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DE FLORA S, LA MAESTRA S, CROCETTI E, MANGONE L, BIANCONI F, STRACCI F, BUZZONI C. Estimates of the incidence of infection-related cancers in Italy and Italian regions in 2018. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2019; 60:E311-E326. [PMID: 31967088 PMCID: PMC6953451 DOI: 10.15167/2421-4248/jpmh2019.60.4.1434] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 11/21/2019] [Indexed: 12/12/2022]
Abstract
Introduction Chronic infections and infestations represent one of the leading causes of cancer. Eleven agents have been categorized by the International Agency for Research on Cancer (IARC) in Group 1, 3 in Group 2A and 4 in Group 2B. We previously estimated that the incidence of cancers associated with infectious agents accounted for the 8.5% of new cancer cases diagnosed in Italy in 2014. Methods In the present study we evaluated the incidence of cancer in Italy and in the 20 Italian regions in 2018, based on the data of Cancer Registries, and calculated the fraction attributable to infectious agents. Results Cancers of infectious origin contributed to the overall burden of cancer in Italy with more than 27,000 yearly cases, the 92% of which was attributable to Helicobacter pylori, human papillomaviruses, and hepatitis B and C viruses. With the exception of papillomavirus-related cancers, the incidence of cancers of infectious origin was higher in males (16,000 cases) than in females (11,000 cases). There were regional and geographical variations of cancers depending on the type of cancer and on the gender. Nevertheless, the overall figures were rather similar, the infection-related cancers accounting for the 7.2, 7.6, and 7.1% of all cancers in Northern, Central, and Southern Italy, respectively. Conclusions The estimate of the incidence of cancers attributable to infectious agents in Italy in 2018 (7.3% of all cancer cases) is approximately half of the worldwide burden, which has been estimated by IARC to be the 15.4% of all cancer cases in 2012.
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MESH Headings
- Adolescent
- Adult
- Age Distribution
- Aged
- Burkitt Lymphoma/epidemiology
- Burkitt Lymphoma/etiology
- Carcinoma, Hepatocellular/epidemiology
- Carcinoma, Hepatocellular/etiology
- Child
- Child, Preschool
- Epstein-Barr Virus Infections/complications
- Female
- Head and Neck Neoplasms/epidemiology
- Head and Neck Neoplasms/etiology
- Helicobacter Infections/complications
- Helicobacter pylori
- Hepatitis B/complications
- Hepatitis C/complications
- Hodgkin Disease/epidemiology
- Hodgkin Disease/etiology
- Humans
- Incidence
- Infant
- Infant, Newborn
- Infections/complications
- Italy/epidemiology
- Leukemia-Lymphoma, Adult T-Cell/epidemiology
- Leukemia-Lymphoma, Adult T-Cell/etiology
- Liver Neoplasms/epidemiology
- Liver Neoplasms/etiology
- Lymphoma, B-Cell, Marginal Zone/epidemiology
- Lymphoma, B-Cell, Marginal Zone/etiology
- Malaria, Falciparum/complications
- Male
- Middle Aged
- Neoplasms/epidemiology
- Neoplasms/etiology
- Papillomavirus Infections/complications
- Penile Neoplasms/epidemiology
- Penile Neoplasms/etiology
- Sarcoma, Kaposi/epidemiology
- Sarcoma, Kaposi/etiology
- Sex Distribution
- Stomach Neoplasms/epidemiology
- Stomach Neoplasms/etiology
- Uterine Cervical Neoplasms/epidemiology
- Uterine Cervical Neoplasms/etiology
- Vaginal Neoplasms/epidemiology
- Vaginal Neoplasms/etiology
- Vulvar Neoplasms/epidemiology
- Vulvar Neoplasms/etiology
- Young Adult
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Affiliation(s)
- S. DE FLORA
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Correspondence: Silvio De Flora, Department of Health Sciences, University of Genoa, via A. Pastore 1, 161232 Genoa, Italy - E-mail:
| | - S. LA MAESTRA
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - E. CROCETTI
- Romagna Cancer Registry, Romagna Cancer Institute (Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, IRST, IRCCS), Meldola, Forlì, Italy
| | - L. MANGONE
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - F. STRACCI
- Department of Experimental Medicine, Section of Public Health, University of Perugia, Perugia, Italy
| | - C. BUZZONI
- Clinical Epidemiology Unit, Oncological Network, Prevention and Research Institute (ISPRO), Florence, Italy
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Zhang CX. The protective role of DMBT1 in cervical squamous cell carcinoma. Kaohsiung J Med Sci 2019; 35:739-749. [PMID: 31400059 DOI: 10.1002/kjm2.12117] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 07/16/2019] [Indexed: 01/03/2023] Open
