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Namutundu J, Kiguli J, Nakku-Joloba E, Makumbi F, Semitala FC, Wanyenze RK, Laker-Oketta M, Nakanjako D, Nakalembe M. Barriers and facilitators of cervical cancer screening literacy among rural women with HIV attending rural public health facilities in East Central Uganda: a qualitative study using the integrated model of health literacy. BMC Womens Health 2024; 24:498. [PMID: 39252051 PMCID: PMC11382383 DOI: 10.1186/s12905-024-03340-4] [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: 02/20/2024] [Accepted: 08/27/2024] [Indexed: 09/11/2024] Open
Abstract
BACKGROUND Several rural public health facilities in East Central Uganda have sub-optimal, below 50%, levels of uptake of cervical cancer screening services among women with HIV. This is attributed to low cervical cancer screening literacy: limited ability to access, understand, appraise, and apply cervical cancer screening information. This research identified multi-level (health facility, community, interpersonal and individual) barriers, and facilitators of accessing, understanding, and applying cervical cancer screening information among rural women with HIV attending rural public health facilities in East Central Uganda to inform interventions. METHODS We conducted ten Focus Group Discussions with rural women aged 25-49 years with HIV attending four selected rural public health facilities: thirty women who had ever screened for cervical cancer and thirty women who had never screened for cervical cancer across different age categories. Data was collected using a guide based on the Integrated model of health literacy. Thematic analysis was used for analysis. Competences (accessing, understanding and applying cervical cancer screening information) and categories of factors (health system, community, interpersonal and individual factors) of the integrated model of health literacy were deductively derived whereas barriers and facilitators were deductively derived from women's statements. RESULTS Lack of communication materials and inability to access information were health facility and individual barriers of accessing cervical cancer screening information respectively. Facilitators of accessing information were access to information at health facility, community, and interpersonal levels and women's ability to access information. Barriers and facilitators of understanding cervical cancer information were related to communication materials, provision of health education and women's concentration during health education. Barriers and facilitators of applying cervical cancer screening information were related to communication and provision of cervical cancer screening services at health facility level, and interpersonal level from peers, partners and other family members as well as women's ability to: understand information and access to cervical cancer screening services at individual level. CONCLUSIONS This study emphasizes the influence of multi-level factors on cervical cancer screening literacy among rural women with HIV attending rural public health facilities in East Central Uganda. Improving uptake of cervical cancer screening services among these women requires multi-level interventions.
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Affiliation(s)
- Juliana Namutundu
- Department of Epidemiology and Biostatistics, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda.
| | - Juliet Kiguli
- Department of Community Health and Behavioral Sciences, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Edith Nakku-Joloba
- Department of Epidemiology and Biostatistics, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Fredrick Makumbi
- Department of Epidemiology and Biostatistics, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Fred C Semitala
- Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
- Makerere University Joint AIDS Program (MJAP), Kampala, Uganda
| | - Rhoda K Wanyenze
- Department of Department of Disease Control and Environmental Health, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Miriam Laker-Oketta
- Infectious Diseases Institute, College of Health Sciences, Makerere University,, Kampala, Uganda
| | - Damalie Nakanjako
- Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
- Infectious Diseases Institute, College of Health Sciences, Makerere University,, Kampala, Uganda
| | - Miriam Nakalembe
- Department of Obstetrics and Gynecology, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
- Infectious Diseases Institute, College of Health Sciences, Makerere University,, Kampala, Uganda
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Hoang TN, Berenson AB, Shan Y, Guo F, Adekanmbi V, Hsu C, Yu X, Kuo Y. Trends in HPV-associated cancer incidence in Texas medically underserved regions. Cancer Med 2024; 13:e70133. [PMID: 39190562 PMCID: PMC11348903 DOI: 10.1002/cam4.70133] [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: 02/28/2024] [Revised: 07/24/2024] [Accepted: 08/09/2024] [Indexed: 08/29/2024] Open
Abstract
BACKGROUND While cervical cancer incidence rates (IR) in the United States have dropped in the last 20 years, non-cervical human papillomavirus (HPV) associated cancers increased. Many people in Texas (TX) live in medically underserved areas and have higher risk of developing HPV-associated cancers. Since previous studies of these regions focused on cervical cancer, we included other HPV-associated cancers in our analysis of IR in East TX and the TX-Mexico Border compared to other TX regions. METHODS Cancer data from 2006 to 2019 were obtained from the TX Cancer Registry. Cases of HPV-associated cervical, vaginal, vulvar, penile, anal, and oropharyngeal cancers and corresponding patient-level demographic data were included. We calculated IR per 100,000 and drew heat maps to visualize cancer IR by county. To control potential confounders, we added county-level risk factors: rates for smoking, excessive drinking, obesity, STIs, primary care provider availability and dentist availability, from the County Health Rankings and Roadmaps program. We reported IRs by region and time and estimated unadjusted and adjusted risk ratio (RR) for association of each type of cancer and region. Lastly, we created adjusted models for each cancer by period to see time trends of regional differences. RESULTS Risk of anal, cervical, and oropharyngeal cancer was lower at parts of the Border than in the rest of TX in the adjusted model. We also observed increasing anal and oropharyngeal cancer risk and decreasing cervical and vaginal cancer risk over time. CONCLUSION Patient sociodemographics, behavioral risk factors, and access to care may contribute to some observed differences in cancer IR across regions. This indicates that targeted prevention efforts towards these regions, especially in low socioeconomic status communities, may benefit future generations.
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Affiliation(s)
- Thao N. Hoang
- Institute for Translational SciencesUniversity of Texas Medical BranchGalvestonTexasUSA
| | - Abbey B. Berenson
- Center for Interdisciplinary Research in Women's HealthUniversity of Texas Medical BranchGalvestonTexasUSA
- Department of Obstetrics and GynecologyThe University of Texas Medical Branch at GalvestonGalvestonTexasUSA
| | - Yong Shan
- Department of Biostatistics and Data ScienceUniversity of Texas Medical BranchGalvestonTexasUSA
| | - Fangjian Guo
- Center for Interdisciplinary Research in Women's HealthUniversity of Texas Medical BranchGalvestonTexasUSA
- Department of Obstetrics and GynecologyThe University of Texas Medical Branch at GalvestonGalvestonTexasUSA
| | - Victor Adekanmbi
- Center for Interdisciplinary Research in Women's HealthUniversity of Texas Medical BranchGalvestonTexasUSA
- Department of Obstetrics and GynecologyThe University of Texas Medical Branch at GalvestonGalvestonTexasUSA
| | - Christine Hsu
- Center for Interdisciplinary Research in Women's HealthUniversity of Texas Medical BranchGalvestonTexasUSA
- Department of Obstetrics and GynecologyThe University of Texas Medical Branch at GalvestonGalvestonTexasUSA
| | - Xiaoying Yu
- Department of Biostatistics and Data ScienceUniversity of Texas Medical BranchGalvestonTexasUSA
| | - Yong‐Fang Kuo
- Department of Biostatistics and Data ScienceUniversity of Texas Medical BranchGalvestonTexasUSA
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Reich O, Regauer S, Gutierrez AL, Kashofer K. Copy Number Profiling Implicates Thin High-Grade Squamous Intraepithelial Lesions as a True Precursor of Cervical Human Papillomavirus-Induced Squamous Cell Cancer. J Transl Med 2024; 104:102108. [PMID: 38977078 DOI: 10.1016/j.labinv.2024.102108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 06/11/2024] [Accepted: 06/25/2024] [Indexed: 07/10/2024] Open
Abstract
Full-thickness high-grade squamous intraepithelial lesions (HSIL) are precursors of invasive cervical squamous cell carcinoma (SCC). The World Health Organization and Lower Anogenital Squamous Terminology Standardization Project for human papilloma virus (HPV)-associated lesions divide full-thickness HSIL of the cervix into thin HSIL with thickness of 1 to 9 cell layers and the typical full-thickness HSIL of >10 cell layers. Although HPV oncogene transcripts and p16ink4a overexpression, as markers of transforming HPV infection, are detectable in thin HSIL, the biological significance of thin HSIL in cervical carcinogenesis remains poorly understood. To further characterize thin HSIL, we performed a comparative study of chromosomal copy number variations (CNV), an analysis of dysregulated genes present in the segments with CNV, and a generalized genetic complexity calculation for 31 thin HSIL, 31 thick HSIL, 24 microinvasive SCC (pT1a SCC), and 22 highly invasive SCC samples. Thin HSIL share various CNV and specific dysregulated gene pathways with thick HSIL and invasive SCC. Thin HSIL exhibited an average CNV of 11.6% compared with 14.1% for thick HSIL, 15.5% for pT1a SCC, and 26.6% for highly invasive SCC. The CNV included gains at 1q and 3q (40% and 43%, respectively), partial loss of 3p, and loss of chromosomes 11 (18%), 16 (50%), 20 (35%), and 22 (40%). Pathways affected solely in thin HSIL were those enhancing immune evasion and primarily involved the (interleukin) IL6, IL21, and IL23 genes. ILs are transiently upregulated in response to infection and play a crucial role in mounting antitumor T-cell activity. Deregulation reflects an attempt by the HPV to evade the initial immune response of the host. The primary pathways shared by thick HSIL and invasive SCC were interactions between lymphoid and nonlymphoid cells, NOTCH2 signaling, tight junction interactions (primarily of the claudin family), and FGR2 alternative splicing. Our results show that thin HSIL carry similar genetic changes as thick HSIL and SCC, indicating that thin HSIL are true precursor lesions that can progress to thick HSIL and SCC.
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Affiliation(s)
- Olaf Reich
- Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
| | - Sigrid Regauer
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Ariadna Lara Gutierrez
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Karl Kashofer
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria.
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da Silva-Júnior AHP, de Oliveira Silva RC, Gurgel APAD, Barros-Júnior MR, Nascimento KCG, Santos DL, Pena LJ, Lima RDCP, Batista MVDA, Chagas BS, de Freitas AC. Identification and Functional Implications of the E5 Oncogene Polymorphisms of Human Papillomavirus Type 16. Trop Med Infect Dis 2024; 9:140. [PMID: 39058182 PMCID: PMC11281449 DOI: 10.3390/tropicalmed9070140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Revised: 06/12/2024] [Accepted: 06/21/2024] [Indexed: 07/28/2024] Open
Abstract
The persistence of the human papillomavirus type 16 (HPV16) infection on the cervical epithelium contributes to the progression of cervical cancer. Studies have demonstrated that HPV16 genetic variants may be associated with different risks of developing cervical cancer. However, the E5 oncoprotein of HPV16, which is related to several cellular mechanisms in the initial phases of the infection and thus contributes to carcinogenesis, is still little studied. Here we investigate the HPV16 E5 oncogene variants to assess the effects of different mutations on the biological function of the E5 protein. We detected and analyzed the HPV16 E5 oncogene polymorphisms and their phylogenetic relationships. After that, we proposed a tertiary structure analysis of the protein variants, preferential codon usage, and functional activity of the HPV16 E5 protein. Intra-type variants were grouped in the lineages A and D using in silico analysis. The mutations in E5 were located in the T-cell epitopes region. We therefore analyzed the interference of the HPV16 E5 protein in the NF-kB pathway. Our results showed that the variants HPV16E5_49PE and HPV16E5_85PE did not increase the potential of the pathway activation capacity. This study provides additional knowledge about the mechanisms of dispersion of the HPV16 E5 variants, providing evidence that these variants may be relevant to the modulation of the NF-κB signaling pathway.
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Affiliation(s)
- Antônio Humberto P. da Silva-Júnior
- Laboratory of Molecular Studies and Experimental Therapy (LEMTE), Department of Genetics, Federal University of Pernambuco, Recife 50670-901, Pernambuco, Brazil; (A.H.P.d.S.-J.); (R.C.d.O.S.); (M.R.B.-J.); (K.C.G.N.); (D.L.S.); (R.d.C.P.L.); (B.S.C.)
| | - Ruany Cristyne de Oliveira Silva
- Laboratory of Molecular Studies and Experimental Therapy (LEMTE), Department of Genetics, Federal University of Pernambuco, Recife 50670-901, Pernambuco, Brazil; (A.H.P.d.S.-J.); (R.C.d.O.S.); (M.R.B.-J.); (K.C.G.N.); (D.L.S.); (R.d.C.P.L.); (B.S.C.)
| | - Ana Pavla A. Diniz Gurgel
- Department of Engineering and Environment, Federal University of Paraiba, João Pessoa 58033-455, Paraíba, Brazil;
| | - Marconi Rêgo Barros-Júnior
- Laboratory of Molecular Studies and Experimental Therapy (LEMTE), Department of Genetics, Federal University of Pernambuco, Recife 50670-901, Pernambuco, Brazil; (A.H.P.d.S.-J.); (R.C.d.O.S.); (M.R.B.-J.); (K.C.G.N.); (D.L.S.); (R.d.C.P.L.); (B.S.C.)
| | - Kamylla Conceição Gomes Nascimento
- Laboratory of Molecular Studies and Experimental Therapy (LEMTE), Department of Genetics, Federal University of Pernambuco, Recife 50670-901, Pernambuco, Brazil; (A.H.P.d.S.-J.); (R.C.d.O.S.); (M.R.B.-J.); (K.C.G.N.); (D.L.S.); (R.d.C.P.L.); (B.S.C.)
| | - Daffany Luana Santos
- Laboratory of Molecular Studies and Experimental Therapy (LEMTE), Department of Genetics, Federal University of Pernambuco, Recife 50670-901, Pernambuco, Brazil; (A.H.P.d.S.-J.); (R.C.d.O.S.); (M.R.B.-J.); (K.C.G.N.); (D.L.S.); (R.d.C.P.L.); (B.S.C.)
| | - Lindomar J. Pena
- Laboratory of Virology and Experimental Therapy, Instituto Aggeu Magalhães (IAM), Oswaldo Cruz Foundation, Recife 50670-901, Pernambuco, Brazil;
| | - Rita de Cássia Pereira Lima
- Laboratory of Molecular Studies and Experimental Therapy (LEMTE), Department of Genetics, Federal University of Pernambuco, Recife 50670-901, Pernambuco, Brazil; (A.H.P.d.S.-J.); (R.C.d.O.S.); (M.R.B.-J.); (K.C.G.N.); (D.L.S.); (R.d.C.P.L.); (B.S.C.)
| | - Marcus Vinicius de Aragão Batista
- Laboratory of Molecular Genetics and Biotechnology (GMBio), Department of Biology, Federal University of Sergipe, São Cristóvão 49107-230, Sergipe, Brazil
| | - Bárbara Simas Chagas
- Laboratory of Molecular Studies and Experimental Therapy (LEMTE), Department of Genetics, Federal University of Pernambuco, Recife 50670-901, Pernambuco, Brazil; (A.H.P.d.S.-J.); (R.C.d.O.S.); (M.R.B.-J.); (K.C.G.N.); (D.L.S.); (R.d.C.P.L.); (B.S.C.)
| | - Antonio Carlos de Freitas
- Laboratory of Molecular Studies and Experimental Therapy (LEMTE), Department of Genetics, Federal University of Pernambuco, Recife 50670-901, Pernambuco, Brazil; (A.H.P.d.S.-J.); (R.C.d.O.S.); (M.R.B.-J.); (K.C.G.N.); (D.L.S.); (R.d.C.P.L.); (B.S.C.)
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Bellosillo B, Ibáñez R, Roura E, Monfil L, Asensio-Puig L, Álvarez I, Muset M, Florencia Y, Paytubi S, de Andrés-Pablo Á, Calvo S, Serrano-Munné L, Pavón MÁ, Lloveras B. Clinical Validation of the Vitro HPV Screening Assay for Its Use in Primary Cervical Cancer Screening. Cancers (Basel) 2024; 16:1322. [PMID: 38611001 PMCID: PMC11011158 DOI: 10.3390/cancers16071322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 03/22/2024] [Accepted: 03/25/2024] [Indexed: 04/14/2024] Open
Abstract
Many scientific societies have issued guidelines to introduce population-based cervical cancer screening with HPV testing. The Vitro HPV Screening assay is a fully automatic multiplex real-time PCR test targeting the L1 GP5+/GP6+ region of HPV genome. The assay detects 14 high risk (HR) HPV genotypes, identifying individual HPV16 and HPV18 genotypes, and the HPV-positive samples for the other 12 HR HPV types are subsequently genotyped with the HPV Direct Flow Chip test. Following international guidelines, the aim of this study was to validate the clinical accuracy of the Vitro HPV Screening test on ThinPrep-collected samples for its use as primary cervical cancer screening, using as comparator the validated cobas® 4800 HPV test. The non-inferiority analysis showed that the clinical sensitivity and specificity of the Vitro HPV Screening assay for a diagnosis of cervical intraepithelial neoplasia of grade 2 or worse (CIN2+) were not inferior to those of cobas® 4800 HPV (p = 0.0049 and p < 0.001 respectively). The assay has demonstrated a high intra- and inter-laboratory reproducibility, also among the individual genotypes. The Vitro HPV Screening assay is valid for cervical cancer screening and it provides genotyping information on HPV-positive samples without further sample processing in a fully automated workflow.
