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Meneses-Urrea LA, Vaquero-Abellán M, Villegas Arenas D, Benachi Sandoval N, Hernández-Carrillo M, Molina-Recio G. Association between Cervical Cancer and Dietary Patterns in Colombia. Nutrients 2023; 15:4889. [PMID: 38068749 PMCID: PMC10707912 DOI: 10.3390/nu15234889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 10/29/2023] [Accepted: 10/30/2023] [Indexed: 12/18/2023] Open
Abstract
Cervical cancer is a global public health problem. It is the second leading cause of death among women of childbearing age worldwide. Several factors, including diet, have been shown to influence the risk of persistent HPV infection and tumor progression. This paper determines the relationship between dietary patterns and cervical cancer. It is an ecological study of multiple groups, based on two national sources: the High-Cost Account and the National Survey of Nutritional Situation of Colombia of 2015. The population consisted of 3472 women aged 35 to 64. The incidence of cervical cancer was used as the dependent variable while the independent variables included food consumption according to established patterns, area of residence, age, physical activity, and BMI, among other variables. The statistical analysis performed through associations between variables was evaluated by multiple linear regression using R2. 38.9% of the evaluated population belonged to the first quartile of wealth, and 76.5% resided in the municipal capital. The incidence of cervical cancer in Colombia was associated with being affiliated to a state-subsidized health regime and having diabetes mellitus. A conservative eating pattern, as well as belonging to a rural area, are evidenced as protective factors. These results invite the need to encourage public policies and promote healthy lifestyles.
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Affiliation(s)
- Luz Adriana Meneses-Urrea
- Research Group “Health Care (Recognized by Colciencias)”, Universidad Santiago de Cali, Cali 760001, Colombia; (L.A.M.-U.); (D.V.A.); (N.B.S.)
- Department of Nursing, Universidad Santiago de Cali, Cali 760001, Colombia
| | - Manuel Vaquero-Abellán
- IMIBIC GC12 Clinical and Epidemiological Research in Primary Care (GICEAP), 14014 Córdoba, Spain
- Department of Nursing, Pharmacology and Physiotherapy, University of Córdoba, 14014 Córdoba, Spain;
| | - Dolly Villegas Arenas
- Research Group “Health Care (Recognized by Colciencias)”, Universidad Santiago de Cali, Cali 760001, Colombia; (L.A.M.-U.); (D.V.A.); (N.B.S.)
- Department of Nursing, Universidad Santiago de Cali, Cali 760001, Colombia
| | - Narly Benachi Sandoval
- Research Group “Health Care (Recognized by Colciencias)”, Universidad Santiago de Cali, Cali 760001, Colombia; (L.A.M.-U.); (D.V.A.); (N.B.S.)
- CAP Casanova, Consorci d’Atenció Primària de Salut Barcelona Esquerra, 08036 Barcelona, Spain
| | - Mauricio Hernández-Carrillo
- Health Faculty, Universidad del Valle, Cali 760001, Colombia;
- Health Faculty, Escuela Nacional del Deporte, Cali 760001, Colombia
| | - Guillermo Molina-Recio
- Department of Nursing, Pharmacology and Physiotherapy, University of Córdoba, 14014 Córdoba, Spain;
- Lifestyles, Innovation and Health (GA-16), Maimonides Biomedical Research Institute of Córdoba (IMIBIC), 14014 Córdoba, Spain
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Lin HY, Fu Q, Tseng TS, Zhu X, Reiss K, Joseph Su L, Hagensee ME. Impact of Dietary Quality on Genital Oncogenic Human Papillomavirus Infection in Women. J Infect Dis 2023; 228:1385-1393. [PMID: 37161924 PMCID: PMC10640770 DOI: 10.1093/infdis/jiad146] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 04/26/2023] [Accepted: 05/08/2023] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND Most cervical cancers are directly linked to oncogenic or high-risk human papillomavirus (HR-HPV) infection. This study evaluates associations between diet quality and genital HPV infection in women. METHODS This study included 10 543 women from the 2003-2016 National Health and Nutrition Examination Survey. The outcome was the genital HPV infection status (HPV-negative, low-risk [LR] HPV, and HR-HPV). Dietary quality was evaluated using the Healthy Eating Index (HEI), in which a higher score indicates a better diet quality. RESULTS Women who did not consume total fruits (15.8%), whole fruits (27.5%), or green vegetables and beans (43%) had a significantly higher risk of HR-HPV infection than women who complied with the Dietary Guidelines for Americans (HR-HPV odds ratio = 1.76, 1.63, and 1.48 for a HEI score of 0 vs 5, respectively) after adjusting confounding factors. Similar results of these food components on LR-HPV infection were found. In addition, intake of whole grains and dairy was inversely associated with LR-HPV infection. CONCLUSIONS This study showed that women who did not eat fruits, dark-green vegetables, and beans had a higher risk of genital HR-HPV infection. Intake of these food components is suggested for women to prevent HPV carcinogenesis.
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Affiliation(s)
- Hui-Yi Lin
- Biostatistics Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - Qiufan Fu
- Biostatistics Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - Tung-sung Tseng
- Behavior and Community Health Sciences Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - Xiaodan Zhu
- Biostatistics Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - Krzysztof Reiss
- Department of Hematology and Oncology, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - L Joseph Su
- School of Public Health, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Michael E Hagensee
- Section of Infection Diseases, Department of Medicine, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
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Letafati A, Sakhavarz T, Khosravinia MM, Ardekani OS, Sadeghifar S, Norouzi M, Naseri M, Ghaziasadi A, Jazayeri SM. Exploring the correlation between progression of human papillomavirus infection towards carcinogenesis and nutrition. Microb Pathog 2023; 183:106302. [PMID: 37567326 DOI: 10.1016/j.micpath.2023.106302] [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: 07/03/2023] [Revised: 08/07/2023] [Accepted: 08/09/2023] [Indexed: 08/13/2023]
Abstract
Human papillomavirus (HPV) is a common sexually transmitted virus that can lead to the development of various types of cancer. While there are vaccines available to prevent HPV infection, there is also growing interest in the role of nutrition in reducing the risk of HPV-related cancers in HPV positive patients. Diet and nutrition play a critical role in maintaining overall health and preventing various diseases. A healthy diet can strengthen the immune system, which is essential for fighting off infections, including HPV infections, and preventing the growth and spread of cancer cells. Therefore, following a healthy diet and maintaining a healthy weight are important components of HPV and cancer prevention. This article explores the current scientific evidence on the relationship between nutrition and HPV, including the impact of specific nutrients, dietary patterns, and supplements on HPV infection toward cancer progression.
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Affiliation(s)
- Arash Letafati
- Virology Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Tannaz Sakhavarz
- Research Center for Clinical Virology, Tehran University of Medical Science, Tehran, Iran.
| | - Mohammad Mahdi Khosravinia
- Personalized Medicine Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Omid Salahi Ardekani
- Research Center for Clinical Virology, Tehran University of Medical Science, Tehran, Iran.
| | - Samira Sadeghifar
- Research Center for Clinical Virology, Tehran University of Medical Science, Tehran, Iran.
| | - Mehdi Norouzi
- Virology Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Research Center for Clinical Virology, Tehran University of Medical Science, Tehran, Iran.
| | - Mona Naseri
- Research Center for Clinical Virology, Tehran University of Medical Science, Tehran, Iran.
| | - Azam Ghaziasadi
- Research Center for Clinical Virology, Tehran University of Medical Science, Tehran, Iran.
| | - Seyed Mohammad Jazayeri
- Virology Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Research Center for Clinical Virology, Tehran University of Medical Science, Tehran, Iran.
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Nazari E, Hasanzadeh M, Rezvani R, Rejali M, Badpeyma M, Delaram Z, Mousavi-Seresht L, Akbari M, Khazaei M, Ferns GA, Avan A. Association of dietary intake and cervical cancer: a prevention strategy. Infect Agent Cancer 2023; 18:42. [PMID: 37415218 DOI: 10.1186/s13027-023-00517-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 06/09/2023] [Indexed: 07/08/2023] Open
Abstract
INTRODUCTION Cervical cancer is one of lethal cancers in women. As a global concern, identifying important factors of cancer is a useful strategy for prevention. Due to the role of diet/nutrition factors for cancer, the purpose of our study was to determine the impact of 150 nutrition/vitamin factors and 50 non-nutritional factor in cervical cancer and phase. METHODS Population samples of 2088 healthy subjects and patients with cervical cancer were investigated. 200 factors such as vitamin E, B1, B6, fruits, HPV, and age were gathered. Deep learning, Decision tree, and correlation matrix were used for modeling and identifying important factors. SPSS 26, R4.0.3, and Rapid miner were utilized for implementation. RESULTS Our findings indicated that zinc, Iron, Niacin, Potassium, Phosphorous, and Cooper have a beneficial impact in reducing the risk of cervical cancer and progression of phase in Iranian women, as well as Salt, snacks and milk Were identified as high-risk food factors (P value < 0.05 and coefficient correlation > 0.6). Also, alcohol, and sex patient with two groups, HPV positive have an impact on cervical cancer incidence. Phosphorus and selenium in the Micronutrients category (R2 = 0.85, AUC = 0.993) and polyunsaturated fatty acid and salt in the Macronutrients category and other categories of nutrients were identified as the most effective factors in cervical cancer using deep learning (R2 = 0.93, AUC = 0.999). CONCLUSIONS A diet and rich nutrition can be helpful for the prevention of cervix cancer and may reduce the risk of disease. Additional research is necessary for different countries.
