1
|
Rizkalla CN, Huang EC. Cervical Human Papillomavirus Testing: Current and Future Impact on Patient Care. Surg Pathol Clin 2024; 17:431-439. [PMID: 39129141 DOI: 10.1016/j.path.2024.04.006] [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] [Indexed: 08/13/2024]
Abstract
Cervical cancer is the fourth most common malignancy in women worldwide. The identification of human papillomavirus (HPV) as the main etiologic cause of cervical cancer has led to the development and adaptation of HPV molecular diagnostics as a cervical cancer screening and prevention tool. This article highlights six Food and Drug Administration-approved HPV molecular platforms, each with unique advantages and disadvantages. In addition, HPV vaccination and the emergence of HPV self-collection as an alternative testing strategy are discussed.
Collapse
Affiliation(s)
- Carol N Rizkalla
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, 1959 NE Pacific Street, Box 357470, Seattle, WA 98195, USA. https://twitter.com/Carol2Path
| | - Eric C Huang
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Harborview Medical Center, 325 9th Avenue, Box 359791, Seattle, WA 98104, USA.
| |
Collapse
|
2
|
Han Q, Guo H, Wu Z, Shi J, Zhang X. Efficacy and Safety of 5-Aminolevulinic Acid Photodynamic Therapy for Treating Cervical and Vaginal Intraepithelial Neoplasia. Pharmaceutics 2024; 16:627. [PMID: 38794289 PMCID: PMC11126115 DOI: 10.3390/pharmaceutics16050627] [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: 03/27/2024] [Revised: 05/02/2024] [Accepted: 05/05/2024] [Indexed: 05/26/2024] Open
Abstract
Persistent HPV infections may cause cervical and vaginal intraepithelial neoplasia (CIN and VaIN). Traditional methods might destroy the structure and function of the cervix. 5-aminolevulinic acid photodynamic therapy (ALA-PDT) is a non-invasive targeted therapy. This study aims to evaluate the efficacy and safety of ALA-PDT for CIN and VaIN and the clearance of HPV. A retrospective study of 303 patients who confirmed CIN or VaIN and received ALA-PDT was conducted. All the patients were followed up at six and twelve months after treatment and then annually thereafter. The effect was evaluated through HPV genotyping, a cytology test, and colposcopy-directed biopsy if necessary. After ALA-PDT, the remission rates for CIN 2, CIN 3, VaIN 2, and VaIN 3 were 90.6%, 88.5%, 87.3%, and 77.8%. For CIN 1, the remission rate at the six-month follow-up was 93.1%. The total HPV clearance rates were 72.5% at the six-month follow-up and 85.7% at the 12-month follow-up. The most common adverse event was vaginal discharge. No severe adverse effect was observed. ALA-PDT is an effective and safe treatment for all grades of CIN and VaIN and is helpful in clearing HPV with minimal side effects. This treatment may not influence fertility and delivery.
Collapse
Affiliation(s)
- Qin Han
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China; (H.G.)
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
| | - Hongyan Guo
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China; (H.G.)
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
| | - Zhangxin Wu
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China; (H.G.)
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
| | - Jiaxin Shi
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China; (H.G.)
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
| | - Xue Zhang
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China; (H.G.)
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
| |
Collapse
|
3
|
Sakai M, Ohara T, Suzuki H, Kadomoto T, Inayama Y, Shitanaka S, Sumitomo M, Matsumura N, Yamanoi K. Clinical impact of age‑specific distribution of combination patterns of cytology and high‑risk HPV status on cervical intraepithelial neoplasia grade 2 or more. Oncol Lett 2023; 26:384. [PMID: 37559589 PMCID: PMC10407864 DOI: 10.3892/ol.2023.13970] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 06/29/2023] [Indexed: 08/11/2023] Open
Abstract
To the best of our knowledge, the present study is the first to elucidate the significance of cytology and high-risk human papillomavirus (hrHPV) status in different age groups for the detection of cervical intraepithelial neoplasia (CIN)2, CIN3 and squamous cell carcinoma (SCC). There were 12 combinations based on cytology and hrHPV status [cytology: Atypical squamous cells (ASC) of undetermined significance, low-grade squamous intraepithelial lesion, ASC not excluding high-grade squamous intraepithelial lesion (HSIL) and HSIL; hrHPV status: HPV16/18-positive (16/18+), hrHPV positive for subtypes other than 16/18 (others+) and hrHPV-negative (hrHPV-)]. All patients were categorized into four groups based on age (18-29, 30-39, 40-49 and ≥50 years). For patients with CIN2, CIN3 and SCC (CIN2+) (n=107), the distribution of cytology and hrHPV was investigated in each age group. In addition, for all patients (n=446), the occurrence of CIN2+ in each of the 12 combinations was investigated in each age group. In the 18-29-year age group, the most common combination was HSIL and 16/18+, followed by HSIL and others+, which accounted for 73% of CIN2+ cases. The occurrence of HSIL and 16/18+ decreased with increasing age, and no cases occurred in the 50-year age group. In the 18-29-year age group, all patients with HSIL and 16/18+ were diagnosed with CIN2+. CIN2+ was predominantly detected in patients with HSIL in the 18-29-year age group, as well as hrHPV- and others+. This definite distinction was not observed in any other age group. For CIN2+, the distribution patterns of cytology and hrHPV status combinations varied significantly among different age groups. Accordingly, the clinical impact of the combination of cytological findings and hrHPV status can vary among age groups.
Collapse
Affiliation(s)
- Mie Sakai
- Department of Obstetrics and Gynecology, Toyooka Public Hospital, Toyooka, Hyogo 663-8501, Japan
- Department of Obstetrics and Gynecology, Shiga General Hospital, Moriyama, Shiga 524-8524, Japan
| | - Tsutomu Ohara
- Department of Obstetrics and Gynecology, Toyooka Public Hospital, Toyooka, Hyogo 663-8501, Japan
- Department of Obstetrics and Gynecology, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
| | - Haruka Suzuki
- Department of Obstetrics and Gynecology, Toyooka Public Hospital, Toyooka, Hyogo 663-8501, Japan
- Department of Obstetrics and Gynecology, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
| | - Tatsuki Kadomoto
- Department of Obstetrics and Gynecology, Toyooka Public Hospital, Toyooka, Hyogo 663-8501, Japan
| | - Yoshihide Inayama
- Department of Obstetrics and Gynecology, Toyooka Public Hospital, Toyooka, Hyogo 663-8501, Japan
- Department of Obstetrics and Gynecology, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
| | - Shimpei Shitanaka
- Department of Obstetrics and Gynecology, Toyooka Public Hospital, Toyooka, Hyogo 663-8501, Japan
- Department of Obstetrics and Gynecology, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
| | - Masahiro Sumitomo
- Department of Obstetrics and Gynecology, Toyooka Public Hospital, Toyooka, Hyogo 663-8501, Japan
| | - Noriomi Matsumura
- Department of Obstetrics and Gynecology, Kindai University Graduate School of Medicine, Osakasayama, Osaka 589-8511, Japan
| | - Koji Yamanoi
- Department of Obstetrics and Gynecology, Toyooka Public Hospital, Toyooka, Hyogo 663-8501, Japan
- Department of Obstetrics and Gynecology, Kyoto University Graduate School of Medicine, Kyoto 606-8507, Japan
| |
Collapse
|
4
|
Al Sad S, Pandit R, Alhashim N, Abdel-Rasoul M. Primary care Providers' approaches to cervical cancer screening in Muslim females. Prev Med Rep 2023; 32:102126. [PMID: 36852309 PMCID: PMC9958399 DOI: 10.1016/j.pmedr.2023.102126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 02/07/2023] Open
Abstract
The utilization of the Papanicolaou (Pap) test and the human papillomavirus (HPV) vaccine has significantly decreased rates of cervical cancer and related mortality. Disparities in receiving these preventive screenings are scarcely studied in Muslim females. Our study explores primary care providers' (PCP) approaches to cervical cancer screening in Muslim females. We created a cross-sectional Qualtrics survey using convenience sampling of PCPs who perform Pap tests in central Ohio. Recruitment emails were disseminated via departmental email listservs. We had 200 analyzable responses and 78% of respondents reported having Muslim patients. Bivariate analysis was used to identify predictors of providers' approaches. Providers younger than 35 years obtained a sexual history from Muslim females less frequently, family medicine providers were more likely to obtain a sexual history from Muslim females, and gynecologists were more likely to offer the HPV vaccine to Muslim females. Providers who counseled patients about Pap tests (P<0.001) and HPV modes of transmission (P<0.004) were more likely to offer cervical cancer screening for Muslim females. Our findings suggested that providers' age and specialty may be predictors of proactive cervical cancer screening and prevention in Muslim females and that there is a gap between current guidelines and preventive clinical practices regarding the HPV vaccine and transmission counseling.
Collapse
Affiliation(s)
- Sondos Al Sad
- Women Health Primary Care Center, Family and Community Medicine Department, University of California San Francisco, 2356 Sutter St, San Francisco, CA 94115, USA,Corresponding author.
| | - Radhika Pandit
- The Ohio State University College of Medicine, 370 W 9th Ave, Columbus, OH 43210, USA
| | | | - Mahmoud Abdel-Rasoul
- The Ohio State University College of Medicine, Center for Biostatistics, 1800 Cannon Drive Columbus, OH 43210, USA
| |
Collapse
|
5
|
Zhao X, Hu S, Zhao S, Rezhake R, Huang L, Duan X, Zhang X, Qiao Y, Arbyn M, Zhao F. Risk assessment of self-sampling HPV tests based on PCR, signal amplification to guide the appropriate screening intervals: A prospective study in China. JOURNAL OF THE NATIONAL CANCER CENTER 2022; 2:298-305. [PMID: 39036548 PMCID: PMC11256609 DOI: 10.1016/j.jncc.2022.08.002] [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: 04/11/2022] [Revised: 07/26/2022] [Accepted: 08/04/2022] [Indexed: 11/21/2022] Open
Abstract
Objective We assessed the longitudinal risk of developing cervical intraepithelial neoplasia (CINs) with self-sampling human papillomavirus (HPV) tests, based on polymerase chain reaction (PCR) and signal amplification (careHPV), to explore the appropriate intervals for cervical cancer screening. Methods A prospective study was conducted in China during 2017-2020. Participants were invited for PCR and careHPV tests with self-samples at baseline. Women positive in either HPV test underwent colposcopy and biopsy if necessary. Women with baseline CIN grade one (CIN1) or less were followed up over 3 years. The absolute risk was assessed by the immediate risk (IR) and cumulative risk (CR), and the relative risk was assessed by the hazard ratio (HR) with a 95% confidence interval (CI). Results A total of 8,126 women were included in the final analysis. Women positive for the PCR HPV test had comparable IRs of CIN2+ and CIN3+ to those positive on the careHPV test. With triage by HPV genotyping, women with HPV 16/18 infection had the highest IRs of CIN2+ (21.15%) and CIN3+ (9.67%). For CR, women negative for PCR HPV test had a lower risk of CIN2+ than that reported in women negative on careHPV test (0.57% versus 0.98%, HR = 0.58, 95% CI: 0.38, 0.87), but no significant difference was found in the CRs of CIN3+ between them (0.25% versus 0.39%, HR = 0.64, 95% CI: 0.34, 1.20). Among women with CIN1 or less at baseline, women who were persistent or recurrent positive on careHPV or PCR HPV test had a higher risk of developing CIN3+ (11.36%-14.59%), compared with women remained HPV negative from baseline throughout follow-up (≤0.28%). Conclusions Routine screening with 3-year intervals is acceptable for self-sampling HPV tests based on PCR or careHPV test. Women positive on HPV16/18 triaging at baseline or with CIN1 or less at baseline while being persistent or recurrent positive on careHPV or PCR HPV test during 3-year follow-up require immediate colposcopy or treatment.