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Affiliation(s)
- Beatriz Bellosillo
- Department of Pathology, Hospital del Mar, 08003 Barcelona, Spain; (B.B.); (I.Á.); (M.M.); (S.C.); (L.S.-M.)
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain
- Department of Medicine and Life Sciences (MELIS), University Pompeu Fabra, Doctor Aiguader 88, 08003 Barcelona, Spain
| | - Raquel Ibáñez
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology—Bellvitge Biomedical Research Institute (IDIBELL), 08908 L’Hospitalet de Llobregat, Spain; (R.I.); (E.R.); (L.M.); (L.A.-P.); (Y.F.); (S.P.); (Á.d.A.-P.); (M.Á.P.)
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública—CIBERESP, 28029 Madrid, Spain
| | - Esther Roura
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology—Bellvitge Biomedical Research Institute (IDIBELL), 08908 L’Hospitalet de Llobregat, Spain; (R.I.); (E.R.); (L.M.); (L.A.-P.); (Y.F.); (S.P.); (Á.d.A.-P.); (M.Á.P.)
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública—CIBERESP, 28029 Madrid, Spain
| | - Laura Monfil
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology—Bellvitge Biomedical Research Institute (IDIBELL), 08908 L’Hospitalet de Llobregat, Spain; (R.I.); (E.R.); (L.M.); (L.A.-P.); (Y.F.); (S.P.); (Á.d.A.-P.); (M.Á.P.)
| | - Laura Asensio-Puig
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology—Bellvitge Biomedical Research Institute (IDIBELL), 08908 L’Hospitalet de Llobregat, Spain; (R.I.); (E.R.); (L.M.); (L.A.-P.); (Y.F.); (S.P.); (Á.d.A.-P.); (M.Á.P.)
| | - Isabel Álvarez
- Department of Pathology, Hospital del Mar, 08003 Barcelona, Spain; (B.B.); (I.Á.); (M.M.); (S.C.); (L.S.-M.)
| | - Mercè Muset
- Department of Pathology, Hospital del Mar, 08003 Barcelona, Spain; (B.B.); (I.Á.); (M.M.); (S.C.); (L.S.-M.)
| | - Yolanda Florencia
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology—Bellvitge Biomedical Research Institute (IDIBELL), 08908 L’Hospitalet de Llobregat, Spain; (R.I.); (E.R.); (L.M.); (L.A.-P.); (Y.F.); (S.P.); (Á.d.A.-P.); (M.Á.P.)
| | - Sonia Paytubi
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology—Bellvitge Biomedical Research Institute (IDIBELL), 08908 L’Hospitalet de Llobregat, Spain; (R.I.); (E.R.); (L.M.); (L.A.-P.); (Y.F.); (S.P.); (Á.d.A.-P.); (M.Á.P.)
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública—CIBERESP, 28029 Madrid, Spain
| | - Álvaro de Andrés-Pablo
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology—Bellvitge Biomedical Research Institute (IDIBELL), 08908 L’Hospitalet de Llobregat, Spain; (R.I.); (E.R.); (L.M.); (L.A.-P.); (Y.F.); (S.P.); (Á.d.A.-P.); (M.Á.P.)
| | - Susana Calvo
- Department of Pathology, Hospital del Mar, 08003 Barcelona, Spain; (B.B.); (I.Á.); (M.M.); (S.C.); (L.S.-M.)
| | - Laia Serrano-Munné
- Department of Pathology, Hospital del Mar, 08003 Barcelona, Spain; (B.B.); (I.Á.); (M.M.); (S.C.); (L.S.-M.)
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain
| | - Miguel Ángel Pavón
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology—Bellvitge Biomedical Research Institute (IDIBELL), 08908 L’Hospitalet de Llobregat, Spain; (R.I.); (E.R.); (L.M.); (L.A.-P.); (Y.F.); (S.P.); (Á.d.A.-P.); (M.Á.P.)
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública—CIBERESP, 28029 Madrid, Spain
| | - Belen Lloveras
- Department of Pathology, Hospital del Mar, 08003 Barcelona, Spain; (B.B.); (I.Á.); (M.M.); (S.C.); (L.S.-M.)
- Cancer Research Program, IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, Spain
- Department of Medicine and Life Sciences (MELIS), University Pompeu Fabra, Doctor Aiguader 88, 08003 Barcelona, Spain
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Divya KT, Chidrawar VR, Bhupalam PK, Shiromwar S, Aljameeli AM, Vyshnavi G, Reddama IS, Boreddy V. Assessment of knowledge and attitude of cervical cancer among the youths in the Rayalaseema region of Andhra Pradesh - India. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2024; 13:73. [PMID: 38559478 PMCID: PMC10979777 DOI: 10.4103/jehp.jehp_318_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 08/30/2023] [Indexed: 04/04/2024]
Abstract
BACKGROUND India suffers a quarter of the global burden of cervical cancer (CC) but is controllable by taking some precautions. The major issue is the low amount of participation among women in screening and vaccination for disease. The objective of the research is to evaluate knowledge, attitude, and practice (KAP) regarding CC among college going students residing in the Rayalaseema region of Andhra Pradesh-India. MATERIAL AND METHODS A cross-sectional study was conducted on a total of 380 subjects whose ages ranged from 15 to 25 and older. The questionnaires were circulated through google forms. The socio-demographic variables and KAP levels are represented by descriptive statistics. The Chi-square test is used to determine the relationship between sociodemographic factors and KAP levels. RESULTS Among 380 subjects, 172 (54.7%) are aware of CC, 71% have poor knowledge, and 20% have good knowledge about CC. More than three-fourths of women 374 (98.4%) are not having regular practice towards CC. CONCLUSION The awareness about CC is very low in the population, so prevention of CC relies on routine screening, proper vaccination, and treatment. Awareness programs and promoting knowledge about cervical health in social media are required.
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Affiliation(s)
- K Thanmaya Divya
- Department of Pharmacology, Raghavendra Institute of Pharmaceutical Education and Research, Andhra Pradesh, India
| | - Vijay R. Chidrawar
- School of Pharmacy and Technology Management, SVKM’s Narsee Monjee Institute of Management Studies (NMIMS), Deemed-to-University, Jadcharla, Hyderabad, Telangana, India
| | - Pradeep Kumar Bhupalam
- Department of Pharmacology, Raghavendra Institute of Pharmaceutical Education and Research, Andhra Pradesh, India
| | - Shruti Shiromwar
- Department of Clinical Pharmacy, Universiti Sains Malaysia (USM), Malaysia
| | - Ahmed M. Aljameeli
- Department of Pharmacy Practice, College of Pharmacy, University of Hafer Al-Batin 31991, Kingdom of Saudi Arabia
| | - G. Vyshnavi
- Department of Pharmacy Practice, Raghavendra Institute of Pharmaceutical Education and Research, Andhra Pradesh, India
| | - I. Sai Reddama
- Department of Pharmacology, Raghavendra Institute of Pharmaceutical Education and Research, Andhra Pradesh, India
| | - Vishali Boreddy
- Department of Pharmacology, Raghavendra Institute of Pharmaceutical Education and Research, Andhra Pradesh, India
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7
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Zhang N, Chen Z, Huang M, Lu Q, Yang H, Xiang J, Yang J, Peng Y, Wang G, Han N, Min X, Huang J. Cervicovaginal microbiota long-term dynamics and prediction of different outcomes in persistent human papillomavirus infection. J Med Virol 2024; 96:e29451. [PMID: 38305046 DOI: 10.1002/jmv.29451] [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: 11/28/2023] [Revised: 01/17/2024] [Accepted: 01/23/2024] [Indexed: 02/03/2024]
Abstract
Persistent human papillomavirus (HPV) infection can lead to cervical intraepithelial neoplasia (CIN) and cervical cancer, posing serious threats to the health of women. Although the cervicovaginal microbiota is strongly associated with CIN, the dynamics of the microbiota during CIN development are unknown. In this retrospective cohort study, we analyzed 3-year longitudinal data from 72 patients diagnosed with a persistent HPV infection almost all caused by high-risk HPV types. Patients were categorized into groups with HPV persistent infection (n = 37), progression to CIN (n = 16), and CIN regression (n = 19) based on infection outcome during the follow-up period. Furthermore, 16S rRNA gene sequencing was performed on consecutively collected cervical samples to explore the composition and dynamics of the cervicovaginal microbiota during the development and regression of CIN. Our results showed that the composition of the cervicovaginal microbiota varied among women with different HPV infection outcomes and remained relatively stable during the follow-up period. Notably, the serial follow-up data showed that these microbial alterations were present for at least 1-2 years and occurred before pathologic changes. In addition, microbial markers that were highly discriminatory for CIN progression or regression were identified. This study provides evidence for a temporal relationship between changes in the cervicovaginal microbiota and the development of CIN, and our findings provide support for future microbial intervention strategies for CIN.
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Affiliation(s)
- Ningqing Zhang
- Department of Laboratory Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, China
- School of Laboratory Medicine, Zunyi Medical University, Zunyi, China
| | - Zuyi Chen
- Department of Laboratory Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, China
- School of Laboratory Medicine, Zunyi Medical University, Zunyi, China
| | - Meirong Huang
- Department of Blood Transfusion, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Qin Lu
- School of Laboratory Medicine, Zunyi Medical University, Zunyi, China
| | - Hui Yang
- School of Laboratory Medicine, Zunyi Medical University, Zunyi, China
| | - Jialin Xiang
- Department of Laboratory Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, China
- School of Laboratory Medicine, Zunyi Medical University, Zunyi, China
| | - Jianru Yang
- Department of Laboratory Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, China
- School of Laboratory Medicine, Zunyi Medical University, Zunyi, China
| | - Yanfeng Peng
- School of Laboratory Medicine, Zunyi Medical University, Zunyi, China
| | - Guangli Wang
- Department of Laboratory Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, China
- School of Laboratory Medicine, Zunyi Medical University, Zunyi, China
| | - Niwei Han
- Department of Laboratory Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, China
- School of Laboratory Medicine, Zunyi Medical University, Zunyi, China
| | - Xun Min
- Department of Laboratory Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, China
- School of Laboratory Medicine, Zunyi Medical University, Zunyi, China
| | - Jian Huang
- Department of Laboratory Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, China
- School of Laboratory Medicine, Zunyi Medical University, Zunyi, China
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8
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Urbute A, Frederiksen K, Thomsen LT, Kesmodel US, Kjaer SK. Overweight and obesity as risk factors for cervical cancer and detection of precancers among screened women: A nationwide, population-based cohort study. Gynecol Oncol 2024; 181:20-27. [PMID: 38103421 DOI: 10.1016/j.ygyno.2023.12.002] [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: 06/01/2023] [Revised: 11/22/2023] [Accepted: 12/02/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVE Obesity is a known risk factor for many types of cancer. However, there is no clear evidence whether overweight and obesity increases the risk of cervical cancer. We investigated the association between body mass index (BMI) and detection of squamous and glandular cervical cancer and precancer. METHODS Based on the Medical Birth Registry, we conducted a nationwide cohort study in Denmark of 384,559 women with BMI ≥18.5 kg/m2 (pre-pregnancy BMI reported at the start of the pregnancy) having a cervical cytology screening at age 23-49 years within 5 years following the date of childbirth. The cohort was followed for 10 years from the first cervical cytology screening after the childbirth. We assessed absolute risks of cervical lesions according to BMI with the Aalen-Johansen estimator. We conducted Cox proportional hazards regression analyses to estimate hazard ratios (HRs) with 95% confidence intervals (CIs). Analyses were adjusted for age, calendar year, parity, oral contraception use, HPV vaccination, smoking, country of origin, and education. RESULTS Overweight and obesity were associated with higher rates of cervical cancer (HR = 1.24, 95% CI 1.04-1.49 and HR = 1.14, 95% CI 0.91-1.43, respectively) and lower rates of cervical precancer detection (HR = 0.88, 95% CI 0.84-0.92 and HR = 0.67, 95% CI 0.63-0.71, respectively). CONCLUSIONS Higher than normal BMI was associated with higher incidence rates of cervical cancer and lower rates of precancer detection, emphasizing the importance of further research in possible mechanisms behind this association.
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Affiliation(s)
- Aivara Urbute
- Unit of Virus, Lifestyle and Genes, Danish Cancer Institute, Strandboulevarden 49, Copenhagen, Denmark
| | - Kirsten Frederiksen
- Statistics and Data analysis, Danish Cancer Institute, Strandboulevarden 49, Copenhagen, Denmark
| | - Louise T Thomsen
- Unit of Virus, Lifestyle and Genes, Danish Cancer Institute, Strandboulevarden 49, Copenhagen, Denmark
| | - Ulrik Schiøler Kesmodel
- Department of Obstetrics and Gynecology, Aalborg University Hospital, and Department of Clinical Medicine, Aalborg University, Reberbansgade 9, Aalborg, Denmark
| | - Susanne K Kjaer
- Unit of Virus, Lifestyle and Genes, Danish Cancer Institute, Strandboulevarden 49, Copenhagen, Denmark; Department of Gynecology, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, Copenhagen, Denmark.
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9
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Elvatun S, Knoors D, Nygård M, Uusküla A, Võrk A, Nygård JF. Cross-population evaluation of cervical cancer risk prediction algorithms. Int J Med Inform 2024; 181:105297. [PMID: 38016404 DOI: 10.1016/j.ijmedinf.2023.105297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 10/11/2023] [Accepted: 11/12/2023] [Indexed: 11/30/2023]
Abstract
BACKGROUND Cervical cancer is a preventable disease, despite being one of the most common types of female cancers worldwide. Integrating existing programs for cervical cancer screening with personalized risk prediction algorithms can improve population-level cancer prevention by enabling more targeted screening and contrive preventive healthcare innovations. While algorithms developed for cervical cancer risk prediction have shown promising performance in internal validation on more homogeneous populations, their ability to generalize to external populations remains to be assessed. METHODS To address this gap, we perform a cross-population comparative study of personalized prediction algorithms for more personalized cervical cancer screening. Using data from the Norwegian and Estonian populations, the algorithms are validated on internal and external datasets to study their potential biases and limitations when applied to different populations. We evaluate the algorithms in predicting progression from low-grade precancerous cervical lesions, simulating a clinically relevant application of more personalized risk stratification. RESULTS As expected, our numerical experiments show that algorithm performance varies depending on the population. However, some algorithms show strong generalization capacity across different data sources. Using Kaplan-Meier estimates, we demonstrate the strengths and limitations of the algorithms in detecting cancer progression over time by comparing to the trends observed from data. We assess their overall discrimination performance in personalized risk predictions by analyzing the accuracy and confidence in individual risk estimates. DISCUSSION AND CONCLUSION This study examines the effectiveness of personalized prediction algorithms across different populations. Our results demonstrate the potential for generalizing risk prediction algorithms to external populations. These findings highlight the importance of considering population diversity when developing risk prediction algorithms.
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Affiliation(s)
- Severin Elvatun
- Department of Registry Informatics, Cancer Registry of Norway, Ullernchausseen 64, 0379 Oslo, Norway.
| | - Daan Knoors
- Department of Registry Informatics, Cancer Registry of Norway, Norway
| | - Mari Nygård
- Department of Research, Cancer Registry of Norway, Norway
| | - Anneli Uusküla
- Department of Family Medicine and Public Health, University of Tartu, Estonia
| | - Andres Võrk
- Institute of Economics, University of Tartu, Estonia
| | - Jan F Nygård
- Department of Registry Informatics, Cancer Registry of Norway, Department of Physics and Technology, UiT The Arctic University of Norway, Norway
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10
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Kumar N, Mangla M, Palo S, Gabbeta S, Aparna J. Stratified Mucin-Producing Intraepithelial Lesion of the Cervix in an HPV-16 Positive Woman: A Rare Encounter. Infect Disord Drug Targets 2024; 24:e290124226396. [PMID: 38288809 DOI: 10.2174/0118715265284722240110114107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 12/22/2023] [Accepted: 01/01/2024] [Indexed: 07/20/2024]
Abstract
BACKGROUND Cervical cancer is the fourth most common cancer among women globally and has a strong association with Human Papillomavirus (HPV) infection. Stratified mucinproducing intraepithelial lesion (SMILE), a variant of Adenocarcinoma in situ (AIS), is a rare cervical precancer lesion that is often missed or detected incidentally. CASE PRESENTATION The present case report briefs the finding of a 39-year-old woman who presented to the gynecological outpatient department with complaints of vaginal discharge for 6-8 months. She had no history of irregular menstrual cycles or postcoital bleeding. Her routine Pap smear revealed atypical squamous cells of undetermined significance (ASCUS) and was positive for HPV-16 type. Her cervical biopsy report revealed AIS and her histopathological report of hysterectomy revealed SMILE, a variant of AIS. DISCUSSION The SMILE variant of AIS is a rare cervical precancerous lesion characterized by the morphological overlap of both squamous intraepithelial lesions and AIS. It is often difficult to diagnose on Pap smear and is commonly associated with high-risk HPV infections. The management of SMILE is the same as that for AIS, which is the excisional procedure followed by a hysterectomy if the margins are negative and depending on the fertility desires of the patient, followed by regular follow-up with HPV testing. CONCLUSION SMILE is a rare variant of AIS, which is often missed on cytological screening of the cervix. It is commonly associated with high-risk types of HPV. Hence, incorporating HPV testing in the screening of cervical cancer is important and recommended to increase the overall sensitivity of screening for adenocarcinoma lesions.