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Affiliation(s)
- Elham Nazari
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Malihe Hasanzadeh
- Department of Gynecology Oncology, Woman Health Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reza Rezvani
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Medical Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Marzieh Rejali
- Department of Gynecology Oncology, Woman Health Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohaddeseh Badpeyma
- Student Research Committee, Department of Clinical Nutrition, Nutrition Research Center, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zeinab Delaram
- Department of Computer Science, The University of Texas at Dallas, Richardson, USA
| | - Leila Mousavi-Seresht
- Department of Gynecology Oncology, Woman Health Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahdieh Akbari
- Department of Gynecology Oncology, Woman Health Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Khazaei
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon A Ferns
- Division of Medical Education, Brighton and Sussex Medical School, Falmer, Brighton, Sussex, UK
| | - Amir Avan
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
- College of Medicine, University of Warith Al-Anbiyaa, Karbala, Iraq.
- School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Australia.
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Antioxidant and inflammatory potential of diet among women at risk of cervical cancer: findings from a cross-sectional study in Italy. Public Health Nutr 2022; 25:1577-1585. [PMID: 33958013 PMCID: PMC9991670 DOI: 10.1017/s1368980021001944] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
OBJECTIVE To evaluate the association of Composite Dietary Antioxidant Index (CDAI) and Dietary Inflammatory Index (DII) with the prevalence of high-grade cervical intraepithelial neoplasia (CIN). DESIGN A cross-sectional study was conducted on women with abnormal Papanicolaou test, who underwent high-risk human papillomavirus (HPV) screening and histological test through colposcopy. Dietary data were collected using a FFQ and used to assess both CDAI and DII. SETTING Women were recruited from 2012 to 2015 at the Cervical Cancer Screening Unit of the 'Azienda Sanitaria Provinciale' of Catania (Italy). PARTICIPANTS The study included 539 women with a mean age of 40·2 years, who were classified as cases (n 127 with CIN2 or more severe lesions) and controls (n 412 with normal cervical epithelium or CIN1). RESULTS Although we observed a lower proportion of HPV-positive women among those with higher CDAI (P < 0·001), the index was not associated with the diagnosis of CIN2 or more severe lesions. By contrast, women with medium or high DII showed higher odds to be diagnosed with CIN2 or more severe lesions than those with low DII (OR = 2·15; 95 % CI 1·11, 4·17; P = 0·024 and OR = 3·14; 95 % CI 1·50, 6·56; P = 0·002, respectively), after adjusting for age, HPV status, educational level, BMI, smoking status, parity, use of oral contraceptives and supplements. CONCLUSIONS Our findings suggested that a pro-inflammatory diet might be associated with an increased risk of CIN2 and more severe lesions. However, further prospective studies should be encouraged to support this evidence.
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Woźniak M, Krajewski R, Makuch S, Agrawal S. Phytochemicals in Gynecological Cancer Prevention. Int J Mol Sci 2021; 22:1219. [PMID: 33530651 PMCID: PMC7865323 DOI: 10.3390/ijms22031219] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 01/22/2021] [Accepted: 01/25/2021] [Indexed: 12/25/2022] Open
Abstract
Gynecological cancer confers an enormous burden among women worldwide. Accumulating evidence points to the role of phytochemicals in preventing cervical, endometrial, and ovarian cancer. Experimental studies emphasize the chemopreventive and therapeutic potential of plant-derived substances by inhibiting the early stages of carcinogenesis or improving the efficacy of traditional chemotherapeutic agents. Moreover, a number of epidemiological studies have investigated associations between a plant-based diet and cancer risk. This literature review summarizes the current knowledge on the phytochemicals with proven antitumor activity, emphasizing their effectiveness and mechanism of action in gynecological cancer.
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Affiliation(s)
- Marta Woźniak
- Department of Pathology, Wroclaw Medical University, 50-368 Wroclaw, Poland; (M.W.); (S.M.)
| | - Rafał Krajewski
- Department and Clinic of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 50-556 Wroclaw, Poland;
| | - Sebastian Makuch
- Department of Pathology, Wroclaw Medical University, 50-368 Wroclaw, Poland; (M.W.); (S.M.)
| | - Siddarth Agrawal
- Department of Pathology, Wroclaw Medical University, 50-368 Wroclaw, Poland; (M.W.); (S.M.)
- Department and Clinic of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 50-556 Wroclaw, Poland;
- Department of Cancer Prevention and Therapy, Wroclaw Medical University, 50-556 Wroclaw, Poland
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7
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Zhang Y, Zhu F, Chen C, Chen S, Huang X, Wang Y, Qiu P, Deng G, Gao J. Dietary Fiber and Human Papillomavirus Infection among US Women: The National Health and Nutrition Examination Survey, 2003-2016. Nutr Cancer 2021; 73:2515-2522. [PMID: 33499695 DOI: 10.1080/01635581.2020.1836242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The impact of dietary fiber on human papillomavirus (HPV) infection is still underway. The aim of our study was to investigate the association between intake of dietary fiber and HPV infection. Overall, 14,151 eligible women, aged 18-59 years old, who submitted an adequate sample for HPV test, were collected from an ongoing, large scale population-based survey for seven cycles. The association of dietary fiber intake and HPV infection was assessed in multivariate logistic models. For sensitivity analysis, generalized additive model (GAM) and smooth curve fitting were employed to verify the robustness of the results. Among 14,151 eligible participants, intake of dietary fiber was negatively associated with HPV infection. Each additional increase in log10 dietary fiber consumption was associated with a 57% lower risk of HPV infection (OR, 0.43; 95% CI 0.38-0.48). The result is stable in minimally and fully adjusted model. The possibility of nonlinear association of dietary fiber and HPV infection has been excluded by GAM and smooth curve fitting. There was an inverse linear correlation between intake of dietary fiber and HPV infection. Our findings obtained from NHANES dataset suggested that increasing dietary fiber consumption may be associated with the prevalence of HPV infection.
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Affiliation(s)
- Yingxuan Zhang
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Lingnan Medical Research Center of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Fangfang Zhu
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Lingnan Medical Research Center of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Chi Chen
- Department of Immunology and Microbiology, Guiyang College of Traditional Chinese Medicine, Guiyang, China
| | - Si Chen
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Lingnan Medical Research Center of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xian Huang
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Lingnan Medical Research Center of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yanxi Wang
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.,Lingnan Medical Research Center of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Pin Qiu
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Gaopi Deng
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jie Gao
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
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Seifert G, Jeitler M, Stange R, Michalsen A, Cramer H, Brinkhaus B, Esch T, Kerckhoff A, Paul A, Teut M, Ghadjar P, Langhorst J, Häupl T, Murthy V, Kessler CS. The Relevance of Complementary and Integrative Medicine in the COVID-19 Pandemic: A Qualitative Review of the Literature. Front Med (Lausanne) 2020; 7:587749. [PMID: 33363186 PMCID: PMC7761649 DOI: 10.3389/fmed.2020.587749] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 11/17/2020] [Indexed: 01/07/2023] Open
Abstract
Background: During the COVID-19 pandemic people are facing risks of adverse health effects due to the restrictions implemented such as quarantine measures, reduced social contact, and self-isolation. In this qualitative review, we collected data on potential preventive and therapeutic health benefits of Complementary and Integrative Medicine (CIM) that might be useful during the COVID-19 pandemic. We have reviewed the scientific literature to summarize CIM practices that could be beneficial for improving physical and mental health and well-being of the population under the current pandemic circumstances. It must be noted that this review is not SARS-CoV-2 specific and we explicitly do not intend to make any SARS-CoV-2 specific health claims in this article. Methods and Findings: A qualitative, non-systematic literature review was conducted in Medline to identify literature describing preventive and therapeutic CIM approaches for strengthening mental and physical health. For a variety of CIM approaches clinical evidence was identified, indicating beneficial effects. CIM approaches include specific dietary measures and selected micronutrients, physical activity, techniques from Mind-Body Medicine, single botanicals or botanical compounds, and spending time in nature among others. The effects of CIM measures on conditions like obesity and hypertension are of special relevance here, as these conditions are considered as risk factors for a severe course of COVID-19. Moreover, a possibly direct effect of CIM approaches on immune functions and clinical parameters in respiratory tract infections, such as influenza, were identified. The findings of this review could be helpful for clinicians, patients, and the general population during the current pandemic when discussing and/or considering CIM options. Conclusions: CIM offers a variety of preventive and therapeutic options for strengthening physical and mental resilience, which could also be useful in the current COVID-19 pandemic. The evidence of CIM approaches with a potential benefit in the COVID-19 pandemic in different areas is worth to be analyzed. While this qualitative review has several obvious limitations, it might serve as useful starting point for further research on this topic.
