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Valantin L, Bertolotti A, Chirpaz E, Ah Pine F, Duquenne S, Jaffar-Bandjee MC, Traversier N, Boukerrou M, Tran PL. High risk human papillomavirus prevalence and genotype distribution in Reunion Island. Eur J Obstet Gynecol Reprod Biol 2024; 301:114-119. [PMID: 39121646 DOI: 10.1016/j.ejogrb.2024.07.037] [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: 03/16/2024] [Revised: 06/27/2024] [Accepted: 07/14/2024] [Indexed: 08/12/2024]
Abstract
OBJECTIVE The primary objective of this study was to assess the prevalence and genotypes of human papilloma virus (HPV) in Reunion Island. STUDY DESIGN In this retrospective study, data were collected from the database of microbiology and anatomopathology laboratories from August 1st 2020 to July 31st 2021. RESULTS The overall prevalence of human papillomavirus (HPV) in Reunion Island was 14.5 %. The most common HPV genotypes in Reunion Island, were as follows: cluster of HPV 56 + 59 + 66, representing 3.3 % of all samples, cluster of HPV 35 + 39 + 68 (3.2 %), HPV 16 (2.9 %), HPV 33 + 58 (2.3 %) and HPV 52 (2.2 %). HPV types contained in the vaccine accounted for 59.3 % of HPV-positive samples and significantly resulted in more severe cytological lesions compared to HPV types that were not included in the vaccine (p < 0.01). Cervical dysplasia were identified in 57.3 % of HPV-positive cases. Multiple infections were detected in 23.2 % of the cases and were more frequent among younger women (<30 years) and in pathological smears (p < 0.001). CONCLUSION In this study, we highlighted that HPV genotypes contained in the vaccine are the most represented in Réunion Island and are the most likely to generate significant cytological abnormalities. Therefore, continuous efforts are necessary to increase HPV vaccination coverage, which is currently in the island among the lowest in developed countries, despite the high mortality rate associated with cervical cancer. Furthermore, considering the inequal offensive capacity of each HPV, identifying patients' HPV infection subtype, could allow customized management and follow-up.
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Affiliation(s)
- Laura Valantin
- Department of Gynecology and Obstetrics, University Hospital of La Reunion, 97410 Saint Pierre, Reunion Island, France
| | - Antoine Bertolotti
- Department of Dermatology and Infectious Diseases, University Hospital of La Reunion, 97410 Saint Pierre, Reunion Island, France; INSERM, CIC 1410, Reunion University Hospital, 97448 Saint-Pierre, France; Faculty of Medicine, University of Reunion, Reunion Island, France
| | - Emmanuel Chirpaz
- Cancer Registry of Reunion Island, Reunion University Hospital, 97490 Saint-Denis, France
| | - Franck Ah Pine
- Department of Anatomopathology, University Hospital of La Reunion, 97410 Saint Pierre, Reunion Island, France
| | - Sebastien Duquenne
- Laboratory of Anatomopathology, 2 rue Ambroise Vallard, 97410 Saint Pierre, Reunion Island, France
| | | | - Nicolas Traversier
- Department of microbiology, University Hospital of La Reunion, 97405 Saint Denis, Reunion Island, France
| | - Malik Boukerrou
- Department of Gynecology and Obstetrics, University Hospital of La Reunion, 97410 Saint Pierre, Reunion Island, France; Faculty of Medicine, University of Reunion, Reunion Island, France; Centre d'Etudes Périnatales de l'Océan Indien, University Hospital of Reunion Island, BP 350, 97448 Saint Pierre Cedex, Reunion, France
| | - Phuong Lien Tran
- Department of Gynecology and Obstetrics, University Hospital of La Reunion, 97410 Saint Pierre, Reunion Island, France; INSERM, CIC 1410, Reunion University Hospital, 97448 Saint-Pierre, France; Faculty of Medicine, University of Reunion, Reunion Island, France.
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Li J, Qi J, Zhang J, Zhang Y, Huang X. Relationships between nine neuropsychiatric disorders and cervical cancer: insights from genetics, causality and shared gene expression patterns. BMC Womens Health 2024; 24:394. [PMID: 38977982 PMCID: PMC11229200 DOI: 10.1186/s12905-024-03234-5] [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: 10/09/2023] [Accepted: 06/27/2024] [Indexed: 07/10/2024] Open
Abstract
BACKGROUND Neuropsychiatric disorders and cervical cancer exert substantial influences on women's health. Furthermore, neuropsychiatric disorders frequently manifest as common symptoms in cancer patients, potentially increasing the risk of malignant neoplasms. This study aimed to identify neuropsychiatric disorders that are genetically and causally related to cervical cancer and to investigate the molecular mechanisms underlying these associations. METHODS GWAS data related to nine neuropsychiatric disorders, namely, schizophrenia, bipolar disorder, autism spectrum disorder, Parkinson's disease, anxiety, Alzheimer's disease, mood disorders, depression, and alcohol dependence, were obtained to calculate heritability (h2) and genetic correlation (rg) with cervical cancer using linkage disequilibrium score regression (LDSC). Mendelian randomization (MR) analysis of the two cohorts was employed to assess the causal effects. Shared gene expression pattern analysis was subsequently conducted to investigate the molecular mechanism underlying these significant associations. RESULTS Anxiety, mood disorders, depression, and alcohol dependence were genetically correlated with cervical cancer (all adjusted P < 0.05). Only depression was causally related to cervical cancer in both the discovery (ORIVW: 1.41, PIVW = 0.02) and replication cohorts (ORIVW: 1.80, PIVW = 0.03) in the MR analysis. Gene expression pattern analysis revealed that 270 genes related to depression and cervical cancer, including tumour necrosis factor (TNF), were significantly upregulated in cervical cancer patients, while vascular endothelial growth factor A (VEGFA), transcription factor AP-1 (JUN), and insulin-like growth factor I (IGF-I) were associated with prognosis in cervical cancer patients (all P < 0.05). These overlapping genes implicated the involvement of multiple biological mechanisms, such as neuron death, the PI3K-Akt signalling pathway, and human papillomavirus infection. CONCLUSIONS Genetic, causal and molecular evidence indicates that depression increases the risk of cervical cancer. The TNF, VEGFA, JUN, and IGF-1 genes and the neuron death, PI3K-Akt, and human papillomavirus infection signalling pathways may possibly explain this association.
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Affiliation(s)
- Jie Li
- Department of Gynecology, Hebei General Hospital, Shijiazhuang, Hebei, 050051, China.
| | - Jie Qi
- Department of Gynecology, Hebei General Hospital, Shijiazhuang, Hebei, 050051, China
| | - Junqin Zhang
- Department of Gynecology, Hebei General Hospital, Shijiazhuang, Hebei, 050051, China
| | - Yuan Zhang
- Department of Gynecology, Hebei General Hospital, Shijiazhuang, Hebei, 050051, China
| | - Xianghua Huang
- Department of Obstetrics and Gynecology, Second Hospital of Hebei Medical University, No. 215, HePing West Road, Shijiazhuang, Hebei, 050000, China.
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Sun K, Han B, Zeng H, Wang S, Li L, Chen R, Zheng R, Wei W. Incidence and Mortality of Cancers in Female Genital Organs - China, 2022. China CDC Wkly 2024; 6:195-202. [PMID: 38523812 PMCID: PMC10960515 DOI: 10.46234/ccdcw2024.040] [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: 02/18/2024] [Accepted: 02/27/2024] [Indexed: 03/26/2024] Open
Abstract
Introduction This study presented the incidence and mortality rates of cancers affecting the female genital organs in China, along with their trends spanning from 2010 to 2018. Methods 700 population-based cancer registries provided relevant cancer incidence and mortality data for the year 2018. Among these, 106 registries had continuous monitoring data suitable for trend analysis from 2010 to 2018. We focused specifically on cancers affecting female genital organs (ICD10=C51-C54, C56) and projected their incidences and mortalities in China for 2022 based on data from 2018 and the trends observed from 2010 to 2018. Age-standardized incidence rate (ASIR) and mortality rate (ASMR) were calculated using Segi's world standard population. Results In 2022, there were an estimated 296,300 new cases and 104,900 deaths from female cancers in China. ASIRs for vulva (C51), vagina (C52), cervix uteri (C53), corpus uteri (C54), and ovary (C56) were 0.32, 0.23, 13.83, 6.84, and 5.68 per 100,000 population. ASIRs for corpus uteri and ovary cancers were higher in urban areas. ASMRs for vulva, vagina, cervix, corpus uteri, and ovary cancers were 0.14, 0.08, 4.54, 1.05, and 2.64 per 100,000 population, respectively. ASMR for ovarian cancer was higher in urban areas. ASIRs and ASMRs for most female genital organ cancers increased from 2010 to 2018, although the rate of increase for vulvar and cervical cancers in rural areas has slowed recently. Conclusions Tailored cancer prevention and control programs specific to each region are necessary to address the growing disease burden.
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Affiliation(s)
- Kexin Sun
- National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Bingfeng Han
- National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hongmei Zeng
- National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shaoming Wang
- National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Li Li
- National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ru Chen
- National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Rongshou Zheng
- National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wenqiang Wei
- National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Dabán-López P, Fernández-Martínez NF, Petrova D, Rodríguez-Barranco M, Jiménez-Moleón JJ, Gutierrez J, Sánchez MJ. Epidemiology of human papillomavirus-associated anogenital cancers in Granada: a three-decade population-based study. Front Public Health 2023; 11:1205170. [PMID: 37780447 PMCID: PMC10537955 DOI: 10.3389/fpubh.2023.1205170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 08/29/2023] [Indexed: 10/03/2023] Open
Abstract
Introduction HPV infection is a common risk factor for all anogenital cancers. However, there are important differences in the epidemiology of anogenital cancers and these have not been compared considering diverse epidemiological indicators over a long period of time. To fill this gap, we investigated incidence, mortality, and survival trends of anogenital cancers over a period of three decades. Methods We conducted an observational registry-based study using data from the population-based cancer registry of Granada in southern Spain. We collected data on all incident cases of anogenital cancer (cervical, anal, penile, vulvar, and vaginal cancer) diagnosed between 1985 and 2017. We calculated crude and age-standardized incidence and mortality rates, and 1, 3, and 5-year overall and net survival. We further conducted time-trend analysis calculating annual percent changes (APC) for each cancer site. Results The incidence of anogenital cancers decreased slightly during the past 30 years, with the exception of vulvar cancer, where a slight increase was observed. Mortality decreased significantly for cervical cancer over the study period but increased non-significantly for the remaining cancer sites. Survival rates were similar to those reported in comparable countries and increased for cervical and vulvar cancer. Discussion Cervical cancer was the greatest contributor to the burden of anogenital cancers and showed a marked improvement in all indicators in comparison to the remaining cancer sites.
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Affiliation(s)
- Pablo Dabán-López
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario San Cecilio, Granada, Spain
| | - Nicolás Francisco Fernández-Martínez
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Dafina Petrova
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Miguel Rodríguez-Barranco
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Jose Juan Jiménez-Moleón
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
| | - Javier Gutierrez
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario San Cecilio, Granada, Spain
| | - María-José Sánchez
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
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Raveinthiranathan N, Simkin J, Donken R, Ogilvie G, Smith L, Van Niekerk D, Lee M, Woods RR. Age-Specific Trends of Invasive Cervical Cancer Incidence in British Columbia, Canada, 1971-2017. Curr Oncol 2023; 30:7692-7705. [PMID: 37623038 PMCID: PMC10453046 DOI: 10.3390/curroncol30080557] [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: 07/07/2023] [Revised: 08/08/2023] [Accepted: 08/16/2023] [Indexed: 08/26/2023] Open
Abstract
This study examined invasive cervical cancer (ICC) incidence trends in British Columbia (BC) by age and stage-at-diagnosis relative to World Health Organization ICC elimination targets (4 per 100,000 persons). Incident ICC cases (1971-2017) were obtained from the BC Cancer Registry. Annual age-standardized incidence rates (ASIRs) per 100,000 persons were generated using the direct method. ASIRs were examined among all ages 15+ years and eight age groups using Joinpoint Regression with the Canadian 2011 standard population. Standardized rate ratios (SRRs) compared stage II-IV (late) versus stage I (early) ASIRs by age (2010-2017). ICC ASIRs did not reach the elimination target. ASIRs declined from 18.88 to 7.08 per 100,000 persons (1971-2017). Stronger declines were observed among ages 45+ years, with the largest decline among ages 70-79 years (AAPC = -3.2%, 95% CI = -3.9% to -2.6%). Among ages 25-69 years, varying levels of attenuation in declining trends and stabilization were observed since the 1980s. SRRs indicated higher rates of late-stage ICC among ages 55+ years (SRR-55-69 years = 1.34, 95% CI = 1.08-1.71). Overall, ICC incidence declined in BC since 1971 but did not reach the elimination target. The pace of decline varied across age groups and increased with age. Continued efforts are needed to progress cervical cancer elimination among all age groups.
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Affiliation(s)
- Nivedha Raveinthiranathan
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
- Cancer Control Research, BC Cancer, Vancouver, BC V5Z 1L3, Canada
| | - Jonathan Simkin
- Cancer Control Research, BC Cancer, Vancouver, BC V5Z 1L3, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Robine Donken
- School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- Women’s Health Research Institute, BC Women’s Hospital and Health Service, Vancouver, BC V6H 3N1, Canada
- Vaccine Evaluation Center, BC Children’s Hospital Research Institute, Vancouver, BC V5Z 4H4, Canada
| | - Gina Ogilvie
- Cancer Control Research, BC Cancer, Vancouver, BC V5Z 1L3, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- Women’s Health Research Institute, BC Women’s Hospital and Health Service, Vancouver, BC V6H 3N1, Canada
| | - Laurie Smith
- Cancer Control Research, BC Cancer, Vancouver, BC V5Z 1L3, Canada
- Women’s Health Research Institute, BC Women’s Hospital and Health Service, Vancouver, BC V6H 3N1, Canada
| | - Dirk Van Niekerk
- Cancer Control Research, BC Cancer, Vancouver, BC V5Z 1L3, Canada
- Cervical Cancer Screening Program, BC Cancer, Vancouver, BC V5Z 1G1, Canada
| | - Marette Lee
- Cancer Control Research, BC Cancer, Vancouver, BC V5Z 1L3, Canada
- Women’s Health Research Institute, BC Women’s Hospital and Health Service, Vancouver, BC V6H 3N1, Canada
| | - Ryan R. Woods
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
- Cancer Control Research, BC Cancer, Vancouver, BC V5Z 1L3, Canada
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Duan R, Zhang H, Yu J, Deng S, Yang H, Zheng YT, Huang Y, Zhao F, Yang H. Temporal trends and projections of gynecological cancers in China, 2007-2030. BMC Womens Health 2023; 23:346. [PMID: 37391767 PMCID: PMC10311708 DOI: 10.1186/s12905-023-02384-2] [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: 12/27/2022] [Accepted: 04/20/2023] [Indexed: 07/02/2023] Open
Abstract
BACKGROUND Gynecological cancer will become a more important public health problem in future years but limited evidence on gynecological cancer burden in China. METHODS We extracted age-specific rate of cancer cases and deaths during 2007-2016 from the Chinese Cancer Registry Annual Report, and estimated age-specific population size using the data released by National Bureau of Statistics of China. Cancer burden were calculated by multiplying the rates with the population size. Temporal trends of the cancer cases, incidence, deaths, and mortality during 2007-2016 were calculated by JoinPoint Regression Program, and from 2017 to 2030 were projected by grey prediction model GM (1,1). RESULTS In China, total gynecological cancer cases increased from 177,839 to 241,800, with the average annual percentage change of 3.5% (95% CI: 2.7-4.3%) during 2007-2016. Cervical, uterine, ovarian, vulva, and other gynecological cancer cases increased by 4.1% (95% CI: 3.3-4.9%), 3.3% (95% CI: 2.6-4.1%), 2.4% (95% CI: 1.4-3.5%), 4.4% (95% CI: 2.5-6.4%), and 3.6% (95% CI: 1.4-5.9%) respectively. From 2017 to 2030, projected gynecological cancer cases are changing from 246,581 to 408,314. Cervical, vulva and vaginal cancers showed evident upward trend, while uterine and ovarian cancer cases are slightly increasing. The increases for age-standardized incidence rates were similar with that of cancer cases. Temporal trends of cancer deaths and mortality were similar with that of cancer cases and incidence during 2007-2030, except that uterine cancer deaths and mortality were declined. CONCLUSIONS With the aging of population and other increased risk factors, the burden of gynecological cancers in China is likely to be grew rapidly in the future, comprehensive gynecological cancer control should be concerned.
