1
|
Belaid L, Budgell R, Sauvé C, Andersson N. Shifting paradigm from biomedical to decolonised methods in Inuit public health research in Canada: a scoping review. BMJ Glob Health 2022; 7:bmjgh-2021-008311. [DOI: 10.1136/bmjgh-2021-008311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 09/25/2022] [Indexed: 11/06/2022] Open
Abstract
BackgroundThe National Inuit Strategy on Research focuses on advancing Inuit governance in research, increasing ownership over data and building capacity. Responding to this call for Inuit self-determination in research, academic researchers should consider cultural safety in research and ways to promote Inuit-led methods.MethodsThis scoping review collated academic literature on public health research in Inuit communities in Canada between 2010 and 2022. A critical assessment of methods used in public health research in Inuit communities examined cultural safety and the use of Inuit-attuned methods. Descriptive and analytical data were summarised in tables and figures. Knowledge user engagement in the research process was analysed with thematic analysis.Results356 articles met the inclusion criteria. Much of the published research was in nutrition and mental health, and few initiatives reported translation into promotion programmes. Almost all published research was disease or deficit focused and based on a biomedical paradigm, especially in toxicology, maternal health and chronic diseases. Recent years saw an increased number of participatory studies using a decolonial lens and focusing on resilience. While some qualitative research referred to Inuit methodologies and engaged communities in the research process, most quantitative research was not culturally safe. Overall, community engagement remained in early stages of co-designing research protocols and interventions. Discussion on governance and data ownership was limited. Recent years saw emerging discussions on these issues. Knowledge user capacity-building was limited to brief training on conventional data collection methods.ConclusionsThe last decade of published public health research has not responded to the National Inuit Strategy on Research. Participatory research is gaining ground, but has not reached its full potential. A shift from biomedical to decolonised methods is slowly taking place, and public health researchers who have not yet embraced this paradigm shift should do so.
Collapse
|
2
|
Plitt SS, Kichuk R, Geier S, Smith T, Roy F, Severini A, Charlton CL. Distribution of HPV genotypes among women with abnormal cytology results in Alberta, Canada. JOURNAL OF THE ASSOCIATION OF MEDICAL MICROBIOLOGY AND INFECTIOUS DISEASE CANADA = JOURNAL OFFICIEL DE L'ASSOCIATION POUR LA MICROBIOLOGIE MEDICALE ET L'INFECTIOLOGIE CANADA 2021; 6:94-103. [PMID: 36341027 PMCID: PMC9608700 DOI: 10.3138/jammi-2020-0048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 02/21/2021] [Indexed: 06/16/2023]
Abstract
BACKGROUND Persistent infection with a subset of human papillomavirus (HPV) genotypes can cause abnormal cytology and invasive cervical cancer. This study examines the circulating HPV genotype strains in a local population of the province of Alberta (a largely unvaccinated population) to establish baseline frequency of vaccine and non-vaccine genotypes causing abnormal cervical cytology. METHOD Remnant liquid-based cytology specimens from the Alberta Cervical Cancer Screening Program (March 2014-January 2016) were examined. Only specimens from women who had a cytology grading of atypical squamous cells of undetermined significance or higher were included. HPV genotype was determined for all samples, and results were stratified by demographics and cytology results. RESULTS Forty-four unique HPV genotypes were identified from 4,794 samples. Of the 4,241 samples with a genotype identified, the most common genotypes were HPV 16, 18, 31, and 51, with 1,599 (37.7%), 441 (12.2%), 329 (7.8%), and 354 (8.4%), respectively. HPV9 vaccine genotypes made up 73.2% of these genotyped samples. Compared with specimens in which HPV9 vaccine genotypes were not detected, those with a genotype covered by the HPV9 vaccine were from younger women (33 [interquartile range {IQR] 28 to 42] y versus 40 [IQR 32 to 51] y; p < 0.00001). CONCLUSIONS The baseline distribution of HPV genotypes in this largely unvaccinated population indicates that the HPV9 vaccine provides good protection from high-risk HPV infections. Determining the frequency of genotypes causing abnormal cytology in this population post-vaccine implementation will be important to assess efficacy of vaccination and monitor for any potential genotype replacement.
Collapse
Affiliation(s)
- Sabrina S Plitt
- Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, Ottawa, Ontario, Canada
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Ryan Kichuk
- Department of Medical Microbiology and Immunology, University of Alberta, Edmonton, Alberta, Canada
| | - Sheena Geier
- Department of Laboratory Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Trenton Smith
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Felicia Roy
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Alberto Severini
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
- Department of Medical Microbiology, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Carmen L Charlton
- Department of Laboratory Medicine, University of Alberta, Edmonton, Alberta, Canada
- Public Health Laboratory (ProvLab), Edmonton, Alberta, Canada
- Li Ka Shing Institute for Virology, Edmonton, Alberta, Canada
| |
Collapse
|
3
|
Simkin J, Smith L, van Niekerk D, Caird H, Dearden T, van der Hoek K, Caron NR, Woods RR, Peacock S, Ogilvie G. Sociodemographic characteristics of women with invasive cervical cancer in British Columbia, 2004-2013: a descriptive study. CMAJ Open 2021; 9:E424-E432. [PMID: 33888548 PMCID: PMC8101640 DOI: 10.9778/cmajo.20200139] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Although cancer screening has led to reductions in the incidence of invasive cervical cancer (ICC) across Canada, benefits of prevention efforts are not equitably distributed. This study investigated the sociodemographic characteristics of women with ICC in British Columbia compared with the general female population in the province. METHODS In this descriptive study, data of individuals 18 years and older diagnosed with ICC between 2004 and 2013 were obtained from the BC Cancer Registry. Self-reported sociodemographic characteristics were derived from standardized health assessment forms (HAFs) completed upon admission in the BC Cancer Registry. Standardized ratios (SRs) were derived by dividing observed and age-adjusted expected counts by ethnicity or race, language, and marital, smoking and urban-rural status. Differences between observed and expected counts were tested using χ2 goodness-of-fit tests. General population data were derived from the 2006 Census, 2011 National Household Survey and 2011/12 Canadian Community Health Survey. RESULTS Of 1705 total cases of ICC, 1315 were referred to BC Cancer (77.1%). Of those who were referred, 1215 (92.4%) completed HAFs. Among Indigenous women, more cases were observed (n = 85) than expected (n = 39; SR 2.16, 95% confidence interval [CI] 2.15-2.18). Among visible minorities, observed cases (n = 320) were higher than expected (n = 253; 95% CI 1.26-1.26). Elevated SRs were observed among women who self-identified as Korean (SR 1.78, 95% CI 1.76-1.80), Japanese (SR 1.77, 95% CI 1.74-1.79) and Filipino (SR 1.60, 95% CI 1.58-1.62); lower SRs were observed among South Asian women (SR 0.63, 95% CI 0.62-0.63). Elevated SRs were observed among current smokers (SR 1.34, 95% CI 1.33-1.34) and women living in rural-hub (SR 1.29, 95% CI 1.28-1.31) and rural or remote (SR 2.62, 95% CI 2.61-2.64) areas; the SR was lower among married women (SR 0.90, 95% CI 0.90-0.90). INTERPRETATION Women who self-identified as visible minorities, Indigenous, current smokers, nonmarried and from rural areas were overrepresented among women with ICC. Efforts are needed to address inequities to ensure all women benefit from cervical cancer prevention.
