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McGill F, Fields PJ, Bahadoor-Yetman A, Manglardi ES, Bailey R, Padala K, Lendore J, John-Ballantyne T, Lake S. Investigating under-reported human papillomavirus genotypes in Grenadian women through self-sampling for cervical cancer screening. Rev Panam Salud Publica 2024; 48:e62. [PMID: 39044773 PMCID: PMC11265311 DOI: 10.26633/rpsp.2024.62] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 04/22/2024] [Indexed: 07/25/2024] Open
Abstract
Objective To compare the adequacy, agreement, and acceptability of Papanicolaou testing (cytology) for cervical cancer screening using self-collected samples compared to physician-collected samples in Grenada in the Caribbean. Furthermore, the study identifies the human papillomavirus (HPV) genotypes present among asymptomatic women testing positive for HPV, the etiologic cause of cervical cancer. Methods Participants were divided into two groups and two cervical samples were collected from the women in each group: a self-collected sample and a physician-collected sample. Cervical specimens were tested for cytology and HPV. HPV genotyping was performed on positive specimens. Results Self-collected samples were adequate and in agreement with physician-collected samples, showing no difference between the two sampling methods. Oncogenic high-risk HPV genotypes were identified in cervical samples which were positive for atypical squamous cells and low-grade squamous intraepithelial lesions. The high-risk HPV genotypes found, notably HPV 45 and 53, differed from those most commonly reported. Although the commonly reported high-risk genotypes HPV 16 and 18 were found, so were 31, 33, 35, 52, 66, 68, and 82. Conclusions Using self-collection facilitated the discovery of unexpected HPV genotypes among asymptomatic women in Grenada. These findings add new information to the literature regarding cervical cancer and neoplasia screening and HPV genotypes in the Caribbean. This genotype information may impact surveillance of women with low-grade lesions, HPV vaccine selection, and possibly further vaccine research. Research regarding HPV in Caribbean pathology samples of cervical neoplasia and cancer is needed.
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Affiliation(s)
- Frances McGill
- St. George’s UniversitySt. George’sGrenadaSt. George’s University, St. George’s, Grenada
| | - Paul J. Fields
- St. George’s UniversitySt. George’sGrenadaSt. George’s University, St. George’s, Grenada
| | - Aví Bahadoor-Yetman
- St. George’s UniversitySt. George’sGrenadaSt. George’s University, St. George’s, Grenada
| | - Erin Salter Manglardi
- St. George’s UniversitySt. George’sGrenadaSt. George’s University, St. George’s, Grenada
| | - Ronelle Bailey
- St. George’s UniversitySt. George’sGrenadaSt. George’s University, St. George’s, Grenada
| | - Kritika Padala
- St. George’s UniversitySt. George’sGrenadaSt. George’s University, St. George’s, Grenada
| | - Jessica Lendore
- St. George’s UniversitySt. George’sGrenadaSt. George’s University, St. George’s, Grenada
| | | | - Sasha Lake
- St. George’s UniversitySt. George’sGrenadaSt. George’s University, St. George’s, Grenada
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2
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Scott-Williams J, Hosein A, Akpaka P, Adidam Venkata CR. Epidemiology of Cervical Cancer in the Caribbean. Cureus 2023; 15:e48198. [PMID: 38054120 PMCID: PMC10694396 DOI: 10.7759/cureus.48198] [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: 11/02/2023] [Indexed: 12/07/2023] Open
Abstract
Cervical cancer (CvC) is considered a preventable disease; however, in the Caribbean, it is still one of the fourth most common causes of death in women. Efforts to overcome obstacles to the treatment and control of this preventable disease are being made by several countries within the Caribbean. However, no health issue can be readily managed without first acquiring an understanding of the dynamics relating to its severity of impact reaching the target population, its clinical pathology, and the availability of treatment and/or preventative measures to control or halt its progression. To assess the status of CvC in the Caribbean, a review of the literature was conducted using PubMed. The Caribbean was defined in the review as comprising nations and islands whose coastlines are touched by the Caribbean Sea. This led to an assessment of the available literature on CvC for 33 Caribbean territories. The review showed a lack of published information on CvC and highlights the need for greater research. This also serves as a template for subsequent investigations.
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Affiliation(s)
- Jamie Scott-Williams
- Biomedical Engineering, The University of Trinidad and Tobago, Port of Spain, TTO
| | - Amalia Hosein
- Biomedical Engineering, The University of Trinidad and Tobago, Port of Spain, TTO
| | - Patrick Akpaka
- Pathology/Microbiology, The University of the West Indies, St. Augustine, TTO
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3
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Jordan KH, Beverly Hery CM, Zhang X, Paskett ED. Low Rates of Dual-Site and Concordant Oral-Cervical Human Papillomavirus Infections and Cancers: A Systematic Review. Front Oncol 2022; 12:848628. [PMID: 35425709 PMCID: PMC9004260 DOI: 10.3389/fonc.2022.848628] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 02/18/2022] [Indexed: 11/13/2022] Open
Abstract
Objective The oral-cervical human papillomavirus (HPV) infection/cancer relationship is not well established. Oral-cervical HPV studies were reviewed to assess dual-site occurrence, HPV type concordance, and study quality/deficiencies. Methods PubMed, EMBASE, Ovid Medline, and Web of Science were searched between 1/1/1990 and 8/10/2021 for studies investigating HPV infections/cancers and type concordance between the oral cavity/oropharynx and cervix. Dual-site and concordant HPV infection rates were summarized as percentages; cancer diagnoses studies were summarized using standardized incidence ratios (SIR). The Quality Assessment Tool for Quantitative Studies (QATQS) evaluated study methodology. Results One hundred fourteen papers were identified. Most were cross-sectional (n=79, 69%), involved synchronous dual-site HPV testing (n=80, 70%), did not report HPV type concordance (n=62, 54%), and achieved moderate methodological QATQS ratings (n=81, 71%). The overall dual-site infection rate averaged 16%; the HPV type concordance rate averaged 41%, among those dually-infected women. Most HPV-related cancer diagnoses studies reported increased secondary cancer risk, with SIRs generally ranging from 1.4 to 29.4 for secondary cervical cancer after primary oral cancer and from 1.4 to 6.3 for secondary oral cancer after primary cervical cancer. Conclusion/Impact Oral-cervical HPV infections/cancers remain understudied. Future research should use stronger methodologies and HPV concordance analyses to better understand oral-cervical HPV epidemiology.
