol drinking are increasing the risk of oral cancer. The aim of the study is to report the experience of 27 years of voluntary actions regarding the prevention of oral cancer in Parana, Brazil. From 1989 to 2015, voluntary health actions were carried out aimed at the prevention of oral cancer. Volunteers over 30 years old answered a questionnaire with personal data and harmful habits, such as smoking and alcoholism, as well as a physical examination. Results: A total of 25,177 patients were examined, of which 21.5% had oral lesions, such as traumatic and inflammatory lesions and leukoplakia, with characteristics of malignancy, papilloma, and erythroplasia. Regarding the harmful habits, from 1989 to 1998, 25% of the participants were smokers and 14.4% drinkers of alcohol. In the subsequent 10 years, there was a drop in habits to 18.4% and 14.3%, respectively. However, frequencies increased between 2009 and 2015, reaching to 24.3% of smokers and 18.4% of alcohol drinkers. The data show that the harmful habits of the population studied varied over the years, while the percentage of smokers and users of alcohol in Parana is still high, and that more preventive campaigns should be made to raise awareness of the population regarding its carcinogenic effects.

Physical Activity and Health Habits of 17- to 25-Year-Old Young People during Their Free Time

The objective was to examine daily health-related habits and physical activity during free time in a group of young people, with the aim of analysing what types of habits are developed and the associations existing between these habits. A cross-sectional and observational study was carried out. The sample was composed of 1132 young people from Castilla-La Mancha (Spain), 53.4% women and 46.6% men, between 17 and 25 years old (M = 20.63; DT = 2.01). The instrument used in this study was the questionnaire of assessment of health-related habits (QAHH). Different ranges of age and gender were taken into account in the analyses. The results showed low rates of physical activity, with only 25% of the participants practicing physical activity in their free time. Regarding gender, no differences were observed between boys and girls in terms of the level of physical activity practice. The inferential analyses revealed several significant relationships between the habits of leisure time and the practice of physical activity. The analyses also revealed that alcohol consumption, tobacco consumption and Internet were used as means to escape from everyday life. The most frequent free-time activities of the participants during the week were the use of new technologies and the consumption of harmful substances. During the weekends the most frequent ones were physical activity and consumption of harmful substances. While the relationship between physical activity, health-related habits and leisure time in young people is complex, these results indicate that physical activity should be promoted in young people, especially during the week and as a healthy alternative to the consumption of harmful substances. To do this, professionals of different fields (education, psychology, sports sciences, nutrition and medicine, among others) should work together.

General practitioners, pregnancy and addictions in France in 2015

Abstract Background Tobacco smoking and alcohol drinking during pregnancy result in serious health hazard for both the baby and the mother. In France, about 17% of pregnant women smoke and 20% consume alcohol. General practitioners (GPs) can have an active role in preventing those behaviors as they often interact with pregnant patients: one quarter of French pregnant women have had at least one antenatal visit with a GP. The aim of our study is to describe French GPs’ practices (screening and counseling) toward pregnant patients regarding tobacco smoking and alcohol drinking. Methods In 2015, a telephone survey was set based on a stratified random sampling of metropolitan France GPs. A representative sample of 1,414 French GPs completed the study. Results Screening for alcohol consumption at least once for every patient was done by 61% of GPs and for smoking by 82% of GPs. Counselling to quit alcohol consumption was done by 77% of GPs while counselling to quit smoking was done by about 90% of them. GPs’ practices were significantly better among those who had more recent ongoing training. Regular drinkers GPs were less likely to systematically screen for alcohol use and GPs’ alcohol use frequency was adversely related to recommending quitting. Current and former smokers GPs were less likely to recommend quitting to pregnant patients smoking over 5 cigarettes per day. Conclusions Screening for alcohol use and smoking during pregnancy is not yet systematic among GPs in France. GPs’ prevention role with pregnant patients could be emphasized, potentially through initial and ongoing trainings adaptation. Besides, as regular alcohol use and smoking are related to unwanted practices, prevention for the benefit of GPs could be even more fruitful. Key messages Screening for alcohol use and smoking during pregnancy is not systematically done by French GPs. GPs’ prevention role with pregnant patients could be emphasized, potentially through initial and ongoing trainings adaptation.