Collapse
Affiliation(s)
- Xuelian Zhao
- Department of Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shangying Hu
- Department of Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shuang Zhao
- Clinical Trial Research Center,Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Remila Rezhake
- Department of Cancer Research Institute, Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi, China
| | - Liuye Huang
- Department of Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xianzhi Duan
- Department of Obstetrics and Gynecology, Beijing Tongren Hospital, Beijing, China
| | - Xun Zhang
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Youlin Qiao
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Marc Arbyn
- Unit of Cancer Epidemiology, Belgian Cancer Centre, Sciensano, Brussels, Belgium
| | - Fanghui Zhao
- Department of Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| |
Collapse
|
6
|
Qi L, Li N, Lin A, Wang X, Cong J. Efficacy and safety of pembrolizumab on cervical cancer: A systematic review and single-arm meta-analysis. Front Oncol 2022; 12:910486. [PMID: 36033480 PMCID: PMC9399507 DOI: 10.3389/fonc.2022.910486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 07/15/2022] [Indexed: 11/23/2022] Open
Abstract
Background According to current research, the objective response rate and overall survival of pembrolizumab in the treatment of several types of solid tumors have been significantly improved. Some high-quality clinical trials have studied the effect of applying pembrolizumab in treating cervical cancer. Multiple clinical trials have been conducted, and some of them have shown good results as expected. Therefore, we performed this meta-analysis on existing studies to reveal the efficacy and safety of pembrolizumab in treating cervical cancer. Methods PubMed, Embase, Cochrane Library and Web of Science were searched for literatures published until October 31, 2021. Outcomes included complete response (CR), partial response (PR), stable disease (SD), disease progression (PD), objective response rate (ORR), disease control rate (DCR), overall survival (OS), progression-free survival (PFS), the best time to response (TTR), death rate, adverse events (AE). Results A total of 7 studies with 727 patients were included. The results were as follows: CR (0.027, 95%CI: 0.008-0.053), PR (0.104, 95% CI: 0.074-0.145), SD (0.190, 95% CI: 0.149-0.240), PD (0.541, 95% CI: 0.421-0.661). ORR was 0.155 (95% CI: 0.098-0.236) and DCR was 0.331 (95% CI: 0.277-0.385). OS was 10.23 months (95% CI: 8.96-11.50) and PFS was 4.27 months (95% CI: 1.57-6.96). TTR was 2.10 months (95%CI: 1.69-2.51). The 1-year death rate was 0.388 (95% CI: 0.230-0.574). Main adverse events included abnormal liver function, hypothyroidism, neutropenia, anemia, decreased appetite, fatigue, fever, etc. The total incidence of the adverse events of grade 3 and above was 0.212 (95% CI: 0.065-0.509). Conclusions Pembrolizumab provides significant benefits in response rate and survival for cervical cancer patients. The results from recent high-quality clinical trials are expected to validate these findings. Systematic Review Registration https://www.crd.york.ac.uk/prospero/, identifier CRD42021291723.
Collapse
Affiliation(s)
- Lin Qi
- *Correspondence: Jianglin Cong, ; Lin Qi,
| | | | | | | | | |
Collapse
|
7
|
Hauwa I, Oluwasanu MM, John-Akinola Y, Oyewole OE. Knowledge of cervical cancer and barriers to screening among women in a city in Northern Nigeria. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-021-01593-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
|
8
|
Peng P, Peng X, Jiao X, Chen N. A unique Levey-Jennings control chart used for internal quality control in human papillomavirus detection. Virol J 2022; 19:125. [PMID: 35902957 PMCID: PMC9331565 DOI: 10.1186/s12985-022-01861-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 07/23/2022] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE The purpose of this study was to provide an updated estimate of the prevalences of different types of human papillomavirus (HPV) in females in Chaoshan District and to establish an internal quality control (IQC) method for excluding false-positive results in HPV detection by using the Levey-Jennings control chart. METHOD HPV types were detected in 23,762 cervical samples by using PCR membrane hybridization. The means and standard deviations (SDs) of the positive rates were calculated, the Levey-Jennings chart was plotted, and the rules for "out of control" and "warning" were established. A set of standardized IQC for HPV DNA tests was developed based on the values and Levey-Jennings charts. RESULT In 466 batches, the positive rate exceeded the 1 + 2SD rule 24 times, but there was no consecutive exceedance, which was considered "in control". When the positive rate exceeded the 1 + 3SD rule 8 times with consecutive exceedance, it was considered "out of control". Further examination revealed that detections showing "out of control" had an undesirable random error, indicating that contamination may occur due to improper operation. CONCLUSION This unique Levey-Jennings control chart is a practical method for eliminating false-positive results in HPV DNA detection and should be widely applicable in molecular diagnostic laboratories.
Collapse
Affiliation(s)
- Peiyi Peng
- Shantou University Medical College, Shantou, Guangdong, China
| | - Xuehong Peng
- Department of Thoracic Surgery, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Xiaoyang Jiao
- Shantou University Medical College, Shantou, Guangdong, China
| | - Nuan Chen
- Department of Clinical Laboratory, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| |
Collapse
|
9
|
Swid MA, Monaco SE. Should screening for cervical cancer go to primary human papillomavirus testing and eliminate cytology? Mod Pathol 2022; 35:858-864. [PMID: 35256738 DOI: 10.1038/s41379-022-01052-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 01/11/2022] [Accepted: 01/18/2022] [Indexed: 12/21/2022]
Abstract
This review will systematically highlight the pros and cons of cervical cancer screening with HPV (human papillomavirus) testing and cytological methods (Papanicolaou (Pap) test). When comparing the screening modalities, various facets will be addressed, such as cost effectiveness, and harms and benefits across different demographics and age groups. It is important to note that due to the expansive variance in material costs, practices, and resource availability across different geographical regions, these comparisons are far from straight forward, and ultimately make it challenging to render definitive global recommendations. Thus, the intent of this review is to highlight some of the differences in difference cervical cancer screening modalities that can help one to choose an optimal screening method in their specific situation.
Collapse
Affiliation(s)
- Mohammed Amer Swid
- Department of Laboratory Medicine, Geisinger Medical Center, Danville, PA, 17822, USA
| | - Sara E Monaco
- Department of Laboratory Medicine, Geisinger Medical Center, Danville, PA, 17822, USA.
| |
Collapse
|
10
|
Lau J, Shrestha P, Shaina Ng J, Jianlin Wong G, Legido-Quigley H, Tan KK. Qualitative factors influencing breast and cervical cancer screening in women: A scoping review. Prev Med Rep 2022; 27:101816. [PMID: 35656228 PMCID: PMC9152777 DOI: 10.1016/j.pmedr.2022.101816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 04/04/2022] [Accepted: 04/30/2022] [Indexed: 11/28/2022] Open
Abstract
Breast and cervical are top cancers for women globally, but few studies have summarised how gender norms influence screening uptake, given sexual connotations and physical exposure. These beliefs may play a central role in decision-making, and understanding them is crucial to improving screening rates and services. This review scopes international literature for gender-based qualitative factors influencing women’s screening uptake. A systematic search of peer-reviewed English articles in PubMed, Scopus, and CINAHL was conducted from inception until December 2019. Articles were included if they were about breast or cervical cancer screening, had mixed or qualitative methodology, and sampled women from the general population. 72 studies spanning 34 countries were analysed. Eight studies also included healthcare providers’ views. Our narrative thematic analysis summarised primary themes extracted from each study into first-level subthemes, then synthesising second-level and third-level themes: (I) gender socialisation of women, (II) gender inequality in society, and (III) lack of empowerment to women in making screening decisions. Women tended to face sociocultural/role-based constraints, were expected to prioritise family, and keep bodily exposure to their husbands. Women showed low awareness and had fewer opportunities for health education compared to men. Male relations were often gatekeepers to financial resources needed to pay for screening tests. Screening risked community norms about women’s or husbands’ perceived embarrassing sexual behaviours. These findings suggest that interventions targeting unhelpful stigmatising beliefs about women’s cancer screening must concurrently address community general norms, familial role-based beliefs, as well as at male relations who hold the purse-strings.
Collapse
Affiliation(s)
- Jerrald Lau
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Pami Shrestha
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Janelle Shaina Ng
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Gretel Jianlin Wong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Ker-Kan Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| |
Collapse
|
11
|
Himiniuc LM, Toma BF, Popovici R, Grigore AM, Hamod A, Volovat C, Volovat S, Nica I, Vasincu D, Agop M, Tirnovanu M, Ochiuz L, Negura A, Grigore M. Update on the Use of Nanocarriers and Drug Delivery Systems and Future Directions in Cervical Cancer. J Immunol Res 2022; 2022:1636908. [PMID: 35571568 PMCID: PMC9095399 DOI: 10.1155/2022/1636908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 03/19/2022] [Accepted: 04/01/2022] [Indexed: 11/17/2022] Open
Abstract
Cervical cancer represents a major health problem among females due to its increased mortality rate. The conventional therapies are very aggressive and unsatisfactory when it comes to survival rate, especially in terminal stages, which requires the development of new treatment alternatives. With the use of nanotechnology, various chemotherapeutic drugs can be transported via nanocarriers directly to cervical cancerous cells, thus skipping the hepatic first-pass effect and decreasing the rate of chemotherapy side effects. This review comprises various drug delivery systems that were applied in cervical cancer, such as lipid-based nanocarriers, polymeric and dendrimeric nanoparticles, carbon-based nanoparticles, metallic nanoparticles, inorganic nanoparticles, micellar nanocarriers, and protein and polysaccharide nanoparticles. Nanoparticles have a great therapeutic potential by increasing the pharmacological activity, drug solubility, and bioavailability. Through their mechanisms, they highly increase the toxicity in the targeted cervical tumor cells or tissues by linking to specific ligands. In addition, a nondifferentiable model is proposed through holographic implementation in the dynamics of drug delivery dynamics. As any hologram functions as a deep learning process, the artificial intelligence can be proposed as a new analyzing method in cervical cancer.
Collapse
Affiliation(s)
| | - Bogdan Florin Toma
- ”Grigore T. Popa” University of Medicine and Pharmacy, Iasi 700115, Romania
| | - Razvan Popovici
- Department of Obstetrics and Gynecology, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi 700115, Romania
| | - Ana Maria Grigore
- ”Grigore T. Popa” University of Medicine and Pharmacy, Iasi 700115, Romania
| | | | - Constantin Volovat
- Center of Oncology Euroclinic, 700110 Iasi, Romania
- “Grigore T. Popa” University of Medicine and Pharmacy, Department of Medical Oncology Radiotherapy, 700115 Iași, Romania
| | - Simona Volovat
- Center of Oncology Euroclinic, 700110 Iasi, Romania
- “Grigore T. Popa” University of Medicine and Pharmacy, Department of Medical Oncology Radiotherapy, 700115 Iași, Romania
| | - Irina Nica
- Department of Odontology, Periodontics and Fixed Restoration, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi 700115, Romania
| | - Decebal Vasincu
- Department of Dental and Oro-Maxillo-Facial Surgery, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi 700115, Romania
| | - Maricel Agop
- Department of Physics, “Gheorghe Asachi” Technical University of Iasi, Iasi 700050, Romania
- Romanian Scientists Academy, Bucharest 050094, Romania
| | - Mihaela Tirnovanu
- Department of Obstetrics and Gynecology, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi 700115, Romania
| | - Lacramioara Ochiuz
- Department of Pharmaceutical and Biotechnological Drug Industry, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi 700115, Romania
| | - Anca Negura
- Oncogenetics Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
- Biology Department, “Alexandru Ioan Cuza” University, 700506 Iaşi, Romania
| | - Mihaela Grigore
- Department of Obstetrics and Gynecology, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi 700115, Romania
| |
Collapse
|
12
|
Zhang Z, Jiang L, Bi R, Wu X, Ke G, Zhu J. Prognostic Effect of Primary Recurrence Patterns in Squamous Cervical Carcinoma After Radical Surgery. Front Oncol 2022; 12:782030. [PMID: 35480094 PMCID: PMC9035744 DOI: 10.3389/fonc.2022.782030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 03/16/2022] [Indexed: 12/09/2022] Open
Abstract
ObjectiveTo examine the effect of primary recurrence patterns on the prognosis of squamous cervical cancer after initial treatment.MethodsPrimary recurrence patterns and prognostic factors were examined in stage IB-IIA cervical cancer patients after initial treatment. Recurrence site (locoregional recurrence and distant metastasis or in-field and out-field recurrence for patients receiving adjuvant radiotherapy) and subtype (nodal and organ recurrence) were examined. Clinicopathological characteristics and survival rates were evaluated to generate a prognostic nomogram.ResultsA total of 472 patients were included. The median follow-up period, 5-year overall (OS) rate, and median OS were 59.1 months, 33.7%, and 24.0 months, respectively. Overall, 38.8% and 61.2% of the patients had locoregional recurrence and distant metastasis, respectively, and survival rates were comparable in these groups. Patients with nodal recurrence had better OS than those with organ recurrence (38.3% vs 30.7%, respectively; P = 0.001). Patients not receiving adjuvant radiotherapy had increased risk of pelvic recurrence [odds ratio (OR) = 0.148; 95% confidence interval[(CI): 0.075–0.291, P = 0.000]. Positive lymph-vascular space invasion (OR= 1.928; 95% CI: 1.151–3.229, P = 0.013) and no chemotherapy (OR = 0.521; 95% CI: 0.317–0.733, P = 0.040) increased the risk of distant metastasis. Positive lymph node status after initial treatment were associated with nodal recurrence (OR = 3.729; 95% CI: 1.838–7.563, P = 0.000), while elevated preoperative squamous cell carcinoma antigen (SCC-Ag) levels were associated with organ recurrence (OR = 1.642; 95% CI: 1.325–2.265, P = 0.002). Recurrence subtype, therapy for relapse, the International Federation of Gynecology and Obstetrics stage, adjuvant radiotherapy, preoperative SCC-Ag levels, and risk subgroup were independently associated with OS.ConclusionsPrimary recurrence patterns were associated with specific clinicopathological characteristics of cervical cancer. Recurrent cervical cancer prognosis was mainly affected by recurrence location and subtype.