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Affiliation(s)
- Georg Seifert
- Department of Paediatric Oncology/Haematology, Otto-Heubner Centre for Paediatric and Adolescent Medicine (OHC), Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany,Department of Pediatrics, Faculty of Medicine, University of São Paulo, São Paulo, Brazil,*Correspondence: Georg Seifert
| | - Michael Jeitler
- Department of Internal and Integrative Medicine, Immanuel Krankenhaus Berlin, Berlin, Germany,Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Rainer Stange
- Department of Internal and Integrative Medicine, Immanuel Krankenhaus Berlin, Berlin, Germany,Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Andreas Michalsen
- Department of Internal and Integrative Medicine, Immanuel Krankenhaus Berlin, Berlin, Germany,Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Holger Cramer
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany,National Centre for Naturopathic Medicine, Southern Cross University, Lismore, NSW, Australia
| | - Benno Brinkhaus
- Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Tobias Esch
- Institute for Integrative Health Care and Health Promotion, University Clinic for Integrative Health Care, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany
| | - Annette Kerckhoff
- Institute for Integrative Health Care and Health Promotion, University Clinic for Integrative Health Care, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany
| | - Anna Paul
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Michael Teut
- Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Pirus Ghadjar
- Department of Radiation Oncology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Jost Langhorst
- Department of Internal and Integrative Medicine, Klinikum Bamberg, Chair for Integrative Medicine, University of Duisburg-Essen, Bamberg, Germany
| | - Thomas Häupl
- Department of Rheumatology and Clinical Immunology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Vijay Murthy
- Faculty of Medicine, Primary Care and Population Sciences, University of Southampton, Southampton, United Kingdom
| | - Christian S. Kessler
- Department of Internal and Integrative Medicine, Immanuel Krankenhaus Berlin, Berlin, Germany,Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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Sreeja SR, Seo SS, Kim MK. Associations of Dietary Glycemic Index, Glycemic Load and Carbohydrate with the Risk of Cervical Intraepithelial Neoplasia and Cervical Cancer: A Case-Control Study. Nutrients 2020; 12:E3742. [PMID: 33291721 PMCID: PMC7761966 DOI: 10.3390/nu12123742] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 11/27/2020] [Accepted: 12/03/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The association of dietary glycemic index (GI) and glycemic load (GL) with the risk of cervical cancer has never been investigated. Thus, we aimed to find evidence of any association of GI and GL with the risk of cervical intraepithelial neoplasia (CIN) and cervical cancer. METHODS In this hospital-based case-control study, we included 1340 women (670 controls and 262, 187 and 221 patients with CIN1, CIN2/3, and cervical cancer, respectively) from the Korean human papillomavirus cohort study. Completed demographic questionnaires and semi-quantitative food-frequency questionnaires were collected. The association of dietary GI and GL with CIN and cervical cancer was estimated using a logistic regression model. RESULTS The multivariate odds ratios (OR) of the highest compared with the lowest quintile of GL for CIN1 were 2.8 (95% confidence interval (CI) = 1.33-5.88). Dietary GI and GL were not associated with CIN2/3 and cervical cancer. Stratified analyses by body mass index (BMI) indicated a positive association between GI and GL and CIN 1 risk among women with a BMI (in kg/m2) <23 (OR = 2.94; 95% CI = 1.32-6.53; p for trend = 0.031 for GI and OR = 3.15; 95% CI = 1.53-6.52; p for trend = 0.013 for GL), but not among those with a BMI of ≥23. A stratification analysis by menopausal status showed that the highest quintile of GI and GL was significantly associated with the risk of CIN1 (OR = 2.91; 95% CI = 1.43-5.96; p for trend = 0.005) (OR = 2.96; 95% CI = 1.53-5.69; p for trend = 0.023) among premenopausal women. Also, in HPV positive women, dietary GL showed significant CIN1 risk (OR = 2.61; 95% CI = 1.09-6.24; p for trend = 0.087). CONCLUSION Our case-control study supports the hypothesized associations of dietary GI and GL with increased risk of CIN1. Thus, the consumption of low GI and GL foods plays a significant role in the prevention of cervical carcinogenesis.
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Affiliation(s)
- Sundara Raj Sreeja
- Division of Cancer Epidemiology and Prevention, National Cancer Center, Ilsandong-gu, Goyang-si 10408, Korea;
| | - Sang Soo Seo
- Center for Uterine Cancer, National Cancer Center, Ilsandong-gu, Goyang-si 10408, Korea;
| | - Mi Kyung Kim
- Division of Cancer Epidemiology and Prevention, National Cancer Center, Ilsandong-gu, Goyang-si 10408, Korea;
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10
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Nam M, Seo SS, Jung S, Jang SY, Lee J, Kwon M, Khan I, Ryu DH, Kim MK, Hwang GS. Comparable Plasma Lipid Changes in Patients with High-Grade Cervical Intraepithelial Neoplasia and Patients with Cervical Cancer. J Proteome Res 2020; 20:740-750. [PMID: 33241689 DOI: 10.1021/acs.jproteome.0c00640] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Cervical cancer is the fourth most prevalent cancer among women worldwide and usually develops from cervical intraepithelial neoplasia (CIN). In the present study, we compared alterations in lipids associated with high-grade CIN and cervical cancer with those associated with a normal status and low-grade CIN by performing global lipid profiling on plasma (66 healthy controls and 55 patients with CIN1, 44 with CIN2/3, and 60 with cervical cancer) using ultraperformance liquid chromatography/quadrupole time-of-flight mass spectrometry. We identified 246 lipids and found 31 lipids with similar alterations in both high-grade CIN and cervical cancer. Among these 31 lipids, four lipid classes (phosphatidylcholine, phosphatidylethanolamine, diglyceride, and free fatty acids) were identified as the major lipid classes with significant differences in the patients with CIN2/3 and cervical cancer compared to the healthy controls and the patients with CIN1. Lipid metabolites belonging to the same classes were positively correlated with each other. High-grade CIN and cervical cancer induce comparable changes in lipid levels, which are closely related to the development of cervical tumors. These results suggest that lipid profiling is a useful method for monitoring progression to cervical cancer.
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Affiliation(s)
- Miso Nam
- Integrated Metabolomics Research Group, Western Seoul Center, Korea Basic Science Institute, 150 Bugahyeon-ro, Seodaemun-gu, Seoul 03759, Korea
| | - Sang-Soo Seo
- Center for Uterine Cancer, National Cancer Center, Madu-dong, Ilsandong-gu, Goyang-si, Gyeonggi-do 10408, Korea
| | - Sunhee Jung
- Integrated Metabolomics Research Group, Western Seoul Center, Korea Basic Science Institute, 150 Bugahyeon-ro, Seodaemun-gu, Seoul 03759, Korea.,Department of Chemistry, Sungkyunkwan University, Suwon 16419, Korea
| | - Seo Young Jang
- Integrated Metabolomics Research Group, Western Seoul Center, Korea Basic Science Institute, 150 Bugahyeon-ro, Seodaemun-gu, Seoul 03759, Korea.,Department of Chemistry and Nano Science, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Korea
| | - Jueun Lee
- Integrated Metabolomics Research Group, Western Seoul Center, Korea Basic Science Institute, 150 Bugahyeon-ro, Seodaemun-gu, Seoul 03759, Korea
| | - Minji Kwon
- Division of Cancer Epidemiology and Prevention, National Cancer Center, Madu-dong, Ilsandong-gu, Goyang-si, Gyeonggi-do 10408, Korea
| | - Imran Khan
- Division of Cancer Epidemiology and Prevention, National Cancer Center, Madu-dong, Ilsandong-gu, Goyang-si, Gyeonggi-do 10408, Korea.,Department of Food Science and Technology, The University of Haripur, Haripur 22620, Pakistan
| | - Do Hyun Ryu
- Department of Chemistry, Sungkyunkwan University, Suwon 16419, Korea
| | - Mi Kyung Kim
- Division of Cancer Epidemiology and Prevention, National Cancer Center, Madu-dong, Ilsandong-gu, Goyang-si, Gyeonggi-do 10408, Korea
| | - Geum-Sook Hwang
- Integrated Metabolomics Research Group, Western Seoul Center, Korea Basic Science Institute, 150 Bugahyeon-ro, Seodaemun-gu, Seoul 03759, Korea.,Department of Chemistry and Nano Science, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Korea
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11
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The Preventive Effect of Dietary Antioxidants on Cervical Cancer Development. ACTA ACUST UNITED AC 2020; 56:medicina56110604. [PMID: 33182663 PMCID: PMC7698010 DOI: 10.3390/medicina56110604] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 11/07/2020] [Accepted: 11/09/2020] [Indexed: 12/11/2022]
Abstract
Cervical cancer results from a continuous process, starting from a normal cervical epithelium after human papillomavirus (HPV) infection and progressing to cervical intraepithelial neoplasia (CIN), before finally developing into invasive squamous carcinoma (ISC). In recent decades, dietary antioxidants, such as vitamins, have received much attention in relation to cancer prevention. We reviewed the relevant literature to investigate the dietary and nutrient intake on cervical cancer. The intake of vitamins A and D and carotenoids may inhibit early cervical cancer development. The intake of folate may prevent or inhibit HPV infection rom progressing to various grades of CIN. The intake of vitamins C and E may widely inhibit the process of cervical cancer development. Polyphenols are often used in cases of cervical cancer in combination chemotherapy and radiation therapy. Regarding nutrients, different antioxidants may have differing abilities to intervene in the natural history of cervical diseases associated with HPV infection. Regarding foods, the intake of both vegetables and fruits containing multiple vitamins may widely suppress cervical cancer development. Most previous papers have described epidemiological studies. Thus, further research using in vitro and in vivo approaches will be needed to clarify the effects of the dietary and nutrient intake in detail.
