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Risley C, Stewart MW, Geisinger KR, Hiser LM, Morgan JC, Owens KJ, Ayyalasomayajula K, Rives RM, Jannela A, Grunes DE, Zhang L, Schiffman M, Wentzensen N, Clarke MA. STRIDES - STudying Risk to Improve DisparitiES in Cervical Cancer in Mississippi - Design and baseline results of a Statewide Cohort Study. Prev Med 2021; 153:106740. [PMID: 34293382 PMCID: PMC8595817 DOI: 10.1016/j.ypmed.2021.106740] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 05/21/2021] [Accepted: 07/17/2021] [Indexed: 12/13/2022]
Abstract
Cervical cancer rates in Mississippi are disproportionately high, particularly among Black individuals; yet, research in this population is lacking. We designed a statewide, racially diverse cohort of individuals undergoing cervical screening in Mississippi. Here, we report the baseline findings from this study. We included individuals aged 21 years and older undergoing cervical screening with cytology or cytology-human papillomavirus (HPV) co-testing at the Mississippi State Health Department (MSDH) and the University of Mississippi Medical Center (UMMC) (December 2017-May 2020). We collected discarded cytology specimens for future biomarker testing. Demographics and clinical results were abstracted from electronic medical records and evaluated using descriptive statistics and chi-square tests. A total of 24,796 individuals were included, with a median age of 34.8 years. The distribution of race in our cohort was 60.2% Black, 26.4% White, 7.5% other, and 5.9% missing. Approximately 15% had abnormal cytology and, among those who underwent co-testing at MSDH (n = 6,377), HPV positivity was 17.4% and did not vary significantly by race. Among HPV positives, Black individuals were significantly less likely to be HPV16/18 positive and more likely to be positive for other high-risk 12 HPV types compared to White individuals (20.5% vs. 27.9%, and 79.5% and 72.1%, respectively, p = 0.011). Our statewide cohort represents one of the largest racially diverse studies of cervical screening in the U.S. We show a high burden of abnormal cytology and HPV positivity, with significant racial differences in HPV genotype prevalence. Future studies will evaluate cervical precancer risk, HPV genotyping, and novel biomarkers in this population.
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Affiliation(s)
- Carolann Risley
- National Cancer Institute, Clinical Genetics Branch, Division of Cancer Epidemiology & Genetics, Rockville, MD, United States of America; University of Mississippi Medical Center, School of Nursing, Jackson, MS, United States of America; University of Mississippi Medical Center, Department of Cell and Molecular Biology, Jackson, MS, United States of America.
| | - Mary W Stewart
- University of Mississippi Medical Center, School of Nursing, Jackson, MS, United States of America.
| | - Kim R Geisinger
- Joint Pathology Center, Walter Reed National Military Medical Center, Silver Spring, MD, United States of America; East Carolina University, Department of Pathology, Greenville, NC, United States of America.
| | - Laree M Hiser
- University of Mississippi Medical Center, School of Nursing, Jackson, MS, United States of America.
| | - Jody C Morgan
- University of Mississippi Medical Center, School of Nursing, Jackson, MS, United States of America.
| | - Kenyata J Owens
- University of Mississippi Medical Center, School of Nursing, Jackson, MS, United States of America; University of Mississippi Medical Center, Center for Informatics & Analytics, Jackson, MS, United States of America.
| | - Krishna Ayyalasomayajula
- University of Mississippi Medical Center, School of Nursing, Jackson, MS, United States of America; University of Mississippi Medical Center, Center for Informatics & Analytics, Jackson, MS, United States of America.
| | - Rhonda M Rives
- University of Mississippi Medical Center, School of Nursing, Jackson, MS, United States of America; University of Mississippi Medical Center, Department of Pathology, Jackson, MS, United States of America..
| | - Ashish Jannela
- University of Mississippi Medical Center, Center for Informatics & Analytics, Jackson, MS, United States of America.
| | - Dianne E Grunes
- University of Mississippi Medical Center, Department of Pathology, Jackson, MS, United States of America..
| | - Lei Zhang
- University of Mississippi Medical Center, School of Nursing, Jackson, MS, United States of America; Mississippi State Department of Health, Research & Statistics, Jackson, MS, United States of America.
| | - Mark Schiffman
- National Cancer Institute, Clinical Genetics Branch, Division of Cancer Epidemiology & Genetics, Rockville, MD, United States of America.
| | - Nicolas Wentzensen
- National Cancer Institute, Clinical Genetics Branch, Division of Cancer Epidemiology & Genetics, Rockville, MD, United States of America.
| | - Megan A Clarke
- National Cancer Institute, Clinical Genetics Branch, Division of Cancer Epidemiology & Genetics, Rockville, MD, United States of America.