Collapse
Affiliation(s)
- Zongkai Zhang
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Long Jiang
- Department of Anesthesia, Zhongshan Hospital Fudan University Shanghai Cancer Center, Shanghai, China
| | - Rui Bi
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Xiaohua Wu
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Department of Gynecologic Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Guihao Ke
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Department of Gynecologic Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Jun Zhu
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Department of Gynecologic Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- *Correspondence: Jun Zhu,
| |
Collapse
|
13
|
What do we know about cervical cancer and HPV vaccines? A cross-sectional questionnaire evaluated by midwives and nurses. JOURNAL OF SURGERY AND MEDICINE 2022. [DOI: 10.28982/josam.1029878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
14
|
Debrah O, Agyemang-Yeboah F, Donkoh ET, Asmah RH. Prevalence of vaccine and non-vaccine human papillomavirus types among women in Accra and Kumasi, Ghana: a cross-sectional study. BMC Womens Health 2021; 21:372. [PMID: 34702246 PMCID: PMC8549380 DOI: 10.1186/s12905-021-01511-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 10/11/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Human Papillomavirus (HPV) infection is the main etiological factor for pre-invasive and invasive cervical cancer. HPV type-specific vaccination is being widely recommended to control the burden of disease, but the genotype-specific distribution of HPV may vary in different countries. The aim of the study was to determine the prevalence and distribution of HPV genotypes among women attending reproductive health services in Ghana, their associated risk factors, and to assess the potential coverage of identified HPV genotypes by three licensed vaccines among these women. METHOD Women presenting for reproductive health services in two regional hospitals in Accra and Kumasi from October 2014 to March 2015 were conveniently recruited into the study (n = 317). HPV-DNA detection and genotype identification were carried out by a nested multiplex PCR assay that combines degenerate E6/E7 consensus primers and type-specific primers for the detection and typing of eighteen HPV genotypes. Cytology was performed to screen women for cervical cancer lesions. Risk factors for HPV infection were analyzed by logistic regression. Statistical significance was accepted for p < 0.05. RESULTS The age of study participants ranged from 21 to 76 years. Among women positive for HPV, 35.0% were infected with high-risk HPV, 14.5% with probable high-risk HPV, and 17.0% with low-risk HPV. The prevalence of HPV 16/18 was 8.2%, HPV 6/11/16/18 was 9.1% and HPV 6/11/16/18/31/33/45/52/58 was 28.4%. The most prevalent among HR-HPV were types 52 (18.3%) and 58 (8.8%). HPV positivity may be associated with educational background (p < 0.001), age at first pregnancy (p = 0.028), and age at coitarche (p = 0.016). CONCLUSIONS Our study revealed a high prevalence of HR-HPV infection among women. The high prevalence of HR HPV indicates that multivalent vaccines will be useful for controlling HPV burden in general population contexts. The distribution of HPVs in this population suggests that of the three currently available vaccines the nonavalent vaccine, which protects against seven HPV types in addition to HPV 16 and 18, has the highest coverage of HPV infections among Ghanaian women. Healthcare officials planning to reduce the transmission of HPV and cervical cancer must consider the coverage of the nonavalent vaccine as an advantage.
Collapse
Affiliation(s)
- Oksana Debrah
- Institutional Care Division, Ghana Health Service Headquarters, Stadium Post Office, Post Office Box SD 329, Accra, Ghana. .,Department of Science Laboratory Technology, Accra Technical University, Accra, Ghana.
| | - Francis Agyemang-Yeboah
- Department of Molecular Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Emmanuel Timmy Donkoh
- Department of Basic and Applied Biology, University of Energy and Natural Resources, Sunyani, Ghana
| | | |
Collapse
|
15
|
Sheu J, Field A, Viswanathan R, Minkowitz J, Calixte R, Lee YC. Prevalence of Positive Cervical Cancer Screening Tests Past the Age of 65 Years With Prior Adequate Negative Screening. J Low Genit Tract Dis 2021; 25:263-266. [PMID: 34542083 DOI: 10.1097/lgt.0000000000000626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Cervical cancer screening recommendations suggest that cessation can be offered above the age of 65 years if specific prior negative screening criteria are met. We investigated the prevalence of abnormal results in individuals who continue screening despite satisfying the American Society for Colposcopy and Cervical Pathology guidelines for cessation. MATERIALS AND METHODS In this retrospective study, medical records 2008-2019 from a single urban hospital-based clinic were queried. Charts were manually reviewed to determine which patients met the American Society for Colposcopy and Cervical Pathology exit criteria but continued screening. Findings detected during the extended surveillance period beyond the age of 65 years were analyzed. RESULTS Two hundred ninety-six patients met the criteria of additional screening despite meeting guidelines for cessation. Length of the continued additional surveillance period ranged from 1 to 15 years with a mean of 3.98 years and median of 3 years. Thirty-nine individuals had abnormalities during additional surveillance: 25 high-risk human papillomavirus (HR-HPV) positive only with negative cytology, 8 atypical squamous cells of undetermined significance, 3 low-grade squamous intraepithelial lesions, 2 atypical glandular cells of undetermined significance, and 1 high-grade squamous intraepithelial lesion. No cases of cervical cancer were detected. Total rate of abnormalities including HR-HPV positive only was 332.20 per 10,000 person-years, and cytologic abnormalities alone at 119.25 per 10,000 person-years. CONCLUSIONS Most findings were HR-HPV positive with negative cytology, which studies suggest may confer low risk of progression in older individuals. In addition, no patient was found to develop cervical malignancy. Despite controversy regarding this recommendation, our data suggest screening cessation may be appropriate with adequate negative screening history.
Collapse
Affiliation(s)
- Joanne Sheu
- Department of Obstetrics and Gynecology, SUNY Downstate Health Sciences University, Brooklyn, NY
| | - Alessia Field
- Department of Obstetrics and Gynecology, SUNY Downstate Health Sciences University, Brooklyn, NY
| | | | - Jeremy Minkowitz
- Department of Pathology, SUNY Downstate Health Sciences University, Brooklyn, NY
| | - Rose Calixte
- SUNY Downstate School of Public Health, Brooklyn, NY
| | - Yi-Chun Lee
- Division of Gynecologic Oncology, SUNY Downstate Health Sciences University, Brooklyn, NY
| |
Collapse
|
16
|
McGovern J, Fuller C, Burris K. Anal cancer screening and prevention: a review for dermatologists. J Eur Acad Dermatol Venereol 2021; 35:1622-1627. [PMID: 33797819 DOI: 10.1111/jdv.17263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 03/22/2021] [Indexed: 12/20/2022]
Abstract
The incidence of and mortality from anal cancer, predominantly squamous cell carcinoma (SCC), have been increasing since the 1980s, during an era when many common malignancies have seen decreases in mortality. Dermatologists may be more likely to see patients at an increased risk for anal SCC, such as those living with HIV, MSM and those presenting for management of anogenital warts, yet there is little guidance in the field on how to manage these patients. We underwent a project to review the evidence surrounding screening and prevention of anal SCC. HPV vaccination, the main preventative measure for anal SCC, is often underutilized and may not be effective for those most at risk. Screening methods currently include high-risk HPV and anal cytology testing, with high-resolution anoscopy (HRA) reserved for biopsy and confirmatory testing. High-risk HPV testing has been associated with high sensitivity for intraepithelial neoplasia, but low specificity in high-risk groups. Recent meta-analyses examining AIN detection using anal cytology estimate a similarly high sensitivity of 74-87%, with a relatively higher specificity (44-66%) for identifying high-grade AIN. HRA is the gold standard for diagnosis, but its accessibility and cost are deterrents from its use as a screening tool. Cervical cancer screening, initially adopted without significant evidence of its impact, has significantly decreased cervical cancer rates. The argument can be made that rates of anal SCC may also benefit from appropriate screening methods, particularly anal cytology. It is prudent for dermatologists to be aware of the methods available to them in the management of at-risk patients, the data supporting them, and the potential benefits of screening in order to counsel patients appropriately and address the increasing burden of disease.
Collapse
Affiliation(s)
- J McGovern
- Vagelos College of Physicians & Surgeons, Columbia University, New York, NY, USA
| | - C Fuller
- Department of Dermatology, Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - K Burris
- Department of Dermatology, Vagelos College of Physicians & Surgeons, Columbia University, New York, NY, USA
| |
Collapse
|
17
|
Zhao J, Cao H, Zhang W, Fan Y, Shi S, Wang R. SOX14 hypermethylation as a tumour biomarker in cervical cancer. BMC Cancer 2021; 21:675. [PMID: 34098886 PMCID: PMC8185922 DOI: 10.1186/s12885-021-08406-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 05/25/2021] [Indexed: 02/14/2023] Open
Abstract
BACKGROUND The association between SOX14 and cancer has been reported. The aim of this study was to identify and validate the potential value of SOX14 methylation in the early detection of cervical cancer. METHODS First, we extracted the data for SOX14 methylation and expression within cervical cancer from The Cancer Genome Atlas (TCGA) database and analysed them via UALCAN, Wanderer, MEXPRESS and LinkedOmics. Subsequently, according to the bioinformatics findings, primers and probes were designed for the most significantly differentiated methylation CpG site and synthesized for methylation-specific PCR (MSP) and quantitative methylation-specific PCR (QMSP) to verify SOX14 methylation in both cervical tissuses and liquid-based cell samples. Eventually, the clinical diagnostic efficacy of SOX14 methylation in the normal, cervical intraepithelial neoplasia, and cancer groups was analysed by ROCAUC. RESULTS Pooled analysis demonstrated that SOX14 methylation levels were significantly increased in cervical squamous cell carcinoma and endocervical adenocarcinoma (CESC) compared to normal tissues (P < 0.001). Both the verification and validation cohorts indicated that the methylation level and the positive rate of SOX14 gradually increased with increasing severity from normal to cancer samples (P < 0.01). When the cut-off value was set as 128.45, the sensitivity and specificity of SOX14 hypermethylation in the diagnosis of cervical cancer were 94.12 and 86.46%, respectively. When taken as a screening biomarker (>CINII), the sensitivity was 74.42% and the specificity was 81.48%, with a cut-off value of 10.37. CONCLUSION SOX14 hypermethylation is associated with cervical cancer and has the potential to be a molecular biomarker for the screening and early diagnosis of cervical cancer.
Collapse
Affiliation(s)
- Jing Zhao
- Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital, Tianjin, China
| | - Huiling Cao
- Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital, Tianjin, China
| | - Wenfan Zhang
- Department of Laboratory Medicine, Tianjin Medical University, Tianjin, China
| | - Yongjuan Fan
- Department of Gynecology and Obstetrics, Tianjin First Central Hospital, Tianjin, China
| | - Shujuan Shi
- Department of Human Anatomy and Histology, Tianjin Medical University, Tianjin, China
| | - Rong Wang
- Department of Laboratory Medicine, Tianjin Medical University, Tianjin, China.
| |
Collapse
|
18
|
Srinivas V, Herbst De Cortina S, Nishimura H, Krupp K, Jayakrishna P, Ravi K, Khan A, Madhunapantula SV, Madhivanan P. Community-based Mobile Cervical Cancer Screening Program in Rural India: Successes and Challenges for Implementation. Asian Pac J Cancer Prev 2021; 22:1393-1400. [PMID: 34048166 PMCID: PMC8408397 DOI: 10.31557/apjcp.2021.22.5.1393] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Indexed: 11/28/2022] Open
Abstract
Background: The aim of this study is to demonstrate the feasibility; mention the challenges encountered and highlight the success of implementing a community-based mobile cervical cancer-screening program in rural India. Methods: Communities were mobilized through extensive peer education and by screening in existing community spaces using a mobile clinic model. An initial “screen and treat” protocol was transitioned to “screen, test, and treat” using Pap smears for confirmatory testing, and cryotherapy or Loop Electrosurgical Excision Procedure (LEEP) for treatment. We trained 50 Peer Educators and conducted 190 screening camps in 58 locations. Results: Of 3,821 registered women, 3,544 (92.8%) accepted screening. Overall, 440/3544 (12.4%, 95% CI 11.3-13.5%) women had VIA-positive lesions. Under “screen and treat”, 56/156 (35.9%) women accepted same-day treatment. Under “screen, test, and treat”, 555/762 (72.8%) women received a Pap smear. Overall, 83 women underwent cryotherapy (n=56) and LEEP (n=27). Of those, 49 (59.0%) participants were followed up, with normal VIA results up to two years after treatment. In summary, the peer educators promoted awareness of cervical cancer and helped in gaining buy-in from communities. Acceptance of same-day treatment was low and accompanied by loss to follow-up, limiting the utility of VIA in these studies. Conclusions: Mobile infrastructure utilized in community spaces brought screening directly to rural women. Culturally appropriate methods to increase linkage to treatment and additional screening options such as HPV DNA testing should be explored.