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Affiliation(s)
- Rufei Duan
- Department of Gynecology, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, No.519 Kunzhou road, Xishan District, Kunming, Yunnan, 650118, China
- Key Laboratory of Animal Models and Human Disease Mechanisms, KIZ-CUHK Joint Laboratory of Bioresources and Molecular Research in Common Diseases, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, Yunnan, China
| | - Hongping Zhang
- Department of Gynecology, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, No.519 Kunzhou road, Xishan District, Kunming, Yunnan, 650118, China
| | - Jing Yu
- Department of Gynecology, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, No.519 Kunzhou road, Xishan District, Kunming, Yunnan, 650118, China
| | - Sisi Deng
- Department of Gynecology, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, No.519 Kunzhou road, Xishan District, Kunming, Yunnan, 650118, China
| | - Haijun Yang
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Yong-Tang Zheng
- Key Laboratory of Animal Models and Human Disease Mechanisms, KIZ-CUHK Joint Laboratory of Bioresources and Molecular Research in Common Diseases, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, Yunnan, China
| | - Yunchao Huang
- Department of Thoracic Surgery, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, Kunming, Yunnan, China
| | - Fanghui Zhao
- Department of Cancer Epidemiology, National Cancer Center / National Clinical Research Center for Cancer / Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hongying Yang
- Department of Gynecology, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, No.519 Kunzhou road, Xishan District, Kunming, Yunnan, 650118, China.
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Trétarre B, Dantony E, Coureau G, Defossez G, Guizard AV, Delafosse P, Daubisse L, Velten M, Karima Hammas, Barra S, Lapotre B, Plouvier S, d'Almeida T, Molinié F, Woronoff AS. Trends in incidence of invasive vaginal cancer in France from 1990 to 2018 and survival of recently diagnosed women - A population-based study. Eur J Obstet Gynecol Reprod Biol 2023; 283:125-129. [PMID: 36842246 DOI: 10.1016/j.ejogrb.2023.02.003] [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: 10/28/2022] [Revised: 01/26/2023] [Accepted: 02/10/2023] [Indexed: 02/15/2023]
Abstract
OBJECTIVE The aim of this study was to analyze trends in the incidence of vaginal cancer in France over a 28-year period and to present survival for recently-diagnosed women. METHODS French cancer registries provided data on invasive vaginal cancers diagnosed from 1990 to 2015 and followed up through June 2018. Trends in incidence were analyzed using a Poisson model with a bidimensional penalized spline of age and year at diagnosis. Net survival analysis was restricted to recently-diagnosed cases (2010-2015) and used a novel approach based on a bidimensional penalized spline of age and time-since-diagnosis to model excess mortality hazard. RESULTS With 162 new cases estimated in France in 2018, vaginal cancer represented 0.9 % of genital cancers in French women. In 2018, the world population age-standardized incidence rate was 0.2 per 100,000 person-years, median age at diagnosis was 75 years. The standardized incidence rate decreased significantly by 3 % per year (95 % CI, -3.8; -2.2) between 1990 and 2018 (0.4 cases per 100,000 person-year in 1990, vs 0.2 in 2018). Age-standardized net survival at 1 and 5 years after diagnosis was respectively 74 % and 45 %. CONCLUSIONS This study confirms that vaginal cancer is still a rare malignancy in France with 5-year net survival that remains low. We observed a consistent decrease in the incidence rate between 1990 and 2018. It may be too early to attribute these trends to a positive impact of vaccination campaigns against hrHPV infection, since vaginal cancer mainly affects older women and HPV vaccination has only been available since the early 2000s, and only targets young girls.
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Affiliation(s)
- Brigitte Trétarre
- Registre des Tumeurs de l'Hérault, 208 rue des Apothicaires, Montpellier, France; CERPOP INSERM U1295, Toulouse III University, F-31000, France; FRANCIM Network, Toulouse F-31073, France.
| | - Emmanuelle Dantony
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France; Laboratoire de Biométrie et Biologie Evolutive, UMR 5558, CNRS, Université Lyon 1, Université de Lyon, Villeurbanne, France
| | - Gaëlle Coureau
- FRANCIM Network, Toulouse F-31073, France; Epicene, Centre Inserm U1219/CHU de Bordeaux, Service d'information Médicale, Université Bordeaux, Bordeaux, France
| | - Gautier Defossez
- FRANCIM Network, Toulouse F-31073, France; Registre général des cancers de Poitou-Charentes, Pôle Biologie, Pharmacie et Santé Publique, CHU de Poitiers, Poitiers, France; Université de Poitiers, Poitiers, France; INSERM Centre d'Investigation Clinique CIC1402, Poitiers, France
| | - Anne-Valérie Guizard
- FRANCIM Network, Toulouse F-31073, France; Registre Général des Tumeurs du Calvados, Caen, France
| | - Patricia Delafosse
- FRANCIM Network, Toulouse F-31073, France; Registre Général des Cancers de l'Isère, Meylan, France
| | - Laetitia Daubisse
- CERPOP INSERM U1295, Toulouse III University, F-31000, France; FRANCIM Network, Toulouse F-31073, France; Claudius Regaud Institute, Regional Cancer Center, IUCT-O, Tarn Cancer Registry, Toulouse, F-31059, France
| | - Michel Velten
- FRANCIM Network, Toulouse F-31073, France; Registre des Cancers du Haut-Rhin, Mulhouse, France
| | - Karima Hammas
- FRANCIM Network, Toulouse F-31073, France; Registre des Cancers du Haut-Rhin, ARER68, Groupe Hospitalier de la Région de Mulhouse et Sud-Alsace (GHRMSA), Mulhouse, France
| | - Simona Barra
- FRANCIM Network, Toulouse F-31073, France; Registre des Cancers de la Manche, Cherbourg-Octeville, France
| | - Bénédicte Lapotre
- FRANCIM Network, Toulouse F-31073, France; Registre du cancer de la Somme, hôpital nord CHU Amiens-Picardie, Amiens, France
| | - Sandrine Plouvier
- FRANCIM Network, Toulouse F-31073, France; Registre général des cancers de Lille et de sa région, Lille, France
| | - Tania d'Almeida
- FRANCIM Network, Toulouse F-31073, France; Registre général des cancers de la Haute-Vienne - CHU de Limoges, Limoges, France
| | - Florence Molinié
- CERPOP INSERM U1295, Toulouse III University, F-31000, France; FRANCIM Network, Toulouse F-31073, France; Registre des Cancers de Loire-Atlantique et Vendee, CHU de Nantes, France
| | - Anne-Sophie Woronoff
- FRANCIM Network, Toulouse F-31073, France; Doubs Cancer Registry, Besançon University Hospital, Besançon, France; Research Unit EA3181, Franche-Comté University, Besançon, France
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Goyal LD, Kaur B, Bhalla S, Garg P. Carcinoma vulva: Ten years experience in a teaching institution of North India. J Family Med Prim Care 2023; 12:654-659. [PMID: 37312782 PMCID: PMC10259558 DOI: 10.4103/jfmpc.jfmpc_1731_22] [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: 08/29/2022] [Revised: 11/09/2022] [Accepted: 11/17/2022] [Indexed: 06/15/2023] Open
Abstract
Introduction Vulvar carcinoma is primarily a disease of post-menopausal women. Surgery is a primary treatment strategy. Chemotherapy and radiotherapy are a part of multimodal therapy. Presently, there is a shift towards neoadjuvant chemotherapy or radiotherapy so as to decrease the surgical morbidities. Objective To study the surgical outcome and prognostic factors in Ca vulva patients. Methodology A retrospective analysis of 19 vulvar cancer patients, surgically treated at a teaching institution of Punjab (2009-2019). Results Mean age of the patients was 60.95 years. Ulcerative swelling (89.5%) over labia majora (73.7%) was the main presenting symptom. Radical vulvectomy-bilateral IFLN dissection was performed in 74% patients, hemivulvectomy-unilateral IFLN dissection in 21% patients and wide local excision in one patient. Squamous cell carcinoma was detected in all, and one had verrucous carcinoma. Thirty-seven per cent patients had FIGO stage III disease, 31.5% - stage II and 31.5% - stage I. On HPE, 78.57% (11/14) patients had positive nodes and two had ECS. Only 5/9 (55.5%) cases could receive PORT. Seven patients defaulted follow-up. Two developed nodal metastasis, and seven women developed recurrence. One patient with regional recurrence faced demise during RT course. In 10/19 regular follow-up patients, four are alive and disease free, five patients are on palliative chemoradiation, and one is undergoing adjuvant radiotherapy for regional recurrence. Estimated 5-year overall survival is 83.33%. Conclusion Tumour stage, nodal positivity and nodal ECS were poor prognostic factors. Radical surgery-extensive groin node dissection causes significant morbidity; hence, studies evaluating the role of neoadjuvant treatment are needed so as to modify current treatment practices. HPV vaccination as a preventive measure and a thorough and extensive evaluation of patients with suspicious signs in vulvar disease is needed.
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Affiliation(s)
- Lajya Devi Goyal
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Bathinda, Punjab, India
| | - Balpreet Kaur
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Bathinda, Punjab, India
| | - Shivali Bhalla
- Department of Obstetrics and Gynaecology, Civil Hospital, Chandigarh, India
| | - Pardeep Garg
- Department of Radiation Oncology, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India
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9
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Mancini S, Bucchi L, Zamagni F, Baldacchini F, Crocetti E, Giuliani O, Ravaioli A, Vattiato R, Preti M, Tumino R, Ferretti S, Biggeri A, Ballotari P, Boschetti L, Brustolin A, Caldarella A, Cavallo R, Cirilli C, Citarella A, Contrino ML, Dal Maso L, Filiberti RA, Fusco M, Galasso R, Lotti FL, Magoni M, Mangone L, Masanotti G, Mazzoleni G, Mazzucco W, Melcarne A, Michiara M, Pesce P, Pinto A, Piras D, Rizzello RV, Rognoni M, Rosso S, Rugge M, Sampietro G, Scalzi S, Scuderi T, Tagliabue G, Toffolutti F, Vitarelli S, Falcini F. Trends in Net Survival from Vulvar Squamous Cell Carcinoma in Italy (1990–2015). J Clin Med 2023; 12:jcm12062172. [PMID: 36983173 PMCID: PMC10054662 DOI: 10.3390/jcm12062172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/27/2023] [Accepted: 03/06/2023] [Indexed: 03/14/2023] Open
Abstract
(1) Objective: In many Western countries, survival from vulvar squamous cell carcinoma (VSCC) has been stagnating for decades or has increased insufficiently from a clinical perspective. In Italy, previous studies on cancer survival have not taken vulvar cancer into consideration or have pooled patients with vulvar and vaginal cancer. To bridge this knowledge gap, we report the trend in survival from vulvar cancer between 1990 and 2015. (2) Methods: Thirty-eight local cancer registries covering 49% of the national female population contributed the records of 6274 patients. Study endpoints included 1- and 2-year net survival (NS) calculated using the Pohar-Perme estimator and 5-year NS conditional on having survived two years (5|2-year CNS). The significance of survival trends was assessed with the Wald test on the coefficient of the period of diagnosis, entered as a continuous regressor in a Poisson regression model. (3) Results: The median patient age was stable at 76 years. One-year NS decreased from 83.9% in 1990–2001 to 81.9% in 2009–2015 and 2-year NS from 72.2% to 70.5%. Five|2-year CNS increased from 85.7% to 86.7%. These trends were not significant. In the age stratum 70–79 years, a weakly significant decrease in 2-year NS from 71.4% to 65.7% occurred. Multivariate analysis adjusting for age group at diagnosis and geographic area showed an excess risk of death at 5|2-years, of borderline significance, in 2003–2015 versus 1990–2002. (4) Conclusions: One- and 2-year NS and 5|2-year CNS showed no improvements. Current strategies for VSCC control need to be revised both in Italy and at the global level.
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Affiliation(s)
- Silvia Mancini
- Romagna Cancer Registry, Romagna Cancer Institute (IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori), 47014 Meldola, Italy; (S.M.); (L.B.); (F.B.); (E.C.); (O.G.); (A.R.); (R.V.); (F.F.)
| | - Lauro Bucchi
- Romagna Cancer Registry, Romagna Cancer Institute (IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori), 47014 Meldola, Italy; (S.M.); (L.B.); (F.B.); (E.C.); (O.G.); (A.R.); (R.V.); (F.F.)
| | - Federica Zamagni
- Romagna Cancer Registry, Romagna Cancer Institute (IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori), 47014 Meldola, Italy; (S.M.); (L.B.); (F.B.); (E.C.); (O.G.); (A.R.); (R.V.); (F.F.)
