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Xu MA, Choi J, Capasso A, DiClemente RJ. Improving HPV Vaccination Uptake Among Adolescents in Low Resource Settings: Sociocultural and Socioeconomic Barriers and Facilitators. Adolesc Health Med Ther 2024; 15:73-82. [PMID: 39100520 PMCID: PMC11296371 DOI: 10.2147/ahmt.s394119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 07/18/2024] [Indexed: 08/06/2024] Open
Abstract
Background Lower- and middle-income countries (LMICs) are disproportionately impacted by human papillomavirus (HPV) and would benefit from implementing the HPV vaccine. In the context of competing health priorities, utilizing scarce domestic infrastructure and human resources for HPV vaccination remains challenging for many LMICs. Given the high benefits of the HPV vaccine, the World Health Organization (WHO) is now encouraging for all countries, particularly LMICs, to introduce HPV vaccines into their routine immunization programs. Understanding the barriers and facilitators to HPV adolescent vaccine programs in LMICs may help strengthen how LMICs implement HPV vaccine programs, in turn, increasing HPV vaccine acceptance, uptake, and coverage. Objective To identify and assess barriers and facilitators to implementing adolescent HPV vaccination programs in LMICs. Methods This study comprised a review of literature assessing adolescent HPV vaccination in LMICs published after 2020 from a sociocultural perspective. Results Overall, the findings showed that LMICs should prioritize increasing HPV vaccine availability and HPV vaccine knowledge, particularly focusing on cancer prevention, as knowledge reduces misinformation and increases vaccine acceptance. Evidence suggests that factors promoting HPV vaccine uptake include fostering low vaccine hesitancy, integrating HPV vaccination as a primary school routine vaccination, and vaccinating both genders. A one-dose HPV vaccine may enable many LMICs to increase vaccine acceptance, uptake, and coverage while controlling financial, infrastructure, and human resource costs. Conclusion As HPV is one of the leading causes of death in many LMICs, implementing the HPV vaccine may be highly beneficial. Cohesive national HPV vaccine buy-in and understanding the success and challenges of prior LMIC HPV vaccine implementation is crucial to developing effective, efficient, and sustainable HPV vaccination programs.
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Affiliation(s)
- Mia Ann Xu
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY, USA
| | - Jasmin Choi
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY, USA
| | | | - Ralph J DiClemente
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY, USA
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Chyderiotis S, Derhy S, Gaillot J, Cobigo A, Zanetti L, Piel C, Mueller JE. Providing parents with HPV vaccine information from a male perspective may render them more inclined to have their daughters vaccinated. Infect Dis Now 2024; 54:104908. [PMID: 38604410 DOI: 10.1016/j.idnow.2024.104908] [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: 09/28/2023] [Revised: 04/01/2024] [Accepted: 04/08/2024] [Indexed: 04/13/2024]
Abstract
OBJECTIVES Several high-income countries have implemented a gender-neutral vaccination program against human papillomavirus (HPV) infections. The impact of a gender-neutral program (GNP) on parental intention to vaccinate their daughters has not been studied, especially in countries with low HPV vaccine coverage among girls. PATIENTS AND METHODS In July 2019, before a GNP was implemented in France (2021), the French National Cancer Institute (INCa) conducted a survey on HPV vaccine acceptance among parents of children aged 11-19 years living in France. In the sample of girls' parents (n = 1424 parents, 1726 girls), we investigated whether parents who declared no initial intention to have their daughter(s) vaccinated changed their minds after reading information including a male perspective on HPV consisting in description of HPV-related disease among men and in ascertainment of the fact that in some countries, the HPV vaccine is recommended for boys, after which they were once again asked about their intentions "if the vaccine were recommended to boys and girls alike". RESULTS As regards 295 (25.7 %) of the 1147 unvaccinated girls, their parents declared no intention to have them vaccinated, while 509 (44.4 %) were not sure. Among the parents of the 804 girls whose parents had not intended to have them vaccinated, 134 (16.7 %) changed their minds after reading about HPV among men. Fathers were more likely than mothers to change their minds, and finally intend to have their daughters vaccinated (adjusted relative risk, 1.74 [95 % confidence interval, 1.20,2.54]). CONCLUSIONS These results suggest that parents, and fathers in particular, could be more motivated to have their daughters vaccinated against HPV if the information with which they were provided included a male perspective and a recommendation of vaccination for boys as well as girls.