Collapse
Affiliation(s)
| | - Sasha Herbst De Cortina
- Public Health Research Institute of India, Mysore, India.,School of Medicine, University of California Irvine, Irvine, USA.,Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, USA
| | - Holly Nishimura
- Department of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, USA
| | - Karl Krupp
- Public Health Research Institute of India, Mysore, India.,Department of Biochemistry, JSS Medical College, Leader, Special Interest Group (SIG) in Cancer Biology and Cancer Stem Cells JSS Academy of Higher Education & Research, Mysore, Karnataka, India
| | | | - Kavitha Ravi
- Public Health Research Institute of India, Mysore, India
| | - Anisa Khan
- Public Health Research Institute of India, Mysore, India
| | | | - Purnima Madhivanan
- Public Health Research Institute of India, Mysore, India.,Department of Biochemistry, JSS Medical College, Leader, Special Interest Group (SIG) in Cancer Biology and Cancer Stem Cells JSS Academy of Higher Education & Research, Mysore, Karnataka, India.,Department of Family & Community Medicine, College of Medicine, University of Arizona, Tucson, USA
| |
Collapse
|
19
|
Pope J, Banaag A, Madsen C, Hanson T, Khan M, Koehlmoos TP. The Mitigation of Racial Disparities in Cervical Cancer Screening Among U.S. Active Duty Service Women. Mil Med 2021; 186:e373-e378. [PMID: 33175967 DOI: 10.1093/milmed/usaa427] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 09/02/2020] [Accepted: 10/07/2020] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION The U.S. Preventive Services Task Force recommends regular cervical cancer screening for women aged 21-65 years. Such screening is key to reducing mortality and morbidity. Despite improvement in the screening rate, cervical cancer still disproportionately affects women of minority groups because of access to quality health care. The Military Health System (MHS) mitigates this barrier through universal healthcare coverage for all active duty service members and their families. However, such racial/ethnic disparities, seen in civilian population, have not been studied in the MHS. MATERIALS AND METHODS This is a retrospective cross-sectional study utilizing fiscal years 2011-2016 claims data obtained from the MHS Data Repository for 112,572 active duty service women aged 21-64 years. Study analyses included descriptive statistics on patient demographics, calculations of the proportion of patients who received cervical cancer screenings as well as the proportion of patients in compliance with USPSTF guidelines, and unadjusted odds ratios for the likelihood of compliance by race and military service. RESULTS Of the study population, 50.0% of active duty women were screened for cervical cancer. When compared to White women, Black (1.05 OR, 1.03-1.08 CI), Native American/Alaskan Native (1.26 OR, 1.15-1.39 CI), and Other (1.12 OR, 1.06-1.18 CI) women were significantly more likely to receive cervical cancer screenings. The proportions of 3-year compliance were relatively equal within each race category (ranging from 43% to 45%), with no significant findings for the odds of compliance in any race when compared to White active duty women; however, proportions of 3-year compliance by service ranged from 11.7% in the Marines to 84.4% in the Navy, and active duty women in the Navy were six times more likely to be in compliance with guidelines than women in the Army. When looking at 5-year compliance in active duty women aged 30-64 years, women in the Navy were more likely than women in the Army to meet compliance guidelines (1.24 OR, 1.14-1.36 CI), while women in the Air Force were slightly less likely (0.90 OR, 0.82-0.98 CI). CONCLUSIONS The women in our population demonstrated similar or lower compliance than other studies conducted in the U.S. general population, and racial disparities for cervical cancer screening were partially mitigated in active duty service women. While our research demonstrates that universal insurance can help provide equal access and care, investigation into the factors that encourage greater usage among members of different military branches may help to understand and develop policies to improve health care systems.
Collapse
Affiliation(s)
- Jessica Pope
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, 20817, USA
| | - Amanda Banaag
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, 20817, USA
| | - Cathaleen Madsen
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, 20817, USA
| | - Tranessia Hanson
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA
| | - Munziba Khan
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, 20817, USA
| | - Tracey Perez Koehlmoos
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA
| |
Collapse
|
20
|
Study of the biological function of LncRNA LUCAT1 on cervical cancer cells by targeting miR-199b-5p. Biosci Rep 2021; 40:222453. [PMID: 32207530 PMCID: PMC7178215 DOI: 10.1042/bsr20200422] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 02/26/2020] [Accepted: 02/27/2020] [Indexed: 12/16/2022] Open
Abstract
To explore the effect and mechanism of LncRNA LUCAT1 in cervical cancer (CC). In the present study, 67 cases of CC patients and 60 healthy cases were selected as the research objects. CC patients were selected as the study group (SG) and healthy physical examination patients were selected as the control group (CG). LUCAT1 expression level in peripheral blood was detected in the two groups. Human cervical carcinoma cells C33A, AV3 and normal cervical epithelial cells H8 were purchased for biological behavior analysis. LUCAT1 was highly expressed in SG and cancer tissues (P<0.050), and it had good diagnostic value for the development of CC (P<0.001). It was closely related to the differentiation, pathological stage and metastasis of CC (P<0.001). The prognosis of CC patients was affected (P<0.050). After transfecting LUCAT1 into CC cells, it was found that the proliferation, invasion ability and anti-apoptosis protein of CC cells were significantly reduced, while the apoptosis rate and apoptosis protein were significantly increased by inhibiting LUCAT1 expression (P<0.050). However, after transfecting miR-199b-5p into CC cells, it was found that the proliferation, invasion ability and anti-apoptosis protein of CC cells were significantly increased, while the apoptosis rate and apoptosis protein were significantly decreased by inhibiting LUCAT1 expression (P<0.050). LUCAT1 was highly expressed in CC. It was involved in the tumor development of CC by targeting miR-199b-5p, which was of great significance for the diagnosis and treatment of CC in the future.
Collapse
|
21
|
Ren H, Jia M, Zhao S, Li H, Fan S. Factors Correlated with the Accuracy of Colposcopy-Directed Biopsy: A Systematic Review and Meta-Analysis. J INVEST SURG 2020; 35:284-292. [PMID: 33377808 DOI: 10.1080/08941939.2020.1850944] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
PURPOSE/AIM OF THE STUDY Colposcopy-directed cervical biopsy has played a major role in diagnosing cervical lesions. The precision of colposcopy-guided biopsy has been questioned. We analyzed several factors that may be correlated with the accuracy of biopsy. METHODS PubMed, EMBASE were searched from January 1, 1998 to March 1, 2020. Odds ratio with 95% confidence intervals (CIs) were calculated. SELECTION CRITERIA Included studies evaluated factors correlated with the accuracy of biopsy and patients' final diagnosis was established by histological examination of the specimen obtained by conization, loop electrosurgical excision procedure (LEEP), or colpohysterectomy. RESULTS A total of 10 studies were selected for the systematic review and meta-analysis. The pooled analysis indicated that the diagnostic inaccuracies of colposcopy-directed cervical biopsy were magnified in women who were 50 years of age or older. Postmenopausal status and transformation zone 3 type were also associated with the diagnostic inaccuracies of colposcopy-directed biopsy. High-grade squamous intraepithelial lesions had better concordance rates than low-grade squamous intraepithelial lesions. The number of vaginal deliveries, number of biopsies, and HPV type were associated with biopsy underdiagnosis and biopsy overestimation. CONCLUSIONS This meta-analysis found that the correlation between the histological findings at biopsy and after surgical treatment was influenced by women's age, menopausal status, and the transformation zone type. The diagnostic efficacy was also better for high-grade squamous intraepithelial lesions than for low-grade squamous intraepithelial lesions. Further large-scale randomized clinical trials are required to analyze the factors correlated with biopsy underdiagnosis and biopsy overestimation.
Collapse
Affiliation(s)
- Hongyan Ren
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Mengzhe Jia
- Department of General Surgery, The First Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Shujun Zhao
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Hongyu Li
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Suzhen Fan
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| |
Collapse
|
22
|
Screening strategies for the detection of anal high-grade squamous intraepithelial lesions in women living with HIV. AIDS 2020; 34:2249-2258. [PMID: 32947592 DOI: 10.1097/qad.0000000000002694] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE HIV-infected women (WLHIV) have more than 10-fold higher risk for squamous cell cancer of the anus. Experts suggest cytology-based strategies developed for cervical cancer screening may prevent anal cancer by detecting anal cytologic or histological high-grade squamous intraepithelial lesion (hHSIL) for treatment. Currently, there is no consensus on anal-hHSIL screening strategies for WLHIV. DESIGN Between 2014 and 2016, 276 WLHIV were recruited at 12 US AIDS Malignancy Consortium clinical trials sites to evaluate hHSIL prevalence and (test) screening strategies. METHODS Participants completed detailed questionnaire, underwent anal assessments including high-risk human papillomavirus (hrHPV) testing using hrHPV-Hybrid Capture 2 (HC2) and hrHPV-APTIMA, anal cytology, and concurrent high-resolution anoscopy. Screening test characteristics for predicting hHSIL validated by central review of histologic diagnosis were estimated sensitivity, specificity, positive predictive value, and false-omission rate. Paired analyses compared sensitivity and specificity for hrHPV single tests to anal cytology alone. RESULTS 83% (229/276) of enrolled WLHIV had complete anal assessment data and were included in this analysis. Mean age was 50, 62% black and 60 (26%) had hHSIL. Anal cyotology (>atypical squamous cells of undetermined significance), hrHPV-HC2, and hrHPV-APTIMA sensitivity estimates were similarly high (83, 77, and 75%, respectively, P values > 0.2). Specificity was higher for both hrHPV-APTIMA and hrHPV-HC2 compared with anal cytology (67 vs. 50%, P < 0.001) and (61 vs. 50%, P = 0.020), respectively. CONCLUSION Anal hrHPV testing demonstrated similar sensitivity for anal cytology (>atypical squamous cells of undetermined significance) to predict anal hHSIL. Among tests with similar sensitivity, the specificity was significantly higher for hrHPV-APTIMA and hrHPV-HC2. Thus, anal hrHPV testing may be an important alternative strategy to anal cytology for anal hHSIL screening among WLHIV.
Collapse
|
23
|
Novel cellular immunotherapy using NKG2D CAR-T for the treatment of cervical cancer. Biomed Pharmacother 2020; 131:110562. [PMID: 32920508 DOI: 10.1016/j.biopha.2020.110562] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 07/16/2020] [Accepted: 07/26/2020] [Indexed: 12/21/2022] Open
Abstract
Cellular immunotherapy, including chimeric antigen receptor (CAR) modified T cell therapy, has been regarded as one of the most potential antineoplastic drugs for hematological malignancies and solid tumor. However, due to lacking the suitable target, there is no CAR-T drug had been appoved by FDA for the treatment of cervical cancer, one of the most malignant cancers for women. In current study, we designed a NKG2D CAR-T targeting NKG2DL. The NKG2D CAR-T exhibited high-efficient anti-tumor capacity for NKG2DL positive cervical cancer cell line in vitro. In addition, the amount of cytokines secreted from CAR-T cells have had significantly enhanced after co-cultured with NKG2DL positive tumor cell in vitro. In vivo, NKG2D CAR-T cells presented a robust capacity of significantly suppressing tumor growth. Moreover, there was no obvious off-target toxicity after NKG2D CAR-T infusion. Taken together, NKG2D CAR-T showed excellent therapy effect for cervical cancer and might be used as a novel cellular therapeutic agent for treating cervical cancer.
Collapse
|
24
|
Saldanha N. STIs in adolescents: Chlamydia, gonorrhea, mycoplasma genitalium, and HPV. Curr Probl Pediatr Adolesc Health Care 2020; 50:100835. [PMID: 32768342 DOI: 10.1016/j.cppeds.2020.100835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Nadia Saldanha
- Division of Adolescent Medicine, Cohen Children's Medical Center, Northwell Health, 410 Lakeville Road, Suite 108, New Hyde Park, NY, United States; Donald and Barbara Zucker, School of Medicine at Hofstra/Northwell, Hempstead, NY, United States.
| |
Collapse
|
25
|
IL-10 c.-592C>A (rs1800872) polymorphism is associated with cervical cancer. J Cancer Res Clin Oncol 2020; 146:1971-1978. [PMID: 32447484 DOI: 10.1007/s00432-020-03256-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 05/12/2020] [Indexed: 01/04/2023]
Abstract
PURPOSE Interleukin-10 (IL-10) is an immunoregulatory cytokine and its cervical and serum concentrations have been associated with a poor prognosis of cervical cancer. The rs1800872 polymorphism (c.-592C>A) in the promotor region of the IL-10 gene affects the production and expression of IL-10 and thus is able to determine the immune response profile in the cervix. Therefore, the aim of this work is to state the association between IL-10 c.-592C>A polymorphism and cervical cancer. METHODS Genomic DNA was extracted from patient's peripheral blood and tumor biopsy. Socio-demographic, sexual behavior and reproductive characteristics data were collected using a questionnaire. RESULTS Co-dominant model in logistic binary regression adjusted for confounders, showed that patients presenting with C/A genotype had 2.15 times more chances for developing cervical cancer (OR 2.15; CI95% 1.02-4.56). The dominant model, C/A + A/A, was also independently associated with 2.71 times more chances for cervical cancer development when compared to control patients (OR 2.71; CI95% 1.05-4.47). CONCLUSION Our study analyses show the association between cervical cancer and IL-10 c.-592C>A polymorphism, demonstrating that the allele A presence was independently associated with higher risks of cervical cancer development.
