1
|
Nogueira-Rodrigues A, Cetina Perez L, Maza M. Editorial: Cervical cancer control in Latin America and the Caribbean. Front Oncol 2024; 13:1226915. [PMID: 38778839 PMCID: PMC11109430 DOI: 10.3389/fonc.2023.1226915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 10/19/2023] [Indexed: 05/25/2024] Open
Affiliation(s)
| | - Lucely Cetina Perez
- Department of Clinical Research, Instituto Nacional de Cancerologia, National Cancer Institute, Mexico City, Mexico
| | - Mauricio Maza
- Pan American Health Organization, Washington, DC, United States
| |
Collapse
|
2
|
Zeng M, Li X, Jiao X, Cai X, Yao F, Xu S, Huang X, Zhang Q, Chen J. Roles of vaginal flora in human papillomavirus infection, virus persistence and clearance. Front Cell Infect Microbiol 2023; 12:1036869. [PMID: 36683675 PMCID: PMC9848591 DOI: 10.3389/fcimb.2022.1036869] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 12/06/2022] [Indexed: 01/06/2023] Open
Abstract
Vaginal flora plays a vital role in human papillomavirus (HPV) infection and progression to cancer. To reveal a role of the vaginal flora in HPV persistence and clearance, 90 patients with HPV infection and 45 healthy individuals were enrolled in this study and their vaginal flora were analyzed. Women with HPV infection were treated with Lactobacillus in the vaginal environment as a supplement to interferon therapy. Our results indicated that patients with high risk HPV (Hr-HPV) 16/18 infection had a significantly higher alpha diversity compared with the healthy control (p < 0.01), while there was no significant difference between the non-Hr-HPV16/18 group and the controls (p > 0.05). Patients with multiple HPV infection had insignificantly higher alpha diversity compared with single HPV infection (p > 0.05). The vaginal flora of patients with HPV infection exhibited different compositions when compared to the healthy controls. The dominant bacteria with the highest prevalence in HPV-positive group were Lactobacillus iners (n = 49, 54.44%), and the top 3 dominant bacteria in the HPV-persistent group were Lactobacillus iners (n = 34, 53.13%), Sneathia amnii (n = 9, 14.06%), and Lactobacillus delbrueckii (n = 3, 4.69%). Patients with HPV clearance had significantly lower alpha diversity, and the flora pattern was also different between groups displaying HPV clearance vs. persistence. The patients with persistent HPV infection had significantly higher levels of Bacteroidaceae, Erysipelotrichaceae, Helicobacteraceae, Neisseriaceae, Streptococcaceae (family level), and Fusobacterium, Bacteroides, Neisseria, and Helicobacter (genus level) than patients who had cleared HPV (p < 0.05). Importance Our study revealed differences in vaginal flora patterns are associated with HPV persistence and its clearance. Interferon plus probiotics can greatly improve virus clearance in some patients. Distinguishing bacterial features associated with HPV clearance in patients would be helpful for early intervention and reverse persistent infection.
Collapse
Affiliation(s)
- Mi Zeng
- Department of Cell Biology and Genetics, Shantou University Medical College, Shantou, Guangdong, China
| | - Xin Li
- Department of Cell Biology and Genetics, Shantou University Medical College, Shantou, Guangdong, China
| | - Xiaoyang Jiao
- Department of Cell Biology and Genetics, Shantou University Medical College, Shantou, Guangdong, China
- Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou, Guangdong, China
| | - Xiaochun Cai
- Department of Gynecology and Obstetrics, Chenghai District People's Hospital, Shantou, Guangdong, China
| | - Fen Yao
- Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou, Guangdong, China
- Department of Pharmacology, Shantou University Medical College, Shantou, Guangdong, China
| | - Shaomin Xu
- Department of Gynecology and Obstetrics, Chenghai District People's Hospital, Shantou, Guangdong, China
| | - Xiaoshan Huang
- Longhu Hospital, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Qiaoxin Zhang
- The First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Jianqiang Chen
- The First Affiliated Hospital of Shantou University Medical College, Shantou, China
| |
Collapse
|
3
|
Borges MFDSO, Koifman S, Koifman RJ, da Silva IF. Cancer incidence in indigenous populations of Western Amazon, Brazil. ETHNICITY & HEALTH 2022; 27:1465-1481. [PMID: 33673784 DOI: 10.1080/13557858.2021.1893663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 02/17/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES This study aims to estimate a population-based cancer incidence among indigenous populations in the State of Acre, Brazilian Western Amazon, to provide knowledge about cancer epidemiological profiles contributing to healthcare policies and service planning. Although cancer epidemiology in Brazil is well described through incidence and mortality estimate in the general population, cancer estimates among indigenous peoples are still unknown. DESIGN This is a descriptive study of cancer incidence among the indigenous population (2000-2012) in the State of Acre, Brazil. The sources used were population-based cancer registries of Goiânia, hospital-based cancer registry of Acre, São Paulo, and Porto Velho; Special Indigenous Health Districts databases of Acre, Goiânia, and São Paulo; Mortality Information System, and Rio Branco's public and private laboratories' reports. Standardized Incidence Ratio (SIR) was calculated using cancer incidence rates of Goiânia as reference. RESULTS From 137 cancer cases, 51.8% occurred in women and 32.1% in people aged 70 + . Among men, the most frequent cancer sites were stomach (25.8%), liver (15.1%), colorectal (7.6%), leukemia (7.6%), and prostate (6.1%). Among women, the most frequent were cervical (50.7%), stomach (8.5%), leukemia (5.6%), liver (4.3%), and breast (4.3%). Among men, there was an excess of cancer cases for stomach (SIR=1.75; 95%CI:1.67-1.83), liver (SIR=1.77; 95%CI:1.66-1.88), and leukemia (SIR=1.64; 95%CI:1.49-1.78). In women, an excess of cancer cases was observed for cervical (SIR=4.49; 95%CI:4.34-4.64) and liver (SIR=2.11; 95%CI:1.88-2.34). A lower cancer incidence for prostate (SIR=0.06; 95%CI:0.05-0.07) and female breast (SIR=0.12; 95%CI:0.11-0.14) was observed. CONCLUSIONS Cervical, stomach, and liver cancers corresponded to 52% of the cases and were highly incident among the Brazilian indigenous population of Western Amazon compared to non-indigenous counterparts. Despite the low frequency of breast and prostate cancer, the fact they were present among indigenous peoples suggests a complex epidemiological transition framework in these populations.
Collapse
Affiliation(s)
| | - Sergio Koifman
- National School of Public Health, Sergio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Rosalina Jorge Koifman
- National School of Public Health, Sergio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Ilce Ferreira da Silva
- National School of Public Health, Sergio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| |
Collapse
|
4
|
Perez-Cuevas R, Doubova SV. Syndemic Nature of COVID-19 in Latin American and Caribbean Countries: The Challenge Ahead. Arch Med Res 2022; 53:535-538. [PMID: 35817648 PMCID: PMC9264275 DOI: 10.1016/j.arcmed.2022.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 06/14/2022] [Indexed: 11/19/2022]
Affiliation(s)
- Ricardo Perez-Cuevas
- Division of Social Protection and Health, Interamerican Development Bank, Jamaica Country Office, Jamaica.
