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American Journal of Cancer Prevention

ISSN (Print): 2328-7322

ISSN (Online): 2328-7314


Current Issue» Volume 2, Number 2 (2014)


Comparison of IHC, FISH, ER and PR in Breast Cancer in Western Iran

1Department of Hematology and Oncology, Kermanshah University of Medical Sciences, Kermanshah, Iran

2Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran

3Department of Nursing, Kermanshah University of Medical Sciences, Kermanshah, Iran

4Department of Biology, Faculty of Basic Sciences, Science and Research Breanch, Islamic Azad University, Tehran, Iran

American Journal of Cancer Prevention. 2014, 2(2), 37-41
DOI: 10.12691/ajcp-2-2-4
Copyright © 2014 Science and Education Publishing

Cite this paper:
Mehrdad Payandeh, Masoud Sadeghi, Edris Sadeghi, Anita Kabir koohian. Comparison of IHC, FISH, ER and PR in Breast Cancer in Western Iran. American Journal of Cancer Prevention. 2014; 2(2):37-41. doi: 10.12691/ajcp-2-2-4.

Correspondence to: Masoud  Sadeghi, Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran. Email:


To evaluate the concordance and discordance between IHC and FISH results for detection of Her2/neu protein, analyses of ER and PR, and also evaluation of the benefit of adjuvant trastuzumab in patients diagnosed with human epidermal growth factor receptor 2 (HER2) –positive invasive ductal carcinoma enrolled onto the Herceptin adjuvant. IHC analysis of ER, PR and HER2 was performed in 133 patients of breast cancer with invasive ductal carcinoma. 90(67.6%) cases were confirmed by FISH. Statistical analysis was performed with IBM SPSS version 19, Kaplan-Meier method and log-rank test. Age mean of patients was 46.39±10.81 years (range, 24-78 years). Concordance rates between IHC and FISH were 32.4% for IHC 2+ and 81.25% for IHC 3+ (P<0.001). There were 17 and 56 patients of IHC 2+ and 3+ with ER positive and also 23 and 59 patients of IHC 2+ and 3+ had PR positive.The 83 patients had age ≤50 years and 50 patients had >50 years. Of 133 the patients, 48(36.1%) patients were treated with trastuzumab and 85(63.9%) were treated without trastuzumab. The overall survival(OS) for patients treating with trastuzumab were mean of 37.8 months and the OS for patients treating without trastuzumab were mean of 20.8 months (P<0.05). The results are that trastuzumab therapy is effective and improves the survival of HER2-positive breast cancer patients and trastuzumab therapy is effective and tolerated for breast cancer with Her-2 positive. There is a statistically significant relationship between ER positive with PR positive and ER negative with PR negative that these results need to more studies with more patients in the world.



