Objective-To evaluate temporal changes in histopathological types of bladder cancer and to assess associated changes in demographic, epidemiologic, and lifestyle risk factors.Methods-We abstracted data from all available medical records from the National Cancer Institute of Cairo University (NCI-Cairo). Six calendar years representing 5-year periods between 1980 and 2005 were evaluated. Information on demographics, schistosomal infection, clinical symptoms of bladder cancer, and tumor pathology was abstracted.Results-During this 26-year period, important changes in the frequency of histopathological types of bladder cancer occurred. We found a statistically significant association between time period of diagnosis and histopathological type. Patients diagnosed in 2005 had a sixfold higher odds associated with transitional cell carcinoma compared to those patients diagnosed in 1980 (odds ratio (OR) 6.00 (95% CI 4.00-8.97)).Conclusions-These data strongly suggest that the histopathological profile of bladder cancer in Egypt has changed significantly over the past 26 years. Historically, squamous cell carcinoma was the predominant form of bladder cancer in Egypt; however transitional cell carcinoma has become the most frequent type. These results corroborate findings from a few small-scale hospital-based studies which conclude that the etiology of bladder cancer in Egypt has changed significantly over the past 26 years.

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Multiple tobacco consumption methods, passive smoking, pesticide exposures, and diabetes are associated with an increased risk for pancreatic cancer. Prolonged lactation and increased parity are associated with a reduced risk for pancreatic cancer.

Cervical screening for carcinogenic human papillomavirus (HPV) infection is being considered for low income countries. Effectiveness requires targeted screening in older women in whom prevalent infections are more likely to be persistent and predictive of precancer. Some studies in West Africa have found unusually high HPV prevalences across all adult ages, that may reduce the positive predictive value (PPV) of HPV-based screening, if positivity in older women does not sufficiently predict elevated risk. We conducted a population-based study in rural Nigeria to identify HPV prevalence and associated cervical abnormalities. Using stratified random sampling, we enrolled women age 15+. Non-virgins had a cervical exam including liquid-based cytology and PCR HPV DNA testing from residual cytology specimens. Two-thirds of invited women participated, and 14.7% had detectable carcinogenic HPV, a proportion that did not decline with age (p-trend=.36) and showed slight peaks in the 15–29 and 60–69 age groups. Among women of the age typically considered for screen-and-treat programs (30–49 years), 12.8% were HPV-positive and the PPV for high-grade or worse cytology was 16.4%. Comparatively, women age <30, were more likely to be HPV-positive (18.9%, p=.03) with a lower PPV (4.2% p=.05). Among women age 50+ (typically excluded from screening in resource-poor settings because inexpensive treatment is not available), HPV positivity was 14.2% with a PPV of 13.9%. In Irun and similar settings where HPV does not decline with age, HPV-based screen-and-treat programs might be feasible for mid-adult women, since prevalence is sufficiently low, positivity predicts elevated risk of more easily treated precancer.

Estrogen receptor (ER) status is an important biomarker in defining subtypes of breast cancer differing in antihormonal therapy response, risk factors and prognosis. However, little is known about association of ER status with various risk factors in the developing world. Our case-control study done in Kerala, India looked at the associations of ER status and risk factors of breast cancer. From 2002 to 2005, 1,208 cases and controls were selected at the Regional Cancer Center (RCC), Trivandrum, Kerala, India. Information was collected using a standardized questionnaire, and 3-way analyses compared ER1/ER2 cases, ER1 cases/controls and ER2 cases/controls using unconditional logistic regression to calculate odds ratios and 95% confidence intervals. The proportion of ER2 cases was higher (64.1%) than ER1 cases. Muslim women were more likely to have ER2 breast cancer compared to Hindus (OR 5 1.48, 95% CI 5 1.09, 2.02), an effect limited to premenopausal group (OR 5 1.87, 95% CI 5 1.26, 2.77). Women with higher socioeconomic status were more likely to have ER1 breast cancer (OR 5 1.48, 95% CI 5 1.11, 1.98). Increasing BMI increased likelihood of ER2 breast cancer in premenopausal women (p for trend < 0.001). Increasing age of marriage was positively associated with both ER1 and ER2 breast cancer. Increased breastfeeding and physical activity were in general protective for both ER1 and ER2 breast cancer. The findings of our study are significant in further understanding the relationship of ER status and risk factors of breast cancer in the context of the Indian subcontinent. ' UICCKey words: estrogen receptor; breast cancer; India Estrogen receptor (ER) status of breast tumors has been instrumental in defining an important subtype of breast cancer with differences observed in risk factors, treatment and prognosis. [1][2][3][4][5][6][7] Numerous studies in the past have looked at differences in etiology and risk factors pertaining to presence or absence of ER-alpha. Most of these studies were conducted in Western populations as early as 1980s. [1][2][3][4][5] Around the same time, it was also discovered that ER1 tumors that lacked progesterone receptor (PR) expression were less responsive to endocrine therapy compared to tumors that expressed PR. 8 This led to studies in the past decade that looked at the link of various risk factors of breast cancer and combined ER/PR information to better explain the underlying differences between the various subtypes of breast cancer. 9-13 Chen and Colditz 14 have emphasized the importance of taking into account the ER/PR status information of breast tumors both for effective treatment as well as risk prediction for instituting prophylactic measures. Although there might be numerous ways to subtype breast cancer, the classification into ER1 and ER2 cancer remains a key divider. 14 However, information related to ER status is lacking for populations in developing countries. In fact, in most developing countries, determination of hormone receptor status is not a part of standard pro...