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Affiliation(s)
| | - Sarah Derhy
- French National Cancer Institute (INCa), Boulogne-Billancourt, France
| | - Julie Gaillot
- French National Cancer Institute (INCa), Boulogne-Billancourt, France
| | - Alexandre Cobigo
- French National Cancer Institute (INCa), Boulogne-Billancourt, France
| | - Laura Zanetti
- French National Authority for Health, St-Denis la Plaine, France
| | - Clément Piel
- French National Authority for Health, St-Denis la Plaine, France
| | - Judith E Mueller
- Institut Pasteur, Paris, France; EHESP French School of Public Health, Paris and Rennes, France
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Lehtinen M, Bruni L, Elfström M, Gray P, Logel M, Mariz FC, Baussano I, Vänskä S, Franco EL, Dillner J. Scientific approaches toward improving cervical cancer elimination strategies. Int J Cancer 2024; 154:1537-1548. [PMID: 38196123 DOI: 10.1002/ijc.34839] [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: 06/20/2023] [Revised: 11/29/2023] [Accepted: 12/13/2023] [Indexed: 01/11/2024]
Abstract
At the 2023 EUROGIN workshop scientific basis for strategies to accelerate the elimination of cervical cancer and its causative agent, human papillomavirus (HPV) were reviewed. Although some countries have reached key performance indicators toward elimination (>90% of girls HPV vaccinated and >70% of women HPV screened), most are yet to reach these targets, implying a need for improved strategies. Gender-neutral vaccination, even with moderate vaccination coverage was highlighted as a strategy to achieve elimination more rapidly. It is more resilient against major disturbances in vaccination delivery, such as what happened during the coronavirus pandemic. Further, an analysis of ethical/legal issues indicated that female-restricted vaccination is problematic. Extended catch-up of vaccination with concomitant screening, and outreach to vulnerable groups were highlighted. Although birth cohorts with high coverage of HPV vaccination at school are protected against HPV, and HPVs have a very low reproductive rate in women above age 35, adult women below age 30 have inadequate direct protection. In addition to herd protection from gender-neutral vaccination, this group can be protected by offering concomitant catch-up HPV vaccination and HPV screening. Furthermore, hepatitis B vaccination experiences indicate that elimination cannot be achieved without prioritizing vulnerable/migrant populations. The long-lasting durability of vaccination-induced antibody responses suggests prolonged protection with HPV vaccines when adequately administrated. Finally, cost-effectiveness modelling suggests that high-coverage HPV vaccination in multiple population segments will be resource-saving due to reduced need for screening. In summary, the workshop found that strategically optimal deployment of vaccination will accelerate elimination of HPV and cervical cancer.
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Affiliation(s)
- Matti Lehtinen
- Medical Faculty, Tampere University, Tampere, Finland
- Center of Cervical Cancer Elimination, Department of Clinical Science Intervention & Technology, Karolinska Institutet, Stockholm, Sweden
| | - Laia Bruni
- Catalan Institute of Oncology, Barcelona, Spain
| | - Miriam Elfström
- Center of Cervical Cancer Elimination, Department of Clinical Science Intervention & Technology, Karolinska Institutet, Stockholm, Sweden
| | - Penelope Gray
- Center of Cervical Cancer Elimination, Department of Clinical Science Intervention & Technology, Karolinska Institutet, Stockholm, Sweden
| | - Margaret Logel
- Division of Cancer Epidemiology, McGill University, Montreal, Canada
| | - Filipe Colaço Mariz
- Tumorvirus-Specific Vaccination Strategies, German Cancer Research Center, Heidelberg, Germany
| | - Iacopo Baussano
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, IARC/WHO, Lyon, France
| | - Simopekka Vänskä
- Infectious Disease Control & Vaccinations, Finnish Institute for Health & Welfare, Helsinki, Finland
| | - Eduardo L Franco
- Division of Cancer Epidemiology, McGill University, Montreal, Canada
| | - Joakim Dillner
- Center of Cervical Cancer Elimination, Department of Clinical Science Intervention & Technology, Karolinska Institutet, Stockholm, Sweden
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Albayat SS, Mundodan JM, Elmardi K, Hasnain S, Khogali H, Baaboura R, Al-Romaihi HE, AlKubaisi NJ, Bougmiza MI. Knowledge, attitude, and practices regarding human papilloma virus vaccination among physicians in Qatar. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057241227360. [PMID: 38282514 PMCID: PMC10826392 DOI: 10.1177/17455057241227360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 12/19/2023] [Accepted: 01/04/2024] [Indexed: 01/30/2024]
Abstract