Collapse
Affiliation(s)
- Jonathan Simkin
- School of Population and Public Health (Simkin, Caron, Ogilvie), University of British Columbia; Cancer Control Research (Simkin, van der Hoek, Woods, Peacock, Ogilvie), BC Cancer; Women's Health Research Institute (Simkin, Smith, Caird, Ogilvie); Cancer Control Research (Smith, van Niekerk, Caron), BC Cancer, Vancouver, BC; Faculty of Health Sciences (Caird, Woods, Peacock), Simon Fraser University, Burnaby, BC; School of Nursing (Dearden), University of British Columbia; Canadian Centre for Applied Research in Cancer Control (van der Hoek, Peacock); Centre for Excellence in Indigenous Health (Caron), University of British Columbia, Vancouver, BC
| | - Laurie Smith
- School of Population and Public Health (Simkin, Caron, Ogilvie), University of British Columbia; Cancer Control Research (Simkin, van der Hoek, Woods, Peacock, Ogilvie), BC Cancer; Women's Health Research Institute (Simkin, Smith, Caird, Ogilvie); Cancer Control Research (Smith, van Niekerk, Caron), BC Cancer, Vancouver, BC; Faculty of Health Sciences (Caird, Woods, Peacock), Simon Fraser University, Burnaby, BC; School of Nursing (Dearden), University of British Columbia; Canadian Centre for Applied Research in Cancer Control (van der Hoek, Peacock); Centre for Excellence in Indigenous Health (Caron), University of British Columbia, Vancouver, BC
| | - Dirk van Niekerk
- School of Population and Public Health (Simkin, Caron, Ogilvie), University of British Columbia; Cancer Control Research (Simkin, van der Hoek, Woods, Peacock, Ogilvie), BC Cancer; Women's Health Research Institute (Simkin, Smith, Caird, Ogilvie); Cancer Control Research (Smith, van Niekerk, Caron), BC Cancer, Vancouver, BC; Faculty of Health Sciences (Caird, Woods, Peacock), Simon Fraser University, Burnaby, BC; School of Nursing (Dearden), University of British Columbia; Canadian Centre for Applied Research in Cancer Control (van der Hoek, Peacock); Centre for Excellence in Indigenous Health (Caron), University of British Columbia, Vancouver, BC
| | - Hannah Caird
- School of Population and Public Health (Simkin, Caron, Ogilvie), University of British Columbia; Cancer Control Research (Simkin, van der Hoek, Woods, Peacock, Ogilvie), BC Cancer; Women's Health Research Institute (Simkin, Smith, Caird, Ogilvie); Cancer Control Research (Smith, van Niekerk, Caron), BC Cancer, Vancouver, BC; Faculty of Health Sciences (Caird, Woods, Peacock), Simon Fraser University, Burnaby, BC; School of Nursing (Dearden), University of British Columbia; Canadian Centre for Applied Research in Cancer Control (van der Hoek, Peacock); Centre for Excellence in Indigenous Health (Caron), University of British Columbia, Vancouver, BC
| | - Tania Dearden
- School of Population and Public Health (Simkin, Caron, Ogilvie), University of British Columbia; Cancer Control Research (Simkin, van der Hoek, Woods, Peacock, Ogilvie), BC Cancer; Women's Health Research Institute (Simkin, Smith, Caird, Ogilvie); Cancer Control Research (Smith, van Niekerk, Caron), BC Cancer, Vancouver, BC; Faculty of Health Sciences (Caird, Woods, Peacock), Simon Fraser University, Burnaby, BC; School of Nursing (Dearden), University of British Columbia; Canadian Centre for Applied Research in Cancer Control (van der Hoek, Peacock); Centre for Excellence in Indigenous Health (Caron), University of British Columbia, Vancouver, BC
| | - Kimberly van der Hoek
- School of Population and Public Health (Simkin, Caron, Ogilvie), University of British Columbia; Cancer Control Research (Simkin, van der Hoek, Woods, Peacock, Ogilvie), BC Cancer; Women's Health Research Institute (Simkin, Smith, Caird, Ogilvie); Cancer Control Research (Smith, van Niekerk, Caron), BC Cancer, Vancouver, BC; Faculty of Health Sciences (Caird, Woods, Peacock), Simon Fraser University, Burnaby, BC; School of Nursing (Dearden), University of British Columbia; Canadian Centre for Applied Research in Cancer Control (van der Hoek, Peacock); Centre for Excellence in Indigenous Health (Caron), University of British Columbia, Vancouver, BC
| | - Nadine R Caron
- School of Population and Public Health (Simkin, Caron, Ogilvie), University of British Columbia; Cancer Control Research (Simkin, van der Hoek, Woods, Peacock, Ogilvie), BC Cancer; Women's Health Research Institute (Simkin, Smith, Caird, Ogilvie); Cancer Control Research (Smith, van Niekerk, Caron), BC Cancer, Vancouver, BC; Faculty of Health Sciences (Caird, Woods, Peacock), Simon Fraser University, Burnaby, BC; School of Nursing (Dearden), University of British Columbia; Canadian Centre for Applied Research in Cancer Control (van der Hoek, Peacock); Centre for Excellence in Indigenous Health (Caron), University of British Columbia, Vancouver, BC
| | - Ryan R Woods
- School of Population and Public Health (Simkin, Caron, Ogilvie), University of British Columbia; Cancer Control Research (Simkin, van der Hoek, Woods, Peacock, Ogilvie), BC Cancer; Women's Health Research Institute (Simkin, Smith, Caird, Ogilvie); Cancer Control Research (Smith, van Niekerk, Caron), BC Cancer, Vancouver, BC; Faculty of Health Sciences (Caird, Woods, Peacock), Simon Fraser University, Burnaby, BC; School of Nursing (Dearden), University of British Columbia; Canadian Centre for Applied Research in Cancer Control (van der Hoek, Peacock); Centre for Excellence in Indigenous Health (Caron), University of British Columbia, Vancouver, BC
| | - Stuart Peacock
- School of Population and Public Health (Simkin, Caron, Ogilvie), University of British Columbia; Cancer Control Research (Simkin, van der Hoek, Woods, Peacock, Ogilvie), BC Cancer; Women's Health Research Institute (Simkin, Smith, Caird, Ogilvie); Cancer Control Research (Smith, van Niekerk, Caron), BC Cancer, Vancouver, BC; Faculty of Health Sciences (Caird, Woods, Peacock), Simon Fraser University, Burnaby, BC; School of Nursing (Dearden), University of British Columbia; Canadian Centre for Applied Research in Cancer Control (van der Hoek, Peacock); Centre for Excellence in Indigenous Health (Caron), University of British Columbia, Vancouver, BC