| | - Svetlana V Doubova
- Unidad de Investigación en Epidemiología y Servicios de Salud, Centro Medico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México
| |
Collapse
|
5
|
Porchia BFMM, Aps LRDMM, Moreno ACR, da Silva JR, Silva MDO, Sales NS, Alves RPDS, Rocha CRR, Silva MM, Rodrigues KB, Barros TB, Pagni RL, Souza PDC, Diniz MDO, Ferreira LCDS. Active immunization combined with cisplatin confers enhanced therapeutic protection and prevents relapses of HPV-induced tumors at different anatomical sites. Int J Biol Sci 2022; 18:15-29. [PMID: 34975315 PMCID: PMC8692155 DOI: 10.7150/ijbs.56644] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 10/19/2021] [Indexed: 12/22/2022] Open
Abstract
The active immunotherapy concept relies on the use of vaccines that are capable of inducing antitumor immunity, reversion of the suppressive immunological environment, and long-term memory responses. Previously, antitumor vaccines based on a recombinant plasmid (pgDE7h) or a purified protein (gDE7) led to regression of early-established human papillomavirus (HPV)-associated tumors in a preclinical model. In this work, the anticancer vaccines were combined with cisplatin to treat HPV-induced tumors at advanced growth stages. The antitumor effects were evaluated in terms of tumor regression, induction of specific CD8+ T cells, and immune modulation of the tumor microenvironment. Acute toxicity induced by the treatment was measured by weight loss and histological alterations in the liver and kidneys. Our results revealed that the combination of cisplatin with either one of the tested immunotherapies (pgDE7h or gDE7) led to complete tumor regression in mice. Also, the combined treatment resulted in synergistic effects, particularly among mice immunized with gDE7, including activation of systemic and tumor-infiltrating E7-specific CD8+ T cells, tumor infiltration of macrophages and dendritic cells, and prevention of tumor relapses at different anatomical sites. Furthermore, the protocol allowed the reduction of cisplatin dosage and its intrinsic toxic effects, without reducing antitumor outcomes. These results expand our knowledge of active immunotherapy protocols and open perspectives for alternative treatments of HPV-associated tumors.
Collapse
Affiliation(s)
- Bruna Felício Milazzotto Maldonado Porchia
- Vaccine Development Laboratory, Department of Microbiology, Biomedical Sciences Institute, University of Sao Paulo, Sao Paulo, SP, Brazil.,ImunoTera Soluções Terapêuticas Ltda
| | - Luana Raposo de Melo Moraes Aps
- Vaccine Development Laboratory, Department of Microbiology, Biomedical Sciences Institute, University of Sao Paulo, Sao Paulo, SP, Brazil.,ImunoTera Soluções Terapêuticas Ltda
| | - Ana Carolina Ramos Moreno
- Vaccine Development Laboratory, Department of Microbiology, Biomedical Sciences Institute, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Jamile Ramos da Silva
- Vaccine Development Laboratory, Department of Microbiology, Biomedical Sciences Institute, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Mariângela de Oliveira Silva
- Vaccine Development Laboratory, Department of Microbiology, Biomedical Sciences Institute, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Natiely Silva Sales
- Vaccine Development Laboratory, Department of Microbiology, Biomedical Sciences Institute, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Rubens Prince Dos Santos Alves
- Vaccine Development Laboratory, Department of Microbiology, Biomedical Sciences Institute, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Clarissa Ribeiro Reily Rocha
- DNA Repair Laboratory, Department of Microbiology, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | - Matheus Molina Silva
- DNA Repair Laboratory, Department of Microbiology, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | - Karine Bitencourt Rodrigues
- Vaccine Development Laboratory, Department of Microbiology, Biomedical Sciences Institute, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Tácita Borges Barros
- Vaccine Development Laboratory, Department of Microbiology, Biomedical Sciences Institute, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Roberta Liberato Pagni
- Vaccine Development Laboratory, Department of Microbiology, Biomedical Sciences Institute, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Patrícia da Cruz Souza
- Vaccine Development Laboratory, Department of Microbiology, Biomedical Sciences Institute, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Mariana de Oliveira Diniz
- Vaccine Development Laboratory, Department of Microbiology, Biomedical Sciences Institute, University of Sao Paulo, Sao Paulo, SP, Brazil.,ImunoTera Soluções Terapêuticas Ltda
| | - Luís Carlos de Souza Ferreira
- Vaccine Development Laboratory, Department of Microbiology, Biomedical Sciences Institute, University of Sao Paulo, Sao Paulo, SP, Brazil
| |
Collapse
|
6
|
Zhao M, Wu Q, Hao Y, Hu J, Gao Y, Zhou S, Han L. Global, regional, and national burden of cervical cancer for 195 countries and territories, 2007-2017: findings from the Global Burden of Disease Study 2017. BMC Womens Health 2021; 21:419. [PMID: 34922503 PMCID: PMC8684284 DOI: 10.1186/s12905-021-01571-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 12/13/2021] [Indexed: 12/09/2022] Open
Abstract
BACKGROUND Cervical cancer is one of the most common cancers among women worldwide. The formulation or evaluation on prevention strategies all require an accurate understanding of the burden for cervical cancer burden. We aimed to report the up-to-date estimates of cervical cancer burden at global, regional, and national levels. METHODS Data were extracted from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 study. The counts, age-standardized rates, and percentage changes of incidence, disability-adjusted life-years (DALYs), and death attributed to cervical cancer at the global, regional, and national levels in all 195 countries and territories from 21 regions during 2007 to 2017 by age and by Socio-demographic Index (SDI) were measured. All estimates were reported with 95% uncertainty intervals (UIs). RESULTS In 2017, 601,186 (95% UI 554,455 to 625,402) incident cases of cervical cancer were reported worldwide, which caused 8,061,667 (7,527,014 to 8,401,647) DALYs and 259,671 (241,128 to 269,214) deaths. The age-standardized rates for incidence, DALYs and death decreased by - 2.8% (- 7.8% to 0.6%), - 7.1% [- 11.8% to - 3.9%] and - 6.9% [- 11.5% to - 3.7%] from 2007 to 2017, respectively. The highest age-standardized incidence, DALYs and death rates in 2017 were observed in the low SDI quintile, Oceania, Central and Eastern Sub-Saharan Africa. During 2007 to 2017, only East Asia showed increase in these rates despite not significant. At the national level, the highest age-standardized rates for incidence, DALYs, and death in 2017 were observed in Kiribati, Somalia, Eritrea, and Central African Republic; and Georgia showed the largest increases in all these rates during 2007 to 2017. CONCLUSION Although the age-standardized rates for incidence, DALYs, and death of cervical cancer have decreased in most parts of the world from 2007 to 2017, cervical cancer remains a major public health concern in view of the absolute number of cervical cancer cases, DALYs, and deaths increased during this period. The challenge is more prone to in the low SDI quintile, Oceania, Central and Eastern Sub-Saharan Africa, East Asia, and some countries, suggesting an urgent to promote human papillomavirus vaccination in these regions.
Collapse
Affiliation(s)
- Miaomiao Zhao
- Department of Health Management, School of Public Health, Nantong University, Nantong, Jiangsu, China
| | - Qunhong Wu
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Yanhua Hao
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Jingcen Hu
- Department of Global Health, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, Zhejiang, China
- Department of Global Health, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, 315010, Zhejiang, China
| | - Yuexia Gao
- Department of Health Management, School of Public Health, Nantong University, Nantong, Jiangsu, China
| | - Shan Zhou
- Department of Endocrinology, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, Zhejiang, China.
| | - Liyuan Han
- Department of Global Health, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, Zhejiang, China.