[1]  M Y, Ahmadi M R H, J K, H P, K H A, M R Y, et al. An 8 years retrospective study of breast cancer incidence in ilam province, Western iran. J Clin Diagn Res.2013. 7(12): 2923-5.
[2]  Toi M, Ohashi Y, Seow A, Moriya T, Tse G, Sasano H, et al. The breast cancer working group presentation divided into three sections: the epidemiology, pathology and treatment of breast cancer. Jpn J Clin Oncol. 2010.40(Suppl 1):i13-18.
[3]  Banin Hirata BK, Oda JM, Losi Guembarovski R, Ariza CB, de Oliveira CE, Watanabe MA. Molecular markers for breast cancer: prediction on tumor behavior. Dis Markers. 2014. 2014: 513158.
[4]  Cui H, Cheng Y, Piao SZ, Xu YJ, Sun HH, Cui X, et al. Correlation between HER-2/neu(erbB-2) expression level and therapeutic effect of combination treatment with HERCEPTIN and chemotherapeutic agents in gastric cancer cell lines. Cancer Cell Int. 2014 Jan 29.14(1): 10.
[5]  Yarden Y, Sliwkowski MX. Untangling the ErbB signalling network. Nat Rev Mol Cell Biol. 2001 Feb. 2(2): 127-37.
Show More References
6]  Buendía JA, Vallejos C, Pichón-Rivière A. An economic evaluation of trastuzumab as adjuvant treatment of early HER2-positive breast cancer patients in Colombia. Biomedica. 2013. 33(3): 411-7.
7]  Rexer BN, Chanthaphaychith S, Dahlman KB, Arteaga CL. Direct inhibition of PI3K in combination with dual HER2 inhibitors is required for optimal antitumor activity in HER2+ breast cancer cells. Breast Cancer Res. 2014. 16(1): R9.
8]  Khabaz MN. Immunohistochemistry subtypes (ER/PR/HER) of breast cancer: where do we stand in the West of Saudi Arabia? Asian Pac J Cancer Prev. 2014.15(19): 8395-400.
9]  Keyhani E, Muhammadnejad A, Behjati F, Sirati F, Khodadadi F, Karimlou M, et al. Angiogenesis markers in breast cancer--potentially useful tools for priority setting of anti-angiogenic agents. Asian Pac J Cancer Prev. 2013.14(12): 7651-6.
10]  Yip CH, Rhodes A. Estrogen and progesterone receptors in breast cancer. Future Oncol. 2014.10(14): 2293-301.
11]  Bahreini F, Soltanian AR, Mehdipour P. A meta-analysis on concordance between immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) to detect HER2 gene overexpression in breast cancer. Breast Cancer. 2014. [Epub ahead of print]
12]  Jacquemier J, Spyratos F, Esterni B, Mozziconacci MJ, Antoine M, Arnould L, et al. SISH/CISH or qPCR as alternative techniques to FISH for determination of HER2 amplification status on breast tumors core needle biopsies: a multicenter experience based on 840 cases. BMC Cancer. 2013. 13: 351.
13]  Jiang H, Bai X, Meng F, Zhang C, Zhang X. Evaluation of chromosome 17 polysomy in breast cancer by FISH analysis of whole nuclei, and its clinicopathological significance. Oncol Lett. 2014. 7(6): 1954-1958.
14]  Sui W, Ou M, Chen J, Wan Y, Peng H, Qi M, et al. Comparison of immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) assessment for Her-2 status in breast cancer. World J Surg Oncol. 2009. 7: 83.
15]  Qiao EQ, Ji M, Wu J, Li J, Xu X, Ma R, et al. Joint detection of multiple immunohistochemical indices and clinical significance in breast cancer. Mol Clin Oncol. 2013.1(4):703-710.
16]  Ha JH, Seong MK, Kim EK, Lee JK, Seol H, Lee JY, et al. Serial Serum HER2 Measurements for the Detection of Breast Cancer Recurrence in HER2-Positive Patients. J Breast Cancer. 2014. 17(1): 33-9.
17]  Varga Z, Noske A, Ramach C, Padberg B, Moch H. Assessment of HER2 status in breast cancer: overall positivity rate and accuracy by fluorescence in situ hybridization and immunohistochemistry in a single institution over 12 years: a quality control study. BMC Cancer. 2013.13:615.
18]  Ghaffari SR, Sabokbar T, Dastan J, Rafati M, Moossavi S. Her2 amplification status in Iranian breast cancer patients: comparison of immunohistochemistry (IHC) and fluorescence in situ hybridisation (FISH). Asian Pac J Cancer Prev. 2011. 12(4): 1031-4.
19]  Shirsat HS, Epari S, Shet T, Bagal R, Hawaldar R, Desai SB. HER 2 status in invasive breast cancer: immunohistochemistry, fluorescence in-situ hybridization and chromogenic in-situ hybridization. Indian J Pathol Microbiol. 2012. 55(2): 175-9.
20]  Park S, Park HS, Koo JS, Yang WI, Kim SI, Park BW. Breast cancers presenting luminal B subtype features show higher discordant human epidermal growth factor receptor 2 results between immunohistochemistry and fluorescence in situ hybridization. Cancer. 2012.118(4):914-23.
21]  DE Vargas Wolfgramm E, Gavioli CF, Entringer ML, Alves LN, Stur E, DE Castro Neto AK, et al. Histological profile and age at diagnosis of breast and ovarian tumors: A register-based study in Espirito Santo, Brazil. Mol Clin Oncol. 2013.1(2):353-358.
22]  Bertrand KA, Tamimi RM, Scott CG, Jensen MR, Pankratz VS, Visscher D, et al. Mammographic density and risk of breast cancer by age and tumor characteristics. Breast Cancer Res. 2013.15(6): R104.
23]  Sofi GN, Sofi JN, Nadeem R, Shiekh RY, Khan FA, Sofi AA, et al. Estrogen receptor and progesterone receptor status in breast cancer in relation to age, histological grade, size of lesion and lymph node involvement. Asian Pac J Cancer Prev. 2012.13(10): 5047-52.
24]  Song Q, Huang R, Li J, Fan J, Zheng S, Zhang B, et al. The diverse distribution of risk factors between breast cancer subtypes of ER, PR and HER2: a 10-year retrospective multi-center study in China. PLoS One. 2013.8(8): e72175.
25]  Shomaf M, Masad J, Najjar S, Faydi D. Distribution of breast cancer subtypes among Jordanian women and correlation with histopathological grade: molecular subclassification study. JRSM Short Rep. 2013.4(10):2042533313490516.
26]  Okita Y, Narita Y, Suzuki T, Arita H, Yonemori K, Kinoshita T, et al. Extended trastuzumab therapy improves the survival of HER2-positive breast cancer patients following surgery and radiotherapy for brain metastases. Mol Clin Oncol. 2013.1(6):995-1001.
27]  Gultekin M, Eren G, Babacan T, Yildiz F, Altundag K, Guler N, et al. Metaplastic breast carcinoma: a heterogeneous disease. Asian Pac J Cancer Prev. 2014.15(6): 2851-6.
Show Less References


