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Algaadi SA, Aldhafiri HJ, Alsubhi RS, Almakrami M, Aljamaan NH, Almulhim YA. The Saudi Population's Knowledge and Attitude Towards Human Papillomavirus (HPV) Infection and Its Vaccination. Cureus 2024; 16:e58427. [PMID: 38765415 PMCID: PMC11099338 DOI: 10.7759/cureus.58427] [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] [Accepted: 04/16/2024] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND Human papillomavirus (HPV) infection is a major worldwide public health concern that can result in a range of clinical disorders, including cervical cancer. Saudi Arabia, similar to numerous other nations, has difficulties in facing HPV and its impact on society. The high incidence of cervical cancer in Saudi Arabia continues to be a cause for worry, highlighting the need for the adoption of efficient immunization programs. Nevertheless, public hesitation and inadequate knowledge can hinder the acceptance of vaccines. Evaluating public knowledge and attitudes concerning HPV and its vaccination is essential in order to create focused programs that enhance awareness and increase vaccine acceptance. METHODS This study was cross-sectional in nature, using data from a sample of 516 Saudi participants 18 years and above. The participants completed online questionnaires that were distributed using Google Forms across social media platforms and ensured anonymity. RESULTS A total of 516 participants made up the sample for this study, which had a predominance of females (83.5%, n=431); the majority aged 18-25 years (78.3%, n=404) and most of them (28.3%, n=146) were from the central region. The study results revealed that 43.7% (n=225) of the participants had a good knowledge level while 56.3% (n=291) of them had a poor level of knowledge about the HPV vaccine. A substantial proportion (35.9%, n=185) of the participants had good knowledge that HPV can be transmitted sexually from one person to another with only 30.2% (n=156) of them being aware that HPV is a common infection that causes cervical cancer (41.5%, n=214) and most of them (76.2%, n=393) knew that cervical cancer can be cured particularly when detected in early stages. The results established statistically significant associations between gender, education level, and occupation with p-values <0.005 (0.023, 0.003 and 0.001 respectively) and level of knowledge about the HPV vaccine. CONCLUSION The study emphasizes the necessity of implementing focused health education and vaccination initiatives in Saudi Arabia to enhance understanding and attitudes regarding HPV infection and its vaccine. The results can provide guidance to healthcare professionals, legislators, and public health authorities in creating programs that increase knowledge and acceptance of the HPV vaccine, ultimately decreasing the prevalence of HPV-related diseases in the nation.
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Affiliation(s)
- Salim A Algaadi
- Department of Dermatology, College of Medicine, Majmaah University, Al-Majmaah, SAU
| | | | - Razan S Alsubhi
- Medicine, College of Medicine, University of Hai'l, Hai'l, SAU
| | - Mohammed Almakrami
- Medicine, University of Szeged Albert Szent-Györgyi Medical School, Szeged, HUN
| | - Nour H Aljamaan
- Medicine and Surgery, College of Medicine, King Faisal University, Alhasa, SAU
| | - Yazeed A Almulhim
- Medicine and Surgery, Alzulfi General Hospital, Second Health Cluster, Riyadh, SAU
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Alrefai EA, Alhejaili RT, Haddad SA. Human Papillomavirus and Its Association With Cervical Cancer: A Review. Cureus 2024; 16:e57432. [PMID: 38699134 PMCID: PMC11063572 DOI: 10.7759/cureus.57432] [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] [Accepted: 04/01/2024] [Indexed: 05/05/2024] Open
Abstract
The human papillomavirus (HPV) belongs to the Papillomavirus family and is considered a non-enveloped virus. HPV affects individuals by causing both benign and malignant lesions. We aim to define HPV and its important characteristics, explain the relation between HPVs and cervical cancer, review its prevalence among Saudi women and their awareness of screening and prevention of cervical cancer, and focus on the importance of HPV vaccination. The persistence of HPV infection is the most important risk factor for the development of cervical cancer. HPVs cannot be cultured, and the identification of the virus is dependent on a variety of techniques, including immunology, serology, and molecular biology. Cervical cancer is the fourth most prevalent form of cancer in women worldwide, while it is considered the 12th type of cancer that affects Saudi women. Unfortunately, many studies have shown a lack of awareness regarding HPV infection, screening, and vaccination among the Saudi population in general, as well as among Saudi healthcare professionals. The HPV vaccine has a potent role in preventing people from getting infected with the virus, despite some previous clinical trials assessing the outcomes of therapeutic HPV vaccinations showing unsatisfactory results. While there is no doubt about the benefits of vaccines and their role in reducing the incidence of HPV infectious diseases, there are discrepancies in the evaluation of the safety of the HPV vaccine. In conclusion, HPV is an essential etiology of cervical cancer, and the expansion of public awareness about protective methods and threat factors associated with HPV infection is highly important.