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Affiliation(s)
- Kelsey H Jordan
- Division of Population Sciences, Comprehensive Cancer Center, The Ohio State University, Columbus, OH, United States
| | - Chloe M Beverly Hery
- Division of Population Sciences, Comprehensive Cancer Center, The Ohio State University, Columbus, OH, United States
| | - Xiaochen Zhang
- Division of Population Sciences, Comprehensive Cancer Center, The Ohio State University, Columbus, OH, United States
| | - Electra D Paskett
- Division of Population Sciences, Comprehensive Cancer Center, The Ohio State University, Columbus, OH, United States.,Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, United States.,Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, OH, United States.,Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, United States
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4
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Jeudin P, Abebe T, Butler R, Hooi D, Watt A, Capo-Chichi CD, George S, Ragin C, McFarlane Anderson N, Schlumbrecht M. Human Papilloma Virus Distribution Across the African Diaspora. JCO Glob Oncol 2021; 7:1206-1208. [PMID: 34314227 PMCID: PMC8457790 DOI: 10.1200/go.21.00151] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Understanding the distribution of human papilloma virus (HPV) subtypes in limited-resource settings is imperative for cancer prevention strategies in these regions. The objective of our study is to compare the prevalence of cervical HPV genotypes in women across the African diaspora.
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Affiliation(s)
- Patricia Jeudin
- Division of Gynecologic Oncology, Sylvester Comprehensive Cancer Center, MI.,African Caribbean Cancer Consortium, Philadelphia, PA
| | - Tamrat Abebe
- African Caribbean Cancer Consortium, Philadelphia, PA.,Department of Microbiology, Immunology & Parasitology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Raleigh Butler
- African Caribbean Cancer Consortium, Philadelphia, PA.,Department of Obstetrics & Gynecology, University of the West Indies, Nassau, Bahamas
| | - Desiree Hooi
- African Caribbean Cancer Consortium, Philadelphia, PA.,Department of Pathology, VU University Medical Center, Amsterdam, Netherlands Antilles
| | - Angela Watt
- African Caribbean Cancer Consortium, Philadelphia, PA.,Department of Basic Medical Sciences, University of West Indies, Mona, Jamaica
| | - Callinice D Capo-Chichi
- African Caribbean Cancer Consortium, Philadelphia, PA.,Division of Molecular Biomarkers in Cancer and Nutrition, University of Aborney-Calavi, Cotonou, Benin
| | - Sophia George
- Division of Gynecologic Oncology, Sylvester Comprehensive Cancer Center, MI.,African Caribbean Cancer Consortium, Philadelphia, PA
| | - Camille Ragin
- African Caribbean Cancer Consortium, Philadelphia, PA.,Cancer Prevention and Control Program at Fox Chase Cancer Center-Temple Health, Philadelphia, PA
| | - Normal McFarlane Anderson
- African Caribbean Cancer Consortium, Philadelphia, PA.,Department of Basic Medical Sciences, University of West Indies, Mona, Jamaica
| | - Matthew Schlumbrecht
- Division of Gynecologic Oncology, Sylvester Comprehensive Cancer Center, MI.,African Caribbean Cancer Consortium, Philadelphia, PA
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5
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Gaete S, Auguste A, Bhakkan B, Peruvien J, Herrmann-Storck C, Socrier Y, Diedhiou A, Deloumeaux J. Frequent high-risk HPV co-infections excluding types 16 or 18 in cervical neoplasia in Guadeloupe. BMC Cancer 2021; 21:281. [PMID: 33726684 PMCID: PMC7962384 DOI: 10.1186/s12885-021-07940-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 02/16/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Cervical cancer is the fourth cancer worldwide. The Human Papilloma Virus is responsible for 99% of the cases but the distribution of its genotypes varies among populations. We aimed to identify HPV genotypes distribution in women with grade 2/3 cervical intraepithelial dysplasia or invasive cervical cancer in Guadeloupe, a French Caribbean territory with a population mainly of African descent. METHODS We used paraffin-embedded tumors for viral DNA extraction from women diagnosed between 2014 and 2016 and identified by the population-based cancer registry. The HPV Genotyping was performed with the InnoLIPA HPV Genotyping Extra kit®. RESULTS Overall, 213 samples out of the 321 eligible records were analyzed. The HPV status was positive for 94% of the cases. The five most common oncogenic HPV genotypes were HPV31 (47%), HPV33 (38%), HPV16 (32%), HPV44 (31%) and HPV26 (28%). HPV18 was found in only in 5% of the cases. Among the studied cases, 94% had multiple infections. More than 60% of single infections were HPV16-related, accounting for 35% of HPV16 infections. CONCLUSIONS These results show a different distribution of oncogenic HPVs in Guadeloupe with "31 > 33 > 16" and a high frequency of multiple infections. Despite a lower coverage, the nine-valent vaccine is nevertheless adequate.
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Affiliation(s)
- Stanie Gaete
- Biological Resources Center Karubiotec™, BRIF n° KARUBIOTEC-GUA-00971, Pointe-à-Pitre, Guadeloupe
| | - Aviane Auguste
- Guadeloupe cancer registry, University Hospital of Guadeloupe, Pointe-à-Pitre, Guadeloupe
| | - Bernard Bhakkan
- Guadeloupe cancer registry, University Hospital of Guadeloupe, Pointe-à-Pitre, Guadeloupe
| | - Jessica Peruvien
- Guadeloupe cancer registry, University Hospital of Guadeloupe, Pointe-à-Pitre, Guadeloupe
| | - Cecile Herrmann-Storck
- Virology-Microbiology Unit, University Hospital of Guadeloupe, Pointe-à-Pitre, Guadeloupe
| | - Youri Socrier
- Pathology Laboratory ALIZES, Baie-Mahault, Guadeloupe
| | - Abdoulaye Diedhiou
- Pathology Laboratory, University Hospital of Guadeloupe, Pointe-à-Pitre, Guadeloupe
| | - Jacqueline Deloumeaux
- Biological Resources Center Karubiotec™, BRIF n° KARUBIOTEC-GUA-00971, Pointe-à-Pitre, Guadeloupe. .,Guadeloupe cancer registry, University Hospital of Guadeloupe, Pointe-à-Pitre, Guadeloupe.
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6
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Tam S, Fu S, Xu L, Krause KJ, Lairson DR, Miao H, Sturgis EM, Dahlstrom KR. The epidemiology of oral human papillomavirus infection in healthy populations: A systematic review and meta-analysis. Oral Oncol 2018; 82:91-99. [PMID: 29909908 DOI: 10.1016/j.oraloncology.2018.04.005] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 04/02/2018] [Accepted: 04/07/2018] [Indexed: 10/16/2022]
Abstract
Human papillomavirus (HPV) is a potentially oncogenic sexually transmitted infection. As the incidence of oropharyngeal cancer (OPC) caused by oral HPV infections is rising, further investigation into the natural history of such infections is needed. This systematic review and meta-analysis aimed to synthesize data on the prevalence, incidence, clearance, and persistence of oral HPV infections in healthy individuals. A systematic review of literature published between January 1995 and August 2017 was conducted using Ovid MEDLINE, PubMed, Embase, and the Cochrane Library. Meta-analysis of prevalence and incidence data was conducted. Clearance and persistence data were extracted. Sixty-six studies met the inclusion criteria. Meta-analysis demonstrated an overall prevalence of 7.7% for all types of HPV and 1.4% for high-risk HPV16. The overall incidence was 4.38 cases per 1000 person-months for all HPV types and 0.92 cases per 1000 person-months for HPV16. This systematic review and meta-analysis demonstrated that oral HPV infection has a lower prevalence and incidence than cervicogenital HPV infection in healthy individuals. Nonetheless, oral HPV is still an important concern, given its oncogenicity and the rising incidence of oropharyngeal cancer. Consistency of methodology will allow for better future comparisons, particularly of infection clearance and persistence.
