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Kohler RE, Wagner RB, Vega J, Rivera YM, Kantor L, Greene K. HPV Vaccination Information Access, Needs, and Preferences Among Black and Hispanic Mothers. JOURNAL OF HEALTH COMMUNICATION 2024; 29:566-579. [PMID: 39129253 PMCID: PMC11384291 DOI: 10.1080/10810730.2024.2386594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/13/2024]
Abstract
HPV-associated cancer disparities disproportionately affect Black/African American and Hispanic individuals in the U.S. HPV vaccination, which can prevent many HPV-associated cancers, should be clearly recommended by pediatricians to parents of adolescents aged 9-12, yet uptake and completion remain lower than other adolescent vaccinations. We used the Structural Influence Model of Health Communication to explore communication inequalities from interviews with 19 Black and Hispanic mothers of adolescents. We identified HPV vaccination information seeking behaviors, media use, and preferred channels to address information needs. This study provides insights into how mothers' nativity and ethno-racial identity influenced how they accessed and processed information from various sources. Preferences for digital and community-based strategies to address information gaps and hesitancy concerns are also presented. Findings suggest future prevention strategies must increase access to accurate information that resonates with NH-Black and Hispanic communities' needs and is disseminated via preferred communication channels to maximize the effects of multi-level interventions promoting HPV vaccination among communities experiencing disparities.
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Affiliation(s)
- Racquel E Kohler
- Center for Cancer Health Equity, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
- School of Public Health, Rutgers University, Piscataway, New Jersey, USA
| | - Rachel B Wagner
- Center for Cancer Health Equity, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
- School of Public Health, Rutgers University, Piscataway, New Jersey, USA
| | - Jacqueline Vega
- Center for Cancer Health Equity, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
- School of Public Health, Rutgers University, Piscataway, New Jersey, USA
| | - Yonaira M Rivera
- School of Communication & Information, Rutgers University, New Brunswick, New Jersey, USA
| | - Leslie Kantor
- School of Public Health, Rutgers University, Piscataway, New Jersey, USA
| | - Kathryn Greene
- School of Communication & Information, Rutgers University, New Brunswick, New Jersey, USA
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2
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Agénor M, Noh M, Eiduson R, LeBlanc M, Line EC, Goldman RE, Potter J, Austin SB. Barriers to and opportunities for advancing racial equity in cervical cancer screening in the United States. BMC Womens Health 2024; 24:362. [PMID: 38907205 PMCID: PMC11191319 DOI: 10.1186/s12905-024-03151-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 05/17/2024] [Indexed: 06/23/2024] Open
Abstract
BACKGROUND In the United States (U.S.), racially minoritized people have higher rates of cervical cancer morbidity and mortality compared to white individuals as a result of racialized structural, social, economic, and health care inequities. However, cervical cancer screening guidelines are based on studies of predominately white individuals and do not substantially discuss or address racialized cervical cancer inequities and their social determinants, including racism. METHODS We conducted in-depth interviews with health care providers (N = 30) and key informants with expertise in health equity (N = 18). We utilized semi-structured interview guides that addressed providers' views and experiences delivering cervical cancer screening to racially minoritized individuals and key informants' recommendations for advancing racial equity in the development and implementation of cervical cancer screening guidelines. Interviews were analyzed using a template style thematic analysis approach involving deductive and inductive coding, memo writing, and matrix analysis for theme development. RESULTS Most health care providers adopted a universal, one-size-fits-all approach to cervical cancer screening with the stated goal of ensuring racial equality. Despite frequently acknowledging the existence of racialized cervical cancer inequities, few providers recognized the role of social inequities in influencing them, and none discussed the impact of racism. In contrast, key informants overwhelmingly recommended that providers adopt an approach to cervical cancer screening and follow-up care that recognizes the role of racism in shaping racialized cervical cancer and related social inequities, is developed in partnership with racially minoritized communities, and involves person-centered, structurally-competent, and trauma-informed practices that address racially minoritized peoples' unique lived experiences in historical and social context. This racism-conscious approach is not to be confused with race-based medicine, which is an essentialist and racist approach to health care that treats race as a biological variable rather than as a social and political construct. CONCLUSIONS Developers and implementers of cervical cancer screening guidelines should explicitly recognize and address the impact of racism on cervical cancer screening, follow-up care, and outcomes, meaningfully incorporate racially minoritized communities' perspectives and experiences, and facilitate provider- and institutional-level practices that foster racial equity in cervical cancer.
