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Chen M, Li C, Cui Q, Zhou C, Chen P, Yao S. The efficacy of human papillomavirus prophylactic vaccination after conization in preventing cervical intraepithelial neoplasia recurrence: A prospective observational study in China. Eur J Obstet Gynecol Reprod Biol 2023; 286:10-15. [PMID: 37159990 DOI: 10.1016/j.ejogrb.2023.04.014] [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: 12/07/2022] [Revised: 03/26/2023] [Accepted: 04/16/2023] [Indexed: 05/11/2023]
Abstract
High-risk human papillomavirus (hrHPV) infection is the cause of most cervical cancers. Since therapeutic vaccines are not yet available for clinical practice, the administration of HPV prophylactic vaccines in patients with cervical intraepithelial neoplasia (CIN) arouses great interest and its value after excisional treatment of CIN remains unclear. We conducted this prospective cohort study to evaluate the impact of HPV prophylactic vaccination on preventing women from subsequent infection and cervical lesions after excision treatment. 148 patients after loop electrosurgical excision procedure (LEEP) for CIN2+ disease received HPV prophylactic vaccination (6/11/16/18 vaccine, Gardasil®, Merck) after surgery (V-group) and 273 didn't get vaccination (NV-group). The HPV infection rates at the first and second year after LEEP were significantly lower in the V-group than that in NV-group (P = 0.049 and P = 0.026). CIN2+ recurrence was observed in 29 cases (10.62 %) in the NV-group and 2 cases (2.03 %) in the V-group. Logistic regression analysis showed that the HPV16/18 infection, the CIN3 pathology after LEEP and no vaccination after LEEP were significant risk factors of recurrence. Patients without HPV vaccination had a higher CIN2+ recurrence rate (OR = 12.35, 95 % CI 1.919-79.492, P = 0.008). Our study showed the quadrivalent prophylactic HPV vaccination after LEEP had a significantly protective role in the prevention of high-grade squamous intraepithelial lesion recurrence. Further randomized, controlled trials are required in elucidating the efficacy of the prophylactic HPV vaccines using shortly after LEEP in patients with CIN disease.
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Affiliation(s)
- Ming Chen
- Department of Gynecology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Clinical Research Center for Obstetrical and Gynecological Diseases, China
| | - Cheng Li
- Department of Gynecology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Clinical Research Center for Obstetrical and Gynecological Diseases, China
| | - Qiulin Cui
- Department of Gynecology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Clinical Research Center for Obstetrical and Gynecological Diseases, China
| | - Chengli Zhou
- Department of Gynecology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Clinical Research Center for Obstetrical and Gynecological Diseases, China
| | - Peisong Chen
- Department of Clinical Laboratory, Department of Laboratory Medicine, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Shuzhong Yao
- Department of Gynecology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Clinical Research Center for Obstetrical and Gynecological Diseases, China.
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Mathivha L, Ramathuba DU, Maputle MS. Factors Affecting Participation in Cervical Screening by Female Nurses in Public Health Institutions in Vhembe District, Limpopo Province. NURSING REPORTS 2023; 13:424-435. [PMID: 36976691 PMCID: PMC10051518 DOI: 10.3390/nursrep13010039] [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: 01/20/2023] [Revised: 02/23/2023] [Accepted: 03/01/2023] [Indexed: 03/29/2023] Open
Abstract
In South Africa, the prevalence and death rates as a result of cervical cancer remains high, creating social and economic instability. The main objective of this study was to determine factors affecting participation in cervical screening by female nurses in public health institutions in Vhembe district, Limpopo Province. Early diagnosis and treatment are essential in cervical cancer screening as the prevalence of the disease decreases. The study was carried out at public health institutions in Vhembe district, Limpopo Province. A quantitative, descriptive, cross-sectional design was used in this study. Structured self-reported questionnaires were used in the collection of data. Descriptive statistics were used when analysing data to identify statistically significant differences in variables using SPSS version 26, and the findings were presented in percentages to generate evidence for the study. According to the study findings, (218, 83%) female nurses had been screened for cervical cancer, while the minority (46, 17%) had not been screened. The reasons cited were that they thought they were healthy (82, 31%), (79, 30%) felt embarrassed, and (15%) feared positive results. The majority (190) of them had last been screened more than three years before, with only a few (27, 10%) screened within the previous three years. A hundred and forty-two (53.8%) displayed negative attitudes and practices towards screening if it is paid for, and a hundred and eighteen (44.6%) perceived themselves as not vulnerable to acquiring cervical carcinoma. Furthermore,(128, 48.5%) strongly disagreed and 17(6.4%) were undecided about being screened by a male practitioner. The study concluded that negative attitudes, poor perception, and embarrassment are factors leading to low uptake by female nurses. Therefore, this study recommends that the Department of Health should build the capacity of nursing staff on matters of national significance to achieve sustainable goals and be a healthy nation. Nurses should be at the forefront of departmental programmes.
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Affiliation(s)
- Lindelani Mathivha
- Department of Advanced Nursing Science, Faculty of Health Science at the University of Venda Limpopo Province and South Africa, University of Venda, Thohoyandou 0950, South Africa
| | - Dorah Ursula Ramathuba
- Department of Advanced Nursing Science, Faculty of Health Science at the University of Venda Limpopo Province and South Africa, University of Venda, Thohoyandou 0950, South Africa
| | - Maria Sonto Maputle
- Department of Advanced Nursing Science, Faculty of Health Science at the University of Venda Limpopo Province and South Africa, University of Venda, Thohoyandou 0950, South Africa
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Kimla LJ, Clark TG, Banerjee S, Campino S. JC Polyomavirus T-antigen protein expression and the risk of colorectal cancer: Systematic review and meta-analysis of case-control studies. PLoS One 2023; 18:e0283642. [PMID: 37000859 PMCID: PMC10065230 DOI: 10.1371/journal.pone.0283642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 03/14/2023] [Indexed: 04/03/2023] Open
Abstract
JC Polyomavirus (JCV) is a human polyomavirus encoding T-antigen protein, which is implicated in carcinogenesis. JCV is prevalent in the upper and lower gastrointestinal track. Several studies have reported JCV associations with the risk of developing colorectal cancer (CRC), however, these findings remain controversial. Since JCV DNA may be present in healthy tissues as well as transformed tissues, JCV T-antigen expression could be a more useful measure of JCV's association with cancer development. The aim of this study is to conduct a meta-analysis of case-control studies to investigate if there is a significant association between JCV T-antigen protein expression and risk of CRC. A systematic review was performed to identify studies reporting JCV DNA prevalence in CRC and JCV T-antigen expression. The strength of the association was estimated by odds ratios (ORs). Five (of 66) studies satisfied analysis inclusion criteria, and spanned years 1999 to 2022. Random effects meta-analysis of CRC cases versus controls showed an 11-fold increased risk of CRC development in JCV DNA positive samples with JCV T-antigen expression versus normal tissues (OR 10.95; 95% CI: 2.48-48.24; P = 0.0016). The results of this meta-analysis of JCV infection followed by JCV T-antigen protein expression for the risk of CRC support the argument that JCV infection significantly increases the risk of colorectal cancer in tissues where the JCV T-antigen protein is expressed. Further research with JCV T-antigen expression in relation to CRC development is needed.