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12
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Abstract
Objective: To summarise the existing evidence of development, validation and current status of utilisation of dish-based dietary assessment tools. Design: Scoping review. Setting: Systematic search using PubMed and Web of Science. Results: We identified twelve tools from seventy-four eligible publications. They were developed for Koreans (n 4), Bangladeshis (n 2), Iranians (n 1), Indians/Malays/Chinese (n 1), Japanese (n 3) and Chinese Americans (n 1). Most tools (10/12) were composed of a dish-based FFQ. Although the development process of a dish list varied among the tools, six studies classified mixed dishes based on the similarity of their characteristics such as food ingredients and cooking methods. Tools were validated against self-reported dietary information (n 9) and concentration biomarkers (n 1). In the eight studies assessing the differences between the tool and a reference, the mean (or median) intake of energy significantly differed in five studies, and 26–83 % of nutrients significantly differed in eight studies. Correlation coefficients for energy ranged from 0·15 to 0·87 across the thirteen studies, and the median correlation coefficients for nutrients ranged from 0·12 to 0·77. Dish-based dietary assessment tools were used in fifty-nine studies mainly to assess diet–disease relationships in target populations. Conclusions: Dish-based dietary assessment tools have exclusively been developed and used for Asian-origin populations. Further validation studies, particularly biomarker-based studies, are needed to assess the applicability of tools.
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13
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Dietary Antioxidant Intake and Human Papillomavirus Infection: Evidence from a Cross-Sectional Study in Italy. Nutrients 2020; 12:nu12051384. [PMID: 32408636 PMCID: PMC7284420 DOI: 10.3390/nu12051384] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 04/27/2020] [Accepted: 05/07/2020] [Indexed: 12/13/2022] Open
Abstract
Several lines of evidence suggested that antioxidants might play a protective role against high-risk human papillomavirus (hrHPV) infection and cervical cancer. However, the effect of combined intake of antioxidants has not been investigated thus far. The current cross-sectional study aimed to understand the relationship between dietary antioxidant intake and the risk of high-risk HPV (hrHPV) infection among 251 Italian women with normal cervical cytology. Women were tested for hrHPV using the Digene HC2 HPV DNA Test. Dietary antioxidant intakes were assessed using a semi-quantitative food frequency questionnaire, and a Composite Dietary Antioxidant Index (CDAI) was constructed on the basis of zinc, selenium, manganese, vitamin A, vitamin C, vitamin E, carotenoid, and flavonoid intake. Logistic regression analysis was used to assess odds ratio (OR) and 95% confidence interval (95% CI) for the associations of antioxidant intakes or CDAI with hrHPV status, adjusting for age, smoking status, body mass index, parity, educational level, marital status, and use of multivitamins and oral contraceptives. We first observed that hrHPV-positive women (n = 84) reported lower intake of zinc, manganese, and vitamins A and C than non-infected women. Specifically, we found a negative association between dietary intake of zinc and hrHPV-positive status when all antioxidants were considered simultaneously (OR = 0.46; 95% CI = 0.27–0.80; p = 0.006). With respect to cumulative dietary antioxidant intake, we demonstrated that women with high CDAI (third tertile) had lower odds of being hrHPV-positive than those with low CDAI (first tertile) (OR = 0.39; 95% CI = 0.18–0.85; p = 0.018). To our knowledge, this is the first study demonstrating that a diet based on the combined intake of nutrients with antioxidant properties might reduce the risk of hrHPV infection. However, further research is needed to understand whether dietary antioxidant intake is associated with hrHPV infection or its persistence.
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Tomita LY, Horta BL, da Silva LLS, Malta MB, Franco EL, Cardoso MA. Fruits and vegetables and cervical cancer: a systematic review and meta-analysis. Nutr Cancer 2020; 73:62-74. [PMID: 32156167 DOI: 10.1080/01635581.2020.1737151] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
We conducted a meta-analysis to examine the association of fruits and vegetables intake with the occurrence of cervical intraepithelial neoplasia (CIN) and invasive cancer. MEDLINE, LILACS, Scopus, Cochrane Library, and Web of Science databases and gray literature on Google Scholar were searched before December 17, 2018. Odds ratio (OR) or relative risk (RR) estimates for the highest vs. the lowest intake of intake and 95% confidence intervals (CI) from the included studies were pooled using fixed and random-effects models. We found 18 studies: 17 case-control studies (n = 9,014 cases, n = 29,088 controls) and one cohort study (n = 299,651). No association was observed for CIN. The pooled adjusted ORs (95% CI) for cervical cancer were 0.61 (95% CI 0.52-0.73) for vegetables and 0.80 (95% CI 0.70-0.93) for fruits. However, no association was observed when the pooled effect was estimated among studies that adjusted for human papillomavirus (HPV). Consumption of vegetables and fruits was not associated with incidence of cervical cancer among studies that controlled for HPV infection. The level of evidence is limited because only one cohort study was included in the analysis.
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Affiliation(s)
- Luciana Yuki Tomita
- Departamento de Medicina Preventiva, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Bernardo Lessa Horta
- Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Rua Marechal Deodoro, Pelotas, Brazil
| | | | - Maira Barreto Malta
- Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil
| | - Eduardo Luis Franco
- Division of Cancer Epidemiology, Department of Oncology and Epidemiology and Biostatistics, McGill University, Montreal, Canada
| | - Marly Augusto Cardoso
- Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil
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15
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Padilla-Raygoza N, Monroy-Torres R, Sandoval-Salazar C, Vera-Becerra LE, Patiño-López ME, de Lourdes García-Campos M, Campos VB, del Carmen Ortega Jiménez M, del Carmen Delgado-Sandoval S, Ramírez-Gómez XS, Jimenez-García SN, Lemus HLL. Cancer prevention programmes in Mexico: are we doing enough? Ecancermedicalscience 2020; 14:997. [PMID: 32153652 PMCID: PMC7032937 DOI: 10.3332/ecancer.2020.997] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Indexed: 12/20/2022] Open
Abstract
Cancer has increased in all the countries of the world and Mexico is no exception. The recognised risk factors for the main types of cancer are reviewed and searched through the Mexican government web pages and cancer prevention programmes to tackle the risk factors in the population. The Mexican government, a member of the World Health Organization, shows that the main approach is an early diagnosis rather than prevention, forgetting that an ounce of prevention is better than a pound of cure. Effective public programmes should be promoted to reduce preventable risk factors in the population (smoking, nutrition, obesity, diet, environmental toxicity, sedentary lifestyle) and control the non-preventable factors (genetics) if we really want to control the incidence of different types of cancer.
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Affiliation(s)
| | - Rebeca Monroy-Torres
- Laboratory of Nutrition and Safety Food, Department of Medicine and Nutrition, Division of Health Sciences, Campus Leon, University of Guanajuato, León CP 37670, Mexico
| | - Cuauhtémoc Sandoval-Salazar
- Department of Nursing and Obstetrics, Division of Health Sciences, Campus Celaya-Salvatierra, University of Guanajuato, Celaya CP38110, Mexico
| | - Luz Elvia Vera-Becerra
- Department of Medicine and Nutrition, Division of Health Sciences, Campus Leon, University of Guanajuato, León CP 37670, Mexico
| | - María Esther Patiño-López
- Department of Clinical Nursing, Division of Health Sciences, Campus Celaya-Salvatierra, University of Guanajuato, Celaya CP38110, Mexico
| | - María de Lourdes García-Campos
- Department of Clinical Nursing, Division of Health Sciences, Campus Celaya-Salvatierra, University of Guanajuato, Celaya CP38110, Mexico
| | - Vicente Beltrán Campos
- Department of Clinical Nursing, Division of Health Sciences, Campus Celaya-Salvatierra, University of Guanajuato, Celaya CP38110, Mexico
| | - Mayra del Carmen Ortega Jiménez
- Department of Nursing and Obstetrics, Division of Health Sciences, Campus Celaya-Salvatierra, University of Guanajuato, Celaya CP38110, Mexico
| | - Silvia del Carmen Delgado-Sandoval
- Department of Nursing and Obstetrics, Division of Health Sciences, Campus Celaya-Salvatierra, University of Guanajuato, Celaya CP38110, Mexico
| | - Xóchitl Sofía Ramírez-Gómez
- Department of Clinical Nursing, Division of Health Sciences, Campus Celaya-Salvatierra, University of Guanajuato, Celaya CP38110, Mexico
| | - Sandra Neli Jimenez-García
- Department of Clinical Nursing, Division of Health Sciences, Campus Celaya-Salvatierra, University of Guanajuato, Celaya CP38110, Mexico
| | - Hilda Lissette López- Lemus
- Department of Nursing and Obstetrics, Division of Health Sciences, Campus Celaya-Salvatierra, University of Guanajuato, Celaya CP38110, Mexico
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16
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Sreeja SR, Lee HY, Kwon M, Shivappa N, Hebert JR, Kim MK. Dietary Inflammatory Index and Its Relationship with Cervical Carcinogenesis Risk in Korean Women: A Case-Control Study. Cancers (Basel) 2019; 11:cancers11081108. [PMID: 31382563 PMCID: PMC6721526 DOI: 10.3390/cancers11081108] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 07/26/2019] [Accepted: 07/31/2019] [Indexed: 12/14/2022] Open
Abstract
Several studies have reported that diet’s inflammatory potential is related to chronic diseases such as cancer, but its relationship with cervical cancer risk has not been studied yet. The aim of this study was to investigate the association between Dietary Inflammatory Index (DII®) and cervical cancer risk among Korean women. This study consisted of 764 cases with cervical intraepithelial neoplasia (CIN)1, 2, 3, or cervical cancer, and 729 controls from six gynecologic oncology clinics in South Korea. The DII was computed using a validated semiquantitative Food Frequency Questionnaire (FFQ). Odds ratios and 95% CI were calculated using multinomial logistic regression. Higher DII scores were associated with higher cervical carcinogenesis risk. A significant association was observed between the DII and risk among CIN2/3 [Odds Ratio (OR) = 3.14; 95% Confidence Intervals (CI) = 1.57–6.29] and cervical cancer patients (OR = 1.98; 95% CI = 1.01–3.88). Among Human Papilloma Virus (HPV)-positive women, a significant association was found between DII and cervical carcinoma risk with CIN2/3 (OR = 5.65; 95% CI = 1.38–23.2). Moreover, women with CIN2/3 and cervical cancer showed a significant association with proinflammatory diet in people without of physical activity (OR = 3.79; 95% CI = 1.81–7.93). These findings suggest that high intake of proinflammatory diets is associated with increased risk of cervical carcinogenesis among women with CIN2/3. Further evaluation in future studies to confirm this association is warranted.
