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PLOS ONE  2012 

Short-Term Effect of Different Teaching Methods on Nasopharyngeal Carcinoma for General Practitioners in Jakarta, Indonesia

DOI: 10.1371/journal.pone.0032756

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Abstract:

In Indonesia, Nasopharyngeal Carcinoma (NPC) is the most frequent cancer of the head and neck region. At first presentation in the hospital most patients already have advanced NPC. Our previous study showed that general practitioners (GPs) working in Yogyakarta, Indonesia lack the knowledge necessary for early detection of NPC. By providing training on early symptoms of NPC we hope that the diagnosis and referral will occur at an earlier stage. Here we assess the current NPC knowledge levels of GPs in Jakarta, evaluate improvement after training, compare the effectiveness of two training formats, and estimate the loss of recall over a two week period. Methods Two Indonesian GPs visited 31 Primary Health Care Centres (PHCCs) and provided a lecture on NPC. The alternative format consisted of a symposium at the Universitas Indonesia, Jakarta, presented by local head and neck surgeons, with all GPs in the region being invited. To evaluate the effect of both formats a questionnaire was conducted before and after. Results The lecture in the PHCCs was attended by 130 GPs. Sixty-six GPs attended the training in the university hospital and 40 GPs attended both. Pre training the NPC knowledge level was poor with an average of 1.6 symptoms being correctly identified out of a potential maximum of 12, this was increased to 4.9 post training (p<0.0001). GPs attending the PHCC course recorded a greater increase in correct symptoms than those attending the symposium (3.8 vs. 2.8; p = 0.01). After a two week period the knowledge levels had declined slightly from 5.5 correctly identified symptoms to 4.2 (p = 0.25). Conclusion These results confirm our findings regarding GPs insufficient knowledge of NPC. Lectures in the PHCC and a symposium have both been proven to be effective training tools in the education of GPs.