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Affiliation(s)
- Lenka J. Kimla
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Walden University, Minneapolis, Minnesota, United States of America
- * E-mail: ,
| | - Taane G. Clark
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Sri Banerjee
- Walden University, Minneapolis, Minnesota, United States of America
- Ross University School of Medicine, Miramar, Florida, United States of America
| | - Susana Campino
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Lipid Nanoparticles for mRNA Delivery to Enhance Cancer Immunotherapy. Molecules 2022; 27:molecules27175607. [PMID: 36080373 PMCID: PMC9458026 DOI: 10.3390/molecules27175607] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/24/2022] [Accepted: 08/24/2022] [Indexed: 12/24/2022] Open
Abstract
Messenger RNA (mRNA) is being developed by researchers as a novel drug for the treatment or prevention of many diseases. However, to enable mRNA to fully exploit its effects in vivo, researchers need to develop safer and more effective mRNA delivery systems that improve mRNA stability and enhance the ability of cells to take up and release mRNA. To date, lipid nanoparticles are promising nanodrug carriers for tumor therapy, which can significantly improve the immunotherapeutic effects of conventional drugs by modulating mRNA delivery, and have attracted widespread interest in the biomedical field. This review focuses on the delivery of mRNA by lipid nanoparticles for cancer treatment. We summarize some common tumor immunotherapy and mRNA delivery strategies, describe the clinical advantages of lipid nanoparticles for mRNA delivery, and provide an outlook on the current challenges and future developments of this technology.
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Akinyemiju T, Ogunsina K, Gupta A, Liu I, Braithwaite D, Hiatt RA. A Socio-Ecological Framework for Cancer Prevention in Low and Middle-Income Countries. Front Public Health 2022; 10:884678. [PMID: 35719678 PMCID: PMC9204349 DOI: 10.3389/fpubh.2022.884678] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 04/26/2022] [Indexed: 02/01/2023] Open
Abstract
Cancer incidence and mortality rates continue to rise globally, a trend mostly driven by preventable cancers occurring in low-and middle-income countries (LMICs). There is growing concern that many LMICs are ill-equipped to cope with markedly increased burden of cancer due to lack of comprehensive cancer control programs that incorporate primary, secondary, and tertiary prevention strategies. Notably, few countries have allocated budgets to implement such programs. In this review, we utilize a socio-ecological framework to summarize primary (risk reduction), secondary (early detection), and tertiary (treatment and survivorship) strategies to reduce the cancer burden in these countries across the individual, organizational, community, and policy levels. We highlight strategies that center on promoting health behaviors and reducing cancer risk, including diet, tobacco, alcohol, and vaccine uptake, approaches to promote routine cancer screenings, and policies to support comprehensive cancer treatment. Consistent with goals promulgated by the United Nations General Assembly on Noncommunicable Disease Prevention and Control, our review supports the development and implementation of sustainable national comprehensive cancer control plans in partnership with local communities to enhance cultural relevance and adoption, incorporating strategies across the socio-ecological framework. Such a concerted commitment will be necessary to curtail the rising cancer and chronic disease burden in LMICs.
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Affiliation(s)
- Tomi Akinyemiju
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, United States,Duke Cancer Institute, Durham, NC, United States,*Correspondence: Tomi Akinyemiju
| | - Kemi Ogunsina
- Department of Public Health Sciences, University of Miller School of Medicine, Miami, FL, United States
| | - Anjali Gupta
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, United States
| | - Iris Liu
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, United States
| | - Dejana Braithwaite
- Department of Epidemiology, University of Florida, Gainesville, FL, United States,University of Florida Cancer Center, Gainesville, FL, United States
| | - Robert A. Hiatt
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, United States,UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, United States
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Di Donato V, Caruso G, Bogani G, Cavallari EN, Palaia G, Perniola G, Ralli M, Sorrenti S, Romeo U, Pernazza A, Pierangeli A, Clementi I, Mingoli A, Cassoni A, Tanzi F, Cuccu I, Recine N, Mancino P, de Vincentiis M, Valentini V, d’Ettorre G, Della Rocca C, Mastroianni CM, Antonelli G, Polimeni A, Muzii L, Palaia I. HPV Vaccination after Primary Treatment of HPV-Related Disease across Different Organ Sites: A Multidisciplinary Comprehensive Review and Meta-Analysis. Vaccines (Basel) 2022; 10:vaccines10020239. [PMID: 35214697 PMCID: PMC8879645 DOI: 10.3390/vaccines10020239] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 01/29/2022] [Accepted: 01/31/2022] [Indexed: 11/16/2022] Open
Abstract
Objective: To assess evidence on the efficacy of adjuvant human papillomavirus (HPV) vaccination in patients treated for HPV-related disease across different susceptible organ sites. Methods: A systematic review was conducted to identify studies addressing the efficacy of adjuvant HPV vaccination on reducing the risk of recurrence of HPV-related preinvasive diseases. Results were reported as mean differences or pooled odds ratios (OR) with 95% confidence intervals (95% CI). Results: Sixteen studies were identified for the final analysis. Overall, 21,472 patients with cervical dysplasia were included: 4132 (19.2%) received the peri-operative HPV vaccine, while 17,340 (80.8%) underwent surgical treatment alone. The recurrences of CIN 1+ (OR 0.45, 95% CI 0.27 to 0.73; p = 0.001), CIN 2+ (OR 0.33, 95% CI 0.20 to 0.52; p < 0.0001), and CIN 3 (OR 0.28, 95% CI 0.13 to 0.59; p = 0.0009) were lower in the vaccinated than in unvaccinated group. Similarly, adjuvant vaccination reduced the risk of developing anal intraepithelial neoplasia (p = 0.005) and recurrent respiratory papillomatosis (p = 0.004). No differences in anogenital warts and vulvar intraepithelial neoplasia recurrence rate were observed comparing vaccinated and unvaccinated individuals. Conclusions: Adjuvant HPV vaccination is associated with a reduced risk of CIN recurrence, although there are limited data regarding its role in other HPV-related diseases. Further research is warranted to shed more light on the role of HPV vaccination as adjuvant therapy after primary treatment.