- Correspondence:
| | - Flavia Baldacchini
- Romagna Cancer Registry, Romagna Cancer Institute (IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori), 47014 Meldola, Italy; (S.M.); (L.B.); (F.B.); (E.C.); (O.G.); (A.R.); (R.V.); (F.F.)
| | - Emanuele Crocetti
- Romagna Cancer Registry, Romagna Cancer Institute (IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori), 47014 Meldola, Italy; (S.M.); (L.B.); (F.B.); (E.C.); (O.G.); (A.R.); (R.V.); (F.F.)
| | - Orietta Giuliani
- Romagna Cancer Registry, Romagna Cancer Institute (IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori), 47014 Meldola, Italy; (S.M.); (L.B.); (F.B.); (E.C.); (O.G.); (A.R.); (R.V.); (F.F.)
| | - Alessandra Ravaioli
- Romagna Cancer Registry, Romagna Cancer Institute (IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori), 47014 Meldola, Italy; (S.M.); (L.B.); (F.B.); (E.C.); (O.G.); (A.R.); (R.V.); (F.F.)
| | - Rosa Vattiato
- Romagna Cancer Registry, Romagna Cancer Institute (IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori), 47014 Meldola, Italy; (S.M.); (L.B.); (F.B.); (E.C.); (O.G.); (A.R.); (R.V.); (F.F.)
| | - Mario Preti
- Department of Obstetrics and Gynaecology, University of Torino, 10124 Torino, Italy;
| | - Rosario Tumino
- Cancer Registry and Histopathology Department, Provincial Health Authority (ASP), 97100 Ragusa, Italy;
| | - Stefano Ferretti
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Local Health Authority, 44121 Ferrara, Italy;
| | - Annibale Biggeri
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, 35128 Padua, Italy;
| | - Paola Ballotari
- Mantova & Cremona Cancer Registry, Epidemiology Unit, Val Padana Health Protection Agency, 46100 Mantova, Italy;
| | - Lorenza Boschetti
- Pavia Cancer Registry, Public Health Agency of Pavia, 27100 Pavia, Italy;
| | - Angelita Brustolin
- Unit of Epidemiology and Cancer Registry, Local Health Authority, 01100 Viterbo, Italy
| | - Adele Caldarella
- Tuscany Cancer Registry, Clinical and Descriptive Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50139 Florence, Italy;
| | - Rossella Cavallo
- Cancer Registry of Local Health Authority Salerno, 84124 Salerno, Italy;
| | - Claudia Cirilli
- Modena Cancer Registry, Public Health Department, Local Health Authority, 41126 Modena, Italy;
| | - Annarita Citarella
- Cancer Registry, Department of Prevention, Unit of Epidemiology, Local Health Authority, 82100 Benevento, Italy;
| | | | - Luigino Dal Maso
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy; (L.D.M.); (F.T.)
| | - Rosa A. Filiberti
- Liguria Cancer Registry, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy;
| | - Mario Fusco
- Napoli 3 Sud Cancer Registry, 80031 Napoli, Italy;
| | - Rocco Galasso
- Unit of Regional Cancer Registry, Clinical Epidemiology and Biostatistics, IRCCS-CROB, Basilicata, 85028 Rionero in Vulture, Italy;
| | - Fernanda L. Lotti
- Brindisi Cancer Registry, Local Health Authority, 72100 Brindisi, Italy;
| | - Michele Magoni
- Cancer Registry of Brescia Province, Epidemiology Unit, Brescia Health Protection Agency, 25124 Brescia, Italy;
| | - Lucia Mangone
- Epidemiology Unit, Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia, Via Amendola 2, 42122 Reggio Emilia, Italy;
| | - Giuseppe Masanotti
- Section of Public Health and RTUP Register, Department of Experimental Medicine, University of Perugia, 06123 Perugia, Italy;
| | | | - Walter Mazzucco
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90131 Palermo, Italy;
| | | | - Maria Michiara
- Parma Cancer Registry, Medical Oncology Unit, University Hospital of Parma, 43126 Parma, Italy;
| | - Paola Pesce
- Catania, Messina and Enna Cancer Registry, 95123 Catania, Italy;
| | - Angela Pinto
- Barletta, Andria, Trani Cancer Registry, BAT Province, 76121 Barletta, Italy;
| | - Daniela Piras
- Sassari Cancer Registry, Azienda Regionale per la Tutela della Salute-ATS, 7100 Sassari, Italy;
| | - Roberto V. Rizzello
- Trento Province Cancer Registry, Unit of Clinical Epidemiology, Azienda Provinciale per i Servizi Sanitari (APSS), 38123 Trento, Italy;
| | - Magda Rognoni
- Epidemiology Unit, Cancer Registry of ATS Brianza, Health Protection Agency, 20900 Monza, Italy;
| | - Stefano Rosso
- Piedmont Cancer Registry, A.O.U. Città della Salute e della Scienza di Torino, 10123 Turin, Italy;
| | - Massimo Rugge
- Veneto Tumour Registry, Azienda Zero, University of Padova-DIMED, 35132 Padova, Italy;
| | | | - Santo Scalzi
- Catanzaro ASP Cancer Registry, 88100 Catanzaro, Italy;
| | - Tiziana Scuderi
- Trapani and Agrigento Cancer Registry, 91100 Trapani, Italy;
| | - Giovanna Tagliabue
- Lombardy Cancer Registry-Varese Province, Cancer Registry Unit, Department of Research, Fondazione IRCCS Istituto Nazionale Tumori, 20133 Milan, Italy;
| | - Federica Toffolutti
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy; (L.D.M.); (F.T.)
| | - Susanna Vitarelli
- Macerata Province Cancer Registry, University of Camerino, 62032 Camerino, Italy;
| | - Fabio Falcini
- Romagna Cancer Registry, Romagna Cancer Institute (IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) Dino Amadori), 47014 Meldola, Italy; (S.M.); (L.B.); (F.B.); (E.C.); (O.G.); (A.R.); (R.V.); (F.F.)
- Cancer Prevention Unit, Local Health Authority, 47121 Forlì, Italy
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Diakite I, Nguyen S, Sabale U, Pavelyev A, Saxena K, Tajik AA, Wang W, Palmer C. Public health impact and cost-effectiveness of switching from bivalent to nonavalent vaccine for human papillomavirus in Norway: incorporating the full health impact of all HPV-related diseases. J Med Econ 2023; 26:1085-1098. [PMID: 37608730 DOI: 10.1080/13696998.2023.2250194] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/16/2023] [Accepted: 08/17/2023] [Indexed: 08/24/2023]
Abstract
AIM The objective of this study was to estimate and compare the cost-effectiveness of switching from a bivalent to a nonavalent human papillomavirus (HPV) vaccination program in Norway, incorporating all nonavalent vaccine-preventable HPV-related diseases and in the context of the latest cervical cancer screening program. METHODS A well-established dynamic transmission model of the natural history of HPV infection and disease was adapted to the Norwegian population. We determined the number of cases of HPV-related diseases and subsequent number of deaths, and the economic burden of HPV-related disease under the current standard of care conditions of bivalent and nonavalent vaccinations of girls and boys aged 12 years. RESULTS Compared to bivalent vaccination, nonavalent vaccination averted an additional 4,357 cases of HPV-related cancers, 421,925 cases of genital warts, and 543 cases of recurrent respiratory papillomatosis (RRP) over a 100-year time horizon. Nonavalent vaccination also averted an additional 1,044 deaths over the 100-year time horizon when compared with bivalent vaccination. Total costs were higher for the nonavalent strategy (10.5 billion NOK [€1.03 billion] vs. 9.3-9.4 billion NOK [€915-925 million] for bivalent vaccination). A switch to nonavalent vaccination had a higher vaccination cost (4.4 billion NOK [€433 million] vs. 2.7 billion NOK [€266 million] for bivalent vaccination) but resulted in a savings of 627-694 million NOK [€62-68 million] in treatment costs. A switch to nonavalent vaccination demonstrated an incremental cost-effectiveness ratio of 102,500 NOK (€10,086) per QALY versus bivalent vaccination. CONCLUSIONS Using a model that incorporated the full range of HPV-related diseases, and the latest cervical cancer screening practices, we found that switching from bivalent to nonavalent vaccination would be considered cost-effective in Norway.
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Affiliation(s)
- Ibrahim Diakite
- Health Economic and Decision Sciences, Merck & Co., Inc., Rahway, NJ, USA
| | | | - Ugne Sabale
- Center for Observational and Real-World Evidence, MSD, Stockholm, Sweden
| | - Andrew Pavelyev
- Health Economic and Decision Sciences, Merck & Co., Inc., Rahway, NJ, USA
| | - Kunal Saxena
- Center for Observational and Real-World Evidence, Merck & Co., Inc., Rahway, NJ, USA
| | | | - Wei Wang
- Health Economic and Decision Sciences, Merck & Co., Inc., Rahway, NJ, USA
| | - Cody Palmer
- Health Economic and Decision Sciences, Merck & Co., Inc., Rahway, NJ, USA
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11
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Pedrão PG, Guimarães YM, Godoy LR, Possati-Resende JC, Bovo AC, Andrade CEMC, Longatto-Filho A, dos Reis R. Management of Early-Stage Vulvar Cancer. Cancers (Basel) 2022; 14:cancers14174184. [PMID: 36077719 PMCID: PMC9454625 DOI: 10.3390/cancers14174184] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/21/2022] [Accepted: 07/25/2022] [Indexed: 11/22/2022] Open
Abstract
Simple Summary Vulvar cancer is a rare gynecological malignancy that affects mainly postmenopausal women. Recently, however, an alarming increase in the rates among young women has been observed due to human papillomavirus infection. The standard treatment for vulvar cancer is surgery with or without radiotherapy as adjuvant treatment. In recent decades, sentinel lymph node biopsy has been included as part of the surgical treatment. Thus, our objective was to review and discuss the advances found in the literature about early-stage vulvar cancer. For this, we searched PubMed for publications in the English language. Relevant articles, such as the GROINS-V studies, and the GOG protocols, are presented in this review exhibiting the evolution of early-stage vulvar cancer treatment and the decrease in surgical morbidity rates. Abstract Vulvar cancer is a rare gynecological malignancy since it represents 4% of all cancers of the female genital tract. The most common histological type is squamous cell carcinoma (90%). This type can be classified into two clinicopathological subtypes according to the etiology. The first subtype is associated with persistent human papillomavirus infection and is usually diagnosed in younger women. The second subtype is associated with lichen sclerosus condition, and in most cases is diagnosed in postmenopausal women. Currently, an increase in first subtype cases has been observed, which raised the concern about associated mortality and treatment morbidity among young women. Vulvar cancer treatment depends on histopathology grade and staging, but surgery with or without radiotherapy as adjuvant treatment is considered the gold standard. In recent decades, sentinel lymph node biopsy has been incorporated as part of the treatment. Therefore, we sought to review and discuss the advances documented in the literature about vulvar cancer focusing on the treatment of early-stage disease. Relevant articles, such as the GROINS-V studies and the GOG protocols, are presented in this review. Additionally, we discuss key points such as the evolution of treatment from invasive surgery with high morbidity, to more conservative approaches without compromising oncologic safety; the role of sentinel lymph node mapping in the initial staging, since it reduces the complications caused by inguinofemoral lymphadenectomy; the recurrences rates, since local recurrence is common and curable, however, groin-associated, or distant recurrences have a poor prognosis; and, finally, the long-term follow-up that is essential for all patients.
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Affiliation(s)
- Priscila Grecca Pedrão
- Molecular Oncology Research Center, Barretos Cancer Hospital, São Paulo 14784-400, Brazil
| | | | - Luani Rezende Godoy
- Molecular Oncology Research Center, Barretos Cancer Hospital, São Paulo 14784-400, Brazil
| | | | - Adriane Cristina Bovo
- Department of Prevention Oncology, Barretos Cancer Hospital, Mato Grosso do Sul 79085-040, Brazil
| | - Carlos Eduardo Mattos Cunha Andrade
- Department of Gynecologic Oncology, Barretos Cancer Hospital, São Paulo 14784-400, Brazil
- Barretos School of Health Sciences, Dr. Paulo Prata-FACISB, Barretos, São Paulo 14785-002, Brazil
| | - Adhemar Longatto-Filho
- Molecular Oncology Research Center, Barretos Cancer Hospital, São Paulo 14784-400, Brazil
- Medical Laboratory of Medical Investigation (LIM) 14, Department of Pathology, Medical School, University of São Paulo, São Paulo 01246-903, Brazil
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal
- ICVS/3B’s—PT Government Associate Laboratory, 4710-057 Braga, Portugal
- ICVS/3B’s—PT Government Associate Laboratory, 4805-017 Guimarães, Portugal
| | - Ricardo dos Reis
- Department of Gynecologic Oncology, Barretos Cancer Hospital, São Paulo 14784-400, Brazil
- Correspondence: ; Tel.: +55-3321-6600 (ext. 7126)
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12
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Zhou WL, Yue YY. Trends in the Incidence of Vulvar and Vaginal Cancers With Different Histology by Race, Age, and Region in the United States (2001–2018). Int J Public Health 2022; 67:1605021. [PMID: 36105176 PMCID: PMC9464823 DOI: 10.3389/ijph.2022.1605021] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 08/04/2022] [Indexed: 11/30/2022] Open
Abstract
Objectives: The race, age, and region-stratified incidence of vulvar (VUC) and vaginal (VAC) cancers with different histology were unclear. Methods: Data was retrieved from the United States Cancer Statistics database. Average annual percent change (AAPC) and incidence rate ratio (IRR) were calculated. Results: Overall, VUC incidence increased from 18.3 (per 1,000,000 woman-years) to 19.6, but VAC incidence decreased from 5.6 to 4.4. VUC squamous cell carcinoma (SCC) incidence increased (AAPC, 0.96; 95% CI, 0.66–1.25), VUC adenocarcinoma (ADE) incidence stabilized (AAPC, −0.24; 95% CI, −1.44 to 0.98), and VUC other malignancies (OM) incidence decreased (AAPC, −1.31; 95% CI, −2.58 to −0.02). While VAC incidence decreased for any histology (AAPC, -0.63; 95% CI, −1.03 to −0.22; AAPC, −1.60; 95% CI, −2.80 to −0.39; and AAPC, −1.57; 95% CI, −2.24 to −0.89 for SCC, ADE, and OM). Similar trends were observed in most of the stratifications. Conclusion: VUC and VAC incidences varied by histology overall and within stratifications by race, age, and region. The incidence decreased for VUC and VAC with all histologies, except for the increasing VUC SCC incidence.
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Affiliation(s)
- Wei-Li Zhou
- Department of General Surgery, ShengJing Hospital of China Medical University, Shenyang, China
| | - Yang-Yang Yue
- Department of Health Management, ShengJing Hospital of China Medical University, Shenyang, China
- *Correspondence: Yang-Yang Yue,
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Duan R, Xu K, Huang L, Yuan M, Wang H, Qiao Y, Zhao F. Temporal Trends and Projection of Cancer Attributable to Human Papillomavirus Infection in China, 2007-2030. Cancer Epidemiol Biomarkers Prev 2022; 31:1130-1136. [PMID: 35266990 DOI: 10.1158/1055-9965.epi-21-1124] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 12/20/2021] [Accepted: 03/08/2022] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Information on temporal trends of cancer attributable to human papillomavirus (HPV) in China is limited. METHODS Cancer incidence and mortality during 2007 to 2015 were extracted from the Chinese Cancer Registry Annual Report and the national population from the National Bureau of Statistics. HPV-attributable cancer burden and the average annual percentage change during 2007 to 2015 were estimated and cancer burden during 2016 to 2030 was projected. RESULTS HPV-attributable cancer cases have increased by 3.8% [95% confidence interval (CI), 2.9%-4.8%] annually from 85,125 to 113,558 and age-standardized incidence rate (ASIR) rose by 3.0% (95% CI, 2.5%-3.5%) from 4.67 to 5.83 per 100,000 persons during 2007 to 2015. Cervical, female anal, and vulva cancer cases have increased by 3.8% (95% CI, 2.8%-4.7%), 6.5% (95% CI, 1.2%-12.2%), and 3.7% (95% CI, 1.6%-5.8%) per year. Male anal and oropharyngeal cancer cases have elevated by 7.5% (95% CI, 2.8%-12.5%) and 4.4% (95% CI, 2.4%-6.3%) annually. The increases of cervical and anal cancer were most rapid among those aged 50 and older. HPV-attributable cancer deaths and mortality rate have risen by 4.7% (95% CI, 2.9%-6.7%) and 3.3% (95% CI, 0.9%-5.8%) respectively. HPV-attributable cancer cases and ASIR are projected to reach 214,077 and 9.35 of 100,000 persons by 2030 respectively, with 87.7% being cervical cancer, and anal cancer cases are expected to triple. CONCLUSIONS HPV-attributable cancer burden has largely increased in the past and will keep rising for the next decade. Cervical cancer control should be the priority and anal cancer prevention should be addressed. IMPACT This study supplies fundamental evidence for policy-making on HPV-attributable cancer control.