Dutasteride and Prostate Cancer Risk: Does Family History of Prostate and/or Breast Cancers Influence the Number Needed to Treat? Results from REDUCE

1Surgery Section, Durham VA Medical Center, Durham, NC

2Duke Prostate Center, Division of Urological Surgery, Department of Surgery, Duke, University School of Medicine, Durham, NC

3Division of Urology, Department of Surgery, Memorial Sloan Kettering Cancer Institute

4Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, NC

5The Arthur Smith Institute for Urology, North Shore Long Island Jewish Health System, New Hyde Park, NY

6Washington University School of Medicine in St. Louis, St. Louis, Missouri

7Duke Prostate Center, Division of Urological Surgery, Department of Surgery, Duke, University School of Medicine, Durham, NC;Department of Pathology, Duke University School of Medicine, Durham, NC

American Journal of Cancer Prevention. 2014, 2(2), 31-36
DOI: 10.12691/ajcp-2-2-3
Copyright © 2014 Science and Education Publishing

Cite this paper:
Jean-Alfred Thomas II, Leah Gerber, Robert J. Hamilton, Adriana C. Vidal, Daniel M. Moreira, Gerald L. Andriole, Stephen J. Freedland. Dutasteride and Prostate Cancer Risk: Does Family History of Prostate and/or Breast Cancers Influence the Number Needed to Treat? Results from REDUCE. American Journal of Cancer Prevention. 2014; 2(2):31-36. doi: 10.12691/ajcp-2-2-3.

Correspondence to: Stephen  J. Freedland, Surgery Section, Durham VA Medical Center, Durham, NC. Email:


Purpose: In REDUCE, dutasteride was associated with a ~5% absolute reduction in the risk of biopsy-detected prostate cancer (PCa). Material and methods: We tested the influence of family history on the association between dutasteride and PCa diagnosis and calculated the number needed to treat (NNT) with dutasteride to avoid one PCa diagnosis. The REDUCE trial tested dutasteride 0.5mg/day for PCa risk reduction in men aged 50-75 with a serum PSA of 2.5-10.0ng/mL and a negative biopsy. Among men who underwent >1 on-study biopsy with complete data (n=6,415; 78.1%), the association between dutasteride and PCa risk as a function of PCa and/or breast cancer (BCa) family history was examined using multivariable logistic regression. Absolute risk reduction (ARR) and NNT were calculated. Results: On multivariate analysis, dutasteride was significantly associated with lower PCa risk in men without family history (25% lower; p<0.001), PCa family history only (37% lower; p=0.009), or BCa family history only (38% lower; p=0.04). While dutasteride lowered PCa risk in men with both PCa and BCa family history by 15%, this was not significant (p=0.69), though the number of men was small (n=115). ARRs were 6-9% for men with a PCa and/or BCa family history vs. 5% in men with no family history which translated into NNTs of 11-16 in men with PCa and/or BCa family history vs. 21 for men without family history. Conclusion: Using dutasteride as a model of chemoprevention, therapies targeting individuals with specific family histories may improve the risk-benefit profile. However, future studies are warranted to confirm our findings.