BACKGROUND The human papilloma virus is a global problem that affects sexually active women and men, with cervical cancer being the most serious associated disease. Most cervical cancer cases can be prevented by vaccination against the human papilloma virus early in life. The objective of this study was to assess the knowledge, attitudes, and practices among physicians working in Qatar, regarding the human papilloma virus, infection, and prevention using vaccines. STUDY-DESIGN This was a cross-sectional study using quantitative data collection. METHODOLOGY An online survey targeting physicians working in Qatar was conducted, using a web-based pretested questionnaire. The questionnaire comprised four sections capturing a few demographic details, 33 questions in the Knowledge Section, 12 questions eliciting the attitude, and 14 practice-related questions. Mean knowledge score was calculated and those with a score more than the mean score were considered to have sufficient knowledge. Association between knowledge and attitude/practices/independent variables were looked for using bivariate and multivariate analysis. Logistic regression was used to identify the predictors for recommending human papilloma virus vaccines. RESULTS Of the 557 physicians who participated, 83.7% had sufficient knowledge, but only 69.1% knew that human papilloma virus vaccines were available in Qatar. The majority (89.4%) knew that human papilloma virus infection could be asymptomatic and 96.1% knew at least one symptom; 77% believed the human papilloma virus vaccine would substantially decrease the chances of human papilloma virus infection and related cancers and 46.5% felt physicians were less motivated to promote the human papilloma virus vaccine. The perceived barriers to community acceptance of the human papilloma virus vaccine were lack of awareness regarding the relationship between human papilloma virus and cervical cancer (61.6%), doubts regarding efficacy (32.5%), fear regarding safety (26.9%), concern that the human papilloma virus vaccination may encourage risky sexual behavior (26.8%), and perceived low-risk (23.3%) and cost (24.6%). Only 21.5% commonly discussed sexual health with their clients. More than one-third were not interested in recommending the human papilloma virus vaccine. Bivariate analysis showed nationality, specialization, discussing with patients, and recommending vaccine to be significantly associated with knowledge. Bivariate and regression analysis identified that female gender and physician's religion were significant predictors to recommend the human papilloma virus vaccine. CONCLUSION Most physicians have good knowledge. Less than one-fourth commonly discussed sexual health with their clients. More than one-third were not interested in recommending the human papilloma virus vaccine. This issue might affect the human papilloma virus vaccination program implementation if not well addressed.
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Affiliation(s)
| | | | - Khalid Elmardi
- HP-CDC, Department of Public Health, Ministry of Public Health, Doha, Qatar
| | - Samina Hasnain
- HP-CDC, Department of Public Health, Ministry of Public Health, Doha, Qatar
| | - Hayat Khogali
- HP-CDC, Department of Public Health, Ministry of Public Health, Doha, Qatar
| | | | | | | | - Mohamed Iheb Bougmiza
- Community Medicine Residency Program Director, Primary Health Care Corporation, Doha, Qatar
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Gheit T, Muwonge R, Lucas E, Galati L, Anantharaman D, McKay-Chopin S, Malvi SG, Jayant K, Joshi S, Esmy PO, Pillai MR, Basu P, Sankaranarayanan R, Tommasino M. Impact of HPV vaccination on HPV-related oral infections. Oral Oncol 2023; 136:106244. [PMID: 36402055 PMCID: PMC9833124 DOI: 10.1016/j.oraloncology.2022.106244] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 11/04/2022] [Accepted: 11/06/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Human papillomavirus (HPV) is one of the most common sexually transmitted infections worldwide. Although the efficacy of the HPV vaccine in preventing the development of cervical pre-malignant lesions has been well demonstrated, the efficacy of the HPV vaccine in preventing HPV infection in the upper respiratory tract has been poorly studied. METHODS In the context of the IARC cohort study of two versus three doses of HPV vaccine in India, we compared the HPV type prevalence in the oral cavity of women vaccinated with three doses, two doses, or a single dose of quadrivalent HPV vaccine with that of unvaccinated women. A total of 997 oral samples, from 818 vaccinated women and 179 unvaccinated women, were collected at three study sites. All the participants were sexually active at the time of sample collection. RESULTS The age-standardized proportion (ASP) of HPV16/18 infections was 2.0 % (95 % CI, 1.0-3.0 %) in vaccinated women and 4.2 % (95 % CI, 1.2-7.2 %) in unvaccinated women. HPV16 was detected in 3.5 % of single-dose recipients, 1.2 % of two-dose recipients (days 1 and 180), and 1.5 % of three-dose recipients (days 1, 60, and 180), whereas 3.3 % of the unvaccinated women tested positive for HPV16. The same trend was observed for HPV18. DISCUSSION Our findings agree with those of previous studies on the efficacy of HPV vaccination in reducing oral HPV infections and provide indications that a single vaccine dose may be less efficient than two or three doses in preventing oral HPV infection.
