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Khamisy-Farah R, Endrawis M, Odeh M, Tuma R, Riccò M, Chirico F, Bragazzi NL. Knowledge of Human Papillomavirus (HPV), Attitudes, and Practices Towards Anti-HPV Vaccination Among Israeli Nurses. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2023:10.1007/s13187-023-02281-0. [PMID: 36914922 DOI: 10.1007/s13187-023-02281-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/05/2023] [Indexed: 06/18/2023]
Abstract
Human papillomavirus (HPV) is a small, non-enveloped, double-stranded DNA virus, belonging to the family of Papillomaviridae. It is a highly common infectious agent, which causes one of the most widespread sexually transmitted infections (STIs), involving approximately 20% of sexually active female adolescents and up to 80% of female adults aged 50 years. There exist two major preventative strategies: namely, anti-HPV vaccination and cervical screening. Healthcare providers, including nurses, can play a crucial role in HPV immunization campaigns, counteracting vaccine hesitancy and doing advocacy and counseling. To explore the overall knowledge of HPV and HPV-related issues, as well as the attitudes and practices of Israeli nurses, a modified and adapted, previously validated knowledge, attitudes, and practices (KAP) questionnaire was administered to a sample of 565 participants, 481 female (85.1%) and 84 male (14.9%). Most of them were married (n = 428, 75.8%), with more than 5 years of experience (n = 405, 71.7%), working in the general/internal medicine ward (n = 432, 76.5%), and Jewish (n = 352, 62.3%). Only 87 nurses (15.4%) got vaccinated against HPV. Forty-four (9.1%) of the female nurses never underwent a Pap smear. Higher percentages of right replies were reported only for the item related to available preventative strategies for cervical cancer (82.1% versus 17.9%). Higher percentages of wrong replies were reported for items related to body regions that can be infected by HPV (60.5% versus 39.5%), percentage of girls aged 15-18 years being sexually active (68.0% versus 32.0%). Similar percentages of right and wrong replies were reported for items related to whom the Pap test is recommended (52.7% versus 47.3%), Israeli Ministry of Health's guidelines for anti-HPV vaccination (50.4% versus 49.6%), and percentage of boys aged 15-18 years being sexually active (44.4% versus 55.6%). Concerning the reliability of the third section of the questionnaire, Cronbach's alpha was deemed to be acceptable (α = 0.64). Statistically significant determinants of reporting lower scores in HPV-related attitudes and practices were religion (OR 1.44 [95%CI 1.02-2.04]), and male offspring (OR 1.22 [1.03-1.44]). This study has important implications for policy- and decision-makers in that they should be aware of the overall poor and unsatisfactory level of HPV-related knowledge among Israeli nurses and implement multipronged HPV vaccine promotion programs, taking into account the challenges of a multicultural and diverse society like Israel.
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Affiliation(s)
- Rola Khamisy-Farah
- Clalit Health Service, Akko, Azrieli Faculty of Medicine, Bar-Ilan University, 13100, Safed, Israel.
| | - Maher Endrawis
- Azrieli Faculty of Medicine, Bar Ilan University, 13100, Safed, Israel
| | - Marwan Odeh
- Department of Obstetrics and Gynecology, Galilee Medical Center, 22100, Nahariya, Galilee, Israel
| | - Ruba Tuma
- Department of Obstetrics and Gynecology, Galilee Medical Center, 22100, Nahariya, Galilee, Israel
| | - Matteo Riccò
- Local Health Unit of Reggio Emilia-Regional Health Service of Emilia Romagna, Department of Public Health, Service for Health and Safety in the Workplace, Reggio Emilia, Italy
| | - Francesco Chirico
- Post-Graduate School of Occupational Medicine, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
- Department of Woman/Child and Public Health, Fondazione Policlinico "A. Gemelli" IRCCS, 00168, Rome, Italy
- Health Service Department, State Police, Ministry of Interior, 20125, Milan, Italy
| | - Nicola Luigi Bragazzi
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, ON, Canada