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Affiliation(s)
- Naina Kumar
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Bibinagar, 508126, Hyderabad, Telangana, India
| | - Mishu Mangla
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Bibinagar, 508126, Hyderabad, Telangana, India
| | - Seetu Palo
- Department of Pathology, All India Institute of Medical Sciences, Bibinagar, 508126, Hyderabad, Telangana, India
| | - Spandana Gabbeta
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Bibinagar, 508126, Hyderabad, Telangana, India
| | - J Aparna
- Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Bibinagar, 508126, Hyderabad, Telangana, India
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11
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Varon M, Salcedo MP, Fellman B, Troisi C, Gowen R, Daheri M, Rodriguez AM, Toscano P, Guerra L, Gasca M, Cavazos B, Marin E, Fisher-Hoch S, Fernandez ME, Reininger B, Ruosha L, Baker E, Schmeler K. A Comprehensive Program to Improve Treatment of Precancerous Cervical Lesions in the Rio Grande Valley of Texas. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2024; 30:89-98. [PMID: 37350621 DOI: 10.1097/phh.0000000000001771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
OBJECTIVE To assess the impact of a multicomponent intervention in women with cervical dysplasia who were treated with loop electrosurgical excision procedure (LEEP), as well as the time between colposcopy and treatment. DESIGN Retrospective cohort study. INTERVENTION Clinic participation in a multicomponent cervical cancer prevention program that included community outreach, patient in-reach, and navigation, as well as provider capacity building with in-person training and ongoing telementoring through Project ECHO. MAIN OUTCOME MEASURES Medical records were reviewed to evaluate women with cervical dysplasia undergoing treatment with LEEP within 90 days of colposcopy, as well as time between colposcopy and treatment. Baseline data from year 1 were compared with each subsequent year of implementation. Additional variables examined included patient's age, history of abnormal screening results, and percentage of families living below poverty line based on county of residence, parity, and clinic site. We performed logistic regression and multiple linear regression analyses to assess the programmatic impact in the outcomes of interest by year of program implementation. RESULTS A total of 290 women were included in the study. The proportion of women undergoing treatment within 90 days of colposcopy increased from 76.2% at baseline to 91.3% in year 3 and 92.9% in year 4 of program implementation. The odds of undergoing treatment within 90 days were 5.11 times higher in year 4 of program implementation than at baseline. The mean time between colposcopy and LEEP decreased from 62 days at baseline to 45 days by year 4 of program implementation. CONCLUSIONS Implementation of our multicomponent cervical cancer prevention program increased the proportion of women undergoing LEEP within 90 days of colposcopy and decreased the time between colposcopy and LEEP. This program has the potential to support cervical cancer prevention efforts and could be implemented in other low-resource settings.
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Affiliation(s)
- Melissa Varon
- The University of Texas MD Anderson Cancer Center, Houston, Texas (Drs Varon, Salcedo, Baker, and Schmeler, and Mr Fellman); The University of Texas Health Science Center, School of Public Health, Houston, Texas (Drs Troisi, Fernandez, and Ruosha); The University of Texas Health Science Center, School of Public Health Brownsville Regional Campus, Brownsville, Texas (Ms Gasca, Drs Gowen, Fisher-Hoch, and Reininger); Harris Health, Houston, Texas (Ms Daheri); The University of Texas Medical Branch, Houston, Texas (Dr Rodriguez); McGovern Medical School, Houston, Texas (Mr Toscano) Su Clinica, Harlingen, Texas (Mss Guerra and Cavazos, and Dr Marin)
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12
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He M, Jia R, Liu X, Su C, Qin Y, Li C, Jia Y. Attributes underlying patient choice of treatment modality for low-grade squamous intraepithelial lesion complicated by high-risk human papillomavirus infection. Int J Hyperthermia 2023; 40:2168075. [PMID: 36683163 DOI: 10.1080/02656736.2023.2168075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVE To use logistic regression to analyze the attributes underlying patients' treatment options for low-grade squamous intraepithelial lesion (LSIL) complicated with high-risk human papillomavirus (HR-HPV) infection, and identify the best benefit group of different treatment options. METHODS Clinical data of 197 LSIL patients with HR-HPV infection between June 2009 and February 2022 were collected. According to the treatment options chosen by the patients, they were divided into the interferon, photodynamic therapy, follow-up observation, and focused ultrasound (FUS) treatment groups. One-way analysis of variance (ANOVA) and multivariate logistic regression analysis were used to analyze the influencing factors, including age, occupation, education level, maternity history, reason for encounter, route of consultation, annual personal and household income, screening for related risk factors, and identifying the best benefit group of different treatment options. RESULTS One-way ANOVA revealed a statistically significant difference in age, education level, maternity history, reason for encounter, and annual household income (p < 0.05). Multivariate logistic regression analysis was performed on these five factors, indicating that age ≤35 years, high school educational level or higher, and no childbirth history were independent risk factors influencing patients' choices of FUS treatment. The receiver operating characteristic curve was used to determine the age threshold of 31 years. CONCLUSION Age, educational level, and maternity history were independent risk factors influencing patients' choice of treatment modality for LSIL complicated with HR-HPV infection. Age ≤31 years, high school, equivalent, or higher educational level, and no childbirth yielded a higher rate of choosing FUS treatment for LSIL patients with HR-HPV infection.
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Affiliation(s)
- Miaomiao He
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, China
| | - Ru Jia
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, China
| | - Xinglin Liu
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, China
| | - Chang Su
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, China
| | - Yi Qin
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, China
| | - Chengzhi Li
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, China.,Chongqing Haifu Hospital, Chongqing, China
| | - Ying Jia
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Key Laboratory of Biomedical Engineering, Chongqing Medical University, Chongqing, China.,The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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13
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Chen F, Zhang GN, Lei W, Zhou SG, Zhang Y, Liu L, Jia Y, Xie RK, Tian XF, Guo J, Yang YB, Wang XF, Wu XM, Sun QJ, Zhou X, Lin Y, Zhang YZ, Ma JQ, Liu YX, Cheng YF, Chen JC, Qu QX, Du DM, Wang GY, Wang S, Ling YL, Wu DF, Zhang CF, Lang JH. Effectiveness and safety of REBACIN as a non-invasive intervention for persistent high-risk human papillomavirus infection: A real-world prospective multicenter cohort study. Gynecol Oncol 2023; 178:8-13. [PMID: 37734188 DOI: 10.1016/j.ygyno.2023.09.004] [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: 06/28/2023] [Revised: 08/06/2023] [Accepted: 09/10/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND We previously reported that REBACIN effectively eliminates persistent high-risk human papillomavirus (hrHPV) infection. Here, we conducted a prospective multicenter cohort study to evaluate the safety and effectiveness of REBACIN, taking into account factors such as specific hrHPV subtype and patient's age. METHODS According to inclusion/exclusion criteria and participant willingness, 3252 patients were divided into REBACIN group while 249 patients into control group. Patients in REBACIN group received one course treatment of intravaginal administration of REBACIN while no treatment in control group. After drug withdrawal, participants in both groups were followed up. RESULTS The clearance rate of persistent hrHPV infection in REBACIN group was 60.64%, compared to 20.08% in control group. Specifically, the clearance rates for single-type infection of HPV16 or HPV18 were 70.62% and 69.23%, respectively, which was higher than that of HPV52 (59.04%) or HPV58 (62.64%). In addition, the single, double, and triple/triple+ infections had a clearance rate of 65.70%, 53.31%, and 38.30%, respectively. Moreover, 1635 patients under 40 years old had a clearance rate of 65.14%, while it was 55.08% for 1447 patients over 40 years old. No serious adverse effects were found. CONCLUSION This study confirmed that REBACIN can effectively and safely eliminate persistent hrHPV infection, which the clearance rate of HPV16/18 is higher than that of HPV52/58, the clearance rate of single-type infection is higher than that of multiple-type infections, and the clearance rate in young patients is higher than that in elder patients, providing a guidance for REBACIN application in clearing hrHPV persistent infection in real-world settings. CLINICAL TRIAL REGISTRATION Chinese Clinical Trial Registry Registration Number: ChiCTR1800015617 http://www.chictr.org.cn/showproj.aspx?proj=26529 Date of Registration: 2018-04-11.
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Affiliation(s)
- Fei Chen
- National Clinical Research Center for Obstetric & Gynecologic Diseases, and Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | | | - Wei Lei
- West China Second University Hospital, Sichuan University, Chengdu, China
| | - Shu-Guang Zhou
- Anhui Medical University Affiliated Maternity and Child Healthcare Hospital, Hefei, China
| | - Ying Zhang
- The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Lin Liu
- The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Ying Jia
- The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Rong-Kai Xie
- Xinqiao Hospital Army Medical University, Chongqing, China
| | | | - Jie Guo
- The Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yue-Bo Yang
- The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Xue-Feng Wang
- The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Xiao-Mei Wu
- The First People's Hospital of Yunnan Province, Kunming, China
| | - Qi-Jian Sun
- First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Xu Zhou
- The Second Hospital of Jilin University, Changchun, China
| | - Yang Lin
- The Second Hospital of Jilin University, Changchun, China
| | | | - Jun-Qi Ma
- The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Yu-Xiu Liu
- China-Mongolia Hospital of Ulanqab, Ulanqab, China
| | - Yi-Fan Cheng
- The Women's Hospital School of Medicine Zhejiang University, Hangzhou, China
| | - Jian-Cui Chen
- Fujian Provincial Maternal and Child Health Care Hospital, Fuzhou, China
| | - Quan-Xin Qu
- Tianjin First Central Hospital, Tianjin, China
| | - Dong-Mei Du
- Key Laboratory of Protein Engineering and Drug Development of Hainan, Haikou, China
| | - Gui-Yu Wang
- Key Laboratory of Protein Engineering and Drug Development of Hainan, Haikou, China
| | - Sheng Wang
- Key Laboratory of Protein Engineering and Drug Development of Hainan, Haikou, China
| | - Yu-Li Ling
- Key Laboratory of Protein Engineering and Drug Development of Hainan, Haikou, China
| | | | | | - Jing-He Lang
- National Clinical Research Center for Obstetric & Gynecologic Diseases, and Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
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14
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Lu Q, Lao X, Gan J, Du P, Zhou Y, Nong W, Yang Z. Impact of NLRP3 gene polymorphisms (rs10754558 and rs10733113) on HPV infection and cervical cancer in southern Chinese population. Infect Agent Cancer 2023; 18:64. [PMID: 37885032 PMCID: PMC10601328 DOI: 10.1186/s13027-023-00529-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 09/08/2023] [Indexed: 10/28/2023] Open
Abstract
OBJECTIVE Mutations in the NLRP3gene have previously been linked to certain forms of cancer, but there have not been any specific studies examining the association between NLRP3 polymorphisms and cervical cancer (CC). This study was therefore designed to investigate the effect of NLRP3 gene polymorphisms on HPV infection and cervical cancer in southern Chinese population. METHODS Multiplex PCR and next-generation sequencing approaches were used to assess the NLRP3 rs10754558 and rs10733113 polymorphisms in 404 cervical lesion patients, including 227 diagnosed with CC and 177 diagnosed with cervical intraepithelial neoplasia(CIN), with 419 healthy female controls being included for comparison. Correlations between the rs10754558 and rs10733113 genotypes and alleles in these patients and CC and CIN were then analyzed. RESULTS No correlations were found between NLRP3 rs10754558 and rs10733113 and human papillomavirus(HPV) infection status. Relative to the healthy control group, the NLRP3 rs10754558 GG genotype, CG + GG genotype, and G allele frequencies were significantly increased among patients with cervical lesions (CC and CIN) (OR = 1.815,P = 0.013;OR = 1.383, P = 0.026; OR = 1.284, P = 0.014,respectively), whereas no such differences were observed for rs10733113. A higher cervical lesion risk was detected for patients over the age of 45 exhibiting the rs10754558 GG genotype (OR = 1.848, P = 0.040). Additionally, the risk of CC was elevated in patients with the rs10754558 GG genotype or the G allele relative to patients with the CC genotype or the C allele(OR = 1.830, P = 0.029; OR = 1.281, P = 0.039). The rs10733113 genotypes or alleles were not significantly associated with CC risk (P > 0.05). No association between rs10754558 and rs10733113 genotypes and CC patient clinicopathological features were observed (P > 0.05). Serum NLRP3, IL-1β, and IL-18 levels were significantly elevated in CC patients relative to healthy controls(P < 0.05). Relative to the CC genotype, CC patients harboring the rs10754558 GG genotype exhibited significantly elevated IL-1β and IL-18 levels(P < 0.05). CONCLUSION The rs10754558 polymorphism in the NLRP3 gene may contribute to an elevated risk of CC, although it is not significantly correlated with HPV infection and CC progression.
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Affiliation(s)
- Qingchun Lu
- Department of Gynecology, Minzu Hospital of Guangxi Zhuang Autonomous Region, Affiliated Minzu Hospital of Guangxi Medical University, Guangxi, China
| | - Xiaoxia Lao
- Department of Clinical Laboratory, Minzu Hospital of Guangxi Zhuang Autonomous Region, Affiliated Minzu Hospital of Guangxi Medical University, Guangxi, China
| | - Jinghua Gan
- Department of Gynecology, Minzu Hospital of Guangxi Zhuang Autonomous Region, Affiliated Minzu Hospital of Guangxi Medical University, Guangxi, China
| | - Ping Du
- Department of Gynecology, Minzu Hospital of Guangxi Zhuang Autonomous Region, Affiliated Minzu Hospital of Guangxi Medical University, Guangxi, China
| | - Yingpei Zhou
- Department of Clinical Laboratory, Minzu Hospital of Guangxi Zhuang Autonomous Region, Affiliated Minzu Hospital of Guangxi Medical University, Guangxi, China
| | - Wenzheng Nong
- Department of Gynecology, Minzu Hospital of Guangxi Zhuang Autonomous Region, Affiliated Minzu Hospital of Guangxi Medical University, Guangxi, China.
| | - Zhige Yang
- Department of Clinical Laboratory, Minzu Hospital of Guangxi Zhuang Autonomous Region, Affiliated Minzu Hospital of Guangxi Medical University, Guangxi, China.
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15
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Kassymbekova F, Zhetpisbayeva I, Tcoy E, Dyussenov R, Davletov K, Rommel A, Glushkova N. Exploring HPV vaccine knowledge, attitudes, barriers and information sources among parents, health professionals and teachers in Kazakhstan: a mixed-methods study protocol. BMJ Open 2023; 13:e074097. [PMID: 37739465 PMCID: PMC10533667 DOI: 10.1136/bmjopen-2023-074097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/24/2023] Open
Abstract
INTRODUCTION Human papillomavirus (HPV) is a prevalent sexually transmitted infection linked to certain types of malignant neoplasms, notably cervical cancer (CC). In Kazakhstan, a high prevalence of high oncogenic HPV types (HR-HPV) has been observed, and CC ranks as the second most common malignancy among women with a crude incidence rate of 18.3 cases per 100 000 women. The HPV vaccine, developed as the primary prevention measure against HPV infection, including the most prevalent HR-HPV, received approval from the WHO in 2009. In 2014, Kazakhstan initiated HPV vaccination as a pilot project in four sub-national regions; however, it was later in 2017 discontinued due to widespread parental refusal influenced by negative media reports. This study aims to examine knowledge, attitudes, information sources, barriers to HPV vaccination and factors associated with HPV vaccination hesitancy among different target groups in Kazakhstan prior to the HPV vaccine re-launch announced by the Ministry of Health. METHODS AND ANALYSIS This mixed-method-designed research comprises quantitative and qualitative components. Data on HPV awareness, attitudes towards HPV vaccination and sources of information will be collected through an online survey administered by parents and legal guardians, health professionals, and schoolteachers in the Republic of Kazakhstan between January 2023 and January 2024. Additionally, qualitative data on Kazakhstani parental beliefs and attitudes toward HPV vaccination will be collected through online focus group discussions. ETHICS AND DISSEMINATION OF RESULTS The study has been approved by the local ethics committee at the Kazakhstan Medical University "Higher School of Public Health" (KMU "KSPH") (No. 138 of 31.05.2021). The results will be reported in publications, at conferences among researchers and healthcare and school education professionals in Kazakhstan, and internationally.