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Affiliation(s)
- Samantha Tam
- Department of Head and Neck Surgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1445, Houston, TX 77030, USA.
| | - Shuangshuang Fu
- Department of Epidemiology, School of Public Health, The University of Texas Health Science Center at Houston, 1200 Pressler St, Houston, TX 77030, USA.
| | - Li Xu
- Department of Head and Neck Surgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1445, Houston, TX 77030, USA.
| | - Kate J Krause
- Research Medical Library, The University of Texas MD Anderson Cancer Center, 1400 Pressler St, Unit 1445, Houston, TX 77030, USA.
| | - David R Lairson
- Department of Management, Policy, and Community Health, School of Public Health, The University of Texas Health Science Center at Houston, 1200 Pressler St, Houston, TX 77030, USA.
| | - Hongyu Miao
- Department of Biostatistics and Data Science, School of Public Health, The University of Texas Health Science Center at Houston, 1200 Pressler St, Houston, TX 77030, USA.
| | - Erich M Sturgis
- Department of Head and Neck Surgery, Division of Surgery, and Department of Epidemiology, Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1445, Houston, TX 77030, USA.
| | - Kristina R Dahlstrom
- Department of Head and Neck Surgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1445, Houston, TX 77030, USA.
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7
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Llanos AAM, Warner WA, Luciani S, Lee TY, Bajracharya S, Slovacek S, Roach V, Lamont-Greene M. Gynecologic cancer mortality in Trinidad and Tobago and comparisons of mortality-to-incidence rate ratios across global regions. Cancer Causes Control 2017; 28:1251-1263. [PMID: 28917021 PMCID: PMC5909810 DOI: 10.1007/s10552-017-0961-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 09/08/2017] [Indexed: 12/30/2022]
Abstract
PURPOSE To examine the factors associated with gynecologic cancer mortality risks, to estimate the mortality-to-incidence rate ratios (MIR) in Trinidad and Tobago (TT), and to compare the MIRs to those of select countries. METHODS Data on 3,915 incident gynecologic cancers reported to the National Cancer Registry of TT from 1 January 1995 to 31 December 2009 were analyzed using proportional hazards models to determine factors associated with mortality. MIRs for cervical, endometrial, and ovarian cancers were calculated using cancer registry data (TT), GLOBOCAN 2012 incidence data, and WHO Mortality Database 2012 data (WHO regions and select countries). RESULTS Among the 3,915 incident gynecologic cancers diagnosed in TT during the study period, 1,795 (45.8%) were cervical, 1,259 (32.2%) were endometrial, and 861 (22.0%) were ovarian cancers. Older age, African ancestry, geographic residence, tumor stage, and treatment non-receipt were associated with increased gynecologic cancer mortality in TT. Compared to GLOBOCAN 2012 data, TT MIR estimates for cervical (0.49 vs. 0.53), endometrial (0.61 vs. 0.65), and ovarian cancers (0.32 vs. 0.48) were elevated. While the Caribbean region had intermediate gynecologic cancer MIRs, MIRs in TT were among the highest of the countries examined in the Caribbean region. CONCLUSIONS Given its status as a high-income economy, the relatively high gynecologic cancer MIRs observed in TT are striking. These findings highlight the urgent need for improved cancer surveillance, screening, and treatment for these (and other) cancers in this Caribbean nation.
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Affiliation(s)
- Adana A M Llanos
- Department of Epidemiology, Rutgers School of Public Health and Division of Population Science, Rutgers Cancer Institute of New Jersey, Rutgers University, New Brunswick, NJ, USA.
- Department of Epidemiology, Rutgers School of Public Health, 683 Hoes Lane West, Room 211, Piscataway, NJ, 08854, USA.
| | - Wayne A Warner
- Oncology Division, Department of Cell Biology and Physiology, Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Silvana Luciani
- Cancer Prevention and Control, Pan American Health Organization, Washington, DC, USA
| | - Tammy Y Lee
- Division of Applied and Advanced Studies in Education, California State University, Los Angeles, CA, USA
| | - Smriti Bajracharya
- Center for Public Health Systems Science, George Warren Brown School of Social Work, Washington University, St. Louis, MO, USA
| | - Simeon Slovacek
- Division of Applied and Advanced Studies in Education, California State University, Los Angeles, CA, USA
| | - Veronica Roach
- Dr. Elizabeth Quamina Cancer Registry, Eric Williams Medical Sciences Complex, Mt. Hope, Trinidad and Tobago
| | - Marjorie Lamont-Greene
- Dr. Elizabeth Quamina Cancer Registry, Eric Williams Medical Sciences Complex, Mt. Hope, Trinidad and Tobago
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8
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Prevalence of oral HPV infection among healthy individuals and head and neck cancer cases in the French West Indies. Cancer Causes Control 2017; 28:1333-1340. [PMID: 28948421 DOI: 10.1007/s10552-017-0966-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 09/16/2017] [Indexed: 12/21/2022]
Abstract
PURPOSE Human papillomavirus (HPV) is known to play a role in the development of head and neck squamous cell carcinomas (HNSCC) and to date, no study has reported on the association between oral HPV infection and HNSCC in the Caribbean. The objective was to determine the prevalence of oral HPV infection in the French West Indies (FWI), overall and by HPV genotype, among HNSCC cases and healthy population controls. METHOD We used data from a population-based case-control study conducted in the FWI. The prevalence of oral HPV was estimated separately among 100 HNSCC cases (mean age 59 years) and 308 population controls (mean age 57 years). Odds ratios (OR) and 95% confidence intervals (CI) were estimated using a logistic regression adjusting for age, sex, tobacco, and alcohol consumption, to assess the association between oral HPV infection and HNSCC. RESULTS Prevalence of oral HPV infections was 26% in controls (30% in men and 14% in women) and 36% in HNSCC cases (36% in men, 33% in women). HPV52 was the most commonly detected genotype, in cases and in controls. The prevalence of HPV16, HPV33, and HPV51 was significantly higher in cases than in controls (p = 0.0340, p = 0.0472, and 0.0144, respectively). Oral infection with high-risk HPV was associated with an increase in risk of HNSCC (OR 1.99, 95% CI 0.95-4.15). HPV16 was only associated with oropharyngeal cancer (OR 16.01, 95% CI 1.67-153.64). CONCLUSION This study revealed a high prevalence of oral HPV infection in this middle-aged Afro-Caribbean population, and a specific distribution of HPV genotypes. These findings may provide insight into HNSCC etiology specific to the FWI.
