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Gardella B, Dominoni M, Pasquali MF, Gotti M, Fraticelli S, Lucioni M, Cesari S, Fiandrino G, De Silvestri A, Zerbi C, Lazic T, Arcaini L, Paulli M, Spinillo A. Retrospective Investigation of Human Papillomavirus Cervical Infection and Lymphoma Incidence: A Clinical and Pathological Evaluation. Gynecol Obstet Invest 2024; 89:95-102. [PMID: 38262378 DOI: 10.1159/000535592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 10/15/2023] [Indexed: 01/25/2024]
Abstract
OBJECTIVE Human papillomavirus (HPV) persistence is considered the main risk factor for neoplastic progression, and evidence suggests that regulatory T cells play an important role in the failure of viral elimination. Regulatory T cells may be involved in maintaining a microenvironment favourable for viral persistence and neoplasticity, through a deregulation of the local immune response. The association between altered immune function and the development of chronic infections, cancer (solid and haematological), and autoimmune diseases is documented in the literature. The purpose of this retrospective analysis was to evaluate the possible correlation between HPV cervical infection and lymphoma incidence in women attending colposcopy due to an abnormal Pap smear during a period of 15 years. DESIGN This is a cross-sectional study. PARTICIPANTS We investigated retrospectively the incidence of haematological diseases in women aged 21-84 with an abnormal Pap smear who referred to our centre between 2004 and 2019. SETTING This study was conducted at the university hospital. METHODS In our analysis, we included women with diagnoses of HL and NHL after the detection of abnormal Pap smears and HPV infections. We excluded patients with a diagnosis of lymphoma preceding the date of the abnormal Pap smear and HPV test. RESULTS We divided the patients into two groups in order to analyse the standard incidence ratio (SIR): HL patients (19/7,064, 0.26%) and NHL patients (22/7,064, 0.31%). In our sample, we reported a significant risk of developing lymphoma compared to the general population, both for HL and NHL disease, at age <45 years. Regarding HL, the SIR of disease in women <45 years was 4.886 (95% CI 2.775-9.6029) and in women between 45 and 59 years was 2.612 (95% CI 0.96-7.108804). On the other hand, for NHL in women <45 years, we reported an SIR of about 3.007 (95%, CI 1.273-7.101575), in women aged 45-59 years, the SIR was 4.291 (95% CI 2.444-7.534399), and in women aged 60-74 years, the SIR was 3.283 (95% CI 1.054-10.22303). LIMITATIONS This retrospective analysis was conducted in a single centre in Northern Italy and did not consider all interregional differences existing in the country in terms of HPV genotypes, ethnicity, and population characteristics. Regarding the analysis of SIR for HL and NHL, we did not divide the disease into subtypes because of the small sample of cases. Finally, we considered in our analysis only women with an abnormal Pap smear and not the general population. CONCLUSIONS Women with chronic and persistent HPV infections may have a higher relative risk of developing lymphoma. This possible association may be caused by the deregulation of the immune system response against HPV and the failure of viral clearance, especially in younger women.
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Affiliation(s)
- Barbara Gardella
- Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
- Department of Obstetrics and Gynecology, IRCCS Foundation Policlinico San Matteo, Pavia, Italy
| | - Mattia Dominoni
- Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
- Department of Obstetrics and Gynecology, IRCCS Foundation Policlinico San Matteo, Pavia, Italy
| | - Marianna Francesca Pasquali
- Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
- Department of Obstetrics and Gynecology, IRCCS Foundation Policlinico San Matteo, Pavia, Italy
| | - Manuel Gotti
- Department of Hematology, IRCCS Foundation Policlinico San Matteo, Pavia, Italy
| | - Sara Fraticelli
- Department of Pathology, Fondazione IRCCS, Policlinico San Matteo, Pavia, Italy
| | - Marco Lucioni
- Department of Pathology, Fondazione IRCCS, Policlinico San Matteo, Pavia, Italy
| | - Stefania Cesari
- Department of Pathology, Fondazione IRCCS, Policlinico San Matteo, Pavia, Italy
| | - Giacomo Fiandrino
- Department of Pathology, Fondazione IRCCS, Policlinico San Matteo, Pavia, Italy
| | - Annalisa De Silvestri
- SSD Biostatistica e Clinical Trial Center, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy
| | - Caterina Zerbi
- Department of Hematology, IRCCS Foundation Policlinico San Matteo, Pavia, Italy
| | - Tanja Lazic
- Department of Hematology, IRCCS Foundation Policlinico San Matteo, Pavia, Italy
| | - Luca Arcaini
- Department of Hematology, IRCCS Foundation Policlinico San Matteo, Pavia, Italy
| | - Marco Paulli
- Department of Pathology, Fondazione IRCCS, Policlinico San Matteo, Pavia, Italy
| | - Arsenio Spinillo
- Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
- Department of Obstetrics and Gynecology, IRCCS Foundation Policlinico San Matteo, Pavia, Italy
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Taylor AS, Acosta AM, Al-Ahmadie HA, Mehra R. Precursors of urinary bladder cancer: molecular alterations and biomarkers. Hum Pathol 2023; 133:5-21. [PMID: 35716731 DOI: 10.1016/j.humpath.2022.06.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 06/07/2022] [Indexed: 01/04/2023]
Abstract
Clinical surveillance and follow-up of patients diagnosed with or at risk for urinary bladder cancers represent long-term, invasive, and costly processes for which supplemental biomarker information could help provide objective, personalized risk assessment. In particular, there are several precursors and possible precursors to urinary bladder cancer for which clinical behavior is heterogenous and interobserver variability in histopathologic diagnosis make it difficult to standardize management. This review seeks to highlight these precursor lesions from a diagnostic perspective (including flat urothelial lesions, papillary urothelial lesions, squamous lesions, and glandular lesions) and qualify known multiomic biomarkers that may help explain their behavior, predict patient risk, and acknowledge the nuance inherent to the question of whether these lesions are "benign" or "preneoplastic."
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Affiliation(s)
- Alexander S Taylor
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Andres M Acosta
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Hikmat A Al-Ahmadie
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Rohit Mehra
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI 48109, USA; Rogel Cancer Center, Michigan Medicine, Ann Arbor, MI 48109, USA; Michigan Center for Translational Pathology, Ann Arbor, MI 48109, USA.
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3
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Whitaker JA. Condyloma acuminatum of the urinary bladder with underlying squamous cell carcinoma: a case report. J Med Case Rep 2022; 16:449. [PMID: 36457102 PMCID: PMC9714249 DOI: 10.1186/s13256-022-03669-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 11/06/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Condyloma acuminatum is a rare finding of the urinary bladder. There are many morphological variants that exist. It has been previously reported that some of these variants were found to be associated with subsequent or concurrent squamous cell carcinoma. However, there are limited cases that describe this underlying malignancy found in patients with bladder condyloma. CASE PRESENTATION A 38-year-old African American female presented with condyloma acuminatum of the urinary bladder and underlying squamous cell carcinoma, which also invaded the neighboring uterus, urethra, and anterior vagina. Initial attempts at treatment began with cystoscopic resection of the condyloma; however, due to diffuse transformation, we pursued radical cystectomy with adjuvant chemotherapy and radiation. CONCLUSION As such a finding is rare in the urinary bladder, with few reports discussing its association with ensuing squamous cell carcinoma, we hope that this continues to generate awareness and consideration in the treatment of affected individuals.
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Affiliation(s)
- John A. Whitaker
- grid.410721.10000 0004 1937 0407School of Medicine, University of Mississippi Medical Center, Jackson, MS USA ,grid.410721.10000 0004 1937 0407Department of Urology, University of Mississippi Medical Center, Jackson, MS USA ,grid.241167.70000 0001 2185 3318Department of General Surgery, Wake Forest University, Winston-Salem, USA
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Ren X, Qiu L, Ke W, Zou H, Liu A, Wu T. Awareness and acceptance of HPV vaccination for condyloma acuminata among men who have sex with men in China. Hum Vaccin Immunother 2022; 18:2115267. [PMID: 36099326 DOI: 10.1080/21645515.2022.2115267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The dissemination of the fact that the human papillomavirus (HPV) vaccine can protect females as well as males is greatly beneficial for the control of condyloma acuminata (CA). We aimed to investigate the acceptance of the HPV vaccine for CA among men who have sex with men (MSM) in China. A cross-sectional online survey in the adult MSM population from 31 regions in China was carried out via WeChat in May 2017. Information on demographic characteristics, sexual behaviors, history of HIV and HPV infection, awareness of CA and HPV/CA vaccines, acceptance of CA vaccination, and behavioral intentions for vaccination were collected through a self-administered questionnaire. In total, 902 questionnaires were analyzed; the prevalence of CA was 13.3% (120/902), the HIV positivity rate was 15.1% (136/902), and the coinfection rate of HIV and CA was 3.9% (35/902). In the MSM population, the knowledge of CA and HPV/CA vaccines was poor, but the acceptance rate of the CA vaccine was high (85.1%, 768/902). Data indicated that MSM who had a history of anal intercourse (OR = 1.9), had heard of CA (OR = 2.9), knew the treatments for CA (OR = 2.0), had heard of HPV vaccines/cervical cancer vaccines (OR = 1.9), and received education about CA (OR = 1.9) were associated with the intention to use CA vaccines. With current moderate levels of CA and HPV/CA vaccine awareness, more emphasis should be placed on improving education and other behavioral interventions for high-risk populations such as MSM in China.