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Affiliation(s)
- Fatima Kassymbekova
- Department of Public Health and Social Sciences, Kazakhstan Medical University "KSPH", Almaty, Kazakhstan
| | - Indira Zhetpisbayeva
- Department of Public Health and Social Sciences, Kazakhstan Medical University "KSPH", Almaty, Kazakhstan
| | - Evgeniya Tcoy
- Department of Obstetrics and Gynaecology, Kazakh-Russian Medical University, Almaty, Kazakhstan
| | - Rassul Dyussenov
- Department of Public Health and Social Sciences, Kazakhstan Medical University "KSPH", Almaty, Kazakhstan
| | - Kairat Davletov
- Health Research Center, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | - Alexander Rommel
- Epidemiology and Health Monotoring, Robert Koch Institute, Berlin, Germany
| | - Natalya Glushkova
- Department of Epidemiology, Biostatistics and Evidence Based Medicine, Al-Farabi Kazakh National University, Almaty, Kazakhstan
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16
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Clarke MA. HPV Testing and its Role in Cervical Cancer Screening. Clin Obstet Gynecol 2023; 66:448-469. [PMID: 37650662 DOI: 10.1097/grf.0000000000000793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
The recognition that persistent infection with carcinogenic human papillomavirus (HPV) is a necessary cause of cervical precancer and cancer has led to the introduction of HPV testing into cervical cancer screening, either as a primary screening test or in conjunction with cervical cytology (i.e., co-testing). HPV testing has much higher sensitivity for detection of cervical precancer and provides greater long-term reassurance if negative compared to cytology. However, most HPV infections are transient, and do not progress to invasive cancer, thus triage tests are required to identify individuals who should be referred to colposcopy for diagnostic evaluation. This chapter begins with a description of the biology, natural history, and epidemiology of HPV as a foundation for understanding the role of HPV in cervical carcinogenesis. This section is followed by a detailed discussion regarding the introduction of HPV-based testing and triage into cervical cancer screening and management. Summarized triage tests include cervical cytology, HPV genotyping, p16/Ki-67 dual stain, and HPV and cellular methylation markers. The final section of this chapter includes an important discussion on cervical cancer disparities, particularly within the United States, followed by concluding remarks.
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Affiliation(s)
- Megan A Clarke
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, Rockville, Maryland
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Vattai A, Kremer N, Meister S, Beyer S, Keilmann L, Buschmann C, Corradini S, Schmoeckel E, Kessler M, Mahner S, Jeschke U, Hertlein L, Kolben T. Increase of the T-reg-recruiting chemokine CCL22 expression in a progressive course of cervical dysplasia. J Cancer Res Clin Oncol 2023; 149:6613-6623. [PMID: 36792811 DOI: 10.1007/s00432-023-04638-w] [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: 11/03/2022] [Accepted: 02/06/2023] [Indexed: 02/17/2023]
Abstract
PURPOSE An increasing infiltration of FoxP3-positive T-regs is associated with a higher grade of cervical intraepithelial neoplasia. The T-reg-recruiting chemokine CCL22 is expressed in various tumour entities. Aim of our study was to investigate the role of CCL22 in the progression and regression of cervical intraepithelial neoplasias, especially in patients with intermediate cervical intraepithelial neoplasias (CIN II). Furthermore, our aim was to characterize the CCL22-producing cells and explore the role of innate immunity in the process of cells recruitment. METHODS CCL22 expression was analyzed immunohistochemically in 169 patient samples. The immunoreactive score as well as the median numbers of positive cells were calculated in each slide and correlated with the histological CIN grade and FoxP3 expression. Additionally, CD68/CCL22 as well as CD68/PPARγ and CD68/FoxP3 expression were examined by double immunofluorescence. Statistical analysis was performed by SPSS 26. RESULTS A significantly higher expression of epithelial CCL22 in CIN II with progression in comparison to CIN II with regression (p = 0.006) could be detected. CCL22 was correlated with FoxP3 (Spearman's Rho: 0.308; p < 0.01). In 88%, CCL22-positive cells were positive for CD68, and 71% of CD68-positive macrophages expressed PPARγ. Colocalization of CD68 and FoxP3 was detected in 12%. CONCLUSION We could demonstrate that increased expression of CCL22, mainly produced by macrophages, correlates with elevated potential of malignancy. CCL22 expression could act as a predictor for regression and progression in cervical intraepithelial neoplasia, and it may help in the decision process regarding surgical treatment versus watchful waiting strategy in order to prevent conisation-associated risks. Furthermore, our findings support the potential of CCL22-producing cells as a target for immune therapy in cervical cancer patients.
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Affiliation(s)
- Aurelia Vattai
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377, Munich, Germany.
- Kinderwunsch Centrum Muenchen, 81241, Munich, Germany.
| | - Nadine Kremer
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377, Munich, Germany
| | - Sarah Meister
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377, Munich, Germany
| | - Susanne Beyer
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377, Munich, Germany
| | - Lucia Keilmann
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377, Munich, Germany
| | - Christina Buschmann
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377, Munich, Germany
| | - Stefanie Corradini
- Department of Radiation Oncology, University Hospital, LMU Munich, 81377, Munich, Germany
| | - Elisa Schmoeckel
- Institute of Pathology, Faculty of Medicine, LMU Munich, 80337, Munich, Germany
| | - Mirjana Kessler
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377, Munich, Germany
| | - Sven Mahner
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377, Munich, Germany
| | - Udo Jeschke
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377, Munich, Germany
- Department of Obstetrics and Gynecology, University Hospital Augsburg, 86156, Augsburg, Germany
| | - Linda Hertlein
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377, Munich, Germany
| | - Thomas Kolben
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377, Munich, Germany
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Pärna K, Nygård M, Tisler A, Toompere K, Naaber P, Ratnik K, Ķīvīte Urtāne A, Zodzika J, Stankūnas M, Baltzer N, Uusküla A. Age-specific and genotype-specific carcinogenic human papillomavirus prevalence in a country with a high cervical cancer burden: results of a cross-sectional study in Estonia. BMJ Open 2023; 13:e069558. [PMID: 37263686 DOI: 10.1136/bmjopen-2022-069558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
OBJECTIVES To describe age-specific and type-specific carcinogenic human papillomavirus (HPV) prevalence prior to large-scale effect of HPV vaccines in Estonia and to analyse the risk factors associated with carcinogenic HPV. DESIGN Cross-sectional study using self-administered questionnaire and self-collected vaginal swabs for detection of HPV infection. SETTING Estonian Biobank database. PARTICIPANTS Stratified random sample of women aged 30-33, 57-60 and 67-70 years living in one of the three largest counties in Estonia. Of 3065 women approached, 1347 (43.9%) returned questionnaires and specimens for HPV DNA detection. OUTCOME MEASURES HPV prevalence and fully adjusted ORs with 95% CIs for risk factors. RESULTS HPV prevalence was highest among women aged 30-33 years (18.7%; 95% CI 15.8 to 21.9) followed by those aged 67-70 years (16.7%; 95% CI 12.4 to 22.0) and 57-60 years (10.2%; 95% CI 7.8 to 13.3). HPV16 and HPV56 were the most common among women aged 30-33 years (both 4.0%; 95% CI 2.7 to 5.9), and HPV68 was the most common among women aged 57-60 years (2.8%; 95% CI 1.5 to 4.7) and 67-70 years (6.4%; 95% CI 3.6 to 10.4). Vaccination with nonavalent vaccine would have halved the carcinogenic HPV prevalence among women aged 30-33 years. The odds of infection with carcinogenic HPV were higher among women with six or more sexual partners among younger (OR 2.99; 95% CI 1.54 to 5.81) and older (OR 3.80; 95% CI 1.25 to 11.55) women and lower (OR 0.35; 95% CI 0.17 to 0.72) among younger married women. CONCLUSIONS This study demonstrated U-shaped age-specific genotype profile of carcinogenic HPV prevalence, indicating that public health providers should focus on developing exit strategies for the cervical cancer screening programme in Estonia with a possible extension of HPV testing beyond the current screening age of 65 years. Generalisability of the findings of this study may be affected by the low response rate.
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Affiliation(s)
- Kersti Pärna
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Mari Nygård
- Department of Research, Cancer Registry of Norway, Oslo, Norway
| | - Anna Tisler
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Karolin Toompere
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Paul Naaber
- SYNLAB Estonia, Tallinn, Estonia
- Department of Microbiology, Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia
| | - Kaspar Ratnik
- SYNLAB Estonia, Tallinn, Estonia
- Department of Human Genetics, Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia
| | - Anda Ķīvīte Urtāne
- Institute of Public Health, Rīga Stradiņš University, Rīga, Latvia
- Department of Public Health and Epidemiology, Rīga Stradiņš University, Rīga, Latvia
| | - Jana Zodzika
- Institute of Public Health, Rīga Stradiņš University, Rīga, Latvia
- Department of Obstetrics and Gynaecology, Rīga Stradiņš University, Rīga, Latvia
| | - Mindaugas Stankūnas
- Department of Health Management, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Nicholas Baltzer
- Division of Infectious Diseases, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Anneli Uusküla
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
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19
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Helenius G, Lillsunde-Larsson G, Bergengren L. Molecular triage of cervical screening samples in women 55-59 years of age: a pilot study. Infect Agent Cancer 2023; 18:31. [PMID: 37221548 DOI: 10.1186/s13027-023-00510-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 05/12/2023] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND With HPV screening the specificity of screening positives has decreased, even with a cytological triage test. Increases in colposcopies and detection of benign or low-grade dysplasia are reported, not least in older women. These results highlight the necessity to find other triage tests in HPV screening strategies, so that women can be more accurately selected for colposcopy, thus minimizing the clinically irrelevant findings. METHODS The study included 55- to 59-year-old women who exited the screening with normal cytology, but later in a follow-up test were positive for the HPV genotypes 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66 and 68 and had a cervical cone biopsy done. To model a screening situation with hrHPV-positive women, three different triage strategies, namely, cytology, genotyping and methylation, were performed. The study considered the effect of direct referral to colposcopy for HPV genotypes 16, 18, 31, 33, 45, 52 and 58, and methylation for FAM19A4 and hsa-mir124-2 and/or any form of abnormal cytology. RESULTS Seven out of 49 women aged 55-59 years with hrHPV had a cone biopsy with high-grade squamous intraepithelial lesion. No triage method found all cases, and when comparing positive and negative predictive value and false negative rate, cytology showed better results than genotyping and methylation. CONCLUSION This study does not support a switch in triage strategies from cytology to hrHPV genotyping and methylation for women above 55 years of age yet, but demonstrates the need for more evidence on molecular triage strategies.
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Affiliation(s)
- Gisela Helenius
- School of Health Sciences, Örebro University, Örebro, Sweden
| | - Gabriella Lillsunde-Larsson
- School of Health Sciences, Örebro University, Örebro, Sweden
- Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Lovisa Bergengren
- Department of Women's Health, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
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20
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Perkins R, Mitchell E. Cervical cancer disparities. J Natl Med Assoc 2023; 115:S19-S25. [PMID: 37202000 DOI: 10.1016/j.jnma.2023.02.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 02/01/2023] [Indexed: 05/20/2023]
Affiliation(s)
- Rebecca Perkins
- Boston University School of Medicine, Boston Medical Center, Boston, Massachusetts, United States
| | - Edith Mitchell
- Sidney Kimmel Cancer Center at Jefferson, Philadelphia, PA, United States.
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21
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Castilha EP, Curti RRDJ, de Oliveira JN, Vitiello GAF, Guembarovski RL, Couto-Filho JD, Oliveira KBD. APOBEC3A/B Polymorphism Is Not Associated with Human Papillomavirus Infection and Cervical Carcinogenesis. Pathogens 2023; 12:pathogens12050636. [PMID: 37242306 DOI: 10.3390/pathogens12050636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 04/17/2023] [Accepted: 04/20/2023] [Indexed: 05/28/2023] Open
Abstract
The persistence of a high-risk Human papillomavirus (HPV-HR) infection of the cervix results in different manifestations of lesions depending on the immunologic capacity of the host. Variations in apolipoprotein B mRNA editing enzyme catalytic polypeptide (APOBEC)-like genes, such as the APOBEC3A/B deletion hybrid polymorphism (A3A/B), may contribute to cervical malignancy in the presence of HPV. The aim of this study was to investigate the association between the A3A/B polymorphism and HPV infection and the development of cervical intraepithelial lesions and cervical cancer in Brazilian women. The study enrolled 369 women, who were categorized according to the presence of infection and subdivided according to the degree of intraepithelial lesion and cervical cancer. APOBEC3A/B was genotyped by allele-specific polymerase chain reaction (PCR). As for the A3A/B polymorphism, the distribution of genotypes was similar between groups and among the analyzed subgroups. There were no significant differences in the presence of infection or development of lesions, even after exclusion of confounding factors. This is the first study to show that the A3A/B polymorphism is not associated with HPV infection and the development of intraepithelial lesions and cervical cancer in Brazilian women.
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Affiliation(s)
- Eliza Pizarro Castilha
- Department of Pathological Sciences, Biological Sciences Center, State University of Londrina, Londrina 86057-970, PR, Brazil
| | - Rafaela Roberta de Jaime Curti
- Department of Pathological Sciences, Biological Sciences Center, State University of Londrina, Londrina 86057-970, PR, Brazil
| | - Janaina Nicolau de Oliveira
- Department of Pathological Sciences, Biological Sciences Center, State University of Londrina, Londrina 86057-970, PR, Brazil
| | | | - Roberta Losi Guembarovski
- Department of Biological Sciences, Biological Sciences Center, State University of Londrina, Londrina 86057-970, PR, Brazil
| | | | - Karen Brajão de Oliveira
- Department of Pathological Sciences, Biological Sciences Center, State University of Londrina, Londrina 86057-970, PR, Brazil
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22
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de Ribamar Ross J, Marinelli NP, Vidal FCB, da Costa Fraga E, do Desterro Soares Brandão Nascimento M, Safádi MAP. Frequency of human papilomavirus and associated factors in gypsy and quilombola women : Human papillomavirus in gypsy and quilombola women. BMC Womens Health 2023; 23:160. [PMID: 37016349 PMCID: PMC10072018 DOI: 10.1186/s12905-023-02239-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 02/23/2023] [Indexed: 04/06/2023] Open
Abstract
BACKGROUND The prevalence of Human Papillomavirus (HPV) infection in the general population is widely known, however, there are still few studies related to this infection in minority groups, Thus, the objective is to analyze the frequency of human papillomavirus and associated factors in quilombola and gypsy women. METHODS Cross-sectional research with 145 quilombola and gypsy women from Caxias, Maranhão. Two Pap smear collections were performed and a questionnaire with 46 questions was applied between January, 2020 and March, 2021. Descriptive analysis and Odds Ratio with 95% confidence interval were performed. The research was approved by the ethics committee. RESULTS There were 09 cases of atypia. The frequency of human papillomavirus was 41.37%, with a higher risk in quilombolas 55 (91.70%). Multiple infections were prevalent (53%) with high-risk genotypes 21 (35%). Types 16 and 18 together accounted for 42.85% of cases. CONCLUSIONS The frequency of human papillomavirus infection was higher than those recorded in the Northeast and Brazil, and therefore type 16 predominated. Due to limitations, the virus lineages and sublineages were not evaluated. Quilombola women had a higher rate of infection than gypsies.
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Affiliation(s)
| | - Natália Pereira Marinelli
- Federal University of Piauí, Teresina, Piauí, Brazil.
- Technical School of Teresina, St Dirce Oliveira, Ininga, Teresina, PI, 64048-550, Brazil.