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Azad AK, Huang CK, Jin H, Zou H, Yanakakis L, Du J, Fiddler M, Naeem R, Goldstein Y. Enhanced Carrier Screening for Spinal Muscular Atrophy: Detection of Silent (SMN1: 2 + 0) Carriers Utilizing a Novel TaqMan Genotyping Method. Lab Med 2021; 51:408-415. [PMID: 31875889 DOI: 10.1093/labmed/lmz088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Individuals whose copies of the survival motor neuron 1 (SMN1) gene exist on the same chromosome are considered silent carriers for spinal muscular atrophy (SMA). Conventional screening for SMA only determines SMN1 copy number without any information regarding how those copies are arranged. A single nucleotide variant (SNV) rs143838139 is highly linked with the silent carrier genotype, so testing for this SNV can more accurately assess risk to a patient of having an affected child. METHODS Using a custom-designed SNV-specific Taqman genotyping assay, we determined and validated a model for silent-carrier detection in the laboratory. RESULTS An initial cohort of 21 pilot specimens demonstrated results that were 100% concordant with a reference laboratory method; this cohort was utilized to define the reportable range. An additional 177 specimens were utilized for a broader evaluation of clinical validity and reproducibility. Allelic-discrimination analysis demonstrated tight clustering of genotype groupings and excellent reproducibility, with a coefficient of variation for all genotypes ranging from 1% to 4%. CONCLUSION The custom-developed Taqman SNV genotyping assay we tested provides a rapid, accurate, and cost-effective method for routine SMA silent-carrier screening and considerably improves detection rates of residual risk for SMA carriers.
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Affiliation(s)
- Abul Kalam Azad
- Department of Pathology, Montefiore Medical Center at Albert Einstein College of Medicine, Bronx, New York
| | - Chih-Kang Huang
- Department of Pathology, Montefiore Medical Center at Albert Einstein College of Medicine, Bronx, New York
| | - Hong Jin
- Department of Pathology, Montefiore Medical Center at Albert Einstein College of Medicine, Bronx, New York
| | | | | | - Juan Du
- Department of Pathology, Montefiore Medical Center at Albert Einstein College of Medicine, Bronx, New York
| | | | - Rizwan Naeem
- Department of Pathology, Montefiore Medical Center at Albert Einstein College of Medicine, Bronx, New York
| | - Yitz Goldstein
- Department of Pathology, Montefiore Medical Center at Albert Einstein College of Medicine, Bronx, New York
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Campos RG, Malacara Rosas A, Gutiérrez Santillán E, Delgado Gutiérrez M, Torres Orozco RE, García Martínez ED, Torres Bernal LF, Rosas Cabral A. Unusual prevalence of high-risk genotypes of human papillomavirus in a group of women with neoplastic lesions and cervical cancer from Central Mexico. PLoS One 2019; 14:e0215222. [PMID: 30998701 PMCID: PMC6474327 DOI: 10.1371/journal.pone.0215222] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 03/28/2019] [Indexed: 12/18/2022] Open
Abstract
Human papillomavirus has been identified as a main etiological agent in the
development of cervical cancer. HPV 16 and 18 have been reported the most widely
prevalent genotypes worldwide. We conducted a study analyzing the prevalence of
high and low risk human papillomavirus viral types in the Mexican state of
Aguascalientes and neighboring cities in the states of Jalisco and Zacatecas in
central Mexico. Specific viral genotype was determined by a PCR and
hybridization-based detection test. The presence of 37 high- and low-risk HPV
genotypes was evaluated in 883 female participants. Of these, 350 presented
low-grade squamous intraepithelial lesions (LGSIL), 176 presented high-grade
squamous intraepithelial lesions (HGSIL), 107 suffered from cervical cancer and
250 women with negative cytological report for intraepithelial lesion or
malignancy (NILM). HPV 51 was the most prevalent genotype, followed by HPV 16:
overall prevalence of HPV 51, including single infections and co-infections was
31.2% in women with LGSIL, whereas prevalence of HPV 16 was 25.1%. Among women
with HGSIL, HPV 51 prevalence was 47.2% and HPV 16 was 30.1%. Prevalence of HPV
51 in women with cervical cancer was 49.5% and type 16 was 33.6%. Between single
and co-infections, most co-infections were not associated with later stages of
the disease, except 51/16 and some others. HPV 51 showed a significant
correlation with the progression of the disease (OR = 10.81 for LGSIL, 19.38 for
HGSIL and 22.95 for ICC), and when analyzing all other genotypes, five different
groups depending on their correlation with all lesion grades were determined.