Impact of depression and anxiety on cancer patients' perceptions of lifestyle behaviors.

141 Background: Health behaviors including tobacco use, alcohol consumption, and physical activity (PA) can impact outcomes in cancer survivors. While the peri-diagnostic period can be a "teachable moment" for behavior change, patients may face barriers including mental health comorbidities. We have previously identified that patient perceptions of behaviors can influence behavior change. Here, we evaluated the impact of anxiety and depression on patient perceptions of these behaviors. Methods: Cancer patients from all disease sites were surveyed (2016-17) on their smoking, alcohol habits, and PA, and perceptions of the impact of these behaviors on fatigue, survival, and quality of life (QofL). Survey data were linked with same day Edmonton Symptom Assessment Symptom (ESAS) anxiety and depression scores. Logistic regression models evaluated the impact of anxiety and depression on patient perceptions. Results: Of 496, 53% were male; median age, 60 years. At diagnosis, 20% were current smokers, 47% were current drinkers, and 67% were not meeting PA guidelines. 30% screened positive for anxiety (ESAS anxiety > 3) and 34% screened positive for depression (ESAS depression > 2); mean [standard deviation] scores were 1.9 [2.3] for anxiety and 1.5 [2.2] for depression. Most current smokers (> 80%) perceived smoking to negatively impact fatigue, survival and QofL. Smokers screening positive for anxiety were more likely to perceive smoking as harmful on survival (OR=9.09, 95% CI (1.15-100), P=0.04); greater ESAS anxiety scores were associated with perceiving smoking to worsen survival (OR=1.51 per point, 95% CI (1.04-2.17), P=0.03). While those less physically active at diagnosis (> 65%) felt that PA improves fatigue, survival and QofL and half of current drinkers (45%-50%) felt that alcohol worsens outcomes, anxiety and depression were not found associated with perceptions (P > 0.10). Conclusions: Among current smokers, greater anxiety scores and those screening positive for anxiety were more likely to perceive continued smoking as harmful to survival. Mental health comorbidities were not found to have an impact on patient perceptions of the effect of alcohol consumption and PA on fatigue, survival, and QofL.

Trauma-informed interventions versus control for cancer-risk behaviours among adults: rationale and design for a randomized trial

BackgroundTobacco use, alcohol use, and sugar-sweetened beverage consumption are each associated with increased cancer-risk. Psychological trauma is a common experience and a key driver of these behaviours among adults. The primary aim of this study is to evaluate the effect of trauma-informed yoga, drumming, and psychoeducation compared to control on tobacco use, alcohol use, and sugar-sweetened beverage consumption among community-based adults. Secondary aims are to evaluate the effect of these interventions compared to control on psychological and physiological stress symptomology, social connection, and coping behaviour.MethodsRecruitment for this single-blinded randomized trial began in April 2019 in the Faculty of Health Sciences at the University of Lethbridge. Adults who consumed tobacco, alcohol, or sugar-sweetened beverages in the past month and live in Lethbridge, Alberta are being recruited using ads placed in public spaces. Participants are randomly allocated to a 12-session group yoga class, 12-session group drumming class, a 12-session psychoeducation class, or control. Participants attend an appointment in-person to fill out an online questionnaire package, provide a saliva sample, and complete physical measures pre-intervention, and 1-month and 6-months post-intervention.DiscussionThis study provides a unique opportunity to compare the impacts of two trauma-informed body-based interventions to psychoeducation and control for cancer-risk behaviour among community-based adults. The findings can be used to develop trauma-informed group interventions to reduce cancer-risk behaviour in general populations. Results are expected in 2022.Trial registrationThis trial was registered with ClinicalTrials.govISRCTN15583681 on 22 August 2019 (retrospectively registered).