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Liang H, Li GL, Liu J, Fu M, Huang H, Zhao K, Wei Y, Xiao J. The application value of PAX1 and ZNF582 gene methylation in high grade intraepithelial lesion and cervical cancer. Clin Transl Oncol 2020; 23:283-288. [PMID: 32514824 DOI: 10.1007/s12094-020-02416-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 05/28/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE To investigate the possibility of using the methylation level of PAX1/ZNF582 gene as molecular marker to differentiate the progression of cervical cancer. METHODS From January 2016 to March 2018, 150 patients, who were admitted to Cervical Disease Diagnosis and Treatment Center of Xuzhu Maternity and Child Care Hospital, were enrolled in this study. Patients were classified into chronic cervicitis (for 19 cases), low-grade squamous intraepithelial lesion (LSIL) (18 cases), high-grade squamous intraepithelial lesion (HSIL) (37 cases) and squamous cell carcinoma (SCC) (31 cases). All patients underwent several tests including Thin-prep cytology test (TCT), HPV DNA detection and detection of methylation level of PAX1/ZNF582 genes. RESULTS For diagnosis of HSIL, the area under curve (AUC) was 0.878 (95% CI 0.806 ~ 0.950); the threshold for PAX1 was 12.285, the sensitivity and specificity were 91.9% and 72.8%, respectively. The AUC of ZNF582 gene detection was 0.900 (95% CI 0.842 ~ 0.959), the threshold was 11.56, while the sensitivity and specificity were 97.3% and 76.7%, respectively. Among various tests we conducted, PAX gene detection methods showed the highest specificity (97.30%). PAX1/ZNF582 gene detection method demonstrated the highest accuracy. CONCLUSIONS For patients with high-grade cervical lesion and cervical cancer, the methylation level of PAX1/ZNF582 gene could be applied as a noteworthy biomarker for diagnosis and for cervical cancer classification.
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Affiliation(s)
- H Liang
- Xuzhou Maternity and Child Health Care Hospital, No. 46 Heping Road, Xuzhou, 221009, People's Republic of China.
| | - G L Li
- Xuzhou Maternity and Child Health Care Hospital, No. 46 Heping Road, Xuzhou, 221009, People's Republic of China
| | - J Liu
- Xuzhou Maternity and Child Health Care Hospital, No. 46 Heping Road, Xuzhou, 221009, People's Republic of China
| | - M Fu
- Xuzhou Maternity and Child Health Care Hospital, No. 46 Heping Road, Xuzhou, 221009, People's Republic of China
| | - H Huang
- Xuzhou Maternity and Child Health Care Hospital, No. 46 Heping Road, Xuzhou, 221009, People's Republic of China
| | - K Zhao
- Xuzhou Maternity and Child Health Care Hospital, No. 46 Heping Road, Xuzhou, 221009, People's Republic of China
| | - Y Wei
- Xuzhou Maternity and Child Health Care Hospital, No. 46 Heping Road, Xuzhou, 221009, People's Republic of China
| | - J Xiao
- Xuzhou Maternity and Child Health Care Hospital, No. 46 Heping Road, Xuzhou, 221009, People's Republic of China
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Manyere NR, Dube Mandishora RS, Magwali T, Mtisi F, Mataruka K, Mtede B, Palefsky JM, Chirenje ZM. Human papillomavirus genotype distribution in genital warts among women in Harare-Zimbabwe. J OBSTET GYNAECOL 2019; 40:830-836. [PMID: 31790323 DOI: 10.1080/01443615.2019.1673710] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
This study aimed to determine the prevalence of HPV genotypes in genital warts among women in Harare, Zimbabwe. Women aged 18-45 years attending gynaecology and genitourinary clinics with a clinical diagnosis of genital-warts were recruited. HPV-DNA was extracted from tissue biopsies. HPV-DNA testing and typing was done by Southern Dot Blot Hybridisation. A hundred samples from 100 women were analysed. Median age of participants was 30.3 years (range 18-45 years). Seventy-eight percent of participants were HIV infected. HPV prevalence was 98%. Low risk genotypes predominated at 86% prevalence. The most prevalent genotypes were 11 (47%), 6 (42%) and 16 (14%). This is the first study on HPV genotype distribution among women with genital warts in Zimbabwe. The high prevalence of HR-HPV 16 in clinically benign lesions shows that warts should have histological analysis to exclude pre-malignancy and malignancy.Impact statementWhat is already known on this subject? Genital warts (GWs), also known as condylomata acuminata (EAC), are a clinical manifestation of persistent infection with 'low risk' or non-oncogenic HPV genotypes. HPV 6 and 11 are examples of low risk genotypes, and both are associated with 90% of GWs. Data on HPV genotypes causing genital warts in the population under study are scarce.What do the results of this study add? A high prevalence (98%) of HPV DNA in genital warts, confirms that the biopsied lesions were HPV related. Over and above the high prevalence of low risk HPV 11 (47%) and HPV 6 (42%), the women had 14% prevalence of HPV 16, an oncogenic genotype, in genital warts. Seventy-eight percent of the participants were HIV infected. The HIV infected women had a 33.3% prevalence of HR-HPV as compared to the 15.8% prevalence in the HIV uninfected women.What are the implications of these findings for clinical practice and/or further research? The population under study will benefit more if an HPV vaccine that includes anti-HPV 6 and 11 is used. The high prevalence of the HR-HPV in apparently benign lesions shows that warts should have histological analysis to exclude vulvar cancer and vulvar intraepithelial neoplasia. All women presenting with genital warts should be offered an HIV test.