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Affiliation(s)
- Xuqi Ren
- Department of Dermatology, Affiliated Hospital of Nantong University, Nantong, China.,Department of Sexually Transmitted Diseases, Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Lingxian Qiu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University, Xiamen, China
| | - Wujian Ke
- Department of Sexually Transmitted Diseases, Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Huachun Zou
- School of Public Health (Shenzhen), Sun Yat-sen University, Guangzhou, China
| | - Anqi Liu
- Department of Dermatology, Affiliated Hospital of Nantong University, Nantong, China
| | - Ting Wu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Strait Collaborative Innovation Center of Biomedicine and Pharmaceutics, School of Public Health, Xiamen University, Xiamen, China
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Zhu P, Qi R, Yang Y, Huo W, Zhang Y, He L, Wang G, Xu J, Zhang F, Yang R, Tu P, Ma L, Liu Q, Li Y, Gu H, Cheng B, Chen X, Chen A, Xiao S, Jin H, Zhang J, Li S, Yao Z, Pan W, Yang H, Shen Z, Cheng H, Song P, Fu L, Chen H, Geng S, Zeng K, Wang J, Tao J, Chen Y, Wang X, Gao X. Clinical guideline for the diagnosis and treatment of cutaneous warts (2022). J Evid Based Med 2022; 15:284-301. [PMID: 36117295 PMCID: PMC9825897 DOI: 10.1111/jebm.12494] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 08/26/2022] [Indexed: 01/11/2023]
Abstract
AIM Cutaneous warts caused by human papillomavirus are benign proliferative lesions that occur at any ages in human lives. Updated, comprehensive and systematic evidence-based guidelines to guide clinical practice are urgently needed. METHODS We collaborated with multidisciplinary experts to formulate this guideline based on evidences of already published literature, focusing on 13 clinical questions elected by a panel of experts. We adopted Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to form classification of recommendations as well as the improved Delphi method to retain respective recommendations with a consensus degree of over 80%. RESULTS Our guideline covered aspects of the diagnosis and treatment of cutaneous warts such as diagnostic gold standard, transmission routes, laboratory tests, treatment principle, clinical cure criterion, definitions, and treatments of common warts, flat warts, plantar warts, condyloma acuminatum, and epidermodysplasia verruciformis. Recommendations about special population such as children and pregnant women are also listed. In total, 49 recommendations have been obtained. CONCLUSIONS It is a comprehensive and systematic evidence-based guideline and we hope this guideline could systematically and effectively guide the clinical practice of cutaneous warts and improve the overall levels of medical services.
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Affiliation(s)
- Peiyao Zhu
- Department of DermatologyThe First Hospital of China Medical UniversityHeping DistrictShenyangP.R. China
- NHC Key Laboratory of Immunodermatology, China Medical UniversityHeping DistrictShenyangP.R. China
- Key Laboratory of Immunodermatology, China Medical UniversityMinistry of EducationHeping DistrictShenyangP.R. China
- National and Local Joint Engineering Research Center of Immunodermatological TheranosticsHeping DistrictShenyangP.R. China
| | - Rui‐Qun Qi
- Department of DermatologyThe First Hospital of China Medical UniversityHeping DistrictShenyangP.R. China
- NHC Key Laboratory of Immunodermatology, China Medical UniversityHeping DistrictShenyangP.R. China
- Key Laboratory of Immunodermatology, China Medical UniversityMinistry of EducationHeping DistrictShenyangP.R. China
- National and Local Joint Engineering Research Center of Immunodermatological TheranosticsHeping DistrictShenyangP.R. China
| | - Yang Yang
- Department of DermatologyThe First Hospital of China Medical UniversityHeping DistrictShenyangP.R. China
- NHC Key Laboratory of Immunodermatology, China Medical UniversityHeping DistrictShenyangP.R. China
- Key Laboratory of Immunodermatology, China Medical UniversityMinistry of EducationHeping DistrictShenyangP.R. China
- National and Local Joint Engineering Research Center of Immunodermatological TheranosticsHeping DistrictShenyangP.R. China
| | - Wei Huo
- Department of DermatologyThe First Hospital of China Medical UniversityHeping DistrictShenyangP.R. China
- NHC Key Laboratory of Immunodermatology, China Medical UniversityHeping DistrictShenyangP.R. China
- Key Laboratory of Immunodermatology, China Medical UniversityMinistry of EducationHeping DistrictShenyangP.R. China
- National and Local Joint Engineering Research Center of Immunodermatological TheranosticsHeping DistrictShenyangP.R. China
| | - Yuqing Zhang
- Department of Clinical Epidemiology and Evidence‐Based MedicineThe First Hospital of China Medical UniversityHeping DistrictShenyangP.R. China
| | - Li He
- Department of DermatologyFirst Affiliated Hospital of Kunming Medical UniversityKunmingP.R. China
| | - Gang Wang
- Department of DermatologyXijing HospitalFourth Military Medical UniversityXi'an, ShaanxiP. R. China
| | - Jinhua Xu
- Department of DermatologyHuashan HospitalFudan UniversityShanghaiP.R. China
| | - Furen Zhang
- Shandong Provincial Hospital for Skin Diseases & Shandong Provincial Institute of Dermatology and VenereologyShandong First Medical University & Shandong Academy of Medical SciencesJinanP.R. China
| | - Rongya Yang
- Department of DermatologyGeneral Hospital of Beijing Military Command of PLADongcheng DistrictBeijingP.R. China
| | - Ping Tu
- Department of Dermatology and VenerologyPeking University First HospitalBeijingP.R. China
| | - Lin Ma
- Department of DermatologyBeijing Children's HospitalCapital Medical UniversityNational Center for Children's HealthBeijingP.R. China
| | - Quanzhong Liu
- Department of DermatologyTianjin Medical University General HospitalTianjinP.R. China
| | - Yuzhen Li
- Department of DermatologySecond Affiliated Hospital of Harbin Medical UniversityHarbinP.R. China
| | - Heng Gu
- Institute of DermatologyChinese Academy of Medical Sciences and Peking Union Medical CollegeNanjingP.R. China
| | - Bo Cheng
- Department of DermatologyThe First Affiliated Hospital of Fujian Medical UniversityFuzhouP.R. China
| | - Xiang Chen
- Department of DermatologyXiangya HospitalCentral South UniversityChangshaP.R. China
| | - Aijun Chen
- Department of DermatologyThe First Affiliated Hospital of Chongqing Medical UniversityChongqingP.R. China
| | - Shengxiang Xiao
- Department of DermatologyThe Second Affiliated HospitalSchool of MedicineXi'an Jiaotong UniversityXi'anP.R. China
| | - Hongzhong Jin
- Department of DermatologyPeking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeDongcheng DistrictBeijingP.R. China
| | - Junling Zhang
- Department of DermatologyTianjin Academy of Traditional Chinese Medicine Affiliated HospitalTianjinP.R. China
| | - Shanshan Li
- Department of DermatologyThe First Hospital of Jilin UniversityChangchunJilin ProvinceP.R. China
| | - Zhirong Yao
- Department of DermatologyXinhua HospitalShanghai Jiao Tong University School of MedicineShanghaiP.R. China
| | - Weihua Pan
- Department of DermatologyShanghai Key Laboratory of Molecular Medical MycologySecond Affiliated Hospital of Naval Medical UniversityShanghaiP.R. China
| | - Huilan Yang
- Department of DermatologyGeneral Hospital of Southern Theatre Command of PLAGuangzhouP.R. China
| | - Zhu Shen
- Department of DermatologyInstitute of Dermatology and VenereologySichuan Academy of Medical Sciences and Sichuan Provincial People's HospitalChengduP.R. China
| | - Hao Cheng
- Department of Dermatology and VenereologySir Run Run Shaw HospitalSchool of MedicineZhejiang UniversityHangzhouP.R. China
| | - Ping Song
- Department of DermatologyGuang'anmen HospitalChina Academy of Chinese Medical SciencesBeijingP.R. China
| | - Lingyu Fu
- Department of Clinical Epidemiology and Evidence‐Based MedicineThe First Hospital of China Medical UniversityHeping DistrictShenyangP.R. China
| | - Hongxiang Chen
- Department of DermatologyUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanP.R. China
| | - Songmei Geng
- Department of DermatologyThe Second Affiliated Hospital of Xi'an Jiaotong UniversityXi'anShaanxiP.R. China
| | - Kang Zeng
- Department of DermatologyNanfang HospitalSouthern Medical UniversityGuangzhouP.R. China
| | - Jianjian Wang
- Evidence‐Based Medicine CenterSchool of Basic Medical SciencesLanzhou UniversityLanzhouP.R. China
| | - Juan Tao
- Department of DermatologyUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanP.R. China
| | - Yaolong Chen
- Evidence‐Based Medicine CenterSchool of Basic Medical SciencesLanzhou UniversityLanzhouP.R. China
- World Health Organization Collaborating Center for Guideline Implementation and Knowledge TranslationLanzhouP.R. China
- GIN AsiaLanzhouP.R. China
| | - Xiuli Wang
- Institute of PhotomedicineShanghai Skin Disease HospitalSchool of MedicineTongji UniversityShanghaiP.R. China
| | - Xing‐Hua Gao
- Department of DermatologyThe First Hospital of China Medical UniversityHeping DistrictShenyangP.R. China
- NHC Key Laboratory of Immunodermatology, China Medical UniversityHeping DistrictShenyangP.R. China
- Key Laboratory of Immunodermatology, China Medical UniversityMinistry of EducationHeping DistrictShenyangP.R. China
- National and Local Joint Engineering Research Center of Immunodermatological TheranosticsHeping DistrictShenyangP.R. China
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Heinzmann J, Schneider A, Riener MO. [Development of a squamous cell carcinoma of the urinary bladder after intravesical condylomas]. Aktuelle Urol 2022; 53:275-278. [PMID: 31940665 DOI: 10.1055/a-0761-2593] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND The occurrence of intravesical condylomata acuminata has been described as a fairly uncommon, benign epithelial lesion. Reports on progression into a muscle-invasive carcinoma of the bladder are rare. CASE We present the case of a 68-year-old man who had a history of intravesical condylomata acuminata over several years and developed a muscle-invasive squamous cell carcinoma of the bladder. Having undergone several transurethral resections, but failed to receive intravesical instillation therapy or continuous follow-up examinations, the patient visited our department. After being diagnosed with ichthyosis vesicae, the patient had a rapid disease progress and developed a muscle-invasive squamous cell carcinoma of the urinary bladder within 3 months. He underwent radical cystectomy. SUMMARY The carcinogenic potency of the human papilloma virus is well known for carcinomas of the male and female genitals. The occurrence of intravesical condylomata is rare. They are commonly perceived as benign lesions and, therefore, mainly treated symptomatically. Our case shows that progression to a highly aggressive muscle-invasive squamous cell carcinoma is possible. CONCLUSION The diagnosis of intravesical condylomata acuminata requires stringent urologic follow-up examinations including biopsy of suspicious lesions and stage-appropriate surgical management in the case of an invasive carcinoma.