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Affiliation(s)
- Rufei Duan
- Department of Gynecology, The Third Affiliated Hospital of Kunming Medical University/Yunnan Cancer Hospital/Yunnan Cancer Center, Kunming, Yunnan, China.,Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Kunpeng Xu
- School of Public Health, Dalian University, Dalian, Liaoning, China.,Department of Quality Management, Dalian No.3 People's Hospital, Dalian, Liaoning, China
| | - Liuye Huang
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Meiwen Yuan
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Honghao Wang
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Youlin Qiao
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fanghui Zhao
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Cervical, vaginal and vulvar cancer incidence and survival trends in Denmark, Finland, Norway and Sweden with implications to treatment. BMC Cancer 2022; 22:456. [PMID: 35473606 PMCID: PMC9044629 DOI: 10.1186/s12885-022-09582-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 04/08/2022] [Indexed: 11/16/2022] Open
Abstract
Background Incidence of cervical cancer has been reduced by organized screening while for vaginal and vulvar cancers no systematic screening has been implemented. All these cancers are associated with human papilloma virus (HPV) infection. We wanted to analyze incidence trends and relative survival in these cancers with specific questions about the possible covariation of incidence, survival changes coinciding with incidence changes and the role of treatment in survival. We used nationwide cancer registry data for Denmark (DK), Finland (FI), Norway (NO) and Sweden (SE) to address these questions. Methods We use the NORDCAN database for the analyses: incidence data were available from 1943 in DK, 1953 in FI and NO and 1960 in SE, through 2016. Survival data were available from 1967 through 2016. World standard population was used in age standardization. Results In each country the incidence of cervical cancer declined subsequent to rolling out of screening activities. The attained plateau incidence was lowest at 4/100,000 in FI and highest at 10/100,000 in DK and NO. The incidence of vaginal and vulvar cancer remained relatively constant at about 2/100,000. Relative 1-year survival in cervical cancer improved in all countries from low 80%s to high 80%s in the 50-year period, and 5-year survival improved also but at 20% units lower level. Survival gains were found only in patients diagnosed before age 60 years. Survival in vaginal and vulvar cancer followed the same patterns but at a few % units lower level. Conclusion Cervical cancer screening appeared to have reached its limits in the Nordic countries by year 2000. Novel treatments, such as immunotherapy, would be needed to improve survival until HPV vaccination will reach population coverage and boost the global fight against these cancers.
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Zhu H, Yan Y, Liu Y, Meng L. The Impact of Minimally Invasive Surgery on Treating Patients with Early Cervical Adenocarcinoma. J INVEST SURG 2022; 35:1593-1601. [PMID: 35437114 DOI: 10.1080/08941939.2022.2064009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To explore the impact of minimally invasive surgery on treating patients with early cervical adenocarcinoma (CA). METHODS From April 2016 to December 2019, patients with early CA and underwent surgery were prospectively included in this study. They were randomly divided into 2 groups: the minimally invasive surgery (MIS) group and conventional laparotomy (CL) group. The baseline characteristics, pathological features, surgical related parameters, serum tumor markers, complications and prognosis were analyzed and compared between the 2 groups. The risk factors for disease free survival (DFS) and overall survival (OS) were also analyzed with logistic regression analyses. RESULT The baseline characteristic and pathological features had no statistical difference between the 2 groups. The mean operation duration in MIS group was significantly longer than CL group (262.39 ± 34.98 vs 241.29 ± 36.98 min, P < 0.001). The intraoperative blood loss volume (189.87 ± 23.87 vs 306.87 ± 24.98 mL, P < 0.001), postoperative anal exhaust time (45.98 ± 4.39 vs 59.87 ± 4.87 days, P < 0.001), catheter removal time (18.29 ± 3.21 vs 21.53 ± 3.19 days, P < 0.001) and length of hospital stay (12.98 ± 2.09 vs 16.98 ± 2.32 days, P < 0.001) were significant lower in MIS group. The serum tumor markers decreased significantly postoperative in both groups with no different levels between the 2 groups. The incidence of complications had no difference between the 2 groups except lymphocysts (P = 0.023). After mean follow up time for 4.23 ± 0.34 years, the DFS rate and OS rate also had no statistical difference between the 2 groups (P = 0.069 and 0.151, respectively). CONCLUSION Extensive hysterectomy with MIS was equally efficacy and safe to CL.
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Affiliation(s)
- Hui Zhu
- Department of Gynaecology and Obstetrics, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Yifen Yan
- Department of Gynaecology and Obstetrics, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Ying Liu
- Department of Gynaecology and Obstetrics, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Linghu Meng
- Department of Neurosurgery, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, China
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Rubió-Casadevall J, Ciurana E, Puigdemont M, Sanvisens A, Marruecos J, Miró J, Urban A, Palhua RL, Martín-Romero F, Ortiz-Duran MR, Marcos-Gragera R. Population-Based Analysis of Trends in Incidence and Survival of Human Papilloma Virus-Related Oropharyngeal Cancer in a Low-Burden Region of Southern Europe. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084802. [PMID: 35457669 PMCID: PMC9027195 DOI: 10.3390/ijerph19084802] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/03/2022] [Accepted: 04/11/2022] [Indexed: 02/05/2023]
Abstract
Introduction: Human papilloma virus (HPV)-related oropharyngeal carcinoma (OPC) can be considered a new subtype of cancer with different clinical characteristics and prognosis than that related to tobacco. Its incidence is increasing worldwide. Its epidemiology has been widely studied in areas such as North America and Northern Europe, but less is known in Southern Europe. Methods: We analyzed the epidemiology of OPC using the database from Girona’s population-based Cancer Registry, in the North-East of Spain, from 1994 to 2018. To analyze differences between neoplasms related to human papillomavirus or not, we determined the immunohistochemical expression of p16 in cases within four time periods: 1997–1999, 2003–2005, 2009–2011, and 2016–2018. Results: Oropharyngeal cancer incidence increased significantly from 2001 to 2018 with an Annual Percentage of Change (APC) of 4.1. OPC p16-positive cases increased with an APC of 11.1. In the most recent period, 2016–2018, 38.5% of OPC cases were p16-positive. European age-standardized incidence rate was 4.18 cases/100.000 inhabitants-year for OPC cancer and 1.58 for those p16-positive. Five-year observed survival was 66.3% for p16-positive OPC and 37.7% for p16-negative. Conclusions: Although with lower burden than in other regions, p16-positive oropharyngeal cancer is increasing in our area and has a better prognosis than p16-negative OPC.
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Affiliation(s)
- Jordi Rubió-Casadevall
- Medical Oncology Department, Catalan Institute of Oncology, Hospital Josep Trueta, 17007 Girona, Spain
- Descriptive Epidemiology, Genetics and Cancer Prevention Group, Girona Biomedical Research Institute (IDIBGI), 17190 Girona, Spain; (M.P.); (A.S.); (R.M.-G.)
- School of Medicine, University of Girona (UdG), 17004 Girona, Spain; (E.C.); (J.M.); (M.R.O.-D.)
- Correspondence:
| | - Elna Ciurana
- School of Medicine, University of Girona (UdG), 17004 Girona, Spain; (E.C.); (J.M.); (M.R.O.-D.)
| | - Montserrat Puigdemont
- Descriptive Epidemiology, Genetics and Cancer Prevention Group, Girona Biomedical Research Institute (IDIBGI), 17190 Girona, Spain; (M.P.); (A.S.); (R.M.-G.)
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan Department of Health Government of Catalonia, Catalan Institute of Oncology, 17004 Girona, Spain
| | - Arantza Sanvisens
- Descriptive Epidemiology, Genetics and Cancer Prevention Group, Girona Biomedical Research Institute (IDIBGI), 17190 Girona, Spain; (M.P.); (A.S.); (R.M.-G.)
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan Department of Health Government of Catalonia, Catalan Institute of Oncology, 17004 Girona, Spain
| | - Jordi Marruecos
- School of Medicine, University of Girona (UdG), 17004 Girona, Spain; (E.C.); (J.M.); (M.R.O.-D.)
- Radiotherapy Oncology Department, Catalan Institute of Oncology, Hospital Josep Trueta, 17007 Girona, Spain
| | - Josefina Miró
- Pathology Department, Girona Clinic, 17007 Girona, Spain;
| | - Antoni Urban
- Pathology Department, Corporació de Salut del Maresme La Selva, Hospital Sant Jaume de Calella, 08370 Barcelona, Spain;
| | - Rosa-Lisset Palhua
- Pathology Department, Serveis de Salut Integrats Baix Empordà, Palamos Hospital, 17230 Girona, Spain;
| | - Ferran Martín-Romero
- Pathology Department, Fundació Salut Emporda, Figueres Hospital, 17600 Girona, Spain;
| | - Maria Rosa Ortiz-Duran
- School of Medicine, University of Girona (UdG), 17004 Girona, Spain; (E.C.); (J.M.); (M.R.O.-D.)
- Pathology Department, Catalan Institute of Health, Hospital Josep Trueta, 17007 Girona, Spain
| | - Rafael Marcos-Gragera
- Descriptive Epidemiology, Genetics and Cancer Prevention Group, Girona Biomedical Research Institute (IDIBGI), 17190 Girona, Spain; (M.P.); (A.S.); (R.M.-G.)
- School of Medicine, University of Girona (UdG), 17004 Girona, Spain; (E.C.); (J.M.); (M.R.O.-D.)
- Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan Department of Health Government of Catalonia, Catalan Institute of Oncology, 17004 Girona, Spain
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Piechocki M, Koziołek W, Sroka D, Matrejek A, Miziołek P, Saiuk N, Sledzik M, Jaworska A, Bereza K, Pluta E, Banas T. Trends in Incidence and Mortality of Gynecological and Breast Cancers in Poland (1980-2018). Clin Epidemiol 2022; 14:95-114. [PMID: 35115839 PMCID: PMC8800373 DOI: 10.2147/clep.s330081] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 12/14/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND This study aimed to analyze and determine the incidence and mortality trends in gynecological and breast cancers (BCs) in Poland. The gynecological cancers assessed were cervical cancer (CC), corpus uteri cancer (CUC), ovarian cancer (OC), vaginal cancer (VAC), and vulvar cancer (VUC). PATIENTS AND METHODS Data concerning the incidence and mortality for the period of 1980-2018 were obtained from the Polish National Cancer Registry (PNCR). Joinpoint regression analysis was performed to identify trends, which were described using the annual percentage change (APC) and the average annual percent change (AAPC). RESULTS Statistically significant increases were observed in BC incidence (AAPC: 2.3; CI: 1.8 to 2.9; p<0.05), CUC incidence (AAPC: 2.3; CI: 1.9 to 2.7; p<0.05), CUC mortality (AAPC: 0.4; CI: 0.1 to 0.7; p<0.05) and VUC mortality (AAPC: 1.16, CI: 0.1 to 2.2; p<0.05). VAC mortality decreased (AAPC: -3.5, CI: -5.0 to -2.0; p<0.05), as did CC incidence and mortality (AAPC: -2.1, CI: -2.3 to -1.8; p<0.05, AAPC: -2.0, CI: -2.2 to -1.8; p<0.05, respectively). Between 1980 and 1993, OC incidence initially increased and then stabilized (AAPC: 0.9; CI: 0.7 to 1.1; p<0.05). After 2007, OC mortality decreased (AAPC: 0.0; CI: -0.2 to 0.2; p=0.8). Trends in VUC and VAC incidence and BC mortality were not statistically significant. CONCLUSION The results of this study showed a significant increase in OC, CUC, and BC incidence, and a decrease in the incidence of CC and VAC. The VUC trends were stable. Mortality trends for BC initially fluctuated and, since 2010, has begun to increase. Throughout the observed period, mortality due to VUC and CUC increased, whereas decreased among patients with CC. OC mortality was stable, but not significant. Furthermore, the study showed a correlation between age group and rate of incidence and mortality of each assessed cancer.
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Affiliation(s)
- Marcin Piechocki
- Department of Gynecology and Oncology, Jagiellonian University Medical College, Krakow, Poland
| | - Wojciech Koziołek
- Department of Gynecology and Oncology, Jagiellonian University Medical College, Krakow, Poland
| | - Damian Sroka
- Department of Gynecology and Oncology, Jagiellonian University Medical College, Krakow, Poland
| | - Anna Matrejek
- Department of Gynecology and Oncology, Jagiellonian University Medical College, Krakow, Poland
| | - Paulina Miziołek
- Department of Gynecology and Oncology, Jagiellonian University Medical College, Krakow, Poland
| | - Nazarii Saiuk
- Department of Gynecology and Oncology, Jagiellonian University Medical College, Krakow, Poland
| | - Monika Sledzik
- Department of Gynecology and Oncology, Jagiellonian University Medical College, Krakow, Poland
| | - Adriana Jaworska
- Department of Gynecology and Oncology, Jagiellonian University Medical College, Krakow, Poland
| | - Krzysztof Bereza
- Department of Mother and Child Health;Faculty of Health Sciences;Institute of Nursing and Midwifery;Jagiellonian University Medical College, Krakow, Poland
| | - Elzbieta Pluta
- Department of Radiotherapy, Maria Sklodowska–Curie Institute - Oncology Centre, Krakow, Poland
| | - Tomasz Banas
- Department of Gynecology and Oncology, Jagiellonian University Medical College, Krakow, Poland
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18
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Jiang L, Wang X. The miR-133b/brefeldin A-inhibited guanine nucleotide-exchange protein 1 (ARFGEF1) axis represses proliferation, invasion, and migration in cervical cancer cells. Bioengineered 2022; 13:3323-3332. [PMID: 35048795 PMCID: PMC8973932 DOI: 10.1080/21655979.2022.2027063] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Cervical cancer is a common gynecological malignancy, and miR-133b is an abnormally expressed cervical cancer gene, which suggests that miR-133b may be involved in the occurrence and development of cervical cancer. However, the underlying mechanism is still unclear. miR-133b was overexpressed or silenced in the cervical cancer cell line C33A. Brefeldin A-inhibited guanine nucleotide-exchange protein 1 (ARFGEF1) was combined with overexpression of miR-133b in C33A cells. Cell Counting Kit-8, clone formation, and Transwell assays were performed to determine the influence of miR-133b and ARFGEF1 on clone formation, proliferation, migration, and invasion of C33A cells. The interaction between miR-133b and ARFGEF1 was verified using a luciferase reporter assay. Finally, the mRNA and protein expression of miR-133b and ARFGEF1 in the tumor and adjacent normal tissues of cervical cancer patients was detected by real-time quantitative PCR, Western blotting, and immunohistochemistry. The results indicated that miR-133b up-regulation suppressed the proliferation, invasion, migration, and clone formation abilities of C33A cells (P < 0.05). However, silence of miR-133b promoted the proliferation, invasion, and migration of C33A cells (P < 0.05). Clone formation ability of C33A cells was also elevated by miR-133b deficiency (P < 0.05). Moreover, miR-133b interacted with ARFGEF1 and repressed ARFGEF1 expression in C33A cells (P < 0.05). ARFGEF1 overexpression weakened miR-133b overexpression-mediated inhibition of proliferation, invasion, and migration of C33A cells (P < 0.05). miR-133b expression was decreased, and ARFGEF1 was up-regulated in tumor tissues of cervical cancer patients (P < 0.05). All results revealed that miR-133b suppresses cervical cancer progression by inhibiting proliferation, invasion, and migration of cervical cancer cells via targeting ARFGEF1. Thus, our study determined the mechanism of miR-133b in cervical cancer, and confirmed miR-133b/ARFGEF1 may become a potential therapeutic target for cervical cancer.