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Affiliation(s)
- Eman A Alrefai
- Obstetrics and Gynaecology, Taibah University, Medina, SAU
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Chen M, Ye Z, Wang H, Cui X, Seery S, Wu A, Xue P, Qiao Y. Genotype, cervical intraepithelial neoplasia, and type-specific cervical intraepithelial neoplasia distributions in hrHPV+ cases referred to colposcopy: A multicenter study of Chinese mainland women. J Med Virol 2024; 96:e29475. [PMID: 38415472 DOI: 10.1002/jmv.29475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 01/30/2024] [Accepted: 02/05/2024] [Indexed: 02/29/2024]
Abstract
To investigate age and type-specific prevalences of high-risk human papillomavirus (hrHPV) and cervical intraepithelial neoplasia (CIN) in hrHPV+ women referred to colposcopy. This is a retrospective, multicenter study. Participants were women referred to one of seven colposcopy clinics in China after testing positive for hrHPV. Patient characteristics, hrHPV genotyping, colposcopic impressions, and histological diagnoses were abstracted from electronic records. Main outcomes were age-related type-specific prevalences associated with hrHPV and CIN, and colposcopic accuracy. Among 4419 hrHPV+ women referred to colposcopy, HPV 16, 52, and 58 were the most common genotypes. HPV 16 prevalence was 39.96%, decreasing from 42.57% in the youngest group to 30.81% in the eldest group. CIN3+ prevalence was 15.00% and increased with age. As lesion severity increases, HPV16 prevalence increased while the prevalence of HPV 52 and 58 decreased. No age-based trend was identified with HPV16 prevalence among CIN2+, and HPV16-related CIN2+ was less common in women aged 60 and above (44.26%) compared to those younger than 60 years (59.61%). Colposcopy was 0.73 sensitive at detecting CIN2+ (95% confidence interval[CI]: 0.71, 0.75), with higher sensitivity (0.77) observed in HPV16+ women (95% CI: 0.74, 0.80) compared to HPV16- women (0.68, 95% CI: 0.64, 0.71). Distributions of hrHPV genotypes, CIN, and type-specific CIN in Chinese mainland hrHPV+ women referred to colposcopy were investigated for the first time. Distributions were found to be age-dependent and colposcopic performance appears related to HPV genotypes. These findings could be used to improve the management of women referred to colposcopy.
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Affiliation(s)
- Mingyang Chen
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zichen Ye
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Huike Wang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaoli Cui
- Dalian Medical University, Dalian, Liaoning Province, China
- Department of Gynecologic Oncology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, Liaoning Province, China
| | - Samuel Seery
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Aiyuan Wu
- Wuxi Maternity and Child Health Care Hospital, Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Peng Xue
- School of Population Medicine and Public Health, 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
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Khamjan NA, Beigh S, Algaissi A, Megha K, Lohani M, Darraj M, Kamli N, Madkhali F, Dar SA. Natural and synthetic drugs and formulations for intravaginal HPV clearance. J Infect Public Health 2023; 16:1471-1480. [PMID: 37535995 DOI: 10.1016/j.jiph.2023.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/14/2023] [Accepted: 06/21/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND Except for a few preventative Human Papillomavirus (HPV) vaccines, there is currently no cure for HPV infection. There are a number of cutting-edge strategies and potent medications or herbal formulations that can be applied topically for early clearance of HPV infection before HPV DNA gets integrated into host cell genome. This is facilitated due to cervical cancer having distinct and well-recognized long precancerous stages. OBJECTIVES This review aims to outline every possible medication and formulation, both natural and synthetic, that can be applied topically as intravaginal application to help remove HPV infection at an early precancerous stage. RESULTS Several anti-HPV/HPV clearance compounds and formulations for high-grade lesions are undergoing clinical trials. However, the majority of compounds are still in the early stages of development and require additional research to become viable HPV clearance candidates. Synthetic drugs may be more promising because they may have a more targeted effect; however, they may also have significant adverse effects. On the other hand, natural medications are safer to use. They are less specific, but have minimal to no adverse effects. CONCLUSIONS This article may serve as a valuable resource of information for managing and preventing precancerous carcinogenic HPV infections. Research could be directed toward developing candidate drugs to make evidence-based decisions about advancing them to clinical trials and, eventually, to the market for potential use in the prevention and control of cervical cancer, which is almost always preventable or even curable if detected early.
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Affiliation(s)
- Nizar A Khamjan
- Department of Medical Laboratories Technology, College of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia.
| | - Saba Beigh
- Department of Public Health, Faculty of Applied Medical Sciences, Albaha University, Albaha 65431, Saudi Arabia
| | - Abdullah Algaissi
- Department of Medical Laboratories Technology, College of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia; Emerging and Epidemic Infectious Disease Research Unit, Medical Research Center, Jazan University, Jazan 45142, Saudi Arabia
| | - Kanu Megha
- School of Life Sciences, Manipal Academy of Higher Education, Dubai International Academic City, Dubai 355050, United Arab Emirates
| | - Mohtashim Lohani
- Department of Emergency Medical Sciences, College of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia
| | - Majid Darraj
- Department of Medical Laboratories Technology, College of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia
| | - Nader Kamli
- Department of Medical Microbiology, College of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia
| | - Faisal Madkhali
- Department of Medical Laboratories Technology, College of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia
| | - Sajad Ahmad Dar
- Research and Scientific Studies Unit, College of Nursing, Jazan University, Jazan 45142, Saudi Arabia.