Risk of second primary neoplasia in patients with oropharyngeal carcinoma: Role of HPV status in the outcome.

e17544 Background: Patients with HPV-positive oropharyngeal cancer (OPC) have better prognosis and a lower risk of appearance of second primary neoplasm (SPN) than HPV-negative OPC patients. The aim of our study was to analyze the risk of developing SPN in a large group of patients with OPC according to HPV status in the primary tumor and its relationship with toxic habits. Methods: This study includes patients from a prospective data-base: 484 OPC patients were treated from 1991 to 2017 for which the HPV DNA positivity was evaluated by PCR in available tumor specimens. HPV DNA positive samples were further tested for HPV E6*I mRNA detection and/or p16INK4a immunohistochemistry. The mean follow-up of patients included in the study was 4.9 years (SD 5.1 years). We estimated the incidence of SPN in all cancer sites and in cancer sites related to tobacco and alcohol consumption according to the HPV status in the primary tumor. Results: Ninety-nine (20.5%) out of 484 OPCs included in the study were HPV-related. During the follow-up period, 127 patients with HPV-negative tumors (33.0%) and 19 patients with HPV-positive tumors (19.2%) had a SPN. Considering only the tobacco/alcohol-related SPNs, 106 of the patients with HPV-negative tumors (27.5%), and 12 patients with HPV-positive tumors (12.1%) had a tobacco/alcohol-related SPN (P < 0.0001). Five-year and 10-year SPN-free survival for HPV-negative versus HPV-positive OPC patients was 61.0% versus 81.5%, and 37.6% versus 73.8%, respectively (P < 0.001). When restricting the analyses to tobacco/alcohol-related SPNs, the corresponding survival rates were 66.6% versus 86.8% and 45.9% versus 83.5% for 5-year and 10-year survival rates, respectively (P < 0.0001). The frequency of tobacco/alcohol-related SPNs occurrence throughout the follow-up period for patients with HPV-negative OPC was 27.5%, for patients with HPV-positive tumors with a previous history of severe tobacco and/or alcohol use was 21.4%, and for patients with HPV-positive tumors without a history of severe tobacco and/or alcohol consumption it was 8.5% (P < 0.0001). Conclusions: HPV status and previous toxic habits might allow classifying patients regarding the risk of tobacco/alcohol-related SPNs. HPV-related OPC patients without previous history of severe tobacco and/or alcohol use have a significant low risk of SPN development, particularly in those locations related to tobacco use or alcohol consumption

The Relationship Between Environmental Exposure and Genetic Architecture of the 2q33 Locus With Esophageal Cancer in South Africa.

Esophageal squamous cell carcinoma (ESCC) has a high prevalence in several countries in Africa and Asia. Previous genome-wide association studies (GWAS) in Chinese populations have identified several ESCC susceptibility loci, including variants on chromosome 2q33 and 6p21, but the contribution of these loci to risk in African populations is unknown. In this study we tested the association of 10 genetic variants at these two risk loci on susceptibility to ESCC in two South African ethnic groups. Variants at 2q33 (rs3769823, rs10931936, rs13016963, rs7578456, rs2244438) and 6p21 (rs911178, rs3763338, rs2844695, rs17533090, rs1536501) were genotyped in a set of Black Xhosa (463 cases and 480 controls) and Mixed Ancestry (269 cases and 288 controls) individuals. Genotyping was performed using TaqMan allelic discrimination assays. The Pearson’s chi-squared test was used to compare the allele frequency between cases and controls. Gene-environment interactions with tobacco smoking and alcohol consumption were investigated in a case-control analysis. A logistic regression analysis was further performed to elucidate the independent effect of each association signal on the risk of ESCC. The 2q33 variants rs10931936, rs7578456, and rs2244438 were marginally associated with higher risk of ESCC in the Mixed Ancestry population (ORs = 1.39–1.58, p ≤ 0.035), of which rs7578456 and rs2244438 remained significant after multiple correction (p < 0.005). The associations with rs7578456 and rs2244438 were also observed across strata of tobacco smoking (ORs = 1.47–2.75, p ≤ 0.035) and alcohol consumption (ORs = 1.45–2.06, p ≤ 0.085) status. However, only the association with rs2244438, which lies within an exon of TRAK2, remained significant after adjustment for the other variants in the region. Interestingly, none of the variants tested were significantly associated with ESCC in the Black South African population. These finding implicate TRAK2 as a casual gene for ESCC risk in the Mixed Ancestry population of South Africa and confirm prior evidence of population-specific differences in the genetic contribution to ESCC, which may reflect differences in genetic architecture and environmental exposure across ethnic groups.