Abstract
To explore the possible influence of deleted in malignant brain tumor 1 (DMBT1) in cervical squamous cell carcinoma (CSCC). DMBT1 expression was detected by Real-time reverse transcription PCR (qRT-PCR) and immunohistochemistry in CSCC and adjacent normal tissues from 167 CSCC patients, and its relationship with clinicopathological features and prognosis was analyzed. Besides, the in vitro experiments, including MTT, Cell-Light EdU, Wound-healing, Transwell invasion, Annexin V-FITC/PI staining, qRT-PCR, and Western blot, were performed in SiHa and CaSKi cells, which were both divided into Blank, Vector, and DMBT1 groups. The mRNA level and the positive expression rate of DMBT1 in CSCC tissues were lower than the adjacent normal tissues. Moreover, DMBT1 positive rate was linked to FIGO stage, tumor diameter, lymph node metastasis, and tumor differentiation of CSCC. Besides, patients with positive DMBT1 expression had higher 5-year survival rate than those negative ones. According to the in vitro experiments, SiHa and CaSKi cells with overexpressed DMBT1 showed the inhibition of proliferative ability and the enhancement of apoptosis with the upregulated pro-apoptosis proteins (Bax and Cleaved caspase-3) and down-regulated anti-apoptosis protein Bcl-2. Moreover, compared with Blank group, DMBT1 group presented decrease in the migration and invasion of SiHa and CaSKi cells with the down-expression of interstitial markers (N-cadherin and Vimentin) and the up-expression of epithelial marker E-cadherin. DMBT1 was decreased in CSCC, whereas its overexpression can not only inhibit the proliferation, migration, and invasion, but induce the apoptosis of human CSCC cells, being a novel strategy for CSCC treatment.
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Sharma A, Gupta S, Sodhani P, Singh V, Sehgal A, Sardana S, Mehrotra R, Sharma JK. Glutathione S-transferase M1 and T1 Polymorphisms, Cigarette Smoking and HPV Infection in Precancerous and Cancerous Lesions of the Uterine Cervix. Asian Pac J Cancer Prev 2015; 16:6429-38. [DOI: 10.7314/apjcp.2015.16.15.6429] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Scheurer ME, Danysh HE, Follen M, Lupo PJ. Association of traffic-related hazardous air pollutants and cervical dysplasia in an urban multiethnic population: a cross-sectional study. Environ Health 2014; 13:52. [PMID: 24924773 PMCID: PMC4063240 DOI: 10.1186/1476-069x-13-52] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Accepted: 06/10/2014] [Indexed: 05/21/2023]
Abstract
BACKGROUND Human papillomavirus (HPV) infection is a necessary cause in the development of cervical cancer; however, not all women infected with HPV develop cervical cancer indicating that other risk factors are involved. Our objective was to determine the association between exposure to ambient levels of common traffic-related air toxics and cervical dysplasia, a precursor lesion for cervical cancer. METHODS The study sample consisted of women enrolled in a Phase II clinical trial to evaluate diagnostic techniques for cervical disease in Houston, Texas. The current assessment is a secondary data analysis in which cases were defined as women diagnosed with cervical dysplasia, while those without cervical dysplasia served as controls. Residential census tract-level estimates of ambient benzene, diesel particulate matter (DPM), and polycyclic aromatic hydrocarbons (PAHs) were used to assess exposure. Census tract-level pollutant estimates were obtained from the United States Environmental Protection Agency. Multivariable logistic regression was used to estimate prevalence odds ratios (aOR) and 95% confidence intervals (CI) adjusted for age, race/ethnicity, education, smoking status, and HPV status. RESULTS Women in the highest residential exposure categories for benzene and DPM had an increased prevalence of cervical dysplasia compared to the lowest exposure category (Benzene: aOR [95% CI] for high exposure = 1.97[1.07-3.62], very high exposure = 2.30[1.19-4.46]. DPM: aOR [95% CI] for high exposure = 2.83[1.55-5.16], very high exposure = 2.10[1.07-4.11]). Similarly, women with high residential exposure to PAHs had an increased prevalence of cervical dysplasia (aOR [95% CI] = 2.46[1.35-4.48]). The highest PAH exposure category was also positively associated with cervical dysplasia prevalence but was not statistically significant. Assessment of the combined effect of HAP exposure indicates that exposure to high levels of more than one HAP is positively associated with cervical dysplasia prevalence (p for trend = 0.004). CONCLUSIONS Traffic-related HAPs, such as benzene, DPM, and PAHs, are not as well-regulated and monitored as criteria air pollutants (e.g., ozone), underscoring the need for studies evaluating the role of these toxicants on disease risk. Our results suggest that exposure to traffic-related air toxics may increase cervical dysplasia prevalence.