- Department of Global Health, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, 315010, Zhejiang, China.
| |
Collapse
|
7
|
Cervical Squamous Intraepithelial Lesions Are Associated with Differences in the Vaginal Microbiota of Mexican Women. Microbiol Spectr 2021; 9:e0014321. [PMID: 34643408 PMCID: PMC8515943 DOI: 10.1128/spectrum.00143-21] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Cervical cancer is an important health concern worldwide and is one of the leading causes of death in Mexican women. Previous studies have shown changes in the female genital tract microbe community related to human papillomavirus (HPV) infection and cervical cancer; yet, this link remains unexplored in many human populations. This study evaluated the vaginal bacterial community among Mexican women with precancerous squamous intraepithelial lesions (SIL). We sequenced the V3 region of the 16S rRNA gene in cervical samples from 228 Mexican women, including 121 participants with SIL, most of which were HPV positive, and 107 healthy women without HPV infection or SIL. The presence of SIL was associated with changes in composition (beta diversity) and with a higher species richness (Chao1). A comparison of HPV-positive women with and without SIL showed that microbiota changes occurred even in the absence of SIL. Multivariate association with linear models (MaAsLin) analysis yielded independent associations between HPV infection and an increase in the relative abundance of Brachybacterium conglomeratum and Brevibacterium aureum as well as a decrease in two Lactobacillus iners operational taxonomic units (OTUs). We also identified a positive independent association between HPV-16, the most common HPV subtype linked to SIL, and Brachybacterium conglomeratum. Our work indicates that HPV infection leading to SIL is primarily associated with shifts in vaginal microbiota composition, some of which may be specific to this human population. IMPORTANCE Human papillomavirus (HPV) plays a critical role in cervical carcinogenesis but is not sufficient for cervical cancer development, indicating the involvement of other factors. The vaginal microbiota is an important factor in controlling infections caused by HPV, and, depending on its composition, it can modulate the microenvironment in vaginal mucosa against viral infections. Ethnic and sociodemographic factors influence differences in vaginal microbiome composition, which underlies the dysbiotic patterns linked to HPV infection and cervical cancer across different populations of women. Here, we provide evidence for associations between vaginal microbiota patterns and HPV infection linked to ethnic and sociodemographic factors. To our knowledge, this is the first report of the species Brevibacterium aureum and Brachybacterium conglomeratum linked to HPV infection or squamous intraepithelial lesions (SIL).
Collapse
|
8
|
Bispo Pereira EH, Camilo-Júnior DJ, D'ávilla SCGP, Mattar NJ, Xavier-Júnior JCC. Comparison of cervical cancer screening results among public and private services in Brazil. Int J Gynaecol Obstet 2021; 158:289-294. [PMID: 34655231 DOI: 10.1002/ijgo.13985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 09/19/2021] [Accepted: 10/14/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To compare the frequency of cervical smear test results between women seen in private and public health services in a medium-sized city in Brazil. METHODS This was an observational analytical study analyzing cervical cytologic results over 16 years. Public data were collected from the Brazilian National Health System, and private refers to those collected at private clinics. RESULTS The overall frequency of unsatisfactory/rejected results was higher in public service examinations (odds ratio [OR] 0.05; 95% confidence interval [CI] 0.04-0.06). The same occurred for atypical squamous cells of undetermined significance (ASC-US) (OR 0.90; 95% CI 0.85-0.95) and atypical squamous cells cannot exclude high grade intraepithelial lesions (ASC-H) (OR 0.55; 95% CI 0.47-0.64) categories. For low-grade squamous intraepithelial lesions, the frequency was higher among women from private services (OR 1.39; 95% CI 1.24-1.55). Among women aged 25-64 years, the frequency of high-grade squamous intraepithelial lesions was higher among women seen in the public service (OR 0.81; 95% CI 0.66-0.99). CONCLUSION Brazilian public services showed higher frequencies of unsatisfactory/rejected results and higher rates of ASC-US and ASC-H. Focusing on pre-analytical phases and establishing an internal quality control program can help improve these rates even though national protocols guide them.
Collapse
Affiliation(s)
| | | | - Solange Correa Garcia Pires D'ávilla
- School of Medicine, Centro Universitário Católico Unisalesiano Auxilium, Araçatuba, Brazil.,São José do Rio Preto Medical School (FAMERP), São Paulo, Brazil
| | | | - José Cândido Caldeira Xavier-Júnior
- School of Medicine, Centro Universitário Católico Unisalesiano Auxilium, Araçatuba, Brazil.,Pathology Institute of Araçatuba, São Paulo, Brazil
| |
Collapse
|
9
|
Nuche-Berenguer B, Sakellariou D. Socioeconomic Determinants of Participation in Cancer Screening in Argentina: A Cross-Sectional Study. Front Public Health 2021; 9:699108. [PMID: 34504827 PMCID: PMC8423085 DOI: 10.3389/fpubh.2021.699108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 07/22/2021] [Indexed: 12/24/2022] Open
Abstract
Low socioeconomic status is associated with late cancer diagnosis and mortality in Argentina. It is important that cancer screening services are accessible to the whole population so that cancer can be detected early. Our aim in this study was to investigate socioeconomic determinants for the disparities in the use of breast, cervical, and colorectal cancer screening services in Argentina, and to measure the country progress in reducing differences in cancer screening participation across socioeconomic levels. We performed a secondary analysis of cross-sectional data from the 2018 National Survey of Risk Factors of Argentina. The sample included data from 49,170 households. We also compared the results with data from the 2013 wave of the same survey in order to assess progress on cancer screening participation across income and education categories. Income, education, health insurance, disability, and marital status were associated with cancer screening underuse in Argentina. Comparison between 2013 and 2018 demonstrated that there has been some progress toward increasing cancer screening uptake, but this increase is not equitably distributed across the population. To further reduce disparities in cancer participation across socioeconomic levels, cancer screening programs in Argentina should reinforce strategies to become more accessible. It is important to proactively reach those populations that are underusers of cancer screening and ensure that barriers that stop people from accessing cancer screening are explored and adequately addressed.
Collapse
|
10
|
Neibart SS, Smith TA, Fang JH, Anderson T, Kulkarni A, Tsui J, Hudson SV, Peck GL, Hanna JS, Beer NL, Einstein MH. Assessment of Cervical Cancer Prevention and Treatment Infrastructure in Belize. JCO Glob Oncol 2021; 7:1251-1259. [PMID: 34351814 PMCID: PMC8389877 DOI: 10.1200/go.21.00138] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
PURPOSE Belize has one of the highest cervical cancer burdens among Latin American and Caribbean countries, despite the implementation of national policies to increase access to prevention and treatment services. This study evaluates the policies, infrastructure, and workforce of the cervical cancer management system in Belize to inform capacity building efforts. METHODS In 2018, health facility assessments were conducted across all six districts of Belize at the national pathology facility and 12 public facilities identified as critical to cervical cancer control. Human and infrastructure resource availability and existing policies related to cervical cancer screening and treatment services were assessed through a structured instrument. RESULTS The public cervical cancer screening workforce in Belize consists of 75 primary care nurses and physicians—one per 1,076 screening-eligible women, with 44% conducting rural outreach. All districts have at least one screening facility, but 50% perform screening services only once per week. Colposcopy and loop electrical excision procedures are available in three and four districts, respectively; radical hysterectomy and chemotherapy are available in two districts; and radiation therapy is unavailable. Of essential pathology equipment, 38.5% were present and functional, 23% were present but nonfunctional, and 38.5% were unavailable. Additionally, 35% of supplies were unavailable at the time of assessment, and 75% were unavailable at least once in the 12 months before assessment. CONCLUSION Public-sector cervical cancer management services differ among districts of Belize, with tertiary service availability concentrated in the largest district. Screening, outreach, and pathology are limited mostly by resource availability. This study characterizes the current capacity of services in Belize and pinpoints health system components for future investment and capacity-building efforts.