| | - Gina Ogilvie
- School of Population and Public Health (Simkin, Caron, Ogilvie), University of British Columbia; Cancer Control Research (Simkin, van der Hoek, Woods, Peacock, Ogilvie), BC Cancer; Women's Health Research Institute (Simkin, Smith, Caird, Ogilvie); Cancer Control Research (Smith, van Niekerk, Caron), BC Cancer, Vancouver, BC; Faculty of Health Sciences (Caird, Woods, Peacock), Simon Fraser University, Burnaby, BC; School of Nursing (Dearden), University of British Columbia; Canadian Centre for Applied Research in Cancer Control (van der Hoek, Peacock); Centre for Excellence in Indigenous Health (Caron), University of British Columbia, Vancouver, BC
| |
Collapse
|
4
|
Yan X, Huang Y, Zhang M, Hu X, Li K, Jing M. Prevalence of human papillomavirus infection and type distribution among Uyghur females in Xinjiang, northwest China. Oncol Lett 2020; 20:25. [PMID: 32774498 PMCID: PMC7406881 DOI: 10.3892/ol.2020.11886] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 05/27/2020] [Indexed: 11/06/2022] Open
Abstract
Human papillomavirus (HPV) infection has a key role in the development of cervical cancer. The present study aimed to determine the HPV type distribution among females of Uyghur ethnicity in Xinjiang province, northwest China. A total of 12,165 individuals aged 30-79 years from 12 villages in Zepu County, Kashgar Prefecture, Xinjiang province were recruited for screening. Cervical and vaginal swabs from each subject were collected by gynecologists and tested for HPV DNA using Luminex xMAP technology. The results indicated that the overall HPV prevalence was 9.34% (1,136/12,165) in the present cohort; 7.41% (901/12,165) of the individuals were positive for high-risk type HPV (HR-HPV) and 1.64% (200/12,165) were positive for multiple types. Among the individuals who tested positive for HR-HPV types, the three most prevalent types were HPV16 (2.83%), HPV31 (0.99%) and HPV68 (0.88%). Subgroup analysis by age indicated that the highest frequency of HPV infections occurred in subjects aged >60 years. The most common genotype combinations in subjects with multiple types were HPV16 + HPV54, HPV16 + HPV31 and HPV16 + HPV68. The present study provided data on the prevalence and type distribution of HPV infections among Uyghur females in Xinjiang province, northwestern China, which will assist in the assessment of the potential cost-effectiveness of HPV screening and vaccination in this population. The data will also facilitate the determination of HPV68 and 54 strains that should be included in the multi-type vaccine and the establishment of a vaccination program that caters for the different age groups of the Uyghur population.
Collapse
Affiliation(s)
- Xiaolong Yan
- Department of Preventive Medicine, Medical College of Shihezi University, Shihezi, Xinjiang 832002, P.R. China
| | - Yan Huang
- Department of Preventive Medicine, Medical College of Shihezi University, Shihezi, Xinjiang 832002, P.R. China
| | - Mei Zhang
- Department of Preventive Medicine, Medical College of Shihezi University, Shihezi, Xinjiang 832002, P.R. China
| | - Xin Hu
- Department of Preventive Medicine, Medical College of Shihezi University, Shihezi, Xinjiang 832002, P.R. China
| | - Ke Li
- Department of Preventive Medicine, Medical College of Shihezi University, Shihezi, Xinjiang 832002, P.R. China
| | - Mingxia Jing
- Department of Preventive Medicine, Medical College of Shihezi University, Shihezi, Xinjiang 832002, P.R. China
| |
Collapse
|
5
|
Ouedraogo RA, Zohoncon TM, Traore IMA, Ouattara AK, Guigma SP, Djigma FW, Obiri-Yeboah D, Ouedraogo C, Simpore J. Genotypic distribution of human oncogenic papillomaviruses in sexually active women in Burkina Faso: Central, Central-Eastern and Hauts-Bassins regions. Biomol Concepts 2020; 11:125-136. [PMID: 32417758 DOI: 10.1515/bmc-2020-0011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 04/15/2020] [Indexed: 11/19/2022] Open
Abstract
Objective this study was conducted to determine the distribution of high-risk human papillomavirus (HR-HPV) genotypes in women in the general population of three regions of Burkina Faso. Method This multicenter, descriptive cross-sectional study involved 1321 sexually active women in five cities in three regions of Burkina Faso: Central, Central-Eastern and Hauts-Bassins regions. After collection of endocervical specimens, pre-cervical lesions were screened by visual inspection with acetic acid and lugol (VIA / VILI). HR-HPV genotypes were characterized by multiplex real-time PCR after extraction of viral DNA. Results The mean age of women was 31.98 ± 10.09 years. The HR-HPV infection in the three regions ranged from 26.16% to 43.26% with 35.42% as overall prevalence in women. The most common HR-HPV genotypes in descending order were: HPV 56, 52, 66, 59, 39, 51, 18, 35. The prevalence of bivalent vaccine genotypes (HPV16 / 18) was 7.83% against 63.78% of genotypes not covered by HPV vaccine; 36.32% (170/468) of women had multiple concomitant HR-HPV infections. Conclusion this study showed significant regional variation and high prevalence of HR-HPV infection in women. The predominant genotypes differ from those covered by available vaccines in Burkina Faso. These results will help guide our health policies towards better prevention of cervical cancer. The diversity of oncogenic genotypes is sparking a large-scale study in the West African sub-region, particularly in cases of cancer and the introduction of the nonavalent vaccine which includes HPV 52 found among the predominant genotypes in this study.