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Tuerxun G, Abudurexiti G, Abulizi G. Prevalence, persistence, clearance and risk factors for HPV infection in rural Uyghur women in China. BMC Womens Health 2023; 23:433. [PMID: 37582764 PMCID: PMC10426228 DOI: 10.1186/s12905-023-02558-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 07/19/2023] [Indexed: 08/17/2023] Open
Abstract
BACKGROUND The incidence of cervical cancer in Uyghur women ranks first among those in Han and other ethnic minority groups. We aimed to understand the natural history of HPV in Uyghur women. METHODS A longitudinal cohort study on the natural history of HPV infection in rural Uyghur women in China was conducted between May 2013 and May 2014. A total of 11000 women from South Xinjiang underwent HPV screening by careHPV and liquid-based cytology. Ultimately, a total of 298 women with positive HPV and normal biopsy results or CIN1 were enrolled to participate in a study including follow-up HPV testing for two years. RESULTS The HPV infection rate in Uyghur women was 9.15%. Among the participants, the careHPV test showed that 298 women were HPV-positive, and histology showed CIN1 or normal results for these women at baseline. Among these patients, after 24 months of initial recruitment, 92 (30.87%) patients had persistent HPV infections, and 206 (69.13%) had cleared HPV infection. Univariate analysis showed that persistent HPV infection was associated with age and shower frequency (P < 0.001 and P = 0.047, respectively). CONCLUSIONS Our results suggest that women over the age of 50 years who have been infected with HR-HPV for more than 1 year should be regularly screened and monitored for HPV. In addition, education should be strengthened to improve poor health habits in these women.
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Affiliation(s)
- Gulixian Tuerxun
- Fifth Department of Gynecologic Surgery, Xinjiang Medical University Affiliated Tumor Hospital, Urumqi, 830000, China
| | - Guligeina Abudurexiti
- Fifth Department of Gynecologic Surgery, Xinjiang Medical University Affiliated Tumor Hospital, Urumqi, 830000, China
| | - Guzalinuer Abulizi
- Fifth Department of Gynecologic Surgery, Xinjiang Medical University Affiliated Tumor Hospital, Urumqi, 830000, China.
- Xinjiang Key Laboratory of Oncology, No. 789 East Suzhou Street, Xinshi District, Urumqi, 830000, China.
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Aldawood E, Alzamil L, Faqih L, Dabbagh D, Alharbi S, Hafiz TA, Alshurafa HH, Altukhais WF, Dabbagh R. Awareness of Human Papillomavirus among Male and Female University Students in Saudi Arabia. Healthcare (Basel) 2023; 11:healthcare11050649. [PMID: 36900652 PMCID: PMC10000570 DOI: 10.3390/healthcare11050649] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 02/18/2023] [Accepted: 02/21/2023] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND Human papillomavirus (HPV) is a common sexually transmitted infection globally. Investigating HPV awareness can reduce the burden of HPV-related cancers. AIMS (1) Assessing HPV awareness and knowledge among health college students at King Saud University, (2) comparing these outcomes across sociodemographic characteristics. METHODS A cross-sectional survey study was conducted from November to December 2022 and included 403 health college students. Associations of HPV awareness and knowledge with sociodemographic characteristics were assessed using logistic regression analysis and linear regression analysis, respectively. RESULTS Only 60% of students were aware of HPV, with awareness higher among females, although their knowledge scores were comparable to males. The odds of awareness of HPV were greater among medical students compared to other colleges and among students belonging to older age groups compared to the younger age group (18-20). The odds of HPV awareness among hepatitis B vaccinated students were 2.10 times that among unvaccinated students (AOR = 2.10; 95% CI = 1.21, 3.64). CONCLUSIONS The low level of HPV awareness among college students warrants the need for HPV educational campaigns to improve HPV awareness and to promote HPV vaccination in the community.
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Affiliation(s)
- Esraa Aldawood
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 12372, Saudi Arabia
- Correspondence:
| | - Lama Alzamil
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 12372, Saudi Arabia
| | - Layla Faqih
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 12372, Saudi Arabia
| | - Deemah Dabbagh
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 12372, Saudi Arabia
| | - Sarah Alharbi
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 12372, Saudi Arabia
| | - Taghreed A. Hafiz
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 12372, Saudi Arabia
| | | | - Wajd F. Altukhais
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 12372, Saudi Arabia
| | - Rufaidah Dabbagh
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh 11461, Saudi Arabia
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Alsanea M, Alsaleh A, Obeid D, Alhadeq F, Alahideb B, Alhamlan F. Genetic Variability in the E6, E7, and L1 Genes of Human Papillomavirus Types 16 and 18 among Women in Saudi Arabia. Viruses 2022; 15:109. [PMID: 36680149 PMCID: PMC9862970 DOI: 10.3390/v15010109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 12/06/2022] [Accepted: 12/14/2022] [Indexed: 01/03/2023] Open
Abstract
Cervical cancer is the eighth most frequent cancer in Saudi Arabia, and most cases are associated with human papillomavirus (HPV) types 16 and 18. HPV-induced carcinogenesis may be associated with the intra-type variant, genetic mutation, or the continuous expression of viral oncogenes E6 and E7. Infection efficiency and virus antigenicity may be affected by changes in the L1 gene. Thus, this retrospective cohort study analyzed E6, E7, and L1 gene mutations in cervical specimens collected from Saudi women positive for HPV16 or HPV18 infection. HPV16 and HPV18 lineages in these specimens were predominantly from Europe. The L83V mutation in the E6 gene of HPV16 showed sufficient oncogenic potential for progression to cervical cancer. By contrast, the L28F mutation in the E7 gene of HPV16 was associated with a low risk of cervical cancer. Other specific HPV16 and HPV18 mutations were associated with an increased risk of cancer, cancer progression, viral load, and age. Four novel mutations, K53T, K53N, R365P, and K443N, were identified in the L1 gene of HPV16. These findings for HPV16 and HPV18 lineages and mutations in the E6, E7, and L1 genes among women in Saudi Arabia may inform the design and development of effective molecular diagnostic tests and vaccination strategies for the Saudi population.