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Affiliation(s)
- Michael E Scheurer
- Department of Pediatrics, Section of Hematology-Oncology and Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, Texas
| | - Heather E Danysh
- Department of Pediatrics, Section of Hematology-Oncology and Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, Texas
| | - Michele Follen
- Department of Obstetrics and Gynecology, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, Texas
| | - Philip J Lupo
- Department of Pediatrics, Section of Hematology-Oncology and Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, Texas
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de Freitas AC, Gurgel APAD, Chagas BS, Coimbra EC, do Amaral CMM. Susceptibility to cervical cancer: an overview. Gynecol Oncol 2012; 126:304-11. [PMID: 22484226 DOI: 10.1016/j.ygyno.2012.03.047] [Citation(s) in RCA: 106] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2011] [Revised: 03/02/2012] [Accepted: 03/29/2012] [Indexed: 12/12/2022]
Abstract
Cervical cancer is the second most common cancer in females worldwide. It is well-established that Human Papillomavirus (HPV) infections play a critical role in the development of cervical cancer. However, a large number of women infected with oncogenic HPV types will never develop cervical cancer. Thus, there are several external environment and genetic factors involved in the progression of a precancerous lesion to invasive cancer. In this review article, we addressed possible susceptible phenotypes to cervical cancer, focusing on host genome and HPV DNA variability, multiple HPV infections, co-infection with other agents, circulating HPV DNA and lifestyle.
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Affiliation(s)
- Antonio Carlos de Freitas
- Laboratory of Molecular Studies and Experimental Therapy, Department of Genetics, Center for Biological Sciences, Federal University of Pernambuco, Recife, Brazil.
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Distribution patterns of infection with multiple types of human papillomaviruses and their association with risk factors. PLoS One 2011; 6:e14705. [PMID: 21379574 PMCID: PMC3040737 DOI: 10.1371/journal.pone.0014705] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2010] [Accepted: 01/28/2011] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Infection with multiple types of human papillomavirus (HPV) is one of the main risk factors associated with the development of cervical lesions. In this study, cervical samples collected from 1,810 women with diverse sociocultural backgrounds, who attended to their cervical screening program in different geographical regions of Colombia, were examined for the presence of cervical lesions and HPV by Papanicolau testing and DNA PCR detection, respectively. PRINCIPAL FINDINGS The negative binomial distribution model used in this study showed differences between the observed and expected values within some risk factor categories analyzed. Particularly in the case of single infection and coinfection with more than 4 HPV types, observed frequencies were smaller than expected, while the number of women infected with 2 to 4 viral types were higher than expected. Data analysis according to a negative binomial regression showed an increase in the risk of acquiring more HPV types in women who were of indigenous ethnicity (+37.8%), while this risk decreased in women who had given birth more than 4 times (-31.1%), or were of mestizo (-24.6%) or black (-40.9%) ethnicity. CONCLUSIONS According to a theoretical probability distribution, the observed number of women having either a single infection or more than 4 viral types was smaller than expected, while for those infected with 2-4 HPV types it was larger than expected. Taking into account that this study showed a higher HPV coinfection rate in the indigenous ethnicity, the role of underlying factors should be assessed in detail in future studies.