According to our findings, HPV genotype 51 has a higher prevalence than HPV 16
and 18 in the Mexican state of Aguascalientes and neighboring cities in the
states of Jalisco and Zacatecas in Central Mexico.
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Affiliation(s)
- Rafael Gutiérrez Campos
- Department of Chemistry, Center for Basic Sciences, Autonomous University
of Aguascalientes, Aguascalientes, Aguascalientes, México
- * E-mail:
| | - Angélica Malacara Rosas
- Department of Chemistry, Center for Basic Sciences, Autonomous University
of Aguascalientes, Aguascalientes, Aguascalientes, México
| | - Elvia Gutiérrez Santillán
- Hospital General de Zona Número 6, Instituto Mexicano del Seguro Social,
Monterrey, Nuevo León, México
| | - Mireya Delgado Gutiérrez
- Hospital General de Zona Número 1, Instituto Mexicano del Seguro Social,
Aguascalientes, Aguascalientes, México
| | - Rusland Enrique Torres Orozco
- Department of Chemistry, Center for Basic Sciences, Autonomous University
of Aguascalientes, Aguascalientes, Aguascalientes, México
| | - Elí Daniel García Martínez
- Department of Chemistry, Center for Basic Sciences, Autonomous University
of Aguascalientes, Aguascalientes, Aguascalientes, México
| | - Luis Fernando Torres Bernal
- Department of Medicine, Center for Health Sciences, Autonomous University
of Aguascalientes, Aguascalientes, México
| | - Alejandro Rosas Cabral
- Department of Medicine, Center for Health Sciences, Autonomous University
of Aguascalientes, Aguascalientes, México
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Segura SE, Ramos-Rivera G, Hakima L, Suhrland M, Khader S. Low-grade squamous intraepithelial lesion, cannot rule out high-grade lesion: Diagnosis, histological outcomes and human papillomavirus results. Cytopathology 2018; 30:99-104. [PMID: 30187975 DOI: 10.1111/cyt.12629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 08/27/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND The 2014 Bethesda System for Reporting Cervical Cytology classifies squamous intraepithelial lesions (SILs) of cervix into two main categories: low-grade SIL (LSIL) and high-grade SIL (HSIL). In some clinical practices, the LSIL cannot rule out high-grade lesion (LROH) interpretive category is used in cases with LSIL and findings that may raise the possibility of HSIL. Our purpose is to assess follow-up histopathology and high-risk human papillomavirus (hrHPV) results in patients with LROH, in comparison with LSIL, atypical squamous cells, cannot rule out HSIL (ASC-H), and HSIL in our institution. DESIGN Cervical Papanicolaou tests with LROH, LSIL, ASC-H and HSIL interpretation, surgical follow-up, and hrHPV status were retrieved from the computer database from May 2014 to December 2016. RESULTS Of 109 963 total Papanicolaou tests, LROH comprised 0.3%, LSIL 3.1%, ASC-H 0.2% and HSIL 0.4%. Only 3272 cases with surgical diagnoses were included in the study. The most common histological outcome for ASC-H was cervical intraepithelial neoplasia (CIN)2/3 (32.6%); LSIL was CIN 1 (45.7%); LROH was CIN 1 (46.7%) and HSIL was CIN 2/3 (64.4%). For LROH and LSIL, 31.1% and 7.5% respectively, had CIN 2/3. Approximately 79% of cases were hrHPV positive. Of LROH cases with surgical follow-up, 86.9% tested hrHPV positive, accounting for the second most common positive group after HSIL (92.6%). CONCLUSION In our study cohort, LROH interpretation is associated with a higher number of CIN 2 or higher lesions on follow-up compared to patients with LSIL (P < 0.0001), and is associated with a significant percentage of positive other hrHPV, supporting LROH as a useful diagnostic category that triggers appropriate follow-up in affected women.
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Affiliation(s)
- Sheila E Segura
- Pathology Department, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
| | - Gloria Ramos-Rivera
- Pathology Department, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
| | - Laleh Hakima
- Pathology Department, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
| | - Mark Suhrland
- Pathology Department, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
| | - Samer Khader
- Pathology Department, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York
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