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Affiliation(s)
- Madina Agénor
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA.
- Center for Health Promotion and Health Equity, Brown University School of Public Health, Providence, RI, USA.
- Department of Epidemiology, Brown University School of Public Health, MPH Box G-S121-4, Providence, RI, 02912, USA.
- The Fenway Institute, Fenway Health, Boston, MA, USA.
| | - Madeline Noh
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
- Center for Health Promotion and Health Equity, Brown University School of Public Health, Providence, RI, USA
| | - Rose Eiduson
- Larner College of Medicine, University of Vermont, Burlington, VT, USA
| | - Merrily LeBlanc
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Department of Sociology, Northeastern University, Boston, MA, USA
| | - Emmett C Line
- Teachers College, Columbia University, New York, NY, USA
| | - Roberta E Goldman
- Department of Family Medicine, Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Jennifer Potter
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - S Bryn Austin
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
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3
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Santana C, Pines HA, Lemus H, Martinez ME, Nodora JN, Pulgarin SP, Crespo NC, Madanat H, McDaniels-Davidson C. HPV Vaccine Misperceptions Among Hispanics/Latinos in Southern California. J Racial Ethn Health Disparities 2024; 11:1557-1563. [PMID: 37195591 PMCID: PMC10191090 DOI: 10.1007/s40615-023-01631-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 04/20/2023] [Accepted: 05/04/2023] [Indexed: 05/18/2023]
Abstract
BACKGROUND Cervical and other vaccine-preventable HPV-associated cancers disproportionately impact Hispanic/Latinos in the USA. HPV vaccine uptake may be impacted by community agreement with common HPV vaccine misperceptions. It is unknown whether Hispanics/Latinos have a greater agreement with these misperceptions relative to non-Hispanic whites. METHODS HPV vaccine misperceptions were assessed through a 12-item Likert scale included in a population health assessment mailed to households in the southwest United States. Linear regression models assessed the association between identifying as Hispanic/Latino and summed misperception score. RESULTS Among the 407 individuals in the analytic sample, 111 (27.3%) were Hispanic/Latino and 296 (72.7%) were non-Hispanic white. On average, Hispanics/Latinos had a 3.03-point higher HPV vaccine misperception sum score relative to non-Hispanic whites, indicating greater agreement with misperceptions (95% confidence interval: 1.16-4.88; p < 0.01). DISCUSSION Culturally relevant interventions are needed to address HPV vaccine misperceptions among Hispanics/Latinos as part of efforts toward HPV-associated cancer health equity.
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Affiliation(s)
- Christina Santana
- School of Public Health, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182-4162, USA
| | - Heather A Pines
- School of Public Health, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182-4162, USA
- School of Public Health and Human Longevity Science, University of California San Diego, San Diego Herbert Wertheim, San Diego, CA, USA
| | - Hector Lemus
- School of Public Health, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182-4162, USA
| | - Maria Elena Martinez
- School of Public Health and Human Longevity Science, University of California San Diego, San Diego Herbert Wertheim, San Diego, CA, USA
- Moores Cancer Center, San Diego Health, University of California, 5500 Campanile Drive, San Diego, CA, 92182-4162, USA
| | - Jesse N Nodora
- School of Public Health and Human Longevity Science, University of California San Diego, San Diego Herbert Wertheim, San Diego, CA, USA
- Moores Cancer Center, San Diego Health, University of California, 5500 Campanile Drive, San Diego, CA, 92182-4162, USA
| | - Salma Parra Pulgarin
- School of Public Health and Human Longevity Science, University of California San Diego, San Diego Herbert Wertheim, San Diego, CA, USA
| | - Noe C Crespo
- School of Public Health, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182-4162, USA
- Moores Cancer Center, San Diego Health, University of California, 5500 Campanile Drive, San Diego, CA, 92182-4162, USA
| | - Hala Madanat
- School of Public Health, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182-4162, USA
- Division of Research and Innovation, San Diego State University, San Diego, CA, USA
| | - Corinne McDaniels-Davidson
- School of Public Health, San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182-4162, USA.