[1]  Lippman SM, Klein EA, Goodman PJ, Lucia MS, Thompson IM, Ford LG, et al. Effect of selenium and vitamin E on risk of prostate cancer and other cancers: the Selenium and Vitamin E Cancer Prevention Trial (SELECT). JAMA. 2009; 301: 39-51.
[2]  Thompson IM, Goodman PJ, Tangen CM, Lucia MS, Miller GJ, Ford LG, et al. The influence of finasteride on the development of prostate cancer. N Engl J Med. 2003; 349: 215-24.
[3]  Andriole GL, Bostwick DG, Brawley OW, Gomella LG, Marberger M, Montorsi F, et al. Effect of dutasteride on the risk of prostate cancer. N Engl J Med. 2010; 362: 1192-202.
[4]  Svatek RS, Lotan Y. Cost utility of prostate cancer chemoprevention with dutasteride in men with an elevated prostate specific antigen. Cancer Prev Res (Phila). 2011; 4: 277-83.
[5]  Theoret MR, Ning YM, Zhang JJ, Justice R, Keegan P, Pazdur R. The risks and benefits of 5alpha- reductase inhibitors for prostate-cancer prevention. N Engl J Med. 2011; 365: 97-9.
Show More References
6]  Hamilton RJ, Kahwati LC, Kinsinger LS. Knowledge and use of finasteride for the prevention of prostate cancer. Cancer Epidemiol Biomarkers Prev. 2010; 19: 2164-71.
7]  Svatek RS, Lee JJ, Roehrborn CG, Lippman SM, Lotan Y. The cost of prostate cancer chemoprevention: a decision analysis model. Cancer Epidemiol Biomarkers Prev. 2006; 15: 1485-9.
8]  Johns LE, Houlston RS. A systematic review and meta-analysis of familial prostate cancer risk. BJU Int. 2003; 91: 789-94.
9]  Cerhan JR, Parker AS, Putnam SD, Chiu BC, Lynch CF, Cohen MB, et al. Family history and prostate cancer risk in a population-based cohort of Iowa men. Cancer Epidemiol Biomarkers Prev. 1999; 8: 53-60.
10]  Liede A, Karlan BY, Narod SA. Cancer risks for male carriers of germline mutations in BRCA1 or BRCA2: a review of the literature. Journal of clinical oncology: official journal of the American Society of Clinical Oncology. 2004; 22: 735-42.
11]  Madersbacher S, Alcaraz A, Emberton M, Hammerer P, Ponholzer A, Schroder FH, et al. The influence of family history on prostate cancer risk: implications for clinical management. BJU international. 2011; 107: 716-21.
12]  Thomas JA, 2nd, Gerber L, Moreira DM, Hamilton RJ, Banez LL, Castro-Santamaria R, et al. Prostate cancer risk in men with prostate and breast cancer family history: results from the REDUCE study (R1). Journal of internal medicine. 2011.
13]  Vollmer RT, Montana GS. Predicting tumor failure in prostate carcinoma after definitive radiation therapy: limitations of models based on prostate-specific antigen, clinical stage, and Gleason score. Clin Cancer Res. 1999; 5: 2476-84.
14]  Freedland SJ, Jalkut M, Dorey F, Sutter ME, Aronson WJ. Race is not an independent predictor of biochemical recurrence after radical prostatectomy in an equal access medical center. Urology. 2000; 56: 87-91.
15]  Wilt TJ, Macdonald R, Hagerty K, Schellhammer P, Tacklind J, Somerfield MR, et al. 5-alpha- Reductase inhibitors for prostate cancer chemoprevention: an updated Cochrane systematic review. BJU international. 2010; 106: 1444-51.
16]  Reed SD, Scales CD, Jr., Stewart SB, Sun J, Moul JW, Schulman KA, et al. Effects of family history and genetic polymorphism on the cost-effectiveness of chemoprevention with finasteride for prostate cancer. J Urol. 2011; 185: 841-7.
17]  Ridker PM, MacFadyen JG, Fonseca FA, Genest J, Gotto AM, Kastelein JJ, et al. Number needed to treat with rosuvastatin to prevent first cardiovascular events and death among men and women with low low-density lipoprotein cholesterol and elevated high-sensitivity C-reactive protein: justification for the use of statins in prevention: an intervention trial evaluating rosuvastatin (JUPITER). Circ Cardiovasc Qual Outcomes. 2009; 2: 616-23.
18]  Theoret MR, Ning YM, Zhang JJ, Justice R, Keegan P, Pazdur R. The risks and benefits of 5alpha- reductase inhibitors for prostate-cancer prevention. The New England journal of medicine. 2011; 365: 97-9.
Show Less References