Collapse
|
26
|
Won S, Kim MK, Seong SJ. Clinical management of abnormal Pap tests: differences between US and Korean guidelines. J Pathol Transl Med 2020; 54:213-219. [PMID: 32460475 PMCID: PMC7253959 DOI: 10.4132/jptm.2020.03.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 03/11/2020] [Indexed: 11/17/2022] Open
Abstract
Cervical cancer has been the most common gynecological cancer in Korea but has become a preventable disease with regular screening and proper vaccination. If regular screening is provided, cervical cancer does not progress to more than carcinoma in situ, due to its comparatively long precancerous duration (years to decades). In 2012, the American Society for Colposcopy and Cervical Pathology published guidelines to aid clinicians in managing women with abnormal Papanicolaou (Pap) tests, and they soon became the standard in the United States. Not long thereafter, the Korean Society of Gynecologic Oncology and the Korean Society for Cytopathology published practical guidelines to reflect the specific situation in Korea. The detailed screening guidelines and management options in the case of abnormal Pap test results are sometimes the same and sometimes different in the United States and Korean guidelines. In this article, we summarize the differences between the United States and Korean guidelines in order to facilitate physicians’ proper management of abnormal Pap test results.
Collapse
Affiliation(s)
- Seyeon Won
- Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University College of Medicine, Seoul, Korea
| | - Mi Kyoung Kim
- Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University College of Medicine, Seoul, Korea
| | - Seok Ju Seong
- Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University College of Medicine, Seoul, Korea
| |
Collapse
|
27
|
Lin W, Zhou L, Hu H, Chen B, Yuan S, Wu B, Liu Z, Wang Y. The number and gender of children synergistically impact on a mother’s practice of human papillomavirus testing and attitudes towards vaccination in Shenzhen, China. Cancer Epidemiol 2020; 65:101682. [DOI: 10.1016/j.canep.2020.101682] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 01/11/2020] [Accepted: 01/28/2020] [Indexed: 01/24/2023]
|
28
|
Goding Sauer A, Bandi P, Saslow D, Islami F, Jemal A, Fedewa SA. Geographic and sociodemographic differences in cervical cancer screening modalities. Prev Med 2020; 133:106014. [PMID: 32027912 DOI: 10.1016/j.ypmed.2020.106014] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 01/29/2020] [Accepted: 02/01/2020] [Indexed: 10/25/2022]
Abstract
Cervical cancer screening recommendations for women aged 30-65 years include co-testing (high-risk human papillomavirus [hrHPV] with Pap testing) every five years or Pap testing alone every three years. Geographic variations of these different screening modalities across the United States have not been examined. We selected 82,426 non-pregnant women aged 30-65 years from the 2016 Behavioral Risk Factor Surveillance System with data on sociodemographics, hysterectomy, and cervical cancer screening, representing 42 states and the District of Columbia. Logistic regression models with predicted marginal probabilities were used to calculate state-level prevalence estimates of recent cervical cancer screening and uptake of co-testing, Pap testing, and hrHPV testing among those who were recently screened. Analysis was conducted in 2018-2019. Recent screening prevalence ranged from 80.0% (Idaho) to 92.2% (Massachusetts), with more state-level geographic variability in co-testing than Pap testing alone. Uptake of co-testing ranged from 27.5% (Utah) to 49.9% (District of Columbia); compared to the national estimate, co-testing was lower in 12 states and higher in six states. Overall, Midwestern and Southern states had the lowest uptake of co-testing whereas Northeastern states had the highest. Sociodemographic, healthcare, and behavioral factors accounted for some but not all state-level variation in co-testing. There was substantial state-level variability in co-testing prevalence, which was lowest in Midwestern and Southern states; the variation was not entirely explained by individual sociodemographic, healthcare, and behavioral factors. Future studies should monitor the impact of geographic variations in screening modalities on state-level differences in cervical cancer incidence, survival, and mortality.
Collapse
Affiliation(s)
- Ann Goding Sauer
- Intramural Research Department, American Cancer Society, United States of America.
| | - Priti Bandi
- Intramural Research Department, American Cancer Society, United States of America
| | - Debbie Saslow
- Cancer Control Department, American Cancer Society, United States of America
| | - Farhad Islami
- Intramural Research Department, American Cancer Society, United States of America
| | - Ahmedin Jemal
- Intramural Research Department, American Cancer Society, United States of America
| | - Stacey A Fedewa
- Intramural Research Department, American Cancer Society, United States of America
| |
Collapse
|
29
|
Cohen AC, Roane BM, Leath CA. Novel Therapeutics for Recurrent Cervical Cancer: Moving Towards Personalized Therapy. Drugs 2020; 80:217-227. [PMID: 31939072 PMCID: PMC7033025 DOI: 10.1007/s40265-019-01249-z] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
While screening programs and HPV vaccination have decreased the incidence of cervical cancer, still over 13,000 cases occur in the USA annually. Early-stage cervical cancer has an excellent long-term prognosis, with 5-year survival for localized disease being > 90%. Survival decreases markedly for both locally advanced and metastatic disease, and both are associated with a higher risk of recurrence. Few effective treatment options exist for persistent, recurrent, or metastatic cervical cancer. In 2014, the anti-VEGF antibody bevacizumab was approved in combination with chemotherapy based on the results of the Phase III GOG-240 study. As the majority of cervical cancers have a viral etiology, which impairs the immune system, immunotherapy using checkpoint inhibitors and other agents, appears to be a promising approach. In June 2018, the US FDA approved the anti-PD1 antibody pembrolizumab for recurrent or metastatic cervical cancer with PD-L1 expression that progressed after one or more lines of chemotherapy. Another anti-PD1 antibody, cemiplimab also shows potential in this setting, either as monotherapy or combined with radiotherapy, and it is currently being evaluated in a Phase III trial. Additional checkpoint inhibitors including nivolumab, durvalumab, atezolizumab, and camrelizumab are in different stages of clinical development for the disease. Finally, an additional targeted approach being pursued involves PARP inhibitors (rucaparib and olaparib are both in Phase II) based on earlier study results.
Collapse
Affiliation(s)
- Alexander C Cohen
- Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Brandon M Roane
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, 1700 6th Avenue South, Room 10250, Birmingham, AL, 35249-7333, USA
| | - Charles A Leath
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, 1700 6th Avenue South, Room 10250, Birmingham, AL, 35249-7333, USA.
| |
Collapse
|
30
|
Lei L, Zheng R, Peng K, Si L, Peng J, Cai W, Zhang S, Wei W, He J. Incidence and mortality of oral and oropharyngeal cancer in China, 2015. Chin J Cancer Res 2020; 32:1-9. [PMID: 32194299 PMCID: PMC7072017 DOI: 10.21147/j.issn.1000-9604.2020.01.01] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Objective To report the incidence and mortality rates of oral and oropharyngeal cancer in Chinese population. Methods Data were taken from a population-based cancer registry collected by the National Central Cancer Registry of China (NCCRC) in 2015. The data collected from 501 local cancer registries in China were assessed using NCCRC screening methods and criteria. Incidence and mortality rates of oral and oropharyngeal cancer were stratified by age group, gender, and area. Age-standardized incidence and mortality rates were adjusted using the Chinese standard population in 2000 and Segi’s world population. Results In 2015, it was estimated that there were 51,765 oral and oropharyngeal cancer incident cases and 23,830 deaths in China. The crude incidence rate of oral and oropharyngeal cancer was 3.77/100,000, and the age-standardized incidence rate by Chinese standard population and by Segi’s world standard population were 2.55/100,000 and 2.49/100,000, respectively. The crude mortality rate and the age-standardized mortality rates by Chinese standard population and by Segi’s world standard population were 1.73/100,000, 1.09/100,000 and 1.08/100,000, respectively. Both incidence and mortality rates of oral and oropharyngeal cancer were higher in males and in urban areas. Residents in eastern areas had the highest incidence and mortality rates, followed by those from middle areas and western areas. The rates of oral and oropharyngeal cancer increased greatly with age, especially after the age of 40 years. Conclusions This study reports the latest incidence and mortality rates of oral and oropharyngeal cancer in China. Prevention intervention including early detection, treatment, and regular follow-ups is encouraged to be set up to reduce incidence and mortality rates of oral and oropharyngeal cancer in the future.
Collapse
Affiliation(s)
- Lin Lei
- Department of Non-communicable Disease Control and Prevention, Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China
| | - Rongshou Zheng
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100021, China
| | - Ke Peng
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2042, Australia
| | - Lei Si
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2042, Australia
| | - Ji Peng
- Department of Non-communicable Disease Control and Prevention, Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China
| | - Weicong Cai
- Department of Non-communicable Disease Control and Prevention, Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China
| | - Siwei Zhang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100021, China
| | - Wenqiang Wei
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100021, China
| | - Jie He
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100021, China
| |
Collapse
|
31
|
Gaspar M, Rosenes R, Burchell AN, Grennan T, Salit I, Grace D. Diagnosing uncertainty: The challenges of implementing medical screening programs for minority sub-populations in Canada. Soc Sci Med 2019; 244:112643. [PMID: 31698281 DOI: 10.1016/j.socscimed.2019.112643] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 10/22/2019] [Accepted: 10/25/2019] [Indexed: 12/29/2022]
Abstract
The social science literature on medical screening has documented a notable disjuncture between the promises of population-based screening programs and the complex realities of their rollout in everyday practice. We contribute to this scholarship by examining how healthcare providers confront numerous uncertainties associated with the implementation of anal cancer screening programs in Canada given the absence of standardized national evidence-based guidelines. The data was derived from in-depth interviews conducted with 13 physicians and 2 clinical researchers about anal cancer screening for gay, bisexual and other men who have sex with men living with HIV, the minority sub-population at the highest risk for HPV-associated anal cancer. Despite having unknown utility and low specificity, an initial anal Pap test was used to triage patients into anal dysplasia clinics for high-resolution anoscopy. This process led to technological scepticism toward the Pap's accuracy, diagnostic ambiguity related to the interpretation of the cytology results and increased patient anxiety regarding abnormal results. Physicians navigated a tension between wanting to avoid exposing their patients to additional uncertainties caused by screening and pre-cancer treatment and wanting to ensure that their patients did not develop anal cancer under their care. A high number of abnormal anal Pap results paradoxically reintroduced some of the capacity issues that the Pap was meant to resolve, as the existing dysplasia clinics were incapable of seeing all patients with abnormal results. We define this sequence as the epistemic-capacity paradox, a dynamic whereby seeking evidence to improve healthcare capacity simultaneously produces evidence that introduces capacity challenges and generates additional uncertainty. The epistemic-capacity paradox demonstrates the limitations of evidence-based medicine frameworks at determining best practices in the context of rarer health conditions affecting minority sub-populations, where smaller population numbers and limited institutional support pose systemic challenges to the acquisition of sufficient evidence.
Collapse
Affiliation(s)
- Mark Gaspar
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
| | - Ron Rosenes
- Toronto General Hospital Research Institute, University Health Network, Toronto, Canada
| | - Ann N Burchell
- Department of Family and Community Medicine and MAP Centre for Urban Health Solutions, St. Michael's Hospital, Unity Health Toronto, Toronto, Canada
| | - Troy Grennan
- British Columbia Centre for Disease Control, Vancouver, Canada
| | - Irving Salit
- Toronto General Hospital Research Institute, University Health Network, Toronto, Canada
| | - Daniel Grace
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
| |
Collapse
|
32
|
Kares S, Veijalainen O, Kholová I, Tirkkonen M, Vuento R, Huhtala H, Tuimala V, Mäenpää J, Kujala P. HIGH‐RISK HPV testing as the primary screening method in an organized regional screening program for cervical cancer: the value of HPV16 and HPV18 genotyping? APMIS 2019; 127:710-716. [DOI: 10.1111/apm.12990] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 08/05/2019] [Indexed: 12/22/2022]
Affiliation(s)
- Saara Kares
- Department of Pathology Fimlab Laboratories Ltd TampereFinland
| | - Olga Veijalainen
- Department of Obstetrics and Gynaecology Päijät‐Häme Central Hospital LahtiFinland
| | - Ivana Kholová
- Department of Pathology Fimlab Laboratories Ltd TampereFinland
- Department of Pathology Faculty of Medicine and Health Technology Tampere University Tampere Finland
| | - Mika Tirkkonen
- Department of Pathology Fimlab Laboratories Ltd TampereFinland
| | - Risto Vuento
- Department of Microbiology Fimlab Laboratories Ltd Tampere Finland
| | - Heini Huhtala
- Faculty of Social Sciences Tampere University Tampere Finland
| | - Veronica Tuimala
- Department of Gynaecology and Obstetrics, and Cancer Centre Tampere University Hospital Tampere Finland
| | - Johanna Mäenpää
- Department of Gynaecology and Obstetrics, and Cancer Centre Tampere University Hospital Tampere Finland
- Faculty of Medicine and Health Technology Tampere University Tampere Finland
| | - Paula Kujala
- Department of Pathology Fimlab Laboratories Ltd TampereFinland
| |
Collapse
|
33
|
Thorsteinsson K, Ladelund S, Storgaard M, Katzenstein TL, Johansen IS, Pedersen G, Rönsholt FF, Nielsen LN, Nilas L, Franzmann M, Obel N, Lebech AM, Bonde J. Persistence of cervical high-risk human papillomavirus in women living with HIV in Denmark - the SHADE. BMC Infect Dis 2019; 19:740. [PMID: 31438877 PMCID: PMC6706931 DOI: 10.1186/s12879-019-4377-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 08/13/2019] [Indexed: 12/29/2022] Open
Abstract
Background Women living with HIV (WLWH) have high rates of persistent high-risk human papillomavirus (hrHPV) infections and cervical cancer. We aimed to assess the distribution of hrHPV genotypes, risk factors of type-specific hrHPV persistence, and high-grade squamous intraepithelial lesions or worse (≥HSIL) in WLWH in Denmark. Methods From the prospective Study on HIV, cervical Abnormalities and infections in women in Denmark (SHADE) we identified WLWH with a positive hrHPV test during the study period; 2011–2014. HIV demographics were retrieved from the Danish HIV Cohort Study and pathology results from the The Danish Pathology Data Bank. Logistic regression was used to identify risk factors associated with persistent hrHPV infection (positivity of the same hrHPV type in two samples one-two years after the first hrHPV positive date) and ≥ HSIL. Results Of 71 WLWH, 31 (43.7%) had persistent hrHPV infection. Predominant hrHPV genotypes were HPV58, 52, 51, and 35 and most frequently observed persistent genotypes were HPV52, 33 and 31. CD4 < 350 cells/μL predicted genotype-specific hrHPV persistence (adjusted OR 4.36 (95%CI: 1.18–16.04)) and ≥ HSIL was predicted by prior AIDS (adjusted OR 8.55 (95% CI 1.21–60.28)). Conclusions This prospective cohort study of well-treated WLWH in Denmark found a high rate of persistent hrHPV infections with predominantly non-16/18 hrHPV genotypes. CD4 count < 350 cells/μL predicted hrHPV persistence, while prior AIDS predicted ≥HSIL. Electronic supplementary material The online version of this article (10.1186/s12879-019-4377-5) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Kristina Thorsteinsson
- Department of Infectious Diseases, Hvidovre Hospital, Kettegaards Allé 30, 2650, Hvidovre, Denmark.