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New Insights into the Epidemiology of Vulvar Cancer: Systematic Literature Review for an Update of Incidence and Risk Factors. Cancers (Basel) 2022; 14:cancers14020389. [PMID: 35053552 PMCID: PMC8773873 DOI: 10.3390/cancers14020389] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/22/2021] [Accepted: 01/07/2022] [Indexed: 12/20/2022] Open
Abstract
Simple Summary Vulvar cancer incidence data were sought from official sources (WHO Cancer Incidence in Five Continents) and studies reporting comparable data. With respect to risk factors, a systematic PubMed search of articles published since 1980 identified 69 original cohort and case-control studies. Information was extracted using a PRISMA predesigned data collection form. Recent advances have provided further evidence in support of the carcinogenic model centred on human papillomavirus infection with different defects of the immune function. Conversely, the model centred on the role of vulvar lichen sclerosus and the often-associated differentiated vulva intraepithelial neoplasia has continued to be understudied. Abstract The aim of this review was an update of vulvar cancer incidence rates and trends and of all known and putative risk factors for the disease. The most recent incidence data were sought from official sources (WHO Cancer Incidence in Five Continents). To obtain an estimate of time trends in some areas, we compared data from Cancer Incidence in Five Continents with the few available studies that measured incidence using comparable methods. With respect to risk factors, a systematic PubMed search identified 1585 relevant articles published between 1980 and 2021. Abstracts and full texts were screened. Sixty-nine eligible original cohort and case-control studies were selected. Information was extracted using a PRISMA predesigned form. Nineteen risk factors, or risk factor categories, were investigated by two or more original studies. Solitary, unreplicated studies addressed the putative role of eight more factors. Recent advances have provided further evidence supporting the carcinogenic model centred on human papillomavirus infection with different defects of the immune function. Conversely, the model centred on the role of vulvar lichen sclerosus and the often associated differentiated vulvar intraepithelial neoplasia has continued to be epidemiologically understudied. More research on the association between these two conditions and vulvar cancer is a priority.
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Hosseini Z, Seyrafi N, Aghamolaei T, Mohseni S, Alavi A, Dadipoor S. The effectiveness of a model-based health education program on genital warts preventive behaviors: a quasi-experimental study. Infect Agent Cancer 2021; 16:68. [PMID: 34895298 PMCID: PMC8666010 DOI: 10.1186/s13027-021-00408-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 11/22/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Genital warts (GWs) are highly prevalent among Iranian women. GWs are not only highly infectious but are also followed by severe adverse effects, including the development of cervical cancer. Therefore, the present study aimed to explore the effect of an educational intervention based on the health belief model (HBM) on the adoption of GWs preventive behaviors by married women in Bandar Abbas, a city in the south of Iran. METHODS A quasi-experimental intervention was conducted between 2019 and 2020 among 150 women participants (75 as the intervention and 75 as the control group). The sampling method was multi-stage clustering. The required data was collected using a reliable and valid tripartite questionnaire which explored demographic information, awareness, and HBM constructs. A total number of 15 educational sessions were held, each 90 min long. The control group received only one 90-min session. The final follow-up was completed three months after the intervention in November 2020. RESULTS The two research groups had no statistically significant differences in terms of awareness, perceived susceptibility, severity, benefits, barriers, and self-efficacy before the intervention (in the pre-test) (p > .05). After the educational intervention, the two groups showed statistically significant differences in all constructs except for the perceived benefits (p < .001). In the intervention group, in the pretest (before the intervention), the behavior score was 2.77 ± 2.59, which was increased to 3.73 ± .52 after the intervention (p < .001). In the control group, however, the difference was not statistically significant (p = 0.227). CONCLUSION The present findings showed that the educational intervention based on the HBM can improve the prevalence of GWs preventive behaviors in women. This education should be provided by experts at regular intervals in all healthcare centers.
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Affiliation(s)
- Zahra Hosseini
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Niloofar Seyrafi
- Student Research Committee, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Teamur Aghamolaei
- Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Shokrollah Mohseni
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Azin Alavi
- Mother and Child Welfare Research Center, Faculty of Nursing and Midwifery, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Sakineh Dadipoor
- Infectious and Tropical Diseases Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
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Albuquerque A, Cappello C, Stirrup O. High-risk human papilloma virus, precancerous lesions and cancer in anal condylomas. AIDS 2021; 35:1939-1948. [PMID: 34101627 DOI: 10.1097/qad.0000000000002975] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Anal condylomas are associated with human papillomavirus (HPV) infection and are a risk factor for anal squamous cell carcinoma (SCC). OBJECTIVE To conduct a meta-analysis evaluating the prevalence of anal high-risk HPV, high-grade squamous intraepithelial lesions (HSIL) and SCC in patients with condylomas. The standardized incidence ratio (SIR) and the incidence rate of anal SCC were also calculated. METHODS Three electronic databases were searched until April 2020. Meta-analyses were performed using random effects models. RESULTS Pooled prevalence estimate of high-risk HPV (HR-HPV) in anal condylomas was 40.2% (21.0-63.1) in immunocompromised and 16.4% (10.7-24.3) in nonimmunocompromised patients, with an odds ratio (OR) of 3.79 (1.51-9.52, P = 0.005) for immunocompromised patients. HR-HPV in condylomas with HSIL was 73.8% (39.1-92.5) and in non-HSIL cases was 17.7% (9.6-30.2), corresponding to an OR of 12.33 (2.97-51.21, P = 0.001) for those with HSIL. The prevalence of HSIL in condylomas was 24.0% (16.4-33.7) in immunocompromised and 11.8% (7.2-18.8) in nonimmunocompromised patients, with an OR of 2.51 (1.72-3.65, P < 0.001) for immunocompromised patients. The overall prevalence of anal SCC in anal condylomas was 0.3% (0.0-1.7). The SIR of anal SCC was 10.7 (8.5-13.5), 20.1 (14.4-28.2) in men and 7.7 (5.6-10.5) in women. The overall incidence rate of anal SCC was 6.5 per 100 000 person-years (3.6-11.7), 12.7 (9.1-17.8) in men and 4.7 (1.7-13) in women. CONCLUSION Patients with a history of anal condylomas have a high risk of anal SCC, especially men. The prevalence of HR-HPV and HSIL in condylomas from immunocompromised patients is high. This information can change patient follow-up and treatment.
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Affiliation(s)
- Andreia Albuquerque
- CINTESIS - Center for Health Technology and Services Research, Medical Research Center, University of Porto, Portugal
| | | | - Oliver Stirrup
- Institute for Global Health, University College London, London, UK
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Zaki SA, Naous J, Ghanem A, Abou Abbas D, Tomb R, Ghosn J, Assi A. Prevalence of STIs, sexual practices and substance use among 2083 sexually active unmarried women in Lebanon. Sci Rep 2021; 11:9855. [PMID: 33972604 PMCID: PMC8110545 DOI: 10.1038/s41598-021-89258-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 04/21/2021] [Indexed: 11/13/2022] Open
Abstract
Access to sexual and reproductive health in conservative communities and in the MENA region are particularly limited and, as such, increase women's vulnerability to unwanted pregnancies, unsafe abortions, and sexually transmitted infections (STIs). The aim was to assess the prevalence of STIs, sexual practices, recreational drug-use and their possible associations among cisgender unmarried women residing in Lebanon. Data on demographics, sexual practices and substance-use were collected from 2083 unmarried cisgender women who voluntarily attended a sexual health clinic in Lebanon between 2015 and 2019. They tested for HIV, Hepatitis B, Hepatitis C and Syphilis through rapid testing. Other infections (genital warts, Neisseria gonorrhea/Chlamydia trachomatis) were screened for. Regression models were computed between variables. There were two cases of HIV, one of Hepatitis B and syphilis, and no cases of Hepatitis C. Genital warts were present in 15% and symptoms indicative of Neisseria gonorrhea/Chlamydia trachomatis in 14%. Inconsistent condom-use (81%) was significantly associated with number of partners (adj. OR: 0.4). Inconsistent condom-use discussion with partners (33%) was significantly associated with unemployment (adj OR: 1.7), recreational drug-use (adj. OR: 1.4), and number of partners (adj. ORs 3.7-4.4). Unwanted pregnancies (11%) were significantly associated with age (adj. ORs 0.1-0.37), recreational drug-use (adj. OR: 2), using intrauterine device (adj. OR:2.9) and natural birth control methods (adj. OR: 2.4). Recreational drug-use (33%) was significantly associated with age (adj ORs 1.9-2.2), and smoking status (adj. OR: 0.6). The results indicate an urgent need for: (1) Accessible, non-stigmatizing, and inclusive sexual health services dedicated to women's sexual health; (2) Comprehensive and non-stigmatizing sexual health education for all, but especially women, in order to promote safer sexual practices and effective decision making with regards to contraception and condom-use.