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Affiliation(s)
- N R Manyere
- Department of Obstetrics and Gynaecology, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe
| | - R S Dube Mandishora
- Department of Medical Microbiology, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe
| | - T Magwali
- Department of Obstetrics and Gynaecology, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe
| | - F Mtisi
- University of Zimbabwe College of Health Sciences Clinical Trials Research Centre (UZCHS-CTRC), University of Zimbabwe College of Health Sciences, Harare, Zimbabwe
| | - K Mataruka
- University of Zimbabwe College of Health Sciences Clinical Trials Research Centre (UZCHS-CTRC), University of Zimbabwe College of Health Sciences, Harare, Zimbabwe
| | - B Mtede
- Program Quality Improvement, Elizabeth Glaser Pediatric AIDS Foundation, Harare, Zimbabwe
| | - J M Palefsky
- Department of Medicine, UCSF School of Medicine, Med Sci San Francisco, CA, USA
| | - Z M Chirenje
- Department of Obstetrics and Gynaecology, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe.,University of Zimbabwe College of Health Sciences Clinical Trials Research Centre (UZCHS-CTRC), University of Zimbabwe College of Health Sciences, Harare, Zimbabwe
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Ishida E, Lee J, Campbell JS, Chakravarty PD, Katori Y, Ogawa T, Johnson L, Mukhopadhyay A, Faquin WC, Lin DT, Wirth LJ, Pierce RH, Pai SI. Intratumoral delivery of an HPV vaccine elicits a broad anti-tumor immune response that translates into a potent anti-tumor effect in a preclinical murine HPV model. Cancer Immunol Immunother 2019; 68:1273-1286. [PMID: 31243491 DOI: 10.1007/s00262-019-02357-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Accepted: 06/11/2019] [Indexed: 12/18/2022]
Abstract
Therapeutic cancer vaccines have met limited clinical success. In the setting of cancer, the immune system is either tolerized and/or has a limited tumor-specific T cell repertoire. In this study, we explore whether intratumoral (IT) vaccination with an HPV vaccine can elicit quantitative and qualitative differences in immune response as compared to intramuscular (IM) vaccination to overcome immune resistance in established tumors. We report that IT administration of an HPV-16 E7 peptide vaccine formulated with polyinosinic-polycytidylic acid [poly(I:C)] generated an enhanced antitumor effect relative to IM delivery. The elicited anti-tumor effect with IT vaccination was consistent among the vaccinated groups and across various C57BL/6 substrains. IT vaccination resulted in an increased frequency of PD-1hi TILs, which represented both vaccine-targeted and non-vaccine-targeted tumor-specific CD8+ T cells. Overall, the CD8+/Treg ratio was increased within the tumor microenvironment using IT vaccination. We also assessed transcriptional changes in several immune-related genes in the tumor microenvironment of the various treated groups, and our data suggest that IT vaccination leads to upregulation of a broad complement of immunomodulatory genes, including upregulation of interferon gamma (IFNγ) and antigen presentation and processing machine (APM) components. IT vaccine delivery is superior to traditional IM vaccination routes with the potential to improve tumor immunogenicity, which has potential clinical application in the setting of accessible lesions such as head and neck squamous cell carcinomas (HNSCCs).