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Affiliation(s)
- Sundara Raj Sreeja
- Cancer Epidemiology Branch, Division of Cancer Epidemiology and Prevention, National Cancer Center, Madu-dong, Ilsan-dong-gu, Goyang-si, Gyeonggi-do 10408, Korea
| | - Hyun Yi Lee
- Cancer Epidemiology Branch, Division of Cancer Epidemiology and Prevention, National Cancer Center, Madu-dong, Ilsan-dong-gu, Goyang-si, Gyeonggi-do 10408, Korea
| | - Minji Kwon
- Cancer Epidemiology Branch, Division of Cancer Epidemiology and Prevention, National Cancer Center, Madu-dong, Ilsan-dong-gu, Goyang-si, Gyeonggi-do 10408, Korea
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
- Connecting Health Innovations Columbia, Columbia, SC 29201, USA
| | - James R Hebert
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
- Connecting Health Innovations Columbia, Columbia, SC 29201, USA
| | - Mi Kyung Kim
- Cancer Epidemiology Branch, Division of Cancer Epidemiology and Prevention, National Cancer Center, Madu-dong, Ilsan-dong-gu, Goyang-si, Gyeonggi-do 10408, Korea.
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17
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Koshiyama M. The Effects of the Dietary and Nutrient Intake on Gynecologic Cancers. Healthcare (Basel) 2019; 7:healthcare7030088. [PMID: 31284691 PMCID: PMC6787610 DOI: 10.3390/healthcare7030088] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 06/23/2019] [Accepted: 07/03/2019] [Indexed: 12/19/2022] Open
Abstract
The contribution of diet to cancer risk has been considered to be higher in advanced countries than in developing countries. In this paper, I review the current issues (a review of the relevant literature), and the effects of the dietary and nutrient intake on three types of gynecologic cancer (cervical, endometrial and ovarian cancers). In cervical cancer, the most important roles of diet/nutrition in relation to cancer are prophylaxis and countermeasures against human papillomavirus (HPV) infection. The main preventive and reductive factors of cervical cancer are antioxidants, such as vitamin A, C, D and E, carotenoids, vegetables and fruits. These antioxidants may have different abilities to intervene in the natural history of diseases associated with HPV infection. For endometrial cancer, the increase in peripheral estrogens as a result of the aromatization of androgens to estrogens in adipose tissue in obese women and insulin resistance are risk factors. Thus, we must mainly take care to avoid the continuous intake of fat energy and sugar. In ovarian cancer, the etiology has not been fully understood. To the best of our knowledge, the long-term consumption of pro-inflammatory foods, including saturated fat, carbohydrates and animal proteins is a risk factor. The intake of acrylamide is also a risk factor for both endometrial and ovarian cancer. Most papers have been epidemiological studies. Thus, further research using in vitro and in vivo approaches is needed to clarify the effects of the dietary and nutrient intake in detail.
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Affiliation(s)
- Masafumi Koshiyama
- Department of Women's Health, Graduate School of Human Nursing, The University of Shiga Prefecture, Shiga 522-8533, Japan.
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18
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Khan I, Nam M, Kwon M, Seo SS, Jung S, Han JS, Hwang GS, Kim MK. LC/MS-Based Polar Metabolite Profiling Identified Unique Biomarker Signatures for Cervical Cancer and Cervical Intraepithelial Neoplasia Using Global and Targeted Metabolomics. Cancers (Basel) 2019; 11:cancers11040511. [PMID: 30974861 PMCID: PMC6521312 DOI: 10.3390/cancers11040511] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 04/04/2019] [Accepted: 04/08/2019] [Indexed: 02/06/2023] Open
Abstract
Cervical cancer remains one of the most prevalent cancers among females worldwide. Therefore, it is important to discover new biomarkers for early diagnosis of cervical intraepithelial neoplasia (CIN) and cervical cancer, preferably non-invasive ones. In the present study, we aimed to identify unique metabolic signatures for CINs and cervical cancers using global and targeted metabolomic profiling. Plasma samples (69 normal, 55 CIN1, 42 CIN2/3, and 60 cervical cancer) were examined by ultra-performance liquid chromatography-quadrupole-time-of-flight mass spectrometry (UPLC-QTOF-MS) coupled with multivariate statistical analysis. Metabolic pathways were analyzed using the integrated web-based tool MetaboAnalyst. A multivariate logistic regression analysis was conducted to evaluate the combined association of metabolites and human papillomavirus (HPV) status with the risk of cervical carcinogenesis. A total of 28 metabolites exhibiting discriminating levels among normal, CIN, and cervical cancer patients (Kruskal–Wallis test p < 0.05) were identified in the global profiling analysis. The pathway analysis showed significantly altered alanine, aspartate, and glutamate metabolic pathways (FDR p-value < 0.05) in both the discovery and validation phases. Seven metabolites (AMP, aspartate, glutamate, hypoxanthine, lactate, proline, and pyroglutamate) were discriminated between CINs and cervical cancer versus normal (area under the curve (AUC) value > 0.8). The levels of these metabolites were significantly high in patients versus normal (p < 0.0001) and were associated with increased risk of developing CIN2/3 and cervical cancer. Additionally, elevated levels of the seven metabolites combined with positive HPV status were correlated with substantial risk of cancer progression. These results demonstrated that metabolomics profiling is capable of distinguishing CINs and cervical cancers from normal and highlighted potential biomarkers for the early detection of cervical carcinogenesis.
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Affiliation(s)
- Imran Khan
- Division of Cancer Epidemiology and Prevention, National Cancer Center, Madu-dong, Ilsandong-gu, Goyang-si, Gyeonggi-do 10408, Korea.
| | - Miso Nam
- Integrated Metabolomics Research Group, Western Seoul Center, Korea Basic Science Institute, Seoul 03759, Korea.
| | - Minji Kwon
- Division of Cancer Epidemiology and Prevention, National Cancer Center, Madu-dong, Ilsandong-gu, Goyang-si, Gyeonggi-do 10408, Korea.
| | - Sang-Soo Seo
- Center for Uterine Cancer, National Cancer Center, Madu-dong, Ilsandong-gu, Goyang-si, Gyeonggi-do 10408, Korea.
| | - Sunhee Jung
- Integrated Metabolomics Research Group, Western Seoul Center, Korea Basic Science Institute, Seoul 03759, Korea.
| | - Ji Soo Han
- Integrated Metabolomics Research Group, Western Seoul Center, Korea Basic Science Institute, Seoul 03759, Korea.
| | - Geum-Sook Hwang
- Integrated Metabolomics Research Group, Western Seoul Center, Korea Basic Science Institute, Seoul 03759, Korea.
| | - Mi Kyung Kim
- Division of Cancer Epidemiology and Prevention, National Cancer Center, Madu-dong, Ilsandong-gu, Goyang-si, Gyeonggi-do 10408, Korea.
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19
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Kwon M, Seo SS, Kim MK, Lee DO, Lim MC. Compositional and Functional Differences between Microbiota and Cervical Carcinogenesis as Identified by Shotgun Metagenomic Sequencing. Cancers (Basel) 2019; 11:cancers11030309. [PMID: 30841606 PMCID: PMC6468638 DOI: 10.3390/cancers11030309] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 02/27/2019] [Accepted: 02/28/2019] [Indexed: 12/15/2022] Open
Abstract
Recent studies have reported the potential role of microbiomes in cervical disease. However, little is known about the microbiome composition and function in cervical carcinogenesis. We aimed to identify the compositional and functional alterations of cervical microbiomes in cases of cervical carcinogenesis of Korean women using shotgun metagenomic sequencing. In this study, using shotgun sequencing, we sequenced the cervical metagenomes of cervical intraneoplasia 2/3 (n = 17), cervical cancer (n = 12), and normal controls (n = 18) to identify the microbial abundances and enriched metabolic functions in cervical metagenomes. At the genus level, the microbiota of cervical cancer were differentially enriched with genera Alkaliphilus, Pseudothermotoga, and Wolbachia. Cervical intraepithelial neoplasia (CIN) 2/3 were enriched with Lactobacillus, Staphylococcus, and Candidatus Endolissoclinum. The normal group was enriched with Pseudoalteromonas and Psychrobacter. Further characterization of the functionalities of the metagenomes may suggest that six Kyoto Encyclopedia of Genes and Genomes (KEGG) orthologies (KOs) that are involved in 10 pathways are associated with an increased risk of CIN2/3 and cervical cancer. Specifically, cervical metagenomes were enriched in the course of peptidoglycan synthesis and depleted by dioxin degradation and 4-oxalocrotonate tautomerase. The Cluster of Orthologous Groups (COG) category ‘Defense mechanisms’ was depleted in cervical cancer patients. Our findings based on shotgun metagenomic sequencing suggest that cervical microbiome community compositions and their metagenomics profiles differed between cervical lesions and normal subjects. Future studies should have larger sample sizes and/or aggregate their results to have sufficient power to detect reproducible and significant associations.