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Affiliation(s)
| | - Jihane Naous
- Marsa Sexual Health Center, Beirut, Lebanon
- Department of Family Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Antoine Ghanem
- Marsa Sexual Health Center, Beirut, Lebanon
- Faculty of Medicine, University of Saint-Joseph, Beirut, Lebanon
| | | | - Roland Tomb
- Faculty of Medicine, University of Saint-Joseph, Beirut, Lebanon
| | - Jade Ghosn
- Service des Maladies Infectieuses et Tropicales, AP-HP Nord, Hôpital Bichat - Claude Bernard, Paris, France
- INSERM IAME - UMR 1137, Université de Paris, Paris, France
- Faculté de Médecine Site Paris Nord, Université de Paris, Paris, France
| | - Ayman Assi
- Marsa Sexual Health Center, Beirut, Lebanon.
- Faculty of Medicine, University of Saint-Joseph, Beirut, Lebanon.
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Panic A, Reis H, Wittka A, Darr C, Hadaschik B, Jendrossek V, Klein D. The Biomarker Potential of Caveolin-1 in Penile Cancer. Front Oncol 2021; 11:606122. [PMID: 33868995 PMCID: PMC8045968 DOI: 10.3389/fonc.2021.606122] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 03/12/2021] [Indexed: 01/11/2023] Open
Abstract
Various types of human cancers were characterized by an altered expression of epithelial or stromal caveolin-1 (CAV1). However, the clinical significance of CAV1 expression in penile cancer remains largely unknown. Here the expression patterns of CAV1 were analyzed in a retrospective cohort (n=43) of penile squamous cell carcinomas (SCC). Upon penile cancer progression, significantly increased CAV1-levels were determined within the malignant epithelium, whereas within the tumor stroma, namely the fibroblastic tumor compartment harboring activated and/or cancer associated fibroblasts, CAV1 levels significantly decline. Concerning the clinicopathological significance of CAV1 expression in penile cancer as well as respective epithelial-stromal CAV1 distributions, high expression within the tumor cells as well as low expression of CAV1 within the stromal compartment were correlated with decreased overall survival of penile cancer patients. Herein, CAV1 expressions and distributions at advanced penile cancer stages were independent of the immunohistochemically proven tumor protein p53 status. In contrast, less differentiated p16-positive tumor epithelia (indicative for human papilloma virus infection) were characterized by significantly decreased CAV1 levels. Conclusively, we provide further and new evidence that the characteristic shift in stromal‐epithelial CAV1 being functionally relevant to tumor progression even occurs in penile SCC.
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Affiliation(s)
- Andrej Panic
- Department of Urology, West German Cancer Center, University of Duisburg-Essen, University Hospital Essen, Essen, Germany
| | - Henning Reis
- Institute of Pathology, West German Cancer Center, University of Duisburg-Essen, University Hospital Essen, Essen, Germany
| | - Alina Wittka
- Institute of Cell Biology (Cancer Research), University of Duisburg-Essen, University Hospital, Essen, Germany
| | - Christopher Darr
- Department of Urology, West German Cancer Center, University of Duisburg-Essen, University Hospital Essen, Essen, Germany
| | - Boris Hadaschik
- Department of Urology, West German Cancer Center, University of Duisburg-Essen, University Hospital Essen, Essen, Germany
| | - Verena Jendrossek
- Institute of Cell Biology (Cancer Research), University of Duisburg-Essen, University Hospital, Essen, Germany
| | - Diana Klein
- Institute of Cell Biology (Cancer Research), University of Duisburg-Essen, University Hospital, Essen, Germany
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Basim P, Yuksel M. Peripheral inflammatory biomarkers as predictors of recurrence in surgically-treated anogenital condylomata acuminata patients. Int J STD AIDS 2020; 31:1380-1388. [PMID: 33104496 DOI: 10.1177/0956462420950562] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The aim of this study was to examine the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) in patients with anogenital condylomata acuminata (CA) and their association with recurrence and squamous intraepithelial neoplasia development. We conducted a descriptive study in 95 patients that had undergone surgical treatment for CA. The descriptive data, disease characteristics, and pre-treatment peripheral inflammatory biomarkers (PIBs) were recorded retrospectively. All parameters were compared in those with recurrent and non-recurrent CA. All PIBs were significantly higher in patients with the greatest genital wart size of >2 cm in the squamous intraepithelial lesion (SIL) group. Human papillomavirus (HPV) types 16, 18, 31 and 33, known to carry high risk for anogenital cancer, were significantly related to higher SII. Greater wart size, high-grade squamous intraepithelial lesion (HSIL), and higher PLR and SII values were highly associated with recurrent disease (p = 0.003, 0.006, 0.005 and 0.000, respectively). Of all recurrences, 34.1% were explained by HSIL and increased PLR and SII values. The prediction of CA recurrence is important to determine those patients at high risk. PLR and SII can be used for risk analysis in selected patient groups.
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Affiliation(s)
- P Basim
- Department of General Surgery, Medical Faculty, Medipol University, Istanbul, Turkey
| | - M Yuksel
- Department of Dermatology, Medical Faculty, Medipol University, Istanbul, Turkey
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13
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Cerejeira A, Cunha S, Coelho R, Macedo G, Barkoudah E, Azevedo F, Lisboa C. Perianal warts as a risk marker for anal high-risk-human papillomavirus (HPV) detection and HPV-associated diseases. J Eur Acad Dermatol Venereol 2020; 34:2613-2619. [PMID: 32713086 DOI: 10.1111/jdv.16834] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Accepted: 07/09/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND Genital warts are the most common sexually transmitted infection (STI) and are caused by human papillomavirus (HPV). Persistent anal infection by oncogenic genotypes of HPV is a determinant for anal cancer. Currently, anal cancer screening is not widely implemented. OBJECTIVES Our aim is to evaluate the role of perianal warts as a risk marker for anal high-risk (HR) HPV detection and anal dysplasia. METHODS In this observational, retrospective, cohort study of attendees of a STI outpatient clinic between January 2010 and June 2018, all human immunodeficiency virus (HIV)-positive men who have sex with men (MSM) who performed anal cytology, anal HPV DNA detection and anoscopy were included. A comparison was made between patients with and without perianal warts. Primary endpoint: proportion of patients with an abnormal anal cytology. Secondary endpoints: proportion of patients with (i) anal HR-HPV detection; (ii) anal HPV 16 detection; (iii) abnormal anal biopsy; and (iv) anal high-grade squamous intraepithelial lesion (HSIL). RESULTS Seventy-eight individuals were included: 39 with perianal warts and 39 without perianal warts. Subjects with perianal warts more frequently had an abnormal anal cytology (71.8% vs. 38.5%; P = 0.003). This group also had a higher rate of anal HPV 16 detection (38.5% vs. 12.8%; P = 0.01). No differences were detected in the proportion of patients with anal HR-HPV detection, with an abnormal anal biopsy or with anal HSIL. Perianal warts was an independent risk factor for an abnormal anal cytology (OR: 7.2) and for anal HPV 16 detection (OR: 6.7). CONCLUSION Given the high risk of anal cancer in HIV-positive MSM, effective screening strategies are greatly needed. This study suggests that the presence of perianal warts is a suitable risk marker for anal HPV 16 detection and anal dysplasia.
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Affiliation(s)
- A Cerejeira
- Department of Dermatology and Venereology, Centro Hospitalar Universitário de São João, EPE Porto, Porto, Portugal
| | - S Cunha
- Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - R Coelho
- Department of Gastroenterology, Centro Hospitalar Universitário de São João EPE, Porto, Portugal
| | - G Macedo
- Department of Gastroenterology, Centro Hospitalar Universitário de São João EPE, Porto, Portugal
| | - E Barkoudah
- Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
| | - F Azevedo
- Department of Dermatology and Venereology, Centro Hospitalar Universitário de São João, EPE Porto, Porto, Portugal
| | - C Lisboa
- Department of Dermatology and Venereology, Centro Hospitalar Universitário de São João, EPE Porto, Porto, Portugal.,Microbiology Service, Department of Pathology and CINTESIS, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
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Abstract
Condyloma acuminatum rarely occurs in the urinary bladder and is considered to be a risk factor for squamous cell carcinoma, although there are only a few publications with limited cases. We studied 51 cases of condyloma acuminatum of the urinary bladder from transurethral resections of the urinary bladder of 38 patients from the consult files of one of the authors. Transurethral resections of the urinary bladder were obtained from 25 males with a median age of 73 years (range: 41 to 87 y) and 13 females with a median age of 68 years (range: 30 to 86 y). The follow-up period ranged from 15 months to 20 years (median: 6 y). Bladder lesions were accompanied by urethral lesions in 4 men. Eight patients (8/38; 21.0%) had a history of immunosuppression. Seven patients (7/8; 87.5%) from this group had multiple and/or recurrent condylomas. One patient (1/38; 2.6%) with renal transplantation had 10 separate bladder condylomas over time. One patient (1/38; 2.6%) had extensive anogenital condylomas and anal intraepithelial neoplasia grade 3. One patient (1/8; 12.5%) with renal transplantation presented with a solitary condyloma with synchronous squamous cell carcinoma in situ. Three female patients (3/38; 7.9%) had a history of premalignant vagina/cervix lesions. In total, 17 patients (17/38; 44.7%) had squamous cell carcinoma of the bladder, either invasive or in situ. In all cases, the squamous cell carcinoma (either in situ or invasive) was diagnosed either concurrent with the diagnosis of bladder condyloma or within 1 year of the condyloma diagnosis). In total, 9 of 38 (23.7%) patients had invasive squamous cell carcinoma with or without in situ squamous cell carcinoma. Eight of 38 (21.0%) patients had squamous cell carcinoma in situ only (without a definitive invasive component-in 3 cases invasive squamous cell carcinoma could not be excluded with certainty). In total, 19 patients (19/38; 50%) were positive for either low-risk human papillomavirus (LR-HPV) or high-risk human papillomavirus (HR-HPV) or both (3 were positive for both LR-HPV and HR-HPV, 12 patients for only LR-HPV, and 4 for only HR-HPV). Of the 19 patients that were negative for both LR-HPV and HR-HPV, 9 of 19 (47.4%) patients had associated squamous cell carcinoma. Of the 12 patients with only LR-HPV, 4 (33.3%) had associated squamous cell carcinoma (either invasive or in situ). Of the 7 patients with HR-HPV (with or without LR-HPV), 4 (57.1%) has associated squamous cell carcinoma. In summary, condyloma acuminatum of the urinary bladder shows a strong association with squamous cell carcinoma of the bladder, regardless of the condyloma's HPV in situ hybridization results. Immunosuppression is associated with condylomas of the bladder. It is important to distinguish bladder condylomas from papillary urothelial carcinoma, given their different risks for panurothelial disease and risk of squamous cell carcinoma. Recognition of bladder condylomas histologically is often challenging given their rarity, and that they can be negative for both LR-HPV and HR-HPV. The lack of a history of other anogenital human papillomavirus-related lesions further increases the difficulty in establishing the correct diagnosis.