Collapse
Affiliation(s)
- Rogomenoma Alice Ouedraogo
- Laboratory of Molecular Biology and Genetics (LABIOGENE), University of Ouagadougou, 03 BP 7021 Ouagadougou 03, Ouagadougou Burkina Faso
- Pietro Annigoni Biomolecular Research Centre (CERBA), 01 BP 364 Ouagadougou 01, Ouagadougou Burkina Faso
| | - Théodora Mahoukèdè Zohoncon
- Laboratory of Molecular Biology and Genetics (LABIOGENE), University of Ouagadougou, 03 BP 7021 Ouagadougou 03, Ouagadougou Burkina Faso
- Pietro Annigoni Biomolecular Research Centre (CERBA), 01 BP 364 Ouagadougou 01, Ouagadougou Burkina Faso
- Faculty of Medicine, University Saint Thomas d'Aquin, 06 BP 10212 Ouagadougou 01, Ouagadougou Burkina Faso
| | - Ina Marie Angèle Traore
- Laboratory of Molecular Biology and Genetics (LABIOGENE), University of Ouagadougou, 03 BP 7021 Ouagadougou 03, Ouagadougou Burkina Faso
- Pietro Annigoni Biomolecular Research Centre (CERBA), 01 BP 364 Ouagadougou 01, Ouagadougou Burkina Faso
| | - Abdoul Karim Ouattara
- Laboratory of Molecular Biology and Genetics (LABIOGENE), University of Ouagadougou, 03 BP 7021 Ouagadougou 03, Ouagadougou Burkina Faso
- Pietro Annigoni Biomolecular Research Centre (CERBA), 01 BP 364 Ouagadougou 01, Ouagadougou Burkina Faso
| | - Sindimalgdé Patricia Guigma
- Laboratory of Molecular Biology and Genetics (LABIOGENE), University of Ouagadougou, 03 BP 7021 Ouagadougou 03, Ouagadougou Burkina Faso
- Faculty of Medicine, University Saint Thomas d'Aquin, 06 BP 10212 Ouagadougou 01, Ouagadougou Burkina Faso
| | - Florencia Wendkuuni Djigma
- Laboratory of Molecular Biology and Genetics (LABIOGENE), University of Ouagadougou, 03 BP 7021 Ouagadougou 03, Ouagadougou Burkina Faso
- Pietro Annigoni Biomolecular Research Centre (CERBA), 01 BP 364 Ouagadougou 01, Ouagadougou Burkina Faso
| | - Dorcas Obiri-Yeboah
- University of Cape Coast, School of Medical Sciences, Department of Microbiology and Immunology, University Post Office, Cape Coast Ghana
| | - Charlemagne Ouedraogo
- Laboratory of Molecular Biology and Genetics (LABIOGENE), University of Ouagadougou, 03 BP 7021 Ouagadougou 03, Ouagadougou Burkina Faso
- Obstetrician-gynecologist, UFR/SDS, University of Ouagadougou, 03 BP 7021 Ouagadougou 03 Ouagadougou Burkina Faso
- Yalgado Ouedraogo University Hospital (CHU/YO), 03 BP 7022, Ouagadougou Burkina Faso
| | - Jacques Simpore
- Laboratory of Molecular Biology and Genetics (LABIOGENE), University of Ouagadougou, 03 BP 7021 Ouagadougou 03, Ouagadougou Burkina Faso
- Pietro Annigoni Biomolecular Research Centre (CERBA), 01 BP 364 Ouagadougou 01, Ouagadougou Burkina Faso
- Faculty of Medicine, University Saint Thomas d'Aquin, 06 BP 10212 Ouagadougou 01, Ouagadougou Burkina Faso
| |
Collapse
|
6
|
Balanda M, Fernández J, Vergara N, Campano C, Arata L, Martín HS, Ramírez E. Genetic variability of human papillomavirus type 66 L1 gene among women presenting for cervical cancer screening in Chile. Med Microbiol Immunol 2019; 208:757-771. [PMID: 31165237 DOI: 10.1007/s00430-019-00621-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 05/23/2019] [Indexed: 12/31/2022]
Abstract
The high-risk human papillomaviruses (HR-HPVs) are involved in the development of cervical cancer. Nevertheless, there are differences in the oncogenic potential among them. HPV-16 and HPV-18 are associated with approximately 70% of cancer worldwide, and both types are the most extensively studied HR-HPV. Great variations in the prevalence of HR-HPV have been described in different countries. The impact of these variations on the epidemiology of lesions and cervical cancer is currently unknown. A high prevalence of HPV-66 has been detected in Chile. Here, we have analyzed the genetic variability of the L1 gene from HPV-66-infected Chilean women. Higher order interactions between identified mutations were analyzed by co-variation and cluster analyses. Antigenic-index alterations following L1 mutations and B-cell epitopes were predicted by BcePred algorithm. HPV-66 L1 sequences clustered phylogenetically into two main clades. The genetic variability in the HPV-66 L1 gene involved thirty nucleotide changes. Four of these were for the first time identified in this study. Some of these variants are embedded in the B-cell epitope regions. Amino acid homology in the immunodominant epitopes of HPV-66 L1 protein (DE, FG and H1 loops) was 42.9-59.1% and 28.6-68.9% compared with HPV-16 and HPV-18, respectively. The results of this research suggest that the neutralizing epitopes of HPV-66 are antigenically different compared to HPV-16 and HPV-18. Our findings show the need to perform new structural and immunological studies on HPV-66 L1 protein to evaluate the cross-protection conferred by current HPV vaccines.