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Affiliation(s)
- Lingling Jiang
- Department of Gynaecology and Obstetrics, First People's Hospital of Wenling, Wenling, Zhejing, China
| | - Xuexin Wang
- Department of Gynaecology and Obstetrics, First People's Hospital of Wenling, Wenling, Zhejing, China
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19
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Essentiality of Trace Elements in Pregnancy, Fertility, and Gynecologic Cancers-A State-of-the-Art Review. Nutrients 2021; 14:nu14010185. [PMID: 35011060 PMCID: PMC8746721 DOI: 10.3390/nu14010185] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 12/23/2021] [Accepted: 12/28/2021] [Indexed: 12/18/2022] Open
Abstract
Gynecological neoplasms pose a serious threat to women's health. It is estimated that in 2020, there were nearly 1.3 million new cases worldwide, from which almost 50% ended in death. The most commonly diagnosed are cervical and endometrial cancers; when it comes to infertility, it affects ~48.5 million couples worldwide and the number is continually rising. Ageing of the population, environmental factors such as dietary habits, environmental pollutants and increasing prevalence of risk factors may affect the reproductive potential in women. Therefore, in order to identify potential risk factors for these issues, attention has been drawn to trace elements. Trace mineral imbalances can be caused by a variety of causes, starting with hereditary diseases, finishing with an incorrect diet or exposure to polluted air or water. In this review, we aimed to summarize the current knowledge regarding trace elements imbalances in the case of gynecologic cancers as well as female fertility and during pregnancy.
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20
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Shin DW, Bae J, Ha J, Lee WM, Jung KW. Trends in incidence and survival of patients with vulvar cancer in an Asian country: Analysis of the Korean Central Cancer Registry 1999-2018. Gynecol Oncol 2021; 164:386-392. [PMID: 34893346 DOI: 10.1016/j.ygyno.2021.11.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 11/16/2021] [Accepted: 11/22/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To report 20-year trends in incidence and survival of vulvar cancer in Korea. METHODS Using data from the Korean Central Cancer Registry, age-standardized incidence rates (ASRs) and annual percentage changes (APCs) were calculated. Net survival (NS) was estimated by the Pohar-Perme method, and conditional net survival (CNS) was calculated. RESULTS A total of 2221 patients was diagnosed with vulvar cancer during the 1999-2018 period, with an ASR of 0.32 per 100,000 person-years. Among the cases, 51.4% were squamous cell carcinoma (SqCC), 21.3% were Paget disease, and 8.6% were basal cell carcinoma (BCC). There was an increase in incidence for all vulvar cancer (APC 2.4%, 95% CI 1.8-3.0). However, although BCC (APC 7.0%, 95% CI 3.3-10.8) and Paget disease (APC 5.9%, 95% CI 4.2-7.6) increased, SqCC did not (APC 0.2%, 95% CI -0.8-1.2). There was an increase in incidence in all age groups. The 5Y NS was 74.0% overall, and it did not improve significantly during the study period. The 5Y CNS of vulvar cancer increased continuously with time survived: from 74.0% (71.4-76.4) at baseline to 98.1% (95% CI, 85.4-99.8) at 5 years after diagnosis. CONCLUSIONS The incidence of vulvar cancer in Korea showed a different pattern from those in the US and Europe: SqCC incidence was relatively low and remained stable, but the incidence of BCC and Paget's disease increased. Survival did not improve in the past two decades. Patients can be considered cured after surviving for 5 years.
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Affiliation(s)
- Dong Wook Shin
- Supportive Care Center/Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Science & Technology, Sungkyunkwan University, Seoul, Republic of Korea
| | - Jaeman Bae
- Department of Obstetrics and Gynecology, Hanyang University, College of Medicine, Seoul, Republic of Korea
| | - Johyun Ha
- The Korea Central Cancer Registry, National Cancer Center, Goyang, Republic of Korea; Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
| | - Won Moo Lee
- Department of Obstetrics and Gynecology, Hanyang University, College of Medicine, Seoul, Republic of Korea.
| | - Kyu-Won Jung
- The Korea Central Cancer Registry, National Cancer Center, Goyang, Republic of Korea; Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea.
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21
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Abstract
Vulvar cancer is an uncommon gynecological malignancy primarily affecting postmenopausal women. There is no specific screening and the most effective strategy to reduce vulvar cancer incidence is the opportune treatment of predisposing and preneoplastic lesions associated with its development. While vulvar cancer may be asymptomatic, most women present with vulvar pruritus or pain, or have noticed a lump or ulcer. Therefore, any suspicious vulvar lesion should be biopsied to exclude invasion. Once established, the most common subtype is squamous cell carcinoma. Treatment of vulvar cancer depends primarily on histology and surgical staging. Treatment is predominantly surgical, particularly for squamous cell carcinoma, although concurrent chemoradiation is an effective alternative, particularly for advanced tumors. Management should be individualized and carried out by a multidisciplinary team in a cancer center experienced in the treatment of these tumors. A useful update for trainees and specialists regarding the diagnosis, staging, treatment, and some controversies in the management of vulvar neoplasms.
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Affiliation(s)
- Alexander B Olawaiye
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Mauricio A Cuello
- Department of Gynecology, Division of Obstetrics and Gynecology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Linda J Rogers
- Division of Gynecological Oncology, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.,South African Medical Research Council University of Cape Town Gynecological Cancer Research Centre (SA MRC UCT GCRC, Cape Town, South Africa
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22
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Abstract
Diagnosis of a primary vaginal cancer is rare, as most vaginal tumors are metastatic from another primary site. Although cancer of the vagina is more common in postmenopausal women, an increase in young women being diagnosed with primary vaginal cancer has been reported, especially in countries with a high HIV prevalence. This is associated with persistence of high‐risk HPV infection. The emphasis should be on primary prevention with prophylactic HPV vaccination. Once there is a suspicion of a primary vaginal cancer, this should be confirmed histologically with biopsy. Staging has been done clinically, as with cervical cancer; however, there is a role for imaging in assisting with staging as this is often a difficult assessment. Treatment should be individualized and depends on stage as well as histologic subtype. It is prudent to refer cases to centers of excellence with experience in dealing with this rare gynecological cancer. A review of the different histologic subtypes of primary vaginal cancer in terms of staging and role of imaging, as well as treatment options and prognoses.
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Affiliation(s)
- Tracey S Adams
- Department of Gynecological Oncology, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.,South African Medical Research Council University of Cape Town Gynecological Cancer Research Centre (SA MRC UCT GCRC), Cape Town, South Africa.,University of Cape Town Global Surgery, Cape Town, South Africa
| | - Linda J Rogers
- Department of Gynecological Oncology, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.,South African Medical Research Council University of Cape Town Gynecological Cancer Research Centre (SA MRC UCT GCRC), Cape Town, South Africa
| | - Mauricio A Cuello
- Division of Obstetrics and Gynecology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
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23
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Rasmussen CL, Bertoli HK, Sand FL, Kjaer AK, Thomsen LT, Kjaer SK. The prognostic significance of HPV, p16, and p53 protein expression in vaginal cancer: A systematic review. Acta Obstet Gynecol Scand 2021; 100:2144-2156. [PMID: 34546565 DOI: 10.1111/aogs.14260] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 08/17/2021] [Accepted: 08/23/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Human papillomavirus (HPV), p16, and p53 have been investigated as prognostic markers in various HPV-related cancers. Within the field of vaginal cancer, however, the evidence remains sparse. In this systematic review, we have compiled the presently published studies on the prognostic significance of HPV and immunohistochemical expression of p16 and p53 among women with vaginal cancer. MATERIAL AND METHODS We conducted a systematic search of PubMed, Embase, and Cochrane Library to identify relevant studies published until April 2021. We included studies reporting survival after histologically verified vaginal cancers tested for HPV, p16, and/or p53. Survival outcomes included overall survival, disease-free survival, disease-specific survival, and progression-free survival. RESULTS We included a total of 12 studies. The vast majority of vaginal cancer cases included in each study were squamous cell carcinomas (84%-100%). Seven studies reported survival after vaginal cancer according to HPV status, and the majority of these studies found a tendency towards improved survival for women with HPV-positive vaginal cancer. Three out of four studies reporting survival according to p16 status found an improved survival among women with p16-positive vaginal cancer. For p53, only one of six studies reported an association between p53 expression and survival. CONCLUSIONS This systematic review suggests that women with HPV- and p16-positive vaginal cancer have an improved prognosis compared with those with HPV- or p16-negative vaginal cancer. Results for p53 were varied, and no conclusion could be reached. Only 12 studies could be included in the review, of which most were based on small populations. Hence, further and larger studies on the prognostic impact of HPV, p16, and p53 in vaginal cancer are warranted.
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Affiliation(s)
- Christina L Rasmussen
- Unit of Virus, Lifestyle, and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Hanna K Bertoli
- Unit of Virus, Lifestyle, and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Freja L Sand
- Unit of Virus, Lifestyle, and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Alexander K Kjaer
- Unit of Virus, Lifestyle, and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Louise T Thomsen
- Unit of Virus, Lifestyle, and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Susanne K Kjaer
- Unit of Virus, Lifestyle, and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark.,Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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Role of Chemotherapy in Vulvar Cancers: Time to Rethink Standard of Care? Cancers (Basel) 2021; 13:cancers13164061. [PMID: 34439215 PMCID: PMC8391130 DOI: 10.3390/cancers13164061] [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: 06/29/2021] [Revised: 08/09/2021] [Accepted: 08/10/2021] [Indexed: 01/12/2023] Open
Abstract
Simple Summary Vulvar cancer is a difficult clinical condition to treat. Although it is not one of the most frequently diagnosed cancers, its incidence is not negligible. Treatment depends on the extent of the disease and is currently based on surgery, radiotherapy and chemotherapy. The combination of these possible treatments, in the context of multidisciplinary discussions, is crucial. In this paper we present a review of the data available in the literature on the role of chemotherapy in the treatment of vulvar cancer, with a look at future perspectives. Abstract The actual role of chemotherapy in vulvar cancer is undeniably a niche topic. The low incidence of the disease limits the feasibility of randomized trials. Decision making is thus oriented by clinical and pathological features, whose relevance is generally weighted against evidence from observational studies and clinical practice. The therapeutic management of vulvar cancer is increasingly codified and refined at an individual patient level. It is of note that the attitude towards evidence sharing and discussion within a multidisciplinary frame is progressively consolidating. Viable options included in the therapeutic armamentarium available for vulvar cancer patients are frequently an adaption from standards used for cervical or anal carcinoma. Chemotherapy is more frequently combined with radiotherapy as neo-/adjuvant or definitive treatment. Drugs commonly used are platinum derivative, 5-fluorouracil and mitomicin C, mostly in combination with radiotherapy for radiosensitization. Exclusive chemotherapy in the neo-/adjuvant setting comprises platinum-derivative, combined with bleomicin and methotrexate, 5-fluorouracil, ifosfamide or taxanes. In advanced disease, current regimens include cisplatin-based chemoradiation, with or without 5-fluorouracil, or doublets with platinum in combination with a taxane. Our work is also enriched by a concise excursus on the biologic pathways underlying vulvar cancer. Introductory hints are also provided on targeted agents, a rapidly evolving research field.
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Crusz SM, El-Shakankery K, Miller RE. Targeting HPV in gynaecological cancers - Current status, ongoing challenges and future directions. ACTA ACUST UNITED AC 2021; 16:1745506520961709. [PMID: 33296284 PMCID: PMC7731692 DOI: 10.1177/1745506520961709] [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] [Indexed: 12/15/2022]
Abstract
Despite the success of preventive vaccination, the Human Papilloma Virus still accounts for 266,000 deaths annually, as the main causative factor of cervical, vaginal, anal, penile and oropharyngeal cancers. Human Papilloma Virus infects epithelial cells, driving tumourigenesis primarily from incorporation of DNA into the host cellular genome. Translation of two particular Human Papilloma Virus-specific oncoproteins, E6 and E7, are the key drivers of malignancy. If diagnosed early cervical, vaginal and vulval cancers have good prognosis and are treated with curative intent. However, metastatic disease carries a poor prognosis, with first-line systemic treatment providing only modest increase in outcome. Having shown promise in other solid malignancies, immune checkpoint inhibition and therapeutic cancer vaccines have been directed towards Human Papilloma Virus-associated gynaecological cancers, mindful that persistent Human Papilloma Virus infection drives malignancy and is associated with immunosuppression and lack of T-cell immunity. In this review, we discuss novel therapeutic approaches for targeting Human Papilloma Virus-driven gynaecological malignancies including vaccination strategies, use of immunomodulation, immune checkpoint inhibitors and agents targeting Human Papilloma Virus-specific oncoproteins. We also highlight the evolving focus on exciting new treatments including adoptive T-cell therapies.
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Affiliation(s)
- Shanthini M Crusz
- Department of Medical Oncology, St Bartholomew's Hospital, London, UK
| | | | - Rowan E Miller
- Department of Medical Oncology, St Bartholomew's Hospital, London, UK.,Department of Medical Oncology, University College London Hospital, London, UK
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Rousset-Jablonski C, Haesebaert J, Denis A, Reix P, Llerena C, Perceval M, Touzet S, Durieu I. Human Papilloma Virus Vaccination Among Female Patients Attending French Pediatric Cystic Fibrosis Centers. J Pediatr Adolesc Gynecol 2021; 34:317-323. [PMID: 33338628 DOI: 10.1016/j.jpag.2020.12.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 11/06/2020] [Accepted: 12/08/2020] [Indexed: 11/16/2022]
Abstract
STUDY OBJECTIVE To describe human papilloma virus (HPV) vaccination practice among adolescent girls with cystic fibrosis (CF) and to identify reasons for non-vaccination. DESIGN Cross-sectional multicentric study. SETTING AND PARTICIPANTS Girls aged 9-17 years, attending 7 French pediatric CF centers, and their accompanying adult. INTERVENTIONS Administration of a self-report questionnaire. MAIN OUTCOME MEASURES The proportion of girls having received or receiving HPV vaccination, compliance with the vaccination schedule, factors associated with vaccination, and reasons for vaccination and for non-vaccination. RESULTS A total of 113 girls and 104 accompanying adults participated. The mean age was 13.6 years (standard deviation 2.5; range 9-17). A total of 34 (30.9%) patients reported having received HPV vaccination. Among the 34 girls aged 15 years or older, 15 (44.1%) were vaccinated. Most patients (58.8%) started vaccination between 11 and 14 years of age (mean age 13.9). Most vaccine prescriptions (67.6%) were made by a CF center health care provider. Factors associated with vaccination were older age (odds ratio [OR] = 1.27, 95% confidence interval [CI] = 1.01-1.6, P = .037 for each year older), previous vaccination by the accompanying parent of one of their children for hepatitis B (OR = 8.01, 95% CI = 0.96-67.02), P = .055), and parental influence on decision-making (OR = 2.77, 95% CI = 0.97-7.95, P = .058). Health care providers' positive advice and fear of HPV-related disease were the main reasons given to justify vaccination decisions. Insufficient knowledge and concerns about potential side effects were the main barriers. CONCLUSION HPV vaccination remains insufficient among girls with CF. CF health care providers may play a crucial role in HPV vaccination acceptance, and their sensitization to cervical cancer prevention is mandatory.