Substance use among municipal solid waste workers in Mumbai: a cross-sectional comparative study

ABSTRACTBackground: Smoking, alcohol consumption and chewing of tobacco affect the health of people as well as the socioeconomic structure of families, communities and eventually the nation. This study assesses the prevalence of substance use among municipal solid waste workers of Mumbai.Methods: To conduct the study, information was collected from 540 municipal workers of Mumbai with regard to substance use as well as their socioeconomic and occupational characteristics. To draw inferential statistics, the data was processed through multivariate logistic regression (MLR) and ordered logistics regression (OLR).Results: Multivariate regression suggests that waste loaders and street sweepers are significantly more likely to smoke, consume alcohol and chew tobacco with reference to the comparison group. Workers with more working years and morbid health status are significantly more likely to get involved with substance use. The results of OLR reveal that municipal waste workers are significantly more likely to consume alcohol on a daily basis (β = 0.220, p < 0.001).Conclusion: Socioeconomic characteristics significantly contribute in increasing the risk of substance use among workers. Workers defend their habit of substance use by considering it as a mechanism for coping with the filthy nature of their occupation. Evidence-based preventive measures need to be developed in order to reduce substance use among municipal solid waste workers.

Are they there yet? Linkage of patients with tuberculosis to services for tobacco cessation and alcohol abuse \u2013 a mixed methods study from Karnataka, India

BackgroundTobacco use and alcohol abuse are associated with higher risk of tuberculosis (TB) infection, progression to active TB and adverse treatment outcomes among patients with TB. Revised National Tuberculosis Control Programme (RNTCP) treatment guidelines (2016) require the documentation of tobacco and alcohol use among patients with TB and their linkage to tobacco and alcohol abuse treatment services. This study aimed to assess the extent of documentation of tobacco and alcohol usage data in the TB treatment card and to explore in-depth, the operational issues involved in linkage.MethodsA convergent parallel mixed methods study was conducted. All new TB treatment cards of adult patients registered under RNTCP between January and June 2017 in Dakshina Kannada district were reviewed to assess documentation. Document review was done to understand the process of linkage (directing patients to tobacco and alcohol abuse treatment services). In-depth interview of health care providers (n = 7) and patients with TB (n = 5) explored into their perspectives on linkage.ResultsAmong 413 treatment cards reviewed, tobacco use was documented in 322 (78%), of whom 86 (21%) were documented as current tobacco users. Sixteen (19%) out of these 86 patients were linked to tobacco cessation services. Alcohol usage status was documented in 319 (77%) cards of whom 71(17%) were documented as alcohol users. Eleven (16%) out of these 71 patients were linked to alcohol abuse treatment services. The questions in the treatment card lacked clarity. Guidelines on eliciting history of substance abuse and criteria for linkage were not detailed. Perceived enablers for linkage included family support, will power of the patients and fear of complications. Challenges included patient’s lack of motivation, financial and time constraints, inadequate guidelines and lack of co-ordination mechanisms between TB programme and tobacco/alcohol abuse treatment services.ConclusionDocumentation was good but not universally done. Clear operational guidelines on linkage and treatment guidelines for health care providers to appropriately manage the patients with comorbidities are lacking. Lack of coordination between the TB treatment programme and tobacco cessation as well as alcohol treatment services was considered a major challenge in effective implementation of the linkage services.