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Affiliation(s)
- Violante Di Donato
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy; (V.D.D.); (G.B.); (G.P.); (S.S.); (F.T.); (I.C.); (N.R.); (P.M.); (L.M.); (I.P.)
| | - Giuseppe Caruso
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy; (V.D.D.); (G.B.); (G.P.); (S.S.); (F.T.); (I.C.); (N.R.); (P.M.); (L.M.); (I.P.)
- Correspondence:
| | - Giorgio Bogani
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy; (V.D.D.); (G.B.); (G.P.); (S.S.); (F.T.); (I.C.); (N.R.); (P.M.); (L.M.); (I.P.)
| | - Eugenio Nelson Cavallari
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy; (E.N.C.); (G.d.); (C.M.M.)
| | - Gaspare Palaia
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy; (G.P.); (U.R.); (A.C.); (M.d.V.); (V.V.); (A.P.)
| | - Giorgia Perniola
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy; (V.D.D.); (G.B.); (G.P.); (S.S.); (F.T.); (I.C.); (N.R.); (P.M.); (L.M.); (I.P.)
| | - Massimo Ralli
- Department of Sense Organs, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy;
| | - Sara Sorrenti
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy; (V.D.D.); (G.B.); (G.P.); (S.S.); (F.T.); (I.C.); (N.R.); (P.M.); (L.M.); (I.P.)
| | - Umberto Romeo
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy; (G.P.); (U.R.); (A.C.); (M.d.V.); (V.V.); (A.P.)
| | - Angelina Pernazza
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy; (A.P.); (C.D.R.)
| | - Alessandra Pierangeli
- Department of Molecular Medicine, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy; (A.P.); (G.A.)
| | - Ilaria Clementi
- Department of Emergency, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy;
| | - Andrea Mingoli
- Department of Surgery “Pietro Valdoni”, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy;
| | - Andrea Cassoni
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy; (G.P.); (U.R.); (A.C.); (M.d.V.); (V.V.); (A.P.)
| | - Federica Tanzi
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy; (V.D.D.); (G.B.); (G.P.); (S.S.); (F.T.); (I.C.); (N.R.); (P.M.); (L.M.); (I.P.)
| | - Ilaria Cuccu
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy; (V.D.D.); (G.B.); (G.P.); (S.S.); (F.T.); (I.C.); (N.R.); (P.M.); (L.M.); (I.P.)
| | - Nadia Recine
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy; (V.D.D.); (G.B.); (G.P.); (S.S.); (F.T.); (I.C.); (N.R.); (P.M.); (L.M.); (I.P.)
| | - Pasquale Mancino
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy; (V.D.D.); (G.B.); (G.P.); (S.S.); (F.T.); (I.C.); (N.R.); (P.M.); (L.M.); (I.P.)
| | - Marco de Vincentiis
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy; (G.P.); (U.R.); (A.C.); (M.d.V.); (V.V.); (A.P.)
| | - Valentino Valentini
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy; (G.P.); (U.R.); (A.C.); (M.d.V.); (V.V.); (A.P.)
| | - Gabriella d’Ettorre
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy; (E.N.C.); (G.d.); (C.M.M.)
| | - Carlo Della Rocca
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy; (A.P.); (C.D.R.)
| | - Claudio Maria Mastroianni
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy; (E.N.C.); (G.d.); (C.M.M.)
| | - Guido Antonelli
- Department of Molecular Medicine, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy; (A.P.); (G.A.)
| | - Antonella Polimeni
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy; (G.P.); (U.R.); (A.C.); (M.d.V.); (V.V.); (A.P.)
| | - Ludovico Muzii
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy; (V.D.D.); (G.B.); (G.P.); (S.S.); (F.T.); (I.C.); (N.R.); (P.M.); (L.M.); (I.P.)
| | - Innocenza Palaia
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy; (V.D.D.); (G.B.); (G.P.); (S.S.); (F.T.); (I.C.); (N.R.); (P.M.); (L.M.); (I.P.)
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The Catastrophic HPV/HIV Dual Viral Oncogenomics in Concert with Dysregulated Alternative Splicing in Cervical Cancer. Int J Mol Sci 2021; 22:ijms221810115. [PMID: 34576278 PMCID: PMC8472041 DOI: 10.3390/ijms221810115] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 09/04/2021] [Accepted: 09/06/2021] [Indexed: 11/16/2022] Open
Abstract
Cervical cancer is a public health problem and has devastating effects in low-to-middle-income countries (LTMICs) such as the sub-Saharan African (SSA) countries. Infection by the human papillomavirus (HPV) is the main cause of cervical cancer. HIV positive women have higher HPV prevalence and cervical cancer incidence than their HIV negative counterparts do. Concurrent HPV/HIV infection is catastrophic, particularly to African women due to the high prevalence of HIV infections. Although various studies show a relationship between HPV, HIV and cervical cancer, there is still a gap in the knowledge concerning the precise nature of this tripartite association. Firstly, most studies show the relationship between HPV and cervical cancer at genomic and epigenetic levels, while the transcriptomic landscape of this relationship remains to be elucidated. Even though many studies have shown HPV/HIV dual viral pathogenesis, the dual molecular oncoviral effects on the development of cervical cancer remains largely uncertain. Furthermore, the effect of highly active antiretroviral therapy (HAART) on the cellular splicing machinery is unclear. Emerging evidence indicates the vital role played by host splicing events in both HPV and HIV infection in the development and progression to cervical cancer. Therefore, decoding the transcriptome landscape of this tripartite relationship holds promising therapeutic potential. This review will focus on the link between cellular splicing machinery, HPV, HIV infection and the aberrant alternative splicing events that take place in HIV/HPV-associated cervical cancer. Finally, we will investigate how these aberrant splicing events can be targeted for the development of new therapeutic strategies against HPV/HIV-associated cervical cancer.