Collapse
Affiliation(s)
- Shane S Neibart
- Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Tiffany A Smith
- Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Jennifer H Fang
- Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Taylor Anderson
- University of Queensland Ochsner Clinical School, Brisbane, QLD, Australia
| | - Abha Kulkarni
- Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Jennifer Tsui
- University of Southern California, Keck School of Medicine, Los Angeles, CA
| | - Shawna V Hudson
- Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ.,Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Gregory L Peck
- Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ.,Rutgers School of Public Health, Piscataway, NJ
| | - Joseph S Hanna
- Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | | | - Mark H Einstein
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ.,Rutgers New Jersey Medical School, Newark, NJ
| |
Collapse
|
11
|
Zhu L, Chen R, Jiang C, Xie Q, Zhao W, Gao X, Huang H. Mechanism underlying long non‑coding RNA ILF3‑AS1‑mediated inhibition of cervical cancer cell proliferation, invasion and migration, and promotion of apoptosis. Mol Med Rep 2021; 24:554. [PMID: 34080029 PMCID: PMC8188751 DOI: 10.3892/mmr.2021.12193] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 11/24/2020] [Indexed: 01/13/2023] Open
Abstract
Long non-coding RNA ILF3 divergent transcript (ILF3-AS1) displays a tumor-suppressing effect. StarBase predicted that the potential target microRNA (miR) of ILF3-AS1 was miR-454-3p; therefore, the present study investigated the effect of ILF3-AS1 and its target miR-454-3p on cervical cancer (CC). Gene Expression Profiling Interactive Analysis was used to predict the expression of ILF3-AS1 in CC and the overall survival rate of patients. The present study demonstrated that ILF3-AS1 expression was significantly downregulated in human CC tissues and cells compared with adjacent tissues (ANTs) and normal cervical epithelial cells (NCEs), respectively. Patients with CC with high ILF3-AS1 expression displayed higher survival rates compared with patients with low ILF3-AS1 expression. Cell viability, apoptosis, migration and invasion were detected by performing Cell Counting Kit-8, flow cytometry, wound healing and Transwell assays, respectively. Compared with the negative control (NC) group, ILF3-AS1 overexpression significantly inhibited CC cell viability and migration, but significantly increased CC cell apoptosis. Moreover, ILF3-AS1 overexpression significantly upregulated E-Cadherin expression levels, but significantly downregulated N-Cadherin and snail family transcriptional repressor 1 expression levels compared with the NC group. miR-454-3p expression was negatively correlated with ILF3-AS1, and highly expressed in CC tissues and cells compared with ANTs and NCEs, respectively. PTEN, which was predicted and verified as the target gene for miR-454-3p, was significantly downregulated in CC tissues and cells compared with ANTs and NCEs, respectively. ILF3-AS1 expression was positively correlated with PTEN expression, and ILF3-AS1 overexpression partially reversed the inhibitory effect of miR-454-3p on PTEN expression. In conclusion, the present study indicated that ILF3-AS1 inhibited CC cell proliferation and migration, and promoted CC cell apoptosis by inhibiting epithelial-mesenchymal transition, and ILF3-AS1 overexpression partially reversed the inhibitory effect of miR-454-3p on PTEN expression.
Collapse
Affiliation(s)
- Linmei Zhu
- Department of Obstetrics and Gynecology, Guangdong Clifford Hospital, Guangzhou, Guangdong 511495, P.R. China
| | - Ruixia Chen
- Department of Anesthesiology, Sun Yat‑sen Memorial Hospital, Sun Yat‑sen University, Guangzhou, Guangdong 510120, P.R. China
| | - Chunlin Jiang
- Department of Obstetrics and Gynecology, Guangdong Clifford Hospital, Guangzhou, Guangdong 511495, P.R. China
| | - Qingsheng Xie
- Department of Gynecology, Sun Yat‑sen Memorial Hospital, Sun Yat‑sen University, Guangzhou, Guangdong 510120, P.R. China
| | - Wenshuai Zhao
- Department of Anesthesiology, Sun Yat‑sen Memorial Hospital, Sun Yat‑sen University, Guangzhou, Guangdong 510120, P.R. China
| | - Xiaohong Gao
- Department of Obstetrics and Gynecology, Guangdong Clifford Hospital, Guangzhou, Guangdong 511495, P.R. China
| | - Haiming Huang
- Department of Anesthesiology, Sun Yat‑sen Memorial Hospital, Sun Yat‑sen University, Guangzhou, Guangdong 510120, P.R. China
| |
Collapse
|
12
|
Universal cervical cancer control through a right to health lens: refocusing national policy and programmes on underserved women. BMC INTERNATIONAL HEALTH AND HUMAN RIGHTS 2020; 20:21. [PMID: 32736623 PMCID: PMC7393343 DOI: 10.1186/s12914-020-00237-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 07/13/2020] [Indexed: 12/30/2022]
Abstract
Background Cervical cancer claims 311,000 lives annually, and 90% of these deaths occur in low- and middle-income countries. Cervical cancer is a highly preventable and treatable disease, if detected through screening at an early stage. Governments have a responsibility to screen women for precancerous cervical lesions. Yet, national screening programmes overlook many poor women and those marginalised in society. Under-screened women (called hard-to-reach) experience a higher incidence of cervical cancer and elevated mortality rates compared to regularly-screened women. Such inequalities deprive hard-to-reach women of the full enjoyment of their right to sexual and reproductive health, as laid out in Article 12 of the International Covenant on Economic, Social and Cultural Rights and General Comment No. 22. Discussion This article argues first for tailored and innovative national cervical cancer screening programmes (NCSP) grounded in human rights law, to close the disparity between women who are afforded screening and those who are not. Second, acknowledging socioeconomic disparities requires governments to adopt and refine universal cancer control through NCSPs aligned with human rights duties, including to reach all eligible women. Commonly reported- and chronically under-addressed- screening disparities relate to the availability of sufficient health facilities and human resources (example from Kenya), the physical accessibility of health services for rural and remote populations (example from Brazil), and the accessibility of information sensitive to cultural, ethnic, and linguistic barriers (example from Ecuador). Third, governments can adopt new technologies to overcome individual and structural barriers to cervical cancer screening. National cervical cancer screening programmes should tailor screening methods to under-screened women, bearing in mind that eliminating systemic discrimination may require committing greater resources to traditionally neglected groups. Conclusion Governments have human rights obligations to refocus screening policies and programmes on women who are disproportionately affected by discrimination that impairs their full enjoyment of the right to sexual and reproductive health. National cervical cancer screening programmes that keep the right to health principles (above) central will be able to expand screening among low-income, isolated and other marginalised populations, but also women in general, who, for a variety of reasons, do not visit healthcare providers for regular screenings.
Collapse
|
13
|
Hassen E, Bansal D, Ghdira R, Chaieb A, Khairi H, Zakhama A, Remadi S, Hoebeke J, Sultan AA, Chouchane L. Prevalence of antibodies against a cyclic peptide mimicking the FG loop of the human papillomavirus type 16 capsid among Tunisian women. J Transl Med 2020; 18:288. [PMID: 32727491 PMCID: PMC7391620 DOI: 10.1186/s12967-020-02450-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 07/21/2020] [Indexed: 12/01/2022] Open
Abstract
Background In the past decade, cervical cancer has gone from being the second to the fourth most common cancer in women worldwide, but remains the second most common in developing countries. This cancer is most commonly caused by high-risk types of human papillomavirus (HPV), mainly type 16 (HPV16), which are sexually transmitted. This study aimed to investigate the usefulness of a cyclic synthetic peptide designed from the major L1 capsid protein of HPV16 for detecting anti-HPV16 antibodies. Methods We designed and synthetized a peptide that corresponds to the full sequence of the surface-exposed FG loop. We tested the antigenicity of the linear and the cyclic peptides against HPV16 L1 monoclonal antibodies. We used ELISA to detect anti-peptide antibodies in sera and cervical secretions of 179 Tunisian women, and we applied polymerase chain reaction and direct sequencing methods to detect and genotype HPV DNA. Results Both the linear and the cyclic peptides were recognized by the same neutralizing monoclonal antibodies, but the cyclic peptide was more reactive with human sera. The prevalence of the anti-peptide antibodies in sera was higher in women with low-grade squamous intraepithelial lesions (LGSIL) than in women with high-grade squamous intraepithelial lesions (HGSIL) (44% and 15%, respectively). This contrasts with HPV16 DNA prevalence. Compared to women from the general population, systemic IgG prevalence was significantly higher among sex workers (25%; P = 0.002) and women with LGSIL (44%; P = 0.001). In addition, systemic IgA and cervical IgG prevalence was higher among sex workers only (P = 0.002 and P = 0.001, respectively). We did not observe anti-peptide IgG antibodies in women with a current HPV16 infection. Conclusion Anti-peptide IgG in sera or in cervical secretions could be markers of an effective natural immunization against HPV16. This may open novel perspectives for monitoring vaccinated women and for the design of synthetic peptide-based vaccines.