Genetic Testing for Risk of Lung Cancer: A Pilot Study Examining Perceived Benefits and Barriers using Health Belief Model

1Division of Social and Administrative Sciences in Pharmacy, Oscar Rennebohm School of Pharmacy, University of Wisconsin-Madison

2Arnold & Marie Schwartz College of Pharmacy and Health Sciences, Long Island University, Brooklyn, New York City

3School of Pharmacy, Philadelphia College of Osteopathic Medicine, Suwanee, Georgia

American Journal of Cancer Prevention. 2014, 2(2), 24-30
DOI: 10.12691/ajcp-2-2-2
Copyright © 2014 Science and Education Publishing

Cite this paper:
Karishma Desai, Bupendra Shah, Hamid Rahim, Hongjun Yin, John Lonie. Genetic Testing for Risk of Lung Cancer: A Pilot Study Examining Perceived Benefits and Barriers using Health Belief Model. American Journal of Cancer Prevention. 2014; 2(2):24-30. doi: 10.12691/ajcp-2-2-2.

Correspondence to: Karishma  Desai, Division of Social and Administrative Sciences in Pharmacy, Oscar Rennebohm School of Pharmacy, University of Wisconsin-Madison. Email:


Aim: To (i) assess participants’ awareness of the availability of genetic testing to determine the risk of different types of cancer; (ii) to assess participants’ beliefs about genetic testing for the risk of lung cancer using Health Belief Model; and (iii) to explore factors affecting intention to use genetic testing for risk of lung cancer. Methods: A sample of 360 New Jersey residents were surveyed by interviewers from three densely populated cities in the northern, central and southern regions of New Jersey. The survey instrument was developed using the Health Belief Model and measures were adapted from the literature. Descriptive statistics and regression analyses were used to examine factors associated with intention to use genetic testing. Results: A total of 360 individuals were surveyed in three cities in New Jersey. Of these, 50% were non-Hispanic White, female, and with an annual income of less than $50,000; 66% were nonsmokers without a family history of lung cancer. The overall intention to use the genetic test to determine lung cancer risk was low (35%), even though the majority of participants believed genetic testing for lung cancer to be highly beneficial, and despite believing it to be a severe condition [M(SD)=11.5(2.3)}. Approximately 50% of participants were aware of the availability of genetic tests for the risk of lung cancer, and respondents believed they were moderately susceptible to lung cancer [M(SD)=25.3(3.7)].Gender, education, smoking habits and perceived benefits of testing were significant predictors of intention. Conclusion: Awareness and intention to use genetic testing for the risk of lung cancer was low. This study provides useful information for healthcare professionals interested in promoting the use of genetic testing for at-risk populations such as smokers, and how to tailor interventions.



