Although the burden of cancer is rapidly growing in Vietnam, there was no up-to-date review that describes cancer burden and control in Vietnam throughout the literature. By identifying various risk factors, means of prevention, and methods for early detection, this review seeks to systematically summarize the evidence for the future planning and management of cancer occurrence in Vietnam. Additionally, this report aims to identify improvements which are necessary for the treatment and palliative care of patients with cancer in Vietnam. We employed a hybrid approach including both a scoping review and narrative synthesis for this study. Information was identified, extracted, and charted from various sources, which include international and domestically published studies, in addition to gray literature. Our results illustrate that the burden of cancer in Vietnam has tripled in the past 30 years, and this situation could be partly explained by the growing prevalence of both old and new risk factors. Besides hepatitis B virus, various other important risk factors such as human papilloma virus, tobacco usage, physical inactivity, and improper diets are still not under control in Vietnam. There is presently a lack of national cancer screening programs, and the capacity of cancer care services could not maintain pace with the demands of a rapidly increasing Vietnamese population. Overall, policy frameworks for cancer control in Vietnam are in place, but there is still a lack of proper financing and governing models necessary to support a sustainable program. In conclusion, Cancer and its associated consequences are both persistent and emerging problems in Vietnam, and the results of cancer control programs are limited. A comprehensive and evidence-based approach toward the prevention and treatment of cancer should be the future direction for Vietnam.

https://journals.sagepub.com/doi/pdf/10.1177/1073274819863802

Cancers in Vietnam—Burden and Control Efforts: A Narrative Scoping Review

The strong invasive and metastatic nature of non-small cell lung cancer (NSCLC) leads to poor prognosis. Collagen triple helix repeat containing 1 (CTHRC1) is involved in cell migration, motility and invasion. The object of this study is to investigate the involvement of CTHRC1 in NSCLC invasion and metastasis. A proteomic analysis was performed to identify the different expression proteins between NSCLC and normal tissues. Cell lines stably express CTHRC1, MMP7, MMP9 were established. Invasion and migration were determined by scratch and transwell assays respectively. Clinical correlations of CTHRC1 in a cohort of 230 NSCLC patients were analysed. CTHRC1 is overexpressed in NSCLC as measured by proteomic analysis. Additionally, CTHRC1 increases tumour cell migration and invasion in vitro. Furthermore, CTHRC1 expression is significantly correlated with matrix metalloproteinase (MMP)7 and MMP9 expression in sera and tumour tissues from NSCLC. The invasion ability mediated by CTHRC1 were mainly MMP7- and MMP9-dependent. MMP7 or MMP9 depletion significantly eradicated the pro-invasive effects mediated by CTHRC1 on NSCLC cells. Clinically, patients with high CTHRC1 expression had poor survival. CTHRC1 serves as a pro-metastatic gene that contributes to NSCLC invasion and metastasis, which are mediated by upregulated MMP7 and MMP9 expression. Targeting CTHRC1 may be beneficial for inhibiting NSCLC metastasis.

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CTHRC1 induces non-small cell lung cancer (NSCLC) invasion through upregulating MMP-7/MMP-9

Cancer of the uterine cervix is a worldwide menace taking innumerable womens' lives. The literature is vast and a large number of studies have been conducted in this field. Analyses have shown significant differences exist in terms of screening and HPV testing facilities among high income and low to middle income countries. In addition, acute lack of awareness and knowledge among the concerned population is particularly noted in rural areas of the low income countries. A detailed review of Indian case studies revealed that early age of marriage and childbirth, multiparity, poor personal hygiene and low socio-economic status among others are the principal risk factors for this disease. This review concludes that a two pronged strategy involving strong government and NGO action is necessary to minimize the occurrence of cervical cancer especially in low and medium income countries.

http://koreascience.or.kr:80/article/JAKO201202950482791.pdf

Current Status of Knowledge, Attitude and Practice (KAP) and Screening for Cervical Cancer in Countries at Different Levels of Development