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9
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Thomas-Purcell KB, Tarver WL, Richards C, Primus-Joseph M. Gatekeepers' perceptions of the quality and availability of services for breast and cervical cancer patients in the English-speaking Windward Islands: an exploratory investigation. Cancer Causes Control 2017; 28:1195-1206. [PMID: 28733787 DOI: 10.1007/s10552-017-0925-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 07/07/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE Although extensive screening services for breast and cervical cancers are available in the Caribbean, these cancers continue to be the leading causes of cancer death among women in this region. The purpose of this study was to determine the quality and availability of breast and cervical cancer treatment care and support services from the perspective of the gatekeepers who provide care for the patients in the Windward Islands of Dominica, Grenada, St Lucia, and St. Vincent. METHODS A qualitative research design using semi-structured, in-depth interviews was used to gather data from gatekeepers who provided oncology prevention and care services to patients for at least one year. Data were collected on availability and quality of cancer care and treatment services and coded using the themes obtained via thematic analysis of the data. RESULTS Twenty-three current providers participated in the study (Dominica, 5; Grenada, 7; St. Lucia, 5; St. Vincent and the Grenadines, 6). The participants' years of work experience ranged from 2 to 45 years. The codes encompassed a range of social ecological factors that influence breast and cervical cancer screening and treatment in the Windward Islands. The emergent themes were availability of resources, cost of care, and social support. CONCLUSION The findings of this study emphasize the varying social determinants of health that affect breast and cervical cancer prevention and treatment. It also highlights the disparities in availability of treatment within the wider Caribbean. It is necessary to broaden the perspective on health from a purely biomedical paradigm to a social perspective.
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Affiliation(s)
- Kamilah B Thomas-Purcell
- Master of Public Health Program, College of Osteopathic Medicine, Nova Southeastern University, 3301 South University Drive Ft., Lauderdale, FL, 3328, USA.
| | - Will L Tarver
- HSR&D Center for Health Information and Communication, Richard L. Roudebush VA Medical Center, 1481 West 10th Street (11-H), Indianapolis, IN, 46202, USA
| | - Christine Richards
- School of Medicine, Department of Public Health, St. George's University and Preventive Medicine, P.O. Box 7, St. George's, Grenada
| | - Marva Primus-Joseph
- Division of Nursing Education Tanteen, T.A. Marryshow Community College, St. George's, Grenada
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10
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Cordel N, Bonnecarrère L, Tressières B. Squamous cell carcinoma in the Afro-Caribbean community: an 11-year retrospective study. J Eur Acad Dermatol Venereol 2017; 31:1462-1467. [PMID: 28543620 DOI: 10.1111/jdv.14348] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 04/21/2017] [Indexed: 01/15/2023]
Abstract
BACKGROUND Squamous cell carcinoma (SCC) is considered the most frequent skin cancer in Black people. Its incidence is not known in the Afro-Caribbean population. OBJECTIVE To assess the incidence of SCC in Guadeloupe, the largest island of the Lesser Antilles (405 000 inhabitants, mostly Black people of African and European descent). The second objective was to characterize clinical and histological patterns of SCC occurring in the Afro-Caribbean community. METHODS This retrospective study was conducted over an 11-year period (2000-2010). Data regarding 723 histological confirmed cases of SCC identified using the three Guadeloupean pathology laboratories' computerized databases were retrieved from the records of 551 patients. Private practice dermatologists and general practitioners were contacted to obtain any missing data. RESULTS The annual age-adjusted incidence of SCC was 15 per 100.000 residents in Guadeloupe. In the Afro-Caribbean community, SCC had a greater size (i.e. 2.8 ± 2.8 cm vs. 1.5 ± 1.0 cm, P < 0.001), was more often located on the anogenital area (i.e. 48/79-60.8% vs. 14/320-4.4%, P < 0.001) in association with an underlying dermatosis due to HPV infection (15/71-21.1% vs. 3/366, 0.8%, P < 0.001) and led more frequently to metastasis (13/84-15.5% vs. 10/366-2.7%, P < 0.001) and/or fatal evolution (11/83-13.3% vs. 7/365-1.9%, P < 0.001). CONCLUSIONS The results of this original study, which first estimated the incidence of SCC in West Indies, suggest that anogenital examination should be routinely performed in skin cancer screening of Afro-Caribbean people to detect the presence of SCC at an early stage. IMPLICATION FOR PRACTICE Squamous cell carcinoma is the most frequent skin cancer in Black people. Its incidence is not known in the Afro-Caribbean population. In Guadeloupe, the largest island of the Lesser Antilles, the annual age-adjusted incidence of SCC was estimated to be 15.0 per 100 000 residents, 95% CI:[13.8; 16.2]. In the Guadeloupean Afro-Caribbean community, SCC seems to more frequently occur in the anogenital area, due to HPV infection. These results support to include a routine genital urinary examination in the skin cancer screening of people of Afro-Caribbean descent.
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Affiliation(s)
- N Cordel
- Dermatology and Internal Medicine Unit, Guadeloupe University Hospital and EA 4546, CELTEC, French West Indies University, Guadeloupe, France.,African Caribbean Cancer Consortium, Philadelphia, USA
| | - L Bonnecarrère
- Dermatology and Internal Medicine Unit, Guadeloupe University Hospital, Guadeloupe, France
| | - B Tressières
- Inserm CIC 1424, Centre d'Investigation Clinique Antilles Guyane, Pointe-à-Pitre, France
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11
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Lupato V, Holzinger D, Höfler D, Menegaldo A, Giorgi Rossi P, Del Mistro A, Da Mosto MC, Pawlita M, Boscolo-Rizzo P. Prevalence and Determinants of Oral Human Papillomavirus Infection in 500 Young Adults from Italy. PLoS One 2017; 12:e0170091. [PMID: 28103272 PMCID: PMC5245874 DOI: 10.1371/journal.pone.0170091] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 12/28/2016] [Indexed: 01/05/2023] Open
Abstract
Although the prevalence of human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) is increasing in developed countries and becoming a relevant health issue, the natural history of oral HPV infection is still unclear. Estimating the infection's prevalence in specific populations and identifying risk factors can widen our understanding of its natural history and help to delineate appropriate prevention strategies. This study sought to (i) determine oral HPV prevalence and genotype distribution in a large series of young Italian adults, (ii) validate an oral rinse sampling/storage protocol, and (iii) pinpoint factors associated with oral HPV infection. Five hundred students, nurses, and technicians (19-35 years-old) studying and working at/for the University of Padua were recruited. Each participant was provided with an oral rinse sampling kit and instructions for use. They were also asked to complete an anonymous questionnaire concerning their demographic characteristics and behaviors. The questionnaires and oral rinse containers were labeled with the same identification code number. The oral rinse samples were tested using a bead-based multiplex BSGP5+/6+-MPG genotyping assay which amplifies the L1 region of 51 mucosal HPV types. The prevalence of oral HPV infection was 4.0% (95% confidence interval (CI), 2.5%-6.1%); those of 14 high-risk HPV types and of HPV-type 16 (HPV16) infection were 2.2% (95% CI, 1.1%-3.9%) and 1.6% (95% CI, 0.6%-3.1%), respectively. HPV16 was the most frequent genotype (40.0% of oral HPV infections). No association was found between oral infection and the co-variables studied (gender, tobacco, alcohol and illegal drug use, number of sex and oral sex partners, HPV vaccination status, history of HPV and sexually transmitted infections, abnormal pap smears, recurrent tonsillitis and tonsillectomy). The oral rinse sampling protocol outlined here proved to be simple, efficient and well tolerated, and the prevalence rate can be considered reliable and thus useful to guide future research. Determinants of oral HPV infection are still unclear and further studies are certainly warranted.