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Affiliation(s)
- Tarik Gheit
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Richard Muwonge
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Eric Lucas
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Luisa Galati
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Devasena Anantharaman
- Rajiv Gandhi Centre for Biotechnology, Poojappura, Thiruvananthapuram, Kerala, India
| | - Sandrine McKay-Chopin
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Sylla G Malvi
- Tata Memorial Centre Rural Cancer Project, Nargis Dutt Memorial Cancer Hospital, Barshi District Solapur, Maharashtra, India
| | - Kasturi Jayant
- Tata Memorial Centre Rural Cancer Project, Nargis Dutt Memorial Cancer Hospital, Barshi District Solapur, Maharashtra, India
| | - Smita Joshi
- Jehangir Clinical Development Centre, Jehangir Hospital Premises, Pune, India
| | - Pulikkottil O Esmy
- Christian Fellowship Community Health Centre, Ambillikai, Dindigul District, Tamil Nadu, India
| | | | - Partha Basu
- International Agency for Research on Cancer, World Health Organization, Lyon, France
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Vega Crespo B, Neira VA, Ortíz S J, Maldonado-Rengel R, López D, Gómez A, Vicuña MJ, Mejía J, Benoy I, Carreño TP, Verhoeven V. Evaluation of Urine and Vaginal Self-Sampling versus Clinician-Based Sampling for Cervical Cancer Screening: A Field Comparison of the Acceptability of Three Sampling Tests in a Rural Community of Cuenca, Ecuador. Healthcare (Basel) 2022; 10:healthcare10091614. [PMID: 36141226 PMCID: PMC9498379 DOI: 10.3390/healthcare10091614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 08/11/2022] [Accepted: 08/22/2022] [Indexed: 11/30/2022] Open
Abstract
Self-sampling methods for HPV testing have been demonstrated to be highly sensitive and specific. The implementation of these methods in settings with a lack of infrastructure or medical attention has been shown to increase the coverage of cervical cancer screening and detect cervical abnormalities in the early stages. The aim of this study is to compare the acceptability of urine and vaginal self-sampling methods versus clinician sampling among rural women. A total of 120 women participated. Each participant self-collected urine and vaginal samples and underwent clinician sampling for Pap smear and HPV testing. After the sample collection, a questionnaire to qualify the device, technique, and individual acceptability was applied, and the additional overall preference of three sample tests was evaluated. Results: The characteristics of the participants were as follows: median age of 35 years; 40.8% were married; 46.7% had a primary level of education; median age of sexual onset of 17.6 years. Compared with clinician sampling, both vaginal self-sampling, OR 20.12 (7.67–52.8), and urine sampling, OR 16.63 (6.79–40.72), were more comfortable; granted more privacy: vaginal self-sampling, OR 8.07 (3.44–18.93), and urine sampling, OR 19.5 (5.83–65.21); were less painful: vaginal self-sampling, OR 0.07 (0.03–0.16), and urine sampling, OR 0.01 (0–0.06); were less difficult to apply: vaginal self-sampling, OR 0.16 (0.07–0.34), and urine sampling, OR 0.05 (0.01–0.17). The overall preference has shown an advantage for vaginal self-sampling, OR 4.97 (2.71–9.12). No statistically significant preference was demonstrated with urine self-sampling versus clinician sampling. Conclusions: Self-sampling methods have a high acceptance in rural communities. Doubts on the reliability of self-sampling often appear to be a limitation on its acceptability. However, the training and education of the community could increase the uptake of these methods.