Collapse
Affiliation(s)
- Monserrat Balanda
- Sección Virus Oncogénicos, Subdepto. de Enfermedades Virales, Instituto de Salud Pública de Chile, Avenida Marathon 1000, Ñuñoa, Santiago, Chile
| | - Jorge Fernández
- Subdepto. de Genética Molecular, Instituto de Salud Pública de Chile, Avenida Marathon 1000, Ñuñoa, Santiago, Chile
| | - Nicolás Vergara
- Sección Virus Oncogénicos, Subdepto. de Enfermedades Virales, Instituto de Salud Pública de Chile, Avenida Marathon 1000, Ñuñoa, Santiago, Chile.,Dirección de Atención Primaria, Servicio de Salud Metropolitano Central, Santiago, Chile
| | - Constanza Campano
- Subdepto. de Genética Molecular, Instituto de Salud Pública de Chile, Avenida Marathon 1000, Ñuñoa, Santiago, Chile
| | - Loredana Arata
- Subdepto. de Genética Molecular, Instituto de Salud Pública de Chile, Avenida Marathon 1000, Ñuñoa, Santiago, Chile
| | - Héctor San Martín
- Sección Virus Oncogénicos, Subdepto. de Enfermedades Virales, Instituto de Salud Pública de Chile, Avenida Marathon 1000, Ñuñoa, Santiago, Chile
| | - Eugenio Ramírez
- Sección Virus Oncogénicos, Subdepto. de Enfermedades Virales, Instituto de Salud Pública de Chile, Avenida Marathon 1000, Ñuñoa, Santiago, Chile.
| |
Collapse
|
7
|
Jin Y, Guan Z, Wang X, Wang Z, Zeng R, Xu L, Cao P. ALA-PDT promotes HPV-positive cervical cancer cells apoptosis and DCs maturation via miR-34a regulated HMGB1 exosomes secretion. Photodiagnosis Photodyn Ther 2018; 24:27-35. [PMID: 30118903 DOI: 10.1016/j.pdpdt.2018.08.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 07/15/2018] [Accepted: 08/10/2018] [Indexed: 02/06/2023]
Abstract
5-Aminolevulinic acid photodynamic therapy(ALA-PDT) has been widely used for cervical cancer treatment, but the mechanisms are still not fully delineated. Here we showed that ALA-PDT significantly upregulated HMGB1 while downregulated miR-34a expression levels in cervical cancer tissues, and the percentages of mature DCs(mDCs) were increased in ALA-PDT treated patients' peripheral blood. After treating HPV-positive Hela, SiHa, Caski and HPV-negative C33 A cervical cancer cell lines with ALA-PDT, HPV-positive cells' proliferative ability was significantly inhibited and apoptosis rates were elevated, while no significant changes were found in HPV-negative C33 A cell line. Most importantly, in HPV-positive cells, we found that miR-34a were downregulated in cytoplasm, and both cytoplasm and exosome HMGB1 were significantly elevated comparing to cancer cells without ALA-PDT treatment, and it could be reversed by miR-34a mimic transfection, which indicated that HPV infection and miR-34a downregulation might be vital for ALA-PDT treatment. Based on the HMGB1 is the potential target of miR-34a and an inverse correlation between miR-34a and HMGB1 in ALA-PDT treated cancer tissues, we verified that HMGB1 could be targeted and downregulated by miR-34a mimic, and ALA-PDT promotes HMGB1 secretion by inhibiting miR-34a expression. By co-culturing cervical cancer cell lines with immature DCs(imDCs) in the Transwell systems, we found that ALA-PDT induced HMGB1 exosomes could promote DCs maturation, which could be reversed by silencing HMGB1 in HPV-positive cervical cancer cells. In vivo animal experiments also proved that ALA-PDT inhibited tumor growth in tumor bearing mice, which was reversed by co-transfected with miR-34a mimic or silencing HMGB1 in HPV-positive cells. Hence we concluded that ALA-PDT treatment specifically inhibited HPV-positive cervical cancer cells' proliferative ability, promoted cell apoptosis and modulated DCs maturation by regulating miR-34a mediated HMGB1 exosomes secretion.
Collapse
Affiliation(s)
- Yichao Jin
- Medical Faculty, Kunming University of Science and Technology, Kunming, Yunnan, China; Department of Dermatology, The First People's Hospital of Yunnan Province, Kunming, Yunnan, China; The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Zhen Guan
- Department of Dermatology, The First People's Hospital of Yunnan Province, Kunming, Yunnan, China; The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Xiaochuan Wang
- Department of Dermatology, The First People's Hospital of Yunnan Province, Kunming, Yunnan, China; The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Zhiqiong Wang
- Department of Dermatology, The First People's Hospital of Yunnan Province, Kunming, Yunnan, China; The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Rong Zeng
- Department of Medical Oncology, The First People's Hospital of Yunnan Province, Kunming, Yunnan, China; The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Liangheng Xu
- Department of Dermatology, The First People's Hospital of Yunnan Province, Kunming, Yunnan, China; The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Ping Cao
- Department of Dermatology, The First People's Hospital of Yunnan Province, Kunming, Yunnan, China; The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China.
| |
Collapse
|
8
|
Henderson RI, Shea-Budgell M, Healy C, Letendre A, Bill L, Healy B, Bednarczyk RA, Mrklas K, Barnabe C, Guichon J, Bedingfield N, MacDonald S, Colquhoun A, Glaze S, Nash T, Bell C, Kellner J, Richardson R, Dixon T, Starlight J, Runner G, Nelson G. First nations people's perspectives on barriers and supports for enhancing HPV vaccination: Foundations for sustainable, community-driven strategies. Gynecol Oncol 2018; 149:93-100. [PMID: 29605057 DOI: 10.1016/j.ygyno.2017.12.024] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 11/17/2017] [Accepted: 12/19/2017] [Indexed: 10/17/2022]
Abstract
OBJECTIVE In Canada, Indigenous people have higher human papillomavirus (HPV) infection rates, lower screening rates for cervical cancer, and higher rates of invasive cancer, leading to worse cervical cancer-related outcomes than observed in non-Indigenous Canadian women. Lingering harms from European colonization drive these health inequities and create public health challenges. Policy guidance is needed to optimize HPV vaccination rates and, thereby, decrease the burden of HPV-related illness, including high-morbidity surgical procedures and chemo-radiotherapy. The Enhancing HPV Vaccination In First Nations Populations in Alberta (EHVINA) project focuses on First Nations, a diverse subset of recognized Indigenous people in Canada, and seeks to increase HPV vaccination among girls and boys living in First Nation communities. METHODS Developing an effective strategy requires partnership with affected communities to better understand knowledge and perceptions about cancer, healthcare, and the HPV vaccine. A 2017 community gathering was convened to engage First Nations community members, health directors, and health services researchers in dialogue around unique barriers and supports to HPV vaccination in Alberta. Voices of community Elders, parents, health directors, and cancer survivors (n=24) are presented as qualitative evidence to help inform intervention design. RESULTS Key findings from discussions indicate barriers to HPV vaccination include resource constraints and service infrastructure gaps, historical mistrust in healthcare systems, impacts of changing modes of communication, and community sensitivities regarding sexual health promotion. Supports were identified as strengthened inter-generational relationships in communities. CONCLUSIONS AND FUTURE DIRECTION Ongoing dialogue and co-development of community-based strategies to increase HPV vaccine uptake are required. The identification of possible barriers to HPV vaccination in a Canadian Indigenous population contributes to limited global literature on this subject and may inform researchers and policy makers who work with Indigenous populations in other regions.