[1]  Collins, F.C. A Brief Primer on Genetic Testing. 2003 April 30 2013 [cited 2013 10/14]; 1]. Available from:
[2]  Services, U.S.d.o.H.a.H., Healthy People 2020: Objectives. 2011.
[3]  Young, R.P., et al., Smoking cessation: the potential role of risk assessment tools as motivational triggers. Postgraduate Medical Journal, 2010. 86(1011): p. 26.
[4]  Shepperd, J.A., et al., Contemplating Genetic Feedback Regarding Lung Cancer Susceptibility. Annals of Behavioral Medicine, 2014. 47(3): p. 395-403.
[5]  Marcy, T.W., M. Stefanek, and K.M. Thompson, Genetic testing for lung cancer risk. Journal of general internal medicine, 2002. 17(12): p. 946-951.
Show More References
6]  Carlsten, C. and W. Burke, Potential for genetics to promote public health. JAMA: the Journal of the American Medical Association, 2006. 296(20): p. 2480.
7]  deCodeme, Lung Cancer. 2011.
8]  Tambor, E.S., B.K. Rimer, and T.S. Strigo, Genetic testing for breast cancer susceptibility: awareness and interest among women in the general population. American Journal of Medical Genetics, 1997. 68(1): p. 43-49.
9]  Lerman, C., et al., Attitudes about genetic testing for breast-ovarian cancer susceptibility. Journal of Clinical Oncology, 1994. 12(4): p. 843.
10]  Durfy, S.J., et al., Attitudes and interest in genetic testing for breast and ovarian cancer susceptibility in diverse groups of women in western Washington. Cancer Epidemiology Biomarkers & Prevention, 1999. 8(suppl 1): p. 369.
11]  MacNew, H.G., et al., Assessing the knowledge and attitudes regarding genetic testing for breast cancer risk in our region of southeastern Georgia. The Breast Journal, 2010. 16(2): p. 189-192.
12]  Lerman, C., et al., Genetic testing for colon cancer susceptibility: anticipated reactions of patients and challenges to providers. International Journal of Cancer, 1996. 69(1): p. 58-61.
13]  Bunn, J.Y., et al., Factors Influencing Intention to Obtain a Genetic Test for Colon Cancer Risk: A Population-Based Study* 1. Preventive Medicine, 2002. 34(6): p. 567-577.
14]  McBride, C.M., et al., Interest in testing for genetic susceptibility to lung cancer among Black college students “at risk” of becoming cigarette smokers. Cancer Epidemiology Biomarkers & Prevention, 2005. 14(12): p. 2978.
15]  Sanderson, S.C., et al., What can interest tell us about uptake of genetic testing? Intention and behavior amongst smokers related to patients with lung cancer. Public Health Genomics, 2009. 13(2): p. 116-124.
16]  Hochbaum, G., S. Kegels, and I. Rosenstock, Health belief model. United States Public Health Service, 1952.
17]  Bosompra, K., et al., Likelihood of undergoing genetic testing for cancer risk: a population-based study. Preventive Medicine, 2000. 30(2): p. 155-166.
18]  McBride, C.M., et al., The Behavioral Response to Personalized Genetic Information: Will Genetic Risk Profiles Motivate Individuals and Families to Choose More Healthful Behaviors? Annual Review of Public Health, 2010. 31: p. 89-103.
19]  Nordin, K., J. Bjork, and G. Berglund, Factors influencing intention to obtain a genetic test for a hereditary disease in an affected group and in the general public. Preventive Medicine, 2004. 39(6): p. 1107-1114.
20]  Cornfield, J., et al., Smoking and lung cancer: recent evidence and a discussion of some questions. International Journal of Epidemiology, 2009.
21]  Asomaning, K., et al., Second hand smoke, age of exposure and lung cancer risk. Lung Cancer (Amsterdam, Netherlands), 2008. 61(1): p. 13.
22]  Glanz, K., et al., Correlates of intentions to obtain genetic counseling and colorectal cancer gene testing among at-risk relatives from three ethnic groups. Cancer Epidemiology Biomarkers & Prevention, 1999. 8(suppl 1): p. 329.
23]  Lacour, R.A., et al., What women with ovarian cancer think and know about genetic testing. Gynecologic Oncology, 2008. 111(1): p. 132-136.
24]  Singer, E., T. Antonucci, and J. Van Hoewyk, Racial and ethnic variations in knowledge and attitudes about genetic testing. Genetic Testing, 2004. 8(1): p. 31-43.
25]  Gan, Q., et al., Disease burden of adult lung cancer and ischaemic heart disease from passive tobacco smoking in China. British Medical Journal, 2007. 16(6): p. 417.
26]  Frost, S., L.B. Myers, and S.P. Newman, Genetic screening for Alzheimer's disease: What factors predict intentions to take a test? Behavioral Medicine, 2001. 27(3): p. 101-109.
27]  Israel, G.D., Determining sample size. 2003. p. 2007.
28]  O'Connor, E.L. and K.M. White, Intentions and willingness to use complementary and alternative medicines: What potential patients believe about CAMs. Complementary Therapies in Clinical Practice, 2009. 15(3): p. 136-140.
29]  Smith, K.R. and R.T. Croyle, Attitudes toward genetic testing for colon cancer risk. American Journal of Public Health, 1995. 85(10): p. 1435.
30]  Sanderson, S.C., et al., Public interest in genetic testing for susceptibility to heart disease and cancer: a population-based survey in the UK. Preventive Medicine, 2004. 39(3): p. 458-464.
31]  Nexoe, J., J. Kragstrup, and J. Sogaard, Decision on influenza vaccination among the elderly: a questionnaire study based on the Health Belief Model and the Multidimensional Locus of Control Theory. Scandinavian Journal of Primary Health Care, 1999. 17(2): p. 105-110.
32]  Hahn, E.J., et al., Perceived risk and interest in screening for lung cancer among current and former smokers. Research in Nursing and Health, 2006. 29(4): p. 359.
33]  Brownson, R.C., et al., Demographic and socioeconomic differences in beliefs about the health effects of smoking. American Journal of Public Health, 1992. 82(1): p. 99.
34]  Gibbons, F.X., Intention, Expectation and Willingness. National Cancer Institute. p. 8.
35]  Dube, S.R., et al., Vital signs: Current cigarette smoking among adults aged= 18 years—United States, 2009. MMWR: Morbidity & Mortality Weekly Report, 2010. 59(35): p. 1135-1140.
Show Less References