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Affiliation(s)
- Minji Kwon
- Division of Cancer Epidemiology and Prevention, National Cancer Center, 323, Ilsan-ro, Ilsandong-gu, Goyang-si 10408, Korea.
| | - Sang-Soo Seo
- Center for Uterine Cancer, National Cancer Center, 323, Ilsan-ro, Ilsandong-gu, Goyang-si 10408, Korea.
| | - Mi Kyung Kim
- Division of Cancer Epidemiology and Prevention, National Cancer Center, 323, Ilsan-ro, Ilsandong-gu, Goyang-si 10408, Korea.
| | - Dong Ock Lee
- Center for Uterine Cancer, National Cancer Center, 323, Ilsan-ro, Ilsandong-gu, Goyang-si 10408, Korea.
| | - Myoung Cheol Lim
- Center for Uterine Cancer, National Cancer Center, 323, Ilsan-ro, Ilsandong-gu, Goyang-si 10408, Korea.
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20
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Association of cervical microbial community with persistence, clearance and negativity of Human Papillomavirus in Korean women: a longitudinal study. Sci Rep 2018; 8:15479. [PMID: 30341386 PMCID: PMC6195586 DOI: 10.1038/s41598-018-33750-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 10/03/2018] [Indexed: 12/20/2022] Open
Abstract
The present study aimed to identify the cervical microbes that are associated with HPV negativity, HPV clearance and HPV persistence and to assess the microbes’ longitudinal associations as related to HPV infection dynamics among Korean women. We enrolled 41 women with 107 samples, and classified them according to the HPV infection dynamics: HPV negativity (21 samples, 10 subjects), HPV clearance (42 samples, 15 subjects), and HPV persistence (44 samples, 16 subjects). Cervical swabs were collected at the baseline and six-month-interval follow-up visits. HPV positivity was determined by HPV DNA HC2 assay, and the microbiome was analyzed using 16SrRNA pyrosequencing, linear discriminant analysis effect size and multivariate logistic analysis. In the multivariate logistic analysis results, Lactobacillus crispatus (multivariate OR (mOR) = 8.25, 95% CI 2.13~32.0) was predominant in the HPV-negative group. We observed that Eubacterium eligens (mOR = 11.5, 95% CI 1.31~101.4), Gardnerella vaginalis (mOR = 17.0, 95% CI 2.18–131.8), and Ureaplasma urealyticum (mOR = 7.42, 95% CI 1.3–42.46) had the strongest associations with HPV clearance, and Lactobacillus johnsonii (mOR = 16.4, 95% CI 1.77–152.2) with HPV persistence. Overall, greater diversity was observed in HPV-persistence than in HPV-negative women. Our findings suggest that the presence and prevalence of a specific cervical microbiome are factors involved in HPV dynamics.
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Khazaee-Pool M, Yargholi F, Jafari F, Ponnet K. Exploring Iranian women's perceptions and experiences regarding cervical cancer-preventive behaviors. BMC Womens Health 2018; 18:145. [PMID: 30170632 PMCID: PMC6119270 DOI: 10.1186/s12905-018-0635-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 08/20/2018] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Preventive behaviors regarding cervical cancer are essential for women's health. Even though many studies have addressed women's knowledge and attitudes toward cervical cancer, little information is available about their experiences of cervical cancer-preventive behaviors. Thus, the aim of this study is to explore the perceptions and experiences of Iranian women regarding cervical cancer-preventive behaviors. METHODS This study used a qualitative approach and was conducted in Zanjan, Iran. Participants included 27 women, aged 20-60 years, with no previous history of cervical cancer symptoms or diagnosis. Data were obtained through semi-structured in-depth interviews and focus group discussions. Inductive qualitative content analysis was employed to converge and compare themes through participant data. RESULTS The following six main themes emerged from the analysis: attitudes toward cervical cancer and preventive behaviors, preventive behaviors' concept, self-care, religion and culture, perceived social support, and awareness about cervical cancer and preventive behavior. The findings revealed that several women had misconceptions about cervical cancer and were even superstitious about the causes of it. Fear, shame, and embarrassment were reasons for not undertaking cervical cancer screening. Cervical cancer was also linked to worries about decreased marital satisfaction, sexuality, and femininity. However, religion was considered a positive factor to conducting cancer-preventive behaviors. CONCLUSIONS This study showed that improving knowledge about the causes of cervical cancer, increasing awareness of the potential consequences of it, and creating positive attitudes toward screening behavior might encourage Iranian women to perform cervical cancer-preventive behaviors.
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Affiliation(s)
- Maryam Khazaee-Pool
- Department of Health Education and Promotion, School of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Fatemeh Yargholi
- Department of Health Education and Promotion, School of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Fatemeh Jafari
- Department of Public Health, School of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Koen Ponnet
- Department of Communication Sciences, imec-mict-Ghent University, Ghent, Belgium
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Barchitta M, Maugeri A, Quattrocchi A, Agrifoglio O, Scalisi A, Agodi A. The Association of Dietary Patterns with High-Risk Human Papillomavirus Infection and Cervical Cancer: A Cross-Sectional Study in Italy. Nutrients 2018; 10:nu10040469. [PMID: 29641467 PMCID: PMC5946254 DOI: 10.3390/nu10040469] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 03/27/2018] [Accepted: 04/09/2018] [Indexed: 02/06/2023] Open
Abstract
Specific foods and nutrients help prevent the progression of persistent high-risk human papillomavirus (hrHPV) infection to cervical cancer (CC). The aim of this study was to investigate dietary patterns which may be associated with hrHPV status and the risk of high-grade cervical intraepithelial neoplasia (CIN2+). Overall, 539 eligible women, including 127 with CIN2+, were enrolled in a cross-sectional study, and tested for hrHPV infection. Food intake was estimated using a food frequency questionnaire. Logistic regression models were applied. Using the Mediterranean Diet Score, we demonstrated that, among 252 women with a normal cervical epithelium, medium adherence to the Mediterranean diet decreased the odds of hrHPV infection when compared to low adherence (adjOR = 0.40, 95%CI = 0.22-0.73). Using the principal component analysis, we also identified two dietary patterns which explained 14.31% of the variance in food groups intake. Women in the third and fourth quartiles of the "Western pattern" had higher odds of hrHPV infection when compared with first quartile (adjOR = 1.77, 95% CI = 1.04-3.54 and adjOR = 1.97, 95%CI = 1.14-4.18, respectively). Adjusting for hrHPV status and age, women in the third quartile of the "prudent pattern" had lower odds of CIN2+ when compared with those in the first quartile (OR = 0.50, 95%CI = 0.26-0.98). Our study is the first to demonstrate the association of dietary patterns with hrHPV infection and CC and discourages unhealthy habits in favour of a Mediterranean-like diet.
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Affiliation(s)
- Martina Barchitta
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, via S. Sofia, 87, 95123 Catania, Italy.
| | - Andrea Maugeri
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, via S. Sofia, 87, 95123 Catania, Italy.
| | - Annalisa Quattrocchi
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, via S. Sofia, 87, 95123 Catania, Italy.
| | - Ottavia Agrifoglio
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, via S. Sofia, 87, 95123 Catania, Italy.
| | - Aurora Scalisi
- Unità Operativa di Screening Ginecologico, Azienda Sanitaria Provinciale di Catania, 95126 Catania, Italy.
| | - Antonella Agodi
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, via S. Sofia, 87, 95123 Catania, Italy.
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High Prevalence of Leptotrichia amnionii, Atopobium vaginae, Sneathia sanguinegens, and Factor 1 Microbes and Association of Spontaneous Abortion among Korean Women. BIOMED RESEARCH INTERNATIONAL 2017; 2017:5435089. [PMID: 29479540 PMCID: PMC5745682 DOI: 10.1155/2017/5435089] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 10/09/2017] [Accepted: 10/22/2017] [Indexed: 01/01/2023]
Abstract
Objective. The purpose of this study was to (i) determine the cervical microbial composition in different abortion samples and to (ii) investigate the correlation between spontaneous abortion and cervical microbes in Korean women. Methods. We collected cervical swabs from women who had never undergone abortion (N = 36), had spontaneous abortion (N = 23), and had undergone induced abortion (N = 88) and subjected those samples to 16S rRNA pyrosequencing. Further, factor analysis and correlation between cervical microbiota and spontaneous abortion were evaluated by logistic regression analysis. Results. In spontaneous abortion women, 16 S rRNA gene sequences showed significant increases in Atopobium vaginae, Megasphaera spp., Gardnerella vaginalis, Leptotrichia amnionii, and Sneathia sanguinegens compared to women in nonabortion group. In multivariate logistic regression analysis, A. vaginae (OD = 11.27; 95% = 1.57–81), L. amnionii (OD = 11.47; 95% = 1.22–107.94), S. sanguinegens (OD = 6.89; 95% = 1.07–44.33), and factor 1 microbes (OD = 16.4; 95% = 1.88–42.5) were strongly associated with spontaneous abortion. Conclusions. This study showed a high prevalence of L. amnionii, A. vaginae, S. sanguinegens, and factor 1 microbes in spontaneous abortion and association with spontaneous abortion in Korean women.