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Adjuvant HPV Vaccination to Prevent Recurrent Cervical Dysplasia after Surgical Treatment: A Meta-Analysis. Vaccines (Basel) 2021; 9:vaccines9050410. [PMID: 33919003 PMCID: PMC8143003 DOI: 10.3390/vaccines9050410] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/13/2021] [Accepted: 04/16/2021] [Indexed: 12/15/2022] Open
Abstract
Objective: The aim of this meta-analysis was to discuss evidence supporting the efficacy of adjuvant human papillomavirus (HPV) vaccination in reducing the risk of recurrent cervical intraepithelial neoplasia (CIN) 2 or greater after surgical treatment. Methods: A systematic literature search was performed for studies reporting the impact of HPV vaccination on reducing the risk of recurrence of CIN 2+ after surgical excision. Results were reported as mean differences or pooled odds ratios (OR) with 95% confidence intervals (95% CI). Results: Eleven studies met the inclusion criteria and were selected for analysis. In total, 21,310 patients were included: 4039 (19%) received peri-operational adjuvant HPV vaccination while 17,271 (81%) received surgery alone. The recurrence of CIN 2+ after treatment was significantly lower in the vaccinated compared with the unvaccinated group (OR 0.35; 95% CI 0.21–0.56; p < 0.0001). The recurrence of CIN 1+ after treatment was significantly lower in the vaccinated compared with the unvaccinated group (OR 0.51; 95% CI 0.31–0.83; p = 0.006). A non-significant trend of reduction rate of HPV persistence was observed in the vaccinated compared with the unvaccinated cohorts (OR was 0.84; 95% CI 0.61–1.15; p = 0.28). Conclusions: HPV vaccination, in adjuvant setting, is associated with a reduced risk of recurrent CIN 1+ and CIN 2+ after surgical treatment.
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Splicing Genomics Events in Cervical Cancer: Insights for Phenotypic Stratification and Biomarker Potency. Genes (Basel) 2021; 12:genes12020130. [PMID: 33498485 PMCID: PMC7909518 DOI: 10.3390/genes12020130] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 01/09/2021] [Accepted: 01/12/2021] [Indexed: 12/24/2022] Open
Abstract
Gynaecological cancers are attributed to the second most diagnosed cancers in women after breast cancer. On a global scale, cervical cancer is the fourth most common cancer and the most common cancer in developing countries with rapidly increasing mortality rates. Human papillomavirus (HPV) infection is a major contributor to the disease. HPV infections cause prominent cellular changes including alternative splicing to drive malignant transformation. A fundamental characteristic attributed to cancer is the dysregulation of cellular transcription. Alternative splicing is regulated by several splicing factors and molecular changes in these factors lead to cancer mechanisms such as tumour development and progression and drug resistance. The serine/arginine-rich (SR) proteins and heterogeneous ribonucleoproteins (hnRNPs) have prominent roles in modulating alternative splicing. Evidence shows molecular alteration and expression levels in these splicing factors in cervical cancer. Furthermore, aberrant splicing events in cancer-related genes lead to chemo- and radioresistance. Identifying clinically relevant modifications in alternative splicing events and splicing variants, in cervical cancer, as potential biomarkers for their role in cancer progression and therapy resistance is scrutinised. This review will focus on the molecular mechanisms underlying the aberrant splicing events in cervical cancer that may serve as potential biomarkers for diagnosis, prognosis, and novel drug targets.
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Adjuvant Human Papillomavirus Vaccine to Reduce Recurrent Cervical Dysplasia in Unvaccinated Women: A Systematic Review and Meta-analysis. Obstet Gynecol 2020; 135:1070-1083. [PMID: 32282601 DOI: 10.1097/aog.0000000000003833] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To perform a systematic review and meta-analysis evaluating the efficacy of adjuvant human papillomavirus (HPV) vaccination in preventing recurrent cervical intraepithelial neoplasia (CIN) 2 or greater after surgical excision. DATA SOURCES Electronic databases (Cochrane, PubMed, EMBASE, MEDLINE, Scopus, and ClinicalTrials.gov) were searched for studies comparing surgical excision alone to surgical excision with adjuvant HPV vaccination for CIN 2 or greater. Studies published from January 1990 to January 2019 were included. METHODS A total of 5,901 studies were reviewed. The primary outcomes evaluated included: recurrence of CIN 2 or greater, CIN 1 or greater, and HPV 16,18 associated CIN within 6-48 months. We used Covidence software to assist with screening, and meta-analysis was performed using Review Manager. TABULATION, INTEGRATION, AND RESULTS Six studies met inclusion criteria and were included in the final analysis. In total 2,984 women were included; 1,360 (45.6%) received adjuvant HPV vaccination after surgical excision, and 1,624 (54.4%) received either placebo or surgical management alone for CIN 2 or greater. Recurrence of CIN 2 or greater occurred within 6-48 months in 115 women (3.9%) overall; however, recurrence was significantly lower for vaccinated women: 26 of 1,360 women (1.9%) vs 89 of 1,624 unvaccinated women (5.9%) (relative risk [RR] 0.36 95% CI 0.23-0.55). The risk of CIN 1 or greater was also significantly lower with adjuvant HPV vaccination, occurring in 86 of 1,360 vaccinated women (6.3%) vs 157 of 1,624 unvaccinated women (9.7%) (RR 0.67 95% CI 0.52-0.85). Thirty-five women developed recurrent CIN 2 or greater lesions specific to HPV 16,18; nine received adjuvant vaccination (0.9%) vs 26 who were unvaccinated (2.0%) (RR 0.41 95% CI 0.20-0.85). CONCLUSION Adjuvant HPV vaccination in the setting of surgical excision for CIN 2 or greater is associated with a reduced risk of recurrent cervical dysplasia overall and a reduction in the risk of recurrent lesions caused by the most oncogenic strains (HPV 16,18). Human papillomavirus vaccination should therefore be considered for adjuvant treatment in patients undergoing surgical excision for CIN 2 or greater. SYSTEMATIC REVIEW REGISTRATION PROSPERO, CRD42019123786.
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Mu W, Chu Q, Liu Y, Zhang N. A Review on Nano-Based Drug Delivery System for Cancer Chemoimmunotherapy. NANO-MICRO LETTERS 2020; 12:142. [PMID: 34138136 PMCID: PMC7770879 DOI: 10.1007/s40820-020-00482-6] [Citation(s) in RCA: 132] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 06/11/2020] [Indexed: 05/11/2023]
Abstract
Although notable progress has been made on novel cancer treatments, the overall survival rate and therapeutic effects are still unsatisfactory for cancer patients. Chemoimmunotherapy, combining chemotherapeutics and immunotherapeutic drugs, has emerged as a promising approach for cancer treatment, with the advantages of cooperating two kinds of treatment mechanism, reducing the dosage of the drug and enhancing therapeutic effect. Moreover, nano-based drug delivery system (NDDS) was applied to encapsulate chemotherapeutic agents and exhibited outstanding properties such as targeted delivery, tumor microenvironment response and site-specific release. Several nanocarriers have been approved in clinical cancer chemotherapy and showed significant improvement in therapeutic efficiency compared with traditional formulations, such as liposomes (Doxil®, Lipusu®), nanoparticles (Abraxane®) and micelles (Genexol-PM®). The applications of NDDS to chemoimmunotherapy would be a powerful strategy for future cancer treatment, which could greatly enhance the therapeutic efficacy, reduce the side effects and optimize the clinical outcomes of cancer patients. Herein, the current approaches of cancer immunotherapy and chemoimmunotherapy were discussed, and recent advances of NDDS applied for chemoimmunotherapy were further reviewed.