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23
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Kulkarni SP, Paliwal S, Kosta S. Genotypic Diversity of Human Papillomavirus (HPV) Types and Its Prevalence With Cervical Cancer (CC) in Central India. Cureus 2023; 15:e35227. [PMID: 36968914 PMCID: PMC10032616 DOI: 10.7759/cureus.35227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2023] [Indexed: 02/22/2023] Open
Abstract
Background The high-risk human papillomavirus (hr-HPV) is linked with cervical cancer (CC), and the distinct proportional impact of each genotype on the prevalence of the disease depends on the area. Therefore, to find out the prevalence of HPV types in women with cervical lesions from central India, the current study was performed. Methodology Age, prior history of cervical disease, changes in lifestyle characteristics, menopausal status, and HPV vaccination status were all carefully gathered at enrollment for the 736 women (aged 21 to 60) screened in this cross-sectional study who were referred for regular screening of cervical during the study period. Cervix was examined for lesions by visual inspection with acetic acid (VIA) screening and HPV genotypes were identified by real-time polymerase chain reaction (RT-PCR). Result Among 736 women 215 (29.2%) were in the 21-30 age group, 321 (43.6%) in the 31-40 age group, 132 (17.9%) in the 41-50 age group, and 68 (9.3%) cases in >50 age group. According to education, there were 398 (54.1 %) with primary and below education, 115 (15.6%) with secondary education, and 223 (30.3%) with college and above education. HPV-16, 18, 31, and 45 each had a prevalence of 29.6%, 11.1%, 12.9%, and 9.2%, respectively, while the overall prevalence of hr-HP) was present in populations at 7.3% in individuals and 37.0% in combinations. Hr-HPV infection and prevalence were provocatively more (79.6%) in the VIA-positivity rate with CC. Conclusion Individual hr-HPV genotype prevalence was shown to be lower than with combinations (HPV-16, 18, 31, and 45). The HPV-16 genotype was identified to have a higher prevalence than HPV-18, 31, and 45. However, more awareness programs are needed for a better understanding of CC and HPV testing in central India.
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24
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Gupta AK, Kumar M. An integrative approach toward identification and analysis of therapeutic targets involved in HPV pathogenesis with a focus on carcinomas. Cancer Biomark 2023; 36:31-52. [PMID: 36245368 DOI: 10.3233/cbm-210413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Persistent infection of high-risk HPVs is known to cause diverse carcinomas, mainly cervical, oropharyngeal, penile, etc. However, efficient treatment is still lacking. OBJECTIVE Identify and analyze potential therapeutic targets involved in HPV oncogenesis and repurposing drug candidates. METHODS Integrative analyses were performed on the compendium of 1887 HPV infection-associated or integration-driven disrupted genes cataloged from the Open Targets Platform and HPVbase resource. Potential target genes are prioritized using STRING, Cytoscape, cytoHubba, and MCODE. Gene ontology and KEGG pathway enrichment analysis are performed. Further, TCGA cancer genomic data of CESC and HNSCC is analyzed. Moreover, regulatory networks are also deduced by employing NetworkAnalyst. RESULTS We have implemented a unique approach for identifying and prioritizing druggable targets and repurposing drug candidates against HPV oncogenesis. Overall, hundred key genes with 44 core targets were prioritized with transcription factors (TFs) and microRNAs (miRNAs) regulators pertinent to HPV pathogenesis. Genomic alteration profiling further substantiated our findings. Among identified druggable targets, TP53, NOTCH1, PIK3CA, EP300, CREBBP, EGFR, ERBB2, PTEN, and FN1 are frequently mutated in CESC and HNSCC. Furthermore, PIK3CA, CCND1, RFC4, KAT5, MYC, PTK2, EGFR, and ERBB2 show significant copy number gain, and FN1, CHEK1, CUL1, EZH2, NRAS, and H2AFX was marked for the substantial copy number loss in both carcinomas. Likewise, under-explored relevant regulators, i.e., TFs (HINFP, ARID3A, NFATC2, NKX3-2, EN1) and miRNAs (has-mir-98-5p, has-mir-24-3p, has-mir-192-5p, has-mir-519d-3p) is also identified. CONCLUSIONS We have identified potential therapeutic targets, transcriptional and post-transcriptional regulators to explicate HPV pathogenesis as well as potential repurposing drug candidates. This study would aid in biomarker and drug discovery against HPV-mediated carcinoma.
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Affiliation(s)
- Amit Kumar Gupta
- Virology Unit and Bioinformatics Centre, Institute of Microbial Technology, Council of Scientific and Industrial Research (CSIR), Chandigarh, India
| | - Manoj Kumar
- Virology Unit and Bioinformatics Centre, Institute of Microbial Technology, Council of Scientific and Industrial Research (CSIR), Chandigarh, India.,Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
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25
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Céspedes-Tenorio D, Arias-Arias JL. The Virus-Induced Cytopathic Effect. Subcell Biochem 2023; 106:197-210. [PMID: 38159228 DOI: 10.1007/978-3-031-40086-5_7] [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] [Indexed: 01/03/2024]
Abstract
The cytopathic effect comprises the set of cellular alterations produced by a viral infection. It is of great relevance since it constitutes a direct marker of infection. Likewise, these alterations are often virus-specific which makes them a phenotypic marker for many viral species. All these characteristics have been used to complement the study of the dynamics of virus-cell interactions through the kinetic study of the progression of damage produced by the infection. Various approaches have been used to monitor the cytopathic effect, ranging from light microscopy, immunofluorescence assays, and direct labeling with fluorescent dyes, to plaque assay for the characterization of the infection over time. Here we address the relevance of the study of cytopathic effect and describe different experimental alternatives for its application.
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Affiliation(s)
- Daniel Céspedes-Tenorio
- Centro de Investigación en Enfermedades Tropicales, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica
| | - Jorge L Arias-Arias
- Centro de Investigación en Enfermedades Tropicales, Facultad de Microbiología, Universidad de Costa Rica, San José, Costa Rica.
- Dulbecco Lab Studio, Residencial Lisboa 2G, Alajuela, Costa Rica.
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Meng R, Soper B, Lee HK, Nygård JF, Nygård M. Hierarchical continuous-time inhomogeneous hidden Markov model for cancer screening with extensive followup data. Stat Methods Med Res 2022; 31:2383-2399. [PMID: 36039541 DOI: 10.1177/09622802221122390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Continuous-time hidden Markov models are an attractive approach for disease modeling because they are explainable and capable of handling both irregularly sampled, skewed and sparse data arising from real-world medical practice, in particular to screening data with extensive followup. Most applications in this context consider time-homogeneous models due to their relative computational simplicity. However, the time homogeneous assumption is too strong to accurately model the natural history of many diseases including cancer. Moreover, cancer risk across the population is not homogeneous either, since exposure to disease risk factors can vary considerably between individuals. This is important when analyzing longitudinal datasets and different birth cohorts. We model the heterogeneity of disease progression and regression using piece-wise constant intensity functions and model the heterogeneity of risks in the population using a latent mixture structure. Different submodels under the mixture structure employ the same types of Markov states reflecting disease progression and allowing both clinical interpretation and model parsimony. We also consider flexible observational models dealing with model over-dispersion in real data. An efficient, scalable Expectation-Maximization algorithm for inference is proposed with the theoretical guaranteed convergence property. We demonstrate our method's superior performance compared to other state-of-the-art methods using synthetic data and a real-world cervical cancer screening dataset from the Cancer Registry of Norway. Moreover, we present two model-based risk stratification methods that identify the risk levels of individuals.
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Affiliation(s)
- Rui Meng
- 8787University of California, Santa Cruz, CA, USA
| | - Braden Soper
- 4578Lawrence Livermore National Laboratory, Livermore, CA, USA
| | | | | | - Mari Nygård
- 11315Cancer Registry of Norway, Oslo, Norway
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Langberg GSRE, Stapnes M, Nygård JF, Nygård M, Grasmair M, Naumova V. Matrix factorization for the reconstruction of cervical cancer screening histories and prediction of future screening results. BMC Bioinformatics 2022; 23:484. [DOI: 10.1186/s12859-022-04949-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 09/16/2022] [Indexed: 11/17/2022] Open
Abstract
Abstract
Background
Mass screening programs for cervical cancer prevention in the Nordic countries have strongly reduced cancer incidence and mortality at the population level. An alternative to the current mass screening is a more personalised screening strategy adapting the recommendations to each individual. However, this necessitates reliable risk prediction models accounting for disease dynamics and individual data. Herein we propose a novel matrix factorisation framework to classify females by the time-varying risk of being diagnosed with cervical cancer. We cast the problem as a time-series prediction model where the data from females in the Norwegian screening population are represented as sparse vectors in time and then combined into a single matrix. Using novel temporal regularisation and discrepancy terms for the cervical cancer screening context, we reconstruct complete screening profiles from this scarce matrix and use these to predict the next exam results indicating the risk of cervical cancer. The algorithm is validated on both synthetic and registry screening data by measuring the probability of agreement (PoA) between Kaplan-Meier estimates.
Results
In numerical experiments on synthetic data, we demonstrate that the novel regularisation and discrepancy term can improve the data reconstruction ability as well as prediction performance over varying data scarcity. Using a hold-out set of screening data, we compare several numerical models and find that the proposed framework attains the strongest PoA. We observe strong correlations between the empirical survival curves from our method and the hold-out data, and evaluate the ability of our framework to predict the females’ next results for up to five years ahead in time using only their current screening histories as input.
Conclusions
We have proposed a matrix factorization model for predicting future screening results and evaluated its performance in a female cohort to demonstrate the potential for developing prediction models for more personalized cervical cancer screening.
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Temporal trends and factors associated with the cancer diagnosed at stage IV in patients included in the integrated hospital-based cancer registry system in Brazil in two decades. Cancer Epidemiol 2022; 80:102242. [PMID: 36087358 DOI: 10.1016/j.canep.2022.102242] [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] [Received: 05/09/2022] [Revised: 08/16/2022] [Accepted: 08/21/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND In several countries, such as Brazil, the oncological diagnosis usually occurs at an advanced stage of the disease. Thus, the aim of this study was to investigate temporal trends and factors associated with the cancer diagnosed at stage IV in Brazil in two decades. METHODS Secondary-based study, with time series analysis for trend assessment and cross-sectional of factors associated with diagnosis of female breast, prostate, cervix uteri, colorectal, lung, stomach, lip and oral cavity, thyroid, esophagus or corpus uteri at stage IV. RESULTS 1,218,322 cases were evaluated. The types of cancer with the highest proportion of stage IV at diagnosis in men and women, respectively, were: lung (53.7% and 57.4%), stomach (48.4% and 45.0%) and lip/oral cavity (53.5% and 43.4%). Most showed an increasing trend of annual percent change of cancer diagnosed at stage IV, being more pronounced in corpus uteri cancer (2013-2019: +7.4%, p < 0.001). The odds of cancer diagnosed at stage IV were associated with different factors, according to primary tumor site, but marked by the inverse association with female sex [odds ratio (OR) ranging from 0.42 to 0.91, p < 0.001] and direct association in cases with < 7 years of study (OR ranging from 1.08 to 1.81, p < 0.001), living without a partner (OR ranging from 1.06, p < 0.050 to1.27, p < 0.001), living in the South and Southeast regions (OR ranging from 1.04 to 1.13, p < 0.001), with more than one tumor (OR ranging from 1.19, p < 0.050 to 1.54, p < 0.001) and treated in Centers of High Complexity in Oncology (OR ranging from 1.03, p < 0.050 to1.24, p < 0.001). CONCLUSION There was a high frequency of cancer diagnosed at stage IV and an increasing trend in different cancer types, which were associated with distinct sociodemographic, lifestyle, and clinical factors.
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Adebamowo SN, Befano B, Cheung LC, Rodriguez AC, Demarco M, Rydzak G, Chen X, Porras C, Herrero R, Kim JJ, Castle PE, Wentzensen N, Kreimer AR, Schiffman M, Campos NG. Different human papillomavirus types share early natural history transitions in immunocompetent women. Int J Cancer 2022; 151:920-929. [PMID: 35603904 PMCID: PMC9329241 DOI: 10.1002/ijc.34128] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 03/30/2022] [Accepted: 04/27/2022] [Indexed: 11/07/2022]
Abstract
Necessary stages of cervical carcinogenesis include acquisition of a carcinogenic human papillomavirus (HPV) type, persistence associated with the development of precancerous lesions, and invasion. Using prospective data from immunocompetent women in the Guanacaste HPV Natural History Study (NHS), the ASCUS-LSIL Triage Study (ALTS) and the Costa Rica HPV Vaccine Trial (CVT), we compared the early natural history of HPV types to inform transition probabilities for health decision models. We excluded women with evidence of high-grade cervical abnormalities at any point during follow-up and restricted the analysis to incident infections in all women and prevalent infections in young women (aged <30 years). We used survival approaches accounting for interval-censoring to estimate the time to clearance distribution for 20 529 HPV infections (64% were incident and 51% were carcinogenic). Time to clearance was similar across HPV types and risk classes (HPV16, HPV18/45, HPV31/33/35/52/58, HPV 39/51/56/59 and noncarcinogenic HPV types); and by age group (18-29, 30-44 and 45-54 years), among carcinogenic and noncarcinogenic infections. Similar time to clearance across HPV types suggests that relative prevalence can predict relative incidence. We confirmed that there was a uniform linear association between incident and prevalent infections for all HPV types within each study cohort. In the absence of progression to precancer, we observed similar time to clearance for incident infections across HPV types and risk classes. A singular clearance function for incident HPV infections has important implications for the refinement of microsimulation models used to evaluate the cost-effectiveness of novel prevention technologies.
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Affiliation(s)
- Sally N. Adebamowo
- Department of Epidemiology and Public Health, Greenebaum Comprehensive Cancer Center; University of Maryland School of Medicine, Baltimore, MD, United States
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, United States
| | - Brian Befano
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, United States
- Information Management Services Inc, Information Management, Calverton, NY, United States
| | - Li C. Cheung
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, United States
| | - Ana Cecilia Rodriguez
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, United States
| | - Maria Demarco
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, United States
| | - Greg Rydzak
- Information Management Services Inc, Information Management, Calverton, NY, United States
| | - Xiaojian Chen
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, United States
| | - Carolina Porras
- Agencia Costarricense de Investigaciones Biomédicas, Fundación INCIENSA, San José, Costa Rica
| | - Rolando Herrero
- Agencia Costarricense de Investigaciones Biomédicas, Fundación INCIENSA, San José, Costa Rica
- Prevention and Implementation Group, International Agency for Research on Cancer, Lyon, France
| | - Jane J. Kim
- Center for Health Decision Science, Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Philip E. Castle
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, United States
- Division of Cancer Prevention, National Cancer Institute, Rockville, MD, United States
| | - Nicolas Wentzensen
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, United States
| | - Aimée R. Kreimer
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, United States
| | - Mark Schiffman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, United States
| | - Nicole G. Campos
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, United States
- Center for Health Decision Science, Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, United States
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Shahmoradi Z, Damgacioglu H, Montealegre J, Chiao EY, Sigel K, Sonawane K, Deshmukh AA. Prevalence of Human Papillomavirus Infection Among Women Born in the 1990s vs the 1980s and Association With HPV Vaccination in the US. JAMA HEALTH FORUM 2022; 3:e222706. [PMID: 36200637 PMCID: PMC9391982 DOI: 10.1001/jamahealthforum.2022.2706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Zahed Shahmoradi
- Center for Health Services Research, Department of Management, Policy, and Community Health, The University of Texas Health Science Center School of Public Health, Houston
| | - Haluk Damgacioglu
- Center for Health Services Research, Department of Management, Policy, and Community Health, The University of Texas Health Science Center School of Public Health, Houston
| | - Jane Montealegre
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Elizabeth Y. Chiao
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston
| | - Keith Sigel
- Department of General Internal Medicine, Department of Medicine, Mount Sinai Icahn School of Medicine, New York, New York
| | - Kalyani Sonawane
- Center for Health Services Research, Department of Management, Policy, and Community Health, The University of Texas Health Science Center School of Public Health, Houston
| | - Ashish A. Deshmukh
- Center for Health Services Research, Department of Management, Policy, and Community Health, The University of Texas Health Science Center School of Public Health, Houston
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Arslan HN, Oruc MA. Results from a cervical cancer screening program in Samsun, Turkey. BMC Womens Health 2022; 22:331. [PMID: 35927723 PMCID: PMC9354280 DOI: 10.1186/s12905-022-01916-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 08/01/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Cervical cancer is a preventable disease. This study aimed to share the results of the national cervical cancer screening program performed in primary health care institutions in Samsun between 2015 and 2019. METHODS Women aged 30-65 years who were screened for cervical cancer in screening centers of Samsun between January 01, 2015, and December 31, 2019, were included in this descriptive study. The data were obtained from the automation program of the "National Human Papilloma Virus (HPV) Laboratory Application" used by the Provincial Directorate of Health Cancer Unit through filtering the completion time of the tests, and all results were evaluated without sampling. Thus, data were presented using descriptive statistics. RESULTS The mean age of 89,302 women included in the cervical cancer screening program was 45.9 ± 9.0 years. Of the samples obtained from the participants, 1.0% were determined as insufficient material, 94.1% as HPV-negative, and 4.9% as HPV-positive. The most common HPV genotypes were 16, 51, 31, and 52. Of the 4337 HPV-positive women, 74.7% of the pap smear results were negative (including infection, 36.5%), and the most common premalignant lesions were atypical squamous cells of undetermined significance in 7.1% and low-grade squamous intraepithelial lesions in 6.9%. HPV 16/18 was also observed in 31.7% of HPV-positive women. Seven hundred ninety-five women were referred to a specialist physician for further examination and treatment within the scope of the screening algorithm. CONCLUSION Detecting HPV-positivity by reaching more women within the national cervical cancer screening program's scope is vital in fighting against this disease. The effectiveness of cancer screening programs should be increased by ensuring community participation through awareness activities.