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Affiliation(s)
- Valentina Lupato
- Department of Neurosciences, Regional Center for Head and Neck Cancer, University of Padua, Treviso, Italy
- Unit of Otolaryngology, Azienda Ospedaliera “S. Maria degli Angeli”, Pordenone, Italy
| | - Dana Holzinger
- Division of Molecular Diagnostics of Oncogenic Infections, Infection, Inflammation and Cancer Program, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Daniela Höfler
- Division of Molecular Diagnostics of Oncogenic Infections, Infection, Inflammation and Cancer Program, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Anna Menegaldo
- Department of Neurosciences, Regional Center for Head and Neck Cancer, University of Padua, Treviso, Italy
| | - Paolo Giorgi Rossi
- Interinstitutional Epidemiology Unit, Local Health Authority, Reggio Emilia, Italy
- Arcispedale S. Maria Nuova, IRCCS, Reggio Emilia, Italy
| | - Annarosa Del Mistro
- Immunology and Molecular Oncology Unit, Istituto Oncologico Veneto—IRCCS, Padova, Italy
| | - Maria Cristina Da Mosto
- Department of Neurosciences, Regional Center for Head and Neck Cancer, University of Padua, Treviso, Italy
| | - Michael Pawlita
- Division of Molecular Diagnostics of Oncogenic Infections, Infection, Inflammation and Cancer Program, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Paolo Boscolo-Rizzo
- Department of Neurosciences, Regional Center for Head and Neck Cancer, University of Padua, Treviso, Italy
- * E-mail:
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Cordel N, Ragin C, Trival M, Tressières B, Janky E. High-risk human papillomavirus cervical infections among healthy women in Guadeloupe. Int J Infect Dis 2015; 41:13-6. [PMID: 26597118 PMCID: PMC4743658 DOI: 10.1016/j.ijid.2015.10.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Revised: 10/12/2015] [Accepted: 10/16/2015] [Indexed: 12/19/2022] Open
Abstract
Objective To assess high-risk human papillomavirus (HR HPV) cervical infections and their type distribution among healthy women in Guadeloupe, French West Indies. Methods The details of consecutive non-pregnant women who attended cervical cancer screening and had HPV genotyping performed at the largest pathology laboratory on the island from January 1, 2013 to December 31, 2014 were recorded retrospectively. All women with available HPV genotyping results were included in the study. Results HR HPV genotyping results for 618 women (median age 42 years) were collected. The overall prevalence rate of HR HPV cervical infection was 36.1% (95% confidence interval (CI) 32.3–40.0%), with the following type distribution: HPV 16 or 18 irrespective of other HPV types, 7.3% (95% CI 5.4–9.6%); other HR HPV types excluding HPV 16 or 18, 28.8% (95% CI 25.3–32.5%). The prevalence rates of overall HR HPV and HR HPV other than 16 or 18 infection increased significantly (p < 0.001) with the severity of cytology grade, from 19.7% for normal cytology to 53.8% in atypical squamous cells of undetermined significance (ASC-US) and 67.7% in low-grade squamous intraepithelial lesions (LSIL). Conclusion The high prevalence rate of HR HPV cervical infection with genotypes other than 16 and 18 in Guadeloupe, irrespective of age and the cytology grade, suggests a potential benefit of the new nine-valent HPV vaccine to prevent HPV infection-related cancers in this Caribbean country.
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Affiliation(s)
- Nadège Cordel
- Dermatology and Internal Medicine Unit, Guadeloupe University Hospital and EA 4546, CELTEC, Antilles University, BP 465, 97159 Pointe-à-Pitre cedex, Guadeloupe.
| | - Camille Ragin
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Temple Health and Department of Epidemiology and Biostatistics, Temple University, College of Public Health, Philadelphia, Pennsylvania, USA
| | | | - Benoît Tressières
- Centre d'Investigation Clinique Antilles-Guyane, Guadeloupe, Inserm CIC 1424
| | - Eustase Janky
- Parent-Child Department, Gynecology and Obstetrics Unit, Guadeloupe University Hospital, EA 4546, CELTEC, Antilles University, Guadeloupe
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Dames DN, Blackman E, Butler R, Taioli E, Eckstein S, Devarajan K, Griffith-Bowe A, Gomez P, Ragin C. High-risk cervical human papillomavirus infections among human immunodeficiency virus-positive women in the Bahamas. PLoS One 2014; 9:e85429. [PMID: 24465558 PMCID: PMC3900425 DOI: 10.1371/journal.pone.0085429] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Accepted: 12/04/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND High-risk (HR) HPV genotypes other than 16 and 18 have been detected in a significant proportion of immunocompromised females. We aim to evaluate the frequency of HR HPV genotypes in a population of HIV-positive Caribbean women. METHODS One hundred sixty-seven consecutive, non-pregnant, HIV-positive females ≥18 years were recruited in this study. Each participant received a vaginal examination, PAP smear, and completed a questionnaire. DNA was extracted for HPV testing in 86 patients. RESULTS Mean age was 39.1 years for women positive for HR HPV and 43.1 years for women negative for HR HPV (P value = 0.040). 78% (130/167) of the women had HR HPV infections; the prevalence of abnormal cervical cytology was 38% among women who were HR HPV-positive compared to women who were HR HPV-negative (22%). Fifty-one percent of the 86 women with available genotype carried infections with HPV 16 and/or HPV 18; genotypes of unknown risk were also frequently observed. Women who had a CD4+ count of ≤200 had 7 times increased odds of carrying HR HPV infection in comparison to women with CD4+>200. CONCLUSIONS HR HPV infections in HIV infected females may consist of more than just HPV 16 and 18, but also HPV 52 and 58. Further studies are needed to determine whether HPV 52 and 58 play a significant role in the development of cervical cytological abnormalities in HIV+ women.