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Affiliation(s)
- Weiwei Mu
- Department of Pharmaceutics, Key Laboratory of Chemical Biology (Ministry of Education), School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, 44 Wenhuaxi Road, Jinan, 250012, People's Republic of China
| | - Qihui Chu
- Department of Pharmaceutics, Key Laboratory of Chemical Biology (Ministry of Education), School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, 44 Wenhuaxi Road, Jinan, 250012, People's Republic of China
| | - Yongjun Liu
- Department of Pharmaceutics, Key Laboratory of Chemical Biology (Ministry of Education), School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, 44 Wenhuaxi Road, Jinan, 250012, People's Republic of China
| | - Na Zhang
- Department of Pharmaceutics, Key Laboratory of Chemical Biology (Ministry of Education), School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, 44 Wenhuaxi Road, Jinan, 250012, People's Republic of China.
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He C, Lv X, Huang C, Angeletti PC, Hua G, Dong J, Zhou J, Wang Z, Ma B, Chen X, Lambert PF, Rueda BR, Davis JS, Wang C. A Human Papillomavirus-Independent Cervical Cancer Animal Model Reveals Unconventional Mechanisms of Cervical Carcinogenesis. Cell Rep 2020; 26:2636-2650.e5. [PMID: 30840887 PMCID: PMC6812687 DOI: 10.1016/j.celrep.2019.02.004] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 12/30/2018] [Accepted: 02/01/2019] [Indexed: 01/17/2023] Open
Abstract
HPV infections are common in healthy women and only rarely cause cervical cancer, suggesting that individual genetic susceptibility may play a critical role in the establishment of persistent HPV infection and the development of cervical cancer. Here, we provide convincing in vitro and in vivo evidence showing that differential expression and activation of YAP1 oncogene determine individual susceptibility to HPV infection and cervical carcinogenesis. We found that hyperactivation of YAP1 in mouse cervical epithelium was sufficient to induce invasive cervical cancer. Cervical epithelial cell-specific HPV16 E6/E7 and YAP1 double-knockin mouse model demonstrated that high-risk HPV synergized with hyperactivated YAP1 to promote the initiation and progression of cervical cancer. Our mechanistic studies indicated that hyperactivation of YAP1 in cervical epithelial cells facilitated HPV infection by increasing the putative HPV receptor molecules and disrupting host cell innate immunity. Our finding reveals an unconventional mechanism for cervical carcinogenesis. HPV infections are common in healthy women and only rarely cause cervical cancer. He et al. provide evidence that hyperactivation of the YAP1 oncogene can drive cervical cancer initiation and progression. YAP1 hyperactivation in cervical epithelial cells increases the HPV receptors and disrupts host cell innate immunity, facilitating HPV infection.
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Affiliation(s)
- Chunbo He
- Vincent Center for Reproductive Biology, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA 02114, USA; Olson Center for Women's Health, Department of Obstetrics & Gynecology, University of Nebraska Medical Center, Omaha, NE 68198, USA; College of Animal Science and Technology, Huazhong Agricultural University, Wuhan, 430070, China
| | - Xiangmin Lv
- Vincent Center for Reproductive Biology, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA 02114, USA; Olson Center for Women's Health, Department of Obstetrics & Gynecology, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Cong Huang
- Vincent Center for Reproductive Biology, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Peter C Angeletti
- Nebraska Center for Virology, School of Biological Sciences, University of Nebraska-Lincoln, Lincoln, NE 68583, USA
| | - Guohua Hua
- Olson Center for Women's Health, Department of Obstetrics & Gynecology, University of Nebraska Medical Center, Omaha, NE 68198, USA; College of Animal Science and Technology, Huazhong Agricultural University, Wuhan, 430070, China
| | - Jixin Dong
- Fred & Pamela Cancer Center, University of Nebraska Medical Center, Omaha NE 68198, USA
| | - Jin Zhou
- Olson Center for Women's Health, Department of Obstetrics & Gynecology, University of Nebraska Medical Center, Omaha, NE 68198, USA; Department of Obstetrics and Gynecology, The Eighth Affiliated Hospital of Sun Yat-Sen University, Shenzhen, 518033, China
| | - Zhengfeng Wang
- Olson Center for Women's Health, Department of Obstetrics & Gynecology, University of Nebraska Medical Center, Omaha, NE 68198, USA; Department of Hepatobiliary Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 45001 China
| | - Bowen Ma
- Olson Center for Women's Health, Department of Obstetrics & Gynecology, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Xingcheng Chen
- Fred & Pamela Cancer Center, University of Nebraska Medical Center, Omaha NE 68198, USA
| | - Paul F Lambert
- McArdle Laboratory for Cancer Research, Department of Oncology, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Bo R Rueda
- Vincent Center for Reproductive Biology, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - John S Davis
- Olson Center for Women's Health, Department of Obstetrics & Gynecology, University of Nebraska Medical Center, Omaha, NE 68198, USA; Omaha Veterans Affairs Medical Center, Omaha, NE 68105, USA
| | - Cheng Wang
- Vincent Center for Reproductive Biology, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA 02114, USA; Olson Center for Women's Health, Department of Obstetrics & Gynecology, University of Nebraska Medical Center, Omaha, NE 68198, USA.