| | - Steen Ladelund
- Clinical Research Center, Copenhagen University Hospital, Hvidovre, Denmark
| | - Merete Storgaard
- Department of Infectious Diseases, Aarhus University Hospital, Skejby, Denmark
| | - Terese L Katzenstein
- Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | | | - Gitte Pedersen
- Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark
| | | | | | - Lisbeth Nilas
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Obstetrics and Gynaecology, Copenhagen University Hospital, Hvidovre, Denmark
| | - Maria Franzmann
- Molecular Pathology Laboratory, Department of Pathology, Copenhagen University Hospital, Hvidovre, Denmark
| | - Niels Obel
- Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Anne-Mette Lebech
- Department of Infectious Diseases, Hvidovre Hospital, Kettegaards Allé 30, 2650, Hvidovre, Denmark.,Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Jesper Bonde
- Molecular Pathology Laboratory, Department of Pathology, Copenhagen University Hospital, Hvidovre, Denmark
| |
Collapse
|
34
|
Ali MAM, Bedair RN, Abd El Atti RM. Cervical high-risk human papillomavirus infection among women residing in the Gulf Cooperation Council countries: Prevalence, type-specific distribution, and correlation with cervical cytology. Cancer Cytopathol 2019; 127:567-577. [PMID: 31390155 DOI: 10.1002/cncy.22165] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 06/16/2019] [Accepted: 07/02/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND The scarcity of updated data on the prevalence of cervical human papillomavirus (HPV) infection in the Gulf Cooperation Council (GCC) countries hampers the establishment of cervical cancer screening and HPV vaccination programs. The current study estimated the prevalence of cervical high-risk (HR) HPV infection among women residing in some countries of the GCC and analyzed the correlation between HR-HPV infection types and cytology results. METHODS In total, 2478 women residing in the Kingdom of Saudi Arabia, Qatar, the United Arab Emirates, and Bahrain were enrolled in this study. Cervical specimens were subjected to simultaneous liquid-based cytology and HR-HPV DNA analysis. RESULTS Of 2478 women, 520 (21%) tested positive for HR-HPV. Other non-HPV genotype 16 (HPV16)/HPV18 HR-HPV was the most frequently detected infection type, accounting for 63.7%. Non-Arab women had a significantly higher HR-HPV positivity rate compared with Arab women (31.6% vs 16.4%; P < .001). The HR-HPV positivity rate was highest among women residing in Qatar (31.3%), followed by women living in Bahrain (20%), the Kingdom of Saudi Arabia (17.2%), and the United Arab Emirates (14.7%). The overall prevalence of HR-HPV infections declined significantly with advancing age (P < .001). Women with abnormal cytology had a significantly higher HR-HPV positivity rate than those with normal cytology (50.6% vs 14.7%; P < .001). The HR-HPV positivity rate increased as the severity of the cytological lesion increased. CONCLUSIONS The current study provides updated data on HR-HPV prevalence in the GCC countries and delivers an evidence base for supporting the introduction of regional/national vaccination and screening programs in these countries.
Collapse
Affiliation(s)
- Mohamed A M Ali
- Department of Biochemistry, Faculty of Science, Ain Shams University, Cairo, Egypt
| | - Rania N Bedair
- Department of Chemical Pathology, Medical Research Institute, Alexandria University, Alexandria, Egypt
- Molecular Diagnostics Unit, Al Borg Medical Laboratories, Jeddah, Kingdom of Saudi Arabia
| | - Rasha M Abd El Atti
- Department of Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| |
Collapse
|
35
|
Murphy J, McKenna M, Abdelazim S, Battiwalla M, Stratton P. A Practical Guide to Gynecologic and Reproductive Health in Women Undergoing Hematopoietic Stem Cell Transplant. Biol Blood Marrow Transplant 2019; 25:e331-e343. [PMID: 31394266 DOI: 10.1016/j.bbmt.2019.07.038] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 07/15/2019] [Accepted: 07/30/2019] [Indexed: 12/25/2022]
Abstract
Optimum care of female transplant recipients requires gynecologic care at several stages through the allogeneic hematopoietic stem cell transplantation (HCT) process. Sex-based considerations in women post-HCT span gynecologic sequelae of transplant along with assessment and maintenance of optimal sexual and gynecologic health. Pre-HCT, managing menstruation and abnormal uterine or genital bleeding, considering fertility preservation, and assessing for sexually transmitted infections, including human papillomavirus (HPV)-related disease and cervical cancer, enhance women's health. While inpatient during transplant when women are thrombocytopenic, menstrual bleeding requires suppression. Whenever graft-versus-host disease (GVHD) is assessed, screening for genital GVHD merits consideration. After the first 100 days, periodic assessments include obtaining a menstrual history, assessing ovarian function, and reviewing current hormonal use and contraindications to hormonal methods. Regular assessment for primary ovarian insufficiency, dyspareunia, and intimacy guides provision of contraception and hormone replacement options. As part of ongoing screening for genital GVHD and HPV-related disease, including sexually transmitted infections, periodic pelvic examinations are performed. Once successful long-term survival is achieved, planning for fertility may be considered. This article offers a comprehensive approach to these aspects of gynecologic care of patients throughout the trajectory of HCT and beyond into survivorship. We review the effects of HCT treatment on sexual health, ovarian function, and resulting menstrual changes and fertility challenges. Identification, treatment, and prevention of subsequent malignancies, including breast cancer, are discussed, with a focus on regular assessment of genital HPV disease and GVHD in long-term follow-up.
Collapse
Affiliation(s)
- Jeanne Murphy
- George Washington University School of Nursing, Washington, District of Columbia.
| | - Mary McKenna
- Loyola University Medical Center, Maywood, Illinois; NIH Clinical Center, Bethesda, Maryland
| | - Suzanne Abdelazim
- NIH Clinical Center, Bethesda, Maryland; Riverside Regional Medical Center, Newport News, Virginia
| | | | - Pamela Stratton
- Office of the Clinical Director, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland
| |
Collapse
|
36
|
Feuerstein JD, Moss AC, Farraye FA. Ulcerative Colitis. Mayo Clin Proc 2019; 94:1357-1373. [PMID: 31272578 DOI: 10.1016/j.mayocp.2019.01.018] [Citation(s) in RCA: 210] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 11/02/2018] [Accepted: 01/22/2019] [Indexed: 02/07/2023]
Abstract
Ulcerative colitis (UC) is a chronic inflammatory bowel disease that can involve any aspect of the colon starting with mucosal inflammation in the rectum and extending proximally in a continuous fashion. Typical symptoms on presentation are bloody diarrhea, abdominal pain, fecal urgency, and tenesmus. In some patients, extraintestinal manifestations may predate the onset of gastrointestinal symptoms. A diagnosis of UC is made on the basis of presenting symptoms consistent with UC as well as endoscopic evidence showing continuous and diffuse colonic inflammation that starts in the rectum. Biopsies of the colon documenting chronic inflammation confirm the diagnosis of UC. Most cases are treated with pharmacological therapy to first induce remission and then to maintain a corticosteroid-free remission. There are multiple classes of drugs used to treat the disease. For mild to moderate UC, oral and rectal 5-aminosalycilates are typically used. In moderate to severe colitis, medication classes include thiopurines, biological agents targeting tumor necrosis factor and integrins, and the small-molecule Janus kinase inhibitors. However, in up to 15% of cases, patients in whom medical therapy fails or who have development of dysplasia secondary to their long-standing colitis will require surgical treatment. Finally, to minimize the complications of UC and adverse events from medications, a working collaboration between primary care physicians and gastroenterologists is necessary to make sure that vaccinations are optimized and that patients are screened for colon cancer, skin cancer, bone loss, depression, and other treatable and preventable complications.
Collapse
Affiliation(s)
- Joseph D Feuerstein
- Department of Medicine and Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
| | - Alan C Moss
- Department of Medicine and Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Francis A Farraye
- Department of Medicine and Section of Gastroenterology, Boston Medical Center, Boston University School of Medicine, Boston, MA
| |
Collapse
|
37
|
Zhang SD, Yu L, Wang P, Kou P, Li J, Wang LT, Wang W, Yao LP, Zhao XH, Fu YJ. Inotodiol inhibits cells migration and invasion and induces apoptosis via p53-dependent pathway in HeLa cells. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2019; 60:152957. [PMID: 31128995 DOI: 10.1016/j.phymed.2019.152957] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 05/10/2019] [Accepted: 05/11/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Inonotus obliquus, namely as Chaga mushroom, is a medicinal and edible fungus, which is widely used in food and medical fields. Inotodiol, a natural lanostane-type triterpenoid with remarkable pharmacological activities, was isolated from Inonotus obliquus, which its potential anti-tumor molecular mechanism was elaborated poorly. PURPOSE The aim of the present study was to investigate the effect of Inotodiol on HeLa cell migration, invasion and apoptosis through p53-dependent pathway. STUDY DESIGN AND METHODS The potential mechanisms of Inotodiol on HeLa cell anti-metastatic and pro-apoptosis via wound healing assay, trans-well invasion assay, flow cytometry, caspase-3 activity assay and western blot analysis were studied, as well as the involvement of p53 signaling pathway in anti-metastatic and pro-apoptosis of Inotodiol. Besides, the function of tumor suppressor p53 was further verified by small interfering RNA. RESULTS Firstly, the cell viability assay showed that low-concentration of Inotodiol had no cytotoxicity to HeLa cells and whereas the concentration above 25 μM significantly inhibited HeLa cell growth and even induced apoptosis. This result was further demonstrated by cell proliferation and morphology assay. Secondly, in vitro wound healing and trans-well invasion assays reported that low-concentration treatment of Inotodiol significantly inhibited cells migration and invasion in a dose-dependent manner, the western blot analysis of matrix mettalloprotinase-2 (MMP2) and matrix mettalloprotinase-9 (MMP9) levels were also decreased. Moreover, Inotodiol notably induced tumor cell apoptosis by Annexin-V-FITC apoptosis assay, which is associated with activation pro-apoptotic proteins of PARP, cleaved caspase-3 and Bax expression, inhibition anti-apoptotic protein Bcl-2 expression. Finally, the anti-tumor activity of Inotodiol was attenuated by silencing p53 tumor suppressor, the result revealed that pre-treatment with p53-specific small interfering RNA (si-p53) markedly inhibited Intodiol-indeuced HeLa cell apoptosis and decreased the caspase-3 activity. What is more, the inhibitory effect of Inotodiol on tumor migration and invasion was blocked under p53 knockdown. CONCLUSION To sum up, the present study indicated that Inotodiol possessed the potential to prevent malignant tumor migration and invasion, and it might be a natural active compound candidate for clinical treatment of human cervical cancer.