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Affiliation(s)
- Dionne N. Dames
- Department of Medicine, Princess Margaret Hospital, Nassau, Bahamas
| | - Elizabeth Blackman
- Cancer Prevention and Control Program, Fox Chase Cancer Center – Temple University Health System, Philadelphia, PA, USA
| | - Raleigh Butler
- Department of Obstetrics & Gynecology, Princess Margaret Hospital, Nassau, Bahamas
| | - Emanuela Taioli
- Department of Population Health, North Shore Long Island Jewish/Hofstra School of Medicine, Manhasset, NY, USA
| | - Stacy Eckstein
- Department of Epidemiology, University of Pittsburgh, Graduate School of Public Health and the University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA
| | - Karthik Devarajan
- Department of Biostatistics, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Andrea Griffith-Bowe
- Department of Obstetrics & Gynecology, Princess Margaret Hospital, Nassau, Bahamas
| | - Perry Gomez
- Department of Medicine, Princess Margaret Hospital, Nassau, Bahamas
| | - Camille Ragin
- Cancer Prevention and Control Program, Fox Chase Cancer Center – Temple University Health System, Philadelphia, PA, USA
- * E-mail:
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Lang Kuhs KA, Gonzalez P, Struijk L, Castro F, Hildesheim A, van Doorn LJ, Rodriguez AC, Schiffman M, Quint W, Lowy DR, Porras C, Delvecchio C, Katki HA, Jimenez S, Safaeian M, Schiller J, Solomon D, Wacholder S, Herrero R, Kreimer AR. Prevalence of and risk factors for oral human papillomavirus among young women in Costa Rica. J Infect Dis 2013; 208:1643-52. [PMID: 24014882 DOI: 10.1093/infdis/jit369] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Little is known about the epidemiology of oral human papillomavirus (HPV) in Latin America. METHODS Women (N = 5838) aged 22-29 in the control and vaccine arms of an HPV-16/18 vaccine trial in Costa Rica had oral, cervical, and anal specimens collected. Samples were tested for alpha mucosal HPV types (SPF10/LiPA25 version 1); a subset of oral samples (n = 500) was tested for cutaneous HPV types in the genera alpha, beta, gamma, mu, and nu. RESULTS In the control arm (n = 2926), 1.9% of women had an oral alpha mucosal HPV detected, 1.3% had carcinogenic HPV, and 0.4% had HPV-16; similar patterns for non-16/18 HPV types were observed in the vaccine arm. Independent risk factors for any oral alpha mucosal HPV among women in the control arm included marital status (adjusted odds ratio [AOR], 3.2; 95% confidence interval [CI], 1.8-5.7 for single compared to married/living as married), number of sexual partners (AOR, 2.4; 95% CI, 1.0-6.1 for ≥4 partners compared to 0-1 partners), chronic sinusitis (AOR, 3.1; 95% CI, 1.5-6.7), and cervical HPV infection (AOR, 2.6; 95% CI, 1.4-4.6). Detection of beta HPV was common (18.6%) and not associated with sexual activity. CONCLUSIONS Unlike cutaneous HPV types, alpha mucosal HPV types were uncommon in the oral region and were predominately associated with sexual behavior. Clinical Trials Registration. NCT00128661.
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Affiliation(s)
- Krystle A Lang Kuhs
- National Cancer Institute, National Institutes of Health, Bethesda, Maryland
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Prevention of oncological diseases: primary and secondary prevention. Int J Biol Markers 2012; 27:e337-43. [PMID: 23250774 DOI: 10.5301/jbm.2012.10370] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2012] [Indexed: 01/16/2023]
Abstract
Cancer is the leading cause of death worldwide. Because there is presently no cure for cancer, the best strategy to combat oncological diseases is through early detection and prevention. The methods currently available are vaccines to target specific viruses (primary prevention), in combination with screening (secondary prevention), use of biomarkers, and administration of adjuvant therapy (tertiary prevention). Modifiable lifestyle-related risk factors are also important in cancer prevention. Vaccination has been proven to be highly effective against targeted diseases leading to the development of cancer, particularly if the vaccination is given in the early years of life. The need for regular screening (for breast cancer, cervical cancer, etc.) should not be neglected and should be followed to detect unusual changes or abnormalities in the body. With discoveries as targeted therapies, adjuvant treatment becomes a secure component of tertiary prevention in the betterment of disease management. The discovery of biomarkers and subsequent targeted therapies has led to personalized medicine as the current trend in cancer care.
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Burden of Human Papillomavirus among Haitian Immigrants in Miami, Florida: Community-Based Participatory Research in Action. JOURNAL OF ONCOLOGY 2012; 2012:728397. [PMID: 22619675 PMCID: PMC3349262 DOI: 10.1155/2012/728397] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2011] [Accepted: 11/30/2011] [Indexed: 11/18/2022]
Abstract
Background. Haitian immigrant women residing in Little Haiti, a large ethnic enclave in Miami-Dade County, experience the highest cervical cancer incidence rates in South Florida. While this disparity primarily reflects lack of access to screening with cervical cytology, the burden of human papillomavirus (HPV) which causes virtually all cases of cervical cancer worldwide, varies by population and may contribute to excess rate of disease. Our study examined the prevalence of oncogenic and nononcogenic HPV types and risk factors for HPV infection in Little Haiti. Methods. As part of an ongoing community-based participatory research initiative, community health workers recruited study participants between 2007 and 2008, instructed women on self-collecting cervicovaginal specimens, and collected sociodemographic and healthcare access data. Results. Of the 242 women who contributed adequate specimens, the overall prevalence of HPV was 20.7%, with oncogenic HPV infections (13.2% of women) outnumbering nononcogenic infections (7.4%). Age-specific prevalence of oncogenic HPV was highest in women 18–30 years (38.9%) although the prevalence of oncogenic HPV does not appear to be elevated relative to the general U.S. population. The high prevalence of oncogenic types in women over 60 years may indicate a substantial number of persistent infections at high risk of progression to precancer.