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Affiliation(s)
- Madain Alsanea
- Department of Infection and Immunity, King Faisal Specialist Hospital and Research Center, Riyadh 11564, Saudi Arabia
| | - Asma Alsaleh
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh 11564, Saudi Arabia
| | - Dalia Obeid
- Public Health Laboratories, Public Health Authority, Riyadh 11564, Saudi Arabia
| | - Faten Alhadeq
- Department of Infection and Immunity, King Faisal Specialist Hospital and Research Center, Riyadh 11564, Saudi Arabia
| | - Basma Alahideb
- Department of Infection and Immunity, King Faisal Specialist Hospital and Research Center, Riyadh 11564, Saudi Arabia
| | - Fatimah Alhamlan
- Department of Infection and Immunity, King Faisal Specialist Hospital and Research Center, Riyadh 11564, Saudi Arabia
- Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh 11564, Saudi Arabia
- College of Medicine, Alfaisal University, Riyadh 11564, Saudi Arabia
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Darraj AI, Arishy AM, Alshamakhi AH, Osaysi NA, Jaafari SM, Sumayli SA, Mushari RY, Alhazmi AH. Human Papillomavirus Knowledge and Vaccine Acceptability in Jazan Province, Saudi Arabia. Vaccines (Basel) 2022; 10:vaccines10081337. [PMID: 36016225 PMCID: PMC9413274 DOI: 10.3390/vaccines10081337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/02/2022] [Accepted: 08/16/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Human Papillomavirus (HPV) is the most common sexually transmitted infection that affects teens and adults in their early 20 s. Screening and HPV vaccination are important preventive measures to reduce cases of HPV and associated complications. Studies about HPV knowledge and vaccine acceptability are scarce in Saudi Arabia. This study evaluated participants’ knowledge, attitude, and acceptability concerning HPV and the HPV vaccine in Jazan Province, Saudi Arabia. Methods: A cross-sectional study was conducted using a pretested survey that assessed knowledge and attitude toward HPV and the HPV vaccine among the population of Jazan Province, Saudi Arabia. Responses were collected from adults between January and March 2022. Data were analyzed using a t-test and chi-square test. Results: We included 569 in the study. Most participants were single (65%), females (83%), with a university-level of education (78%). The recorded knowledge score for all participants was 1.99 (out of 10). About half of the participants denied that HPV is a common sexually transmitted infection. Further, 53% were interested in the HPV vaccine, and 63% of participants acknowledged that the HPV vaccine could prevent warts and cervical cancer. About 30% of the participants opposed the vaccine due to religious reasons. Conclusion: The results of our study highlight the inadequate level of knowledge concerning HPV infection, even among highly educated people. Thus, by promoting the HPV vaccine acceptance and use, awareness can be raised in our community to assure better knowledge and achieve higher protection from this virus and its complications.
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Affiliation(s)
- Atheer I. Darraj
- Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia
| | | | | | - Njoud A. Osaysi
- Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia
| | | | | | | | - Abdulaziz H. Alhazmi
- Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia
- Medical Research Center, Jazan University, Jazan 45142, Saudi Arabia
- Correspondence:
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Alhamlan F, Obeid D, Khayat H, Asma T, Al-Badawi IA, Almutairi A, Almatrrouk S, Fageeh M, Bakhrbh M, Nassar M, Al-Ahdal M. Prognostic impact of human papillomavirus infection on cervical dysplasia, cancer, and patient survival in Saudi Arabia: A 10-year retrospective analysis. Ann Saudi Med 2021; 41:350-360. [PMID: 34873934 PMCID: PMC8650596 DOI: 10.5144/0256-4947.2021.350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Data on human papillomavirus (HPV) prevalence and survival rates among HPV-infected women are scarce in Saudi Arabia. OBJECTIVE Assess the prevalence of HPV genotypes in cervical biopsy specimens and its effect on survival over a 10-year timeframe. DESIGN Retrospective, cross-sectional. SETTINGS Saudi referral hospital. PATIENTS AND METHODS Cervical biopsy specimens were collected from women aged 23-95 years old who underwent HPV detection, HPV genotyping, p16INK4a expression measurement using immunohistochemistry. Kaplan-Meier plots were constructed to analyze overall survival rates. MAIN OUTCOME MEASURES Survival rate of HPV-positive cervical cancer patients. SAMPLE SIZE 315 cervical biopsy specimens. RESULTS HPV was detected in 96 patients (30.4%): 37.3% had cervical cancer; 14.2% cervical intraepithelial neoplasia (CIN) III, 4.1% CIN II, and 17.0% CIN I. A significant association was found between HPV presence and cervical cancer (χ2=56.78; P<.001). The expression of p16INK4a was a significant predictor of survival: women who had p16INK4a overexpression had poorer survival rates (multivariate Cox regression, hazard ratio, 3.2; 95% CI, 1.1-8.8). In addition, multivariate models with HPV status and cervical cancer diagnosis showed that HPV status was a significant predictor of survival: HPV-positive women had better survival rates than HPV-negative women. CONCLUSION These findings suggest that implementing cervical and HPV screening programs may decrease cervical cancer rates and improve survival rates of women in Saudi Arabia. LIMITATION Single center and small sample size. CONFLICT OF INTEREST None.