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Affiliation(s)
- Hatice Nilden Arslan
- Department of Public Health, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey.
| | - Muhammet Ali Oruc
- Department of Family Medicine, Faculty of Medicine, Ahi Evran University, Kirsehir, Turkey
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Pauli S, Kops NL, Bessel M, Lina Villa L, Moreno Alves Souza F, Mendes Pereira GF, Neves Hugo F, Marcia Wendland E. Sexual practices and HPV infection in unvaccinated young adults. Sci Rep 2022; 12:12385. [PMID: 35859090 PMCID: PMC9300667 DOI: 10.1038/s41598-022-15088-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 06/17/2022] [Indexed: 11/30/2022] Open
Abstract
The present study aimed to evaluate the association of genital and oral HPV infection among different sexual practices in both sexes. In total, 6388 unvaccinated men and women aged 16–25 years from all state capitals of Brazil were enrolled in through primary care services between September 2016 and November 2017. Genital and oral HPV genotyping was performed using the Roche Linear Array. Poisson regression analysis with robust variance was conducted to examine factors associated with overall HPV infection. A higher prevalence of genital HPV was found in women who practiced oral sex (57.85%) and in men who practiced all types of sex (65.87%). However, having more sexual partners and being younger were more important than the type of sex practiced. HPV 6 (7.1%) and 16 (10.5%) were significantly more prevalent in women who practiced oral sex, while HPV 6 (23.96%) and 11 (21.49%) were more prevalent in men who practiced anal sex. The type of sex was not associated with oral HPV prevalence. Genital and oral HPV infection were not associated by different sexual practices in the studied population.
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Affiliation(s)
- Sílvia Pauli
- Hospital Moinhos de Vento, Rua Ramiro Barcelos 910, Porto Alegre, RS, 90035-004, Brazil
| | - Natália Luiza Kops
- Hospital Moinhos de Vento, Rua Ramiro Barcelos 910, Porto Alegre, RS, 90035-004, Brazil
| | - Marina Bessel
- Hospital Moinhos de Vento, Rua Ramiro Barcelos 910, Porto Alegre, RS, 90035-004, Brazil
| | - Luisa Lina Villa
- Department of Radiology and Oncology, Medical School, Universidade de São Paulo (USP), and Instituto do Câncer do Estado de São Paulo (ICESP), São Paulo, SP, Brazil
| | - Flávia Moreno Alves Souza
- Department of Chronic Conditions and Sexually Transmitted Infections, Ministry of Health, Brasília, DF, Brazil
| | | | - Fernando Neves Hugo
- Department of Preventive and Social Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | - Eliana Marcia Wendland
- Hospital Moinhos de Vento, Rua Ramiro Barcelos 910, Porto Alegre, RS, 90035-004, Brazil. .,Department of Public Health, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil.
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33
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Langberg GSRE, Nygård JF, Gogineni VC, Nygård M, Grasmair M, Naumova V. Towards a data-driven system for personalized cervical cancer risk stratification. Sci Rep 2022; 12:12083. [PMID: 35840652 PMCID: PMC9287371 DOI: 10.1038/s41598-022-16361-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 07/08/2022] [Indexed: 12/04/2022] Open
Abstract
Mass-screening programs for cervical cancer prevention in the Nordic countries have been effective in reducing cancer incidence and mortality at the population level. Women who have been regularly diagnosed with normal screening exams represent a sub-population with a low risk of disease and distinctive screening strategies which avoid over-screening while identifying those with high-grade lesions are needed to improve the existing one-size-fits-all approach. Machine learning methods for more personalized cervical cancer risk estimation may be of great utility to screening programs shifting to more targeted screening. However, deriving personalized risk prediction models is challenging as effective screening has made cervical cancer rare and the exam results are strongly skewed towards normal. Moreover, changes in female lifestyle and screening habits over time can cause a non-stationary data distribution. In this paper, we treat cervical cancer risk prediction as a longitudinal forecasting problem. We define risk estimators by extending existing frameworks developed on cervical cancer screening data to incremental learning for longitudinal risk predictions and compare these estimators to machine learning methods popular in biomedical applications. As input to the prediction models, we utilize all the available data from the individual screening histories.Using data from the Cancer Registry of Norway, we find in numerical experiments that the models are strongly biased towards normal results due to imbalanced data. To identify females at risk of cancer development, we adapt an imbalanced classification strategy to non-stationary data. Using this strategy, we estimate the absolute risk from longitudinal model predictions and a hold-out set of screening data. Comparing absolute risk curves demonstrate that prediction models can closely reflect the absolute risk observed in the hold-out set. Such models have great potential for improving cervical cancer risk stratification for more personalized screening recommendations.
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Affiliation(s)
| | - Jan F Nygård
- Department of Registry Informatics, CRN, Oslo, 0379, Norway
| | - Vinay Chakravarthi Gogineni
- Department of Electronic Systems, Norwegian University of Science and Technology (NTNU), Trondheim, 7491, Norway
| | - Mari Nygård
- Department of Research, Cancer Registry of Norway (CRN), Oslo, 0379, Norway
| | - Markus Grasmair
- Department of Mathematical Sciences, NTNU, Trondheim, 7491, Norway
| | - Valeriya Naumova
- Machine Intelligence Department, Simula Research Laboratory, Oslo, 0164, Norway
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Aryanian Z, Mohammadi M, Babazadeh A, Hatami P, Mohseni Afshar Z, Goodarzi A, Etesami I, Barary M, Ebrahimpour S, Sabbagh P. Knowledge and Attitude of Iranian University Students toward Genital Warts. Interdiscip Perspect Infect Dis 2022; 2022:6730476. [PMID: 39282591 PMCID: PMC11401711 DOI: 10.1155/2022/6730476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 06/16/2022] [Indexed: 09/19/2024] Open
Abstract
Human papillomavirus (HPV) is one of the well-known causes of cervical cancer and one of the most prevalent sexually transmitted diseases (STDs). Since cervical cancer is one of the most common causes of morbidity and mortality in women, this study was performed to investigate Iranian medical students' knowledge and attitudes towards genital warts. This cross-sectional study assessed the perception and attitudes of 385 students at Babol University of Medical Sciences using a preconceived questionnaire. The participants' mean age was 23.70 ± 3.27 years, with a range of 20-50 years. Evaluation of these students' level of general information about HPV showed that 7 (1.8%) students had inadequate general information, 34 (8.8%) had moderate knowledge, and 344 (89.4%) had good general knowledge in this regard. There was also a significant association between students' general knowledge of HPV and their field of study. Based on our results, the knowledge of the majority of Babol University of Medical Sciences students about genital warts was in a good range, and their knowledge about HPV routes of transmission was of moderate level. Moreover, the majority had an appropriate attitude to interact with people infected with HPV.
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Affiliation(s)
- Zeinab Aryanian
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Dermatology, School of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Maedeh Mohammadi
- Department of Dermatology, School of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Arefeh Babazadeh
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Parvaneh Hatami
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Zeinab Mohseni Afshar
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Azadeh Goodarzi
- Department of Dermatology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ifa Etesami
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Barary
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Soheil Ebrahimpour
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Parisa Sabbagh
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
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35
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Liu J, Li Y, Bo D, Wang J, Wang Y. High-risk human papillomavirus infection in pregnant women: a descriptive analysis of cohorts from two centers. J Investig Med 2022; 70:1494-1500. [PMID: 35728867 DOI: 10.1136/jim-2022-002442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2022] [Indexed: 11/03/2022]
Abstract
The aim was to descriptively analyze the clinical characteristics, cytopathology, and outcomes of pregnant patients with high-risk human papillomavirus (HPV) infection. Clinical data of 151,516 female patients with high-risk HPV infection were retrospectively collected. Baseline data, cervical cytology results, histopathology, HPV types, delivery mode, and follow-up outcomes were recorded for descriptive analysis. A total of 157 patients were identified as positive for high-risk HPV. There were 32 (24.2%), 6 (4.5%), and 107 (81.1%) cases of HPV-16, HPV-18, and other types, respectively. Additionally, 12 patients showed combined infection with HPV-18 or HPV-16 and other types. Cytopathological examinations showed that the most common type was low-grade squamous intraepithelial lesion (LSIL; 104 cases, 78.8%), followed by high-grade squamous intraepithelial lesion (HSIL; 17 cases, 12.8%), atypical squamous cells of undetermined significance (10 cases, 9.6%), and cervical cancer (1 case, 0.7%). Thirty-seven patients underwent colposcopic biopsy, of whom 9 (24.3%) showed normal results, while 12 (32.4%) and 13 (35.1%) patients had LSIL and HSIL, respectively. χ2 tests demonstrated that different delivery modes did not show significant difference in patients' cervical cytopathology (p>0.05). However, therapeutic methods were statistically different among patients with different cytopathological types (p<0.05). Cervical alterations in pregnancy mostly go along with high-risk HPV infection. High-risk HPV infection in pregnancy with abnormal cervical cytology should be followed closely during the pregnancy and postpartum period.
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Affiliation(s)
- Jing Liu
- Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Yuhong Li
- Department of Gynecologic Oncology, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Di Bo
- Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Jiandong Wang
- Department of Gynecological Oncology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Yudong Wang
- Department of Gynecologic Oncology, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
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Altay-Kocak A, Kazanci F, Dogu-Tok C, Onan A, Erdem O, Ozkan S, Bozdayi G. The prevalence and distribution of human papillomavirus in 4267 Turkish women with or without cervical lesions: A hospital-based study. J Med Virol 2022; 94:5026-5032. [PMID: 35676203 DOI: 10.1002/jmv.27921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 05/10/2022] [Accepted: 06/06/2022] [Indexed: 11/10/2022]
Abstract
In the present study, it was aimed to screen the genotypes of human papillomavirus (HPV) retrospectively in women with gynecological symptoms who were admitted to a tertiary care university hospital in Ankara, Turkey. A total of 4267 cervical swab samples of women aged 18-79 years were sent to Medical Virology Laboratory from January 2017 to November 2020. Nucleic acid extraction and amplification of samples were done by an automated system. The test can detect 14 high-risk HPV (HR-HPV) types in a single analysis that performs a real-time polymerase chain reaction, by providing individual results on the highest-risk genotypes HPV 16 and HPV 18 and pooled results on other high-risk genotypes (OHR-HPV) (31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68). HPV DNA positivity was detected in 14.2% (605/4267) of the samples. HPV type 16 and type 18 were detected in 2.4% and 0.7% of the samples, respectively. OHR-HPV types were found in 8.8% of the samples. Of the 1.9% and 0.4% samples had mixed types with type 16+ OHR-HPV and type 18+ OHR-HPV, respectively. The results of this study presented the rates of HR-HPV genotypes of a university hospital in Ankara, over a 4-year period. It was observed that the positivity rate of type 18 is decreasing and some OHR-HPV types are increasing. HPV vaccination is not in the national immunization program in Turkey yet, however, HPV vaccines are available and the vaccination rates for women are increasing.
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Affiliation(s)
- Aylin Altay-Kocak
- Department of Medical Microbiology, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Ferah Kazanci
- Department of Obstetrics and Gynecology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Canan Dogu-Tok
- Department of Medical Microbiology, Division of Medical Virology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Anil Onan
- Department of Obstetrics and Gynecology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Ozlem Erdem
- Department of Pathology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Secil Ozkan
- Department of Public Health, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Gulendam Bozdayi
- Department of Medical Microbiology, Division of Medical Virology, Faculty of Medicine, Gazi University, Ankara, Turkey
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Wong ELY, Cheung AWL, Chen Z, Wong AYK, Yeung ACM, Yau PSY, Chan PKS. Molecular Epidemiology of Human Papillomavirus Infection Among Chinese Women With Cervical Cytological Abnormalities. Front Public Health 2022; 10:820517. [PMID: 35655449 PMCID: PMC9152134 DOI: 10.3389/fpubh.2022.820517] [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: 11/24/2021] [Accepted: 04/11/2022] [Indexed: 11/13/2022] Open
Abstract
Background Virtually all invasive cervical cancers are caused by persistent genital human papillomavirus (HPV) infection. Therefore, HPV-based screening becomes an essential tool as one of the cervical prevention strategies to reduce the disease burden. Population-specific epidemiologic information on HPV infection among women with cytological abnormalities is essential to inform the strategy of HPV-based screening programme. The study also explored the presence of cutaneous HPV types (Beta-β and Gamma-γ) in cervical infections. Methods A cross-sectional study on Chinese women aged ≥25 years who were referred to public specialist out-patient clinics for colposcopy or further management of cervical cytological abnormalities were recruited between 2015 and 2016 in Hong Kong. HPV was detected and typified by the novel PCR-based Next-Generation Sequencing (NGS) strategies. Results The overall HPV infection rate was 74% and detected in 222 of the 300 respondents, with the prevalence of cutaneous HPV infection being 2.3%. The overall prevalence of HPV infection among women with current cytological abnormalities was 79.1% (197/249). The age-specific prevalence of HPV (any-type HPV infection) among women with cytological abnormalities reached the first peak with 87.9% in the age group of 35–39 years and gradually declined to 56.0% at 55–59 years. While a second peak occurred at 65 years or above (92.9%). HPV58 (13.7%), HPV52 (11.7%), HPV53 (11.2%), HPV16 (10.0%), HPV18 (5.2%), and HPV51 (5.2%) were the top five high-risk HPV genotypes among women with cytological abnormalities. Any-HPV type infection was significantly associated with an abnormal cervical smear (OR = 3.7; 95% CI 2.0–7.1), and high-risk HPV infection was also significantly associated with an abnormal cervical smear (OR = 6.3; 95% CI 3.0–13.5). Conclusion New evidence on the second peak of HPV infection at ≥65 years old suggests the necessity to review the current guideline for the cervical screening program extending to age 65 and above. Moreover, the high prevalence of two HPV genotypes—high-risk HPV51 and potential high-risk HPV53, among women with cytological abnormalities—suggests further research work is needed to confirm the contributory role of HPV51 and HPV53 in cervical cancer and the need for inclusion in the next generation of the HPV vaccine.
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Affiliation(s)
- Eliza Lai-Yi Wong
- Centre for Health Systems and Policy Research, The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Annie Wai-Ling Cheung
- Centre for Health Systems and Policy Research, The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Zigui Chen
- Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Amy Yuen-Kwan Wong
- Centre for Health Systems and Policy Research, The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Apple Chung-Man Yeung
- Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Peter Sen-Yung Yau
- Centre for Health Systems and Policy Research, The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Paul Kay-Sheung Chan
- Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
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Chen F, Novák Z, Dannecker C, Mokráš C, Sui L, Zhang Y, You Z, Han L, Lang J, Hillemanns P. Multicentre, prospective, randomised controlled trial to evaluate hexaminolevulinate photodynamic therapy (Cevira) as a novel treatment in patients with high-grade squamous intraepithelial lesion: APRICITY phase 3 study protocol. BMJ Open 2022; 12:e061740. [PMID: 35667715 PMCID: PMC9171256 DOI: 10.1136/bmjopen-2022-061740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 05/13/2022] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION High-risk human papilloma virus (HPV)-associated cervical cancer is the fourth most common cancer in women worldwide. Current treatments of high-grade squamous intraepithelial lesion (HSIL) of the cervix are based on invasive surgical interventions, compromising cervical competence and functionality. APRICITY is a multicentre, prospective, double-blind, randomised controlled phase 3 study further evaluating the efficacy and safety of Cevira, an integrated drug-delivery and light-delivery device for hexaminolevulinate photodynamic therapy, which shows promise as a novel, non-invasive outpatient therapy for women with HSIL. METHODS AND ANALYSIS Patients with biopsy-confirmed HSIL histology are invited to participate in the study planned to be conducted at 47 sites in China and 25 sites in Ukraine, Russia and the European Union. The aim is to include at least 384 patients, which will be randomised to either Cevira or placebo group (2:1). All patients will be assessed 3 months after first treatment and a second treatment will be administered in patients who are HPV positive or have at least low-grade squamous intraepithelial lesion. Primary endpoint is the proportion of the responders 6 months after first treatment. Secondary efficacy and safety endpoints will be assessed at 6 months, and data for secondary performance endpoints of the Cevira device will be collected at 3 months and 6 months, in case second treatment was administered. All patients in the Cevira group will be enrolled in an open, long-term extension study for 6 months to collect additional efficacy and safety data (study extension endpoints). ETHICS AND DISSEMINATION The study was approved by the ethics committee of the Peking Union Medical College Hospital and Hannover Medical University, Germany. Findings will be disseminated through peer review publications and conference presentations. TRIAL REGISTRATION NUMBER NCT04484415; clinicaltrials.gov.