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Affiliation(s)
- Bernardo Vega Crespo
- Facultad de Ciencias Médicas, Universidad de Cuenca, Cuenca 010203, Ecuador
- Correspondence:
| | - Vivian Alejandra Neira
- Facultad de Ciencias Médicas, Universidad de Cuenca, Cuenca 010203, Ecuador
- Facultad de Medicina, Universidad del Azuay UDA, Cuenca 010104, Ecuador
| | - José Ortíz S
- Facultad de Ciencias Médicas, Universidad de Cuenca, Cuenca 010203, Ecuador
| | - Ruth Maldonado-Rengel
- Facultad de Ciencias de la Salud, Universidad Técnica Particular de Loja UTPL Loja Ecuador, Loja 1101608, Ecuador
- Programa de Doctorado en Ciencias Morfológicas, Universidad de La Frontera UFRO, Temuco 4811230, Chile
| | - Diana López
- Facultad de Medicina, Universidad del Azuay UDA, Cuenca 010104, Ecuador
| | - Andrea Gómez
- Facultad de Ciencias Médicas, Universidad de Cuenca, Cuenca 010203, Ecuador
| | - María José Vicuña
- Facultad de Ciencias Médicas, Universidad de Cuenca, Cuenca 010203, Ecuador
| | - Jorge Mejía
- Facultad de Ciencias Médicas, Universidad de Cuenca, Cuenca 010203, Ecuador
| | - Ina Benoy
- AMBIOR, Laboratory for Cell Biology and Histology, University of Antwerp, 2610 Antwerp, Belgium
| | - Tesifón Parrón Carreño
- Facultad de Ciencias de la Salud y Neurociencias, Universidad de Almería UAL, 04120 Almería, Spain
| | - Veronique Verhoeven
- Family Medicine and Population Health, University of Antwerp, 2610 Antwerp, Belgium
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Non-Functionalized Gold Nanoparticles Inhibit Human Papillomavirus (HPV) Infection. Int J Mol Sci 2022; 23:ijms23147552. [PMID: 35886898 PMCID: PMC9318239 DOI: 10.3390/ijms23147552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/01/2022] [Accepted: 07/04/2022] [Indexed: 02/04/2023] Open
Abstract
The spontaneous interaction between human papillomavirus type 16 (HPV16) L1 virus-like particles (VLPs) and non-functionalized gold nanoparticles (nfGNPs) interferes with the nfGNPs’ salt-induced aggregation, inhibiting the red–blue color shift in the presence of NaCl. Electron microscopy and competition studies showed that color-shift inhibition is a consequence of direct nfGNP–VLP interaction and, thus, may produce a negative impact on the virus entry cell process. Here, an in vitro infection system based on the HPV16 pseudovirus (PsV) was used to stimulate the natural infection process in vitro. PsVs carry a pseudogenome with a reporter gene, resulting in a fluorescent signal when PsVs infect a cell, allowing quantification of the viral infection process. Aggregation assays showed that nfGNP-treated PsVs also inhibit color shift in the presence of NaCl. High-resolution microscopy confirmed nfGNP–PsV complex formation. In addition, PsVs can interact with silver nanoparticles, suggesting a generalized interaction of metallic nanoparticles with HPV16 capsids. The treatment of PsVs with nfGNPs produced viral infection inhibition at a higher level than heparin, the canonical inhibitor of HPV infection. Thus, nfGNPs can efficiently interfere with the HPV16 cell entry process and may represent a potential active component in prophylactic formulations to reduce the risk of HPV infection.