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Affiliation(s)
- Fatimah Alhamlan
- From the Department of Infection and Immunity, Research Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Dalia Obeid
- From the Department of Infection and Immunity, Research Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Hadeel Khayat
- From the Department of Infection and Immunity, Research Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Tulbah Asma
- From the Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Ismail A Al-Badawi
- From the Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Areej Almutairi
- From the Department of Infection and Immunity, Research Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Shihana Almatrrouk
- From the Department of Infection and Immunity, Research Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Mohammed Fageeh
- From the Infection Diseases Program, National Center for Biotechnology, King Abdulaziz City for Science and Technology. Riyadh, Saudi Arabia
| | - Muhammed Bakhrbh
- From the Infection Diseases Program, National Center for Biotechnology, King Abdulaziz City for Science and Technology. Riyadh, Saudi Arabia
| | - Majed Nassar
- From the Infection Diseases Program, National Center for Biotechnology, King Abdulaziz City for Science and Technology. Riyadh, Saudi Arabia
| | - Mohammed Al-Ahdal
- From the Department of Infection and Immunity, Research Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
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Alshehri AM, Ahmed Alamri MM, Mahdi Alharazi AA, Essa Alhazmi AM, Hassan Alfaqih RM, Alzaylaee AAI, Harb Awadh Almarhabi S, Alfaqih HMH, Ali Khneen Alderhami A, Almarhabi MHA, Alsllami A. The Awareness of the Human Papillomavirus Infection and Oropharyngeal Cancer in People to Improve the Health Care System at Al Qunfudhah Region, Kingdom of Saudi Arabia. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:5185075. [PMID: 34712459 PMCID: PMC8548161 DOI: 10.1155/2021/5185075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/26/2021] [Accepted: 09/16/2021] [Indexed: 11/18/2022]
Abstract
With 14 million new infections each year, the human papillomavirus (HPV) is the most common sexually transmitted infection (STI) among both men and women in the United States (US). Infections with the human papillomavirus (HPV) are responsible for a considerable portion of the global cancer burden. HPV-related oral malignancies are on the rise around the world, according to epidemiological studies. To provide accurate advice to their patients, dental practitioners require thorough, up-to-date HPV-related knowledge. Methods. In this cross-sectional study, data were collected by the purposely constructed questionnaire. A questionnaire composed of the demographic items and items related to the awareness and knowledge about Human papillomavirus. The questionnaire was constructed after a series of discussions between the panel of experts. This panel was composed of a subject specialist, researcher, and language expert. The Cronbach alpha of the questionnaire was calculated. The study will be conducted in the Al Qunfudhah. Results. The Cronbach alpha of the questionnaire was 0.72. Out of a total of 550 respondents, with a mean (SD) age of 47.5 (11.5), the female respondents were 167 (30.4%) while male were 383 (69.6%). 20.5% of the respondents (out of 550) were having awareness of HPV. Implications. Knowledge of HPV-related oral cancer is critical, and it is advised to be taught as part of dental students' basic curriculum and clinical training. This problem can be solved by better educational training programs. Knowledge of HPV-related oral cancer is critical, and it is advised to be taught as part of dental students' basic curriculum and clinical training.
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Affiliation(s)
- Ali Maeed Alshehri
- Otolaryngology College of Medicine, King Khalid University, Abha, Saudi Arabia
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11
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Abstract
Human Papillomavirus (HPV) is the causative agent in the majority of anal, head and neck, oral, oropharyngeal, penile, vaginal, vulvar, and cervical cancers. Cervical cancer is the fourth most common cancer among women worldwide. Of all diagnosed human malignant neoplasms, approximately 4.5% are attributable to HPV, including cervical, anal cancers, vaginal, vulvar, penile, and oropharyngeal cancers. Over 182 HPV types have been identified and sequenced to date however, only certain types of HPV are more frequent in malignant lesions and considered to be a major risk factor in the development of some cancers. Because most HPV infections are transient, and an individual's immunocompetent may clear the infection, HPV infection has received little attention from clinicians, the general public, or policy makers. This lack of attention may underpin a deadly and increasing problem because each newly acquired infection has the potential to persist and become an incurable, lifelong affliction. In addition, no successful treatment of HPV infection currently exists despite the great strides toward understanding the mechanisms underlying HPV pathogenesis. Moreover, ample research has proven that the use of prophylactic vaccines, such as Gardasil and Cervarix, have led to documented progress in decreasing the burden of HPV infection, however not all countries introduced a government-funded National HPV Vaccination Program to protect young men and women. This chapter summarizes the HPV infection, detection and prevention. We also shed light on non-cervical HPV-related cancers, which is rapidly increasing in more developed countries toward cervical cancer.