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Cervix smear abnormalities: linking pathology data in female twins, their mothers and sisters. Eur J Hum Genet 2010; 19:108-11. [PMID: 20717168 DOI: 10.1038/ejhg.2010.139] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Mass screening for cervical cancer precursors has decreased the incidence of cervical cancer in several countries, including the Netherlands. Persistent infections of certain types of human papillomavirus are strongly associated with the development of cervical cancer. A number of factors may affect the liability to infection and subsequent progression to cervical intraepithelial neoplasia and cancer. This paper examines whether genetic factors are involved in explaining individual differences in liability. Data of 3178 women registered with the Netherlands Twin Register were successfully linked to the nationwide Dutch Pathology database that contains all results of mass screening for cervical cancer. The data from mono- and dizygotic twins and their female relatives were used to disentangle the influence of heritable and environmental factors on cervix smear abnormalities. Results showed that differences in cervix smear results clustered within families and resemblance was stronger in monozygotic twins (correlation 0.37, 95% confidence interval: 0.12-0.58) compared with other first-degree relatives (correlation 0.14, 95% confidence interval: -0.01-0.29). The familial clustering for an abnormal cervix smear is due to shared genetic factors that explain 37% of the variance in liability. The largest proportion of the variation in cervical smear abnormalities is due to unique environmental factors.
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Agodi A, Barchitta M, Cipresso R, Marzagalli R, La Rosa N, Caruso M, Castiglione MG, Travali S. Distribution of p53, GST, and MTHFR Polymorphisms and Risk of Cervical Intraepithelial Lesions in Sicily. Int J Gynecol Cancer 2010; 20:141-6. [DOI: 10.1111/igc.0b013e3181c20842] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
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Khanna N, Mishra SI, Tian G, Tan MT, Arnold S, Lee C, Ramachandran S, Bell L, Baquet CR, Lorincz A. Human papillomavirus detection in self-collected vaginal specimens and matched clinician-collected cervical specimens. Int J Gynecol Cancer 2007; 17:615-22. [PMID: 17504376 DOI: 10.1111/j.1525-1438.2006.00835.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Human papillomavirus (HPV) detection is an integral part of cervical cancer screening, and a range of specimen collection procedures are being tested. Preliminary studies have found that the majority of women prefer self-collection of vaginal specimens instead of clinician-collected specimens of the cervix. The purposes of the current study were to explore the social and behavioral predictors of acceptance of self-collection of vaginal specimens among patients and to assess concordance in detection of HPV between clinician-collected cervical specimens and self-collected vaginal specimens. The study was conducted at a university family medicine clinic using a cross-sectional study design, and enrollment of women presenting for routine gynecological examination consecutively in a period of 1 year, self-administered questionnaires, collection of paired vaginal and cervical specimens for HPV DNA using Hybrid Capture 2, and cytologic analysis. Most women (79.8% [398/499]) agreed to collect vaginal specimens. In our study, 76.6% (216/282) African American women (AA), 88.1% (156/176) white non-Hispanic (WNH) women, and 63.4% (26/41) women of other races (P < 0.0001) agreed to self-collect vaginal specimens. HPV was detected in 16.0% (80/499) of clinician-collected cervical specimens and 26.1% (104/398) of self-collected vaginal specimens (P < 0.001). HPV detection was concordant in 13.4% (53/398) women in both cervical and vaginal specimens. Self-collection of vaginal specimens for HPV DNA detection is acceptable to most women presenting for routine gynecological examination. WNH women were more likely to obtain self-collected specimens than AA women. Vaginal specimens were more likely to be positive for HPV than were cervical specimens.