Collapse
Affiliation(s)
- R I Henderson
- Department of Family Medicine, Cumming School of Medicine, Calgary, AB, Canada.
| | - M Shea-Budgell
- Department of Oncology, Cumming School of Medicine, Calgary, AB, Canada
| | - C Healy
- Alberta First Nations Information Governance Centre, Calgary, AB, Canada
| | - A Letendre
- Alberta Cancer Prevention Legacy Fund, Edmonton, AB, Canada
| | - L Bill
- Alberta First Nations Information Governance Centre, Calgary, AB, Canada
| | - B Healy
- Alberta First Nations Information Governance Centre, Calgary, AB, Canada
| | - R A Bednarczyk
- Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - K Mrklas
- Department of Community Health Sciences, Cumming School of Medicine, Calgary, AB, Canada
| | - C Barnabe
- Department of Medicine, Cumming School of Medicine, Calgary, AB, Canada
| | - J Guichon
- Department of Community Health Sciences, Cumming School of Medicine, Calgary, AB, Canada
| | - N Bedingfield
- Department of Community Health Sciences, Cumming School of Medicine, Calgary, AB, Canada
| | - S MacDonald
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - A Colquhoun
- Alberta Ministry of Health, Edmonton, AB, Canada
| | - S Glaze
- Department of Oncology, Cumming School of Medicine, Calgary, AB, Canada
| | - T Nash
- Indigenous Mental Health Program, Calgary, AB, Canada
| | - C Bell
- Alberta Ministry of Health, Edmonton, AB, Canada
| | - J Kellner
- Department of Pediatrics, Cumming School of Medicine, Calgary, AB, Canada
| | - R Richardson
- First Nations and Inuit Health Branch, Alberta Region, Edmonton, AB, Canada
| | - T Dixon
- Elder, Eden Valley Nation, AB, Canada
| | | | - G Runner
- Elder, Tsuut'ina Nation, AB, Canada
| | - G Nelson
- Department of Oncology, Cumming School of Medicine, Calgary, AB, Canada
| |
Collapse
|
9
|
Mrklas KJ, MacDonald S, Shea-Budgell MA, Bedingfield N, Ganshorn H, Glaze S, Bill L, Healy B, Healy C, Guichon J, Colquhoun A, Bell C, Richardson R, Henderson R, Kellner J, Barnabe C, Bednarczyk RA, Letendre A, Nelson GS. Barriers, supports, and effective interventions for uptake of human papillomavirus- and other vaccines within global and Canadian Indigenous peoples: a systematic review protocol. Syst Rev 2018; 7:40. [PMID: 29499749 PMCID: PMC5833130 DOI: 10.1186/s13643-018-0692-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 01/22/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Despite the existence of human papilloma virus (HPV) vaccines with demonstrated safety and effectiveness and funded HPV vaccination programs, coverage rates are persistently lower and cervical cancer burden higher among Canadian Indigenous peoples. Barriers and supports to HPV vaccination in Indigenous peoples have not been systematically documented, nor have interventions to increase uptake in this population. This protocol aims to appraise the literature in Canadian and global Indigenous peoples, relating to documented barriers and supports to vaccination and interventions to increase acceptability/uptake or reduce hesitancy of vaccination. Although HPV vaccination is the primary focus, we anticipate only a small number of relevant studies to emerge from the search and will, therefore, employ a broad search strategy to capture literature related to both HPV vaccination and vaccination in general in global Indigenous peoples. METHODS Eligible studies will include global Indigenous peoples and discuss barriers or supports and/or interventions to improve uptake or to reduce hesitancy, for the HPV vaccine and/or other vaccines. Primary outcomes are documented barriers or supports or interventions. All study designs meeting inclusion criteria will be considered, without restricting by language, location, or data type. We will use an a priori search strategy, comprised of key words and controlled vocabulary terms, developed in consultation with an academic librarian, and reviewed by a second academic librarian using the PRESS checklist. We will search several electronic databases from date of inception, without restrictions. A pre-defined group of global Indigenous websites will be reviewed for relevant gray literature. Bibliographic searches will be conducted for all included studies to identify relevant reviews. Data analysis will include an inductive, qualitative, thematic synthesis and a quantitative analysis of measured barriers and supports, as well as a descriptive synthesis and quantitative summary of measures for interventions. DISCUSSION To our knowledge, this study will contribute the first systematic review of documented barriers, supports, and interventions for vaccination in general and for HPV vaccination. The results of this study are expected to inform future research, policies, programs, and community-driven initiatives to enhance acceptability and uptake of HPV vaccination among Indigenous peoples. SYSTEMATIC REVIEW REGISTRATION PROSPERO Registration Number: CRD42017048844.