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Poniewierza P, Panek G. Cervical Cancer Prevention in the Era of the COVID-19 Pandemic. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:732. [PMID: 35743995 PMCID: PMC9229337 DOI: 10.3390/medicina58060732] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 05/23/2022] [Indexed: 11/17/2022]
Abstract
Background and Objectives: Cervical cancer (CC) is the fourth most common cause of cancer-related morbidity and mortality among women worldwide. CC prevention is based on screening and HPV vaccination. The COVID-19 pandemic has caused difficulties in implementing CC-preventative measures. The aim of this study was to collect data on the implementation of CC prophylaxis in Poland provided by public and private health care with a particular focus on the impact of the COVID-19 pandemic and attempt to estimate the level of CC-screening implementation by 2026 under public and private health care. Materials and Methods: Data on the implementation of privately funded (2016-2021) and publicly funded (2014-2021) CC-preventative measures in Poland were examined. The Prophet algorithm, which positions itself as an automatic forecasting procedure and represents a local Bayesian structural time-series model, was used to predict data. The correlation test statistic was based on Pearson's product moment correlation coefficient and follows a t distribution. An asymptotic confidence interval was given based on Fisher's Z transform. Results: In 2021, a significantly higher population screening coverage was observed in private health care (71.91%) than in the public system (12.6%). Our estimation assumes that the adverse downward trend of population coverage (pap smear CC screening) in the public system will continue to 5.02% and in the private health system to 67.92% in 2026. Correlation analysis showed that with the increase in the sum of HPV tests and LBC, the percentage of Pap smear coverage in the private healthcare sector decreases r = -0.62, p = 0.260 df = 3, CI = [-0.97, 0.57]. The amount of HPV vaccinations provided in private health care is steadily increasing. Immunization coverage of the population of girls aged 9-18 years under private health care at the end of the observation period was 4.3% (2021). Conclusions: It is necessary to reorganize the public CC-screening system in Poland based on a uniform reporting system for tests performed in both public and private health care using the model of action proposed by us. We recommend the introduction of a national free HPV vaccination program funded by the government and implemented in public and private health care facilities.
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Affiliation(s)
| | - Grzegorz Panek
- Department of Oncologic Gynecology and Obstetrics, The Center of Postgraduate Medical Education, 00-416 Warsaw, Poland;
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Ma L, Li Q, Guo Y, Tan X, Wang M, Qi Q. Laparoscopic nerve‑sparing radical hysterectomy for the treatment of cervical cancer: a meta-analysis of randomized controlled trials. World J Surg Oncol 2021; 19:301. [PMID: 34657619 PMCID: PMC8522166 DOI: 10.1186/s12957-021-02408-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 09/21/2021] [Indexed: 12/29/2022] Open
Abstract
Background The effects and safety of laparoscopic nerve‑sparing radical hysterectomy (LNSRH) and laparoscopic radical hysterectomy (LRH) in cervical cancer treatment remain unclear. This article aims to evaluate the role of LNSRH versus LRH in the treatment of cervical cancer. This is because the updated meta-analysis with synthesized data may provide more reliable evidence on the role of LNSRH and LRH. Methods We searched Pubmed et al. databases for randomized controlled trials (RCTs) involving laparoscopic nerve‑sparing radical hysterectomy (LNSRH) and laparoscopic radical hysterectomy (LRH) for cervical cancer treatment from the inception of databases to June 15, 2021. The RevMan 5.3 software was used for data analyses. This meta-analysis protocol had been registered online (available at: https://inplasy.com/inplasy-2021-9-0047/). Results Thirteen RCTs involving a total of 1002 cervical cancer patients were included. Synthesized results indicated that the duration of surgery of the LNSRH group was significantly longer than that of the LRH group [SMD 1.11, 95% CI (0.15 ~ 2.07), P = 0.02]. The time to intestinal function recovery [SMD −1.27, 95% CI (−1.84 ~ −0.69), P < 0.001] and the time to postoperative urinary catheter removal of the LNSRH group [SMD −1.24, 95% CI (−1.62 ~ −0.86), P < 0.001] were significantly less than that of the LRH group. There were no significant differences in the estimated blood loss [SMD 0.10, 95% CI (−0.14 ~ 0.34), P = 0.41], the length of parauterine tissue resection [SMD −0.10, 95% CI (−0.25 ~ 0.05), P = 0.19], length of vaginal excision [SMD 0.04, 95% CI (−0.26 ~ 0.34), P = 0.78], and incidence of intraoperative adverse events [RR 0.97, 95% CI (0.44 ~ 2.13), P = 0.94] between the LNSRH group and the LRH group. Conclusions LNSRH significantly results in earlier bladder and bowel function after surgery. Limited by sample size, LNSRH should be considered with caution in the future.