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Affiliation(s)
- Christine Rousset-Jablonski
- Department of Internal medicine, Cystic Fibrosis Adult Reference Center, Hospices Civils de Lyon, Groupe Hospitalier Sud, Pierre Benite, France; Department of Obstetrics and Gynecology, Hospices Civils de Lyon, Groupe Hospitalier Sud, Pierre Benite, France; Department of Surgical Oncology, Leon Berard Cancer Center, Centre Léon Bérard, Lyon, France; EA 7425 HESPER-Health Services and Performance Research-Lyon 1 Claude Bernard University, Lyon, France.
| | - Julie Haesebaert
- EA 7425 HESPER-Health Services and Performance Research-Lyon 1 Claude Bernard University, Lyon, France; Pôle de Santé Publique-Service de Recherche et d'Epidémiologie Cliniques, Hospices civils de Lyon, Groupement hospitalier Est, Bron, France
| | - Angélique Denis
- Pôle Information Médicale Evaluation Recherche, Hospices Civils de Lyon, Lyon, France
| | - Philippe Reix
- Service de Pneumologie Pédiatrique et CRCM enfant, Hospices civils de Lyon, Hôpital Femme Mère Enfant, Bron, France; UMR 5558 (EMET), CNRS, LBBE, Université de Lyon, Villeurbanne, France
| | - Cathy Llerena
- Pneumologie Pédiatrique, Antenne Pédiatrique du CIC, Center Hospitalier Universitaire de Grenoble Alpes, Grenoble, France
| | - Marie Perceval
- Department of Internal medicine, Cystic Fibrosis Adult Reference Center, Hospices Civils de Lyon, Groupe Hospitalier Sud, Pierre Benite, France
| | - Sandrine Touzet
- EA 7425 HESPER-Health Services and Performance Research-Lyon 1 Claude Bernard University, Lyon, France; Pôle Information Médicale Evaluation Recherche, Hospices Civils de Lyon, Lyon, France
| | - Isabelle Durieu
- Department of Internal medicine, Cystic Fibrosis Adult Reference Center, Hospices Civils de Lyon, Groupe Hospitalier Sud, Pierre Benite, France; EA 7425 HESPER-Health Services and Performance Research-Lyon 1 Claude Bernard University, Lyon, France
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Lehtinen T, Elfström KM, Mäkitie A, Nygård M, Vänskä S, Pawlita M, Dillner J, Waterboer T, Lehtinen M. Elimination of HPV-associated oropharyngeal cancers in Nordic countries. Prev Med 2021; 144:106445. [PMID: 33678237 DOI: 10.1016/j.ypmed.2021.106445] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 01/25/2021] [Accepted: 01/27/2021] [Indexed: 12/31/2022]
Abstract
Incidence of human papillomavirus (HPV, most notably HPV type 16) associated oropharyngeal squamous cell carcinoma (OPSCC) among middle-aged (50-69 year-old) males has tripled in four high income Nordic countries (Denmark, Finland, Norway and Sweden) over the last 30 years. In Finland and Sweden, this increase was preceded by an HPV16 epidemic in fertile-aged populations in the 1980's. The recent implementation of school-based prophylactic HPV vaccination in early adolescent boys and girls will gradually decrease the incidence, and eventually eliminate the HPV-associated OPSCCs (especially tonsillar and base of tongue carcinomas) in the Nordic countries. However, beyond the adolescent and young adult birth cohorts vaccinated, there are approximately 50 birth cohorts (born in 1995 or before) that would benefit from screening for HPV-associated OPSCC. This article reviews the need, prerequisites, proof-of-concept trial and prospects of preventing HPV-associated OPSCC in the Nordic countries.
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Affiliation(s)
| | - K Miriam Elfström
- Center for Cervical Cancer Prevention, Karolinska University Laboratory, Karolinska University Hospital, Sweden; Regional Cancer Center of Stockholm-Gotland, Stockholm, Sweden
| | - Antti Mäkitie
- Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institute and Karolinska Hospital, Stockholm, Sweden; Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital, and Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | | | - Simopekka Vänskä
- Department of Health Security, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Michael Pawlita
- Infections and Cancer Epidemiology, Deutsches Krebsforschungzentrum, Heidelberg, Germany
| | - Joakim Dillner
- Department of Lab Medicine, Karolinska Institute, Stockholm, Sweden; Regional Cancer Center of Stockholm-Gotland, Stockholm, Sweden
| | - Tim Waterboer
- Infections and Cancer Epidemiology, Deutsches Krebsforschungzentrum, Heidelberg, Germany
| | - Matti Lehtinen
- FICAN-MID, Tampere, Finland; Department of Health Security, Finnish Institute for Health and Welfare, Helsinki, Finland; Infections and Cancer Epidemiology, Deutsches Krebsforschungzentrum, Heidelberg, Germany; Department of Lab Medicine, Karolinska Institute, Stockholm, Sweden
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Muzaffar J, Bari S, Kirtane K, Chung CH. Recent Advances and Future Directions in Clinical Management of Head and Neck Squamous Cell Carcinoma. Cancers (Basel) 2021; 13:338. [PMID: 33477635 PMCID: PMC7831487 DOI: 10.3390/cancers13020338] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 12/10/2020] [Accepted: 01/11/2021] [Indexed: 12/24/2022] Open
Abstract
Head and neck squamous cell carcinoma (HNSCC) is the most common cancer arising in the head and neck region. The most common risk factors are smoking, excessive drinking, and human papillomavirus (HPV) infection. While the overall incidence of smoking is decreasing, the incidence of HPV-related HNSCC is increasing in the United States and Western Europe, which led to a shift in understanding of the pathophysiology, treatment, and prognosis of this disease. The outcomes for non-metastatic HNSCC remains very encouraging and continues to improve. Advances in radiation technology and techniques, better organ preserving surgical options, and multidisciplinary treatment modalities have improved cure rates for locally advanced HNSCC patients. The treatment of metastatic disease, however, remains an area of need. The advancement of immune checkpoint inhibitors has provided significantly better outcomes, but only a small proportion of patients obtain benefits. Most recurrent and/or metastatic HNSCC patients continue to have poor survival. This has led to the vigorous investigation of new biomarkers and biomarker-based therapies. Novel therapeutic options including adaptive cellular therapy and therapeutic vaccines are also on the horizon. In this review, we highlight the latest advances in the field of HNSCC and the future direction of research.
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Affiliation(s)
- Jameel Muzaffar
- Moffitt Cancer Center, Department of Head and Neck-Endocrine Oncology, Tampa, FL 33612, USA; (J.M.); (K.K.)
| | - Shahla Bari
- Hematology Oncology Fellow, Moffitt Cancer Center, Tampa, FL 33612, USA;
| | - Kedar Kirtane
- Moffitt Cancer Center, Department of Head and Neck-Endocrine Oncology, Tampa, FL 33612, USA; (J.M.); (K.K.)
| | - Christine H. Chung
- Moffitt Cancer Center, Department of Head and Neck-Endocrine Oncology, Tampa, FL 33612, USA; (J.M.); (K.K.)
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Is There a Place for Immune Checkpoint Inhibitors in Vulvar Neoplasms? A State of the Art Review. Int J Mol Sci 2020; 22:ijms22010190. [PMID: 33375467 PMCID: PMC7796178 DOI: 10.3390/ijms22010190] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 12/15/2020] [Accepted: 12/24/2020] [Indexed: 12/11/2022] Open
Abstract
Vulvar cancer (VC) is a rare neoplasm, usually arising in postmenopausal women, although human papilloma virus (HPV)-associated VC usually develop in younger women. Incidences of VCs are rising in many countries. Surgery is the cornerstone of early-stage VC management, whereas therapies for advanced VC are multimodal and not standardized, combining chemotherapy and radiotherapy to avoid exenterative surgery. Randomized controlled trials (RCTs) are scarce due to the rarity of the disease and prognosis has not improved. Hence, new therapies are needed to improve the outcomes of these patients. In recent years, improved knowledge regarding the crosstalk between neoplastic and tumor cells has allowed researchers to develop a novel therapeutic approach exploiting these molecular interactions. Both the innate and adaptive immune systems play a key role in anti-tumor immunesurveillance. Immune checkpoint inhibitors (ICIs) have demonstrated efficacy in multiple tumor types, improving survival rates and disease outcomes. In some gynecologic cancers (e.g., cervical cancer), many studies are showing promising results and a growing interest is emerging about the potential use of ICIs in VC. The aim of this manuscript is to summarize the latest developments in the field of VC immunoncology, to present the role of state-of-the-art ICIs in VC management and to discuss new potential immunotherapeutic approaches.
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Hampson IN, Oliver AW, Hampson L. Potential Effects of Human Papillomavirus Type Substitution, Superinfection Exclusion and Latency on the Efficacy of the Current L1 Prophylactic Vaccines. Viruses 2020; 13:v13010022. [PMID: 33374445 PMCID: PMC7823767 DOI: 10.3390/v13010022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 12/22/2020] [Accepted: 12/22/2020] [Indexed: 12/16/2022] Open
Abstract
There are >200 different types of human papilloma virus (HPV) of which >51 infect genital epithelium, with ~14 of these classed as high-risk being more commonly associated with cervical cancer. During development of the disease, high-risk types have an increased tendency to develop a truncated non-replicative life cycle, whereas low-risk, non-cancer-associated HPV types are either asymptomatic or cause benign lesions completing their full replicative life cycle. HPVs can also be present as non-replicative so-called “latent” infections and they can also show superinfection exclusion, where cells with pre-existing infections with one type cannot be infected with a different HPV type. Thus, the HPV repertoire and replication status present in an individual can form a complex dynamic meta-community which changes with respect to both time and exposure to different HPV types. In light of these considerations, it is not clear how current prophylactic HPV vaccines will affect this system and the potential for iatrogenic outcomes is discussed in light of recent outcome data.
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Goncalves A, Soper B, Nygård M, Nygård JF, Ray P, Widemann D, Sales AP. Improving five-year survival prediction via multitask learning across HPV-related cancers. PLoS One 2020; 15:e0241225. [PMID: 33196642 PMCID: PMC7668590 DOI: 10.1371/journal.pone.0241225] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 10/11/2020] [Indexed: 12/12/2022] Open
Abstract
Oncology is a highly siloed field of research in which sub-disciplinary specialization has limited the amount of information shared between researchers of distinct cancer types. This can be attributed to legitimate differences in the physiology and carcinogenesis of cancers affecting distinct anatomical sites. However, underlying processes that are shared across seemingly disparate cancers probably affect prognosis. The objective of the current study is to investigate whether multitask learning improves 5-year survival cancer patient survival prediction by leveraging information across anatomically distinct HPV related cancers. Data were obtained from the Surveillance, Epidemiology, and End Results (SEER) program database. The study cohort consisted of 29,768 primary cancer cases diagnosed in the United States between 2004 and 2015. Ten different cancer diagnoses were selected, all with a known association with HPV risk. In the analysis, the cancer diagnoses were categorized into three distinct topography groups of varying specificity. The most specific topography grouping consisted of 10 original cancer diagnoses differentiated by the first two digits of the ICD-O-3 topography code. The second topography grouping consisted of cancer diagnoses categorized into six distinct organ groups. Finally, the third topography grouping consisted of just two groups, head-neck cancers and ano-genital cancers. The tasks were to predict 5-year survival for patients within the different topography groups using 14 predictive features which were selected among descriptive variables available in the SEER database. The information from the predictive features was shared between tasks in three different ways, resulting in three distinct predictive models: 1) Information was not shared between patients assigned to different tasks (single task learning); 2) Information was shared between all patients, regardless of task (pooled model); 3) Only relevant information was shared between patients grouped to different tasks (multitask learning). Prediction performance was evaluated with Brier scores. All three models were evaluated against one another on each of the three distinct topography-defined tasks. The results showed that multitask classifiers achieved relative improvement for the majority of the scenarios studied compared to single task learning and pooled baseline methods. In this study, we have demonstrated that sharing information among anatomically distinct cancer types can lead to improved predictive survival models.
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Affiliation(s)
- Andre Goncalves
- Lawrence Livermore National Laboratory, Livermore, CA, United States of America
| | - Braden Soper
- Lawrence Livermore National Laboratory, Livermore, CA, United States of America
| | | | | | - Priyadip Ray
- Lawrence Livermore National Laboratory, Livermore, CA, United States of America
| | - David Widemann
- Lawrence Livermore National Laboratory, Livermore, CA, United States of America
| | - Ana Paula Sales
- Lawrence Livermore National Laboratory, Livermore, CA, United States of America
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Bray F, Laversanne M, Weiderpass E, Arbyn M. Geographic and temporal variations in the incidence of vulvar and vaginal cancers. Int J Cancer 2020; 147:2764-2771. [PMID: 32410226 DOI: 10.1002/ijc.33055] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 03/27/2020] [Accepted: 04/14/2020] [Indexed: 01/03/2023]
Abstract
Vulvar and vaginal cancers are relatively rare cancers, together responsible for less than 1% of the global cancer incidence among women in 2018. The majority of vaginal cancers and a lesser proportion of vulvar cancers are associated with HPV, with rising incidence rates of vulvar cancer observed in younger women, possibly due to an increased prevalence of high-risk HPV types. This report assesses recent international variations in the incidence rates of vulvar and vaginal cancer derived from high-quality data from population-based cancer registries in 68 countries, and further assesses time trends for selected longer-term series in eight countries (Australia, China, Colombia, India, Norway, Slovakia, the U.S., and the U.K.) over the period 1983 to 2012. We observed a 30-fold variation in the recorded incidence rates of vulvar cancer in contrast with the threefold variation for vaginal cancer. We also observed a rising incidence of vulvar cancer in Australia, Norway and the U.K., and Slovakia, with a more rapid rise in the rates seen in women aged < 60 years at diagnosis. The annual percentage change over the most recent decade varied from 1.7% in Norway to 4.1% in Slovakia. The increases are largely confined to younger women and are likely linked to generational changes in sexual behaviour (earlier age at sexual debut and increasing transmission of HPV among cohorts born 1940 to 1950 and thereafter. Vaginal cancer incidence rates, in contrast, were lower and more stable, despite the higher HPV-attributable fraction relative to vulvar cancer. Irrespective of the trends, an increasing number of women are predicted to be diagnosed worldwide with both cancer types in future decades as population ageing and growth continues. The promise of high-coverage HPV vaccination will likely counter this rising burden, but the impact may take a number of decades.
