Bandit Chumworathayi

Incidence and Survival Trends of Cervical Cancer in Khon Kaen, Thailand

To evaluate and report the incidence and survival trends of cervical cancer in Khon Kaen, Thailand, during 1991-2020. A retrospective study was conducted by using the electronic cancer registry database of Khon Kaen province population. Joinpoint regression model was used to analyze the Age-Standardized Incidence Rate (ASR) and the incidence trend graph was built. Overall Observed Survival (OS) was analyzed by Kaplan Meier method and the survival trend graph was built similarly. During 1991-2020, 3,071 cervical cancer patients were found in Khon Kaen. Their mean age was 51.7 year-old. The ASR had decreased from 13.51 (95%CI: 10.67-16.35) per 100,000 women-year in 1991 to 7.63 (95%CI: 5.93-9.33) per 100,000 women-year in 2020. This trend was consistent with the country's and international trends. The highest incidence was found in 1993, which was 17.73 (95%CI: 14.65-20.81), and the lowest incidence was found in 2016, which was 5.7 (95%CI: 4.30-7.10) per 100,000 women-year. However, the 5-year OS was 48.37% (95%CI: 46.49-50.22), which was a constant trend. At the beginning in 1991-1995, the OS was 40.31% (95%CI: 35.43-45.12), and at the end in 2016-2020, the OS was 40.46% (95%CI: 34.59-46.23). These were very similar. In Khon Kaen, Thailand, during 1991-2020, the cervical cancer incidence (ASR) trend was decreasing, while the cervical cancer survival (OS) trend was constant. WHO elimination of cervical cancer initiative target should be reached by 2030.

Effects of Mefenamic Acid in Pain Control during Loop Electrical Excision Procedure:A Prospective Double-Blind Randomized Control Trial

To investigate the effectiveness of pre-procedural oral mefenamic acid compared with placebo in women undergoing Loop Electrosurgical Excision Procedure (LEEP) with intracervical lidocaine injection. A prospective double-blinded randomized control trial. Materials, Setting, Methods: Women undergoing LEEP for any indications were asked to participate in the study. The participants were randomly allocated into two groups. In group 1 (oral mefenamic acid), the participants were offered oral mefenamic acid (500 mg) for 30 minutes before procedures. In group 2 (placebo), the patients were given oral placebo (identical tablet) for 30 minutes before operation. All participants received immediate 10 mL of 2% lidocaine with 1:100,000 of epinephrine intracervical injection before undergoing the LEEP. All participants were excised in one piece of LEEP. No top-hat excision in this study.  The patients graded their pain on a 10-cm visual analog scale (VAS) at different points during the procedure, including speculum insertion, at starting excision, and 30 minutes post excision. Primary outcomes revealed the difference of VAS during all steps of LEEP by generalized estimating equations procedure. Sixty participants (30 in mefenamic group and 30 in placebo group) participated in this study. The study did not find differences of VAS during all steps of LEEP and analgesic drug requirement at 30 minutes after LEEP procedure. All patients reported no immediate complications and no intervention-related adverse events were observed. Using pre-procedural oral mefenamic acid before LEEP procedure was not associated with pain reduction during all steps of excision..

Knowledge and Attitude Toward Human Papillomavirus Infection and Vaccination among Thai Women: A Nationwide Social Media Survey

This study was performed first to assess Thai women's knowledge and attitude toward Human papillomavirus (HPV) infection and vaccination and second to find out factors associated with knowledge in this regard. The survey announcement was advertised via Facebook from 17 May 2019 to 14 June 2019 to recruit women aged 18-26 years living in Thailand. A score below 5 out of total score of 10 on the survey was considered as a poor level of knowledge. Multivariate analysis was applied to identify factors associated with HPV infection and vaccination knowledge. A total of 1,175 participants were recruited. The participants' median age was 22 years. Approximately, 46% of the participants had poor level of knowledge regarding HPV infection and vaccination. Factors associated with poor knowledge included low educational level (adjusted OR, 1.35; 95% CI 1.04-1.77), low family income (adjusted OR, 2.14; 95% CI 1.65-2.78), being Christian (adjusted OR, 4.04; 95% CI 1.22-13.40), being engaged in sexual intercourse (adjusted OR, 0.75; 95%CI 0.58-0.97), and being unvaccinated against HPV infection (adjusted OR, 5.74; 95% CI 3.07-10.74). Nearly half of the Thai women who participated in the survey had poor level of knowledge regarding HPV infection and vaccination, indicating a need for more effective health education intervention. Factors associated with knowledge included socioeconomic status and sexual behavior..