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Min KJ, Lee JK, So KA, Kim MK. Association Between Passive Smoking and the Risk of Cervical Intraepithelial Neoplasia 1 in Korean Women. J Epidemiol 2017; 28:48-53. [PMID: 29093300 PMCID: PMC5742379 DOI: 10.2188/jea.je20160118] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background The role of passive smoking on cervical carcinogenesis remains controversial. We investigated the association of passive smoking with the risk of cervical intraepithelial neoplasia (CIN) and cervical cancer. Methods The study recruited 1,322 women, aged 18–65 with normal cytology (n = 592), CIN1 (n = 420), CIN2/3 (n = 165), and cervical cancer (n = 145) from 2006 to 2009. This study is a cross-sectional analysis using the baseline data from the Korean human papillomavirus (HPV) cohort study. Detailed information on smoking behaviors and lifestyles were collected using questionnaires. Multinomial logistic regression analysis was performed to estimate multivariable-adjusted odds ratios (ORs). Results Passive smoking was not statistically related to the risk of CINs and cervical cancer. However, passive smoking among non-smokers was associated with higher CIN 1 risk (OR 1.53; 95% confidence interval [CI], 1.07–2.18), compared to not passive smoking, after adjusting for demographic factors, lifestyles, and oncogenic-HPV infection status. CIN 1 risk increased with longer time exposed to passive smoking (P for trend <0.0003). Multivariate odds of <2 hours/day of passive smoking and that of ≥2 hours/day of passive smoking were 2.48 (95% CI, 1.49–4.14) and 2.28 (95% CI, 1.21–4.26) for CIN 1, compared to not passive smoking. Conclusions This study found that passive smoking among non-smoking women is associated with the risk of CIN 1.
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Affiliation(s)
- Kyung-Jin Min
- Department of Obstetrics and Gynecology, College of Medicine, Korea University
| | - Jae-Kwan Lee
- Department of Obstetrics and Gynecology, College of Medicine, Korea University
| | - Kyeong A So
- Cheil General Hospital & Women's Healthcare Center, Dankook University College of Medicine
| | - Mi Kyung Kim
- Translational Epidemiology Research Branch, Division of Cancer Epidemiology and Management, National Cancer Center
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Seo SS, Oh HY, Lee JK, Kong JS, Lee DO, Kim MK. Combined effect of diet and cervical microbiome on the risk of cervical intraepithelial neoplasia. Clin Nutr 2016; 35:1434-1441. [DOI: 10.1016/j.clnu.2016.03.019] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Revised: 03/22/2016] [Accepted: 03/24/2016] [Indexed: 01/13/2023]
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26
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Serra-Majem L. Head and neck cancer: smoking, drinking, eating and…sexual practices. Eur J Epidemiol 2016; 31:333-5. [DOI: 10.1007/s10654-016-0143-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 03/15/2016] [Indexed: 01/01/2023]
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Oh HY, Kim MK, Seo SS, Lee JK. Association of Combined Tobacco Smoking and Oral Contraceptive Use With Cervical Intraepithelial Neoplasia 2 or 3 in Korean Women. J Epidemiol 2015; 26:22-9. [PMID: 26441210 PMCID: PMC4690737 DOI: 10.2188/jea.je20150047] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Background Cigarette smoking and oral contraceptive (OC) use have been associated with cervical neoplasia, and the combination of smoking and OC use could influence cervical carcinogenesis. We aimed to assess the joint effect of smoking and OC use on the risk of cervical intraepithelial neoplasia (CIN). Methods From a cohort of human papillomavirus-positive subjects recruited from 6 hospitals in Korea from March 2006 to November 2012, a total of 678 subjects (411 control, 133 CIN 1, and 134 CIN 2 or 3 cases) were selected for this study (mean age, 43 years). The risk of CIN associated with smoking and OC use on additive and multiplicative scales was estimated via multinomial logistic regression after adjustment for potential confounding factors. The relative excess risk due to interaction (RERI) and the synergy index (S) were used to evaluate the additive interaction. Results OC users (odds ratio [OR] 1.98; 95% confidence interval [CI], 1.07–3.69) and long-term OC use (≥20 months; OR 2.71; 95% CI, 1.11–6.59) had a higher risk of CIN 2/3, but had no association with CIN 1, compared to non-OC users. Smokers and heavy smoking (≥8 cigarettes/day) were not associated with any CIN grade. Combined smoking and OC use (OR 4.91; 95% CI, 1.68–14.4; RERI/S, 3.77/27.4; P for multiplicative interaction = 0.003) and combined heavy smoking and long-term OC use (OR 11.5; 95% CI, 1.88–70.4; RERI/S, 9.93/18.8; P for multiplicative interaction = 0.009) had a higher risk of CIN 2/3 but had no association with CIN 1 compared to combined non-smoking and non-OC use. Conclusions OC use and smoking acted synergistically to increase the risk of CIN 2 or 3 in Korean women.
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Affiliation(s)
- Hea Young Oh
- Division of Cancer Epidemiology and Prevention, National Cancer Center
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Association between Obesity and Cervical Microflora Dominated by Lactobacillus iners in Korean Women. J Clin Microbiol 2015; 53:3304-9. [PMID: 26269625 DOI: 10.1128/jcm.01387-15] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 08/01/2015] [Indexed: 11/20/2022] Open
Abstract
Lactobacillus spp. are associated with the maintenance of reproductive health, but obesity reduces fertility and is a risk factor for obstetric and neonatal complications. We assessed the association between obesity and the cervical Lactobacillus composition, which has not been examined previously. Pyrosequencing was performed using cervical swabs collected from 76 normal participants with negative results for cervical intraepithelial neoplasia (CIN) and 57 participants with CIN, based on histological examinations. Cluster analysis of nine Lactobacillus spp. was performed, and five cluster types were identified. The association between obesity and the Lactobacillus community was assessed by logistic regression analysis after adjustment for confounding factors. The proportion of Lactobacillus iners increased and that of Lactobacillus crispatus decreased according to body mass index (BMI) categories, i.e., underweight (BMI of <18.5 kg m(-2)), normal weight (BMI of 18.5 to 22.9 kg m(-2)), overweight (BMI of 23.0 to 24.9 kg m(-2)), and obese (BMI of ≥25 kg m(-2)). The L. iners-dominant type had a significant association with obesity (odds ratio [OR], 7.55 [95% confidence interval [CI], 1.18 to 48.2]), compared to the L. crispatus-dominant type. The group with high values for the ratio obtained by dividing the relative abundance of L. iners by that of L. crispatus had a significant association with obesity (OR, 6.54 [95% CI, 1.22 to 35.1]), compared to the low-ratio group. Associations between obesity and the L. iners/L. crispatus ratio were observed among young women (OR, 6.26 [95% CI, 1.15 to 33.9]) but not older women and in the normal group (OR, 6.97 [95% CI, 1.20 to 70.4]) but not the CIN group. Obesity was associated with cervical microflora dominated by L. iners in reproductive-age women without dysplasia.
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Oh HY, Kim BS, Seo SS, Kong JS, Lee JK, Park SY, Hong KM, Kim HK, Kim MK. The association of uterine cervical microbiota with an increased risk for cervical intraepithelial neoplasia in Korea. Clin Microbiol Infect 2015; 21:674.e1-9. [PMID: 25752224 DOI: 10.1016/j.cmi.2015.02.026] [Citation(s) in RCA: 119] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Revised: 01/04/2015] [Accepted: 02/26/2015] [Indexed: 12/19/2022]
Abstract
Recent studies have suggested potential roles of the microbiome in cervicovaginal diseases. However, there has been no report on the cervical microbiome in cervical intraepithelial neoplasia (CIN). We aimed to identify the cervical microbiota of Korean women and assess the association between the cervical microbiota and CIN, and to determine the combined effect of the microbiota and human papillomavirus (HPV) on the risk of CIN. The cervical microbiota of 70 women with CIN and 50 control women was analysed using pyrosequencing based on the 16S rRNA gene. The associations between specific microbial patterns or abundance of specific microbiota and CIN risk were assessed using multivariate logistic regression, and the relative excess risk due to interaction (RERI) and the synergy index (S) were calculated. The phyla Firmicutes, Actinobacteria, Bacteroidetes, Proteobacteria, Tenericutes, Fusobacteria and TM7 were predominant in the microbiota and four distinct community types were observed in all women. A high score of the pattern characterized by predominance of Atopobium vaginae, Gardnerella vaginalis and Lactobacillus iners with a minority of Lactobacillus crispatus had a higher CIN risk (OR 5.80, 95% CI 1.73-19.4) and abundance of A. vaginae had a higher CIN risk (OR 6.63, 95% CI 1.61-27.2). The synergistic effect of a high score of this microbial pattern and oncogenic HPV was observed (OR 34.1, 95% CI 4.95-284.5; RERI/S, 15.9/1.93). A predominance of A. vaginae, G. vaginalis and L. iners with a concomitant paucity of L. crispatus in the cervical microbiota was associated with CIN risk, suggesting that bacterial dysbiosis and its combination with oncogenic HPV may be a risk factor for cervical neoplasia.