Collapse
Affiliation(s)
- Elham Hassen
- Laboratoire d'immuno-oncologie moléculaire, Faculté de Médecine de Monastir, 5019, Monastir, Tunisia.,Institut Supérieur de Biotechnologie de Monastir, Université de Monastir, Monastir, Tunisia
| | - Devendra Bansal
- Department of Microbiology and Immunology, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Randa Ghdira
- Laboratoire d'immuno-oncologie moléculaire, Faculté de Médecine de Monastir, 5019, Monastir, Tunisia
| | - Anouar Chaieb
- Laboratoire d'immuno-oncologie moléculaire, Faculté de Médecine de Monastir, 5019, Monastir, Tunisia.,Service d'obstétrique et des maladies féminines, Hôpital Universitaire Farhat Hached, Sousse, Tunisia
| | - Hedi Khairi
- Laboratoire d'immuno-oncologie moléculaire, Faculté de Médecine de Monastir, 5019, Monastir, Tunisia.,Service d'obstétrique et des maladies féminines, Hôpital Universitaire Farhat Hached, Sousse, Tunisia
| | - Abdelfattah Zakhama
- Laboratoire d'immuno-oncologie moléculaire, Faculté de Médecine de Monastir, 5019, Monastir, Tunisia.,Laboratoire d'anatomo-pathologie, Faculté de Médecine de Monastir, Monastir, Tunisia
| | | | - Johan Hoebeke
- UPR9021 «Immunologie et Chimie Thérapeutiques», Institut de Biologie Moléculaire et Cellulaire, CNRS, Strasbourg, France
| | - Ali A Sultan
- Department of Microbiology and Immunology, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Lotfi Chouchane
- Department of Microbiology and Immunology, Weill Cornell Medicine-Qatar, Doha, Qatar. .,Department of Genetic Medicine, Weill Cornell Medicine, New York, USA. .,Genetic Intelligence Laboratory, Weill Cornell Medicine-Qatar, Qatar Foundation, P.O. Box 24144, Doha, Qatar.
| |
Collapse
|
14
|
Binagwaho A, Garcia PJ, Gueye B, Dykens JA, Simelela N, Torode J, Goba G, Bosland MC. Eliminating Deaths From Cervical Cancer-Report of a Panel at the 7th Annual Symposium on Global Cancer Research, a Satellite Meeting at the Consortium of Universities for Global Health 10th Annual Meeting. J Glob Oncol 2020; 5:1-7. [PMID: 31774712 PMCID: PMC6882512 DOI: 10.1200/jgo.19.00287] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
This is a summary of the presentations addressing approaches and achievements to reach the goal of eliminating cervical cancer as a global public health problem that were delivered at the 7th Annual Symposium on Global Cancer Research at the 10th Annual Consortium of Universities for Global Health Meeting in March 2019. Dr Princess Nothemba Simelela, Assistant Director-General for Family, Women, Children and Adolescents, World Health Organization, gave an introduction to the World Health Organization-led Cervical Cancer Elimination Initiative and the emerging conceptual framework and targets that will shape the global 2020 to 2030 strategy. Subsequent presentations shared experiences from national programs in Rwanda (Agnes Binagwaho), Latin America (Patricia J. Garcia), and Senegal (Babacar Gueye and J. Andrew Dykens. Successes in intensified human papillomavirus vaccination and screening with follow-up treatment of early and advanced lesions detected are highlighted as well as the challenges and obstacles in achieving and maintaining high coverage in Africa and Latin America. With strong political leadership, commitment of national stakeholders, and the use of proven and cost-effective approaches to human papillomavirus vaccination, screening, and treatment, the vision of a world free of cervical cancer and saving women's lives every year by preventing deaths from cervical cancer will be achievable in the next generation in all countries.
Collapse
Affiliation(s)
- Agnes Binagwaho
- University of Global Health Equity, Butaro, Rwanda.,Harvard Medical School, Boston, MA
| | - Patricia J Garcia
- Cayetano Heredia University, Lima, Peru.,University of Washington, Seattle, WA
| | - Babacar Gueye
- Senegal Ministry of Health and Social Action, Dakar, Senegal
| | | | | | - Julie Torode
- Union for International Cancer Control, Geneva, Switzerland
| | - Gelila Goba
- University of Illinois at Chicago, Chicago, IL
| | | |
Collapse
|
15
|
Carioli G, Bertuccio P, Malvezzi M, Rodriguez T, Levi F, Boffetta P, La Vecchia C, Negri E. Cancer mortality predictions for 2019 in Latin America. Int J Cancer 2019; 147:619-632. [PMID: 31637709 DOI: 10.1002/ijc.32749] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 10/03/2019] [Accepted: 10/09/2019] [Indexed: 12/11/2022]
Abstract
We estimated mortality figures for 2019 in seven Latin American countries, with focus on breast cancer. We retrieved cancer death certification and population data from the WHO and PAHO databases. We obtained mortality statistics for Argentina, Brazil, Chile, Colombia, Cuba, Mexico and Venezuela for 1970-2015. We predicted current death numbers and age-standardised (world population) mortality rates using joinpoint regression models. Total cancer mortality is predicted to decline in all countries and both sexes, except Argentinian women. Cuba had the highest all cancer rates for 2019, 136.9/100,000 men and 90.4 women, while Mexico showed the lowest ones, 63.8/100,000 men and 61.9 women. Stomach cancer showed favourable trends over the whole period, while colorectal cancer only recently. Lung cancer rates declined in men, while in women they decreased slightly over the most recent years, only. In Cuban women, lung cancer rates overtook breast cancer ones. Breast cancer showed overall favourable trends, but rates are rising in young women. Prostate and uterine cancer had favourable trends. Pancreas, ovary, bladder and leukaemias showed slightly decreasing trends. Between 1990 and 2019, mortality from all neoplasms is predicted to fall by about 18% in Argentina, 26% in Chile, 14% in Colombia, 17% in Mexico and 13% in Venezuela, corresponding to almost 0.5 million avoided cancer deaths. No decline was observed in Brazil and Cuba. Of concern, the persisting high rates of (cervix) uterus cancer, the high lung cancer rates in Cuba, the possible increases in breast cancer in young women, and the lack of overall declines in Brazil, Cuba and Venezuelan men.
Collapse
Affiliation(s)
- Greta Carioli
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Paola Bertuccio
- Department of Biomedical and Clinical Sciences, L. Sacco, Università degli Studi di Milano, Milan, Italy
| | - Matteo Malvezzi
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Teresa Rodriguez
- Navarra General Hospital, Navarra Health Service, Pamplona, Navarra, Spain
| | - Fabio Levi
- Institute of Social and Preventive Medicine (IUMSP), University of Lausanne, Lausanne, Switzerland
| | - Paolo Boffetta
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY.,Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Eva Negri
- Department of Biomedical and Clinical Sciences, L. Sacco, Università degli Studi di Milano, Milan, Italy
| |
Collapse
|
16
|
Nogueira-Rodrigues A. HPV Vaccination in Latin America: Global Challenges and Feasible Solutions. Am Soc Clin Oncol Educ Book 2019; 39:e45-e52. [PMID: 31099692 DOI: 10.1200/edbk_249695] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
HPV vaccine programs in Latin America run the risk of repeating the problems associated with Papanicolaou (Pap) test programs, an efficient, life-saving tool that is unfortunately underutilized for cancer prevention, in low- and middle-income countries. There is a great need for vigilance in the ongoing implementation of the HPV vaccine in Latin America.