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Affiliation(s)
- Linlin Ma
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Heilongjiang University of Chinese Medicine, No. 26 Heping Road, Xiangfang District, Harbin City, 150040, Heilongjiang Province, China
| | - Qiwei Li
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Heilongjiang University of Chinese Medicine, No. 26 Heping Road, Xiangfang District, Harbin City, 150040, Heilongjiang Province, China
| | - Ying Guo
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Heilongjiang University of Chinese Medicine, No. 26 Heping Road, Xiangfang District, Harbin City, 150040, Heilongjiang Province, China.
| | - Xiaoyu Tan
- Department of Obstetrics and Gynecology, Harbin Fifth Hospital, Harbin City, China
| | - Mengying Wang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Heilongjiang University of Chinese Medicine, No. 26 Heping Road, Xiangfang District, Harbin City, 150040, Heilongjiang Province, China
| | - Qi Qi
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Heilongjiang University of Chinese Medicine, No. 26 Heping Road, Xiangfang District, Harbin City, 150040, Heilongjiang Province, China
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Wu Y, Zhang J, Yang X, Yin Z, Yang H, Tang T, Chen Z, Tian D, Yang Y, Zhou Z, Lu F. Early Diagnosis of Occult Blood of Colorectal Cancer Based on Nano-Colloidal Gold Sandwich Immunochromatography. J Biomed Nanotechnol 2021; 17:1525-1534. [PMID: 34544530 DOI: 10.1166/jbn.2021.3135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The development of science and technology has deepened people's understanding of cancer, changing the management of malignant tumors in the medical field. Given the common precancerous characteristics of colorectal cancer (CRC), researchers studied early CRC screening. The complexity of traditional diagnostics forced medical staff to speed up CRC innovation early screening methods. Here, we prepared nano-colloidal gold raw materials with different particle sizes (15 and 30 nm) and observed the morphological characteristics and properties of the materials. Simultaneously, the nanocolloidal gold double antibody sandwich kit was designed through the optimum pH value and protein content screening experiment. The results of clinical enteroscopy confirmed the important guiding significance of the equipment in early CRC screening.
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Affiliation(s)
- Yongying Wu
- Laboratory Department, Second Affiliated Hospital of Guizhou Medical University, Kaili 556000, Guizhou, PR China
| | - Jiaoyan Zhang
- Early Screening of Digestive Tract Tumors in the Department of Gastroenterology, The Second Affiliated Hospital of Guizhou Medical University, Kaili 556000, Guizhou, PR China
| | - Xiaolin Yang
- Hunan Tumor Hospital Department of Digestive Urology, Changsha 410006, Hunan, PR China
| | - Zou Yin
- Department of Oncology, The Second Affiliated Hospital of Guizhou Medical University, Kaili 556000, Guizhou, PR China
| | - Hui Yang
- Department of Gastroenterology, The Second Affiliated Hospital of Guizhou Medical University, Kaili 556000, Guizhou, PR China
| | - Tao Tang
- Department of Science and Education and Department of Infection, The Second Affiliated Hospital of Guizhou Medical University, Kaili 556000, Guizhou, PR China
| | - Zhitao Chen
- Department of Pathology, The Second Affiliated Hospital of Guizhou Medical University, Kaili 556000, Guizhou, PR China
| | - Dayong Tian
- Department of Gastroenterology, The Second Affiliated Hospital of Guizhou Medical University, Kaili 556000, Guizhou, PR China
| | - Yixia Yang
- Laboratory Department, Second Affiliated Hospital of Guizhou Medical University, Kaili 556000, Guizhou, PR China
| | - Zhihua Zhou
- Department of Oncology, The Second Affiliated Hospital of Guizhou Medical University, Kaili 556000, Guizhou, PR China
| | - Fangyang Lu
- Department of Oncology, The Second Affiliated Hospital of Guizhou Medical University, Kaili 556000, Guizhou, PR China
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Drolet M, Laprise JF, Martin D, Jit M, Bénard É, Gingras G, Boily MC, Alary M, Baussano I, Hutubessy R, Brisson M. Optimal human papillomavirus vaccination strategies to prevent cervical cancer in low-income and middle-income countries in the context of limited resources: a mathematical modelling analysis. THE LANCET. INFECTIOUS DISEASES 2021; 21:1598-1610. [PMID: 34245682 PMCID: PMC8554391 DOI: 10.1016/s1473-3099(20)30860-4] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 10/23/2020] [Accepted: 10/27/2020] [Indexed: 11/13/2022]
Abstract