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Elasbali AM. Human papillomavirus: present and future perspective in Saudi Arabia. J OBSTET GYNAECOL 2020; 41:497-502. [PMID: 32347771 DOI: 10.1080/01443615.2020.1737662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Human papillomavirus (HPV) is a widely dispersed DNA double-stranded carcinogenic virus worldwide. Many cancers have been attributed to HPV subtypes as a major aetiological factor. Around 90% of cervical cancers have been attributed to the HPV infection, in addition to other cancers such as head and neck cancer, breast cancer and other cancers. As the carcinogenic high risk and low-risk, HPV subtypes are sexually transmitted viruses, and the Saudi community is religiously conservative, lots of measures of the precise burden of the HPV and its related cancers are still obscure. With the absence of cervical-screening programmes and in-depth research in HPV-related cancers, there a lack of literature except for literature pertained to awareness and perceptions. Consequently, the present review is deemed to explore the present state of the HPV-related issues, the future perspective in light of the current scientific evidence, as well as, Saudi community practices, and health policies in this regard. Making accessible data on HPV-related cancers can assist in designing HPV-related early detection and control sustainable programmes. Therefore, this review aimed to discuss the most important magnitudes related to the HPV, concerning the available literature from Saudi Arabia and the data in the neighbouring Arab countries interrelated to Saudi Arabia. The review depended on searching Electronic databases using strongly considered indexes including PubMed, Medline, Web of Science, Scopus, ABSCO, EMBASE, and others. In conclusion, though Saudi Arabia is pronounced as a conservative community with low sexual transmitted diseases, there is an alarming menace of HPV-attributable diseases necessitating a quick intervention.
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Affiliation(s)
- Abdelbaset Mohamed Elasbali
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Qurayyat, Saudi Arabia
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Alotaibi HJ, Almajhdi FN, Alsaleh AN, Obeid DA, Khayat HH, Al-Muammer TA, Tulbah AM, Alfageeh MB, Al-Ahdal MN, Alhamlan FS. Association of sexually transmitted infections and human papillomavirus co-infection with abnormal cervical cytology among women in Saudi Arabia. Saudi J Biol Sci 2020; 27:1587-1595. [PMID: 32489299 PMCID: PMC7253883 DOI: 10.1016/j.sjbs.2020.03.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 03/11/2020] [Accepted: 03/15/2020] [Indexed: 11/28/2022] Open
Abstract
Human papillomavirus (HPV) is a causative agent of cervical and other cancers. Sexually transmitted Infections (STIs) may play a crucial role in HPV persistence, leading to serious complications, including cervical cancer. This study investigated the association of HPV/STI co-infection in cervical samples with cervical dysplasia among women in Saudi Arabia. HPV-positive cervical samples (n = 142) were obtained from previous studies and newly collected samples (n = 209) were obtained from women aged 19–83 years. For HPV detection and genotyping, PCR and Genoflow HPV assay kits were used. STIs were detected using a Genoflow STD array kit. Of 351 samples, 94 (27%) were positive for STIs. Among HPV-positive samples, 36 (25%) were positive for STIs; the most common pathogens were Ureaplasma urealyticum/Ureaplasma parvu (13%) and Mycoplasma hominis (6%). A global significant correlation was detected between HPV and STIs with progression of abnormal cervical cytology (χ2 = 176, P < 0.0001). Associations between cervical cytology diagnosis and HPV status, STI types (opportunistic and pathogenic), and the presence of Ureaplasma spp., and Mycoplasma hominis were significant (P < 0.05). Our results suggest that additional study in a larger population is warranted to determine the association between HPV/STI co-infection and cervical neoplasia in Saudi women.