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Affiliation(s)
- H Y Oh
- Division of Cancer Epidemiology and Management, National Cancer Centre, Ilsandong-gu, Goyang, Korea
| | - B-S Kim
- Chunlab Inc., Seoul National University, Seoul, Korea; Department of Life Science, Hallym University, Chuncheon, Korea
| | - S-S Seo
- Centre for Uterine Cancer, National Cancer Centre, Ilsandong-gu, Goyang, Korea
| | - J-S Kong
- Division of Cancer Epidemiology and Management, National Cancer Centre, Ilsandong-gu, Goyang, Korea
| | - J-K Lee
- Department of Obstetrics and Gynaecology, Korea University College of Medicine, Seoul, Korea
| | - S-Y Park
- Centre for Uterine Cancer, National Cancer Centre, Ilsandong-gu, Goyang, Korea
| | - K-M Hong
- Division of Cancer Biology, National Cancer Centre, Goyang-si, Korea
| | - H-K Kim
- Division of Cancer Biology, National Cancer Centre, Goyang-si, Korea
| | - M K Kim
- Division of Cancer Epidemiology and Management, National Cancer Centre, Ilsandong-gu, Goyang, Korea.
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Chih HJ, Lee AH, Colville L, Binns CW, Xu D. A review of dietary prevention of human papillomavirus-related infection of the cervix and cervical intraepithelial neoplasia. Nutr Cancer 2013; 65:317-28. [PMID: 23530631 DOI: 10.1080/01635581.2013.757630] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The natural history of cervical cancer suggests that prevention can be achieved by modification of the host's immune system through a nutrient-mediated program. This study reviews the preventive role of dietary intake on cervical intraepithelial neoplasia (CIN) induced by human papillomavirus (HPV). Electronic databases were searched using relevant keywords such as, but not limited to, human papillomavirus infection, cervical intraepithelial neoplasia, lifestyle factors, nutrients intake, and diet. High consumption of fruit and vegetables appears to be protective against CIN. The findings also highlight the possibility of consuming high levels of specific nutrients, vitamins, and minerals, and retaining sufficient level of these elements in the body, especially those with high antioxidants and antiviral properties, to prevent progression of transient and persistent HPV infections to high-grade CIN 2 and 3 (including in situ cervical cancer). The protective effect is not significant for high-risk HPV persistent infections and invasive cervical cancer. Although it appears that intake of specific nutrients, vitamins, and minerals may be good in CIN prevention, there is lack of evidence from controlled trial to confirm this. Health professionals shall focus on implementation of a balanced-diet prevention strategy at an early stage for cervical cancer prevention.
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Affiliation(s)
- Hui Jun Chih
- School of Public Health, Faculty of Health Sciences, Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia, Australia.
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Min KJ, Lee JK, Lee S, Kim MK. Alcohol consumption and viral load are synergistically associated with CIN1. PLoS One 2013; 8:e72142. [PMID: 23977233 PMCID: PMC3747046 DOI: 10.1371/journal.pone.0072142] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2013] [Accepted: 07/07/2013] [Indexed: 11/29/2022] Open
Abstract
Purpose We investigated the association between alcohol consumption and risk of cervical intraepithelial neoplasia (CIN) and cervical cancer, and determined whether these associations were modified by human papillomavirus (HPV) viral load in high-risk HPV-positive women participating in the Korean HPV cohort study (KHPV). Methods Among the women recruited in the KHPV (n = 1,243) from March 2006 to December 2009, we analyzed normal cytology (n = 581) as control group, CIN1 (n = 299), CIN2/3 (n = 161), or cervical cancer (n = 202). Multinomial logistic analysis was performed to estimate multivariate-adjusted odds ratios (OR). Results Alcohol drinkers had an increased risk of CIN1 (OR = 2.18, 95% CI 1.22–3.89) compared with non-drinkers after adjusting for potential confounders. Subjects with more frequent alcohol consumption had a higher risk of CIN1 (p for linear trend <0.0001). Higher ethanol consumption was associated with an increased risk of CIN1 (p for linear trend = 0.0001). We also observed a synergistic effect between HPV viral load and alcohol consumption: drinkers with a high HPV viral load (≥100 RLU/PC) were associated with a significantly increased risk of CIN1 (OR = 19.1; 95% CI, 6.60–55.3, interaction p<0.001). There were no associations between alcohol drinking and CIN2/3 or cervical cancer. Conclusions HPV viral load and alcohol was associated with the risk of CIN1 among high-risk HPV-positive women. This is the first demonstration that alcohol is an independent and combined risk factor of CIN1.
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Affiliation(s)
- Kyung-Jin Min
- Department of Obstetrics and Gynecology, Inha University Hospital, Incheon, Korea
| | - Jae-Kwan Lee
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea
| | - Sanghoon Lee
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea
| | - Mi Kyung Kim
- Carcinogenesis Branch, Division of Cancer Epidemiology and Management, National Cancer Center, Goyang, Korea
- * E-mail:
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Mild obesity, physical activity, calorie intake, and the risks of cervical intraepithelial neoplasia and cervical cancer. PLoS One 2013; 8:e66555. [PMID: 23776686 PMCID: PMC3680419 DOI: 10.1371/journal.pone.0066555] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Accepted: 05/08/2013] [Indexed: 01/02/2023] Open
Abstract
Objective We investigated whether obesity, physical activity, and calorie intake are associated with the risks of cervical intraepithelial neoplasia (CIN) and cervical cancer. Methods We enrolled 1125 women (age, 18–65 years) into a human papillomavirus cohort study established from 2006 to 2012. Multinomial logistic regression models were used to estimate crude and multivariate odds ratios (ORs) and the corresponding 95% confidence intervals (95% CIs), and to assess whether body mass index (BMI), height, weight, total calorie intake, and physical activity were associated with the risks of CIN and cervical cancer. Results Cervical cancer risk was positively associated with BMI and inversely associated with physical activity. When compared with women with a normal BMI (18.5–23 kg/m2), the multivariate ORs (95% CIs) for those overweight (23–25 kg/m2) and mild obesity (≥25 kg/m2) were 1.25 (0.79–2.00) and 1.70 (1.10–2.63), respectively. When compared with women with the lowest tertile of physical activity (<38.5 MET-hours/week), the ORs (95% CIs) for cervical cancer were 0.95 (0.61–1.48) and 0.61 (0.38–0.98) for women with medium physical activity (38.5–71.9 MET-hours/week) and those with high physical activity (72 MET-hours/week), respectively (p for linear trend = 0.03). The CIN2/3 risk was inversely associated with physical activity after adjustment for confounders. Compared with women with low physical activity (< 38.5 MET-hours/week), the ORs (95% CIs) for CIN2/3 were 0.64 (0.40–1.01) and 0.58 (0.36–0.93) for the medium and high physical activity groups, respectively (p for linear trend = 0.02). Total calorie intake was not statistically associated with the risks of CIN and cervical cancer after adjustment for confounders. Conclusion Our results indicate that in addition to screening for and treatment of CIN, recommendations on the maintenance of an appropriate BMI with an emphasis on physical activity could be an important preventive strategy against the development of cervical cancer.
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Piyathilake CJ, Badiga S, Kabagambe EK, Azuero A, Alvarez RD, Johanning GL, Partridge EE. A dietary pattern associated with LINE-1 methylation alters the risk of developing cervical intraepithelial neoplasia. Cancer Prev Res (Phila) 2012; 5:385-92. [PMID: 22262813 DOI: 10.1158/1940-6207.capr-11-0387] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
There is a paucity of research examining the relationships between dietary patterns and risk of developing precancerous lesions as well as biomarkers associated with such dietary patterns. The purpose of the current study was to identify dietary patterns that are associated with higher grades of cervical intraepithelial neoplasia (CIN 2+) and to determine whether these dietary patterns are associated with the degree of DNA methylation in the long interspersed nucleotide elements (L1s) of peripheral blood mononuclear cells (PBMCs), a biomarker associated with risk of developing CIN 2+. Study population consisted of 319 child-bearing age women. Dietary patterns were derived by factor analysis. The degree of PBMC L1 methylation was assessed by pyrosequencing. Logistic regression models were used to evaluate the associations between dietary patterns and CIN 2+. Similar models were used to evaluate the associations between dietary patterns and degree of PBMC L1 methylation in women free of CIN 2+. Women with the unhealthiest dietary pattern were 3.5 times more likely to be diagnosed with CIN 2+ than women with the healthiest dietary pattern [OR = 3.5; 95% confidence interval (CI), 1.2-10.1; P = 0.02]. Women at risk for developing CIN 2+ with the healthiest dietary pattern were 3.3 times more likely to have higher PBMC L1 methylation than women with the unhealthiest dietary pattern (OR = 3.3; 95% CI, 1.0-10.6; P = 0.04). Our findings suggest that human papilloma virus associated risk of developing CIN 2+ may be reduced by improving dietary patterns. The degree of PBMC L1 methylation may serve as a biomarker for monitoring the effectiveness of dietary modifications needed for reducing the risk of CIN 2+.
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Affiliation(s)
- Chandrika J Piyathilake
- Department of Nutrition Sciences, University of Alabama at Birmingham, 1675 University Blvd, Webb 326, Birmingham, AL 35294, USA.
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Feng CY, Lin M, Lakhaney D, Sun HK, Dai XB, Zhao FH, Qiao YL. The association between dietary intake and cervical intraepithelial neoplasia grade 2 or higher among women in a high-risk rural area of china. Arch Gynecol Obstet 2010; 284:973-80. [DOI: 10.1007/s00404-010-1743-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2010] [Accepted: 10/19/2010] [Indexed: 11/28/2022]
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