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Affiliation(s)
- Fei Chen
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, China
| | - Zoltán Novák
- Aranyklinika Gynecology, Budapest, Hungary
- Department of Gynaecology, National Institute of Oncology, Budapest, Hungary
| | - Christian Dannecker
- Department of Obstetrics and Gynaecology, University Hospital Augsburg, Augsburg, Germany
| | | | - Long Sui
- Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Youzhong Zhang
- Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan, China
| | - Zhixue You
- Department of Obstetrics and Gynecology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, China
| | - Ling Han
- Asieris Pharmaceuticals (Shanghai) Co., Ltd, Shanghai, China
| | - Jinghe Lang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, China
| | - Peter Hillemanns
- Department of Gynecology and Obstetrics, Hannover Medical School, Hannover, Germany
- Comprehensive Cancer Center Niedersachsen, Hannover, Germany
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Plotti F, Rossini G, Ficarola F, De Cicco Nardone C, Montera R, Guzzo F, Luvero D, Fabris S, Angioli R, Terranova C. Early Mini-Invasive Treatment of Persistent Cervical Dysplasia: Clinical Outcome and Psycho-Relational Impact. Front Surg 2022; 9:888457. [PMID: 35662822 PMCID: PMC9160712 DOI: 10.3389/fsurg.2022.888457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 03/21/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionAfter the diagnosis of L-SIL, 77. 3% had a persistent infection and anomalous Pap Test results. Many of these patients had highlighted psychological consequences such as anxiety, hypochondria, fear of cancer, and sexual problems. Several studies suggested that the clearance of HR-HPV infection could be accelerated by cervical excisional procedures, especially in L-SIL. In consideration of the psychological implications for HPV infection and related dysplasia in patients with CIN1 at PAP-smear and HR-HPV positivity at least for 6 months, we decided to plan a prospective study where we tried to anticipate excisional cervical using a minimally invasive treatment: thin loop electrosurgical excision procedure (t-LEEP). This study aims to analyze the clearance of HR-HPV after 6 and 12 months, clinical outcomes related to t-LEEP, and the psycho-relational impact at 12 months after t-LEEP.Materials and MethodsWe enrolled patients with the diagnosis of L-SIL at PAP-smear and HR-HPV positivity with a persistent CIN 1 (at least for 6 months), confirmed by cervical biopsy. All enrolled patients underwent t-LEEP. We followed prospectively and performed for all patients the HPV DNA test at 6 (T1) and 12 months (T2) and STAI-Y and FSFI scores at T0 and T2.ResultsWe prospectively enrolled 158 patients, 22 are excluded for the established criteria. Patients with HR-HPV and CIN 1 lesions treated with t-LEEP had an overall clearance of 83.8% at T2. In subgroups analysis at T2, we had a regression: in smoker 71.8%, in contraceptive users 69.5%, in patients aged <25 years 100%, aged 25–30 years 85%, aged 30–35 years 94.4%, aged 35–40 years 92%, and aged ≥40 years 89.1%, in HPV-16 96.4%, in HPV-53 89.5%, in HPV-18 87.5%, in HPV-31 86.6%, and in coinfected 3.5%. STAI-Y and FSFI after t-LEEP (T2) were statistically significant, reducing anxiety status and improving sexual function.ConclusionBased on these results, the use of t-LEEP in patients with persistent CIN 1 and HPV-HR at least for 6 months could be useful for accelerating HPV-HR clearance, in particular, for a subpopulation patient with an increased risk of progression and/or patients with psychological and sexual consequences of carrying an HR-HPV infection.
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Affiliation(s)
- Francesco Plotti
- Department of Gynecology, Campus Bio-Medico University Hospital Foundation, Rome, Italy
| | - Gianmarco Rossini
- ASST of the Olona Valley, Department of Obstetrics and Gynecology, Varese, Italy
| | - Fernando Ficarola
- Department of Gynecology, Campus Bio-Medico University Hospital Foundation, Rome, Italy
- *Correspondence: Fernando Ficarola
| | | | - Roberto Montera
- Department of Gynecology, Campus Bio-Medico University Hospital Foundation, Rome, Italy
| | - Federica Guzzo
- Department of Gynecology, Campus Bio-Medico University Hospital Foundation, Rome, Italy
| | - Daniela Luvero
- Department of Gynecology, Campus Bio-Medico University Hospital Foundation, Rome, Italy
| | - Silvia Fabris
- National Center for Control and Emergency Against Animal Diseases and Central Crisis Unit–Office III, Directorate-General for Animal Health and Veterinary Drugs, Italian Ministry of Health, Rome, Italy
- Medical Statistics and Epidemiology Unit, Campus Bio-Medico University, Rome, Italy
| | - Roberto Angioli
- Department of Gynecology, Campus Bio-Medico University Hospital Foundation, Rome, Italy
| | - Corrado Terranova
- Department of Gynecology, Campus Bio-Medico University Hospital Foundation, Rome, Italy
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Developing a Biosensor-Based Immunoassay to Detect HPV E6 Oncoprotein in the Saliva Rinse Fluid of Oral Cancer Patients. J Pers Med 2022; 12:jpm12040594. [PMID: 35455710 PMCID: PMC9027100 DOI: 10.3390/jpm12040594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 03/22/2022] [Accepted: 03/23/2022] [Indexed: 02/04/2023] Open
Abstract
Transmission of Human papillomavirus (HPVs) is faithfully associated with carcinogenesis of oral cavity and oropharyngeal cancers. Therefore, clinical researchers may need to generate customized antibodies for the upcoming ELISA-based analysis to discover rare but valuable biomarkers. The aim of study was to develop and generate a biosensor-based immunoassay for early screening HPV-related oral cancer via saliva rinse fluid analysis. A peptide fragment of high-risk HPV subtype 16/18 protein, E6 protein (HP-1 protein sequence 48–66), was designed and synthesized, followed by the generation of polyclonal antibodies (anti-HP1 IgY) in our university-based laboratories. The titer and specificity of antibodies were determined by enzyme-linked immunosorbent assay (ELISA), and the Surface Plasmon Resonance (SPR) biosensor-based method was developed. Kinetic analyses by SPR confirmed that this designed peptide showed a high affinity with its generated polyclonal antibodies. Saliva fluid samples of thirty oral cancer patients and 13 healthy subjects were analyzed. SPR indicated that 26.8% of oral cancer patients had higher resonance unit (ΔRU) values than normal subjects. In conclusion, we developed a biosensor-based immunoassay to detect HPV E6 oncoprotein in the saliva rinse fluid for early screening and discrimination of HPV-related oral cancer patients.
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Liu Y, Yin Y, Zhang Y, Lin L, Zhao M, Chen Q. Diagnostic Management of Oncogenic HPV Cervical Infections: The Field Experience in Wuxi, China. Front Med (Lausanne) 2022; 9:825228. [PMID: 35402444 PMCID: PMC8984024 DOI: 10.3389/fmed.2022.825228] [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: 11/30/2021] [Accepted: 02/28/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction A liquid-based cytology test was introduced for cervical cancer screening in the 2000s worldwide. However, the concordance of diagnostic findings between the liquid-based cytology test and cervical biopsy has not been fully investigated, especially the overall failure rate on the diagnosis of cervical cancer and high-grade squamous intraepithelial lesion (HSIL) by cytology testing. The aim of this retrospective study was to investigate the concordance between ThinPrep cytology and histology test in the diagnosis of cervical cancer and HSIL in HPV-positive women. Methods ThinPrep cytology test was performed in 2,472 HPV-positive women. Out of 2,472 HPV-positive women, the cervical biopsy was concurrently performed in 1,533 women. Data on the HPV type and the diagnostic findings of the ThinPrep cytology test and cervical biopsy were collected from our hospital electronic database. The concordance of diagnostic findings between cytology and histology was compared. Results The rate of agreement in the diagnosis of the low-grade squamous intraepithelial lesion (LSIL) or HSIL between cervical biopsy and ThinPrep cytology test was 58 or 49%. The overall false negative rate in the diagnosis of cervical cancer and HSIL by ThinPrep cytology test was 6%. However, when considering the total number of HPV-positive women diagnosed with cervical cancer (n = 36) and HSIL (n = 117) by cervical biopsy, we found that a significant number of HPV-positive women with cervical cancer (n = 12, 33%), or women with HSIL (n = 77, 66%) were failed to be diagnosed by the ThinPrep cytology test. These HPV-positive women were either diagnosed with cervical infection or ASCUS, or LSIL. Discussion Our data demonstrated that in order to ensure an accurate diagnosis, an immediate cervical biopsy in women with cervical infection or ASCUS or LSIL should be strongly recommended in clinical practice.
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Affiliation(s)
- Yang Liu
- Department of Obstetrics and Gynaecology, The University of Auckland, Auckland, New Zealand
| | - Yongxiang Yin
- Department of Pathology, Wuxi Maternity and Child Health Hospital Affiliated Nanjing Medical University, Wuxi, China
| | - Yi Zhang
- Department of Obstetrics and Gynaecology, The University of Auckland, Auckland, New Zealand
| | - Luling Lin
- Liggins Institutes, The University of Auckland, Auckland, New Zealand
| | - Min Zhao
- Department of Gynaecological Cancer, Wuxi Maternity and Child Health Hospital Affiliated Nanjing Medical University, Wuxi, China
| | - Qi Chen
- Department of Obstetrics and Gynaecology, The University of Auckland, Auckland, New Zealand
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Song C, Lee Y, Kim S. Bioinformatic Analysis for the Prognostic Implication of Genes Encoding Epithelial Sodium Channel in Cervical Cancer. Int J Gen Med 2022; 15:1777-1787. [PMID: 35210842 PMCID: PMC8863188 DOI: 10.2147/ijgm.s346222] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 02/08/2022] [Indexed: 12/22/2022] Open
Abstract
Background Cervical cancer is one of the leading causes of death in women. Among the sodium ion channels associated with cancer development, voltage gated sodium channel plays an important role in pathophysiology of cervical cancer; however, the clinicopathological implication of epithelial sodium channel (ENaC) has not been explored. Purpose This study focused on identifying dysregulation of ENaC encoding genes, including SCNN1A, SCNN1B, and SCNN1G, and their relationship with clinicopathologic features in cervical cancer patients. Materials and Methods RNA sequencing data of ENaC-encoding genes, clinicopathologic data, and survival data of cervical cancer patients were obtained from The Cancer Genome Atlas cohort. Microarray data of ENaC-encoding genes were obtained from Gene Expression Omnibus datasets: GSE6791 and GSE63514. Results The expression levels of SCNN1A, SCNN1B, and SCNN1G were positively correlated with each other. SCNN1A, SCNN1B, and SCNN1G are significantly overexpressed in normal tissues than in tumor tissues. Survival analysis showed that simultaneous overexpression of all three genes associated with better overall survival (OS). Each overexpression of SCNN1B and SCNN1G was significantly associated with better OS. Moreover, each expression level of SCNN1A, SCNN1B, and SCNN1G was negatively correlated with histologic grade of tumor. Conclusion ENaC-encoding genes might be potential biological markers to better predict survival outcomes in cervical cancer patients.
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Affiliation(s)
- Changho Song
- Department of Obstetrics and Gynecology, School of Medicine, Keimyung University, Daegu, 42601, Republic of Korea
| | - Yongho Lee
- Department of Anesthesiology and Pain Medicine, Keimyung University Dongsan Hospital, Daegu, 42601, Republic of Korea
| | - Shin Kim
- Department of Immunology, School of Medicine, Keimyung University, Daegu, 42601, Republic of Korea
- Institute of Medical Science, Keimyung University, Daegu, 42601, Republic of Korea
- Institute for Cancer Research, Keimyung University Dongsan Medical Center, Daegu, 42601, Republic of Korea
- Correspondence: Shin Kim, 1095 Dalgubeol-Daero, Dalseo-gu, Daegu, 42601, Republic of Korea, Tel +82-53-258-7359, Fax +82-53-258-7355, Email
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Johnson LG, Saidu R, Svanholm-Barrie C, Boa R, Moodley J, Tergas A, Persing D, Campbell SA, Tsai WY, Wright TC, Denny L, Kuhn L. Clinical utility of reflex testing with cancer biomarkers to improve diagnostic accuracy of primary Human Papillomavirus screening. Cancer Epidemiol Biomarkers Prev 2022; 31:595-603. [PMID: 35027434 DOI: 10.1158/1055-9965.epi-21-0972] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 11/02/2021] [Accepted: 12/14/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND HPV testing is the cornerstone of cervical cancer screening with outstanding sensitivity but only moderate specificity. We evaluated whether reflex testing for cancer biomarkers improves the sensitivity/specificity balance of screening. METHODS Cervical samples from women in Cape Town, South Africa, aged 30-65 years, were collected and tested with Xpert HPV and with real-time PCR to detect mRNA for Cyclin-Dependent Kinase Inhibitor 2A (CDKN2A), Topoisomerase 2 alpha (TOP2A) and Ki67 (MKi67). Women with histologically-confirmed cervical intraepithelial neoplasia grade 2 or worse (CIN2+) (85 women without and 166 with HIV) and women with no cervical disease (331 without and 257 with HIV) were included. RESULTS When used as reflex tests after a positive HPV result, biomarkers discriminated well between women with and without CIN2+. The inclusion of both CDKN2A and MKi67 had the best performance with area under the curve (AUC) of 0.9171 and 0.8734 in women without and with HIV, respectively. While excellent, these performance parameters did not improve on an approach utilizing only HPV testing with more stringent cycle threshold cut-offs and HPV genotype selection which achieved AUC of 0.9059 and 0.8705 in women without and with HIV, respectively. CONCLUSION Biomarkers can be used as triage after positive HPV results but do not out-perform an approach utilizing higher viral load cut-offs on selected high-risk genotypes. IMPACT A screening approach using HPV testing alone can be more easily implemented at the point-of-care.
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Affiliation(s)
| | - Rakiya Saidu
- Department of Obstetrics and Gynecology; South African Medical Research Council Gynaecological Cancer Research Centre (SAMRC GCRC), University of Cape Town
| | | | - Rosalind Boa
- Department of Obstetrics and Gynecology, University of Cape Town
| | - Jennifer Moodley
- School of Public Health and Family Medicine; South African Medical Research Council Gynaecological Cancer Research Centre (SAMRC GCRC), University of Cape Town
| | | | | | | | | | | | - Lynette Denny
- Department of Obstetrics and Gynecology, University of Cape Town
| | - Louise Kuhn
- Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center; Department of Epidemiology, Mailman School of Public Health, Columbia University, Columbia University Irving Medical Center
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Wen T, Xia C, Yu Q, Yu Y, Li S, Zhou C, Sun K, Yue S. A dual-signal electrochemical immunosensor for the detection of HPV16 E6 oncoprotein based on PdBP dendritic ternary nanospheres and MBSi-Chi nanocomposites. Analyst 2022; 147:2272-2279. [DOI: 10.1039/d1an02120f] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
A dual-signal electrochemical immunosensor was fabricated to detect HPV16 E6 oncoprotein for the first time, which meets the requirements for a quick and sensitive detection.
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Affiliation(s)
- Tao Wen
- Institute of Life Science, Chongqing Medical University, Chongqing 400016, P.R. China
| | - Chenchen Xia
- Institute of Life Science, Chongqing Medical University, Chongqing 400016, P.R. China
| | - Qiubo Yu
- Molecular Medical Laboratory and Department of Pathology, Chongqing Medical University, Chongqing 400016, P.R. China
| | - Yujie Yu
- School of Public Health and Management, Chongqing Medical University, Chongqing 400016, P.R. China
| | - Siyuan Li
- Institute of Life Science, Chongqing Medical University, Chongqing 400016, P.R. China
| | - Chunli Zhou
- Institute of Life Science, Chongqing Medical University, Chongqing 400016, P.R. China
| | - Kexin Sun
- Department of Ophthalmology, The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology, Chongqing Eye Institute, Chongqing, 400016, P.R. China
| | - Song Yue
- Obstetrics and Gynecology Department, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, P.R. China
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Curti RRDJ, Castilha EP, Bonaldo ALL, Okuyama NCM, Trugilo KP, Guembarovski RL, Couto-Filho JD, Watanabe MAE, de Oliveira KB. Development of cervical intraepithelial lesions and cervical cancer is not influenced by SOD2 RS4880 polymorhism. Pathol Res Pract 2021; 230:153742. [PMID: 34959097 DOI: 10.1016/j.prp.2021.153742] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 12/14/2021] [Accepted: 12/16/2021] [Indexed: 01/17/2023]
Abstract
Some of the more than 200 known HPV types are essential for cervical cancer development, the third type of cancer most incident in the female population. However, for the malignant transformation occur, some cofactors are needed, as the reactive oxygen species (ROS), which can be neutralized by the antioxidant system. The SOD2 enzyme, encoded by the same name gene, is found in mitochondria and is part of the first line of defense against oxidative stress damage. Genetic polymorphisms can act by altering the efficiency of the enzyme, among which the most studied is the rs4880. Thus, the purpose of the present study was to evaluate the association of this polymorphism with HPV infection and the development of low and high grade squamous intraepithelial lesions (LSIL and HSIL) and cervical cancer, in 407 women attended by the public health system in Brazil. HPV detection in cervical secretion samples was carried out by polymerase chain reaction (PCR) and blood samples were used for polymorphism genotyping through PCR followed by restriction fragment length polymorphism (RFLP). PCR and restriction products were subjected to 10% polyacrylamide gel electrophoresis. HPV negative group (control) included 158 women and the HPV positive group (case) 249 women. The infected group was divided into No Lesion (n = 90), LSIL (n = 20), HSIL (n = 67) and cervical cancer (n = 72). The data found on socio-epidemiological characteristics and habits corroborated with data found in the literature. The distribution of genotypes in the control group was 51.9% women TC, 29.8% TT and 18.3% CC. In the case group, the distribution was 55.0% women TC, 26.1% TT and 18.9% CC. This is the first study evaluating the influence of SOD2 rs4880 polymorphism on HPV infection, the development of cervical intraepithelial lesions and cervical cancer in a Brazilian population, although additional studies are needed to corroborate the results.