Collapse
Affiliation(s)
- Angelica Nogueira-Rodrigues
- 1 Federal University of Minas Gerais, Belo Horizonte, Brazil.,2 Brazilian Group of Gynecologic Oncology, EVA, Brazil.,3 Global Cancer Institute, Boston, MA.,4 DOM Oncologia, Minas Gerais, Brazil.,5 LACOG, Latin America Cooperative Oncology Group
| |
Collapse
|
17
|
Zamorano AS, Barnoya J, Gharzouzi E, Chrisman Robbins C, Orozco E, Polo Guerra S, Mutch DG. Treatment Compliance as a Major Barrier to Optimal Cervical Cancer Treatment in Guatemala. J Glob Oncol 2019; 5:1-5. [PMID: 31067142 PMCID: PMC6550059 DOI: 10.1200/jgo.18.00243] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
PURPOSE Despite being the only hospital to provide comprehensive cervical cancer treatment to many medically underserved Guatemalan women, no assessment of the cervical cancer patient population at the Guatemala Cancer Institute has been performed. To understand the demographics of the patient population, their treatment outcomes, and access to care, we sought to assess treatment compliance of patients with cervical cancer at the Guatemala Cancer Institute and its effects on patient outcomes. METHODS A retrospective chart review was conducted of patients with cervical cancer between 2005 and 2007 and assessed for follow-up through December 2015. Demographics and clinical characteristics were tabulated. A Kaplan-Meier curve to model compliance was generated. RESULTS Ninety-two patients with invasive cancer were analyzed. Most presented with squamous cell carcinoma (73%) and at locally advanced stages (IIB, 51%; IIIB, 33%). Most (75 of 92, 81.5%) initiated treatment after diagnosis, but 18.5% (17 of 92) were lost to follow-up before treatment initiation. For treatment, 97% received external beam radiation, 84% brachytherapy, and 4% concomitant chemotherapy. Nearly 20% of patients were lost to follow-up in the first 6 months and 65% in the first 5 years. Of the 67 patients who completed treatment, only 15 (16% of the initial cohort) were diagnosed with a recurrence. No deaths were recorded. CONCLUSION The low recurrence rate and no documented deaths suggest a correlation with the low compliance rate and poor follow-up. This finding highlights the need to examine more fully the barriers to compliance and access to care among this population to optimize the treatment of cervical cancer.
Collapse
Affiliation(s)
| | - Joaquin Barnoya
- Unidad de Cirugía Cardiovascular de Guatemala, Guatemala City, Guatemala
| | | | | | | | | | - David G Mutch
- Washington University School of Medicine, St Louis, MO
| |
Collapse
|
18
|
Liebermann EJ, VanDevanter N, Shirazian T, Frías Gúzman N, Niles M, Healton C, Ompad D. Barriers to Cervical Cancer Screening and Treatment in the Dominican Republic: Perspectives of Focus Group Participants in the Santo Domingo Area. J Transcult Nurs 2019; 31:121-127. [DOI: 10.1177/1043659619846247] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Introduction: Cervical cancer is the second leading cause of cancer death among women in the Dominican Republic, and high rates persist despite existing Pap smear screening programs. The purpose of this study was to explore Dominican women’s knowledge and attitudes regarding human papillomavirus (HPV) and cervical cancer, cervical cancer screening practices, and perceived barriers and facilitators to early detection of cervical cancer. Method: Six focus groups ( N = 64) were conducted in Spanish in urban, suburban, and rural locations, in private and public school settings, community and workplace settings, in or near Santo Domingo, as part of a larger study on barriers and facilitators to HPV vaccine implementation. Audio recordings were transcribed verbatim and translated from Spanish to English. Qualitative data analysis used inductive and deductive approaches. Results: Knowledge regarding HPV and cervical cancer varied across groups, but all agreed there was significant stigma and fear regarding HPV. Most women reported having Pap screening at least yearly. Follow-up of abnormal Pap testing was less consistent, with cost and uncertainty about provider recommendations identified as barriers. Discussion: Broader examination of provider-level and health system barriers and facilitators to cervical cancer prevention in the Dominican Republic is essential, in order to inform interventions to improve the effectiveness of cervical cancer screening and treatment programs and reduce preventable deaths.
Collapse
Affiliation(s)
| | | | | | - Natalia Frías Gúzman
- Instituto Nacional de Cáncer Rosa Emilia Sánchez Pérez de Tavares, Santo Domingo, Dominican Republic
| | | | | | | |
Collapse
|
19
|
Zhao Y, Yuan X, Li X, Zhang Y. Resveratrol significantly inhibits the occurrence and development of cervical cancer by regulating phospholipid scramblase 1. J Cell Biochem 2019; 120:1527-1531. [PMID: 30350320 DOI: 10.1002/jcb.27335] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 06/28/2018] [Indexed: 01/24/2023]
Abstract
Cervical cancer (CC) is one of the most common female malignancies, and resveratrol is a polyphenol isolated from the skins of grapes, which has been reported to significantly alter the cellular physiology of tumor cells. However, little is known about the role of phospholipid scramblase 1 (PLSCR1) in pathogenesis of CC. Here, we demonstrated that resveratrol could significantly inhibit both the growth of HeLa cells and expression of PLSCR1. These results suggest that resveratrol-mediated cell growth inhibition can be regulated by PLSCR1.
Collapse
Affiliation(s)
- Yanhua Zhao
- Department of Obstetrics and Gynecology, Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Xiying Yuan
- Department of Obstetrics and Gynecology, Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Xiang Li
- Department of Pathology, Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yi Zhang
- Department of Obstetrics and Gynecology, Xiangya Hospital of Central South University, Changsha, Hunan, China
| |
Collapse
|
20
|
García-Muentes GD, Mendoza-García MA, Burgos-Galárraga RI, Ollague K, Vargas-Wachter C, Ruiz-Cabezas JC. Frequency and distribution of HPV genotypes in 800 genital samples of Ecuadorian men and women from the city of Guayaquil. Rev Inst Med Trop Sao Paulo 2019; 61:e41. [PMID: 31432990 PMCID: PMC6710005 DOI: 10.1590/s1678-9946201961041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 07/16/2019] [Indexed: 11/22/2022] Open
Abstract
Even though there are data published on HPV epidemiology in Ecuador, the
distribution of genotypes in Guayaquil, the largest city in the country, has not
been previously determined in a study including including both, men and women.
The present study aimed to determine the distribution of 37 HPV genotypes in
genital samples from Ecuadorian men and women living in the city of Guayaquil.
Genital samples included in daily diagnostic routine were analyzed by the 37 HPV
GenoArray Diagnostic Kit (Hybribio® Ltd., Sheung Wan, Hong Kong). The
relative frequency of detectable genotypes was determined. HPV relative
frequency according to sample characteristics, including sex and age groups, was
compared using c2 test. From the 800 samples (400 men and 400 women),
411 (51.38%) were positive for HPV DNA. The obtained frequency was higher among
samples from men (253/400 or 63.25%) in comparison to samples from women
(158/400 or 39.50%), with a p value <0.05. Samples from men showed a higher
frequency of HPV genotypes 6, 16, 18 and 11, while among samples from women
genotypes 39, 16, 6 and 58 were the most frequent. Considering male and female
samples together, genotypes 6, 16, 39 and 11 presented the highest frequencies.
HPV DNA was detected in half of the studied samples, with a higher frequency
among samples from men. Genotype 39 was the most frequent among women, and
ranked third when samples from men and women are analyzed together.
Collapse
Affiliation(s)
| | | | | | | | | | - Juan Carlos Ruiz-Cabezas
- Sociedad de Lucha Contra el Cáncer, Ecuador; Universidad de Especialidades Espíritu Santo, Ecuador
| |
Collapse
|
21
|
Tipirneni KE, Rosenthal EL, Moore LS, Haskins AD, Udayakumar N, Jani AH, Carroll WR, Morlandt AB, Bogyo M, Rao J, Warram JM. Fluorescence Imaging for Cancer Screening and Surveillance. Mol Imaging Biol 2018; 19:645-655. [PMID: 28155079 DOI: 10.1007/s11307-017-1050-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The advent of fluorescence imaging (FI) for cancer cell detection in the field of oncology is promising for both cancer screening and surgical resection. Particularly, FI in cancer screening and surveillance is actively being evaluated in many new clinical trials with over 30 listed on Clinical Trials.gov . While surgical resection forms the foundation of many oncologic treatments, early detection is the cornerstone for improving outcomes and reducing cancer-related morbidity and mortality. The applications of FI are twofold as it can be applied to high-risk patients in addition to those undergoing active surveillance. This technology has the promise of highlighting lesions not readily detected by conventional imaging or physical examination, allowing disease detection at an earlier stage of development. Additionally, there is a persistent need for innovative, cost-effective imaging modalities to ameliorate healthcare disparities and the global burden of cancer worldwide. In this review, we outline the current utility of FI for screening and detection in a range of cancer types.