Collapse
Affiliation(s)
- Kelly J. Mrklas
- Research Innovation and Analytics, Alberta Health Services, Edmonton, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | | | - Melissa A. Shea-Budgell
- Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Nancy Bedingfield
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Heather Ganshorn
- Health Sciences Library, Libraries and Cultural Resources, University of Calgary, Calgary, Canada
| | - Sarah Glaze
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Department of Obstetrics and Gynaecology, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Lea Bill
- Alberta First Nations Information Governance Centre, Calgary, Canada
| | - Bonnie Healy
- Alberta First Nations Information Governance Centre, Calgary, Canada
| | - Chyloe Healy
- Alberta First Nations Information Governance Centre, Calgary, Canada
| | - Juliet Guichon
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Amy Colquhoun
- Analytics and Performance Reporting Branch, Alberta Health, Edmonton, Canada
| | - Christopher Bell
- Analytics and Performance Reporting Branch, Alberta Health, Edmonton, Canada
| | - Ruth Richardson
- Health Canada First Nations and Inuit Health Branch, Edmonton, Canada
| | - Rita Henderson
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - James Kellner
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Cheryl Barnabe
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Robert A. Bednarczyk
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA USA
| | | | - Gregg S. Nelson
- Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Department of Obstetrics and Gynaecology, Cumming School of Medicine, University of Calgary, Calgary, Canada
| |
Collapse
|
10
|
Nejo Y, Olaleye D, Odaibo G. Prevalence and Risk Factors for Genital Human Papillomavirus Infections Among Women in Southwest Nigeria. ARCHIVES OF BASIC AND APPLIED MEDICINE 2018; 6:105-112. [PMID: 29905313 PMCID: PMC5997288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
There is a great variation in the prevalence of cervical HPV infection worldwide with some of the highest rates being found in African women. Early onset of sexual activity (≤ 15 age), multiparity and sexual promiscuity have been recognized as some of the significant risk factors for HPV infection. In Nigeria, there is scarcity of data on the degree of relationship between these factors and the prevalence of HPV infection. Thus, this study was designed to determine the prevalence of genital HPV infection with its potential risk factors among women in Southwest Nigeria. Cervical swab specimen was collected from 295 consenting women including those presenting for routine cervical cancer screening, STI clinic attendees and women who attended community based outreach programmes. Viral DNA was extracted from the swab samples using commercially available DNA extraction Kit and amplified by PCR using two set of consensus primers (PGMY09/11 and degenerate GP-E6/E7). Fifty-five samples were positive to HPV DNA giving a prevalence of 18.6%. Risk factors such as lack of formal education (P-value: 0.003), divorcee (P-value: 0.019), polygamy (P-value: 0.027), unemployment (P-value: 0.023), low income earnings (P-value: 0.018), younger age (<18years) at sexual debut (P-value: 0.039) and passive smoking (P-value: 0.017) were significantly associated with HPV infection. High HPV prevalence and associated risk factors observed in this study shows the continuous transmission of the virus in Southwest Nigeria. Hence, enlarged monitoring including intense public awareness and cervical cancer screening is urgently needed for prevention and control strategies.
Collapse
Affiliation(s)
- Y.T. Nejo
- Department of Virology, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Biological Sciences, Bowen University, Iwo, Osun State, Nigeria
| | - D.O. Olaleye
- Department of Virology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - G.N. Odaibo
- Department of Virology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| |
Collapse
|
11
|
Awua AK, Adanu RMK, Wiredu EK, Afari EA, Severini A. Differences in age-specific HPV prevalence between self-collected and health personnel collected specimen in a cross-sectional study in Ghana. Infect Agent Cancer 2017; 12:26. [PMID: 28529541 PMCID: PMC5437497 DOI: 10.1186/s13027-017-0136-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 05/09/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND HPV infections are ubiquitous and particularly common among sexually active young women. However, there are regional and national variations in age-specific HPV prevalence, which have implications for cervical cancer control. Data on age-specific HPV prevalences for Ghana and most sub-Saharan countries are scanty. Therefore, this study primarily sought to determine the age-specific HPV prevalence among women in a Ghanaian community and to determine whether these prevalences determined with health-personnel and self-collected specimens were comparable. METHODS In this cross-sectional study, conducted between March 2012 and March 2013, cervical specimens were collected by self- and health-personnel collection from 251 women who were between the ages of 15 and 65 years. HPV present in these specimens were genotyped by a nested-multiplex PCR and Luminex fluoro-microspheres based method. Information on the demographic, sexual and reproductive characteristics of the women were also obtained. A Chi-square test of association was employed to determine the association of the distribution of age groups with each categorised sexual and reproductive characteristic and HPV risk type's status. RESULTS The age group distribution of the participants was significantly associated with overall (χ2 = 36.1; p = 0.001), high risk (χ2 = 26.09; p = 0.002) and low risk (χ2 = 21.49; p = 0.011) HPV prevalences. The age-specific HPV prevalence pattern for each of the HPV risk types, determined with self-collected specimen, showed three peaks (at 20-24 years; 40-44 years and ≥ 55 years), while those determined with health-personnel collected specimen, showed two peaks (at 20-24 years and ≥ 55 years) for each HPV risk type's prevalence pattern. The high risk HPV prevalences determined with self-collected specimen were often higher than those determined with health-personnel specimen for the age groups between 25 and 45 years, who are mostly targeted for screening by HPV testing. Additionally, there were interesting variations in patterns of age-specific HPV genotype-specific prevalence between the two specimen collection methods. CONCLUSIONS The usefulness of self-collected specimen for high risk HPV burden determination and the existence of a two peaked and three peaked age-specific HPV prevalences in Ghana have been clearly indicated.
Collapse
Affiliation(s)
- Adolf K. Awua
- Department of Epidemiology and Disease Control, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
- Cellular and Clinical Research Centre, Radiological and Medical Sciences Research Institute, GAEC, Accra, Ghana
| | - Richard M. K. Adanu
- Population, Family and Reproductive Health, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Edwin K. Wiredu
- Department of Pathology, School of Biomedical and Allied Health Science, College of Health Sciences, University of Ghana, Korle-Bu, Accra, Ghana
| | - Edwin A. Afari
- Department of Epidemiology and Disease Control, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Alberto Severini
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB Canada
- University of Manitoba, Winnipeg, MB Canada
| |
Collapse
|
12
|
Cao D, Zhang S, Zhang Q, Wei X, Zhao M, Ma Q, Li Y, Wang L, Pei M, Yang T, Zhao J, Yang X. Prevalence of high-risk human papillomavirus infection among women in Shaanxi province of China: A hospital-based investigation. J Med Virol 2016; 89:1281-1286. [PMID: 27935120 DOI: 10.1002/jmv.24748] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 11/02/2016] [Accepted: 11/30/2016] [Indexed: 11/10/2022]
Abstract
This study aimed to investigate the characteristics of female high-risk human papillomavirus (HR-HPV) infection in Shaanxi province of China. A total of 14 111 women were enrolled for HPV genotyping test, and a cytology, and/or cervix biopsy were performed in partial women. Of these women, the HPV infection rate was 30.21%, and 26.73% were caused by HR-HPV. The most common HR-HPV genotypes were HPV-16, HPV-58, HPV-52, HPV-18, and HPV-31. The prevalence of HR-HPV among women older than 50 years was significantly higher than the other groups (P < 0.05). The main carcinogenic genotypes were HPV-16, HPV-18, HPV-58, HPV-52, and HPV-31. HPV-16 and HPV-18 combined caused 80.79% of cervical cancer cases. The infection with multiple HR-HPVs was not a risk factor for cervical lesions. In conclusion, HPV infection was common among women in Shaanxi province. Women older than 50 years were a high-risk group for HR-HPV infection and cervical cancer. HPV-16 and HPV-18 were the main carcinogenic genotypes in this region.