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15
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Hoffmann R, Logan C, Pese K. An interesting cause of haematuria – urethral condyloma acuminatum. JOURNAL OF CLINICAL UROLOGY 2020. [DOI: 10.1177/2051415818773952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Richard Hoffmann
- Department of Urology, Flinders Medical Centre, Australia
- Division of Surgery, University of Adelaide, Australia
| | - Callum Logan
- Department of Urology, Flinders Medical Centre, Australia
| | - Kim Pese
- Department of Urology, Flinders Medical Centre, Australia
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Ao C, Zeng K. The role of regulatory T cells in pathogenesis and therapy of human papillomavirus-related diseases, especially in cancer. INFECTION GENETICS AND EVOLUTION 2018; 65:406-413. [PMID: 30172014 DOI: 10.1016/j.meegid.2018.08.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 08/13/2018] [Accepted: 08/15/2018] [Indexed: 12/19/2022]
Abstract
Human papillomavirus (HPV) is the most common sexually transmitted agent in the world. It can cause condyloma acuminatum, anogenital malignancies, and head and neck cancers. The host immune responses to HPV involve multiple cell types that have regulatory functions, and HPV-mediated changes to regulatory T cells (Tregs) in both the local lesion tissues and the circulatory system of patients have received considerable attention. The role of Tregs in HPV infections ranges from suppression of effector T cell (Teff) responses to protection of tissues from immune-mediated injury in different anatomic subsites. In this review, we explore the influence of Tregs in the immunopathology of HPV-related diseases and therapies targeting Tregs as novel approaches against HPV.
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Affiliation(s)
- Chunping Ao
- Department of Dermatology and Venereology, Nanfang hospital, Southern Medical University, Guangzhou, 510515, China
| | - Kang Zeng
- Department of Dermatology and Venereology, Nanfang hospital, Southern Medical University, Guangzhou, 510515, China.
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17
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Cho CY, Lo YC, Hung MC, Lai CC, Chen CJ, Wu KG. Risk of cancer in patients with genital warts: A nationwide, population-based cohort study in Taiwan. PLoS One 2017; 12:e0183183. [PMID: 28806741 PMCID: PMC5555692 DOI: 10.1371/journal.pone.0183183] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 07/31/2017] [Indexed: 11/18/2022] Open
Abstract
Background Condyloma acuminata currently affects around 1% of sexually active adults, and its incidence is increasing. The coexistence of genital warts (GW) and certain cancers and an association between human papillomavirus (HPV) and various malignancies have been reported. Therefore, we conducted this large national study to analyze the risk of malignancies among men and women with GW in Taiwan. Methods and findings Between January 2000 and December 2013, approximately 3 million patients were reported to the National Health Insurance Research Database of Taiwan. Of these patients, 21,763 were diagnosed with GW. In the same time period, a total of 213,541 cancer cases were reported to the registry, of which 1002 were recorded among patients with GW. The age-specific incidence rates of GW and standardized incidence ratios (SIRs) of malignancies compared to the general population were calculated. Women acquired GW earlier than men, with a mean age at diagnosis of 32.63±12.78 years. The highest incidence rate for both genders peaked at 20–29 years. Of the 1002 patients with GW and malignancies, the SIR was 1.95 (95%CI 1.83–2.07). The most markedly increased risk was found for HPV-related cancers, with a SIR of 9.74 (95%CI 3.70–15.77). Significantly elevated risks were also noted for smoking-related cancers, anogenital cancers, cervix in situ, colon, rectum, lung, kidney, and prostate cancers. Most cancers developed within 10 years after the diagnosis of GW. Conclusions Patients with GW have an increased risk of HPV-related cancers, especially anogenital malignancies in Taiwan. The elevated risk of other cancers highlights differences in exposure and risk factors among patients with GW compared to the general population. Cancer screening and HPV vaccination programs should be emphasized for at-risk patients.
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Affiliation(s)
- Ching-Yi Cho
- Department of Pediatrics, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan
- Division of Infectious Diseases, Department of Pediatrics, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan
| | - Yu-Cheng Lo
- Department of Pediatrics, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan
| | - Miao-Chiu Hung
- Department of Pediatrics, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan
- Division of Infectious Diseases, Department of Pediatrics, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan
| | - Chou-Cheng Lai
- Department of Pediatrics, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan
- Division of Infectious Diseases, Department of Pediatrics, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan
| | - Chun-Jen Chen
- Department of Pediatrics, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan
- Division of Infectious Diseases, Department of Pediatrics, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan
| | - Keh-Gong Wu
- Department of Pediatrics, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan
- Division of Infectious Diseases, Department of Pediatrics, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan
- * E-mail:
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Oral and oropharyngeal papillomas are not associated with high-risk human papillomavirus infection. Eur Arch Otorhinolaryngol 2017. [DOI: 10.1007/s00405-017-4649-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Rodriguez O, Kovarik CL. Immunostaining for High-Risk Human Papillomavirus in Condyloma Lesions in Immunocompromised Patients. Am J Clin Dermatol 2017; 18:413-417. [PMID: 28224503 DOI: 10.1007/s40257-017-0262-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Human papillomavirus (HPV) is the underlying infectious cause of condyloma acuminata (CA) and high-risk types of HPV can cause cancer. Condyloma may undergo malignant degeneration, particularly in immunosuppressed patients. The presence of high-risk HPV in CA is a risk factor for developing malignancy; however, determining which patients with condyloma are clinically at risk can be difficult. High-risk HPV can now be localized within CA using routine immunohistochemical stains. METHODS We examined HPV (cocktail, 16, 18) immunohistochemical staining of CA and the relevant clinical history from immunocompromised patients and compared them with age- and sex- matched immunocompetent patients with biopsied CA. RESULTS HPV was detected in 9 of the 12 specimens from immunocompromised patients (75%), and 6 of the 12 specimens from the age- and sex-matched comparison patients (50%). HPV-16 was detected in 7 of the 12 specimens from immunocompromised patients (58%), and 4 of the 12 specimens from comparison patients (33%). HPV-18 was not detected in any of the 21 specimens from immunocompromised or comparison patients for which the stain was available. CONCLUSION High-risk HPV is found within CA lesions, more often in immunocompromised patients, and confirming the presence of these HPV types with stains in high-risk patient populations may help guide the clinician in treatment and surveillance in certain cases.
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Affiliation(s)
- Olaf Rodriguez
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Carrie L Kovarik
- Department of Dermatology, University of Pennsylvania, 3600 Spruce Street, 2 Maloney Building, Philadelphia, PA, 19104, USA.
- Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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Sarier M, Ozel E, Duman I, Yuksel Y, Demirbas A. HPV type 45-positive condyloma acuminata of the bladder in a renal transplant recipient. Transpl Infect Dis 2017; 19. [PMID: 28100036 DOI: 10.1111/tid.12667] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 09/10/2016] [Accepted: 10/09/2016] [Indexed: 11/27/2022]
Abstract
Condyloma acuminata (CA) are warty lesions caused by human papilloma virus (HPV) that generally affect the external genitalia and mucocutaneous junctions. Involvement of the urinary tract is rare, and involvement of the urinary bladder is thought to be due to immunosuppression. A 30-year-old woman was diagnosed with urethral CA 12 months after renal transplantation. She underwent transurethral resection (TUR) of the urethral lesions. During the operation, multiple sessile warty lesions were found incidentally inside the bladder and were also removed by TUR. The patient's postoperative course was uneventful. Pathological examination confirmed that the lesions were CA. Multiplex real-time polymerase chain reaction was performed to confirm the HPV genotype and revealed type 45 HPV DNA. CA of the urethra are uncommon, and bladder involvement is extremely rare. This case is the first reported, to our knowledge, to involve HPV type 45 in bladder condyloma. TUR may be the preferred option for the management of CA in the urinary bladder.
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Affiliation(s)
- Mehmet Sarier
- Department of Urology, Kemerburgaz University, İstanbul, Turkey
| | - Esin Ozel
- Department of Pathology, Antalya Pathology Laboratories, Antalya, Turkey
| | - Ibrahim Duman
- Department of Urology, Kemerburgaz University, İstanbul, Turkey
| | - Yucel Yuksel
- Transplantation Unit, Medical Park Hospital, Antalya, Turkey
| | - Alper Demirbas
- Transplantation Unit, Medical Park Hospital, Antalya, Turkey
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Associations of Anogenital Low-Risk Human Papillomavirus Infection With Cancer and Acquisition of HIV. Sex Transm Dis 2016; 42:541-4. [PMID: 26372925 DOI: 10.1097/olq.0000000000000319] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
α-Mucosal human papillomavirus (HPV) types are implicated in a range of clinical conditions and categorized as "low-risk" (LR) and "high-risk" (HR) types according to their degree of association with cervical cancers. The causative role of LR HPV infection in the development of anogenital warts and in low-grade squamous intraepithelial lesions is well established. In addition, there is a growing body of evidence that infection with LR HPV types may be associated with an elevated risk of cancers and potentiation of coinfections. Prospective and case-control studies consistently report a higher risk of anogenital cancers in men and women with a history of anogenital warts. Based on currently available evidence, this higher risk may be due to shared exposure to HR HPV types or an underlying immune impairment, rather than a direct role of LR HPV types in subsequent cancer risk. Data also suggest that infection with LR HPV, HR HPV, or both may increase the risk of HIV acquisition, although the relative contribution of different HPV types is not yet known. There is also evidence implicating HPV clearance, rather than HPV infection, in increased risk of HIV acquisition.