Collapse
Affiliation(s)
- K E Tipirneni
- Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA
| | - E L Rosenthal
- Department of Otolaryngology, Stanford University, Stanford, CA, USA
| | - L S Moore
- Department of Otolaryngology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - A D Haskins
- Department of Otolaryngology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - N Udayakumar
- Department of Biology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - A H Jani
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - W R Carroll
- Department of Otolaryngology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - A B Morlandt
- Department of Oral and Maxillofacial Surgery, University of Alabama at Birmingham, Birmingham, AL, USA
| | - M Bogyo
- Department of Pathology, Stanford University, Stanford, CA, USA
| | - J Rao
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Jason M Warram
- Department of Otolaryngology, University of Alabama at Birmingham, Birmingham, AL, USA. .,Departments of Otolaryngology, Neurosurgery, & Radiology, The University of Alabama at Birmingham, Birmingham, AL, USA.
| |
Collapse
|
22
|
Torres KL, Mariño JM, Pires Rocha DA, de Mello MB, de Melo Farah HH, Reis RDS, Alves VDCR, Gomes E, Martins TR, Soares AC, de Oliveira CM, Levi JE. Self-sampling coupled to the detection of HPV 16 and 18 E6 protein: A promising option for detection of cervical malignancies in remote areas. PLoS One 2018; 13:e0201262. [PMID: 30036381 PMCID: PMC6056043 DOI: 10.1371/journal.pone.0201262] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Accepted: 07/11/2018] [Indexed: 11/18/2022] Open
Abstract
Objective To evaluate both the performance and acceptability of a method coupling self-sampling with detection of cervical malignancy via elevated HPV 16 and 18 E6 oncoproteins (OncoE6™ Cervical Test) in remote areas in Brazil. Methods Women living in rural villages in proximity to Coari city, Amazonas, Brazil were invited to participate in a cervical cancer screening study. 412 subjects were enrolled; there were no refusals. In addition to E6 protein detection, DNA was extracted from the brushes and evaluated for HPV genotypes by PCR (PGMY09/11), followed by typing by the Papillocheck™ if positive. Subjects who were found to be positive for OncoE6 or HPV-DNA were referred for colposcopy. Results For 110 subjects (27%) this was the first cervical cancer exam. Overall the HPV-DNA prevalence was 19.1% (n = 79); 1.4% (n = 6) were positive by the OncoE6 Test. Fifty-six women attended the invitation for colposcopy where nine had an abnormal cervix and were subsequently biopsied. Histopathological analysis revealed 2 CIN3, 2 carcinomas and 5 CIN1. OncoE6 called two out of the three HPV 16 or 18 associated CIN3+ lesions. Conclusions The findings suggest that self-administered sample collection in combination with OncoE6 Test is feasible in this population. This could enable expanded screening coverage while ensuring a high specificity which is imperative given the remote geographic location, since women bearing abnormal test results would necessitate travel and logistical burden to access colposcopy and treatment.
Collapse
Affiliation(s)
- Kátia Luz Torres
- Programa de Pós-Graduação em Ciências da Saúde da Universidade Federal do Amazonas (UFAM), Manaus, Amazonas/Brazil
- Programa de Pós-Graduação em Imunologia Básica e Aplicada da Universidade Federal do Amazonas (UFAM), Manaus, Amazonas/Brazil
- Fundação Centro de Oncologia do Estado do Amazonas (FCECON), Manaus, Amazonas/Brazil
| | | | - Danielle Albuquerque Pires Rocha
- Programa de Pós-Graduação em Ciências da Saúde da Universidade Federal do Amazonas (UFAM), Manaus, Amazonas/Brazil
- Universidade Federal do Amazonas—UFAM, Coari, Amazonas/Brazil
| | | | - Heydy Halanna de Melo Farah
- Programa de Pós-Graduação em Imunologia Básica e Aplicada da Universidade Federal do Amazonas (UFAM), Manaus, Amazonas/Brazil
| | | | - Valquíria do Carmo Rodrigues Alves
- Programa de Pós-Graduação em Imunologia Básica e Aplicada da Universidade Federal do Amazonas (UFAM), Manaus, Amazonas/Brazil
- Fundação Centro de Oncologia do Estado do Amazonas (FCECON), Manaus, Amazonas/Brazil
| | - Edson Gomes
- Laboratório Sebastião Marinho, Manaus, Amazonas/Brazil
| | | | - Ana Carolina Soares
- Instituto de Medicina Tropical da Universidade de São Paulo, São Paulo/Brazil
| | | | - José Eduardo Levi
- Instituto de Medicina Tropical da Universidade de São Paulo, São Paulo/Brazil
- * E-mail:
| |
Collapse
|
23
|
Factors associated with changes in vaginal length and diameter during pelvic radiotherapy for cervical cancer. Arch Gynecol Obstet 2017; 296:1125-1133. [PMID: 28975498 DOI: 10.1007/s00404-017-4553-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Accepted: 09/22/2017] [Indexed: 12/16/2022]
Abstract
OBJECTIVES This study reports the incidence and factors associated with vaginal stenosis and changes in vaginal dimensions after pelvic radiotherapy for cervical cancer. METHODS A descriptive longitudinal study with 139 women with cervical cancer was conducted from January 2013 to November 2015. The outcome variables were vaginal stenosis assessed using the Common Terminology Criteria for Adverse Events (CTCAE v3.0) and changes in vaginal diameter and length after the end of radiotherapy. Independent variables were the characteristics of the neoplasm, clinical and sociodemographic data. Bivariate analysis was carried out using χ 2, Kruskal-Wallis and Mann-Whitney's test. Multiple analysis was carried out using Poisson regression and a generalized linear model. RESULTS Most women (50.4%) had stage IIIB tumors. According to CTCAE v3.0 scale, 30.2% had no stenosis, 69.1% had grade 1 and 0.7% had grade 2 stenosis after radiotherapy. Regarding changes in vaginal measures, the mean variation in diameter was - 0.6 (± 1.7) mm and the mean variation in length was - 0.6 (± 1.3) cm. In the final statistical model, having tumoral invasion of the vaginal walls (coefficient + 0.73, p < 0.01) and diabetes (coefficient + 1.16; p < 0.01) were associated with lower vaginal stenosis and lower reduction of vaginal dimensions. Advanced clinical stage (coefficient + 1.44; p = 0.02) and receiving brachytherapy/teletherapy (coefficient - 1.17, p < 0.01) were associated with higher reduction of vaginal dimensions. CONCLUSIONS Most women had mild vaginal stenosis with slight reductions in both diameter and length of the vaginal canal. Women with tumoral invasion of the vagina have an increase in vaginal length soon after radiotherapy due to a reduction in tumoral volume.