Collapse
Affiliation(s)
- Sun-Dong Zhang
- Key Laboratory of Forest Plant Ecology, Ministry of Education, Northeast Forestry University, Harbin 150040, China
| | - Liang Yu
- Key Laboratory of Forest Plant Ecology, Ministry of Education, Northeast Forestry University, Harbin 150040, China
| | - Peng Wang
- Key Laboratory of Forest Plant Ecology, Ministry of Education, Northeast Forestry University, Harbin 150040, China
| | - Ping Kou
- Key Laboratory of Forest Plant Ecology, Ministry of Education, Northeast Forestry University, Harbin 150040, China
| | - Ji Li
- Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin 150001, China
| | - Li-Tao Wang
- College of Forestry, Beijing Forestry University, Beijing 100083, China
| | - Wei Wang
- Key Laboratory of Forest Plant Ecology, Ministry of Education, Northeast Forestry University, Harbin 150040, China
| | - Li-Ping Yao
- Key Laboratory of Forest Plant Ecology, Ministry of Education, Northeast Forestry University, Harbin 150040, China
| | - Xiu-Hua Zhao
- Key Laboratory of Forest Plant Ecology, Ministry of Education, Northeast Forestry University, Harbin 150040, China
| | - Yu-Jie Fu
- Key Laboratory of Forest Plant Ecology, Ministry of Education, Northeast Forestry University, Harbin 150040, China; College of Forestry, Beijing Forestry University, Beijing 100083, China.
| |
Collapse
|
38
|
Hashiguchi M, Nakao Y, Honda A, Kawaguchi A, Hanashima K, Nishiyama S, Yokoyama M. What Has Changed Since the Introduction of Human Papillomavirus Testing with the Cytology-Based Cervical Cancer Screening System in Japan A Social Experiment. Acta Cytol 2019; 63:385-390. [PMID: 31163443 DOI: 10.1159/000500190] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 04/04/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND Uterine cervical cancer is the fourth most common female cancer in the world. In Japan, we have an apparently low rate of joining cervical cancer screening programs compared with Western countries. Furthermore, the incidence and mortality rate of cervical cancer among the younger generation has been increasing. OBJECT The aim of this study was to assess the effectiveness of cervical cancer screening with human papillomavirus (HPV) testing and cytology in Japan. METHODS Collaborating with Saga City government, we initiated a cervical cancer screening system consisting of HPV testing and baseline cervical cytology from April 2011 as a social experiment. A total of 17,284 participants have been screened with this new combination system. RESULTS After HPV testing with cytology-based cervical cancer screening, the number of screenings done in women aged under 40 years has significantly increased. In addition, the number of women diagnosed with cervical intraepithelial neoplasia grade 3 has increased (25 of 14,025 vs. 146 of 23,049 under 50 years: p < 0.001). CONCLUSION These data suggested that the introduction of HPV testing with cytology-based cervical cancer screening as an adjunct to conventional cytology resulted in better efficiency and more accurate screening among the Japanese population.
Collapse
Affiliation(s)
- Mariko Hashiguchi
- Department of Obstetrics and Gynecology, Faculty of Medicine, Saga University, Saga, Japan,
| | - Yoshifumi Nakao
- Department of Obstetrics and Gynecology, Faculty of Medicine, Saga University, Saga, Japan
| | - Atsuko Honda
- The Synthetic Health Association of Saga, Saga, Japan
| | - Atsushi Kawaguchi
- Center for Comprehensive Community Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Katsuyuki Hanashima
- Department of Obstetrics and Gynecology, Faculty of Medicine, Saga University, Saga, Japan
| | - Satoshi Nishiyama
- Department of Obstetrics and Gynecology, Faculty of Medicine, Saga University, Saga, Japan
| | - Masatoshi Yokoyama
- Department of Obstetrics and Gynecology, Faculty of Medicine, Saga University, Saga, Japan
| |
Collapse
|
39
|
dos Santos AV, dos Santos GT, Brackmann RL, Prolla JC, Bica CG. Follow-Up of Women with Cervical Cytological Abnormalities:
Progression and Regression Events. Asian Pac J Cancer Prev 2019; 20:1019-1024. [PMID: 31030468 PMCID: PMC6948908 DOI: 10.31557/apjcp.2019.20.4.1019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Section Title Abnormalities in the cervix, when identified early by Pap smear, can be treated in the early stages or in the precursor stages of the neoplasia, which may increase the chances of regression of the lesion. The aim to verify the rate of cervical abnormalities and to evaluate the risk of progression or regression associated with age and cytological diagnosis. Methods: The study was conducted in a referral hospital in Southern Brazil, based on the results of pathology and cytopathology laboratory tests of uterine cervix. The historical cohort included patients with an abnormal cytology diagnosis in the period from January 2010 to December 2014, followed until July 2016. Results: A total of 42,389 cervical smears were analyzed, 4,427 of which were eligible for analysis of the evolution of cervical abnormalities. In progression and regression events analysis, we observed that patients with a cytological diagnosis of atypical glandular cells presented a higher risk of cervical abnormality progression (Hazard Ratio: 2.0 and 95% confidence intervals 1.36–3.48). We also observed that patients younger than 25 years old were more likely to regress the cervical lesions (Hazard Ratio:1.4 and 95% confidence intervals 1.20–1.74). Conclusions: The associations found between the events (progression and regression), age and cytological diagnosis, highlights the importance of cytological screening in populations at risk of precursor of cervical cancer lesions, especially in women older than 25 years.
Collapse
Affiliation(s)
- Aniúsca Vieira dos Santos
- Pathology Research Laboratory,Federal University of Health Sciences of Porto Alegre, Rio Grande do Sul, Brazil
| | - Giovana Tavares dos Santos
- Pathology Research Laboratory,Federal University of Health Sciences of Porto Alegre, Rio Grande do Sul, Brazil
| | | | - João Carlos Prolla
- Laboratory of Pathology, Santa Casa de Misericórdia of Porto Alegre, Rio Grande do Sul, Brazil
| | - Claudia Giuliano Bica
- Department of Basic Health Sciences, Federal University of Health Sciences of Porto Alegre, Rio Grande do Sul, Brazil.
| |
Collapse
|
40
|
Jia QP, Yan CY, Zheng XR, Pan X, Cao X, Cao L. Upregulation of MTA1 expression by human papillomavirus infection promotes CDDP resistance in cervical cancer cells via modulation of NF-κB/APOBEC3B cascade. Cancer Chemother Pharmacol 2019; 83:625-637. [PMID: 30631898 DOI: 10.1007/s00280-018-03766-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 12/29/2018] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Compelling evidence establishes the etiological role of viral proteins E6 and E7 of high-risk human papillomaviruses (HPV) in cervical carcinogenesis, but their contribution in chemoresistance that leads to advanced metastatic lesions remains poorly defined. Since metastasis-associated protein 1 (MTA1) upregulation and augmentation of APOBEC3B expression are both strongly associated with cervical cancer (CCa) development, and both molecules have been shown to be functionally associated with NF-κB pathway, we therefore sought to investigate the potential mechanistic link between MTA1, APOBEC3B and NF-κB during the pathogenesis of cisplatin (CDDP) resistance in HPV-positive CCa cells. METHODS MTA1 expression was assessed in HPV-transfected CCa cells using quantitative RT-PCR and immunoblotting. Effects of MTA1 deregulation on CDDP chemosensitivity in CCa cells were determined by measuring cell viability, apoptosis and in vivo oncogenic capacity. Finally, we studied the transcriptional regulation of the antiviral DNA cytosine deaminase APOBEC3B by MTA1 using multiple approaches including DNA deaminase activity assay, luciferase reporter assay, chromatin immunoprecipitation, co-immunoprecipitation and transient/stable transfection, at the molecular and functional levels. RESULTS Expression levels of MTA1 were significantly induced in HPV-positive CCa cells. Transduction experiments showed that the E6 oncoprotein alone was sufficient to cause MTA1 upregulation. Moreover, MTA1 knockdown potentiated CDDP sensitivity in highly metastatic CCa cells. Mechanistically, MTA1 acted as an indirect upstream modulator of APOBEC3B transcription during the pathogenesis of CDDP chemoresistance. HPV-mediated stimulation of APOBEC3B expression was accompanied by the enhanced recruitment of Iκκ α/β and p65 to the NF-κB consensus sites in the APOBEC3B promoter, and this recruitment was substantially abrogated by MTA1 siRNA treatment. CONCLUSIONS These findings reveal an obligatory coregulatory role of MTA1 in the indirect regulation of APOBEC3B expression via classical NF-κB pathway, and also suggest that inhibition of MTA1/NF-κB/APOBEC3B cascade may be repositioned to suppress cancer mutagenesis, dampen tumor evolution, and decrease the probability of adverse outcomes from CDDP resistance in CCa.
Collapse
Affiliation(s)
- Qiu-Ping Jia
- Department of Gynaecology and Obstetrics, The 2nd Affiliated Hospital of Xi'an Medical University, No. 167 Fangdong Road, Xi'an, 710038, Shaanxi, People's Republic of China
| | - Chang-You Yan
- Family Planning Service Stations of Health and Family Planning Commission of Chengcheng County, Chengcheng County, Weinan, 714000, Shaanxi, China
| | - Xue-Rong Zheng
- Department of Gynaecology and Obstetrics, The 1st Affiliated Hospital of Xi'an Medical University, Xi'an, 710038, Shaanxi, People's Republic of China
| | - Xia Pan
- Department of Gynaecology and Obstetrics, XD Group Hospital, Xi'an, 710077, Shaanxi, People's Republic of China
| | - Xin Cao
- Department of Gynaecology and Obstetrics, XD Group Hospital, Xi'an, 710077, Shaanxi, People's Republic of China
| | - Lei Cao
- Department of Gynaecology and Obstetrics, The 2nd Affiliated Hospital of Xi'an Medical University, No. 167 Fangdong Road, Xi'an, 710038, Shaanxi, People's Republic of China.
| |
Collapse
|
41
|
Karadag Arli S, Bakan AB, Aslan G. Distribution of cervical and breast cancer risk factors in women and their screening behaviours. Eur J Cancer Care (Engl) 2018; 28:e12960. [PMID: 30421468 DOI: 10.1111/ecc.12960] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 08/29/2018] [Accepted: 10/08/2018] [Indexed: 01/06/2023]
Abstract
Breast cancer and cervical cancer are important causes of cancer-related mortality in women all over the world. The present study was conducted in order to investigate the distribution of cervical and breast cancer risk factors in women and their knowledge and behaviours about cancer screening methods. The study is cross-sectional in nature. It was conducted with the participation of 1,886 women in Turkey. Data were collected through a questionnaire. The knowledge and behaviours of women aged 40 and over about breast cancer or cervical cancer screening methods were investigated according to the education level; results showed that the rates of those who knew and did breast self-examination were significantly lower in illiterate women. Besides, the rates of women who did breast self-examination were significantly lower in those who were aged 40 and over, and the rates of those who had clinical breast examination and Pap smear test were significantly lower in women aged 39 and below (p < 0.01). This study identified the most notable breast and cervical cancer risk factors as low education levels, high number of deliveries, short breastfeeding period, obesity and low socio-economic level. For this reason, public health policies should be developed to minimise these risk factors.
Collapse
Affiliation(s)
- Senay Karadag Arli
- Department of Nursing, Agri Ibrahim Cecen University School of Health, Agri, Turkey
| | - Ayse Berivan Bakan
- Department of Nursing, Agri Ibrahim Cecen University School of Health, Agri, Turkey
| | - Gulpinar Aslan
- First and Immediate Aid Program, Agri Ibrahim Cecen University Health Services Vocational School, Agri, Turkey
| |
Collapse
|
42
|
Abstract
High-resolution anoscopy (HRA) is a form of low-resolution anal microscopy currently utilized in the screening and management of anal squamous dysplasia. No randomized controlled trials, national or international guidelines exist on the use of HRA for this purpose. Much of our understanding of this entity has been adapted from the literature on cervical squamous dysplasia, including the technique of HRA itself. Epidemiologic evidence has shown that the prevalence and incidence of anal dysplasia is highest in HIV-positive populations. The history of this technique parallels the evolution of our understanding of anal dysplasia. To understand the history of the use of HRA and its place in the screening and management of anal squamous dysplasia, we discuss key advances in the understanding of human papillomavirus-related squamous dysplasia. We begin with early reports in the field establishing the link between this virus and squamous dysplasia, through the marked increase in anal cancer seen with the onset of the HIV epidemic, the identification of relevant populations at risk, the performance of the test itself, to its use today.
Collapse
Affiliation(s)
- S David Cho
- Department of Surgery, Kaiser Permanente, Portland, Oregon
| | - Emily Groves
- Department of General Surgery, Oregon Health and Science University, Portland, Oregon
| | - Victoria V Lao
- Department of General Surgery, University of Washington, Seattle, Washington
| |
Collapse
|
43
|
Zhang X, Li F, Zhu L. Clinical significance and functions of microRNA-93/CDKN1A axis in human cervical cancer. Life Sci 2018; 209:242-248. [PMID: 30098344 DOI: 10.1016/j.lfs.2018.08.021] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Revised: 07/29/2018] [Accepted: 08/07/2018] [Indexed: 12/21/2022]
Abstract
AIM Accumulating studies have revealed that microRNA (miR)-93 may exert an oncogenic role in various cancers via inhibiting CDKN1A. However, the involvement of miR-93/CDKN1A axis in cervical cancer remains unclear. We aimed to investigate expression pattern, clinical significance and potential functions of miR-93/CDKN1A axis in cervical cancer. METHODS Expression levels of miR-93 and CDKN1A mRNA in 100 pairs of cervical cancer and matched non-cancerous tissue samples were detected by quantitative-PCR. Statistical analyses were performed to evaluate associations of miR-93 and/or CDKN1A expression with various clinicopathologic features and patients' prognosis. The functions of miR-93/CDKN1A axis on cell proliferation and invasion were also examined. RESULTS Compared to non-cancerous tissues, the expression levels of miR-93 and CDKN1A were dramatically increased and decreased in cervical cancer tissues, respectively (both P < 0.01). High miR-93 and/or low CDKN1A expression were significantly associated with advanced International Federation of Gynecology and Obstetrics stage, the presence of lymph node metastasis and recurrence (all P < 0.05). Importantly, patients with high miR-93 and/or low CDKN1A expression had shorter overall survival than those with low miR-93 and/or high CDKN1A expression. The multivariate analysis identified miR-93 and/or CDKN1A expression as independent prognostic factors of cervical cancer. Functionally, miR-93 promoted cell proliferation and invasion of cervical cancer cells via inhibiting CDKN1A. CONCLUSION miR-93 upregulation and CDKN1A downregulation may be both associated with the development, progression and patients' prognosis of cervical cancer. miR-93/CDKN1A axis may also play an important role in the malignancy of cervical cancer cells, suggesting its potential as a therapeutic target for this cancer.