- Moores Cancer Center, San Diego Health, University of California, 5500 Campanile Drive, San Diego, CA, 92182-4162, USA.
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Stephens ES, Dema E, McGee-Avila JK, Shiels MS, Kreimer AR, Shing JZ. Human Papillomavirus Awareness by Educational Level and by Race and Ethnicity. JAMA Netw Open 2023; 6:e2343325. [PMID: 37962885 PMCID: PMC10646733 DOI: 10.1001/jamanetworkopen.2023.43325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 10/04/2023] [Indexed: 11/15/2023] Open
Abstract
Importance Understanding disparities in human papillomavirus (HPV) awareness is crucial, given its association with vaccine uptake. Objective To investigate differences in HPV awareness by educational attainment, race, ethnicity, and their intersectionality. Design, Setting, and Participants This cross-sectional study used the Health Information National Trends Survey (HINTS) 5 cycles 1 to 4 data (January 26, 2017, to June 15, 2020). The data were analyzed from December 12, 2022, to June 20, 2023. A sample of the noninstitutionalized civilian US population 18 years or older was included in the analysis. Main Outcomes and Measures Weighted prevalence of HPV awareness, HPV vaccine awareness, and knowledge that HPV causes cancer, stratified by educational attainment and by race and ethnicity. Interaction between educational attainment and race and ethnicity was assessed using a Wald test. Results A total of 15 637 participants had educational attainment data available; of these, 51.2% were women, and the median age was 58 (IQR, 44-69) years. A total of 14 444 participants had race and ethnicity information available; of these, 4.6% were Asian, 13.9% were Black, 15.3% were Hispanic, 62.6% were White, and 3.6% were of other race or ethnicity (including American Indian or Alaska Native, Native Hawaiian or Other Pacific Islander, and more than 1 race or ethnicity). Awareness of HPV by educational attainment ranged from 40.4% for less than high school to 78.2% for college or higher; awareness by race and ethnicity ranged from 46.9% among Asian individuals to 70.2% among White individuals. Awareness of HPV vaccines across educational attainment ranged from 34.7% among those with less than high school to 74.7% among those with a college degree or higher and by race and ethnicity from 48.4% among Asian individuals to 68.2% among White individuals. Among adults who were aware of HPV, knowledge that HPV causes cervical cancer differed by educational attainment, ranging from 51.7% among those with less than high school to 84.7% among those with a college degree or higher, and by race and ethnicity, ranging from 66.0% among Black individuals to 77.9% among Asian individuals. The interaction between educational attainment and race and ethnicity on HPV awareness and HPV vaccine awareness was not significant; however, within each educational attainment level, awareness differed by race and ethnicity, with the lowest awareness consistently among Asian individuals regardless of educational attainment. Within each racial and ethnic group, HPV awareness and HPV vaccine awareness significantly decreased with decreasing educational attainment. Conclusions and Relevance Disparities in HPV awareness were evident across social factors, with the lowest awareness among Asian individuals and individuals with lower educational attainment. These results emphasize the importance of considering social factors in HPV awareness campaigns to increase HPV vaccination.