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Affiliation(s)
- Rafaela Roberta de Jaime Curti
- Laboratory of Molecular Genetics and Immunology, Department of Pathological Sciences, State University of Londrina, 86.057-970 Paraná, Brazil
| | - Eliza Pizarro Castilha
- Laboratory of Molecular Genetics and Immunology, Department of Pathological Sciences, State University of Londrina, 86.057-970 Paraná, Brazil
| | - Ana Luiza Labbate Bonaldo
- Laboratory of Molecular Genetics and Immunology, Department of Pathological Sciences, State University of Londrina, 86.057-970 Paraná, Brazil
| | - Nádia Calvo Martins Okuyama
- Laboratory of Molecular Genetics and Immunology, Department of Pathological Sciences, State University of Londrina, 86.057-970 Paraná, Brazil
| | - Kleber Paiva Trugilo
- Laboratory of Molecular Genetics and Immunology, Department of Pathological Sciences, State University of Londrina, 86.057-970 Paraná, Brazil
| | - Roberta Losi Guembarovski
- Laboratory of Mutagenesis and Oncogenetics, Molecular Genetics and Immunology, Department of Biological Sciences, Londrina State University, Londrina, Paraná, Brazil
| | | | - Maria Angelica Ehara Watanabe
- Laboratory of Study and Application of DNA Polymorphism, Department of Pathological Science, Londrina State University, Londrina, Paraná, Brazil
| | - Karen Brajão de Oliveira
- Laboratory of Molecular Genetics and Immunology, Department of Pathological Sciences, State University of Londrina, 86.057-970 Paraná, Brazil.
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Zhang L, Yu H, Deng T, Ling L, Wen J, Lv M, Ou R, Wang Q, Xu Y. FNDC3B and BPGM Are Involved in Human Papillomavirus-Mediated Carcinogenesis of Cervical Cancer. Front Oncol 2021; 11:783868. [PMID: 34976823 PMCID: PMC8716600 DOI: 10.3389/fonc.2021.783868] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 11/17/2021] [Indexed: 12/11/2022] Open
Abstract
Human papillomavirus (HPV)-mediated cervical carcinogenesis is a multistep progressing from persistent infection, precancerous lesion to cervical cancer (CCa). Although molecular alterations driven by viral oncoproteins are necessary in cervical carcinogenesis, the key regulators behind the multistep process remain not well understood. It is pivotal to identify the key genes involved in the process for early diagnosis and treatment of this disease. Here we analyzed the mRNA expression profiles in cervical samples including normal, cervical intraepithelial neoplasia (CIN), and CCa. A co-expression network was constructed using weighted gene co-expression network analysis (WGCNA) to reveal the crucial modules in the dynamic process from HPV infection to CCa development. Furthermore, the differentially expressed genes (DEGs) that could distinguish all stages of progression of CCa were screened. The key genes involved in HPV-CCa were identified. It was found that the genes involved in DNA replication/repair and cell cycle were upregulated in CIN compared with normal control, and sustained in CCa, accompanied by substantial metabolic shifts. We found that upregulated fibronectin type III domain-containing 3B (FNDC3B) and downregulated bisphosphoglycerate mutase (BPGM) could differentiate all stages of CCa progression. In patients with CCa, a higher expression of FNDC3B or lower expression of BPGM was closely correlated with a shorter overall survival (OS) and disease-free survival (DFS). A receiver operating characteristic (ROC) analysis of CIN and CCa showed that FNDC3B had the highest sensitivity and specificity for predicting CCa development. Taken together, the current data showed that FNDC3B and BPGM were key genes involved in HPV-mediated transformation from normal epithelium to precancerous lesions and CCa.
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Affiliation(s)
- Luhan Zhang
- School of Basic Medicine, Southwest Medical University, Luzhou, China
- Department of Dermatovenerology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Hong Yu
- School of Basic Medicine, Southwest Medical University, Luzhou, China
| | - Tian Deng
- Department of Stomatology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Li Ling
- Department of Stomatology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Juan Wen
- Department of Dermatovenerology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Mingfen Lv
- Department of Dermatovenerology, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China
| | - Rongying Ou
- Department of Obstetrics and Gynaecology, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China
| | - Qiaozhi Wang
- School of Basic Medicine, Southwest Medical University, Luzhou, China
- *Correspondence: Qiaozhi Wang, ; Yunsheng Xu,
| | - Yunsheng Xu
- Department of Dermatovenerology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
- *Correspondence: Qiaozhi Wang, ; Yunsheng Xu,
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Castanon A, Kamineni A, Elfström KM, Lim AWW, Sasieni P. Exposure Definition in Case-Control Studies of Cervical Cancer Screening: A Systematic Literature Review. Cancer Epidemiol Biomarkers Prev 2021; 30:2154-2166. [PMID: 34526301 PMCID: PMC8643309 DOI: 10.1158/1055-9965.epi-21-0376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 06/14/2021] [Accepted: 09/08/2021] [Indexed: 01/07/2023] Open
Abstract
The first step in evaluating the effectiveness of cervical screening is defining exposure to screening. Our aim was to describe the spectrum of screening exposure definitions used in studies of the effectiveness of cervical screening. This systematic review included case-control studies in a population-based screening setting. Outcome was incidence of cervical cancer. Three electronic databases were searched from January 1, 2012 to December 6, 2018. Articles prior to 2012 were identified from a previous review. The qualitative synthesis focused on describing screening exposure definitions reported in the literature and the methodologic differences that could have an impact on the association between screening and cervical cancer. Forty-one case-control studies were included. Six screening exposure definitions were identified. Cervical cancer risk on average decreased by 66% when screening exposure was defined as ever tested, by 77% by time since last negative test, and by 79% after two or more previous tests. Methodologic differences included composition of the reference group and whether diagnostic and/or symptomatic tests were excluded from the analysis. Consensus guidelines to standardize exposure definitions are needed to ensure evaluations of cervical cancer screening can accurately measure the impact of transitioning from cytology to human papillomavirus-based screening and to allow comparisons between programs.
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Affiliation(s)
- Alejandra Castanon
- King's College London, Faculty of Life Sciences & Medicine, School of Cancer & Pharmaceutical Sciences, Cancer Prevention Group, Innovation Hub, Guys Cancer Centre, Guys Hospital, Great Maze Pond, London, United Kingdom.
| | - Aruna Kamineni
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington
| | - K Miriam Elfström
- Institutionen för Laboratoriemedicin, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Anita W W Lim
- King's College London, Faculty of Life Sciences & Medicine, School of Cancer & Pharmaceutical Sciences, Cancer Prevention Group, Innovation Hub, Guys Cancer Centre, Guys Hospital, Great Maze Pond, London, United Kingdom
| | - Peter Sasieni
- King's College London, Faculty of Life Sciences & Medicine, School of Cancer & Pharmaceutical Sciences, Cancer Prevention Group, Innovation Hub, Guys Cancer Centre, Guys Hospital, Great Maze Pond, London, United Kingdom
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Role of FoxP3-positive regulatory T-cells in regressive and progressive cervical dysplasia. J Cancer Res Clin Oncol 2021; 148:377-386. [PMID: 34739585 DOI: 10.1007/s00432-021-03838-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 09/14/2021] [Indexed: 02/05/2023]
Abstract
PURPOSE Forkhead Box Protein 3 (FoxP3) is known as a key mediator in the immunosuppressive function of regulatory T-cells (Tregs). The aim of our study was to investigate whether FoxP3-positive Tregs have the potential to act as an independent predictor in progression as well as in regression of cervical intraepithelial neoplasia, especially in patients with intermediate cervical intraepithelial neoplasia (CIN II). METHODS Nuclear FoxP3 expression was immunohistochemically analysed in 169 patient samples (CIN I, CIN II with regressive course, CIN II with progressive course, CIN III). The median numbers were calculated for each slide and correlated with the histological CIN grade. Statistical analysis was performed by SPSS 26 (Mann-Whitney U test, Spearman's rank correlation). RESULTS An increased FoxP3 expression in CIN II with progression could be detected in comparison to CIN II with regression (p = 0.003). Total FoxP3 expression (epithelium and dysplasia-connected stroma) was higher in more advanced CIN grades (p < 0.001 for CIN I vs. CIN II; p = 0.227 for CIN II vs. CIN III). A positive correlation could be detected between FoxP3-positive cells in epithelium and total FoxP3 expression (Spearman's Rho: 0,565; p < 0.01). CONCLUSION Expression of FoxP3 could be a helpful predictive factor to assess the risks of CIN II progression. As a prognosticator for regression and progression in cervical intraepithelial lesions it might thereby help in the decision process regarding surgical treatment vs. watchful waiting strategy to prevent conisation-associated risks for patients in child-bearing age. In addition, the findings support the potential of Tregs as a target for immune therapy in cervical cancer patients.
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Clarke MA, Risley C, Stewart MW, Geisinger KR, Hiser LM, Morgan JC, Owens KJ, Ayyalasomayajula K, Rives RM, Jannela A, Grunes DE, Zhang L, Schiffman M, Wagner S, Boland J, Bass S, Wentzensen N. Age-specific prevalence of human papillomavirus and abnormal cytology at baseline in a diverse statewide prospective cohort of individuals undergoing cervical cancer screening in Mississippi. Cancer Med 2021; 10:8641-8650. [PMID: 34734483 PMCID: PMC8633239 DOI: 10.1002/cam4.4340] [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: 07/07/2021] [Revised: 09/21/2021] [Accepted: 09/24/2021] [Indexed: 12/22/2022] Open
Abstract
Background Mississippi (MS) has among the highest rates of cervical cancer incidence and mortality in the United States, with disproportionately higher rates among Blacks compared to Whites. Here, we evaluate the prevalence of high‐risk human papillomavirus (HPV) and abnormal cytology in a representative baseline sample from a diverse statewide cohort of individuals attending cervical screening in MS from the STRIDES Study (STudying Risk to Improve DisparitiES in cervical cancer). Methods We included individuals aged 21–65 years undergoing screening at the University of Mississippi Medical Center (UMMC) and the Mississippi State Department of Health (MSDH) from May to November 2018. We calculated age‐specific HPV prevalence, overall and by partial HPV16/18 genotyping, and abnormal cytology by race. Results A total of 6871 individuals (mean age 35.7 years) were included. HPV prevalence was 25.6% and higher in Blacks (28.0%) compared to Whites (22.4%). HPV prevalence was significantly higher in Blacks aged 21–24 years (50.2%) and 30–34 years (30.2%) compared to Whites in the same age groups (32.1% and 20.7%; p < 0.0001, respectively). The prevalence of high‐grade cytologic abnormalities, a cytologic sign of cervical precancer, peaked earlier in Blacks (ages 25–29) compared to Whites (35–39). For comparison, we also analyzed HPV prevalence data from the National Health and Nutrition Examination Survey (NHANES, 2013–2016) and observed similar racial differences in HPV prevalence among women aged 21–24 years. Conclusions Our findings suggest that Blacks undergoing cervical cancer screening in MS have higher prevalence of other high‐risk 12 HPV types at younger ages and experience an earlier peak of high‐grade cytologic abnormalities compared to Whites.
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Affiliation(s)
- Megan A Clarke
- Clinical Genetics Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Carolann Risley
- Clinical Genetics Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, Rockville, Maryland, USA.,School of Nursing, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Mary W Stewart
- School of Nursing, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Kim R Geisinger
- Walter Reed National Military Medical Center, Armed Forces Joint Pathology Center, Bethesda, Maryland, USA
| | - Laree M Hiser
- School of Nursing, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Jody C Morgan
- School of Nursing, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Kenyata J Owens
- School of Nursing, University of Mississippi Medical Center, Jackson, Mississippi, USA.,Center for Informatics & Analytics, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Krishna Ayyalasomayajula
- School of Nursing, University of Mississippi Medical Center, Jackson, Mississippi, USA.,Center for Informatics & Analytics, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Rhonda M Rives
- School of Nursing, University of Mississippi Medical Center, Jackson, Mississippi, USA.,Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Ashish Jannela
- School of Nursing, University of Mississippi Medical Center, Jackson, Mississippi, USA.,Center for Informatics & Analytics, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Dianne E Grunes
- Department of Pathology, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Lei Zhang
- School of Nursing, University of Mississippi Medical Center, Jackson, Mississippi, USA.,Office of Health Data & Research, Mississippi State Department of Health, Jackson, Mississippi, USA
| | - Mark Schiffman
- Clinical Genetics Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Sarah Wagner
- Cancer Genomics Research Laboratory, Division of Cancer Epidemiology and Genetics, NCI, Bethesda, Maryland, USA
| | - Joseph Boland
- Cancer Genomics Research Laboratory, Division of Cancer Epidemiology and Genetics, NCI, Bethesda, Maryland, USA
| | - Sara Bass
- Cancer Genomics Research Laboratory, Division of Cancer Epidemiology and Genetics, NCI, Bethesda, Maryland, USA
| | - Nicolas Wentzensen
- Clinical Genetics Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, Rockville, Maryland, USA
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Wang X, Du T, Shi X, Wu K. Attitude and practice on human papilloma virus infection and vaccination among students from secondary occupational health school: a cross-sectional study. Hum Vaccin Immunother 2021; 17:4397-4405. [PMID: 34499572 PMCID: PMC8828119 DOI: 10.1080/21645515.2021.1954443] [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: 05/01/2021] [Revised: 06/13/2021] [Accepted: 07/07/2021] [Indexed: 02/05/2023] Open
Abstract
Cervical cancer (CC) is reported as the second-most common female cancer worldwide, of which 99% is caused by persistent human papillomavirus (HPV) infection. HPV vaccine protects against HPV infection and most cases of CC, which has only been introduced for a short time in mainland China. This study aimed to evaluate the attitude and practice related to HPV infection and vaccination among students at secondary occupational health school (SOHS) in China. We conducted a cross-sectional study in Southern China where data of 2248 participants were collected through questionnaires to estimate attitude and practice of students. Only 4.1% believed they were easily infected by HPV, 38.2% were willing to receive HPV vaccine and 30.8% intended to do regular screening of HPV infection in the future. Students in the second grade (OR = 1.51, 95%CI [1.25, 1.81]) and third grade (OR = 3.99, 95%CI [2.53, 6.27]) were more willing to take HPV vaccine compared to students in the first grade. Among the non-vaccinated participants, the most frequent reason for not receiving HPV vaccine was insufficient knowledge about HPV (91.1%). Characteristics of higher grade, personal education before enrollment and academic performance, medical specialty, history of sex experience and HPV vaccine and family history of other cancers were associated with higher attitude scores (p < .05). Considering the increasing prevalence of HPV infection and the need of improvement in attitude and practice toward HPV, more education about HPV infection and vaccination should be incorporated into school curriculum.
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Affiliation(s)
- Xin Wang
- Department of Preventive Medicine, Shantou University Medical College, Shantou, China
| | - Taifeng Du
- Department of Preventive Medicine, Shantou University Medical College, Shantou, China
| | - Xiaoling Shi
- Department of Preventive Medicine, Shantou University Medical College, Shantou, China
| | - Kusheng Wu
- Department of Preventive Medicine, Shantou University Medical College, Shantou, China
- CONTACT Kusheng Wu Department of Preventive Medicine, Shantou University Medical College, No.22, Xinling Rd, Shantou, Guangdong515041, China
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