Effect of modifiable risk factors on semen parameters

Objective: This article examines the potential effects of lifestyle factors on male reproductive health. Evidence of a global decline in human sperm quality over recent decades has been accumulating. Environmental, occupational and modifiable lifestyle factors may contribute to this decline. This review focuses on key lifestyles factors such as diet, caffeine intake, tobacco chewing and alcohol intake. Method: A comprehensive literature search was performed to identify the major lifestyle factors associated with male infertility and semen quality. Database searches were limited to reports published in English only. Results: A prudent diet consists of high intake of fish, fruit, vegetables and legumes. Fat in diet is also as essential as other component of the diet. Although largely the evidence is observation based, evidence appears to support an approach of moderation carbohydrate and fats with better semen parameters. A good intake of antioxidants in diet and supplement correlates with higher sperm numbers and motility. The other very important modifiable factors are tobacco chewing, alcohol and caffeine intake. Nicotine in tobacco is found to suppress sperm progressive motility; it also reduces the percentage of viable spermatozoa and increases the altered chromatin compactness. Alcohol consumption leads to increased testosterone level due to change in oxidation metabolism of steroids in liver. Alcohol oxidation increases the Nicotinamide adenine dinucleotide (NAD) ratio which causes the re-dox state in favour of conversion of androstenedione into the reduced steroids testosterone and oestradiol. Caffeine intake has been associated with sperm DNA defects, aneuploidy and DNA breaks. Conclusion: The major lifestyle factors discussed in the present review are the potential issues that can possibly impair male infertility. However, their negative impact can be overcome by behavioural modification and better lifestyle changes.

The changing face of risk factors for non-communicable disease in Myanmar: findings from the 2009 and 2014 WHO STEP Surveys.

Myanmar is burdened with the dual problem of communicable and non-communicable diseases (NCD), and is constantly endeavoring to attain its health objectives with limited resources. This study compares the results for the 2009 and 2014 WHO STEPs surveys (the 'stepwise' approach to adult risk factor surveillance) in Myanmar to determine the change in NCD risk factors over time. The proportion of individuals with major NCD risk factors such as current tobacco and alcohol consumption, <5 fruit/vegetable servings, physical activity, raised blood pressure (BP) and overweight and obesity from the year 2009 (n = 6414) and year 2014 (n = 8757) WHO STEP surveys were compared for the age group 25-64 and relative changes (RC) calculated. Tobacco and alcohol consumption has increased significantly (25 and 49% RC, respectively) over the years. Individuals with low fruit/vegetable consumption (<5 servings) have declined (4.3% RC) and physical activity has increased significantly (46.5% RC). The prevalence of overweight, obese and hypertensive individuals has reduced significantly during this period with a RC reduction of 18, 28 and 20%, respectively. Reductions in some NCD risk factors are encouraging but control of tobacco use and alcohol consumption requires more stringent policies in order to prevent NCDs in the future.

Abstract SY03-01: Government and civil society efforts in global cancer control

Abstract SY03-01: Government and civil society efforts in global cancer control

Abstract 5253: Dietary fiber intake and lung cancer risk: A pooled analysis of 1.44 million individuals in 10 cohorts

Abstract Background: Dietary fiber has been shown to have various health benefits, including anti-inflammation. However, the role of dietary fiber on lung cancer risk has not been well characterized. In this pooled analysis of 10 prospective cohort studies from the US, Europe, and Asia, we evaluated the association between dietary fiber intake and risk of lung cancer and further, potential effect modifications by tobacco smoking, alcohol drinking, and demographic factors (e.g., sex and race/ethnicity). Methods: Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated within each cohort using Cox proportional hazard models with adjustment for major lung cancer risk factors. Risk estimates from each cohort were pooled using random-effects meta-analysis. To reduce potential reverse causation due to preclinical dietary changes, all analyses were conducted excluding the first two years of observation. Results: A total of 18,822 incident lung cancer cases were identified among 1,445,850 participants during mean follow-ups of 9.4 years. After adjustment for lung cancer risk factors (i.e., age, total energy, smoking status, smoking pack-years, gender, race/ethnicity, education, obesity status, diabetes, family history of lung cancer, alcohol consumption, physical activity level, menopausal status in women, and intake of saturated and polyunsaturated fat), dietary fiber intake was inversely associated with lung cancer risk (HR [95% CI] = 0.90 [0.83-0.99] for highest vs. lowest quintile and 0.93 [0.89-0.97] per 10g/day increase). Stratified analyses showed a significant inverse association in men (HRs [95% CIs] per 10g/day increase = 0.92 [0.85-1.00]), women (0.94 [0.90-0.99]), whites (0.92 [0.88-0.95]), smokers (0.92 [0.88-0.97]), and alcohol drinkers (0.89 [0.86-0.94]). However, no significant association was found in Blacks (1.05 [0.92-1.19]), Asians (0.99 [0.85-1.16]), never smokers (0.97 [0.88-1.07]), and never drinkers (0.99 [0.94-1.05]) (P interaction = 0.06 for sex, 0.004 for race, 0.17 for tobacco smoking, and &amp;lt;0.001 for alcohol drinking). Conclusion: Our findings suggest that a high-fiber diet was associated with a lower risk of lung cancer among whites, smokers, and alcohol drinkers. Further research is needed to determine if the association between dietary fiber intake and lung cancer risk reflects a causal relation. Citation Format: Jae Jeong Yang, Danxia Yu, Yong-Bing Xiang, William Blot, Kim Robien, Rashmi Sinha, Yikyung Park, Emily White, Yumie Takata, Mattias Johansson, Wei Zheng, Xiao-Ou Shu. Dietary fiber intake and lung cancer risk: A pooled analysis of 1.44 million individuals in 10 cohorts [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 5253.

