Breast and cervical cancer screening in the Philippines: Challenges and steps forward

Ho, Frances Dominique V.; Arevalo, Ma Veronica Pia N.; Claro, Patricia Therese S. de; Jacomina, Luisa E.; Germar, Maria Julieta V; Dee, Edward Christopher; Eala, Michelle Ann B

doi:10.1016/j.pmedr.2022.101936

Cited by 13 publications

(13 citation statements)

References 16 publications

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“…The high out-of-pocket healthcare costs, lack of organized national screening programs, centralization and/or unequal distribution of health resources/infrastructure and providers across the country and socioeconomic and cultural barriers preclude access to both breast cancer screening and timely surgical management [ 36 , 37 ]. Lastly, specific challenges in the care of young breast cancer patients such as fertility preservation/future pregnancy, bone health maintenance, inherited breast cancer syndromes, and associated psychosocial issues should be included and discussed during multidisciplinary treatment planning [ 38 , 39 ].…”

Section: Discussionmentioning

confidence: 99%

Young Filipino breast cancer patients have worse survival outcomes

Yap,

Marquez,

De La Serna

2023

ecancer Journal

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Background In the 2020 GLOBOCAN report, breast cancer is the 3rd most common cause of cancer-related mortality in the Philippines. The incidence of breast cancer in the young (≤40 years) was reported to be higher in the Philippines compared to other Asian countries. Several studies have consistently demonstrated poor survival outcomes in this age group due to its aggressiveness and unique tumour biology. However, data on survival outcomes of young Filipino breast cancer patients remains unknown in the Philippines. Methods A retrospective study was performed involving patients with stage I–III breast cancer who underwent definitive surgery from January 2010 to December 2015 at a single-tertiary institution. Patients were grouped according to age (≤40 and >40 years old). Their clinicopathological characteristics, treatment profile and 5-year survival outcomes were analyzed. Results A total of 524 Filipino patients (15.1% aged ≤40 years) were included. Younger patients were diagnosed at a higher stage and pathologic grade. A negative hormone receptor, high Ki67 status, and triple negative breast cancer (TNBC) subtypes were also more common among younger patients. The overall breast-conserving surgery rate was low at 8.9%. The use of adjuvant chemoradiotherapy was more common and both 5-year overall survival (OS) and disease-free survival (DFS) were lower (61.1% versus 77.1% and 31.1% versus 66.8%, respectively) in the ≤40-year-old group. In the multivariate analysis, age group, tumour size, and nodal status were significant predictors for DFS. However, only tumour size was significant for OS. Conclusion Young Filipino breast cancer patients have demonstrated unique pathologic characteristics with associated lower survival outcomes similar to the published literature. Increasing awareness of cancer screening practices among young women, provision of equitable access to healthcare, and prompt management of breast cancer in the young are crucial.

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Section: Discussionmentioning

confidence: 99%

Young Filipino breast cancer patients have worse survival outcomes

Yap,

Marquez,

De La Serna

2023

ecancer Journal

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“…Little is known about drivers of sex disparities that are epidemiologic in nature, especially in Southeast Asia (SEA), a diverse region that is home to nearly 670 million people, where most reside in lower-middle income countries, and where socioeconomic and cultural factors increase cancer risk for women. 13 , 14 , 15 We therefore explore unique epidemiologic patterns affecting the Southeast Asian region and their mediators, such as environmental exposure, lifestyle, genetic predispositions, access to and utilization of preventive cancer services, and social determinants of health.…”

Section: Introductionmentioning

confidence: 99%

“… 17 , 18 Although group differences between men and women in the incidence of breast cancer represent sex differences, disparities exist in access to timely treatment and diagnosis. 15 , 19 , 20 , 21 …”

Section: Introductionmentioning

confidence: 99%

Social determinants of sex disparities in cancer in Southeast Asia

Arevalo¹,

Maslog²,

Manlongat³

et al. 2023

iScience

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“…1 In 2020, breast and cervical cancers are the top 2 leading malignancies affecting Filipino women, most of whom have been diagnosed at advanced stages. 2 A metaanalysis reports that 26 out of 100 females may be diagnosed with breast cancer in the Philippines. The DOH website cites the 2020 data from the Global Cancer Observatory, showing breast cancer as the leading cause of cancers and the third leading cause of cancer deaths among Filipinos.…”

Section: Introductionmentioning

confidence: 99%

Cytotoxic and Apoptotic Properties of the Flavonoid-rich Ethyl Acetate Fraction of the Crude Methanol Leaf Extract of Syzygium samarangense (Blume) Merr. (Myrtaceae) against MCF-7 Breast Cancer Cells

2022

Acta Med Philipp

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Introduction. Breast cancer is the most common cancer among women in the Philippines and about 3 in every 100 Filipina will be diagnosed with breast cancer in their lifetime. There is a need to discover safe, yet inexpensive herbal extracts with potential cytotoxic properties as potential treatment modalities to treat breast cancer.Objectives. This study seeks to explore the cytotoxic and apoptotic properties of the ethyl acetate fraction of the defatted crude methanol leaf extract of Syzygium samarangense in MCF-7 breast cancer cell lines.Methods. Screening for flavonoids of the extracts was performed using TLC, total flavonoids, total phenols, FTIR and LC-MS spectroscopy. The hydrogen peroxide and ferric reducing anti-oxidant power were used as substrates to assess in vitro anti-oxidative properties of the extracts. The MTT dye viability assay was used to assess the cytotoxic properties of the extracts against MCF-7 cells. Apoptotic properties of the extracts in MCF-7 cells were determined by caspase-3 activation assay, DNA fragmentation patterns and fluorescence microscopy after annexin-V and propidium iodide staining.Results. The abundance of flavonoids in the ethyl acetate fraction of the crude methanol leaf extract was established by TLC, FTIR, LC-MS/MS, total flavonoid and total phenol analyses. The in vitro anti-oxidative properties of this extract was comparable to ascorbic acid. The median inhibitory concentration (IC 50 ) of this extract in MCF-7 breast cancer cell lines was 7.2 mcg/mL while doxorubicin registered an IC 50 of 1.2 mcg/mL. At this concentration, the extract was not cytotoxic to normally-dividing breast epithelial cells. Cytotoxicity of the extract was mediated via apoptosis as demonstrated by DNA fragmentation, caspase-3 activation and fluorescence microscopic analyses. Conclusion.The study shows that the flavonoid-rich ethyl acetate fraction of the crude methanol leaf extract of S. samarangense possesses potent apoptotic and cytotoxic properties against MCF-7 breast cancer cell lines at low concentrations.

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Breast and cervical cancer screening in the Philippines: Challenges and steps forward

Cited by 13 publications

References 16 publications

Young Filipino breast cancer patients have worse survival outcomes

Young Filipino breast cancer patients have worse survival outcomes

Social determinants of sex disparities in cancer in Southeast Asia

Cytotoxic and Apoptotic Properties of the Flavonoid-rich Ethyl Acetate Fraction of the Crude Methanol Leaf Extract of Syzygium samarangense (Blume) Merr. (Myrtaceae) against MCF-7 Breast Cancer Cells

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