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Oral HPV infection and sexuality: a cross-sectional study in women. Int J Mol Sci 2011; 12:3928-40. [PMID: 21747715 PMCID: PMC3131599 DOI: 10.3390/ijms12063928] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2011] [Revised: 04/12/2011] [Accepted: 06/03/2011] [Indexed: 01/22/2023] Open
Abstract
Human Papillomavirus (HPV) is the main risk factor for cervical cancers and is associated with close to 36% of oropharyngeal cancers. There is increasing evidence that oral HPV transmission is related to sexual behavior but to our knowledge studies that involve women who have sex with women have not been performed. We examined the prevalence of oral HPV according to sexual behavior among a population-based sample of 118 women and have made some inferences of possible predictors of oral HPV infection. Women were categorized as heterosexual (history of vaginal sex and/or oral sex with males only, n = 75), bisexual (history of vaginal sex and oral sex with females, n = 32) and other (no history of vaginal sex but oral sex with females [homosexuals], virgins and women with incomplete sexual exposure data, n = 11) The prevalence of oral HPV infection was 12/118 (10.2%) for the overall study population and was not significantly different between heterosexual and bisexual women (10.7% (8/75) vs. 12.5% (4/32), p = 0.784). There was no oral HPV detected among homosexual women, virgins or among women where sexual exposure was unknown. Never smokers were more likely to be oral HPV+ compared to former smokers (Adjusted Odds Ratio (Adj OR) = 0.1, 95% CI, 0.0–1.1) and there was no difference in risk between never smokers and current smokers (Adj OR = 0.7, 95% CI, 0.1–4.6). Twenty-five percent (3/12) of oral HPV+ women had a history of HPV and/or genital warts compared to 9% (10/106) of oral HPV-women (p = 0.104). For the women with a history of vaginal sex (n = 110), oral HPV status was statistically significantly different according to oral sex exposure (p = 0.039). A higher proportion of oral HPV-positive women reported that they had no history of oral sex exposure compared to oral HPV-negative women (4/12, 33% vs. 7/98, 8%). The prevalence of cervical HPV infection did not vary between heterosexuals and bisexuals (35.7% (25/70) vs. 35.5% (11/31), p-value 0.411) and for all other women the cervical HPV prevalence was significantly lower (11.1%, 1/9). Our study suggests that smoking and sexual behavior involving males rather than female partners may be possible predictors of oral HPV infection in women. Further studies with larger sample size are needed to confirm these findings.
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de Mattos AT, de Freitas LB, Lima BMC, Miranda AE, Spano LC. Diversity and uncommon HPV types in HIV seropositive and seronegative women attending an STI clinic. Braz J Microbiol 2011; 42:786-93. [PMID: 24031694 PMCID: PMC3769843 DOI: 10.1590/s1517-838220110002000047] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2010] [Revised: 09/02/2010] [Accepted: 01/13/2011] [Indexed: 01/05/2023] Open
Abstract
Given the causal relationship between specific types of HPV with cervical cancer and precursor lesions, it is important to identify the viral type involved. The aim of this study is to access the prevalence of HPV types in HIV seropositive and seronegative women. Accordingly, 77 HPV positive cervical samples were obtained from 284 women (seropositive (n=112) and seronegative (n=172) for HIV) who attended a Sexually Transmitted Infection clinic, in Vitoria, Southeastern Brazil. Viral DNA was amplified by PCR using MY09/MY11 degenerated primers and the genotyping was performed by Restriction Fragment Length Polymorphism. Seventy five out of the 77 HPV samples were genotyped: 6, 11, 13, 16, 18, 26, 31, 31b, 32, 33, 34, 35, 52, 53, 55, 56, 58, 59, 61, 62, 64, 66, 71, 81, 83, 84. The most prevalent type was HPV16 followed by HPV types 6, 11 and 53. Fifty five percent and 45% belonged to high and low risk types, respectively. High risk types corresponded to 59% and 54.5% of the HPV detected in HIV seronegative and seropositive women, respectively. The uncommon HPV 13 type in cervical samples was also observed in this study. The oncogenic types were more common in the HIV seronegative samples and the number of cases with multiple infections was similar for the two groups. HPV typing is not only important clinically for the establishment of monitoring and treatment of a patient, it also provides knowledge of the viral types circulating in a population, which is of interest in the development of prevention and treatment programs for this disease.
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Abstract
BACKGROUND Human papillomavirus type 16 (HPV16) is a common infection in the anogenital tract. HPV16 DNA detected in oral specimens has recently been identified as a risk factor for some oropharyngeal cancers. The reported prevalence of oral HPV infection from individual studies is highly variable. METHODS We systematically reviewed and abstracted data from published studies (n = 18) that detected oral HPV DNA in 4581 cancer-free subjects to determine the pooled prevalence (and 95% confidence intervals [CI]) of HPV16, carcinogenic HPV, and any HPV. RESULTS 1.3% (95% CI: 1.0-1.7%) of 3977 healthy subjects had oral HPV16, 3.5% (95% CI: 3.0-4.1) of 4441 subjects had carcinogenic HPV, and 4.5% (95% CI: 3.9-5.1) of 4070 subjects were positive for any HPV. Oral HPV16 accounted for 28% of all HPV detected in the oral region. Men (47 of 1017) and women (117 of 3690) had nearly exactly the same prevalence of any oral HPV detected (4.6% vs. 4.4%, respectively). CONCLUSIONS HPV-16, a common anogenital infection, was rarely detected in oral specimens. However, a small but noteworthy proportion of healthy individuals have oral HPV infections with types known to cause cancer in the oral region.
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Ragin C, Edwards R, Heron DE, Kuo J, Wentzel E, Gollin SM, Taioli E. Prevalence of Cancer-Associated Viral Infections in Healthy Afro-Caribbean Populations: A Review of the Literature. Cancer Invest 2009; 26:936-47. [DOI: 10.1080/07357900801975280] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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McDonald AC, Ragin CC, Jenkins FJ, Weissfeld J, Wilson J, Wheeler VW, Wilson JB, Bunker CH, Taioli E. Human herpesvirus 8 seroprevalence among Tobago women and the role of sexual lifestyle behavior. J Med Virol 2009; 81:264-70. [PMID: 19107975 DOI: 10.1002/jmv.21346] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Human herpesvirus 8 (HHV-8) infection is present in 22.9% of Tobago men. However, seroprevalence and modes of transmission of HHV-8 among Tobago women are not known. HHV-8 seropositivity rates in Tobago women were examined and compared rates to Tobago men of similar ages. To assess possible modes of transmission, sexual behavior among Tobago women was examined to determine its association with HHV-8 seropositivity. A cross-sectional study was conducted in 213 Tobago women, ages 18-65 years, who participated in the Tobago Cervical and Oral Cancer Screening Study. HHV-8 seropositivity was determined by a monoclonal immunofluorescence assay. Age-specific rates were compared to those previously observed in men. Logistic regression analyses were performed to determine the association between HHV-8 seropositivity and sexual behavior among the women. HHV-8 seroprevalence among Tobago women was 14.1% (95% CI, 10-19%), with no significant difference with men of similar age (P-value = 0.741). Age <or=17 years at first sexual intercourse was found to have a minimal significant association with HHV-8 seropositivity (OR = 2.51, 95% CI = 1.09-5.78) in women. HHV-8 age-specific rates were similar between genders. Sexual activity may not be a major contributor to HHV-8 infection among Tobago women.