Combinational chromosomal aneuploidies and HPV status for prediction of head and neck squamous cell carcinoma prognosis in biopsies and cytological preparations.

Head and neck squamous cell carcinoma (HNSCC) is one of the most common human cancer types with a very poor prognosis despite improvements in therapeutic modalities. The major known risk factors are tobacco use and alcohol consumption or infection with high-risk human papilloma viruses (HPV), especially in oropharyngeal tumors. The current management based on the assessment of a variety of clinical and pathological parameters does not sufficiently predict outcome. Chromosomal alterations detected in HNSCCs were characterized by metaphase comparative genomic hybridization (CGH) and correlated with clinical parameters as well as survival time. Candidate regions were validated by quantitative polymerase chain reaction, fluorescence-in situ-hybridization (FISH) on dapped tumor tissue and liquid-based cytological smear preparations. In addition, HPV status was determined by polymerase chain reaction and simultaneous immunocytochemical p16INK4a-Ki67 staining. The most frequent DNA copy number gains were observed on chromosome arms 3q, 8q, 5p, 7q, 12p, and 12q. DNA copy number decreases occurred most frequently at 3p, 17p, 4q, and 5q. FISH analysis verified in part the observed alterations by CGH on dapped tissues and was especially able to detect the most frequent DNA copy changes in cytological specimens. The combination of HPV status and prognostic copy number alteration detected by FISH in biopsies or cytological specimens may be an applicable protocol for screening head and neck cancer patients prior to therapy.

Tobacco Smoke and Alcohol Consumption in Relation to Oral Cancer in Albania

Objective: The purpose of this study is to investigate the relationship between tobacco, alcohol and other viruses in increasing the risk of being affected by oral carcinomas. Material and method: In our study the sample was composed by 200 patients, all Albanians. The experiment was conducted in the time period 2014-2018, in Albania. The participants were of the age range 45-75 years old and their average age was 60 years old. The ratio between males and females was 3:1, so 152 of the participants were males and 48 were females. The participants were all tobacco users, but they also had other characteristics such as: being virus carriers. More specifically, 44 patients were HPV carriers, 12 patients were EBV carriers, 16 patients were HIV carriers, 72 patients were alcohol addicted, while the remained 56 patients had no viruses they were only tobacco and marijuana smokers. Results: There were 200 patients who were smokers, so smoking is not excluded in any patient. Smoking was the dominant characteristic among participants, 36% of the patients were smokers and consumed alcohol, which increased the risk for oral carcinomas of both kinds. Based on our findings we claim that 36% of the patients smoked and drank alcohol at the same time, 36% were smokers and virus carriers, while 28% were only smokers. Conclusion: Tobacco smoking causes oral carcinomas in those patients who carry viruses, such as: HPV, HIV and EBV, although they are not regular tobacco users.