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Affiliation(s)
- N Khanna
- Department of Family Medicine, School of Medicine, and Greenebaum Cancer Center, University of Maryland, Baltimore, Maryland, USA.
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Au WW. Usefulness of biomarkers in population studies: from exposure to susceptibility and to prediction of cancer. Int J Hyg Environ Health 2006; 210:239-46. [PMID: 17174154 DOI: 10.1016/j.ijheh.2006.11.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
From a review of decades of intensive biomarker research and prospective validation studies, it becomes clear that only a limited number of biomarkers can be used to provide reliable documentation of excessive exposure to environmental mutagenic agents, expression of detrimental biological effects from the exposure and increased risk for cancer. These studies also demonstrate that expression of each biomarker represents an integrated response to the exposure that is influenced by susceptibility factors, and an integral component of the complex carcinogenic pathway. A current interest is in the use of phenotypic functional assays to improve and complement the assessment of cancer risk. A recommended approach includes assays that indicate DNA repair deficiency, i.e. host-cell-mediated reporter gene and challenge (mutagen-sensitivity) assays. The usefulness and limitations in biomarker investigations will be discussed. The review emphasizes the need for carefully designed investigations that involve adequate sample sizes and a combination of appropriate biomarkers to generate reproducible results that can be translated into more reliable cancer risk assessment. The assessment can be used to drive the implementation of disease prevention and intervention activities. Such an approach is consistent with the current priority in translating basic science knowledge into health applications.
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Affiliation(s)
- William W Au
- Department of Preventive Medicine and Community Health, 2.102 Ewing Hall, 700 Harborside Drive, The University of Texas Medical Branch, Galveston, TX 77555-1110, USA.
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Au WW, Abdou-Salama S, Sierra-Torres CH, Al-Hendy A. Environmental risk factors for prevention and molecular intervention of cervical cancer. Int J Hyg Environ Health 2006; 210:671-678. [PMID: 17157560 DOI: 10.1016/j.ijheh.2006.10.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2006] [Revised: 10/06/2006] [Accepted: 10/31/2006] [Indexed: 10/23/2022]
Abstract
Cervical cancer (CC) is potentially the most preventable and treatable cancer in human but it is a leading cause for cancer morbidity and mortality in women around the world. Therefore, more innovative prevention and treatment protocols need to be developed and implemented. With better understanding of the etiology of the disease, specific prevention protocols that involve life-style modifications to minimize the impact of environmental risk factors can be developed. It may be necessary to implement unique modification protocols for different countries. In addition, antiviral vaccine is a highly promising prevention approach. With respect to therapy, the development of more specific protocols that have fewer side effects is needed. With the availability of sophisticated molecular techniques, a new generation of targeted approach that has the potential to generate outstanding efficacy is being tested. Using the siRNA technology against the expression of human papillomavirus oncogenes, specific biological pathways that are essential to the growth and survival of the CC cells can be interrupted. Another promising approach is the molecular intervention of the estrogen pathway by blocking the expression of estrogen receptors. These molecular techniques may work by reactivating endogenous regulatory processes, e.g., the core apoptotic machinery, that can cause self-destruction of the CC cells, thus providing potentially effective molecular therapy. These topics are discussed in this review.
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Affiliation(s)
- William W Au
- Department of Preventive Medicine and Community Health, The University of Texas Medical Branch, Galveston, TX 77555-1110, USA.
| | - Salama Abdou-Salama
- Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, TX, USA
| | - Carlos H Sierra-Torres
- Laboratorio de Genética Humana, Departamento de Ciencias Fisiológicas, Facultad Ciencias de la Salud, Universidad del Cauca, Popayán, Colombia
| | - Ayman Al-Hendy
- Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, TX, USA
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