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Affiliation(s)
- H J Alotaibi
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - F N Almajhdi
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - A N Alsaleh
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - D A Obeid
- Department of Infection and Immunity, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - H H Khayat
- Department of Infection and Immunity, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - T A Al-Muammer
- Department of Family Medicine and Polyclinic, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - A M Tulbah
- Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - M B Alfageeh
- Infectious Diseases Program, National Center for Biotechnology, King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia
| | - M N Al-Ahdal
- Department of Infection and Immunity, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.,College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - F S Alhamlan
- Department of Infection and Immunity, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.,College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
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Obeid DA, Almatrrouk SA, Khayat HH, Al-Muammer TA, Tulbah AM, Albadawi IA, Al-Ahdal MN, Alhamlan FS. Human papillomavirus type 16 and 18 viral loads as predictors associated with abnormal cervical cytology among women in Saudi Arabia. Heliyon 2020; 6:e03473. [PMID: 32140590 PMCID: PMC7047185 DOI: 10.1016/j.heliyon.2020.e03473] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 09/08/2019] [Accepted: 02/10/2020] [Indexed: 01/05/2023] Open
Abstract
The detection of HPV viral DNA is regularly conducted with cervical screening. However, using a molecular marker such as the viral load may serve as a predictor associated with disease detection and progression. The present study aimed to screen for and genotype HPV among women in Saudi Arabia, develop and validate sensitive quantitative polymerase chain reaction (qPCR) assays to detect viral load for the two most common HPV types, namely 16 and 18, and assess whether HPV viral load could be used as a marker for cervical abnormality and disease progression. This study examined 733 specimens (both formalin-fixed paraffin embedded specimens and PAP smear samples) from women who underwent cervical screening. The specimens and samples were processed for DNA extraction and then tested for HPV DNA using nested PCR. Approximately 165 specimens (18%) were positive for HPV. Those specimens were genotyped using a reverse line blotting hybridization assay. The results indicated that the most common HPV types detected were a single infection with HPV 16 (51%) or with HPV 18 (28%) followed by infections with multiple HPV types (~7%). A qPCR TaqMan assay developed and validated in-house was used to determine viral load for HPV genotypes 16 (n = 80) and 18 (n = 45). Viral loads for both HPV types were significantly associated with cervical cytology grade (P < 0.05). The odds ratio (OR) for the HPV 16 viral load was high for specimens with cervical cancer (OR, 18.8; 95% CI, 4.3–82.9) or for those with high-grade squamous intraepithelial lesions (OR, 14.7; 95% Cl, 2.43–88.49). For the HPV 18 viral load, the OR was significant only for specimens with cervical cancer (OR, 11.1; 95% Cl, 2.2–54.9). Logistic regression models for HPV 16 and for HPV 18 viral load levels were significant, with higher viral load associated with cervical abnormalities. These findings indicate that viral load is a predictor significantly associated with cytology abnormality in women who are positive for high-risk HPVs and suggest that integrating a viral load test into current clinical screening practices for HPV-positive women is warranted in Saudi Arabia.
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Affiliation(s)
- D A Obeid
- Department of Infection and Immunity, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - S A Almatrrouk
- Department of Infection and Immunity, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - H H Khayat
- Department of Infection and Immunity, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - T A Al-Muammer
- Department of Family Medicine and Polyclinic, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - A M Tulbah
- Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.,College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - I A Albadawi
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia.,College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - M N Al-Ahdal
- Department of Infection and Immunity, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.,College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - F S Alhamlan
- Department of Infection and Immunity, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.,College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
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Mousa M, Al-Amri SS, Degnah AA, Tolah AM, Abduljabbar HH, Oraif AM, Abduljabbar HS, Mirza AA, Azhar EI, Hashem AM. Prevalence of human papillomavirus in Jeddah, Saudi Arabia. Ann Saudi Med 2019; 39:403-409. [PMID: 31804132 PMCID: PMC6894452 DOI: 10.5144/0256-4947.2019.403] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Human papillomaviruses (HPVs) are small, non-enveloped, double-stranded DNA viruses that consist of more than 200 genotypes. Low-risk genotypes are associated with warts or benign lesions, whereas high-risk genotypes are usually associated with malignancies and cancers including cervical cancer. However, the real prevalence and incidence of HPV in Saudi Arabia may be understated due to a lack of comprehensive data reporting. OBJECTIVES Determine the positivity rate of HPV in men and women in Jeddah, Saudi Arabia. DESIGN Cross-sectional. SETTING Tertiary care center in Jeddah. SUBJECTS AND METHODS Self-collected vaginal swab samples were obtained from females attending the gynecological clinic in the period between October 2017 and April 2018 at a tertiary care center, Jeddah, Saudi Arabia. PCR-positive HPV samples were sequenced to determine genotype. Additionally, serum samples were collected from healthy male and female blood donors and screened for HPV IgG antibodies by ELISA. MAIN OUTCOME MEASURES Molecular and serological positivity for HPV. SAMPLE SIZE 119 self-collected vaginal swabs from females at a gynecology clinic and 966 serum samples from healthy blood donors. RESULTS Of the 119 tested vaginal swabs, 7 samples (5.9%) were positive for HPV DNA. Several genotypes were identified. Most of the positive samples were from Saudi females in the age range of 31-50 years seeking care for infertility. Of the 966 serum samples, only 16 samples (1.7%) were positive for HPV IgG antibodies. CONCLUSION While the prevalence of HPV in men and women in our sample from the western region of Saudi Arabia was low, our data clearly show that it is not uncommon among high-risk groups and people are still exposed to the risk of HPV infection. Most importantly, these data provide valuable information that could aid in enhancing national awareness about HPV and in introducing an HPV vaccination program. LIMITATIONS Single hospital and a convenience sample CONFLICT OF INTEREST: None.