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Khambati A, Bhanji Y, Oberlin DT, Yang XJ, Nadler RB, Perry KT, Kundu SD. Progression of Intravesical Condyloma Acuminata to Locally Advanced Poorly Differentiated Squamous Cell Carcinoma. Urol Case Rep 2016; 7:61-3. [PMID: 27335797 PMCID: PMC4909633 DOI: 10.1016/j.eucr.2016.04.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 04/26/2016] [Indexed: 11/15/2022] Open
Abstract
Condyloma acuminata (CA) is a common sexually transmitted disease caused by Human Papilloma Virus (HPV) infection. CA of the bladder, however, is an exceedingly rare lesion. We present a rare case of poorly differentiated locally invasive squamous cell carcinoma (SCC) arising from recurrent CA of the bladder in an immunocompetent patient and discuss pathophysiology and management of this unusual condition.
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Affiliation(s)
- A Khambati
- Northwestern University Feinberg School of Medicine, Department of Urology, 303 E Chicago Ave., Chicago, IL 60611, USA
| | - Y Bhanji
- Northwestern University Feinberg School of Medicine, USA
| | - D T Oberlin
- Northwestern University Feinberg School of Medicine, Department of Urology, 303 E Chicago Ave., Chicago, IL 60611, USA
| | - X J Yang
- Northwestern University Feinberg School of Medicine, Department of Pathology, 251 E Huron, Chicago, IL 60611, USA
| | - R B Nadler
- Northwestern University Feinberg School of Medicine, Department of Urology, 303 E Chicago Ave., Chicago, IL 60611, USA
| | - K T Perry
- Northwestern University Feinberg School of Medicine, Department of Urology, 303 E Chicago Ave., Chicago, IL 60611, USA
| | - S D Kundu
- Northwestern University Feinberg School of Medicine, Department of Urology, 303 E Chicago Ave., Chicago, IL 60611, USA
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Abstract
Condyloma acuminata are the most frequent cause of infections in the anal genital area. They are caused by the human papilloma virus (HPV). Risk factors are early onset of sexual activity, multiple sexual partners, a history of sexually transmitted disease, and immunosuppression. The urethra is afflicted in only 20% of cases; of these, 80% of the warts are at the meatus and 20% in the proximal urethra. This article reports on two cases with condyloma acuminata affection of the total urethra. The current diagnostic, different treatment modalities, and prophylaxis are reviewed.
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Intaraphet S, Farkas DK, Johannesdottir Schmidt SA, Cronin-Fenton D, Søgaard M. Human papillomavirus infection and lymphoma incidence using cervical conization as a surrogate marker: a Danish nationwide cohort study. Hematol Oncol 2015. [PMID: 28620926 DOI: 10.1002/hon.2270] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Persistent human papillomavirus (HPV) infection may promote carcinogenesis by hyperactivation of the immune system. We, therefore, explored the associations between HPV infection and risk of Hodgkin and non-Hodgkin lymphoma in a nationwide cohort study using conization as a surrogate marker. We identified all Danish women who underwent conization between 1978 and 2011. We computed standardized incidence ratios and 95% confidence intervals for Hodgkin and non-Hodgkin lymphoma based on national cancer incidence rates. Among 87 435 women who underwent conization, we noted an increased incidence of Hodgkin (standardized incidence ratio 1.48, 95% confidence interval 1.05-2.02) but only a slight increase for non-Hodgkin lymphoma (standardized incidence ratio 1.10, 95% confidence interval 0.97-1.25). As measured by conization, HPV infection is associated with an increased risk of lymphoma. This association may be attributable to a chronic immune activation induced by persistent HPV infection and/or failure of the immune system both to clear HPV infection and to control lymphoma development. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Suthida Intaraphet
- Boromarajonani College of Nursing, Khon Kaen, 40000, Thailand.,Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus N, 8200, Denmark
| | - Dóra Körmendiné Farkas
- Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus N, 8200, Denmark
| | | | - Deirdre Cronin-Fenton
- Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus N, 8200, Denmark
| | - Mette Søgaard
- Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus N, 8200, Denmark
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Prevalence of anal human papillomavirus infection and anal HPV-related disorders in women: a systematic review. Am J Obstet Gynecol 2015; 213:278-309. [PMID: 25797230 DOI: 10.1016/j.ajog.2015.03.034] [Citation(s) in RCA: 107] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Revised: 03/16/2015] [Accepted: 03/16/2015] [Indexed: 02/07/2023]
Abstract
The aim of this study was to systematically review the findings of publications addressing the epidemiology of anal human papillomavirus (HPV) infection, anal intraepithelial neoplasia, and anal cancer in women. We conducted a systematic review among publications published from Jan. 1, 1997, to Sept. 30, 2013, to limit to publications from the combined antiretroviral therapy era. Three searches were performed of the National Library of Medicine PubMed database using the following search terms: women and anal HPV, women anal intraepithelial neoplasia, and women and anal cancer. Publications were included in the review if they addressed any of the following outcomes: (1) prevalence, incidence, or clearance of anal HPV infection, (2) prevalence of anal cytological or histological neoplastic abnormalities, or (3) incidence or risk of anal cancer. Thirty-seven publications addressing anal HPV infection and anal cytology remained after applying selection criteria, and 23 anal cancer publications met the selection criteria. Among HIV-positive women, the prevalence of high-risk (HR)-HPV in the anus was 16-85%. Among HIV-negative women, the prevalence of anal HR-HPV infection ranged from 4% to 86%. The prevalence of anal HR-HPV in HIV-negative women with HPV-related pathology of the vulva, vagina, and cervix compared with women with no known HPV-related pathology, varied from 23% to 86% and from 5% to 22%, respectively. Histological anal high-grade squamous intraepithelial lesions (anal intraepithelial neoplasia 2 or greater) was found in 3-26% of the women living with HIV, 0-9% among women with lower genital tract pathology, and 0-3% for women who are HIV negative without known lower genital tract pathology. The incidence of anal cancer among HIV-infected women ranged from 3.9 to 30 per 100,000. Among women with a history of cervical cancer or cervical intraepithelial neoplasia 3, the incidence rates of anal cancer ranged from 0.8 to 63.8 per 100,000 person-years, and in the general population, the incidence rates ranged from 0.55 to 2.4 per 100,000 person-years. This review provides evidence that anal HPV infection and dysplasia are common in women, especially in those who are HIV positive or have a history of HPV-related lower genital tract pathology. The incidence of anal cancer continues to grow in all women, especially those living with HIV, despite the widespread use of combined antiretroviral therapy.
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Sundström K, Ploner A, Arnheim-Dahlström L, Eloranta S, Palmgren J, Adami HO, Ylitalo Helm N, Sparén P, Dillner J. Interactions Between High- and Low-Risk HPV Types Reduce the Risk of Squamous Cervical Cancer. J Natl Cancer Inst 2015; 107:djv185. [PMID: 26160881 DOI: 10.1093/jnci/djv185] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Accepted: 06/17/2015] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND The clinical significance of co-infections with high-risk (HR) and low-risk (LR) human papillomavirus (HPV) in the etiology of cervical cancer is debated, as prospective evidence on this issue is limited. However, the question is of increasing relevance in relation to HPV-based cancer prevention. METHODS In two population-based nested case-control studies among women participating in cervical screening with baseline normal smears, we collected 4659 smears from women who later developed cancer in situ (CIS; n = 524) or squamous cervical cancer (SCC; n = 378) and individually matched control subjects who remained free of disease during study follow-up. The median follow-up until diagnosis was 6.4 to 7.8 years. All smears were tested for HPV. We used conditional logistic regression models with two-way interaction terms to estimate relative risks (RRs) for CIS and SCC, respectively. All statistical tests were two-sided. RESULTS Compared with women who were infected with HRHPV only, women who were also infected with LRHPV had a lower risk for SCC (RR = 0.2, 95% confidence interval [CI] = 0.04 to 0.99, P = .049). This interaction was not shown for CIS (RR = 1.1, 95% CI = 0.4 to 3.6). Women who were positive for both HRHPV and LRHPV had, on average, a 4.8 year longer time to diagnosis of SCC than women who were positive for HRHPV only (P = .006). Results were highly robust in sensitivity analyses. CONCLUSION Co-infection with LRHPV is associated with a lower risk of future invasive disease and longer time to diagnosis than infection with HRHPV alone. We propose that co-infection with LRHPV interferes with the rate of progression to invasive cervical cancer.