Collapse
Affiliation(s)
- Xiaofeng Zhang
- Department of Radiology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - Fengshuang Li
- Department of Gynecology & Tumor, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - Linzhong Zhu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Interventional Therapy, Peking University Cancer Hospital & Institute, China.
| |
Collapse
|
44
|
Neves ACO, Morais CLM, Mendes TPP, Vaz BG, Lima KMG. Mass spectrometry and multivariate analysis to classify cervical intraepithelial neoplasia from blood plasma: an untargeted lipidomic study. Sci Rep 2018; 8:3954. [PMID: 29500376 PMCID: PMC5834598 DOI: 10.1038/s41598-018-22317-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 02/21/2018] [Indexed: 02/06/2023] Open
Abstract
Cervical cancer is still an important issue of public health since it is the fourth most frequent type of cancer in women worldwide. Much effort has been dedicated to combating this cancer, in particular by the early detection of cervical pre-cancerous lesions. For this purpose, this paper reports the use of mass spectrometry coupled with multivariate analysis as an untargeted lipidomic approach to classifying 76 blood plasma samples into negative for intraepithelial lesion or malignancy (NILM, n = 42) and squamous intraepithelial lesion (SIL, n = 34). The crude lipid extract was directly analyzed with mass spectrometry for untargeted lipidomics, followed by multivariate analysis based on the principal component analysis (PCA) and genetic algorithm (GA) with support vector machines (SVM), linear (LDA) and quadratic (QDA) discriminant analysis. PCA-SVM models outperformed LDA and QDA results, achieving sensitivity and specificity values of 80.0% and 83.3%, respectively. Five types of lipids contributing to the distinction between NILM and SIL classes were identified, including prostaglandins, phospholipids, and sphingolipids for the former condition and Tetranor-PGFM and hydroperoxide lipid for the latter. These findings highlight the potentiality of using mass spectrometry associated with chemometrics to discriminate between healthy women and those suffering from cervical pre-cancerous lesions.
Collapse
Affiliation(s)
- Ana C O Neves
- Institute of Chemistry, Biological Chemistry and Chemometrics, Federal University of Rio Grande do Norte, Natal, 59072-970, RN, Brazil
| | - Camilo L M Morais
- Institute of Chemistry, Biological Chemistry and Chemometrics, Federal University of Rio Grande do Norte, Natal, 59072-970, RN, Brazil
- School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Preston, PR1 2HE, United Kingdom
| | - Thais P P Mendes
- School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Preston, PR1 2HE, United Kingdom
| | - Boniek G Vaz
- Institute of Chemistry, Federal University of Goiás, Goiânia, 74690-900, GO, Brazil
| | - Kássio M G Lima
- Institute of Chemistry, Biological Chemistry and Chemometrics, Federal University of Rio Grande do Norte, Natal, 59072-970, RN, Brazil.
| |
Collapse
|
45
|
Dual-Stained Cervical Cytology and Histology with Claudin-1 and Ki67. Pathol Oncol Res 2018; 25:477-486. [DOI: 10.1007/s12253-018-0384-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 01/30/2018] [Indexed: 12/20/2022]
|
46
|
Morel ME, McBride SE, Gomez MP. Comparative study of a novel application of automated HR HPV assay and stability in a previously untested Preservative media. PAPILLOMAVIRUS RESEARCH (AMSTERDAM, NETHERLANDS) 2017; 4:12-16. [PMID: 29179863 PMCID: PMC5883225 DOI: 10.1016/j.pvr.2017.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 05/25/2017] [Accepted: 06/02/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND The suitability and stability of cervical cells in Novaprep media (NHQ) for certain HPV assays is unknown. METHODS We evaluated the accuracy of an automated HPV assay (Abbott RealTime HR HPV) for cervical cells prepared in NHQ and NHQ with a pre-treatment to mimic a worst case clinical use, compared to the assay manufacturers media; repeatability and reproducibility of HPV results and the stability of detectable HPV in NHQ over time compared to CE marked liquid based cytology preservatives. Cell lines were used to simulate patient samples. RESULTS Cells stored in NHQ produced accurate, repeatable and reproducible results. Stability in NHQ was comparable to the best performing LBC, with at least 7 months' stability at 18-25°C, 2-8°C, -20°C and -80°C; and at least 3 months' stability at 40°C. Similar results were obtained for pre-treated NHQ except only 3.5 months' stability at 18-25°C. Cell line samples in all media and concentrations tested were detected appropriately by the assay. CONCLUSIONS Based on this first stage validation analytical study, cervical cells stored in NHQ are suitable for the Realtime HPV assay. There should be no reservations for inclusion of NHQ in any further validation and clinical performance evaluation of this assay.
Collapse
Affiliation(s)
- Mike E Morel
- Lab21 Ltd., Park House, Winship Road, Cambridge CB24 6BQ, United Kingdom.
| | - Simon E McBride
- Lab21 Ltd., Park House, Winship Road, Cambridge CB24 6BQ, United Kingdom
| | - Maria P Gomez
- Lab21 Ltd., Park House, Winship Road, Cambridge CB24 6BQ, United Kingdom
| |
Collapse
|
47
|
Granados R, Tellez-Safina H, Solis I, Mateos F, Rodriguez-Barbero JM, Aramburu JA, Huertas MA, Bajo P, Camarmo E, Corrales T, Medina P, Calvo B, Martin E, Anta L, Zamora M, Alcaide T. Cervical cancer screening cotesting with cytology and MRNA HPV E6/E7 yields high rates of CIN2+ lesions in young women. Diagn Cytopathol 2017; 45:1065-1072. [PMID: 28949442 DOI: 10.1002/dc.23821] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 09/01/2017] [Accepted: 09/12/2017] [Indexed: 01/15/2023]
Abstract
BACKGROUND European guidelines recommend primary HPV testing for cervical cancer screening. However, the starting age remains to be defined, with an undecided window between 30 and 35 years. This pilot study compares the effectiveness of primary HPV testing to that of cytology for the detection of high-grade (CIN2+) lesions stratified by age. METHODS Cotesting with LBC cytology and APTIMA® HPV (AHPV) was performed in 5053 women aged 25-65 in an opportunistic screening program in Madrid. AHPV-positive cases were referred to colposcopy and genotyped for HPV16 and 18/45 (AHPV-GT). Results were analyzed stratified in four age groups. RESULTS 454 cases (9.0%) were AHPV-positive. Women under 35 had a 30.2% CIN2+ rate, compared to 21.9% and 20.4% for women aged 35-44 or 45-54. There was a significant increase (P < .05) in the rate of CIN2+ in AHPV-GT-positive women when compared to that for other HPV types (AHPV-other), being 43.3% versus 15.7%. AHPV-GT-positive women under 35 had significantly higher rates of CIN2+ lesions than any other age-group. The sensitivity of cytology for cervical CIN2+ in APHV-positive women was 60.6%. All 4 carcinomas, including one AHPV-negative endometrial adenocarcinoma, had abnormal cytology. All cervical CIN2+ lesions biopsied were AHPV-positive. CONCLUSIONS Aptima HPV shows a significantly higher sensitivity for cervical CIN2+ lesions than cytology alone. Unexpectedly, AHPV-positive women under 35 had the highest incidence of CIN2+ lesions, particularly when they are HPV16/18/45-positive. Reconsidering HPV primary screening before the recommended age of 35 is warranted.
Collapse
Affiliation(s)
- Rosario Granados
- Department of Pathology, Hospital Universitario de Getafe, Madrid, Spain
| | - Hilda Tellez-Safina
- Department of Pathology, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - Isabel Solis
- Department of Gynecology, Hospital Universitario de Getafe, Madrid, Spain
| | - Francisco Mateos
- Department of Gynecology, Hospital Universitario de Getafe, Madrid, Spain
| | | | | | | | - Paloma Bajo
- Department of Pathology, Hospital Universitario de Getafe, Madrid, Spain
| | | | - Teresa Corrales
- Department of Pathology, Hospital Universitario de Getafe, Madrid, Spain
| | - Pedro Medina
- Direccion Asistencial Norte Madrid, Primary Care, Alfonso Rodriguez Castelao 17, Madrid
| | - Beatriz Calvo
- Direccion Asistencial Sur Madrid, Primary Care, Juan de la Cierva s/n, Getafe
| | - Esther Martin
- Direccion Asistencial Sur Madrid, Primary Care, Juan de la Cierva s/n, Getafe
| | - Laura Anta
- Direccion Asistencial Sur Madrid, Primary Care, Juan de la Cierva s/n, Getafe
| | - Manuel Zamora
- Direccion Asistencial Sur Madrid, Primary Care, Juan de la Cierva s/n, Getafe
| | - Teresa Alcaide
- Direccion Asistencial Sur Madrid, Primary Care, Juan de la Cierva s/n, Getafe
| |
Collapse
|
48
|
Zhang M, Adeniran AJ, Vikram R, Tamboli P, Pettaway C, Bondaruk J, Liu J, Baggerly K, Czerniak B. Carcinoma of the urethra. Hum Pathol 2017; 72:35-44. [PMID: 28827100 DOI: 10.1016/j.humpath.2017.08.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 07/26/2017] [Accepted: 08/10/2017] [Indexed: 01/05/2023]
Abstract
Primary carcinomas of the urethra are rare and poorly understood lesions; hence, their clinical and pathologic spectrum is not completely defined. We analyzed a series of 130 primary urethral tumors and classified 106 of them as primary urethral carcinomas. The age at diagnosis of patients with primary urethral carcinomas ranged from 42 to 97 years (mean, 69.4 years; median, 70 years). There were 73 male and 33 female patients with a ratio of 2.2:1. In male patients, the tumors most frequently developed in the bulbous-membranous segment of the urethra. In female patients, the entire length of the urethra was typically involved. Microscopically, they were poorly differentiated carcinomas with hybrid squamous and urothelial features and developed from precursor intraepithelial conditions such as dysplasia and carcinoma in situ, which were frequently present in the adjacent urethral mucosa. High-risk human papilloma virus infection could be documented in 31.6% of these tumors. Follow-up information was available for 95 patients. Twenty-three patients died of the disease with a mean and median survival of 39 and 21 months, respectively. Urethral carcinomas are aggressive tumors with a high propensity for regional and distant metastases with mean and median survival of 39 and 21 months, respectively. Our observations have important implications for the management of patients with primary carcinoma of the urethra by defining them as a unique entity linked to human papilloma virus infection.
Collapse
Affiliation(s)
- Miao Zhang
- Department of Pathology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, United States
| | | | - Raghunandan Vikram
- Department of Radiology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, United States
| | - Pheroze Tamboli
- Department of Pathology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, United States
| | - Curtis Pettaway
- Department of Urology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, United States
| | - Jolanta Bondaruk
- Department of Pathology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, United States
| | - Jinsong Liu
- Department of Pathology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, United States
| | - Keith Baggerly
- Department of Bioinformatics and Computational Biology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, United States
| | - Bogdan Czerniak
- Department of Pathology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, United States.
| |
Collapse
|
49
|
|
50
|
Barroeta JE, Adhikari-Guragain D, Grotkowski CE. Cervical cancer screening in the era of HPV vaccination: A review of shifting paradigms in cytopathology. Diagn Cytopathol 2017; 45:903-914. [PMID: 28589649 DOI: 10.1002/dc.23737] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 03/16/2017] [Accepted: 04/07/2017] [Indexed: 01/14/2023]
Abstract
Significant changes in cervical cancer screening practice, guidelines, and prevention of cervical cancer have taken place in recent years including the raising of initial cervical cancer screening age, changes in frequency of cytology screening, and the adoption of high risk HPV and cytology co-testing for some patients; the introduction of the bivalent, quadrivalent, and 9-valent HPV vaccines; and the recent approval of high risk HPV testing as primary screening with the use of cytology as triage in positive cases. This review discusses the significance of primary HPV screening, the impact of HPV vaccination in the prevalence of cervical cancer and its precursors, the interplay between high risk HPV testing and vaccination, and the implications for clinical and cytological management. Future strategies for cervical screening in the post-vaccination era are also discussed.
Collapse
Affiliation(s)
- Julieta E Barroeta
- Department of Pathology, Cooper University Hospital, M.D. Anderson Cancer Center at Cooper, Camden, New Jersey
| | - Deepti Adhikari-Guragain
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Carolyn E Grotkowski
- Department of Pathology, Cooper University Hospital, M.D. Anderson Cancer Center at Cooper, Camden, New Jersey
| |
Collapse
|