Cervical cancer is the first female cancer in Lao PDR, a low-income country with no national screening and prevention programs for this human papillomavirus (HPV) associated pathology. HIV-infected women have a higher risk of persistent oncogenic HPV infection. The purpose of this study was to determine the knowledge, awareness and attitudes about cervical cancer among Lao women attending or not an HIV treatment center, in order to understand if this attendance had offered an opportunity for information and prevention. A cross-sectional case–control survey was conducted in three provinces of Lao PDR, Vientiane, Luang Prabang and Savannakhet. Cases were 320 women aged 25 to 65, living with HIV and followed in an HIV treatment center. Controls were 320 women matched for age and place of residence, not attending an HIV treatment center. Cases had a greater number of sexual partners and used condoms more often than controls. Only 36.6% of women had consulted a gynecologist (47.5% among cases and 25.6% among controls, p < 0.001) and 3.9% had benefited from at least one Pap smear screening (5.6% cases and 2.2% controls, p = 0.02). The average knowledge score was 3.5 on a 0 to 13 scale, significantly higher in cases than in controls (p < 0.0001). Despite having a lower education level and economic status, the women living with HIV had a better knowledge about cervical cancer and were more aware than the controls of the risk of developing such a cancer (35.9% vs. 8.4%, p = 0.0001). The main source of information was healthcare professionals. The main reasons for not undergoing Pap smear were the absence of symptoms and the default of medical injunction for cases, the lack of information and ignorance of screening usefulness for controls. In Lao PDR, routine consultation in HIV treatment centers is not enough harnessed to inform women of their high risk of developing cervical cancer, and to perform screening testing and treatment of precancerous lesions. Implementing this cost-effective strategy could be the first step toward a national prevention program for cervical cancer.

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Knowledge, awareness and attitudes about cervical cancer among women attending or not an HIV treatment center in Lao PDR

Background
The Expanded Program on Immunization currently considers offering Human Papilomavirus vaccine on a routine basis in Vietnam. However, as the current available vaccine can prevent only two types HPV 16 and 18, before implementing a large-scale vaccine campaign we need information about the prevalence of infection with only HPV 16 and 18 in Viet Nam. This study was done in 5 large cities in Vietnam to estimate the prevalence of HPV 16 and/or 18 infections and to explore the distribution of other high risk types of HPV among married women in these provinces.

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Prevalence of cervical infection with HPV type 16 and 18 in Vietnam: implications for vaccine campaign.

The burden of cervical cancer is increasing in Vietnam in the recent years, infection with high risk HPV being the cause. This study aimed to examine the prevalence of HPV and the distribution of HPV specific types among the general population in 5 big cities in Vietnam. Totals of 1500 women in round 1 and 3000 in round 2 were interviewed and underwent gynecological examination. HPV infection status, and HPV genotyping test were perfoirmed for all participants. Results indicated that the prevalence of HPV infection in 5 cities ranged from 6.1% to 10.2% with Can Tho having highest prevalence. The most common HPV types in all 5 cities were HPV 16, 18 and 58. Most of the positive cases were infected with high risk HPV, especially in Hanoi and Can Tho where more than 90% positive cases were high risk HPV. Furthermore, in Can Tho more than 60% of women were infected with multiple HPV types. The information from this study can be used to provide updated data for planning preventive activities for cervical cancer in the studied cities.

http://koreascience.or.kr:80/article/JAKO201212851254276.pdf

Prevalence of cervical human papilloma virus infection among married women in Vietnam, 2011.

Human papilloma virus (HPV) is the necessary cause of cervical cancer. This survey used a sample of 1,500 married women aged 15-69 to examine the prevalence of HPV infection and HPV specific types in Vietnam as well as risk factors of HPV infection. Results indicated that the prevalence of HPV infection in Hanoi and HCM was 6.13 and 8.27. The proportion of multiple HPV infection was also higher in HCM than in Hanoi (35.5% vs. 17.4%). Risk factors having significant associations with general HPV infection were early age at first sexual intercourse, number of life time sexual partners and period of use of oral contraceptives. Future implementation of HPV vaccine campaigns in Vietnam should consider the fact that HPV type 58 is common among both Hanoi and HCM populations, which none of the currently available vaccines target.

Lan T H Vu

Papers

Prevalence of cervical infection with HPV type 16 and 18 in Vietnam: implications for vaccine campaign.

Prevalence of cervical human papilloma virus infection among married women in Vietnam, 2011.

Cervical human papilloma virus infection among the general female population in Vietnam: a situation analysis.