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Affiliation(s)
- Manar Mousa
- From the Department of Medical Microbiology and Parasitology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Sawsan S Al-Amri
- From the Vaccines and Immunotherapy Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Afnan A Degnah
- From the Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia.,From the Special Infectious Agents Unit, King Fahad Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ahmed M Tolah
- From the Special Infectious Agents Unit, King Fahad Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Hanin H Abduljabbar
- From the Reproductive endocrinology and infertility unit, Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia
| | - Ayman M Oraif
- From the Department of Obstetrics and Gynecology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Hassan S Abduljabbar
- From the Department of Obstetrics and Gynecology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ahmed A Mirza
- From the Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Esam I Azhar
- From the Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia.,From the Special Infectious Agents Unit, King Fahad Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Anwar M Hashem
- From the Department of Medical Microbiology and Parasitology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.,From the Vaccines and Immunotherapy Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
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Aldohaian AI, Alshammari SA, Arafah DM. Using the health belief model to assess beliefs and behaviors regarding cervical cancer screening among Saudi women: a cross-sectional observational study. BMC WOMENS HEALTH 2019; 19:6. [PMID: 30621680 PMCID: PMC6323726 DOI: 10.1186/s12905-018-0701-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 12/12/2018] [Indexed: 01/17/2023]
Abstract
Background Cervical cancer in Saudi Arabia is ranked as the third most frequent gynecological cancer among women. The Pap smear test is a screening test that can be used as a primary prevention tool for cervical cancer, and prophylactic vaccination against HPV is also considered to be a factor in decreasing the prevalence of the disease. This study aimed to assess women’s beliefs about cervical cancer and the Pap smear test. In addition, the relationship between cervical cancer and the social and demographic characteristics was also evaluated. Methods A descriptive cross-sectional study was performed among Saudi women living in Riyadh in 2018. Women were randomly selected, and the total sample size was 450. A predesigned self-administered questionnaire that included the Health Belief Model scale was used to collect data. Data were analyzed using SPSS 21.0. P values < 0.05 were considered as statistically significant in this study. Results Among the 450 participants, the Pap smear test uptake was 26% and the HPV vaccine uptake was less than 1%. A low education level and family history for cervical cancer were significantly associated with the belief of high susceptibility for developing cervical cancer (p < 0.05). The seriousness of the disease was recognized by 38%, and the benefit of screening was recognized by 82% of the participants. In addition, 27% of the participants perceived barriers to obtaining a Pap smear test. Conclusions This study showed a high level of perception regarding benefits and motivation, and a low incidence of perceived barriers among women regarding cervical cancer screening. However, these attitudinal aspects did not translate into practice, as reflected by the low uptake of the screening test. Our findings imply that concerted efforts are needed to promote cervical cancer screening programs in Saudi Arabia. In view of the planned implementation of Saudi vision 2030, which emphasizes on prevention, we recommend launching a national cervical cancer screening program, to be available and accessible to all women in primary health care centers and hospitals.
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Affiliation(s)
- Arwa I Aldohaian
- Department of Family & community medicine, College of Medicine, King Saud Medical University, Riyadh, Kingdom of Saudi Arabia.
| | - Sulaiman A Alshammari
- Department of Family & community medicine, College of Medicine, King Saud Medical University, Riyadh, Kingdom of Saudi Arabia
| | - Danyah M Arafah
- Department of Family & community medicine, College of Medicine, King Saud Medical University, Riyadh, Kingdom of Saudi Arabia
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Nasser H, AlAyyaf M, Atallah A, Aminulislam M, Rizwan L, Aodah A, Alkahtani Y, Alshammari H, Alsayed A, Szpunar S. Eleven-year review of data on Pap smears in Saudi Arabia: We need more focus on glandular abnormalities! Ann Saudi Med 2017; 37:265-271. [PMID: 28761025 PMCID: PMC6150586 DOI: 10.5144/0256-4947.2017.265] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND We reviewed data from Saudi Arabia on epithelial cell abnormalities (ECA) detected by Pap smear after noticing a slight increase in the incidence of cervical glandular abnormalities in our regional laboratory in recent years. OBJECTIVE Clarify data on adenocarcinoma (ADCA) on Pap smears in Saudi Arabia. DESIGN Descriptive, retrospective study. SETTINGS Regional laboratory, Riyadh. PATIENTS AND METHODS We reviewed all Pap smears of adult females between 2006 and 2016 and compared our data with previously published results from Saudi Arabia. MAIN OUTCOME MEASURE(S) Descriptive data on ECAs. RESULTS Among 19759 cases, atypical squamous cell of undetermined significance (ASC-US) was the most prevalent ECA (1.16%). ADCA occurred more than squamous cell carcinoma (SCC). In a comparison of published data before 2014 and after 2014 (including ours), there was a significant rise in ADCA (28 vs 48 cases; P=.004) with a significant drop in SCC, high-grade squamous intraepithelial lesions (HSIL) and low-grade squamous intraepithelial lesions (LSIL) (P < .0001, .004, and < .0001, respectively). CONCLUSION We recommend that pathologists and cytotechnologists be vigilant in screening Pap smears in our population, particularly for glandular abnormalities. We also recommend use of Pap smears in the initial workup of women with suspected gynecological abnormalities, regardless of evolutions in HPV testing. LIMITATIONS The pooling of data instead of analyzing by study year.
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Affiliation(s)
- Haitham Nasser
- Dr. Haitham Nasser, Department of Histopathology,, King Saud Medical City,, Riyadh 11575, T: +966-11-4355555;, F: +966-11-4353045, , ORCID: http://orcid.org/0000-0001-5939-1542
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