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Affiliation(s)
- Freddie Bray
- Cancer Surveillance Section, International Agency for Research on Cancer, Lyon, France
| | - Mathieu Laversanne
- Cancer Surveillance Section, International Agency for Research on Cancer, Lyon, France
| | - Elisabete Weiderpass
- Office of the Director, International Agency for Research on Cancer, Lyon, France
| | - Marc Arbyn
- Unit of Cancer Epidemiology, Belgian Cancer Centre, Brussels, Belgium
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Time trends in the incidence and survival of vaginal squamous cell carcinoma and high-grade vaginal intraepithelial neoplasia in Denmark - A nationwide population-based study. Gynecol Oncol 2020; 158:734-739. [PMID: 32571683 DOI: 10.1016/j.ygyno.2020.05.683] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 05/31/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To describe trends in incidence of high-grade vaginal intraepithelial neoplasia (VaIN) and vaginal squamous cell carcinoma (SCC) in Denmark. For vaginal SCC, we also examine 5-year relative survival and mortality. METHODS All high-grade VaIN cases diagnosed 1997-2017 and vaginal SCCs during 1978-2017 were identified in two high-quality nationwide registers. Age-standardized incidence rates and average annual percentage change (AAPC) were assessed. For vaginal SCC, 5-year relative survival was calculated, and Cox regression was applied to study the effect of selected characteristics on mortality. RESULTS Altogether, 831 cases of high-grade VaIN and 721 vaginal SCCs were identified. The age-standardized incidence rate of high-grade VaIN showed no clear trend over time. However, when we stratified by age and divided the study period according to HPV vaccine licensure in Denmark (2006), the incidence of high-grade VaIN decreased significantly by 15.6% per year (95% CI: -23.2, -7.3%) after 2007 onwards among the youngest women (<30 years). For vaginal SCC, the incidence decreased from 0.5 (1978-1982) to 0.3 (2013-2017) per 100,000 woman-years. The 5-year relative survival improved over time and was 67.9% (95% CI: 54.9, 84.1%) in the most recent time period. Mortality was significantly associated with calendar year, age, and stage at diagnosis. CONCLUSIONS The overall incidence of high-grade VaIN showed no clear trend over time, but a significant decline was observed in women younger than 30 years after HPV vaccine licensure. The incidence of vaginal SCC was reduced by approximately 50% and survival after vaginal SCC improved over time.
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Lu Y, Li P, Luo G, Liu D, Zou H. Cancer attributable to human papillomavirus infection in China: Burden and trends. Cancer 2020; 126:3719-3732. [PMID: 32484937 DOI: 10.1002/cncr.32986] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 04/07/2020] [Accepted: 04/28/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Human papillomavirus (HPV) is associated with a substantial percentage of cervical cancer, and a significant percentage of anal, penile, vaginal, vulvar, oral cavity, oropharyngeal, and laryngeal cancers. Understanding the burden and trends of HPV-attributable cancers is crucial to HPV prevention strategies. In the current study, the authors estimated the latest burden and trends of HPV-attributable cancers in China. METHODS Data from the following sources were used. The number of new cancer cases and cancer deaths in China were estimated based on the China Cancer Registry Annual Report. The population-attributable fraction was estimated using pooled high-risk HPV prevalence and biomarker-positive rates, which were calculated using random effects meta-analyses. Cancer burden estimates were stratified by anatomic site, sex, and age. RESULTS In 2015, a total of 110,650 new cancer cases and 36,714 cancer deaths attributable to HPV infection were estimated to have occurred in China, of which cervical cancer accounted for 85.6% and 78.1%, respectively. The age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) of HPV-attributable cancers were 5.63 and 1.81 per 100,000 person-years, respectively. The ASIR and ASMR both varied by anatomic site, with the highest rates noted for cervical cancer at 4.83 and 1.42 per 100,000 person-years, respectively. Between 2005 and 2015, the ASIR and ASMR demonstrated significant upward trends for all HPV-attributable cancers combined. CONCLUSIONS Between 2005 and 2015, cervical cancer accounted for the vast majority of HPV-attributable cancers and its incidence and mortality increased rapidly in China. The comprehensive prevention of cervical cancer remains the most important target in the prevention of HPV-attributable cancers.
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Affiliation(s)
- Yong Lu
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Peiyang Li
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Ganfeng Luo
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Di Liu
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Huachun Zou
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China.,Kirby Institute, The University of New South Wales, Sydney, New South Wales, Australia
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Rasmussen CL, Thomsen LT, Aalborg GL, Kjaer SK. Incidence of vulvar high-grade precancerous lesions and cancer in Denmark before and after introduction of HPV vaccination. Gynecol Oncol 2020; 157:664-670. [PMID: 32276790 DOI: 10.1016/j.ygyno.2020.03.030] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 03/29/2020] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To assess the incidence of vulvar high-grade precancerous lesions and cancer in Denmark during 1997-2018. METHODS We identified incident vulvar cancer cases in the Danish Cancer Registry and incident cases of vulvar precancerous lesions in the Danish Pathology Register. We calculated age-standardized incidence rates of vulvar squamous cell carcinoma (VSCC), non-SCC and precancerous lesions, and age-specific incidence rates of VSCC and precancerous lesions. Incidence trends were evaluated using linear Poisson regression to estimate the average annual percentage change (AAPC). For vulvar precancerous lesions, trends were evaluated in the period before (1997-2007) and after (2008-2018) implementation of HPV vaccination. RESULTS In the 22-year study period, the age-standardized incidence rate of VSCC increased from 1.23 (1997-1998) to 1.98 per 100,000 (2017-2018), corresponding to an average yearly increase of 2.95% (95%CI: 2.15-3.75). The incidence of non-SCC increased only slightly. Overall, the incidence of vulvar precancerous lesions increased (AAPC = 2.38%; 95%CI: 1.75-3.02). After implementation of HPV vaccination, the incidence of vulvar precancerous lesions decreased significantly in women aged <20 (AAPC = -22.10% (95%CI: -35.27 to -6.26)) and 20-29 years (AAPC = -6.57, 95% CI: -10.63 to -2.33), whereas the incidence increased in the majority of age groups ≥50 years. CONCLUSIONS Overall, the incidence of VSCC and vulvar precancerous lesions increased during 1997-2018. However, after introduction of HPV vaccination, the incidence of vulvar precancerous lesions decreased among women aged <20 and 20-29 years, pointing towards a possible effect of HPV vaccination in this group. This development should be followed in the future.
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Affiliation(s)
| | - Louise T Thomsen
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Gitte Lerche Aalborg
- Unit of Statistics and Pharmaco-Epidemiology, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Susanne K Kjaer
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
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Layman H, Rickert KW, Wilson S, Aksyuk AA, Dunty JM, Natrakul D, Swaminathan N, DelNagro CJ. Development and validation of a multiplex immunoassay for the simultaneous quantification of type-specific IgG antibodies to E6/E7 oncoproteins of HPV16 and HPV18. PLoS One 2020; 15:e0229672. [PMID: 32214362 PMCID: PMC7098588 DOI: 10.1371/journal.pone.0229672] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Accepted: 02/11/2020] [Indexed: 01/24/2023] Open
Abstract
More than 170 types of human papilloma viruses (HPV) exist with many causing proliferative diseases linked to malignancy in indications such as cervical cancer and head and neck squamous cell carcinoma. Characterization of antibody levels toward HPV serology is challenging due to complex biology of oncoproteins, pre-existing titers to multiple HPV types, cross-reactivity, and low affinity, polyclonal responses. Using multiplex technology from MSD, we have developed an assay that simultaneously characterizes antibodies against E6 and E7 oncoproteins of HPV16 and 18, the primary drivers of HPV-associated oncogenesis. We fusion tagged our E6 and E7 proteins with MBP via two-step purification, spot-printed an optimized concentration of protein into wells of MSD 96-well plates, and assayed various cynomolgus monkey, human and HPV+ cervical cancer patient serum to validate the assay. The dynamic range of the assay covered 4-orders of magnitude and antibodies were detected in serum at a dilution up to 100,000-fold. The assay was very precise (n = 5 assay runs) with median CV of human serum samples ~ 5.3% and inter-run variability of 11.4%. The multiplex serology method has strong cross-reactivity between E6 oncoproteins from human serum samples as HPV18 E6 antigens neutralized 5 of 6 serum samples as strongly as HPV16 E6. Moderate concordance (Spearman’s Rank = 0.775) was found between antibody responses against HPV16 E7 in the multiplex assay compared to standard ELISA serology methods. These results demonstrate the development of a high-throughput, multi-plex assay that requires lower sample quantity input with greater dynamic range to detect type-specific anti-HPV concentrations to E6 and E7 oncoproteins of HPV16 and 18.
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Affiliation(s)
- Hans Layman
- AstraZeneca plc, South San Francisco, California, United States of America
- * E-mail:
| | - Keith W. Rickert
- AstraZeneca plc, Gaithersburg, Maryland, United States of America
| | - Susan Wilson
- AstraZeneca plc, Gaithersburg, Maryland, United States of America
| | | | - Jill M. Dunty
- Meso Scale Diagnostics, LLC., Rockville, Maryland, United States of America
| | - Dusit Natrakul
- Meso Scale Diagnostics, LLC., Rockville, Maryland, United States of America
| | - Nithya Swaminathan
- AstraZeneca plc, South San Francisco, California, United States of America
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Orumaa M, Kjaer SK, Dehlendorff C, Munk C, Olsen AO, Hansen BT, Campbell S, Nygård M. The impact of HPV multi-cohort vaccination: Real-world evidence of faster control of HPV-related morbidity. Vaccine 2020; 38:1345-1351. [PMID: 31917039 DOI: 10.1016/j.vaccine.2019.12.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 12/08/2019] [Accepted: 12/10/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND In 2009, both Norway and Denmark initiated routine quadrivalent human papillomavirus vaccination (qHPV) for 12-year-old girls; however, Denmark also introduced free-of-charge multi-cohort vaccination for older age groups in 2008. We aim to describe trends in genital warts (GWs) incidence rates (IRs) among men and women and qHPV vaccine coverage among women in Norway and Denmark in 2006-2015. METHODS We linked multiple national health registries in Norway and Denmark via national personal identifiers to access data on GWs incidence and qHPV vaccination among women and men aged 12-35 years residing in Norway and Denmark in 2006-2015. We calculated age-specific and age-standardized GWs IRs, GWs IR trends before (2006-2009) and after (2009-2015) the implementation of qHPV vaccination, and qHPV vaccine coverage among women. RESULTS In Norway and Denmark together, there were more than 200,000 cases of incident GWs and over 710,000 girls got at least one dose of qHPV vaccine during the study period. The total qHPV coverage in Norway and Denmark in 2015 was among women aged 12-35 years 24% and 70%, respectively. GWs IRs in Norway and Denmark decreased annually in 2009-2015 among women by 4.8% (95% confidence interval: 4.3 to 5.3) and 18.0% (95%CI: 17.5 to 18.6), respectively, and among men 1.9% (95%CI: 1.4 to 2.4) and 10.7% (95%CI: 10.3 to 11.2), respectively. In Denmark, GWs IRs decreased rapidly among both sexes and all age groups after qHPV vaccination, while Norway showed only a modest decrease. CONCLUSION Rapid decline in HPV-related morbidity is feasible with high coverage of multi-cohort vaccination. However, the decision to vaccinate a single cohort of 12-years-old girls only will postpone HPV-related disease control by at least a decade. Thus countries planning HPV vaccination programs should also initiate multi-cohort vaccination for faster disease control.
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Affiliation(s)
- Madleen Orumaa
- HPV-related Epidemiological Research Unit, Department of Research, Cancer Registry of Norway, Oslo University Hospital, P.O. Box 5313 Majorstuen, N-0304 Oslo, Norway
| | - Susanne K Kjaer
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen, Denmark
| | - Christian Dehlendorff
- Unit of Statistics and Pharmacoepidemiology, Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen, Denmark
| | - Christian Munk
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen, Denmark
| | - Anne Olaug Olsen
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Forskningsveien 3A, 0373 Oslo, Norway
| | - Bo T Hansen
- HPV-related Epidemiological Research Unit, Department of Research, Cancer Registry of Norway, Oslo University Hospital, P.O. Box 5313 Majorstuen, N-0304 Oslo, Norway
| | - Suzanne Campbell
- HPV-related Epidemiological Research Unit, Department of Research, Cancer Registry of Norway, Oslo University Hospital, P.O. Box 5313 Majorstuen, N-0304 Oslo, Norway
| | - Mari Nygård
- HPV-related Epidemiological Research Unit, Department of Research, Cancer Registry of Norway, Oslo University Hospital, P.O. Box 5313 Majorstuen, N-0304 Oslo, Norway.
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Nandwani M, Barmon D, Begum D, Liegise H, Kataki AC. An Overview of Vulvar Cancer: A Single-Center Study from Northeast India. J Obstet Gynaecol India 2019; 69:541-545. [PMID: 31844370 DOI: 10.1007/s13224-019-01261-z] [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: 01/31/2019] [Accepted: 08/05/2019] [Indexed: 12/31/2022] Open
Abstract
Study Carcinoma vulva is a rare cancer of the female genital tract. It mostly presents in postmenopausal women. The treatment of vulvar cancer is surgery, chemoradiation, radiotherapy or a combination of all modalities. Here, we present a study of 33 cases of carcinoma vulva over a period of 2 years at a Northeast India regional cancer institute describing its demographic features and treatment outcomes. Methodology A retrospective cohort study of vulvar cancer diagnosed at Northeast India regional cancer institute from January 2017 to December 2018. Results A total of 33 cases of biopsy proven carcinoma (Ca) vulva were studied. Maximum number of cases belonged to the age group: 60-69 years (39.4%). 66.67% cases had palpable inguinal lymph nodes at presentation, and 100% had squamous cell carcinoma on histopathology. Maximum number of cases belonged to stage III (44.8%), and least number of cases belonged to stage IV (10.3%) of FIGO 2009 staging of Ca vulva. 87.9% cases underwent treatment, and 12.1% were lost to follow-up. Out of the cases who underwent treatment, 55.2% cases were taken up for primary surgery and 44.8% cases for primary radiotherapy. 75% cases who underwent surgery received adjuvant radiotherapy. No complication was seen in patients post-radiation. But, 6.25% patients post-surgery developed lymphocyst and 18.75% patients developed wound necrosis (p > 0.05). Conclusion Vulvar cancer is not a common malignancy of the female genital tract that presents in sixth and seventh decades of life and often with palpable inguinal lymph nodes. Though early stages of Ca vulva are treated by surgery, the incidence of immediate postoperative complications in our study was more as compared to post-radiotherapy. Also, maximum patients in the present study post-surgery received adjuvant radiotherapy. Thus, radiotherapy can be considered as the primary treatment modality for patients with early as well as advanced vulvar carcinoma.
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Affiliation(s)
| | - D Barmon
- Dr. B Borooah Cancer Institute, Guwahati, Assam India
| | - Dimpy Begum
- Dr. B Borooah Cancer Institute, Guwahati, Assam India
| | | | - A C Kataki
- Dr. B Borooah Cancer Institute, Guwahati, Assam India
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Eich ML, Del Carmen Rodriguez Pena M, Schwartz L, Granada CP, Rais-Bahrami S, Giannico G, Amador BM, Matoso A, Gordetsky JB. Morphology, p16, HPV, and outcomes in squamous cell carcinoma of the penis: a multi-institutional study. Hum Pathol 2019; 96:79-86. [PMID: 31698006 DOI: 10.1016/j.humpath.2019.09.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 09/12/2019] [Indexed: 12/11/2022]
Abstract
Our objective was to evaluate the pathologic features and clinical outcomes in cases of invasive penile squamous cell carcinoma (SCC) and the association with p16 immunohistochemistry (IHC) and human papilloma virus (HPV) in situ hybridization (ISH). A retrospective multi-institutional database search was conducted for invasive SCC of the penis diagnosed between 2007 and 2018 that had undergone surgical resection. Pathologic features, p16 IHC, and HPV ISH were investigated with clinical outcomes. A total of 102 patients were included in the study. The average age was 63 ± 13.3 years. Based on histology, 46% of tumors displayed an HPV-related subtype, whereas p16 was positive in 52% of all cases. Tumor histology correlated well with p16 positivity (P < .001), and p16 IHC accurately predicted the presence of HPV in 25/26 (96%) cases. On multivariate analysis, perineural invasion was associated with local disease recurrence (P = .02), whereas lymphovascular invasion was associated with progression to metastatic disease (P = .002) and increased overall mortality (P = .02). Urethral involvement was also associated with increased overall mortality (P = .02). In addition, HPV-related tumors based on histologic features correlated with lower rates of metastatic disease (P = .007). HPV is a common cause of penile SCC and can be diagnosed by tumor histology and confirmed by overexpression of p16 on IHC. The presence of lymphovascular invasion, perineural invasion, and urethral involvement are poor prognostic indicators, whereas HPV-related tumors based on histology may have lower risk for metastatic disease.