Awareness and Knowledge of Smoking-Related Cancers Among University Students in Jordan

1Faculty of Medicine, University of Jordan, Amman, Jordan

American Journal of Cancer Prevention. 2014, 2(2), 20-23
DOI: 10.12691/ajcp-2-2-1
Copyright © 2014 Science and Education Publishing

Cite this paper:
Ayoub A. Innabi, Dina A. Ammari, Wa'el J. K. Tuqan. Awareness and Knowledge of Smoking-Related Cancers Among University Students in Jordan. American Journal of Cancer Prevention. 2014; 2(2):20-23. doi: 10.12691/ajcp-2-2-1.

Correspondence to: Ayoub  A. Innabi, Faculty of Medicine, University of Jordan, Amman, Jordan. Email:


Background: Jordan, a Middle Eastern country, has a high prevalence rate of smoking. However, little research was done to evaluate knowledge of smoking-related cancers in the region. Objective: To assess knowledge of smoking-related cancers among Jordanian university students. Design: Cross-sectional study conducted in July, 2013, using a self-administered online questionnaire. The questionnaire was sent to students from University of Jordan. Results: The final sample consisted of 230 students. The majority of participants (98.7%) were aware that smoking has harmful health effects and (95.7%) agreed that smoking causes cancer. Most of the participants agreed that smoking causes lung cancer (97.8%), oral cancer (83.0%), laryngeal cancer (82.6%), pharyngeal cancer (80.0%), and esophageal cancer (63.0%), while less than half of the participant thought that smoking causes AML (46.1%), stomach cancer (36.1%), kidney cancer (32.6%), cervical cancer (19.6%), pancreatic cancer (19.1%), and bladder cancer (14.8%). Females showed more knowledge about smoking-related cancers than males (p < 0.05) but the there was no significant difference between smokers and non-smokers. Conclusion: These findings show that most of the students know that lung cancer is caused by smoking. However, there is a lower knowledge of other smoking-related cancers. Our study suggests that more efforts should be done to increase the awareness of the adverse health hazards of smoking especially that are related to cancer.