References

[1]  Plianbangchang S (2007) WHO Country Cooperation Strategy 2007–2011 Indonesia.
[2]  Drager N, Vieira C (2002) Trade in health services: global, regional, and country perspectives.
[3]  Ferlay J, Shin HR, Bray F, Forman D, Mathers C, et al. (2010) Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. International journal of cancer Journal international du cancer 127: 2893–2917.
[4]  Yu MC, Yuan JM (2002) Epidemiology of nasopharyngeal carcinoma. Semin Cancer Biol 12: 421–429.
[5]  Devi BC, Pisani P, Tang TS, Parkin DM (2004) High incidence of nasopharyngeal carcinoma in native people of Sarawak, Borneo Island. Cancer Epidemiol Biomarkers Prev 13: 482–486.
[6]  Wei WI, Sham JS (2005) Nasopharyngeal carcinoma. Lancet 365: 2041–2054.
[7]  zur Hausen H, Schulte-Holthausen H, Klein G, Henle W, Henle G, et al. (1970) EBV DNA in biopsies of Burkitt tumours and anaplastic carcinomas of the nasopharynx. Nature 228: 1056–1058.
[8]  Poirier S, Hubert A, D-The G, Ohshima H, Bourgade MC, et al. (1987) Occurrence of volatile nitrosamines in food samples collected in three high-risk areas for nasopharyngeal carcinoma. IARC Sci Publ 415–419:
[9]  Guo X, Johnson RC, Deng H, Liao J, Guan L, et al. (2009) Evaluation of nonviral risk factors for nasopharyngeal carcinoma in a high-risk population of Southern China. Int J Cancer 124: 2942–2947.
[10]  Armstrong RW, Imrey PB, Lye MS, Armstrong MJ, Yu MC, et al. (1998) Nasopharyngeal carcinoma in Malaysian Chinese: salted fish and other dietary exposures. Int J Cancer 77: 228–235.
[11]  Armstrong RW, Imrey PB, Lye MS, Armstrong MJ, Yu MC, et al. (2000) Nasopharyngeal carcinoma in Malaysian Chinese: occupational exposures to particles, formaldehyde and heat. Int J Epidemiol 29: 991–998.
[12]  Chang ET, Adami HO (2006) The enigmatic epidemiology of nasopharyngeal carcinoma. Cancer Epidemiol Biomarkers Prev 15: 1765–1777.
[13]  Parkin DM, Bray F, Ferlay J, Pisani P (2005) Global cancer statistics, 2002. CA Cancer J Clin 55: 74–108.
[14]  Ozyar E, Atahan IL, Akyol FH, Gurkaynak M, Zorlu AF (1994) Cranial nerve involvement in nasopharyngeal carcinoma: its prognostic role and response to radiotherapy. Radiation medicine 12: 65–68.
[15]  Lee AW, Foo W, Law SC, Poon YF, Sze WM, et al. (1997) Nasopharyngeal carcinoma: presenting symptoms and duration before diagnosis. Hong Kong Med J 3: 355–361.
[16]  Zhang L, Zhao C, Ghimire B, Hong MH, Liu Q, et al. (2010) The role of concurrent chemoradiotherapy in the treatment of locoregionally advanced nasopharyngeal carcinoma among endemic population: a meta-analysis of the phase III randomized trials. BMC Cancer 10: 558.
[17]  Lee AW, Sze WM, Au JS, Leung SF, Leung TW, et al. (2005) Treatment results for nasopharyngeal carcinoma in the modern era: the Hong Kong experience. Int J Radiat Oncol Biol Phys 61: 1107–1116.
[18]  Lee AW, Poon YF, Foo W, Law SC, Cheung FK, et al. (1992) Retrospective analysis of 5037 patients with nasopharyngeal carcinoma treated during 1976–1985: overall survival and patterns of failure. Int J Radiat Oncol Biol Phys 23: 261–270.
[19]  Fles R, Wildeman MA, Sulistiono B, Haryana SM, Tan IB (2010) Knowledge of general practitioners about nasopharyngeal cancer at the Puskesmas in Yogyakarta, Indonesia. BMC Med Educ 10: 81.
[20]  Devi BC, Tang TS, Corbex M (2007) Reducing by half the percentage of late-stage presentation for breast and cervix cancer over 4 years: a pilot study of clinical downstaging in Sarawak, Malaysia. Ann Oncol 18: 1172–1176.
[21]  Prasad U, Pua KC (2000) Nasopharyngeal carcinoma: a delay in diagnosis. Med J Malaysia 55: 230–235.
[22]  Alho OP, Teppo H, Mantyselka P, Kantola S (2006) Head and neck cancer in primary care: presenting symptoms and the effect of delayed diagnosis of cancer cases. CMAJ 174: 779–784.
[23]  Koivunen P, Rantala N, Hyrynkangas K, Jokinen K, Alho OP (2001) The impact of patient and professional diagnostic delays on survival in pharyngeal cancer. Cancer 92: 2885–2891.
[24]  Teppo H, Koivunen P, Hyrynkangas K, Alho OP (2003) Diagnostic delays in laryngeal carcinoma: professional diagnostic delay is a strong independent predictor of survival. Head Neck 25: 389–394.