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Affiliation(s)
- Eiichi Ishida
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Jina Lee
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jean S Campbell
- Department of Immunology, Fred Hutchinson Cancer Center, Seattle, WA, USA.,Department of Pathology, University of Washington, Seattle, WA, USA
| | | | - Yukio Katori
- Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Takenori Ogawa
- Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | | | | | - William C Faquin
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Derrick T Lin
- Department of Otology and Laryngology, Massachusetts Eye and Ear, Boston, MA, USA
| | - Lori J Wirth
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Robert H Pierce
- Department of Immunology, Fred Hutchinson Cancer Center, Seattle, WA, USA.,Department of Pathology, University of Washington, Seattle, WA, USA
| | - Sara I Pai
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. .,Division of Surgical Oncology, Department of Surgery, Massachusetts General Hospital Cancer Center, Harvard Medical School, 55 Fruit Street, GRJ 9-904G, Boston, MA, 02114, USA.
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Schneede P, Schlenker B. [Human papillomavirus and penile cancer : Thinking about measures for prevention]. Urologe A 2019; 57:413-417. [PMID: 29484460 DOI: 10.1007/s00120-018-0597-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Two major pathways of penile carcinogenesis are known: human papillomavirus (HPV)-induced penile cancer and HPV-negative cancers associated with chronic dermatoses. Therefore, modern measures for prevention of penile cancer may for example include prophylactic HPV vaccination. The resulting B‑cell-mediated immunity to HPV capsid proteins is effective protection against future HPV infections. Contrarily when treating existing HPV infections or HPV-associated cancers an antigen-specific T‑cell immunity is necessary. To date, screening and treatment of precancerous lesions to prevent penile cancer are not established in the German health care program and the highly expected therapeutic HPV vaccines are still on the horizon. In this article, we focus on possible strategies to prevent HPV-related penile cancer on different levels of carcinogenesis.
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Affiliation(s)
- P Schneede
- Urologische Klinik, Klinikum Memmingen, Bismarckstraße 23, 87700, Memmingen, Deutschland.
| | - B Schlenker
- Klinikum der Universität München, Großhadern, München, Deutschland
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Zhang M, Adeniran AJ, Vikram R, Tamboli P, Pettaway C, Bondaruk J, Liu J, Baggerly K, Czerniak B. Carcinoma of the urethra. Hum Pathol 2017; 72:35-44. [PMID: 28827100 DOI: 10.1016/j.humpath.2017.08.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 07/26/2017] [Accepted: 08/10/2017] [Indexed: 01/05/2023]
Abstract
Primary carcinomas of the urethra are rare and poorly understood lesions; hence, their clinical and pathologic spectrum is not completely defined. We analyzed a series of 130 primary urethral tumors and classified 106 of them as primary urethral carcinomas. The age at diagnosis of patients with primary urethral carcinomas ranged from 42 to 97 years (mean, 69.4 years; median, 70 years). There were 73 male and 33 female patients with a ratio of 2.2:1. In male patients, the tumors most frequently developed in the bulbous-membranous segment of the urethra. In female patients, the entire length of the urethra was typically involved. Microscopically, they were poorly differentiated carcinomas with hybrid squamous and urothelial features and developed from precursor intraepithelial conditions such as dysplasia and carcinoma in situ, which were frequently present in the adjacent urethral mucosa. High-risk human papilloma virus infection could be documented in 31.6% of these tumors. Follow-up information was available for 95 patients. Twenty-three patients died of the disease with a mean and median survival of 39 and 21 months, respectively. Urethral carcinomas are aggressive tumors with a high propensity for regional and distant metastases with mean and median survival of 39 and 21 months, respectively. Our observations have important implications for the management of patients with primary carcinoma of the urethra by defining them as a unique entity linked to human papilloma virus infection.
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Affiliation(s)
- Miao Zhang
- Department of Pathology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, United States
| | | | - Raghunandan Vikram
- Department of Radiology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, United States
| | - Pheroze Tamboli
- Department of Pathology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, United States
| | - Curtis Pettaway
- Department of Urology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, United States
| | - Jolanta Bondaruk
- Department of Pathology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, United States
| | - Jinsong Liu
- Department of Pathology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, United States
| | - Keith Baggerly
- Department of Bioinformatics and Computational Biology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, United States
| | - Bogdan Czerniak
- Department of Pathology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, United States.
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