[1]  Lee, H., S.J. Yoon, and H.S. Ahn, Measuring the burden of major cancers due to smoking in Korea. Cancer Sci, 2006. 97 (6): p. 530-4.
[2]  Das, S.K., Harmful health effects of cigarette smoking. Mol Cell Biochem, 2003. 253 (1-2): p. 159-65.
[3]  Levitz, J.S., T.P. Bradley, and A.L. Golden, Overview of smoking and all cancers. Med Clin North Am, 2004. 88(6): p. 1655-75, xiii.
[4]  Rastogi, T., A. Hildesheim, and R. Sinha, Opportunities for cancer epidemiology in developing countries. Nat Rev Cancer, 2004. 4 (11): p. 909-17.
[5]  Shishani, K., et al., Smoking patterns among Jordanian health professionals: a study about the impediments to tobacco control in Jordan. Eur J Cardiovasc Nurs, 2011. 10 (4): p. 221-7.
Show More References
6]  Merrill, R.M., et al., Nurse and physician patient counseling about tobacco smoking in Jordan. Promot Educ, 2008. 15 (3): p. 9-14.
7]  Haddad, L.G. and M.Z. Malak, Smoking habits and attitudes towards smoking among university students in Jordan. Int J Nurs Stud, 2002. 39 (8): p. 793-802.
8]  Naddaf, A., The social factors implicated in cigarette smoking in a Jordanian community. Pak J Biol Sci, 2007. 10 (5): p. 741-4.
9]  Khabour, O.F., et al., Waterpipe tobacco and cigarette smoking among university students in Jordan. Int J Tuberc Lung Dis, 2012. 16 (7): p. 986-92.
10]  Thomas, J.L., et al., Abstinence and relapse rates following a college campus-based quit & win contest. J Am Coll Health, 2010. 58 (4): p. 365-72.
11]  Brockman, L.N., et al., Hookah's new popularity among US college students: a pilot study of the characteristics of hookah smokers and their Facebook displays. BMJ Open, 2012. 2 (6).
12]  Egan, K.G. and M.A. Moreno, Alcohol references on undergraduate males' Facebook profiles. Am J Mens Health, 2011. 5 (5): p. 413-20.
13]  Kofahi, M.M. and L.G. Haddad, Perceptions of lung cancer and smoking among college students in Jordan. J Transcult Nurs, 2005. 16 (3): p. 245-54.
14]  Bhanji, S., et al., Factors related to knowledge and perception of women about smoking: a cross sectional study from a developing country. BMC Womens Health, 2011. 11: p. 16.
15]  Ahmed, H.G., Survey on knowledge and attitudes related to the relation between tobacco, alcohol abuse and cancer in the northern state of Sudan. Asian Pac J Cancer Prev, 2013. 14 (4): p. 2483-6.
16]  Al-Naggar, R.A., et al., Prevalence and of smoking and associated factors among Malaysian University students. Asian Pac J Cancer Prev, 2011. 12 (3): p. 619-24.
17]  Al-Naggar, R.A. and S.Y. Kadir, Lung cancer knowledge among secondary school male teachers in Kudat, Sabah, Malaysia. Asian Pac J Cancer Prev, 2013. 14 (1): p. 103-9.
18]  Yang, Y., et al., Awareness of tobacco-related health hazards among adults in China. Biomed Environ Sci, 2010. 23 (6): p. 437-44.
19]  Hawari, F.I., et al., Perceptions of young Jordanian adults to proposed anti-tobacco pictorial warning labels. BMC Public Health, 2011. 11: p. 414.
20]  Al Dubai, S.A., et al., Awareness and knowledge of oral cancer among university students in Malaysia. Asian Pac J Cancer Prev, 2012. 13 (1): p. 165-8.
21]  Oncken, C., et al., Knowledge and perceived risk of smoking-related conditions: a survey of cigarette smokers. Prev Med, 2005. 40 (6): p. 779-84.
22]  Tadbir, A.A., et al., Evaluation of levels of knowledge about etiology and symptoms of oral cancer in southern Iran. Asian Pac J Cancer Prev, 2013. 14 (4): p. 2217-20.
23]  Nieder, A.M., et al., Are patients aware of the association between smoking and bladder cancer? J Urol, 2006. 176 (6 Pt 1): p. 2405-8; discussion 2408.
24]  Anastasiou, I., et al., Patient awareness of smoking as a risk factor for bladder cancer. Int Urol Nephrol, 2010. 42 (2): p. 309-14.
25]  Ma, G.X., et al., Perceived risks of certain types of cancer and heart disease among Asian American smokers and non-smokers. J Community Health, 2002. 27 (4): p. 233-46.
26]  Joy, T., et al., Awareness of cervix cancer risk factors in educated youth: a cross-sectional, questionnaire based survey in India, Nepal, and Sri Lanka. Asian Pac J Cancer Prev, 2011. 12 (7): p. 1707-12.
27]  Murphy-Hoefer, R., S. Alder, and C. Higbee, Perceptions about cigarette smoking and risks among college students. Nicotine Tob Res, 2004. 6 Suppl 3: p. S371-4.
28]  Minh An, D.T., et al., Knowledge of the health consequences of tobacco smoking: a cross-sectional survey of Vietnamese adults. Glob Health Action, 2013. 6: p. 1-9.
29]  Xu, Y., et al., Tobacco knowledge among adults in Zhejiang Province, China. PLoS One, 2013. 8 (3): p. e59172.
30]  Hammond, D., et al., Effectiveness of cigarette warning labels in informing smokers about the risks of smoking: findings from the International Tobacco Control (ITC) Four Country Survey. Tob Control, 2006. 15 Suppl 3: p. iii19-25.
31]  Hafstad, A., et al., Provocative appeals in anti-smoking mass media campaigns targeting adolescents--the accumulated effect of multiple exposures. Health Educ Res, 1997. 12 (2): p. 227-36.
32]  Flynn, B.S., et al., Mass media and school interventions for cigarette smoking prevention: effects 2 years after completion. Am J Public Health, 1994. 84 (7): p. 1148-50.
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