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Affiliation(s)
- Erica S. Stephens
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Emily Dema
- Institute for Global Health, University College London, London, United Kingdom
| | - Jennifer K. McGee-Avila
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Meredith S. Shiels
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Aimée R. Kreimer
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Jaimie Z. Shing
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
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Shin MB, Sloan KE, Martinez B, Soto C, Baezconde-Garbanati L, Unger JB, Kast WM, Cockburn M, Tsui J. Examining multilevel influences on parental HPV vaccine hesitancy among multiethnic communities in Los Angeles: a qualitative analysis. BMC Public Health 2023; 23:545. [PMID: 36949438 PMCID: PMC10031192 DOI: 10.1186/s12889-023-15318-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 02/24/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND Human papillomavirus (HPV) vaccine hesitancy is a growing concern in the United States, yet understudied among racial/ethnic minority parents. We conducted qualitative research to understand parental HPV vaccine hesitancy and inform community-specific, multilevel approaches to improve HPV vaccination among diverse populations in Los Angeles. METHODS We recruited American Indian/Alaska Native (AI/AN), Hispanic/Latino/a (HL) and Chinese parents of unvaccinated children (9-17 years) from low-HPV vaccine uptake regions in Los Angeles for virtual focus groups (FGs). FGs were conducted in English (2), Mandarin (1), and Spanish (1) between June-August 2021. One English FG was with AI/AN-identifying parents. FGs prompted discussions about vaccine knowledge, sources of information/hesitancy, logistical barriers and interpersonal, healthcare and community interactions regarding HPV vaccination. Guided by the social-ecological model, we identified multilevel emergent themes related to HPV vaccination. RESULTS Parents (n = 20) in all FGs reported exposure to HPV vaccine information from the internet and other sources, including in-language media (Mandarin) and health care providers (Spanish). All FGs expressed confusion around the vaccine and had encountered HPV vaccine misinformation. FGs experienced challenges navigating relationships with children, providers, and friends/family for HPV vaccine decision-making. At the community-level, historical events contributed to mistrust (e.g., forced community displacement [AI/AN]). At the societal-level, transportation, and work schedules (Spanish, AI/AN) were barriers to vaccination. Medical mistrust contributed to HPV vaccine hesitancy across the analysis levels. CONCLUSION Our findings highlight the importance of multilevel influences on parental HPV vaccine hesitancy and decision-making and the need for community-specific messaging to combat medical mistrust and other barriers to HPV vaccination among racial/ethnic minority communities.
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Affiliation(s)
- Michelle B Shin
- Department of Child, Family, and Population Health Nursing, School of Nursing, University of Washington, Seattle, WA, United States
| | - Kylie E Sloan
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Bibiana Martinez
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Claradina Soto
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Lourdes Baezconde-Garbanati
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jennifer B Unger
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - W Martin Kast
- Department of Molecular Microbiology & Immunology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Myles Cockburn
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jennifer Tsui
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
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6
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Magana K, Strand L, Love M, Moore T, Peña A, Ito Ford A, Vassar M. Health inequities in human papillomavirus prevention, diagnostics and clinical care in the USA: a scoping review. Sex Transm Infect 2023; 99:128-136. [PMID: 36396174 DOI: 10.1136/sextrans-2022-055587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 10/31/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Human papillomavirus (HPV) represents the most common STI in the USA. HPV inequities in prevention, diagnostics and clinical care persist. We define inequities as systematic, avoidable and unfair differences in health outcomes. OBJECTIVES The objectives of this scoping review are to chart existing data on HPV-related inequities, identify gaps in existing literature and guide future research to reduce these inequities. METHODS We completed a scoping review following guidelines from the Joanna Briggs Institute and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses scoping reviews extension. We performed a literature search on PubMed and Ovid Embase in July 2022 for articles pertaining to HPV and evaluating populations within the USA. We included English language publications from 2018 to 2022 evaluating at least one health inequity outlined by the National Institutes of Health. General publication characteristics and health inequity data were charted in a masked, duplicate fashion using a pilot-tested Google Form. We analysed frequencies of health inequities and summarised main findings from included studies. RESULTS Our final sample included 170 publications. The most common inequities examined were race/ethnicity (140 studies), sex or gender (97 studies), and income (69 studies). Many historically marginalised racial/ethnic groups had lower rates of HPV-related knowledge, vaccination and worse overall outcomes related to HPV. Compared with women, men had lower rates of HPV vaccination and provider recommendation, and higher rates of HPV-infection. Results regarding income were largely conflicting. CONCLUSION Findings from our review demonstrate clear gaps in HPV-related inequity research. Vaccine completion, provider recommendation and intersectionality should continue to be evaluated to implement targeted interventions.