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Affiliation(s)
- Marie-Lisa Eich
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, 35294 USA
| | | | - Lauren Schwartz
- Department of Pathology, University of Pennsylvania, Philadelphia, PA, 19104 USA
| | - Carlos Prieto Granada
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, 35294 USA
| | - Soroush Rais-Bahrami
- Department of Urology, University of Alabama at Birmingham, Birmingham, AL, 35294 USA; Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, 35294 USA; O'Neal Comprehensive Cancer Center at UAB, University of Alabama at Birmingham, Birmingham, AL, 35294 USA
| | - Giovanna Giannico
- Department of Pathology, Vanderbilt University, Nashville, TN, 37212 USA
| | | | - Andres Matoso
- Department of Pathology, Johns Hopkins University, Baltimore, MD, 21287 USA
| | - Jennifer B Gordetsky
- Department of Pathology, Vanderbilt University, Nashville, TN, 37212 USA; Department of Urology, Vanderbilt University, Nashville, TN, 37212 USA.
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Hansen BT, Kjaer SK, Arnheim-Dahlström L, Liaw KL, Juul KE, Thomsen LT, Frederiksen K, Elfström KM, Munk C, Nygård M. Age at first intercourse, number of partners and sexually transmitted infection prevalence among Danish, Norwegian and Swedish women: estimates and trends from nationally representative cross-sectional surveys of more than 100 000 women. Acta Obstet Gynecol Scand 2019; 99:175-185. [PMID: 31529491 DOI: 10.1111/aogs.13732] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 08/23/2019] [Accepted: 09/07/2019] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Sexual behavior at the population level impacts on public health. Recent representative sexual behavior data are lacking. MATERIAL AND METHODS Cross-sectional surveys in 2005 and 2012 on women age 18-45 years randomly selected from the general population in Denmark (n = 40 804), Norway (n = 30 331) and Sweden (n = 32 114). RESULTS Median (interquartile range) age at first intercourse was 16 (15-18) years in Denmark, 17 (16-18) years in Norway, and 17 (15-18) years in Sweden. Women in the most recent birth cohort had sexual debut at the lowest age, and were most likely to have sexual debut before the legal age of consent. Proportions with debut age ≤14 years among women born 1989-1994 vs 1971-1976, odds ratio (95% confidence interval) were: 18.4% vs 10.9%, 1.95 (1.74-2.18) in Denmark, 12.9% vs 6.3%, 2.38 (2.01-2.82) in Norway, 17.8% vs 11.4%, 1.75 (1.55-1.98) in Sweden. Median (interquartile range) number of lifetime sexual partners was 6 (3-10) in Denmark, 5 (2-10) in Norway, and 6 (3-11) in Sweden. The proportion of women reporting >10 sexual partners was also highest in the most recent survey. The percentage with odds ratio (95% confidence interval) in 2012 vs 2005 surveys were: 24.9% vs 22.8%, 1.13 (1.07-1.18) for Denmark; 23.8% vs 19.8%, 1.27 (1.19-1.34) for Norway; and 28.3% vs 23.8%, 1.31 (1.24-1.38) for Sweden. Similarly, the proportion of women reporting ever having had a sexually transmitted infection among women age <30 years were: 29.4% vs 26.4%, 1.21 (1.13-1.31) in Denmark, 28.9% vs 25.0%, 1.20 (1.10-1.31) in Norway, and 29.4% vs 22.2%, 1.45 (1.33-1.58) in Sweden. CONCLUSIONS Scandinavian women reported lower age at first intercourse in younger birth cohorts. Moreover, they reported more lifetime sexual partners and a higher prevalence of ever having a sexually transmitted infection in 2012 than in 2005. Our findings may inform the interpretation of trends in outcomes associated with sexual health, and public health policies.
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Affiliation(s)
- Bo T Hansen
- Department of Research, Cancer Registry of Norway, Oslo, Norway
| | - Susanne K Kjaer
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark.,Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Lisen Arnheim-Dahlström
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Kai-Li Liaw
- Epidemiology, Merck Sharp & Dome Corporation, Whitehouse Station, NJ, USA
| | - Kirsten E Juul
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Louise T Thomsen
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Kirsten Frederiksen
- Unit of Statistics and Pharmacoepidemiology, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - K Miriam Elfström
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Christian Munk
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Mari Nygård
- Department of Research, Cancer Registry of Norway, Oslo, Norway
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Jiang HY, Shi YD, Zhang X, Pan LY, Xie YR, Jiang CM, Deng M, Ruan B. Human papillomavirus vaccination and the risk of autoimmune disorders: A systematic review and meta-analysis. Vaccine 2019; 37:3031-3039. [PMID: 31036452 DOI: 10.1016/j.vaccine.2019.04.049] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 04/12/2019] [Accepted: 04/12/2019] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Human papillomavirus (HPV) vaccination has been proven to effectively protect against HPV infection and infection-associated cancer. However, there are concerns about the relationship between HPV vaccination and the risk of autoimmune disorders (ADs). Therefore, we performed a systematic review and meta-analysis to comprehensively evaluate the relationship between HPV vaccination and ADs risk. METHODS To identify relevant studies, we conducted a systematic search in EMBASE and PubMed databases of scientific articles published through June 2018. Fixed or random effects models were adopted to estimate overall relative risk. RESULTS In total, 20 studies (12 cohort studies, 6 case-control studies, and 2 randomized controlled trials) involving more than 169,000 AD events were included in our meta-analysis. Our results show that HPV vaccination was not associated with an increased risk of subsequent ADs (odds ratio [OR] = 1.003, 95% confidence interval (CI): 0.95-1.06), particularly among those with a prior ADs (OR = 0.82, 95% CI: 0.7-0.96). Most of the subgroup analysis results based on the location or type of ADs were consistent with the overall results. CONCLUSION No evidence of an association between HPV vaccination and ADs was found. Given the low number of estimates for individual AD, additional and larger observational studies are needed to verify our findings.
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Affiliation(s)
- Hai-Yin Jiang
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China
| | - Yu-Dan Shi
- Department of Chinese Internal Medicine, Taizhou First People's Hospital, Taizhou, Zhejiang 318020, China
| | - Xue Zhang
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China
| | - Li-Ya Pan
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China
| | - Yi-Rui Xie
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China
| | - Chun-Ming Jiang
- Department of Pediatrics, the Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, China
| | - Min Deng
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China
| | - Bing Ruan
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China.
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Orumaa M, Leinonen MK, Campbell S, Møller B, Myklebust TÅ, Nygård M. Recent increase in incidence of cervical precancerous lesions in Norway: Nationwide study from 1992 to 2016. Int J Cancer 2019; 145:2629-2638. [PMID: 30734284 PMCID: PMC6767573 DOI: 10.1002/ijc.32195] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 01/09/2019] [Accepted: 01/23/2019] [Indexed: 12/22/2022]
Abstract
We analysed patterns in the incidence of cervical intraepithelial neoplasia grades 2 and 3 (CIN2, CIN3) and adenocarcinoma in situ (AIS) by age and histology in 1992–2016 in Norway and described changes in screening tests. Incident cases of CIN2, CIN3, AIS and cervical cancer were identified in the Cancer Registry of Norway, as were all women with at least one screening test. The annual percentage change statistic was used to assess point estimates and changes in age‐specific and age‐standardised incidence rates (IR). Women aged 25–29 years had the highest incidence of cervical precancerous lesions (CIN2: 192.9/10, CIN3: 737.2/10, AIS: 32.5/105 in 2016). The IR of CIN2 increased for all screening ages (25–69 years) from 3.6% to 6.7% per year. CIN3 incidence increased by 1.6% (95% confidence interval [CI] 0.6–2.6) annually. A steep increase in AIS incidence was observed in all age groups (7.1% per year, 95% CI 5.3–8.8). Changes in screening tests and the histological verification of cervical precancerous lesions alone cannot explain the steady increase in incidence we observed over the 25‐year study period, and increased exposure to human papillomavirus (HPV) likely plays a role. Age‐appropriate treatment of screening‐detected cervical precancerous lesions is needed for effective cervical cancer control while avoiding overtreatment and related health risks. In order to perform an appropriate harm‐benefit evaluation of cervical cancer control efforts, detailed information on screening technology and background risks, including HPV vaccination status, is needed to create optimal public health policy. What's new? In Norway, cervical cancer screening coverage has held steady around 65–68%, while incidence of cervical precancerous lesions has increased. Here, the authors analysed changes in incidence of cervical intraepithelial neoplasias grades 2 and 3 (CIN2 and 3) and adenocarcinoma in situ (AIS). They observed period effects of the same magnitude for all three, indicating that changes in the screening test accounts for part of the increase. Another likely cause, they report, is increased exposure to HPV. Public health policy, they conclude, should consider detailed information on screening technology and background risks, including HPV vaccination status.
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Affiliation(s)
- Madleen Orumaa
- Department of Research, Cancer Registry of Norway, Oslo, Norway
| | | | | | - Bjørn Møller
- Department of Registration, Cancer Registry of Norway, Oslo, Norway
| | - Tor Åge Myklebust
- Department of Registration, Cancer Registry of Norway, Oslo, Norway.,Department of Research and Innovation, Møre and Romsdal Hospital Trust, Ålesund, Norway
| | - Mari Nygård
- Department of Research, Cancer Registry of Norway, Oslo, Norway
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Rising Incidence and Improved Survival of Anal Squamous Cell Carcinoma in Norway, 1987-2016. Clin Colorectal Cancer 2019; 18:e96-e103. [DOI: 10.1016/j.clcc.2018.10.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 10/08/2018] [Accepted: 10/09/2018] [Indexed: 01/29/2023]
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Abstract
Diagnosis of a primary vaginal cancer is rare because most of these lesions will be metastatic from another primary site. Although cancer of the vagina is more common in postmenopausal women, an increase in young women being diagnosed with primary vaginal cancer has been reported, especially in countries with a high HIV prevalence. This will be associated with persistence of high-risk HPV infection. The emphasis should be on primary prevention with prophylactic HPV vaccination. Once there is a suspicion of a primary vaginal cancer, this should be confirmed histologically with biopsy. Staging has been done clinically, similar to cervical cancer; however, there is a role for imaging in assisting with staging as this is often a difficult assessment. Treatment should be individualized and depends on stage as well as histologic subtype. It is prudent to refer cases to centers of excellence with experience in dealing with this rare gynecological cancer.
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Affiliation(s)
- Tracey S Adams
- Department of Gynecological Oncology, Groote Schuur Hospital/University of Cape Town, Cape Town, South Africa.,South African Medical Research Council/University of Cape Town Gynaecological Cancer Research Centre (SA MRC/UCT GCRC), Cape Town, South Africa
| | - Mauricio A Cuello
- Division of Obstetrics and Gynecology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
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Abstract
Vulvar cancer is an uncommon gynecological malignancy primarily affecting postmenopausal women. There is no specific screening and the most effective strategy to reduce vulvar cancer incidence is the opportune treatment of predisposing and preneoplastic lesions associated with its development. While vulvar cancer may be asymptomatic, most women present with vulvar pruritus or pain, or have noticed a lump or ulcer. Therefore, any suspicious vulvar lesion should be biopsied to exclude invasion. Once established, the most common subtype is squamous cell carcinoma. Treatment of vulvar cancer depends primarily on histology and surgical staging. Treatment is predominantly surgical, particularly for squamous cell carcinoma, although concurrent chemoradiation is an effective alternative, particularly for advanced tumors. Management should be individualized, and carried out by a multidisciplinary team in a cancer center experienced in the treatment of these tumors.
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Affiliation(s)
- Linda J Rogers
- Division of Gynecological Oncology, Groote Schuur Hospital/University of Cape Town, Cape Town, South Africa.,South African Medical Research Council/University of Cape Town Gynaecological Cancer Research Centre (SA MRC/UCT GCRC), Cape Town, South Africa
| | - Mauricio A Cuello
- Division of Obstetrics and Gynecology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
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Kaneko N. Factors associated with cervical cancer screening among young unmarried Japanese women: results from an internet-based survey. BMC Womens Health 2018; 18:132. [PMID: 30064505 PMCID: PMC6069882 DOI: 10.1186/s12905-018-0623-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 07/20/2018] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND The prevalence of cervical cancer among women aged 20-30 years has been increasing. A better understanding of the factors correlated with cervical cancer screening is vital to better identify suitable candidates and develop effective interventions. However, few studies have examined factors correlated with cervical cancer screening using a quantitative research design. Thus, this study aimed to assess the prevalence of and factors correlated with cervical cancer screening among unmarried and sexually active Japanese women aged 20-29 years. METHODS Seven hundred Japanese women who responded to an internet-based cross-sectional survey conducted by a marketing research company in 2015 were enrolled. Associations between lifetime cervical cancer screening and demographic profile, sexual behavior, and psychosocial factors were assessed via univariate analysis. Variables indicating significance (P < 0.05) were used in the univariate analysis to determine adjusted odds ratios (AOR). RESULTS Overall, 383 (54.7%) respondents underwent cervical cancer screening during their lifetime. Multiple regression analysis indicated that age, employment status, income, lifetime number of sex partners, human papillomavirus (HPV) vaccination, receipt of a free coupon for cervical cancer screening from the local government, perceived susceptibility and logistical barriers (cost/time), and confidence of receiving Pap testing from a male physician were significantly correlated with lifetime cervical cancer screening. Individuals aged 28-29 years (AOR = 1.86) and those with full-time employment (AOR = 3.30), income ≥ ¥ 4,000,000($35,000) (AOR = 1.60), > 5 lifetime sex partners (AOR = 1.97), HPV vaccination (AOR = 4.88), coupon from the local government (AOR = 3.14), higher perceived level of cervical cancer susceptibility (middle, AOR = 1.77; high, AOR = 3.23), lower perceived logistical barriers (middle, AOR = 0.55; high, AOR = 0.31), and higher confidence of receiving pap testing from a male physician (AOR = 2.66) were more likely to undergo cervical cancer screening. CONCLUSIONS Women who were younger and unemployed and those with lower perceived cervical cancer susceptibility, higher perceived logistical barriers, and lower confidence of receiving Pap testing from a male physician were less likely to undergo lifetime cervical cancer screening. Thus, to increase the cervical cancer screening rate among young women, it may be effective to target younger unemployed women, provide interventions to increase perceived susceptibility, and recommend tests while considering psychosocial barriers.
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Affiliation(s)
- Noriyo Kaneko
- Department of Global and Community Health, School of Nursing, Kawasumi 1, Aza, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, Japan.
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