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Affiliation(s)
- Karin Sundström
- Department of Laboratory Medicine (KS, JD), Department of Medical Epidemiology and Biostatistics (AP, LAD, JP, HOA, PS, JD), and Department of Medicine, Clinical Epidemiology Unit (SE), Karolinska Institutet, Stockholm, Sweden; Swedish eScience Research Center, Stockholm, Sweden (JP); Institute for Molecular Medicine Finland, Helsinki University, Helsinki, Finland (JP); Department of Epidemiology, Harvard School of Public Health, Boston, MA (HOA); Division of Clinical Cancer Epidemiology, Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden (NYH).
| | - Alexander Ploner
- Department of Laboratory Medicine (KS, JD), Department of Medical Epidemiology and Biostatistics (AP, LAD, JP, HOA, PS, JD), and Department of Medicine, Clinical Epidemiology Unit (SE), Karolinska Institutet, Stockholm, Sweden; Swedish eScience Research Center, Stockholm, Sweden (JP); Institute for Molecular Medicine Finland, Helsinki University, Helsinki, Finland (JP); Department of Epidemiology, Harvard School of Public Health, Boston, MA (HOA); Division of Clinical Cancer Epidemiology, Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden (NYH).
| | - Lisen Arnheim-Dahlström
- Department of Laboratory Medicine (KS, JD), Department of Medical Epidemiology and Biostatistics (AP, LAD, JP, HOA, PS, JD), and Department of Medicine, Clinical Epidemiology Unit (SE), Karolinska Institutet, Stockholm, Sweden; Swedish eScience Research Center, Stockholm, Sweden (JP); Institute for Molecular Medicine Finland, Helsinki University, Helsinki, Finland (JP); Department of Epidemiology, Harvard School of Public Health, Boston, MA (HOA); Division of Clinical Cancer Epidemiology, Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden (NYH)
| | - Sandra Eloranta
- Department of Laboratory Medicine (KS, JD), Department of Medical Epidemiology and Biostatistics (AP, LAD, JP, HOA, PS, JD), and Department of Medicine, Clinical Epidemiology Unit (SE), Karolinska Institutet, Stockholm, Sweden; Swedish eScience Research Center, Stockholm, Sweden (JP); Institute for Molecular Medicine Finland, Helsinki University, Helsinki, Finland (JP); Department of Epidemiology, Harvard School of Public Health, Boston, MA (HOA); Division of Clinical Cancer Epidemiology, Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden (NYH)
| | - Juni Palmgren
- Department of Laboratory Medicine (KS, JD), Department of Medical Epidemiology and Biostatistics (AP, LAD, JP, HOA, PS, JD), and Department of Medicine, Clinical Epidemiology Unit (SE), Karolinska Institutet, Stockholm, Sweden; Swedish eScience Research Center, Stockholm, Sweden (JP); Institute for Molecular Medicine Finland, Helsinki University, Helsinki, Finland (JP); Department of Epidemiology, Harvard School of Public Health, Boston, MA (HOA); Division of Clinical Cancer Epidemiology, Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden (NYH)
| | - Hans-Olov Adami
- Department of Laboratory Medicine (KS, JD), Department of Medical Epidemiology and Biostatistics (AP, LAD, JP, HOA, PS, JD), and Department of Medicine, Clinical Epidemiology Unit (SE), Karolinska Institutet, Stockholm, Sweden; Swedish eScience Research Center, Stockholm, Sweden (JP); Institute for Molecular Medicine Finland, Helsinki University, Helsinki, Finland (JP); Department of Epidemiology, Harvard School of Public Health, Boston, MA (HOA); Division of Clinical Cancer Epidemiology, Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden (NYH)
| | - Nathalie Ylitalo Helm
- Department of Laboratory Medicine (KS, JD), Department of Medical Epidemiology and Biostatistics (AP, LAD, JP, HOA, PS, JD), and Department of Medicine, Clinical Epidemiology Unit (SE), Karolinska Institutet, Stockholm, Sweden; Swedish eScience Research Center, Stockholm, Sweden (JP); Institute for Molecular Medicine Finland, Helsinki University, Helsinki, Finland (JP); Department of Epidemiology, Harvard School of Public Health, Boston, MA (HOA); Division of Clinical Cancer Epidemiology, Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden (NYH)
| | - Pär Sparén
- Department of Laboratory Medicine (KS, JD), Department of Medical Epidemiology and Biostatistics (AP, LAD, JP, HOA, PS, JD), and Department of Medicine, Clinical Epidemiology Unit (SE), Karolinska Institutet, Stockholm, Sweden; Swedish eScience Research Center, Stockholm, Sweden (JP); Institute for Molecular Medicine Finland, Helsinki University, Helsinki, Finland (JP); Department of Epidemiology, Harvard School of Public Health, Boston, MA (HOA); Division of Clinical Cancer Epidemiology, Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden (NYH)
| | - Joakim Dillner
- Department of Laboratory Medicine (KS, JD), Department of Medical Epidemiology and Biostatistics (AP, LAD, JP, HOA, PS, JD), and Department of Medicine, Clinical Epidemiology Unit (SE), Karolinska Institutet, Stockholm, Sweden; Swedish eScience Research Center, Stockholm, Sweden (JP); Institute for Molecular Medicine Finland, Helsinki University, Helsinki, Finland (JP); Department of Epidemiology, Harvard School of Public Health, Boston, MA (HOA); Division of Clinical Cancer Epidemiology, Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden (NYH)
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Schmidt SAJ, Hamilton-Dutoit SJ, Farkas DK, Steiniche T, Sørensen HT. Human papillomavirus and the incidence of nonmelanoma and melanoma skin cancer using cervical conization as a surrogate marker: a nationwide population-based Danish cohort study. Ann Epidemiol 2015; 25:293-296.e2. [PMID: 25560876 DOI: 10.1016/j.annepidem.2014.12.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 11/28/2014] [Accepted: 12/03/2014] [Indexed: 02/07/2023]
Abstract
PURPOSE Human papillomavirus' (HPV's) role in skin cancer is controversial. To examine whether an individual is prone to develop a chronic oncogenic infection, we conducted a nationwide population-based cohort study of the risk of skin cancer after another HPV-related neoplasia-that is, cervical high-grade dysplasia or carcinoma-using cervical conization as a surrogate marker. METHODS Using Danish registries, we identified all women who underwent conization from 1978 to 2011 (n = 87,164) and followed them until first-time skin cancer diagnosis, death, emigration, or 31 December 2011, whichever came first. We calculated standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) for basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and malignant melanoma (MM) according to national incidence rates. RESULTS The 1-year absolute risks were 0.0012%, 0.045%, and 0.029% for SCC, BCC, and MM, respectively. Conization was clearly associated with increased incidence of SCC (SIR = 1.37; 95% CI: 1.13-1.65), but not MM (SIR = 1.00; 95% CI: 0.91-1.11). BCC risk was slightly increased (SIR = 1.08; 95% CI: 1.02-1.13). CONCLUSIONS The association between conization and cutaneous SCC provides evidence for conization as a marker of underlying general susceptibility to oncogenic HPV.
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Affiliation(s)
| | | | | | - Torben Steiniche
- Institute of Pathology, Aarhus University Hospital, Aarhus C, Denmark
| | - Henrik Toft Sørensen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark
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Deleré Y, Remschmidt C, Leuschner J, Schuster M, Fesenfeld M, Schneider A, Wichmann O, Kaufmann AM. Human Papillomavirus prevalence and probable first effects of vaccination in 20 to 25 year-old women in Germany: a population-based cross-sectional study via home-based self-sampling. BMC Infect Dis 2014; 14:87. [PMID: 24552260 PMCID: PMC3933406 DOI: 10.1186/1471-2334-14-87] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2013] [Accepted: 02/10/2014] [Indexed: 11/10/2022] Open
Abstract
Background Estimates of Human Papillomavirus (HPV) prevalence in a population prior to and after HPV vaccine introduction are essential to evaluate the short-term impact of vaccination. Methods Between 2010 and 2012 we conducted a population-based cross-sectional study in Germany to determine HPV prevalence, genotype distribution and risk factors for HPV-infection in women aged 20-25 years. Women were recruited by a two-step cluster sampling approach. A home-based self-collection of cervicovaginal lavages was used. Specimens were analysed using a general primer GP5+/GP6+-based polymerase chain reaction and genotyped for 18 high-risk and 6 low-risk HPV- strains by Luminex-based multiplexed genotyping. Results Among 787 included women, 512 were not vaccinated against HPV. In the non-vaccinated population, HPV prevalence of any type was 38.1%, with HPV 16 (19.5%) being the most prevalent genotype. Prevalence of any high-risk type was 34.4%, and in 17.4% of all women, more than one genotype was identified. A higher number of lifetime sexual partners and low educational status were independently associated with HPV-infection. In 223 vaccinated women, prevalence of HPV 16/18 was significantly lower compared to non-vaccinated women (13.9% vs. 22.5%, p = 0.007). When stratifying by age groups, this difference was only significant in women aged 20-21 years, who at time of vaccination were on average younger and had less previous sexual contacts than women aged 22-25 years. Conclusion We demonstrate a high prevalence of high-risk HPV genotypes in non-vaccinated women living in Germany that can be potentially prevented by vaccination. Probable first vaccination effects on the HPV prevalence were observed in women who were vaccinated at younger age. This finding reinforces the recommendation to vaccinate girls in early adolescence.
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Affiliation(s)
- Yvonne Deleré
- Immunisation Unit, Department for Infectious Disease Epidemiology, Robert Koch Institute, Seestraße 10 13353 Berlin, Germany.