Collapse
|
24
|
Gottschlich A, Rivera-Andrade A, Grajeda E, Alvarez C, Mendoza Montano C, Meza R. Acceptability of Human Papillomavirus Self-Sampling for Cervical Cancer Screening in an Indigenous Community in Guatemala. J Glob Oncol 2017; 3:444-454. [PMID: 29094082 PMCID: PMC5646882 DOI: 10.1200/jgo.2016.005629] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
PURPOSE Cervical cancer rates in Latin America are higher than those in developed countries, likely because of the lower prevalence of screening. Specifically, less than 40% of women in Guatemala are regularly screened and even fewer women are screened in indigenous communities. Current screening strategies-Pap smears and visual inspection with acetic acid-might not be the most effective methods for controlling cancer in these settings. We thus investigated the potential of self-collection of cervical samples with testing for human papillomavirus (HPV) to help prevent cervical cancer in an indigenous community in Guatemala. PATIENTS AND METHODS A community representative random sample of 202 indigenous women age 18 to 60 years residing in Santiago Atitlan, Guatemala, were surveyed to assess knowledge of and risk factors for HPV and cervical cancer. Women were then invited to self-collect a cervical sample using HerSwab collection kits to assess the prevalence of HPV and the acceptability of self-sampling. RESULTS Of 202 women who completed the survey, 178 (89%) provided a self-sample. In all, 79% of these women found the test comfortable, 91% found the test easy to use, and 100% reported they were willing to perform the test periodically as a screening method. Thirty-one samples (17%) were positive for at least one of 13 high-risk HPV types, and eight (4.5%) were positive for HPV 16/18. CONCLUSION HPV testing by using self-collected samples was well accepted, suggesting that it is a plausible modality for cervical cancer screening in indigenous communities. Further studies are needed to assess rates of follow-up after a positive test and to determine whether these findings extend to other indigenous and nonindigenous communities in Guatemala and Latin America.
Collapse
Affiliation(s)
- Anna Gottschlich
- Anna Gottschlich, Christian Alvarez, and Rafael Meza, University of Michigan, Ann Arbor, MI; Alvaro Rivera-Andrade and Carlos Mendoza Montano, Institute of Nutrition of Central America and Panama; Carlos Mendoza Montano, Universidad Mariano Galvez de Guatemala; Edwin Grajeda, Universidad Rafael Landivar, Guatemala City, Guatemala; and Alvaro Rivera-Andrade, The Hebrew University, Jerusalem, Israel
| | - Alvaro Rivera-Andrade
- Anna Gottschlich, Christian Alvarez, and Rafael Meza, University of Michigan, Ann Arbor, MI; Alvaro Rivera-Andrade and Carlos Mendoza Montano, Institute of Nutrition of Central America and Panama; Carlos Mendoza Montano, Universidad Mariano Galvez de Guatemala; Edwin Grajeda, Universidad Rafael Landivar, Guatemala City, Guatemala; and Alvaro Rivera-Andrade, The Hebrew University, Jerusalem, Israel
| | - Edwin Grajeda
- Anna Gottschlich, Christian Alvarez, and Rafael Meza, University of Michigan, Ann Arbor, MI; Alvaro Rivera-Andrade and Carlos Mendoza Montano, Institute of Nutrition of Central America and Panama; Carlos Mendoza Montano, Universidad Mariano Galvez de Guatemala; Edwin Grajeda, Universidad Rafael Landivar, Guatemala City, Guatemala; and Alvaro Rivera-Andrade, The Hebrew University, Jerusalem, Israel
| | - Christian Alvarez
- Anna Gottschlich, Christian Alvarez, and Rafael Meza, University of Michigan, Ann Arbor, MI; Alvaro Rivera-Andrade and Carlos Mendoza Montano, Institute of Nutrition of Central America and Panama; Carlos Mendoza Montano, Universidad Mariano Galvez de Guatemala; Edwin Grajeda, Universidad Rafael Landivar, Guatemala City, Guatemala; and Alvaro Rivera-Andrade, The Hebrew University, Jerusalem, Israel
| | - Carlos Mendoza Montano
- Anna Gottschlich, Christian Alvarez, and Rafael Meza, University of Michigan, Ann Arbor, MI; Alvaro Rivera-Andrade and Carlos Mendoza Montano, Institute of Nutrition of Central America and Panama; Carlos Mendoza Montano, Universidad Mariano Galvez de Guatemala; Edwin Grajeda, Universidad Rafael Landivar, Guatemala City, Guatemala; and Alvaro Rivera-Andrade, The Hebrew University, Jerusalem, Israel
| | - Rafael Meza
- Anna Gottschlich, Christian Alvarez, and Rafael Meza, University of Michigan, Ann Arbor, MI; Alvaro Rivera-Andrade and Carlos Mendoza Montano, Institute of Nutrition of Central America and Panama; Carlos Mendoza Montano, Universidad Mariano Galvez de Guatemala; Edwin Grajeda, Universidad Rafael Landivar, Guatemala City, Guatemala; and Alvaro Rivera-Andrade, The Hebrew University, Jerusalem, Israel
| |
Collapse
|
25
|
Nogueira-Rodrigues A, Bukowski A, Paulino E, St Louis J, Barrichello A, Sternberg C, Gifoni MAC, Luciani S, Goss PE. An alert to Latin America: Current human papillomavirus vaccination trends highlight key barriers to successful implementation. Cancer 2017; 123:2193-2199. [PMID: 28440878 DOI: 10.1002/cncr.30647] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 01/30/2017] [Accepted: 01/31/2017] [Indexed: 12/14/2022]
Affiliation(s)
- Angelica Nogueira-Rodrigues
- The Global Cancer Institute, Boston, Massachusetts.,MGH-Avon Global Breast Cancer Program, Massachusetts General Hospital, Boston, Massachusetts.,Federal University of Minas Gerais, Belo Horizonte, Brazil.,Brazilian Group of Gynecologic Oncology, EVA, Brazil
| | - Alexandra Bukowski
- The Global Cancer Institute, Boston, Massachusetts.,MGH-Avon Global Breast Cancer Program, Massachusetts General Hospital, Boston, Massachusetts
| | - Eduardo Paulino
- The Global Cancer Institute, Boston, Massachusetts.,MGH-Avon Global Breast Cancer Program, Massachusetts General Hospital, Boston, Massachusetts.,Brazilian Group of Gynecologic Oncology, EVA, Brazil.,Brazilian National Cancer Institute, Rio de Janeiro, Brazil.,Integrated Oncology Clinics Group, Rio de Janeiro, Brazil
| | - Jessica St Louis
- The Global Cancer Institute, Boston, Massachusetts.,MGH-Avon Global Breast Cancer Program, Massachusetts General Hospital, Boston, Massachusetts
| | | | - Cinthya Sternberg
- Brazilian Society of Clinical Oncology, Belo Horizonte, Minas Gerais, Brazil.,Post-Graduate Program of Anatomic Pathology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Markus A C Gifoni
- Brazilian Society of Clinical Oncology, Belo Horizonte, Minas Gerais, Brazil
| | | | - Paul E Goss
- The Global Cancer Institute, Boston, Massachusetts.,MGH-Avon Global Breast Cancer Program, Massachusetts General Hospital, Boston, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
26
|
Musselwhite LW, Oliveira CM, Kwaramba T, de Paula Pantano N, Smith JS, Fregnani JH, Reis RM, Mauad E, Vazquez FDL, Longatto-Filho A. Racial/Ethnic Disparities in Cervical Cancer Screening and Outcomes. Acta Cytol 2016; 60:518-526. [PMID: 27825171 DOI: 10.1159/000452240] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 10/03/2016] [Indexed: 12/15/2022]
Abstract
Invasive cervical cancer disproportionately affects women without sufficient access to care, with higher rates among minority groups in higher-income countries and women in low-resource regions of the world. Many elements contribute to racial/ethnic disparities in the cervical cancer continuum - from screening and diagnosis to treatment and outcome. Sociodemographic factors, access to healthcare, income and education level, and disease stage at diagnosis are closely linked to such inequities. Despite the identification of such elements, racial/ethnic disparities persist, and are widening in several minority subgroups, particularly in older women, who are ineligible for human papillomavirus (HPV) vaccination and are underscreened. Recent studies suggest that racial/ethnic differences in HPV infection exist and may also have a role in observed differences in cervical cancer. In this review, we provide an overview of the current literature on racial disparities in cervical cancer screening, incidence, treatment and outcome to inform future strategies to reduce persistent inequities.
Collapse
|