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Knowledge, awareness and attitude towards human papilloma virus vaccine in a resource-constrained setting: a comparison between an urban and rural population in South Africa. SOUTHERN AFRICAN JOURNAL OF GYNAECOLOGICAL ONCOLOGY 2019. [DOI: 10.1080/20742835.2019.1589183] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Teteh DK, Dawkins-Moultin L, Robinson C, LaGroon V, Hooker S, Alexander K, Kittles RA. Use of community forums to increase knowledge of HPV and cervical cancer in African American communities. J Community Health 2019; 44:492-499. [DOI: 10.1007/s10900-019-00665-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Rema P. Gynecological Cancers-the Changing Paradigm. Indian J Surg Oncol 2019; 10:156-161. [PMID: 30948892 PMCID: PMC6414572 DOI: 10.1007/s13193-018-0842-7] [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: 06/09/2018] [Accepted: 11/23/2018] [Indexed: 10/27/2022] Open
Abstract
Outstanding research in the last few decades led to newer insights into the management of gynecological cancers. In the preventive arena, the efficacy and safety of HPV vaccination are well accepted and is now in addition to bi- and quadrivalent vaccines; there is a nonavalent vaccine against nine oncogenic HPV strains. Recent studies also looked into the dosaging schedules and age of vaccination against HPV to improve the vaccine efficacy and coverage. HPV testing is now approved as a primary screening test for cervical cancer in women aged more than 30 years with better sensitivity than the traditional cytology. Opportunistic salpingectomy for ovarian cancer prevention and neoadjuvant chemotherapy for advanced ovarian cancers are accepted practices. The role of personalized medicine in ovarian cancer and comprehensive genomic analysis of endometrial cancers are also covered in this review.
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Affiliation(s)
- P. Rema
- Division of Gynaeoncology, Regional Cancer Centre, Trivandrum, Kerala India
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Soi C, Gimbel S, Chilundo B, Muchanga V, Matsinhe L, Sherr K. Human papillomavirus vaccine delivery in Mozambique: identification of implementation performance drivers using the Consolidated Framework for Implementation Research (CFIR). Implement Sci 2018; 13:151. [PMID: 30545391 PMCID: PMC6293623 DOI: 10.1186/s13012-018-0846-2] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 11/28/2018] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Since 2012 Gavi, the Vaccine Alliance has provided financial support for HPV vaccine introduction in low- and middle-income countries (LMICs); however, funding has been contingent on establishing a demonstration project prior to national scale-up, in order to gauge effectiveness of delivery models. Although by 2016, most beneficiary countries had completed demonstration projects, few have scaled up delivery nationwide. An important barrier was the dearth of published, country-specific implementation recommendations. We employed the Consolidated Framework for Implementation Research (CFIR) as a lens to identify drivers of heterogeneous (dissimilar) implementation performance during Mozambique's 2-year demonstration project. Mozambique presents a compelling example as the country conducted demonstration projects in three different districts with extremely different economic resources and sociocultural practices. METHODS A post implementation interpretive evaluation was undertaken. Forty key informant interviews were conducted with district and health facility immunization staff, Ministry of Education managers, and teachers across the three demonstration districts, central level informants from MOH, research institutes, and immunization program partners. We compared valence and strength ratings of CFIR constructs, across diverse implementation sites, so as to explain drivers and barriers to implementation success. Two researchers coded separately, and subsequent content analysis followed pre-defined CFIR construct themes. RESULTS Eighteen constructs emerged from informants' responses as implementation influencers. Adaptability was identified as an important construct because delivery modalities needed to meet differing levels of girls' school attendance. Expanding outside of school-based delivery was needed in the low-performing district, making the vaccine delivery process more complex. Available resources varied across the three sites, with one site receiving direct Gavi support, while others received primarily state-based support. These latter sites reported considerably more implementation bottlenecks, in part related to weaker infrastructural characteristics and insufficient organizational incentives. Health workers' beliefs in importance of vaccines and an organizational culture of making personal sacrifice for immunization program activities drove implementation performance. Advocacy and social mobilization through the right opinion leaders and champions generated higher demand. CONCLUSION HPV vaccination presents a pertinent opportunity for the prevention of cervical cancer in Mozambique, sub-Saharan Africa, and other LMICs. However, important barriers to broad-scale implementation exist. We recommend the development of local and global strategies to overcome barriers and facilitate its expanded utilization.
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Affiliation(s)
- Caroline Soi
- Department of Global Health, University of Washington, Harris Hydraulics Laboratory, 1510 San Juan Road, Seattle, WA 98195 USA
- Health Alliance International, 1107 NE 45th St #350, Seattle, WA 98105 USA
| | - Sarah Gimbel
- Department of Global Health, University of Washington, Harris Hydraulics Laboratory, 1510 San Juan Road, Seattle, WA 98195 USA
- Health Alliance International, 1107 NE 45th St #350, Seattle, WA 98105 USA
- Department of Family and Child Nursing, University of Washington, Magnuson Health Sciences Building, 1959 NE Pacific St, Seattle, WA 98195 USA
| | - Baltazar Chilundo
- Universidade Eduardo Mondlane, Av. Salvador Allende no. 702, Maputo, Mozambique
| | - Vasco Muchanga
- Universidade Eduardo Mondlane, Av. Salvador Allende no. 702, Maputo, Mozambique
| | - Luisa Matsinhe
- Health Alliance International, Rua Caetano Viegas no. 67, Maputo, Mozambique
| | - Kenneth Sherr
- Department of Global Health, University of Washington, Harris Hydraulics Laboratory, 1510 San Juan Road, Seattle, WA 98195 USA
- Health Alliance International, 1107 NE 45th St #350, Seattle, WA 98105 USA
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Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018; 68:394-424. [PMID: 30207593 DOI: 10.3322/caac.21492] [Citation(s) in RCA: 52807] [Impact Index Per Article: 8801.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
This article provides a status report on the global burden of cancer worldwide using the GLOBOCAN 2018 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer, with a focus on geographic variability across 20 world regions. There will be an estimated 18.1 million new cancer cases (17.0 million excluding nonmelanoma skin cancer) and 9.6 million cancer deaths (9.5 million excluding nonmelanoma skin cancer) in 2018. In both sexes combined, lung cancer is the most commonly diagnosed cancer (11.6% of the total cases) and the leading cause of cancer death (18.4% of the total cancer deaths), closely followed by female breast cancer (11.6%), prostate cancer (7.1%), and colorectal cancer (6.1%) for incidence and colorectal cancer (9.2%), stomach cancer (8.2%), and liver cancer (8.2%) for mortality. Lung cancer is the most frequent cancer and the leading cause of cancer death among males, followed by prostate and colorectal cancer (for incidence) and liver and stomach cancer (for mortality). Among females, breast cancer is the most commonly diagnosed cancer and the leading cause of cancer death, followed by colorectal and lung cancer (for incidence), and vice versa (for mortality); cervical cancer ranks fourth for both incidence and mortality. The most frequently diagnosed cancer and the leading cause of cancer death, however, substantially vary across countries and within each country depending on the degree of economic development and associated social and life style factors. It is noteworthy that high-quality cancer registry data, the basis for planning and implementing evidence-based cancer control programs, are not available in most low- and middle-income countries. The Global Initiative for Cancer Registry Development is an international partnership that supports better estimation, as well as the collection and use of local data, to prioritize and evaluate national cancer control efforts. CA: A Cancer Journal for Clinicians 2018;0:1-31. © 2018 American Cancer Society.