Background Introduction of human papillomavirus (HPV) vaccination has been slow in low-income and middle-income countries (LMICs) because of resource constraints and worldwide shortage of vaccine supplies. To help inform WHO recommendations, we modelled various HPV vaccination strategies to examine the optimal use of limited vaccine supplies and best allocation of scarce resources in LMICs in the context of the WHO global call to eliminate cervical cancer as a public health problem. Methods In this mathematical modelling analysis, we developed HPV-ADVISE LMIC, a transmission-dynamic model of HPV infection and diseases calibrated to four LMICs: India, Vietnam, Uganda, and Nigeria. For different vaccination strategies that encompassed use of a nine-valent vaccine (or a two-valent or four-valent vaccine assuming high cross-protection), we estimated three outcomes: reduction in the age-standardised rate of cervical cancer, number of doses needed to prevent one case of cervical cancer (NNV; as a measure of efficiency), and the incremental cost-effectiveness ratio (ICER; in 2017 international $ per disability-adjusted life-year [DALY] averted). We examined different vaccination strategies by varying the ages of routine HPV vaccination and number of age cohorts vaccinated, the population targeted, and the number of doses used. In our base case, we assumed 100% lifetime protection against HPV-16, HPV-18, HPV-31, HPV-33, HPV-45, HPV-52, and HPV-58; vaccination coverage of 80%; and a time horizon of 100 years. For the cost-effectiveness analysis, we used a 3% discount rate. Elimination of cervical cancer was defined as an age-standardised incidence of less than four cases per 100 000 woman-years. Findings We predicted that HPV vaccination could lead to cervical cancer elimination in Vietnam, India, and Nigeria, but not in Uganda. Compared with no vaccination, strategies that involved vaccinating girls aged 9–14 years with two doses were predicted to be the most efficient and cost-effective in all four LMICs. NNV ranged from 78 to 381 and ICER ranged from $28 per DALY averted to $1406 per DALY averted depending on the country. The most efficient and cost-effective strategies were routine vaccination of girls aged 14 years, with or without a later switch to routine vaccination of girls aged 9 years, and routine vaccination of girls aged 9 years with a 5-year extended interval between doses and a catch-up programme at age 14 years. Vaccinating boys (aged 9–14 years) or women aged 18 years or older resulted in substantially higher NNVs and ICERs. Interpretation We identified two strategies that could maximise efforts to prevent cervical cancer in LMICs given constraints on vaccine supplies and costs and that would allow a maximum of LMICs to introduce HPV vaccination. Funding World Health Organization, Canadian Institute of Health Research, Fonds de recherche du Québec–Santé, Compute Canada, PATH, and The Bill & Melinda Gates Foundation. Translations For the French and Spanish translations of the abstract see Supplementary Materials section.
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Affiliation(s)
- Mélanie Drolet
- Centre de recherche du CHU de Québec, Université Laval, Quebec City, QC, Canada
| | | | - Dave Martin
- Centre de recherche du CHU de Québec, Université Laval, Quebec City, QC, Canada
| | - Mark Jit
- Centre for Mathematical Modelling of Infectious Disease, London School of Hygiene & Tropical Medicine, London, UK; Modelling and Economics Unit, Public Health England, London, UK; School of Public Health, University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Élodie Bénard
- Centre de recherche du CHU de Québec, Université Laval, Quebec City, QC, Canada
| | - Guillaume Gingras
- Centre de recherche du CHU de Québec, Université Laval, Quebec City, QC, Canada
| | - Marie-Claude Boily
- Centre de recherche du CHU de Québec, Université Laval, Quebec City, QC, Canada; Département de médecine sociale et preventive, Université Laval, Quebec City, QC, Canada; MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, UK
| | - Michel Alary
- Centre de recherche du CHU de Québec, Université Laval, Quebec City, QC, Canada; Département de médecine sociale et preventive, Université Laval, Quebec City, QC, Canada; Institut national de santé publique du Québec, Québec City, QC, Canada
| | | | - Raymond Hutubessy
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | - Marc Brisson
- Centre de recherche du CHU de Québec, Université Laval, Quebec City, QC, Canada; Département de médecine sociale et preventive, Université Laval, Quebec City, QC, Canada; MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, UK.
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Affiliation(s)
- Anna R Giuliano
- Moffitt Cancer Center, Center for Immunization and Infection Research in Cancer (CIIRC), USA.
| | - Linda M Niccolai
- Yale School of Public Health, Department of Epidemiology of Microbial Diseases, USA
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