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Affiliation(s)
- Kimberly Magana
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Laura Strand
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Mitchell Love
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Ty Moore
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Andriana Peña
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Alicia Ito Ford
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA.,Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Matt Vassar
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA.,Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
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Najioullah F, Dorival MJ, Joachim C, Dispagne C, Macni J, Abel S, Sulpicy C, Charpentier-Baltide H, Sainte-Rose D, Salomon-Frechou B, Dieye M, Véronique-Baudin J, Pré M, Marquet M, Wan-Ajouhu G, Janky E, Riethmuller D, Cesaire R. Genotype distribution of cervical HPV among Caribbean women in a population-based study in Martinique: The DEPIPAPUFR study. PLoS One 2021; 16:e0257915. [PMID: 34618835 PMCID: PMC8496807 DOI: 10.1371/journal.pone.0257915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 09/13/2021] [Indexed: 12/09/2022] Open
Abstract
The Caribbean ranks seventh among the world regions most affected by cervical cancer. HPV-prevalence and genotype distributions also differ from regions. Knowledge of HPV genotype profiles is important for patients care and HPV vaccination implementation. The objective of this study was to describe HPV genotype distribution and risk factors in a population-based cohort of women in Martinique. In this study, 1312 women were included and underwent cervical cancer screening with successful sample collection between 2009 and 2014. Sociodemographic and clinical variables were recorded. Cytological examination of cervical vaginal smear was performed and classified(Bethesda). Detection of HPV DNA was performed with the PapilloCheck© Kit from Greiner Bio-one. Genotypes were analyzed for18 high-risk HPV (hrHPV) and 6low-risk HPV(lrHPV) types. A total of 1075 women were included with a mean age of 49.1±10.5 years. HPV prevalence was 27.6% (297/1075) with 19.4% (209/1075) women with only hrHPV, 5.3% (57/1075) with only lrHPV. Multiple infections (hrHPV/lrHPV) were detected in 31/240 cases of hrHPV (12.9%). A total of 353 hrHPV genotypes were analyzed; the most common HPV types were HPV51 (11.0%), HPV68 (10.8%), HPV53 (9.1%) and HPV 52 (7.1%). HPV16 and HPV18 represented respectively 4.8% and 4.0% of hrHPV genotypes. Abnormal cytology was observed in 34 cases (3.2%), with 14 ASCUS (1.3%), 10 LSIL (0.9%), 5 HSIL (0.5%), 3 ASC-H (0.3%) and 2 AGC (0.2%). Fifteen (44.1%) were hrHPV and 4 (14.7%) lrHPV; 7 cases of hrPHV were in the age-group 25-34 years. Among 1041cases of normal cytology, 225 had positive hrHPV detection (21.6%). This is the first population-based study of HPV profiles in our country, and we found a high prevalence of hrHPV. The most common genotypes were HPV51, 68, 53. These results could serve for cancer vaccination strategies and HPV surveillance in Martinique.
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Affiliation(s)
- Fatiha Najioullah
- CHU de Martinique, Pôle de Biologie - Pathologie, Laboratoire de Virologie, Martinique, France
| | | | - Clarisse Joachim
- CHU de Martinique, Pôle de Cancérologie Hématologie Urologie, UF1441 Registre Général des cancers de la Martinique, Martinique, France
- * E-mail:
| | | | - Jonathan Macni
- CHU de Martinique, Pôle de Cancérologie Hématologie Urologie, UF1441 Registre Général des cancers de la Martinique, Martinique, France
| | - Sylvie Abel
- Service de Maladies Infectieuses et Tropicales, CHU de Martinique, Martinique, France
| | - Caroline Sulpicy
- Laboratoire de Pathologie SERAL, Fort-de-France, Martinique, France
| | | | | | | | | | - Jacqueline Véronique-Baudin
- CHU de Martinique, Pôle de Cancérologie Hématologie Urologie, UF1441 Registre Général des cancers de la Martinique, Martinique, France
| | | | | | | | - Eustase Janky
- CHU de Guadeloupe-Laboratory CELTEC Cancer and Environment EA4546, Université des Antilles, Guadeloupe, France
| | - Didier Riethmuller
- Service de Gynécologie Obstétrique, CHRU de Besançon - Hôpital Jean Minjoz, Besançon, France
| | - Raymond Cesaire
- CHU de Martinique, Pôle de Biologie - Pathologie, Laboratoire de Virologie, Martinique, France
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