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Affiliation(s)
- Freddie Bray
- Head, Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Jacques Ferlay
- Informatics Officer, Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Isabelle Soerjomataram
- Deputy Head, Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Rebecca L Siegel
- Scientific Director, Surveillance and Health Services Research, American Cancer Society, Atlanta, GA
| | - Lindsey A Torre
- Scientist, Surveillance and Health Services Research, American Cancer Society, Atlanta, GA
| | - Ahmedin Jemal
- Scientific Vice President, Surveillance and Health Services Research, American Cancer Society, Atlanta, GA
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Intersectional nativity and racial/ethnic disparities in human papillomavirus vaccination initiation among U.S. women: a national population-based study. Cancer Causes Control 2018; 29:927-936. [PMID: 30120642 DOI: 10.1007/s10552-018-1069-1] [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: 05/02/2018] [Accepted: 08/06/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Overall, foreign-born women are less likely than U.S.-born women to have initiated human papillomavirus (HPV) vaccination. However, foreign-born women are a racially/ethnically diverse population, and race/ethnicity is an independent predictor of HPV vaccination. METHODS Using 2011-2015 National Health Interview Survey data, we used multivariable logistic regression to estimate odds ratios for foreign-born black, Latina, and Asian women compared to foreign-born white women and U.S.-born white women, adjusting for sociodemographic factors. We added socioeconomic factors followed by health care access indicators, which we conceptualized as potential mediators, to each model to assess whether they helped explain observed disparities. RESULTS Foreign-born Asian ([odds ratio=] 0.43; [95% confidence interval:] 0.29-0.65) and Latina (0.46; 0.32-0.68) women had significantly lower adjusted odds of initiating HPV vaccination compared to foreign-born white women. Foreign-born white (0.64; 0.45-0.90), black (0.44; 0.29, 0.67), Latina (0.29; 0.24-0.35), and Asian (0.28; 0.21-0.38) women had significantly lower adjusted odds of HPV vaccination initiation compared to U.S.-born white women. Socioeconomic factors only explained HPV vaccination initiation disparities between foreign-born Latina women and foreign-born and U.S.-born white women. Health care access indicators modestly explained disparities between foreign-born white, black, and Latina women and U.S.-born white women only. CONCLUSIONS We observed pronounced HPV vaccination initiation disparities among foreign-born women in relation to race/ethnicity and between foreign-born women from minoritized racial/ethnic backgrounds and U.S.-born white women. Research on nativity disparities in HPV vaccination should take into account race/ethnicity, and vice versa. Interventions that seek to facilitate HPV vaccination among foreign-born women are needed and should address the unique needs of those from minoritized racial/ethnic backgrounds to promote cancer equity.
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Wang Z, Li Z, Li J, Wang C, Wang W, Hao M, Zhao C. Prevalence and Distribution of HPV Genotypes in 1387 Women with Cervical Intraepithelial Neoplasia 2/3 in Shanxi Province, China. J Cancer 2018; 9:2802-2806. [PMID: 30123348 PMCID: PMC6096374 DOI: 10.7150/jca.25614] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 06/10/2018] [Indexed: 11/05/2022] Open
Abstract
Objective: The distribution of human papillomavirus (HPV) genotypes varies by countries and regions. Data regarding HPV genotype distribution for women with cervical intraepithelial neoplasia 2/3 (CIN2/3) are still limited. This study aimed to investigate the distribution of HPV genotypes for women with CIN2/3 in Shanxi province, China. Methods: Prior HPV testing/genotyping resulted from women with histologic diagnosis of CIN2/3 were retrospectively collected between August 2011 and August 2016. Results: A total of 1387 women with a diagnosis of CIN2/3 were included in this study. The average age of the women was 45.7 years and the average time period from HPV testing to histological diagnosis was 0.4 months. The overall high-risk HPV (hrHPV) positive rate was 91.6%. In all tested women, the most commonly detected hrHPV genotype was HPV16 (59.3%) followed by HPV58 (14.4%) and HPV33 (10.0%), while HPV18 was in the 6th position (6.0%). Conclusions: This is one of the largest studies of HPV genotyping for women with CIN2/3 in China. The prevalence and distribution of HPV genotypes in these Chinese women differed from those in women from Western countries. Our results provide important information for developing specific HPV vaccines for Chinese women.
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Affiliation(s)
- Zhilian Wang
- Department of Obstetrics and Gynecology, Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Zaibo Li
- Department of Pathology, Ohio State Wexner Medical Center, Columbus, OH 43210, USA
| | - Jing Li
- Department of Obstetrics and Gynecology, Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Chen Wang
- Department of Obstetrics and Gynecology, Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Wenhao Wang
- Department of Obstetrics and Gynecology, Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Min Hao
- Department of Obstetrics and Gynecology, Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Chengquan Zhao
- Department of Pathology, Magee-Womens Hospital, University of Pittsburgh Medical Center. 300 Halket St, Pittsburgh, PA, 15213, USA
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Yan L, Sethi S, Bitterman P, Reddy V, Gattuso P. Umbilical Lesions: Clinicopathologic Features of 99 Tumors. Int J Surg Pathol 2018; 26:417-422. [DOI: 10.1177/1066896918758916] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Background. Umbilical lesions are rare, and can be benign or malignant. This retrospective study was conducted to assess the epidemiological, clinical, and histologic characteristics of umbilical masses. Methods. Cases of umbilical masses from January 1994 to August 2016 were retrieved from our institution’s pathology databases, and their clinicopathological features were reviewed. Results. There were a total of 99 cases of umbilical masses, 78 women (78.8%) and 21 men (21.2%). Of these, 59 were malignant (59.6%) and 40 were benign (40.4%). Among the malignant cases, 48 were women with a mean age of 65 years and 11 were men with a mean age of 66 years. All malignant lesions were secondary tumors. Twenty-five patients (42.3%) had a metastatic tumor to the umbilicus with an average of 7 months from the original diagnosis (12 gynecological, 8 pancreatic/gastrointestinal, 2 lymphomas, and a case each of breast, prostate, and melanoma). Of the patients with a benign diagnosis, 30 were women (75%) with a mean age of 52 years and 10 were men (25%) with a mean age of 43 years. The benign lesions included epidermal inclusion cysts (15/40), endometriosis (11/40), lipomas (3/40), neurofibromas (3/40), fibromas (3/40), abscesses (2/40), and 1 case each of tubular apocrine adenoma, serous cystadenoma, and calcified nodule. Conclusion. The most common metastatic tumors to the umbilicus are from the adjacent organs with the gynecologic tract as the most frequent primary followed by the gastrointestinal system. Primary malignant tumors of the umbilical region are rarely identified in clinical practice.