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Risk factors for cervical human papillomavirus infection and high-grade intraepithelial lesion in women aged 20 to 31 years in Germany. Int J Gynecol Cancer 2013; 23:519-26. [PMID: 23360813 DOI: 10.1097/igc.0b013e318285a4b2] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Persistent infection with high-risk human papillomaviruses (HPVs) can lead to cervical intraepithelial lesion and cervical cancer. Sexual behavior and smoking have been identified as risk factors for HPV infection. However, it is unclear which factors account for the persistence of HPV infection and for high-grade squamous intraepithelial lesions (HSIL). Therefore, we conducted a study to identify epidemiological risk factors for the following: (1) the presence of HPV among women without a recent diagnosis of HSIL and (2) HSIL. MATERIALS AND METHODS Participants aged 20 to 31 years were recruited at 2 study sites. All women received a cervical Papanicolaou test, were tested for HPV, and categorized into 1 of 3 different groups: The women of the first group had negative cytological test results and a negative HPV test result (HPV-negative group), and the women of the second group had negative cytological test result but positive HPV test result (HPV-positive group). The third group consisted of women with a diagnosis of HSIL (HSIL group). We first compared the HPV-negative group with the HPV-positive group, and then the HPV-positive group with the HSIL group. RESULTS One hundred forty-seven women were included: 53 women in the HPV-negative group, 46 women in the HPV-positive group, and 48 women in the HSIL group. Comparing the HPV-negative with the HPV-positive group, we found that more than 5 sexual partners during a lifetime were independently associated with cervical HPV infection, whereas the chance of being infected decreased with older age. Irregular condom use during one-night stands or smoking was associated with HPV infection only in univariable but not multivariable analysis. In contrast, older age and having had genital warts were independently associated with an HSIL diagnosis when comparing the HPV-positive group with the HSIL group. DISCUSSION Although the study was hampered by its relatively small sample size, our data suggest that main risk factors for the acquisition of HPV infection are a higher number of sexual partners and younger age, whereas older age and genital warts may be epidemiological cofactors in the development of HSIL.
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Leval A, Herweijer E, Arnheim-Dahlstrom L, Walum H, Frans E, Sparen P, Simard JF. Incidence of Genital Warts in Sweden Before and After Quadrivalent Human Papillomavirus Vaccine Availability. J Infect Dis 2012; 206:860-6. [DOI: 10.1093/infdis/jis405] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Blomberg M, Friis S, Munk C, Bautz A, Kjaer SK. Genital warts and risk of cancer: a Danish study of nearly 50 000 patients with genital warts. J Infect Dis 2012; 205:1544-53. [PMID: 22427679 DOI: 10.1093/infdis/jis228] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND We conducted a large national cohort study to examine the risk of cancer among men and women with genital warts (GW). METHODS By use of the Danish National Patient Register, we identified 16,155 men and 32,933 women who received a diagnosis of GW during 1978-2008. Standardized incidence ratios (SIRs) were computed as estimates of the relative risk of specific cancers or sites. RESULTS A diagnosis of GW was strongly related to anal (SIR for men, 21.5; SIR for women, 7.8), vulvar (SIR, 14.8), vaginal (SIR, 5.9), cervical (SIR, 1.5), penile (SIR, 8.2), and head and neck cancer (SIR, 2.8), including subsites of head and neck cancer with confirmed HPV association (SIR for men, 3.5; SIR for women, 4.8). The risks remained elevated for >10 years following GW diagnosis. In addition, we found moderately increased SIR estimates for nonmelanoma skin cancer, smoking-related cancers, and Hodgkin and non-Hodgkin lymphoma. CONCLUSIONS Individuals with GW have a long-term increased risk of anogenital cancers and head and neck cancers. The elevated risks of nonmelanoma skin cancers might indicate an association with HPV, while excess risks of other cancers could point to differences in other risk factors between individuals with GW and the general population.
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Affiliation(s)
- Maria Blomberg
- Institute of Cancer Epidemiology, Danish Cancer Society, Denmark
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White R, Donnellan S, Leong T. Complete resolution of urinary bladder condyloma acuminatum following definitive chemoradiotherapy for anal cancer. BJU Int 2011; 108 Suppl 2:38-41. [PMID: 22085125 DOI: 10.1111/j.1464-410x.2011.10685.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
UNLABELLED What's known on the subject? and What does the study add? Condyloma acuminatum of the bladder is a rare affliction and as such its ideal management is unknown. This manuscript describes curative treatment of severe disease with external beam radiotherapy concurrent with low dose chemotherapy, an approach which has not previously been utilised. OBJECTIVES • To report the first occurrence of complete and sustained resolution of symptomatic condyloma acuminatum of the bladder with chemoradiotherapy. • To describe the relevant patient details, imaging findings and chemoradiation treatment. PATIENT AND METHOD • A 54-year-old female with extensive condyloma acuminatum of the bladder and a long history of human papilloma virus related anogenital disease was diagnosed with anal squamous cell carcinoma. • Cystectomy for the bladder disease was delayed whilst chemoradiotherapy was administered for the anal cancer. RESULTS • There was complete resolution of bladder disease at follow-up which has negated the need for cystectomy with its associated morbidity. • Condyloma acuminatum has not recurred in 4 years of follow-up. CONCLUSION • This is the first published report to our knowledge of the successful treatment of condyloma acuminatum of the bladder with chemoradiotherapy. • The individual contributions of radiotherapy vs chemotherapy cannot be discerned.
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Affiliation(s)
- Rohen White
- Peter MacCallum Cancer Centre, East Melbourne Southern Health, Clayton, Australia.
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Thuret R, Sun M, Abdollah F, Budaus L, Lughezzani G, Liberman D, Morgan M, Johal R, Jeldres C, Latour M, Shariat SF, Iborra F, Guiter J, Patard JJ, Perrotte P, Karakiewicz PI. Tumor Grade Improves the Prognostic Ability of American Joint Committee on Cancer Stage in Patients With Penile Carcinoma. J Urol 2011; 185:501-7. [DOI: 10.1016/j.juro.2010.09.111] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2010] [Indexed: 11/25/2022]
Affiliation(s)
- Rodolphe Thuret
- Cancer Prognostics and Health Outcomes Unit, University of Montreal, Montreal, Quebec, Canada
- Department of Urology, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Maxine Sun
- Cancer Prognostics and Health Outcomes Unit, University of Montreal, Montreal, Quebec, Canada
| | - Firas Abdollah
- Cancer Prognostics and Health Outcomes Unit, University of Montreal, Montreal, Quebec, Canada
- Department of Urology, Vita-Salute San Raffaele University, Milan, Italy
| | - Lars Budaus
- Cancer Prognostics and Health Outcomes Unit, University of Montreal, Montreal, Quebec, Canada
- Martini-Clinic, Prostate Cancer Center Hamburg-Eppendorf, Hamburg, Germany
| | - Giovanni Lughezzani
- Cancer Prognostics and Health Outcomes Unit, University of Montreal, Montreal, Quebec, Canada
- Department of Urology, Vita-Salute San Raffaele University, Milan, Italy
| | - Daniel Liberman
- Cancer Prognostics and Health Outcomes Unit, University of Montreal, Montreal, Quebec, Canada
- Department of Urology, University of Montreal, Montreal, Quebec, Canada
| | - Monica Morgan
- Cancer Prognostics and Health Outcomes Unit, University of Montreal, Montreal, Quebec, Canada
- Department of Urology, University of Montreal, Montreal, Quebec, Canada
| | - Rupinder Johal
- Cancer Prognostics and Health Outcomes Unit, University of Montreal, Montreal, Quebec, Canada
- Department of Urology, University of Montreal, Montreal, Quebec, Canada
| | - Claudio Jeldres
- Cancer Prognostics and Health Outcomes Unit, University of Montreal, Montreal, Quebec, Canada
- Department of Urology, University of Montreal, Montreal, Quebec, Canada
| | - Mathieu Latour
- Department of Pathology, University of Montreal, Montreal, Quebec, Canada
| | - Shahrokh F. Shariat
- Cancer Prognostics and Health Outcomes Unit, University of Montreal, Montreal, Quebec, Canada
| | - François Iborra
- Department of Urology, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Jacques Guiter
- Department of Urology, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | | | - Paul Perrotte
- Department of Urology, University of Montreal, Montreal, Quebec, Canada
| | - Pierre I. Karakiewicz
- Cancer Prognostics and Health Outcomes Unit, University of Montreal, Montreal, Quebec, Canada
- Department of Urology, University of Montreal, Montreal, Quebec, Canada
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Pizzocaro G, Algaba F, Horenblas S, Solsona E, Tana S, Van Der Poel H, Watkin NA. EAU penile cancer guidelines 2009. Eur Urol 2010; 57:1002-12. [PMID: 20163910 DOI: 10.1016/j.eururo.2010.01.039] [Citation(s) in RCA: 250] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2010] [Accepted: 01/25/2010] [Indexed: 12/18/2022]
Abstract
CONTEXT Squamous cell carcinoma (SCC) of the penis is a relatively rare but ominous disease. OBJECTIVE To present a condensed version of the updated 2009 European Association of Urology (EAU) guidelines on penile SCC. EVIDENCE ACQUISITION We performed a literature search of new data available up to December 2009. No randomized study was found; consequently, level of evidence (LE) and grade of recommendations (GR) are low. EVIDENCE SYNTHESIS More insight was gained into the etiology of SCC of the penis, together with improved staging and treatment: Human papillomavirus 16 plays an etiologic role in approximately 40-50% of cases. Similarities in etiology with SCC of the head and neck, the female genitalia, and the anal canal have been found. Improved diagnostics allowed earlier diagnosis, leading to more conservative treatments. Adjuvant and neoadjuvant chemotherapy showed promising results in patients with advanced or recurrent disease. Centralization of the disease contributed to standardization and rapid diffusion of new treatments with improved results and increased organ preservation. CONCLUSIONS Improvements in the management of SCC of the penis are reflected in changes in the guidelines, but the rarity of the disease precluded randomized studies, leading to low level of evidence and grade of recommendation.
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Affiliation(s)
- Giorgio Pizzocaro
- Second Urologic Clinic, Milan University, Ospedale S. Giuseppe, Milano, Italy.
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Abstract
Condylomata acuminata are the most frequently diagnosed sexually transmitted disease of the anogenital area worldwide. The basis of successful therapy is the correct diagnosis. There are numerous differential diagnostic considerations, many of which can only be confirmed with histological examination. The diagnosis and differential diagnosis of condylomata acuminata is reviewed. Combining histologic evaluation into the diagnostic approach should improve the therapeutic results.
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