[25]  Wildeman MA, Zandbergen J, Vincent A, Herdini C, Middeldorp JM, et al. (2011) Can an online clinical data management service help in improving data collection and data quality in a developing country setting? Trials 12: 190.
[26]  Cevenini R, Donati M, Caliceti U, Moroni A, Tamba I, et al. (1986) Evaluation of antibodies to Epstein-Barr virus in Italian patients with nasopharyngeal carcinoma. J Infect 12: 127–131.
[27]  Chen JY, Chen CJ, Liu MY, Cho SM, Hsu MM, et al. (1987) Antibodies to Epstein-Barr virus-specific DNase in patients with nasopharyngeal carcinoma and control groups. J Med Virol 23: 11–21.
[28]  Ji MF, Wang DK, Yu YL, Guo YQ, Liang JS, et al. (2007) Sustained elevation of Epstein-Barr virus antibody levels preceding clinical onset of nasopharyngeal carcinoma. Br J Cancer 96: 623–630.
[29]  Tamada A, Makimoto K, Yamabe H, Imai J, Hinuma Y, et al. (1984) Titers of Epstein-Barr virus-related antibodies in nasopharyngeal carcinoma in Japan. Cancer 53: 430–440.
[30]  de Vathaire F, Sancho-Garnier H, de-The H, Pieddeloup C, Schwaab G, et al. (1988) Prognostic value of EBV markers in the clinical management of nasopharyngeal carcinoma (NPC): a multicenter follow-up study. Int J Cancer 42: 176–181.
[31]  Fachiroh J, Schouten T, Hariwiyanto B, Paramita DK, Harijadi A, et al. (2004) Molecular diversity of Epstein-Barr virus IgG and IgA antibody responses in nasopharyngeal carcinoma: a comparison of Indonesian, Chinese, and European subjects. J Infect Dis 190: 53–62.
[32]  Fachiroh J, Paramita DK, Hariwiyanto B, Harijadi A, Dahlia HL, et al. (2006) Single-assay combination of Epstein-Barr Virus (EBV) E. J Clin Microbiol 44: 1459–1467.
[33]  Paramita DK, Fachiroh J, Artama WT, van Benthem E, Haryana SM, et al. (2007) Native early antigen of Epstein-Barr virus, a promising antigen for diagnosis of nasopharyngeal carcinoma. J Med Virol 79: 1710–1721.
[34]  Fachiroh J, Prasetyanti PR, Paramita DK, Prasetyawati AT, Anggrahini DW, et al. (2008) Dried-blood sampling for epstein-barr virus immunoglobulin G (IgG) and IgA serology in nasopharyngeal carcinoma screening. J Clin Microbiol 46: 1374–1380.
[35]  Paramita DK, Fachiroh J, Haryana SM, Middeldorp JM (2009) Two-step Epstein-Barr virus immunoglobulin A enzyme-linked immunosorbent assay system for serological screening and confirmation of nasopharyngeal carcinoma. Clin Vaccine Immunol 16: 706–711.
[36]  Lin JC, Wang WY, Chen KY, Wei YH, Liang WM, et al. (2004) Quantification of plasma Epstein-Barr virus DNA in patients with advanced nasopharyngeal carcinoma. N Engl J Med 350: 2461–2470.
[37]  Stevens SJ, Verkuijlen SA, Hariwiyanto B, Harijadi , Fachiroh J, et al. (2005) Diagnostic value of measuring Epstein-Barr virus (EBV) DNA load and carcinoma-specific viral mRNA in relation to anti-EBV immunoglobulin A (IgA) and IgG antibody levels in blood of nasopharyngeal carcinoma patients from Indonesia. J Clin Microbiol 43: 3066–3073.
[38]  Stevens SJ, Verkuijlen SA, Hariwiyanto B, Harijadi , Paramita DK, et al. (2006) Noninvasive diagnosis of nasopharyngeal carcinoma: nasopharyngeal brushings reveal high Epstein-Barr virus DNA load and carcinoma-specific viral BARF1 mRNA. Int J Cancer 119: 608–614.
[39]  Tune CE, Liavaag PG, Freeman JL, van den Brekel MW, Shpitzer T, et al. (1999) Nasopharyngeal brush biopsies and detection of nasopharyngeal cancer in a high-risk population. J Natl Cancer Inst 91: 796–800.
[40]  Tong JH, Tsang RK, Lo KW, Woo JK, Kwong J, et al. (2002) Quantitative Epstein-Barr virus DNA analysis and detection of gene promoter hypermethylation in nasopharyngeal (NP) brushing samples from patients with NP carcinoma. Clin Cancer Res 8: 2612–2619.
[41]  Ji MF, Yu YL, Cheng WM, Zong YS, Ng PS, et al. (2011) Detection of Stage I nasopharyngeal carcinoma by serologic screening and clinical examination. Chin J Cancer 30: 120–123.
[42]  Ali TS, Baig S (2006) Evaluation of a cancer awareness campaign: experience with a selected population in Karachi. Asian Pac J Cancer Prev 7: 391–395.
[43]  Bhurgri H, Gowani SA, Itrat A, Samani S, Zuberi A, et al. (2008) Awareness of cancer risk factors among patients and attendants presenting to a tertiary care hospital in Karachi, Pakistan. J Pak Med Assoc 58: 584–588.

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