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Affiliation(s)
- Lei Yan
- Rush University Medical Center, Chicago, IL, USA
| | - Shenon Sethi
- Rush University Medical Center, Chicago, IL, USA
| | | | - Vijaya Reddy
- Rush University Medical Center, Chicago, IL, USA
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Kaur P, Mehrotra R, Rengaswamy S, Kaur T, Hariprasad R, Mehendale SM, Rajaraman P, Rath GK, Bhatla N, Krishnan S, Nayyar A, Swaminathan S. Human papillomavirus vaccine for cancer cervix prevention: Rationale & recommendations for implementation in India. Indian J Med Res 2017; 146:153-157. [PMID: 29265015 PMCID: PMC5761024 DOI: 10.4103/ijmr.ijmr_1906_16] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
| | - Ravi Mehrotra
- National Institute of Cancer Prevention & Research, Noida, India
| | | | - Tanvir Kaur
- Indian Council of Medical Research, New Delhi, India
| | - Roopa Hariprasad
- National Institute of Cancer Prevention & Research, Noida, India
| | | | - Preetha Rajaraman
- Center for Global Health, National Cancer Institute, New Delhi, India
| | - G K Rath
- Dr. B.R. Ambedkar Institute-Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Neerja Bhatla
- Department of Obstetrics & Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | | | | | - Soumya Swaminathan
- Department of Health Research & Indian Council of Medical Research, New Delhi, India
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Shanmugasundaram S, You J. Targeting Persistent Human Papillomavirus Infection. Viruses 2017; 9:v9080229. [PMID: 28820433 PMCID: PMC5580486 DOI: 10.3390/v9080229] [Citation(s) in RCA: 102] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2017] [Revised: 07/30/2017] [Accepted: 08/15/2017] [Indexed: 12/14/2022] Open
Abstract
While the majority of Human papillomavirus (HPV) infections are transient and cleared within a couple of years following exposure, 10-20% of infections persist latently, leading to disease progression and, ultimately, various forms of invasive cancer. Despite the clinical efficiency of recently developed multivalent prophylactic HPV vaccines, these preventive measures are not effective against pre-existing infection. Additionally, considering that the burden associated with HPV is greatest in regions with limited access to preventative vaccination, the development of effective therapies targeting persistent infection remains imperative. This review discusses not only the mechanisms underlying persistent HPV infection, but also the promise of immunomodulatory therapeutic vaccines and small-molecular inhibitors, which aim to augment the host immune response against the viral infection as well as obstruct critical viral-host interactions.
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Affiliation(s)
- Srinidhi Shanmugasundaram
- Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
| | - Jianxin You
- Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
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Lessons learnt from human papillomavirus (HPV) vaccination in 45 low- and middle-income countries. PLoS One 2017; 12:e0177773. [PMID: 28575074 PMCID: PMC5456063 DOI: 10.1371/journal.pone.0177773] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 05/02/2017] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To synthesise lessons learnt and determinants of success from human papillomavirus (HPV) vaccine demonstration projects and national programmes in low- and middle-income countries (LAMICs). METHODS Interviews were conducted with 56 key informants. A systematic literature review identified 2936 abstracts from five databases; after screening 61 full texts were included. Unpublished literature, including evaluation reports, was solicited from country representatives; 188 documents were received. A data extraction tool and interview topic guide outlining key areas of inquiry were informed by World Health Organization guidelines for new vaccine introduction. Results were synthesised thematically. RESULTS Data were analysed from 12 national programmes and 66 demonstration projects in 46 countries. Among demonstration projects, 30 were supported by the GARDASIL® Access Program, 20 by Gavi, four by PATH and 12 by other means. School-based vaccine delivery supplemented with health facility-based delivery for out-of-school girls attained high coverage. There were limited data on facility-only strategies and little evaluation of strategies to reach out-of-school girls. Early engagement of teachers as partners in social mobilisation, consent, vaccination day coordination, follow-up of non-completers and adverse events was considered invaluable. Micro-planning using school/ facility registers most effectively enumerated target populations; other estimates proved inaccurate, leading to vaccine under- or over-estimation. Refresher training on adverse events and safe injection procedures was usually necessary. CONCLUSION Considerable experience in HPV vaccine delivery in LAMICs is available. Lessons are generally consistent across countries and dissemination of these could improve HPV vaccine introduction.
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Basu P, Bhatla N, Ngoma T, Sankaranarayanan R. Less than 3 doses of the HPV vaccine - Review of efficacy against virological and disease end points. Hum Vaccin Immunother 2016; 12:1394-402. [PMID: 26933961 PMCID: PMC4964672 DOI: 10.1080/21645515.2016.1146429] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 01/07/2016] [Accepted: 01/21/2016] [Indexed: 01/06/2023] Open
Abstract
World Health Organization (WHO) recommended 2 doses of the Human Papillomavirus (HPV) vaccine for girls below 15 y on the basis of the immune-bridging studies demonstrating non-inferior immune response of 2 doses in the adolescent girls compared to 3 doses in the young adult women in whom the efficacy against disease is established. The biological nature of the antigens (virus-like particles) constituting the HPV vaccine is responsible for the vigorous antibody response that may make the third dose redundant. The protection offered by 2 doses has been demonstrated in non-randomized clinical trials to be comparable to that offered by 3 doses against incident and persistent infections of vaccine targeted HPV types. However, results emerging from the ecological and nested case-control studies embedded in the population based screening programs of different countries indicate reduced efficacy of 2 doses against virological and disease end points. Some recent studies observed the protective effect of single dose of the vaccine against incident and persistent infections of the vaccine targeted HPV types to be similar to 3 doses in spite of immunological inferiority. The sample size, duration of follow-ups and number of events were limited in these studies. Longer follow ups of the less than 3 doses cohorts in the ongoing studies as well as appropriately designed and ethically justifiable randomized studies are needed to establish the protection offered by the alternative schedules at least beyond 10 y of vaccination.
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Affiliation(s)
- Partha Basu
- Screening Group, Early Detection and Prevention Section, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Neerja Bhatla
- Department of Obstetrics & Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Twalib Ngoma
- Department of Clinical Oncology, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania
| | - Rengaswamy Sankaranarayanan
- Screening Group, Early Detection and Prevention Section, International Agency for Research on Cancer (IARC-WHO), Lyon, France
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