Collapse
Affiliation(s)
- Di Cao
- Department of Gynecology and Obstetrics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Shaohua Zhang
- Department of Gynecology and Obstetrics, The Affiliated Hospital of Xi'an Medical College, Xi'an, Shaanxi, China
| | - Qian Zhang
- Department of Gynecology and Obstetrics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Xing Wei
- Department of Gynecology and Obstetrics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Minyi Zhao
- Department of Gynecology and Obstetrics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Qian Ma
- Department of Gynecology, The Affiliated Yan An Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Yang Li
- Department of Gynecology and Obstetrics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Li Wang
- Department of Gynecology and Obstetrics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Meili Pei
- Department of Gynecology and Obstetrics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Ting Yang
- Department of Gynecology and Obstetrics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Juan Zhao
- Department of Gynecology and Obstetrics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Xiaofeng Yang
- Department of Gynecology and Obstetrics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| |
Collapse
|
13
|
Liu XX, Fan XL, Yu YP, Ji L, Yan J, Sun AH. Human papillomavirus prevalence and type-distribution among women in Zhejiang Province, Southeast China: a cross-sectional study. BMC Infect Dis 2014; 14:708. [PMID: 25523884 PMCID: PMC4278233 DOI: 10.1186/s12879-014-0708-8] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 12/11/2014] [Indexed: 11/10/2022] Open
Abstract
Background Human papillomavirus (HPV) infection is the main etiological factor for cervical cancer and premalignant lesions of the cervix. The purposes of the present study were to determine the prevalence of type-specific HPV infections and the association of different HPV types with cervical dysplasia among women in Zhejiang province, Southeast China. Methods A total of 15,267 women presenting to a gynaecological outpatient clinic were enrolled in this study. Women were screened for HPV in addition to routine cervical cytology testing. Microarray hybridization and liquid-based cytology tests were used to detect HPV genotypes and cervical cytology, respectively. Results Based on the population attending a gynaecological outpatient clinic, overall prevalence of any 23 HPV type was 22.8% and multiple HPV infection was found in 4.0% of all the outpatients. HPV prevalence showed bimodal age distribution, with a peak (55.7%) at the ≤20 age group and a second one (35.5%) at >60 age group. In total samples, the five most frequent types were HPV 16 (4.4%), 58 (2.9%), 52 (2.7%), 33 (2.2%) and 11 (1.9%). Overall HPV prevalence increased with the severity of the cytologic result. Analysis through crude odds ratios (ORs) revealed that the cervical lesion risk of HPV-infected women increased to about 26-fold of uninfected women (OR 26.1, 95% CI 22.4 to 30.3). The five most risky HPV types associated with abnormal cytology were HPV 73, 16, 82, 45 and 51. Conclusions This study provided baseline data on HPV prevalence in women attending a gynecological outpatient clinic in Zhejiang province. Our data will supply guidance for the primary screening and vaccination program for cervical cancer in this area. Electronic supplementary material The online version of this article (doi:10.1186/s12879-014-0708-8) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Xiao-Xiang Liu
- Faculty of Basic Medicine, Zhejiang Medical College, Zhejiang, Hangzhou, 310053, P. R. China.
| | - Xing-Li Fan
- Faculty of Basic Medicine, Zhejiang Medical College, Zhejiang, Hangzhou, 310053, P. R. China.
| | - Yue-Ping Yu
- Faculty of Basic Medicine, Zhejiang Medical College, Zhejiang, Hangzhou, 310053, P. R. China.
| | - Lei Ji
- Faculty of Basic Medicine, Zhejiang Medical College, Zhejiang, Hangzhou, 310053, P. R. China.
| | - Jie Yan
- Division of Basic Medical Microbiology, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital of Zhejiang University, Hangzhou, Zhejiang, 310003, P. R. China. .,Department of Medical Microbiology and Parasitology, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310058, P. R. China.
| | - Ai-Hua Sun
- Faculty of Basic Medicine, Zhejiang Medical College, Zhejiang, Hangzhou, 310053, P. R. China.
| |
Collapse
|
14
|
Decker KM, Demers AA, Kliewer EV, Biswanger N, Musto G, Elias B, Griffith J, Turner D. Pap test use and cervical cancer incidence in First Nations women living in Manitoba. Cancer Prev Res (Phila) 2014; 8:49-55. [PMID: 25403849 DOI: 10.1158/1940-6207.capr-14-0277] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study examined Papanicolaou (Pap) test utilization, Pap test results, and cervical cancer incidence among First Nations (FN) women living in Manitoba, Canada taking into account age group, time period, and area of residence. Six population-based data sources were linked at an individual level. Negative binomial regression was used to compare Pap test utilization and results between FN and all other Manitoba (AOM) women. Poisson regression was used to compare cervical cancer incidence. Among women younger than 25 years, FN were more likely than AOM women to have had a Pap test [rate ratio (RR) = 1.37, 95% confidence intervals (CI), 1.22-1.53, 18-19 year olds; RR = 1.17, 95% CI, 1.05-1.31, 20-24 year olds]. There was no difference in Pap test use for women 25 to 29 or 30 to 39 years. FN 40 years and older were less likely to have a Pap test than AOM women (RR = 0.84, 95% CI, 0.75-0.93, 40-49 years old; RR = 0.71, 95% CI, 0.63-0.79, 50-59 years old; RR = 0.59, 95% CI, 0.52-0.66, 60-69 years old). FN were more likely than AOM women to have a high (RR = 1.88, 95% CI, 1.65-2.13) or low-grade Pap test result (RR = 1.60, 95% CI, 1.48-1.73). The invasive cervical cancer incidence rate was double for FN women 25 to 39 years of age (21.9 per 100,000, FN; 10.2 per 100,000, AOM, P = 0.006) and 40 to 69 years of age (24.3 per 100,000, FN; 12.3 per 100,000, AOM, P = 0.007). In conclusion, cervical cancer screening among FN women over 40 years of age must be increased to address the higher cervical cancer incidence.
Collapse
Affiliation(s)
- Kathleen M Decker
- Screening Programs, CancerCare Manitoba, Winnipeg, Manitoba, Canada. Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Alain A Demers
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada. Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, Manitoba, Canada
| | - Erich V Kliewer
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada. Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, Manitoba, Canada. Cancer Control Research, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | | | - Grace Musto
- Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, Manitoba, Canada
| | - Brenda Elias
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jane Griffith
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada. Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, Manitoba, Canada
| | - Donna Turner
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada. Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, Manitoba, Canada.
| |
Collapse
|