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Affiliation(s)
- Alicia C McDonald
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
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Watt A, Garwood D, Jackson M, Younger N, Ragin C, Smikle M, Fletcher H, McFarlane-Anderson N. High-risk and multiple human papillomavirus (HPV) infections in cancer-free Jamaican women. Infect Agent Cancer 2009; 4 Suppl 1:S11. [PMID: 19208202 PMCID: PMC2638456 DOI: 10.1186/1750-9378-4-s1-s11] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background Vaccines, that target human papillomavirus (HPV) high risk genotypes 16 and 18, have recently been developed. This study was aimed at determining genotypes commonly found in high-risk and multiple-HPV infections in Jamaican women. Two hundred and fifty three (253) women were enrolled in the study. Of these, 120 pregnant women, aged 15–44 years, were recruited from the Ante Natal Clinic at the University Hospital of the West Indies and 116 non-pregnant, aged 19–83, from a family practice in Western Jamaica. Cervical cell samples were collected from the women and HPV DNA was detected using Polymerase Chain Reaction and Reverse Line Hybridization. HPV genotypes were assessed in 236 women. Data were collected from January 2003 to October 2006. Results HPV DNA was detected in 87.7% (207/236) and of these 80.2% were positive for high-risk types. The most common high-risk HPV types were: HPV 45 (21.7%), HPV 58 (18.8%), HPV 16 (18.4%), HPV 35 (15.0%), HPV 18 (14.5%), HPV 52 (12.0%) and HPV 51(11.1%). Other high-risk types were present in frequencies of 1.4% – 7.2%. Multivariate regression analyses showed that bacterial vaginosis predicted the presence of multiple infections (OR 3.51; CI, 1.26–9.82) and that alcohol use (OR 0.31; CI, 0.15–0.85) and age at first sexual encounter (12–15 years: OR 3.56; CI, 1.41–9.12; 16–19 years, OR 3.53, CI, 1.22–10.23) were significantly associated with high risk infections. Cervical cytology was normal in the majority of women despite the presence of high-risk and multiple infections. Conclusion HPV genotype distribution in this group of Jamaican women differs from the patterns found in Europe, North America and some parts of Asia. It may be necessary therefore to consider development of other vaccines which target genotypes found in our and similar populations. HPV genotyping as well as Pap smears should be considered.
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Affiliation(s)
- Angela Watt
- Department of Basic Medical Sciences, Faculty of Medical Sciences, University of the West Indies, Kingston, Jamaica.
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Ragin CC, Dallal C, Okobia M, Modugno F, Chen J, Garte S, Taioli E. Leptin levels and leptin receptor polymorphism frequency in healthy populations. Infect Agent Cancer 2009; 4 Suppl 1:S13. [PMID: 19208204 PMCID: PMC2638458 DOI: 10.1186/1750-9378-4-s1-s13] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The leptin receptor gene (LEPR) polymorphism Q223R is one of the most common in the general population, and is thought to be associated with an impaired signaling capacity of the leptin receptor and with higher mean circulating levels of leptin. Leptin is a hormone primarily produced in adipose tissue. Increased levels of leptin have been positively correlated with obesity. We have determined the frequency of the leptin receptor polymorphism (LEPR Q223R) in healthy populations from various ethnic groups, and compared plasma leptin levels across the LEPR Q223R polymorphism in healthy African-Caribbean and Caucasian women. RESULTS The study population consists of 1,418 healthy subjects from various ethnic groups. The LEPR Q223R homozygous variant was observed overall in 19% of subjects (n = 1,418), with significant differences based on self reported ethnicity: the proportion of subjects with the homozygous variant was lower in Caucasians (14%, n = 883) than in African-Caribbean (n = 194), African-American (n = 36) and Asian/other ethnic groups (n = 26), (35%, 33% and 34.6% respectively); the frequency in Africans (20%), was similar to the overall study population. The mean +/- standard deviation (SD), circulating leptin levels for African-Caribbean women was 44.7 +/- 31.4 ng/ml, while for Caucasian women the mean was 42.4 +/- 34.8 ng/ml. Adjusted circulating leptin levels in post-menopausal Caucasian women who were LEPR Q223R homozygous variant were marginally statistically significantly higher than in women with the wild-type genotype (p = 0.098). No significant differences in leptin levels by genotype were observed for African-Caribbean women, (heterozygous: p = 0.765, homozygous variant: p = 0.485). CONCLUSION These findings suggest an association between mean circulating leptin levels and the LEPR Q223R genotype among post-menopausal Caucasian women.
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Affiliation(s)
- Camille C Ragin
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, USA.
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Ragin CC, Watt A, Markovic N, Bunker CH, Edwards RP, Eckstein S, Fletcher H, Garwood D, Gollin SM, Jackson M, Patrick AL, Smikle M, Taioli E, Wheeler VW, Wilson JB, Younger N, McFarlane-Anderson N. Comparisons of high-risk cervical HPV infections in Caribbean and US populations. Infect Agent Cancer 2009; 4 Suppl 1:S9. [PMID: 19208214 PMCID: PMC2638468 DOI: 10.1186/1750-9378-4-s1-s9] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background Disparities in cervical cancer incidence and mortality rates exist among women of African ancestry (African-American, African-Caribbean and African). Persistent cervical infection with Human papillomavirus (HPV) is associated with cervical dysplasia and if untreated, could potentially progress to invasive cervical cancer. Very few studies have been conducted to examine the true prevalence of HPV infection in this population. Comparisons of cervical HPV infection and the type-specific distribution of HPV were performed between cancer-free Caribbean and US women. Results The Caribbean population consisted of 212 women from Tobago and 99 women from Jamaica. The US population tested, consisted of 82 women from Pittsburgh. The majority of the US subjects was Caucasian, 74% (61/82) while 12% (10/82) and 13% (11/82) were African-American or other ethnic groups, respectively. The age-adjusted prevalence of any HPV infection among women from Tobago was 35%, while for Jamaica, it was 81% (p < 0.0001). The age-adjusted prevalence of HPV infection for Caribbean subjects was not statistically significantly different from the US (any HPV: 47% vs. 39%, p > 0.1; high-risk HPVs: 27% vs. 25%, p > 0.1); no difference was observed between US-Blacks and Jamaicans (any HPV: 92% vs. 81%, p > 0.1; high-risk HPV: 50% vs. 53%, p > 0.1). However, US-Whites had a lower age-adjusted prevalence of HPV infections compared to Jamaican subjects (any HPV: 29% vs. 81%, p < 0.0001; high-risk HPV: 20% vs. 53%, p < 0.001). Subjects from Jamaica, Tobago, and US-Blacks had a higher proportion of high-risk HPV infections (Tobago: 20%, Jamaica: 58%, US-Blacks: 40%) compared to US-Whites (15%). Similar observations were made for the presence of infections with multiple high-risk HPV types (Tobago: 12%, Jamaica: 43%, US-Blacks: 30%, US-Whites: 8%). Although we observed similar prevalence of HPV16 infections among Caribbean and US-White women, there was a distinct distribution of high-risk HPV types when comparisons were made between the ethnic groups. Conclusion The higher prevalence of cervical HPV infections and multiple high-risk infections in Caribbean and US-Black women may contribute to the high incidence and prevalence of cervical cancer in these populations. Evaluation of a larger sample size is currently ongoing to confirm the distinct distribution of HPV types between ethnic groups.
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Affiliation(s)
- Camille C Ragin
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, USA.
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